Neonatal seizures are the most common neurological symptoms caused by various etiologies in the neonatal period, but their diagnosis and treatment are challenging because their pathophysiology and electroclinical manifestations differ from those of patients in older age groups. Many seizures present as electrographic-only events without clinical signs or as obscure clinical manifestations that are difficult to distinguish from other neonatal behaviors. Accordingly, a new definition and classification of neonatal seizures was recently proposed by the International League Against Epilepsy Task Force on neonatal seizures, highlighting the role of electroencephalography in diagnosing and treating neonatal seizures. Neonatal seizures are defined as electrographic events with sudden, paroxysmal, and abnormal alteration of activity and divided into electroclinical seizures and electrographic-only seizures according to their clinical signs, thus excluding clinical events without an electrographic correlation. Seizure types are described by their predominant clinical features and divided into motor (automatisms, clonic, epileptic spasms, myoclonic, tonic, and sequential), nonmotor (autonomic and behavioral arrest), and unclassified. Although many neonatal seizures are acute reactive events caused by hypoxic-ischemic encephalopathy or vascular insults, structural, genetic, or metabolic etiologies of neonatal-onset epilepsy should also be thoroughly evaluated to determine their appropriate management.

Background/Objectives: Extrauterine growth restriction (EUGR) is associated with high mortality and an increased incidence of poor neurodevelopmental outcomes in preterm infants. In this study, we aimed to compare the Intergrowth-21^ST (IG-21^ST) and Fenton charts in predicting long-term neurodevelopmental and anthropometric outcomes of very low birth weight (VLBW) infants. Methods: Data were collected from 2649 VLBW infants registered in the Korean Neonatal Network born between 24^0/7 and 31^6/7 weeks of gestational age from January 2013 to December 2017. Follow-up assessments were conducted at 18–24 months of age, corrected for prematurity. Multiple logistic regression analysis was performed to evaluate the association between EUGR and long-term outcomes. Results: Among the 2649 VLBW infants, 60.0% (1606/2649) and 36.9% (977/2649) were diagnosed as having EUGR defined by the Fenton chart (EUGR_F) and by the IG-21^ST chart (EUGR_IG), respectively. The EUGR_IG group exhibited a higher proportion of infants with cerebral palsy, neurodevelopmental impairment (NDI), and growth failure. In multiple logistic regression analysis, adjusted for risk factors for long-term outcome, the EUGR_IG group showed higher risk of cerebral palsy (adjusted odds ratio [aOR], 1.66; 95% confidence interval [CI], 1.04–2.65), NDI (aOR, 2.09; 95% CI, 1.71–2.55), and growth failure (aOR, 1.57; 95% CI, 1.16–2.13). Infants with EUGR_F tended to develop NDI (aOR, 1.29; 95%CI, 1.03–1.63) and experience growth failure (aOR, 2.44; 95% CI, 1.77–3.40). Conclusions: The IG-21^ST chart demonstrated a more effective prediction of long-term neurodevelopmental outcomes, whereas the Fenton chart may be more suitable for predicting growth failure at 18–24 months.

This prospective cohort study investigated the longitudinal compositional changes of the gut microbiome across different gestational age groups, from birth to six months’ corrected age for prematurity. Fecal samples (n = 709) from 349 neonates [51 very preterm, 195 moderate-to-late preterm, and 93 full-term infants] were analyzed. Proteobacteria, Firmicutes, and Bacteroidetes constituted the core microbiome of the meconium. Proteobacteria and Firmicutes were the dominant phyla before discharge, whereas Firmicutes was the most dominant phylum in all groups after discharge. Ralstonia was the most prevalent genus in the meconium of preterm infants. After discharge, the relative abundance of Veillonella continued to increase in all gestational groups (p = 0.011 for very preterm, p < 0.001 for moderate-to-late preterm and full-term). By six months corrected age, differences in the gut microbiota composition became less pronounced between the groups. The α-diversity of meconium was highest across all groups, and this significantly decreased during the neonatal intensive care unit stay and increased thereafter. The β-diversity was significantly different (p < 0.05) but of limited practical significance (R² < 0.1). The differences between groups diminished as infants grew older, indicating that preterm infants were able to achieve a balanced gut microbiota and overcome dysbiosis.

Objectives: The aim of this study is to analyze data from 36 cases of combined Korean medicine treatment, including TBT to evaluate its effectiveness in correcting facial asymmetry.Methods: Using the initial charts, DSLR photographs, and cranial X-ray images of 36 patients who received facial asymmetry correction treatment, changes in angles along the midline and horizontal plane, as well as differences in the ratio of left and right jaw lengths, were measured and analyzed. Improvement rates were calculated for each factor, and a paired sample t-test was used to determine the statistical significance of pre- and post-treatment differences.Results: The changes in angles measured in the soft tissue analysis showed statistically significant improvements according to the t-test (p < 0.05). Similarly, cephalometric analysis also demonstrated statistically significant improvements (p < 0.05). The highest correction rate was observed in the angle formed by the line drawn vertically from the clavicle midline and the line connecting the clavicle midline to the center of the glabella, with an improvement of 74.74 ± 21.15%. The correction rate for the ratio of the line connecting the ends of both rami from the midline (LL/RL) was the third highest at 60.42 ± 37.08%, but this change was not statistically significant in the t-test.Conclusion: This study suggests that non-surgical Korean medicine treatments, such as TBT, may have a statistically significant effect on correcting facial asymmetry.

Rationale: Vascular access is a critical component of care in the neonatal intensive care unit, especially for nutritional support and medication administration. While umbilical vein catheters are commonly used during the first few days of life, peripherally inserted central catheters (PICCs) become the preferred method of central venous access thereafter. However, malpositioning of PICCs, particularly when the tip lies within or in close proximity to the right atrium, may lead to severe complications such as pericardial effusion and cardiac tamponade, especially in extremely low birth weight infants. Patient concerns: Two extremely low birth weight preterm infants experienced sudden clinical deterioration following PICC insertion, raising concerns about catheter-related complications. Diagnoses: Both infants were diagnosed with cardiac tamponade secondary to pericardial effusion caused by PICC malposition, with the catheter tip located in or near the right atrium. Interventions: In both cases, emergency pericardiocentesis was attempted after echocardiographic confirmation of pericardial effusion and clinical signs of tamponade. Despite resuscitative efforts, both infants succumbed to the complication. Outcomes: The outcome was fatal in both cases and confirmed catheter malposition as the underlying cause of pericardial effusion and cardiac tamponade. Lessons: To prevent fatal complications such as cardiac tamponade, PICCs should be positioned in safe area. Proper placement in the superior vena cava should be confirmed and maintained. Regular verification of catheter tip position and minimizing unnecessary repositioning are essential for preventing catheter-related adverse events in vulnerable preterm infants.

Purpose: To identify factors associated with the clinical response to low-dose dexamethasone therapy (LDDT) in preterm infants for bronchopulmonary dysplasia (BPD). Methods: We used a retrospective medical record review to evaluate preterm infants who were born before 32 weeks of gestation or with a birth weight less than 1,500 g. All infants were admitted to the neonatal intensive care unit at a tertiary academic hospital between January 2010 and June 2019, and received LDDT for BPD. The preterm infants' respiratory severity scores (RSS) were calculated from the first day of LDDT to the day of extubation, or the last day of LDDT. A good response was defined as a decreasing RSS with a slope greater than 0.181. A poor response was defined as a non-decreasing RSS, or a decreasing RSS with a slope less than 0.181 during LDDT. A total dose of 1.1 mg/kg was administered for 10 days for each single course of LDDT. Results: A total of 51 preterm infants were included in the final analysis. Thirty preterm infants (58.8 %) were in the good response group, and 21 preterm infants (41.2%) were in the poor response group. There were no significant differences in gestational age, birth weight, and sex between the good response group and poor response group. Preterm premature rupture of membrane and histologic chorioamnionitis were significantly associated with a poor response to LDDT. Higher RSS on the first day of the LDDT was associated with a good response to LDDT. Conclusion: Antenatal infection and/or inflammation may be associated with an unfavorable response to postnatal LDDT for BPD. Preterm infants with more severe respiratory failure seem to benefit more from LDDT for BPD.