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Clinical Problems in ML II and III: Extra-skeletal Manifestations

  • Park, Sung Won
    • Journal of mucopolysaccharidosis and rare diseases
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    • v.2 no.1
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    • pp.5-7
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    • 2016
  • Mucolipidoses II and III alpha/beta (ML II and ML III) are lysosomal disorders in which the essential mannose-6-phosphate recognition marker is not synthesized onto lysosomal hydrolases and other glycoproteins. The disorders are caused by mutations in GNPTAB, which encodes two of three subunits of the heterohexameric enzyme, N-acetylglucosamine-1-phosphotransferase ML II, recognizable at birth, often causes intrauterine growth impairment and sometimes the prenatal "Pacman" dysplasia. The main postnatal manifestations of ML II include gradual coarsening of neonatally evident craniofacial features, early cessation of statural growth and neuromotor development, dysostosis multiplex and major morbidity by hardening of soft connective tissue about the joints and in the cardiac valves. Fatal outcome occurs often before or in early childhood. ML III with clinical onset rarely detectable before three years of age, progresses slowly with gradual coarsening of the facial features, growth deficiency, dysostosis multiplex, restriction of movement in all joints before or from adolescence, painful gait impairment by prominent hip disease. Cognitive handicap remains minor or absent even in the adult, often wheelchair-bound patient with variable though significantly reduced life expectancy. As yet, there is no cure for individuals affected by these diseases. So, clinical manifestations and conservative treatment is important. This review aimed to highlight the extra-skeletal clinical problems in ML II and III.

A Study of Public Health Project Based on Family Unit (가정단위(家庭單位) 보건관리사업(保健管理事業)에 관(關)한 연구(硏究))

  • Maeng, Shi-Soun
    • Journal of Preventive Medicine and Public Health
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    • v.9 no.1
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    • pp.39-47
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    • 1976
  • The organized community is the one of the best system for the effective public health administration, and a model area was selected for the study to see what would be achieved when a certain small community is placed under the special public health control based on the family unit. The 178 families involved total of 875 populations. The rate of vaccination with B.C.G. among 191 infants and children could be increased upto 100.0% from 72.5% of the time when the basic study was performed after 8 months period of this study; 99.0% from 47.1% with D.P.T.; 96,9% from 71.7% against smallpox; 83.2% from 69.1% against poliomyelitis; but only 25,7% from 21.5% against measles. The status of family planing was 36.8% among 155 women of possible conception at the time of the basic research. And, at the end of this study, the number of women utilizing one of the methods of contraception for family planning were increased upto 52.9% among the same number. The most frequently utilized method was 34.1% of oral pills followed by 30.5% of intrauterine device; but both of which had higher rate of interruption of use because of the complications, 14.3% and 16.0% respectively. The 10 pregnant women at the time of basic research experienced normal deliveries during the period of study and they had received pre and postnatal health care through this health center. The status of oral hygiene, pulmonary tuberculosis control, and parasitological examination were also reported as well as the cases with diseases seen among the population and vaccinations performed against other infectious diseases. The stress on discussion was placed upon the effectiveness of public health administration when it is undergone on the individual family unit to achieve the best results. However, the shortness of both personnel and material resources were considered to be the one of the major difficulties retarding the generalization of the idea obtained through this study based on family unit public health administration.

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Meaning of Happiness Based on ERG Theory in Middle-Aged Korean Women (ERG 이론에 근거한 한국 중년여성의 행복에 관한 구성요인 도출 연구)

  • Shin, Hee-Jin;Kim, Jeung-Im
    • Korean Journal of Women Health Nursing
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    • v.25 no.3
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    • pp.315-328
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    • 2019
  • Purpose: The purpose of this study was to explore the components and nature of happiness in middle-aged women in Korea. Methods: Thirty middle-aged women living in metropolitan Seoul and Gyeonggi and Chungcheong provinces agreed to participate in this study. The data were collected through in-depth interviews with the participants in one-on-one settings. The data were analyzed qualitative using Colaizzi's method of phenomenology. Results: The three theme clusters were extracted from the raw data, along with 13 themes and 138 meaningful sentences and phrases. The three happiness theme clusters in middle-aged women were "live healthy for stability," "rule one's mind for harmony," and "activate hopes for self-esteem." The first theme cluster included healthy life, economic stability, physical youth, and positive thought. The second theme cluster included that harmonious family, ruling of mind, my position as invisible person in social relationships, and precious relationships to support. The last theme included the center of one's life is oneself, a sense of accomplishment, self-improvement, recognition of one's worth and rest for one self. The three theme clusters were associated with the existence, relatedness, and growth (ERG) of ERG areas, respectively. Conclusions: We conclude that the core components of happiness in middle-aged women are to live healthy and mind-ruled and activate hope. The nature of happiness is egocentric stability in middle-aged women. The results suggest that theme clusters might be used to develop a scale for measuring happiness in middle-aged women. This will be helpful to assess the psychosocial status of middle-aged women in Korea.

Assessment of Maternal and Neonatal Risk Factors for Postpartum Depression (산모 및 신생아 상태에 따른 산후우울증 유발 위험인자 분석)

  • Choi, Jin-Young;Lee, Jin-Moo;Cho, Jung-Hoon;Lee, Chang-Hoon;Jang, Jun-Bock;Lee, Kyung-Sub
    • The Journal of Korean Obstetrics and Gynecology
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    • v.23 no.2
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    • pp.106-115
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    • 2010
  • Purpose: The purposes of this study were in understanding maternal and neonatal risk factors for postpartum depression using Edinburgh Postnatal Depression Scale(EPDS). Methods: Among 788 women, who had delivery include cesarean section in the department of obstetrics and gynecology at OO medical center from May 28th 2008 to October 6st 2009, 72 women filled out EPDS questionnaire sheets. Additional aspects included for the analysis are maternal factors including age, number of children, parity, delivery method, and hemoglobin; and neonatal factors such as weight, sex, gestational age, apgar score, and neonatal intensive care unit admission. Comparison was performed between the women with EPDS score equal or less than 8 and the women with EPDS score equal to or higher than 9 using statistical methods of student t-test for linear variables and chi-square test for non-linear variables. SPSS version 13.0 for windows was used for analysis. Results: Thirty women(41.7%) were included in the postpartum depression risk group (EPDS score ${\geqq}9$). Statistically significant difference(P<0.05) was found in gestational ages of the risk group($36.57{\pm}29.6$ weeks) and the non-risk group ($38.10{\pm}1.97$ weeks). Identified statistically significant risk factors(P<0.05) include cesarean section (OR=3.304 [1.121-9.744]), low birth weight infant(OR =6.500 [1.606-26.314]), preterm delivery(OR=2.857[1.071-7.621]), low apgar score (1minute) after delivery (OR=14.909 [1.750-127.025]). There was no statistically significant difference in maternal age, number of children, parity, hemoglobin, neonatal sex, apgar score (5minutes), NICU admission. Conclusions: Through the results showed, gestational age, delivery method, neonatal weight, apgar score(1minute) were identified as risk factors for postpartum depression. To prevent or minimize postpartum depression, oriental medical intervention is recommended for pregnant women through early detection.

An Analysis on Actual Condition of Health Promotion Program through Oriental Medicine in Health Center (한방건강증진HUB보건소사업 실태분석)

  • Cho, Woo-Young;Yoo, Wang-Keu
    • Journal of Society of Preventive Korean Medicine
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    • v.10 no.2
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    • pp.81-93
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    • 2006
  • This study was carried out to examine the actual condition of health promotion program through oriental medicine in the health center and to provide basic data to develop proper policy of oriental medical health promotion program for the community people. The data were collected from 26 health centers which have been implementing the oriental medical health promotion program, using selfadministered questionnaire for two weeks from 1 October to 15 October 2006. The results are as follows : Generally, the respondents have the positive views on the level of budget and facilities/equipments of the oriental medical health promotion program in health center. However, they have the negative views on the level of manpower and education/training of the program. And also more than 70% of the respondents have the negative opinion on capabilities of formulating and evaluating the oriental medical health promotion program. The respondents indicated that there was the lack of coordination between the oriental medical health promotion program and existing health promotion in health center, and that low rate of utilizing community resources. With regard to the method of selecting the target group for the program, there are differences according to the each program. Many programs tended to select the target group not through the criteria of life-course and illness group but through the efficiency of selecting group. And many programs such as stroke prevention program, constitutional medicine program, oriental medical prenatal program, oriental medical prenatal and postnatal program, oriental medical child care program are mainly composed of the development of educational program and lecture. Regarding the number of the present oriental medical health promotion programs, around 65% of respondents answered that the number of the programs was many and thus they needed to decrease to the proper level. And with regard to the priority of the need, effectiveness and the satisfaction for each programs, on the whole, Qui gong program, stroke prevention program, area-specialty program and oriental medical home visiting program have high score. In particular, oriental medical quit-smoking program has lowest score. From these results, it requires to develop and improve the oriental medical health promotion program in health center considering the need and characteristics of community.

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Motherhood and Role Confidence in the Immediate Postpartum Period (산욕초기 어머니 됨과 돌봄 자신감)

  • Bang, Mi-Ran;Lee, Jung-Hee;Lee, Jee-Ae;Jung, Jee-Yun;Park, Se-Young;An, Ok-Sim;Park, Sook-Hee;Kim, Young-Hee
    • Korean Journal of Women Health Nursing
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    • v.6 no.2
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    • pp.291-304
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    • 2000
  • Being a mother is motherhood which means maternal role attainment and has to meet maternal identity and role confidence of caring infant. This study was designed to examine maternal identity as a motherhood and role confidence in the immediate postpartum period, and then explain the correlations of them. Data were collected for 2 months by questionnaires from 64 mothers in the hospital. The scales were to measure motherhood questionnaire which consisted of 11 items and role confidence questionnaire which consisted of 13 items. The analysis of data was done with SPSSWIN program for descriptive statistics and t-test, chi-square, ANOVA, Multiple Regression Analysis. The results were as follows: 1. Mean score of maternal identity of primipara was 55.41 and multipara was 53.81. In this outcome primipara's score was higher than multipara's. 2. Mean score of role confidence of primipara was 44.0 and multipara was 46.81. Multipara's score was higher than primipara's. 3. Correlation between maternal identity and role confidence was r=0.29(P=0.03). This was a interesting result. Because many studies reported that primipara had a lower score of maternal identity and role confidence than multipara's. But this study showed that primipara's score of maternal identity was higher than multipara's. So nurse has to support primipara's identity as a mother, taking advantage of nursing intervention from prenatal to postnatal periods. Also nurse has to offer many opportunities to experience premiparas and multiparas how to care their infants.

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A Study on the Self-related Postpartum Body Evaluation by Maternal Age and Delivery Method (출산 후 산모들의 주관적인 신체 평가에 대한 연령과 분만방식에 따른 분석)

  • Ha, Su-Jin;Hwang, Deok-Sang;Lee, Jin-Moo;Jang, Jun-Bock;Lee, Chang-Hoon
    • The Journal of Korean Obstetrics and Gynecology
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    • v.33 no.2
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    • pp.63-76
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    • 2020
  • Objectives: The purpose of this study is to compare postpartum symptoms of 528 women by age groups and delivery method through health questionnaires of postpartum care center. Methods: From January 2018 to December 2018, we statistically compared the 528 women's postpartal symptoms who divided into 4 age groups using SPSS Statistics 21.0 program. Results: There were no differences in weight changes, gestational age and degree of subjective discomfort by age (p>.05). On the other hand, parity, fetal weight and delivery method were statistically associated with age (p<.05). Especially the rate of cesarean delivery was increased with age. Degree of feeling dyspepsia and edema was higher in cesarean section delivery group (p<.05). Also, as the weight increased by 1 kg during pregnancy, the degree of feeling postnatal edema increased by 0.204 (β=0.204, t=4.204, p<.05). Conclusion: This study showed that age itself will not affect postpartum symptoms alone. Instead it is necessary to consider post-cesarean delivery symptoms for advanced maternal age.

An Intervention Study on Integration of Family Planning and Maternal/Infant Care Services in Rural Korea (가족계획과 모자보건 통합을 위한 조산원의 투입효과 분석 -서산지역의 개입연구 평가보고-)

  • Bang, Sook;Han, Seung-Hyun;Lee, Chung-Ja;Ahn, Moon-Young;Lee, In-Sook;Kim, Eun-Shil;Kim, Chong-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.20 no.1
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    • pp.165-203
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    • 1987
  • This project was a service-cum-research effort with a quasi-experimental study design to examine the health benefits of an integrated Family Planning (FP)/Maternal & Child health (MCH) Service approach that provides crucial factors missing in the present on-going programs. The specific objectives were: 1) To test the effectiveness of trained nurse/midwives (MW) assigned as change agents in the Health Sub-Center (HSC) to bring about the changes in the eight FP/MCH indicators, namely; (i)FP/MCH contacts between field workers and their clients (ii) the use of effective FP methods, (iii) the inter-birth interval and/or open interval, (iv) prenatal care by medically qualified personnel, (v) medically supervised deliveries, (vi) the rate of induced abortion, (vii) maternal and infant morbidity, and (viii) preinatal & infant mortality. 2) To measure the integrative linkage (contacts) between MW & HSC workers and between HSC and clients. 3) To examine the organizational or administrative factors influencing integrative linkage between health workers. Study design; The above objectives called for quasi-experimental design setting up a study and control area with and without a midwife. An active intervention program (FP/MCH minimum 'package' program) was conducted for a 2 year period from June 1982-July 1984 in Seosan County and 'before and after' surveys were conducted to measure the change. Service input; This study was undertaken by the Soonchunhyang University in collaboration with WHO. After a baseline survery in 1981, trained nurses/midwives were introduced into two health sub-centers in a rural setting (Seosan county) for a 2 year period from 1982 to 1984. A major service input was the establishment of midwifery services in the existing health delivery system with emphasis on nurse/midwife's role as the link between health workers (nurse aids) and village health workers, and the referral of risk patients to the private physician (OBGY specialist). An evaluation survey was made in August 1984 to assess the effectiveness of this alternative integrated approach in the study areas in comparison with the control area which had normal government services. Method of evaluation; a. In this study, the primary objective was first to examine to what extent the FP/MCH package program brought about changes in the pre-determined eight indicators (outcome and impact measures) and the following relationship was first analyzed; b. Nevertheless, this project did not automatically accept the assumption that if two or more activities were integrated, the results would automatically be better than a non-integrated or categorical program. There is a need to assess the 'integration process' itself within the package program. The process of integration was measured in terms of interactive linkages, or the quantity & quality of contacts between workers & clients and among workers. Intergrative linkages were hypothesized to be influenced by organizational factors at the HSC clinic level including HSC goals, sltrurture, authority, leadership style, resources, and personal characteristics of HSC staff. The extent or degree of integration, as measured by the intensity of integrative linkages, was in turn presumed to influence programme performance. Thus as indicated diagrammatically below, organizational factors constituted the independent variables, integration as the intervening variable and programme performance with respect to family planning and health services as the dependent variable: Concerning organizational factors, however, due to the limited number of HSCs (2 in the study area and 3 in the control area), they were studied by participatory observation of an anthropologist who was independent of the project. In this observation, we examined whether the assumed integration process actually occurred or not. If not, what were the constraints in producing an effective integration process. Summary of Findings; A) Program effects and impact 1. Effects on FP use: During this 2 year action period, FP acceptance increased from 58% in 1981 to 78% in 1984 in both the study and control areas. This increase in both areas was mainly due to the new family planning campaign driven by the Government for the same study period. Therefore, there was no increment of FP acceptance rate due to additional input of MW to the on-going FP program. But in the study area, quality aspects of FP were somewhat improved, having a better continuation rate of IUDs & pills and more use of effective Contraceptive methods in comparison with the control area. 2. Effects of use of MCH services: Between the study and control areas, however, there was a significant difference in maternal and child health care. For example, the coverage of prenatal care was increased from 53% for 1981 birth cohort to 75% for 1984 birth cohort in the study area. In the control area, the same increased from 41% (1981) to 65% (1984). It is noteworthy that almost two thirds of the recent birth cohort received prenatal care even in the control area, indicating that there is a growing demand of MCH care as the size of family norm becomes smaller 3. There has been a substantive increase in delivery care by medical professions in the study area, with an annual increase rate of 10% due to midwives input in the study areas. The project had about two times greater effect on postnatal care (68% vs. 33%) at delivery care(45.2% vs. 26.1%). 4. The study area had better reproductive efficiency (wanted pregancies with FP practice & healthy live births survived by one year old) than the control area, especially among women under 30 (14.1% vs. 9.6%). The proportion of women who preferred the 1st trimester for their first prenatal care rose significantly in the study area as compared to the control area (24% vs 13%). B) Effects on Interactive Linkage 1. This project made a contribution in making several useful steps in the direction of service integration, namely; i) The health workers have become familiar with procedures on how to work together with each other (especially with a midwife) in carrying out their work in FP/MCH and, ii) The health workers have gotten a feeling of the usefulness of family health records (statistical integration) in identifying targets in their own work and their usefulness in caring for family health. 2. On the other hand, because of a lack of required organizational factors, complete linkage was not obtained as the project intended. i) In regards to the government health worker's activities in terms of home visiting there was not much difference between the study & control areas though the MW did more home visiting than Government health workers. ii) In assessing the service performance of MW & health workers, the midwives balanced their workload between 40% FP, 40% MCH & 20% other activities (mainly immunization). However, $85{\sim}90%$ of the services provided by the health workers were other than FP/MCH, mainly for immunizations such as the encephalitis campaign. In the control area, a similar pattern was observed. Over 75% of their service was other than FP/MCH. Therefore, the pattern shows the health workers are a long way from becoming multipurpose workers even though the government is pushing in this direction. 3. Villagers were much more likely to visit the health sub-center clinic in the study area than in the control area (58% vs.31%) and for more combined care (45% vs.23%). C) Organization factors (admistrative integrative issues) 1. When MW (new workers with higher qualification) were introduced to HSC, it was noted that there were conflicts between the existing HSC workers (Nurse aids with less qualification than MW) and the MW for the beginning period of the project. The cause of the conflict was studied by an anthropologist and it was pointed out that these functional integration problems stemmed from the structural inadequacies of the health subcenter organization as indicated below; i) There is still no general consensus about the objectives and goals of the project between the project staff and the existing health workers. ii) There is no formal linkage between the responsibility of each member's job in the health sub-center. iii) There is still little chance for midwives to play a catalytic role or to establish communicative networks between workers in order to link various knowledge and skills to provide better FP/MCH services in the health sub-center. 2. Based on the above findings the project recommended to the County Chief (who has power to control the administrative staff and the technical staff in his county) the following ; i) In order to solve the conflicts between the individual roles and functions in performing health care activities, there must be goals agreed upon by both. ii) The health sub·center must function as an autonomous organization to undertake the integration health project. In order to do that, it is necessary to support administrative considerations, and to establish a communication system for supervision and to control of the health sub-centers. iii) The administrative organization, tentatively, must be organized to bind the health worker's midwive's and director's jobs by an organic relationship in order to achieve the integrative system under the leadership of health sub-center director. After submitting this observation report, there has been better understanding from frequent meetings & communication between HW/MW in FP/MCH work as the program developed. Lessons learned from the Seosan Project (on issues of FP/MCH integration in Korea); 1) A majority or about 80% of the couples are now practicing FP. As indicated by the study, there is a growing demand from clients for the health system to provide more MCH services than FP in order to maintain the achieved small size of family through FP practice. It is fortunate to see that the government is now formulating a MCH policy for the year 2,000 and revising MCH laws and regulations to emphasize more MCH care for achieving a small size family through family planning practice. 2) Goal consensus in FP/MCH shouBd be made among the health workers It administrators, especially to emphasize the need of care of 'wanted' child. But there is a long way to go to realize the 'real' integration of FP into MCH in Korea, unless there is a structural integration FP/MCH because a categorical FP is still first priority to reduce the rate of population growth for economic reasons but not yet for health/welfare reasons in practice. 3) There should be more financial allocation: (i) a midwife should be made available to help to promote the MCH program and coordinate services, (in) there should be a health sub·center director who can provide leadership training for managing the integrated program. There is a need for 'organizational support', if the decision of integration is made to obtain benefit from both FP & MCH. In other words, costs should be paid equally to both FP/MCH. The integration slogan itself, without the commitment of paying such costs, is powerless to advocate it. 4) Need of management training for middle level health personnel is more acute as the Government has already constructed 90 MCH centers attached to the County Health Center but without adequate manpower, facilities, and guidelines for integrating the work of both FP and MCH. 5) The local government still considers these MCH centers only as delivery centers to take care only of those visiting maternity cases. The MCH center should be a center for the managment of all pregnancies occurring in the community and the promotion of FP with a systematic and effective linkage of resources available in the county such as i.e. Village Health Worker, Community Health Practitioner, Health Sub-center Physicians & Health workers, Doctors and Midwives in MCH center, OBGY Specialists in clinics & hospitals as practiced by the Seosan project at primary health care level.

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The factors associated with the efficacy of indomethacin treatment in premature infants with patent ductus arteriosus (인도메타신 투여 시 미숙아 동맥관개존 치료효과에 영향을 미치는 인자)

  • Yoon, Min Jeong;Yoon, Hye Sun;Chung, Sung Hoon;Han, Mi Young;Bae, Chong Woo
    • Clinical and Experimental Pediatrics
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    • v.50 no.6
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    • pp.531-535
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    • 2007
  • Purpose : Indomethacin treatment is successful in about 90% of patent ductus arteriosus (PDA) in premature infants, but in some, repeated administration or surgical closure is required. The object of the present study is to determine the factors affecting the efficacy of indomethacin treatment and to predict the treatment result. Method : The 29 preterm neonates, admitted to neonatal intensive care unit of Kyunghee university medical center and Eulji university hospital between September 2002 and April 2006 were diagnosed of PDA and treated with indomethacin. The risk factors that might affect the efficacy of treatment were studied retrospectively. Results : The single-administered group was 19 patients out of 29 (65.5%) and among the repeated-administered group, 5 patients (17.2%) had repeated indomethacin administration and the other 5 patients (17.2%) underwent surgery due to reopening of the duct after repeated medical treatment. In repeated-administered group, the diameter of PDA was significantly larger ($3.66{\pm}0.8mm$ vs $2.55{\pm}0.8mm$, P<0.01), especially when larger than 3.5 mm (sensitivity: 70%, specificity: 89%). Also, the mean postnatal age of the first indomethacin administration was significantly delayed in repeated-administered group (19.7 days vs 12.5 days, P<0.05). There were no significant differences in gestational age (32 wk 5 days vs 30 wk 8 days) and in birth weight (1598.9 g vs 1750.5 g). There were no significant differences in associated morbidities. Conclusion : In patients with larger diameter of PDA (>3.5 mm) and older postnatal age (>7 days), the effect of indomethacin was decreased. Therefore in such cases, repeated dose of indomethacin or surgical ligation should be considered earlier.

Effect of Synagis (palivizumab) prophylaxis on readmission due to respiratory syncytial virus in very low birth weight infants (극소 저체중 출생아에서 Synagis (palivizumab) 접종이 respiratory syncytial virus 감염으로 인한 재입원에 미치는 영향)

  • Park, Soo Kyoung;Jung, Yu Jin;Yoo, Hye Soo;Ahn, So Yoon;Seo, Hyun Joo;Choi, Seo Hui;Kim, Myo Jing;Jeon, Ga Won;Koo, Soo Hyun;Lee, Kyung-Hoon;Chang, Yun Sil;Park, Won Soon
    • Clinical and Experimental Pediatrics
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    • v.53 no.3
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    • pp.358-364
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    • 2010
  • Purpose : The aim of this study was to determine the efficacy of $Synagis^{(R)}$ (palivizumab) in reducing the respiratory syncytial virus (RSV) readmission rate in very low birth weight infants (VLBWI ) and the subgroup that showed the most effective vaccination. Methods : We enrolled 350 VLBWI who had been discharged alive from the neonatal intensive care unit of Samsung Medical Center from January 2005 to December 2007 and were followed up for at least one year. A retrospective study based on medical records was performed for a period of one year after discharge. RSV readmission rate was investigated according to BPD (bronchopulmonary dysplasia, requiring oxygen at postnatal day 28) and $Synagis^{(R)}$ prophylaxis. We categorized the subgroups by the severity of BPD gestational age, and birth weight and compared the RSV readmission rates between subgroups. Results : Eleven VLBWI were readmitted. $Synagis^{(R)}$ prophylaxis resulted in a 86% reduction in the rate of readmission due to RSV infection (prophylaxis group, 0.7% and no prophylaxis group, 5.0%; P =0.02). Readmission rate in BPD patients was also reduced in the prophylaxis group (0.7% in the prophylaxis group vs. 5.2% in the no prophylaxis group, P =0.03). The readmission rate in patients without BPD was reduced in the prophylaxis group (0% in the prophylaxis group vs. 4.9% in the no prophylaxis group, P =1.00), but this was not statistically significant.Conclusion : $Synagis^{(R)}$ prophylaxis was effective at reducing RSV readmission in VLBWI. Its efficacy was verified irrespective of BPD, gestational age, or birth weight.