Prospective investigation of the neural risk factors for postoperative delirium using magnetic resonance imaging

의과대학/박사Delirium is an acute confusional state that is characterized by sudden alteration and fluctuation in consciousness and cognition associated with impaired attention. Delirium frequently occurs after surgery, particularly in patients undergoing hip fracture, however, the underlying neural mechanism remains uncertain. The present study aimed to investigate predictive neural correlates of postoperative delirium. Before surgery, patients with hip fracture were assessed for cognitive impairment and scanned using magnetic resonance imaging. After surgery, they were evaluated for postoperative delirium for 7 successive days and additional functional scans were performed on postoperative delirium onset or the end of assessment day according to postoperative delirium occurrence. Then anatomical and functional data were analyzed with voxel based morphometry, diffusion tensor imaging, and functional connectivity analysis. Patients with postoperative delirium had bigger total intracranial volume and ventricle volume, and smaller volume in the medial frontal gyrus, cingulate/precuneus, superior and transverse temporal gyrus, and caudate nucleus. These changes of brain areas were similar with Alzheimer's disease. In particular, the frontal areas, temporal areas, and caudate nucleus were more associated with MMSE scores. Patients with postoperative delirium also showed broadly reduced fractional anisotropy across the brain, including the superior and longitudinal fasciculus, corpus callosum, and external capsule. In functional connectivity, patients on delirious state showed greater association in the caudate nucleus and insula with the superior and transverse temporal regions, and there were negative correlations between Korean-Delirium Rating Scale and connectivity strength of the superior temporal gyrus and inferior frontal gyrus (r = -0.672, p = 0.048), and connectivity strength of the caudate nucleus and inferior frontal gyrus (r = -0.633, p = 0.067), respectively. This study suggests that cortical atrophy, particularly in the temporal areas and caudate nucleus, and overall impairment of cortical connections may be involved in postoperative delirium occurrence; nevertheless, increased connectivity of the bilateral temporal brain regions with the thalamo-cortical brain regions on delirious state could be interpreted as efforts to prevent persistent postoperative delirium and promote restoration of altered consciousness.ope

Human Neural Stem Cells: Translational Research for Neonatal Hypoxic-Ischemic Brain Injury

Neonatal hypoxic-ischemic (HI) brain injury is a major cause of neonatal mortality and long-term neurodevelopmental disabilities. Although promising neuroprotective interventions have been studied, the current management of HI brain injury has been limited to supportive measures and induced hypothermia. In addition to engrafting, migrating toward the damage sites and differentiating into multiple lineages, multipotent neural stem/progenitor cells (NSPCs) also provide trophic/immunomodulatory factors and integrate into the host neurons upon implantation into an HI-injured brain. However, NSPC-based therapies have shown poor cell survival and integration, poor differentiation or restricted differentiation into the glial lineages. Furthermore, to achieve full functional recovery following brain injury, the optimization of cell therapy is needed to recapitulate the precise migration of stem cells to the region of interest and the neural rewiring present in the brain microenvironment. Therefore, the efficacy of NSPCs in the treatment of CNS injury is currently insufficient. Human NSPCs (hNSPCs) were isolated from the forebrain of an aborted fetus at 13 weeks of gestation with full parental consent and the approval of the Institutional Review Board of the Yonsei University College of Medicine. Here, to enhance the regenerative ability of hNSPCs in HI brain injury, cells were either pretreated with pharmacological agents or engineered to serve as vehicles for gene delivery. Furthermore, when combined with a poly (glycolic acid)-based synthetic scaffold, hNSPCs provide a more versatile treatment for neonatal HI brain injury. Finally, hNSPCs transfected with zinc-doped ferrite magnetic nanoparticles for controlling both cell migration and differentiation offer a simple and smart tool for cell-based therapies.ope

Incidence of Unplanned Extubation and Related Factors of Reintubation in the Neonatal Intensive Care Unit

Purpose This descriptive study aimed to identify the incidence and related factors of reintubation after unplanned extubation in the neonatal intensive care unit. Methods A secondary data analysis was conducted using electronic medical records. All events of unplanned extubation were audited from January 2020 to August 2021. The data were analyzed by chi-square test using IBM SPSS Statistics ver. 24.0 program. Results Fifty-eight unplanned extubation events were identified for 20 months. The incidence was 2.6 per 100 ventilation days during the study period. After unplanned extubation, 35 neonates (60.3%) were immediately reintubated. There was a statistically significant difference between the gestational age (p=0.018) and postconceptional age at unplanned extubation (p=0.044) and the total intubation period (p=0.003) between the reintubation and nonreintubation groups. Conclusion These findings indicate that the incidence of unplanned extubation was significantly higher than that of an adult in South Korea. According to this study, targeting interventions are required to prevent unplanned extubation and ensure patient safety.ope

A Study on Food Brand Design for the New Silver Generation

학위논문(박사)--서울대학교 대학원 :미술대학 디자인학부 디자인전공,2020. 2. 김경선.Korea is expected to be a super-aged society at a much more rapid-pace than all other nations in the world. Specifically, the so-called new silver-generation of the baby-boomers will increase the total number of the elderly in Korea very rapidly. This growing group will have a new style of life and differing consumption habits while pursuing independence, a healthy and entertaining life-style as well as a reasonable and emotion-oriented (sensitive) consumption. Thus, our society must adapt to changes in various social and economical areas that may occur due to shifts in the composition of our population around the new silver generation. Leading countries in the global economy are paying attention to changes in population due to the increase in the silver generation and the shift in the economical environment followed by this change. The leading reason is that the active development of senior markets for such a group is becoming more necessary as the new silver generation is growing as a huge customer group. A representative area for the new silver generation is within brand design. In our modern society the quality and level of convenient living have been improved, purchasing desires and the attitudes of customers are becoming more diversified in addition to the fact that global competition is more severe due to more diversity in consumption behaviors as shifts in the population cause branding to be more important. Now food companies are in the midst of preparing various brand strategies which can stimulate customers food consumption tendencies in order to strengthen brand image in the food industry. They are especially focused on applying food brand designs as a strategic resource to deal with changes in market due to the increase in number of members of the new silver generation. As food is the most important daily necessity for continuing differentiated consciousness and life patterns and is the product which customers select and purchase by combining rationality and sensitivity. To accomplish this, the main food enterprises around the world have been applying various food package design elements aggressively to create brand strategies as methods of brand identity acquisition to strengthen brand recognition and memory effectively. In the food brand strategy, food package design based on visual differentiation is an important communication medium connecting the brand and the customer by the design that characteristics and the perceived higher quality of foods are produced and promoted. Thus, in the growing food market for the growing new silver generation which is increasing the number of silver generation rapidly, a differentiation strategy which forms positive and effective food brand images and strengthens the competitive edge of a food brand for the new silver generation is necessary. As a result, studies on brand design based on food package design which affect increases in purchasing intention and food brand image specifically targeting the new silver generation are necessary in the future. As most of the previous studies in the field were focused only on functional aspects such as physical support of elder people, this study is more meaningful as this study is focused on inference of brand design based on food package design towards the new silver generation in order to influence the perceived brand value of food companies and to provide an effective way. The purpose of this study is to suggest revisions to strategies on various food brand designed based on food package design for the growing elderly population base. In detail, this study recommends method of food brand design based on food package design targeted on the improvement of purchasing intentions for products and towards a better brand image for the elder generation. The research scope of the targeted subjects of this study includes a case study with a total of 427 cases of food package that won international design awards for 3 years between 2016 and 2018 as well as 226 male and female representatives of the growing aforementioned group between their 50s and 60s who participated in the survey and in-depth interviews. The research scope of targeted subjects in this study were classified based on food package design type by Information-specialized Type and Sensitivity-specialized Type designated into groups classified by appeal type followed by modern package design suggested in research by Seong-cheol Shin (2004). Based on the evaluation of standards of package design obtained from a previous study, there are a total of 6 detailed types divided by appeal type, Sensitivity, Distinction, Convenience, Trustworthiness, and Aesthetic Impression were used as investigation tools for this study. The investigation methods implemented in this study consisted of case studies, in-depth interviews, and surveys. Through the case study, types and definitions of food package design have deduced. Also, the application method of food package design influencing purchase intentions was investigated through an in-depth interview. And through the survey, design principles of food package design influencing purchasing intentions was investigated. The survey served as a form of design principal evaluation of food package design divided by the type that each item was evaluated on through a 5 point system measuring the degree of importance and degree of satisfaction. And the investigation result was applied to an IPA model for analyzation. The result of this study is as follows. ① The new silver generation tends to pursue trustworthiness based on food information displayed on the food packaging. In other words, it is necessary to apply a form of package design which can provide and delivers highly-reliable information such as price/volume of food, display of country of origin/production, eco-friendly/organic raw materials and production characteristics, and expire date. ② The new silver generation tends to pursue distinction based on images such as freshness, and eco-friendliness in the design of food packaging. In other words, it is necessary to build up the trustworthiness of food information by applying eco-friendly ingredients, fresh raw materials and an image of the origin of products. And based on them, application of package designs should be implemented which can differentiate the products visually is necessary. ③ The new silver generation tends to pursue sensitivity and trustworthiness based on a form of harmonious typography in the food package design. In other words, it is necessary to apply package designs based on trustworthiness and sensitivity such as highly readable letters and characterful handwriting which can express the product information clearly. ④ The new silver generation tends to pursue sensitivity and distinction through brand story and brand character design in the food package design. In other words, it is necessary to have sensible distinction applying eco-friendly brand story and brand character based on simple and natural image. ⑤The new silver generation tends to pursue sensitivity based on expression of sensible shape on the characteristic of products in the food package design. In other words, it is necessary to apply illustrated expression on characteristics such as characteristics of package design shape, food image, origin, and ingredients that express characteristics of products as well as package design applying both sensible and clear logos with deep expression. Through this study, food brand design for the new silver generation based on investigative research on food package design is recommended as listed above.한국은 세계에서 가장 빠른 속도로 초고령사회(super-aged society)로 진입할 것으로 예상된다. 특히 향후 실버세대의 급격한 증가에 기여하게 되는 1차 베이비붐 세대인 뉴실버세대는 적극적이고 독립적인 의식 추구, 건강과 여가 지향의 생활 추구, 감성 지향의 합리적인 소비성향 등 새로운 생활과 소비 특성을 보이고 있다. 따라서 미래의 우리 사회는 뉴실버세대를 중심으로 한 인구구성의 변화로 인해 발생되는 다양한 사회적·경제적 변화에 대비해야 할 필요가 있다. 현재 글로벌 경제를 주도하는 주요 국가들은 뉴실버세대의 증가로 인한 인구 변화와 이에 따른 경제적 환경의 변화에 주목하고 있다. 이는 뉴실버세대가 거대 소비 집단으로 부상하면서 이들을 위한 시니어 시장의 적극적인 개척의 필요성이 증가하기 때문이다. 그 중 대표적인 분야가 뉴실버세대를 위한 브랜드 디자인이다. 삶의 질과 수준이 향상된 현대사회에서 소비자들의 구매욕구와 행동은 점차 다양화되어간다. 또한 인구 변화로 인한 소비 행태의 변화에 따라 글로벌 경쟁이 치열해지면서 브랜드의 중요성이 더욱 커지고 있다. 현재 기업들은 식품 시장 경쟁에서 우위를 차지하기 위해 소비자 식품 소비 성향을 자극하여 브랜드 입지를 강화하기 위한 다양한 브랜드 전략을 내세우고 있다. 특히 뉴실버세대의 증가에 따른 시장 변화에 대응하여 식품 브랜드 디자인을 기업의 전략적 자원으로 활용하고 있다. 식품은 뉴실버세대의 차별화된 의식과 생활 특성을 지속하기 위해 가장 중요한 생활필수품이며 소비자의 이성과 감성이 결합되어 선택, 구매하게 되는 제품이라고 할 수 있다. 이를 위해 전 세계 주요 식품 기업들은 뉴실버세대에게 브랜드 인지와 기억을 효과적으로 강화하기 위한 브랜드 아이덴티티 확보 방안으로 식품 패키지디자인을 브랜드 전략으로 적극 활용하고 있다. 식품 브랜드 전략에서 시각적 차별화에 기반한 식품 패키지디자인은 식품의 특성과 우수성을 디자인으로 연출하고 홍보함으로써 브랜드와 소비자를 직접 연결하는 중요한 커뮤니케이션 매개체이다. 이에 향후 실버세대의 급속한 증가에 기여하는 뉴실버세대를 위한 식품 시장에서 기업의 긍정적이며 효과적인 식품 브랜드 이미지를 형성하고, 식품 브랜드 경쟁력을 강화하기 위해 뉴실버세대를 위한 식품 패키지디자인의 차별화 전략이 필요하다. 따라서 향후 뉴실버세대를 대상으로 구매의도 향상과 식품 브랜드 이미지에 영향을 미치는 식품 패키지디자인에 기반한 브랜드 디자인에 관한 연구가 필요한 실정이다. 특히 뉴실버세대와 식품 패키지디자인 관련 선행연구가 대부분 고령자에 대한 물리적 지원 등 기능적인 측면에 국한되어 진행된 상황을 고려한다면, 식품 기업의 브랜드 가치에 영향을 미치고, 이를 위한 효과적인 방안을 제시하고자 뉴실버세대를 중심으로 식품 패키지디자인에 기반하여 브랜드 디자인을 도출하기 위한 본 연구의 필요성은 크다고 할 수 있다. 본 연구의 목적은 뉴실버세대를 위해 식품 패키지디자인에 기반한 식품 브랜드 디자인을 제안하는 것이다. 세부적으로 본 연구는 뉴실버세대를 대상으로 제품의 구매의도 향상과 브랜드 이미지에 영향을 미치는 식품 패키지디자인을 중심으로 식품 브랜드 디자인의 방안을 제시하고자 한다. 본 연구의 조사대상 연구범위는 사례조사 대상으로 2016년부터 2018년까지 최근 3년간 국제 디자인 어워즈에서 수상한 식품 패키지디자인 사례 총 427개, 설문조사 및 심층면접 대상으로 뉴실버세대 50~60대 남녀 310명을 설정하였다또한 본 연구의 조사내용 연구범위는 신성철(2004)의 연구에서 제시된 현대 패키지디자인 소구 유형에 따라 정보 특화형, 감성 특화형 식품 패키지디자인 유형으로 분류하였고 소구 유형에 따른 총 6가지 세부 유형을 선행연구를 통해 감성, 차별성, 편리성, 신뢰성, 심미성의 패키지디자인 평가 기준을 바탕으로 본 연구를 위한 조사도구를 설계하였다. 본 연구의 연구방법은 사례조사와 심층면접 및 설문조사이다. 본 연구는 사례조사를 통해 식품 패키지디자인 유형과 특성 및 정의를 도출하였다. 또한 심층면접을 통해 구매의도에 영향을 미치는 식품 패키지디자인 적용방안을 조사하고, 설문조사를 통해 구매의도에 영향을 미치는 식품 패키지디자인의 디자인 원리를 조사하였다. 설문조사는 유형별 식품 패키지디자인에 대한 디자인 원리 평가로서 동일 항목에 대해 5점 척도의 중요도와 만족도를 평가하였으며, 조사결과를 IPA 모형에 적용하여 분석하였다. 본 연구의 조사결과는 다음과 같다. ① 뉴실버세대는 식품 패키지디자인에서 식품 정보에 기반한 신뢰성 추구의 특성을 나타내고 있다. 즉, 식품의 가격/용량, 원산지/생산지 표시, 친환경/유기농의 원재료 및 생산 특성, 유통기한 등 식품의 신뢰도 높은 정보를 제공, 전달할 수 있는 패키지디자인의 적용이 필요하다. ② 뉴실버세대는 식품 패키지디자인에서 신선, 친환경 등의 이미지에 기반한 차별성 추구 특성을 나타내고 있다. 즉, 친환경적인 소재, 신선한 원재료 및 원산지 이미지를 활용해 식품 정보의 신뢰성을 확보하고, 이를 통한 시각적 차별화 패키지디자인의 적용이 필요하다. ③ 뉴실버세대는 식품 패키지디자인에서 조화로운 타이포그래피에 기반한 감성과 신뢰성 추구 특성을 나타내고 있다. 즉, 제품의 정보를 명료하게 나타내는 가독성 높은 글씨와 개성있는 손글씨 등 신뢰성과 감성을 바탕으로한 패키지디자인의 적용이 필요하다. ④ 뉴실버세대는 식품 패키지디자인에서 브랜드 스토리와 브랜드 캐릭터 디자인을 통한 감성과 차별성 추구 특성을 나타내고 있다. 즉, 담백하고 자연스러운 이미지를 바탕으로 자연친화적인 브랜드 스토리와 브랜드 캐릭터를 활용한 감성 차별화가 필요하다. ⑤ 뉴실버세대는 식품 패키지디자인에서 제품의 속성에 대해 감성적 형태 표현에 기반한 감성 추구 특성을 나타내고 있다. 즉, 제품의 특성을 나타내는 패키지디자인의 형태적 특성, 식품 이미지, 원산지, 재료 등의 특성에 대한 일러스트 표현과 감성적이며 명료한 표현의 로고 등을 활용한 패키지디자인의 적용이 필요하다. 본 연구는 이상과 같은 식품 패키지디자인에 관한 조사결과를 바탕으로 뉴실버세대를 위한 식품 브랜드 디자인을 제안하였다.Ⅰ. 서론 1 1.1. 연구의 배경 및 필요성 2 1.2. 연구의 목적 8 1.3. 연구문제 및 연구가설 8 1.4. 연구범위 및 방법 9 Ⅱ. 뉴실버세대 13 2.1. 실버세대 증가 및 식품시장의 변화 14 2.2. 실버세대와 뉴실버세대에 대한 고찰 16 2.2.1. 뉴실버세대의 정의 및 특성 16 2.2.2. 뉴실버세대의 신체적 변화 18 2.3. 실버산업과 뉴실버세대 소비성향 21 2.4. 식품산업과 실버푸드 25 Ⅲ. 식품 브랜드와 패키지디자인 31 3.1. 브랜드와 브랜드 이미지의 개념 및 역할 32 3.2. 브랜드의 시대적 흐름과 패러다임의 변화 34 3.3. 식품 브랜드와 패키지디자인의 연계성 39 3.4. 식품 및 라이프스타일 브랜드 사례와 시사점 40 3.4.1. 국내 식품 브랜드 현황 40 3.4.2. 해외 식품 및 라이프스타일 브랜드 사례 52 3.4.3. 해외 식품 및 라이프스타일 브랜드 사례의 시사점 63 3.5. 식품 및 제품 패키지디자인의 주요 사례와 시사점 65 3.5.1. 해외 식품 및 제품 패키지디자인 주요 사례 65 3.5.2. 해외 식품 및 제품 패키지디자인 주요 사례의 시사점 72 3.5.3. 국내외 식품 패키지디자인 기타 사례와 특성 74 3.6. 실버세대를 위한 실버푸드 현황 79 3.7. 실버세대를 위한 패키지디자인 현황 89 3.8. 뉴실버세대를 위한 식품 패키지 적용 테크놀로지 92 3.9. 뉴실버세대를 위한 패키지디자인 원리와 평가척도 96 3.9.1. 뉴실버세대를 위한 패키지디자인 원리 96 3.9.2. 뉴실버세대를 위한 패키지디자인 평가척도 103 Ⅳ. 연구 설계 및 조사결과 105 4.1. 식품 브랜드 디자인을 위한 패키지디자인 연구설계 106 4.2. 뉴실버세대 특성, 식품 구매의식 및 경향 설문조사 106 4.2.1. 설문조사 대상자 일반사항 106 4.2.2. 뉴실버세대 특성, 식품 구매의식 및 경향 설문조사 결과 109 4.3. 뉴실버세대를 위한 식품 패키지디자인 심층면접 114 4.3.1. 심층면접 조사대상자 일반사항 114 4.3.2. 뉴실버세대를 위한 식품 패키지디자인 심층면접 결과 115 4.4. 뉴실버세대의 식품 브랜드 디자인 설문조사 119 4.4.1. IPA 기법 119 4.4.2. 식품 브랜드 디자인을 위한 IPA 모형 설정 및 자료수집 120 4.4.3. 설문조사 대상자 일반사항 122 4.4.4. 식품 패키지디자인 유형별 신뢰도 분석 및 평균비교 122 4.4.5. 식품 패키지디자인의 전체 IPA 124 4.4.6. 정보 특화형 식품 패키지디자인의 IPA 128 4.4.7. 감성 특화형 식품 패키지디자인의 IPA 132 4.5. 조사결과 종합 139 Ⅴ. 연구작품 143 5.1. 대상 선정 144 5.2. 식품 브랜드 전략 145 5.2.1. 브렌드 네임 145 5.2.2. 포지셔닝 147 5.2.3. 유통구조 148 5.2.4. 상품구성 151 5.3. 디자인 개발 프로세스 152 5.3.1. 심볼 디자인 153 5.3.2. 이미지 154 5.3.3. 타이포그래피 157 5.3.4. 패키지디자인 159 5.3.5. 소식지 171 5.3.6. 영상광고 174 5.4. 전시 177 Ⅵ. 결론 183 6.1. 맺음말 184 6.2. 제언 189 참고문헌 192 Abstract 197Docto

Clinical Usefulness of Regional Tissue Oxygen Saturation Monitoring Using Near-Infrared Spectroscopy in Neonates

Objective Recently, near-infrared spectroscopy (NIRS) has been introduced in the neonatal intensive care unit (NICU) to monitor the altered hemodynamic status causing cerebral hypoxemia or affecting mesenteric and/or renal oxygenation. This study aimed to reassess the clinical usefulness of NIRS and the correlation between regional O2 saturation (rSO2) and various physiological parameters in neonates. Methods Thirty-nine newborns, admitted in NICU from June 2019 to June 2020 and continuously monitored with NIRS (cerebral and renal) during the first 72 hours, were included. Results Among 39 newborns with a median gestational age of 33.9 weeks, and a median birth weight of 2,180 g, the median of the cerebral and renal rSO2 were 84% (30%–95%) and 95% (45%–95%), respectively. Cerebral rSO2 tended to increase over time since the time of delivery, while renal rSO2 tended to decline, especially in preterm infants. Average of renal rSO2 during 72 hours showed a statistically significant difference between term and preterm infants (P<0.05). Cerebral rSO2 showed significant correlation with hemoglobin (r=0.35, P<0.05) and hematocrit (r=0.37, P<0.05). Renal rSO2 showed significant correlation with capillary blood gas analysis such as pH (r=0.36, P<0.05), pCO2 (r=-0.19, P<0.05), pO2 (r=0.23, P<0.05), base excess (r=0.19, P<0.05), hemoglobin (r=0.33, P<0.05), hematocrit (r=0.32, P<0.05) as well as renal function indicator such as blood urea nitrogen (r=-0.50, P<0.05) and creatinine (r=-0.59, P<0.05). Conclusion We re-evaluated the clinical usefulness of NIRS in neonates by identifying trends and correlations of rSO2 with clinical parameters. It is necessary to confirm its effectiveness through further study.ope

Successful Treatment of Neonatal Pylorospasm with Intravenous Atropine

Pylorospasm is a cause of delayed gastric emptying in young infants. As in patients with hypertrophic pyloric stenosis, most pylorospasm patients present with projectile vomiting. However, unlike that in case of hypertrophic pyloric stenosis, no persistent pyloric stenotic lesions are present. As such, follow-up using serial gastrointestinal fluoroscopy or ultrasonography can be helpful in diagnosing patients with clinical signs of gastroparesis. Most cases can be treated conservatively, but some patients require pharmacologic treatment. Antispasmodics have been proposed as a treatment for pylorospasm, but their use in neonates and infants has rarely been reported. Herein, we present a case of pylorospasm diagnosed in the neonatal period and successfully treated with intravenous atropine.ope

TNF-α Pretreatment Improves the Survival and Function of Transplanted Human Neural Progenitor Cells Following Hypoxic-Ischemic Brain Injury

Neural progenitor cells (NPCs) therapy offers great promise in hypoxic-ischemic (HI) brain injury. However, the poor survival of implanted NPCs in the HI host environment limits their therapeutic effects. Tumor necrosis factor-alpha (TNF-α) is a pleiotropic cytokine that is induced in response to a variety of pathological processes including inflammation and immunity. On the other hand, TNF-α has protective effects on cell apoptosis and death and affects the differentiation, proliferation, and survival of neural stem/progenitor cells in the brain. The present study investigated whether TNF-α pretreatment on human NPCs (hNPCs) enhances the effectiveness of cell transplantation therapy under ischemic brain. Fetal brain tissue-derived hNPCs were pretreated with TNF-α before being used in vitro experiments or transplantation. TNF-α significantly increased expression of cIAP2, and the use of short hairpin RNA-mediated knockdown of cIAP2 demonstrated that cIAP2 protected hNPCs against HI-induced cytotoxicity. In addition, pretreatment of hNPCs with TNF-α mediated neuroprotection by altering microglia polarization via increased expression of CX3CL1 and by enhancing expression of neurotrophic factors. Furthermore, transplantation of TNF-α-treated hNPCs reduced infarct volume and improved neurological functions in comparison with non-pretreated hNPCs or vehicle. These findings show that TNF-α pretreatment, which protects hNPCs from HI-injured brain-induced apoptosis and increases neuroprotection, is a simple and safe approach to improve the survival of transplanted hNPCs and the therapeutic efficacy of hNPCs in HI brain injury.ope

Evaluation of Newborn Infants with Prenatally Diagnosed Congenital Pulmonary Airway Malformation: A Single-Center Experience

Purpose Congenital pulmonary airway malformation (CPAM)－a rare developmental anomaly－affects the lower respiratory tract in newborns. By comparing the reliability of diagnostic tools and identifying predictive factors for symptoms, we provide comprehensive clinical data for the proper management of CPAM. Methods We reviewed the medical records of 66 patients with prenatally diagnosed CPAM delivered at Severance Children’s Hospital between January 2005 and July 2017. Results We enrolled 33 boys and 33 girls. Their mean gestational age and birth weight were 38.8 weeks and 3,050 g, respectively. Prenatal ultrasonography and postnatal radiography, lung ultrasonography, and chest computed tomography (CT) showed inconsistent findings. Chest CT showed superior sensitivity (100%) and positive predictive value (90%). Among the 66 patients, 59 had postnatally confirmed CPAM, three had pulmonary sequestration, one had cystic teratoma, and one had a normal lung. Of the 59 patients with CPAM, 21 (35%; mean age, 23.4 months) underwent surgery, including 15 who underwent video-assisted thoracoscopy. Twenty-five and 12 patients exhibited respiratory symptoms at birth and during infancy, respectively. Apgar scores and mediastinal shift on radiography were significantly associated with respiratory symptoms at birth. However, none of the factors could predict respiratory symptoms during infancy. Conclusion Radiography or ultrasonography combined with chest CT can confirm an unclear or inconsistent lesion. Apgar scores and mediastinal shift on radiography can predict respiratory symptoms at birth. However, symptoms during infancy are not associated with prenatal and postnatal factors. Chest CT combined with periodic symptom monitoring is important for diagnosing and managing patients with prenatally diagnosed CPAM and to guide appropriate timing of surgery.ope

Glial Cell Line-derived Neurotrophic Factor-overexpressing Human Neural Stem/Progenitor Cells Enhance Therapeutic Efficiency in Rat with Traumatic Spinal Cord Injury

Spinal cord injury (SCI) causes axonal damage and demyelination, neural cell death, and comprehensive tissue loss, resulting in devastating neurological dysfunction. Neural stem/progenitor cell (NSPCs) transplantation provides therapeutic benefits for neural repair in SCI, and glial cell linederived neurotrophic factor (GDNF) has been uncovered to have capability of stimulating axonal regeneration and remyelination after SCI. In this study, to evaluate whether GDNF would augment therapeutic effects of NSPCs for SCI, GDNF-encoding or mock adenoviral vector-transduced human NSPCs (GDNF-or Mock-hNSPCs) were transplanted into the injured thoracic spinal cords of rats at 7 days after SCI. Grafted GDNFhNSPCs showed robust engraftment, long-term survival, an extensive distribution, and increased differentiation into neurons and oligodendroglial cells. Compared with Mock-hNSPC- and vehicle-injected groups, transplantation of GDNF-hNSPCs significantly reduced lesion volume and glial scar formation, promoted neurite outgrowth, axonal regeneration and myelination, increased Schwann cell migration that contributed to the myelin repair, and improved locomotor recovery. In addition, tract tracing demonstrated that transplantation of GDNF-hNSPCs reduced significantly axonal dieback of the dorsal corticospinal tract (dCST), and increased the levels of dCST collaterals, propriospinal neurons (PSNs), and contacts between dCST collaterals and PSNs in the cervical enlargement over that of the controls. Finally grafted GDNF-hNSPCs substantially reversed the increased expression of voltage-gated sodium channels and neuropeptide Y, and elevated expression of GABA in the injured spinal cord, which are involved in the attenuation of neuropathic pain after SCI. These findings suggest that implantation of GDNF-hNSPCs enhances therapeutic efficiency of hNSPCs-based cell therapy for SCI.ope

Oral characteristics and dietary habits of preterm children: A retrospective study using National Health Screening Program for Infants and Children

The rate of preterm birth is increasing worldwide and preterm infants are susceptible to oral health problems. Hence, this study aimed to investigate the effect of premature birth on dietary and oral characteristics as well as dental treatment experiences of preterm infants using a nationwide cohort study. Data was retrospectively analyzed from National Health Screening Program for Infants and Children (NHSIC) of the National Health Insurance Service of Korea. 5% sample of children born between 2008 and 2012 who completed first or second infant health screening were included and divided into full-term and preterm-birth groups. Clinical data variables such as dietary habits, oral characteristics, and dental treatment experiences were investigated and comparatively analyzed. Preterm infants showed significantly lower rates of breastfeeding at 4–6 months (p&lt;0.001), delayed start of weaning food at 9–12 months (p&lt;0.001), higher rates of bottle feeding at 18–24 months (p&lt;0.001), poor appetite at 30–36 months (p&lt;0.001) and higher rates of improper swallowing and chewing function at 42–53 months (p = 0.023) than full-term infants. Preterm infants also had eating habits leading to poor oral conditions and higher percentage of absence of dental visit compared to full-term infants (p = 0.036). However, dental treatments including 1-visit pulpectomy (p = 0.007) and 2-visit pulpectomy (p = 0.042) significantly decreased when oral health screening was completed at least once. The NHSIC can be an effective policy for oral health management in preterm infants.ope