PurposeTransient tachypnea of the newborn (TTN) is a disorder caused by the delayed clearance of fetal alveolar fluid. β-adrenergic agonists such as albuterol (salbutamol) are known to catalyze lung fluid absorption. This study examined whether inhalational salbutamol therapy could improve clinical symptoms in TTN. Additional endpoints included the diagnostic and therapeutic efficacy of salbutamol as well as its overall safety.MethodsFrom January 2010 through December 2010, we conducted a prospective study of 40 newborns hospitalized with TTN in the neonatal intensive care unit. Patients were given either inhalational salbutamol (28 patients) or placebo (12 patients), and clinical indices were compared.ResultsThe duration of tachypnea was shorter in patients receiving inhalational salbutamol therapy, although this difference was not statistically significant. The duration of supplemental oxygen therapy and the duration of empiric antibiotic treatment were significantly shorter in the salbutamol-treated group. No adverse effects were observed in either treatment group.ConclusionsInhalational salbutamol therapy reduced the duration of supplemental oxygen therapy and the duration of empiric antibiotic treatment, with no adverse effects. However, the time between salbutamol therapy and clinical improvement was too long to allow definitive conclusions to be drawn. Further studies examining a larger number of patients with strict control over dosage and frequency of salbutamol inhalations are necessary to better direct the treatment of TTN.

In Korea, changes in the decisions on end-of-life care in neonates are shifting from active resuscitation to nonactive resuscitation based on clinical conditions.

Early, aggressive nutrition is an important contributing factor of long-term neurodevelopmental outcomes. To ensure optimal growth in premature infants, adequate protein intake and optimal protein/energy ratio should be emphasized rather than the overall energy intake. Minimal enteral nutrition should be initiated as soon as possible in the first days of life, and feeding advancement should be individualized according to the clinical course of the infant. During hospitalization, enteral nutrition with preterm formula and fortified human milk represent the best feeding practices for facilitating growth. After discharge, the enteral nutrition strategy should be individualized according to the infant's weight at discharge. Infants with suboptimal weight for their postconceptional age at discharge should receive supplementation with human milk fortifiers or nutrient-enriched feeding, and the enteral nutrition strategy should be reviewed and modified continuously to achieve the target growth parameters.

We describe a case of secondary hypertension caused by renal arteriovenous fistula. An 8-year old girl was hospitalized with a severe headache, vomiting, and seizure. Renal angiography demonstrated multiple renal arteriovenous fistula and increased blood renin concentration in the left renal vein. Thus, left renal arteriovenous fistula and renin induced secondary hypertension were diagnosed. Her blood pressure was well controlled by medication with angiotensin converting enzyme inhibitor.

Deletions of the long arm of chromosome 6 are relatively rare. To date, only one case with a deletion of the long arm of chromosome 6 has been identified through standard cytogenetic analyses in Korean patients [1]. The clinical features of 6q deletions, including facial dysmorphism, mental retardation, developmental delay, and defects of the brain, heart, lungs, bones, and joints, vary with the size and location of the deleted regions [2]. Here, we report a case of interstitial 6q deletion associated with facial and skeletal anomalies, umbilical hernia, and brain defects in a female infant. The location of the chromosomal breakpoints and the size of the deleted region, previously identified by routine cytogenetics, which have limited resolution, could be confirmed using the array comparative genomic hybridization (array CGH) method that facilitates high-resolution analysis of chromosomal aneuploidy. CASE REPORTThe female infant was the product of the first pregnancy of a 22-yr-old woman. She was born vaginally at the 38th week and 4th day of gestation with a birth weight of 2,400 g. Details of birth head circumference and length are, however, not available. Apgar scores were 5 and 7 at 1 and 5 min, respectively. The patient had a cleft palate and sucking difficulties. Physical examination revealed a flat face, low-set ears, dislocation of both hips, and a small umbilical hernia. Brain MRI showed porencephaly of the basal ganglia and thalamus, cerebromalacia, petechial hemorrhage along the gyrus and parietal area, and brain atro- 84Deletions of chromosome 6q, particularly in the proximal region, are relatively rare. Here, we report on a de novo interstitial deletion of (6)(q13q16.2) in a girl with facial dysmorphism, congenital hip dislocation, porencephaly, and brain atrophy. Array comparative genomic hybridization analysis showed arr 6q13q16. 2(73,378,824-99,824,130), demonstrating higher resolution than the conventional cytogenetic findings, del(6)(q12q15). The clinical data were analyzed and compared with those of similar patients previously reported in the literature. (Korean J Lab Med 2010;30:84-8)