Human milk banks are a solution for mothers who cannot supply their own breast milk to their sick or hospitalized infants; premature infants, in particular, are unable to receive a full volume of breast milk for numerous reasons. As of December 2015, there was only one milk bank in a university hospital in Korea. We reviewed the basic characteristics of donors and recipients, and the amounts and contamination of breast milk donated at the Human Milk Bank in Kyung Hee University Hospital at Gangdong in Korea from 2008 to 2015. The donor pool consisted of 463 first-time donors and 452 repeat donors who made 1,724 donations. A total of 10,820 L of breast milk was collected, and 9,541.6 L were processed. Detectable bacteria grew in 12.6% after pasteurization and 52.5% had cytomegalovirus DNA before pasteurization in donated milk. There were 836 infant and 25 adult recipients; among new infant recipients, 48.5% were preterm; the groups received 8,009 and 165.7 L of donor milk, respectively. There was an increase in the percentage of preterm infants among new infant recipients in 2015 (93.1%) compared to 2008 (8.5%). Based on the number of premature infants in Korea, the number of potential recipients is not likely to diminish anytime soon, despite efforts to improve the breastfeeding rate. Sustainability and quality improvement of the milk bank need long-term financial support by health authorities and a nationwide network similar to blood banking will further contribute to the progress of milk banking.

Intravenous immunoglobulin (IVIG) infusion in the acute stage is the standard therapy in patients with Kawasaki disease (KD). Although some risk-scoring system made in Japan are widely used, there are few reports that describe the usefulness of risk-scoring systems to predict initial IVIG resistance. This study aimed to investigate which risk-scoring system of KD is the most useful. And this study evaluated the usefulness of N-terminal pro-brain natriuretic peptide (NT-proBNP) as an additional criteria of risk-scoring system. In this study, 228 patients with a diagnosis of KD who received IVIG treatment were viewed retrospectively. Of these 228 patients, 27 were nonresponders who received additional rescue therapy. The Kobayashi score (responders n=201, non-responders n=27) showed statistically significant difference between IVIG-sensitive and IVIG-resistant patients, yielding a sensitivity of 83 % and specificity of 67 %. The Egami score (responders n=201, non-responders n=27) also showed statistically significant difference between IVIG-sensitive and IVIG-resistant patients, yielding a sensitivity of 38 % and specificity of 92 %. The Sano score (responders n=108, non-responders n=15) also showed statistically significant difference between IVIG-sensitive and IVIG-resistant patients, yielding a sensitivity of 52 % and specificity of 90 %. The new risk-scoring system ( Kobayashi risk-scoring + NT-proBNP > 1093 pg/mL, responders n=201, non-responders n=27, high risk ≥ 5 points ) also showed statistically significant difference between IVIG-sensitive and IVIG-resistant patients, yielding a sensitivity of 83 % and specificity of 71 %. This findings show the new risk-scoring system is helpful in determining patients at risk for non-responders to initial IVIG treatment. This study suggest that in patients with high risk defined as ≥ 5 points, risk calculation by new scoring system are likely to fail to the initial IVIG therapy and may require further rescue therapy in Korean Kawasaki disease patients .

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