• Child Health Nursing Research
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• 제9권3호
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• pp.259-271
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• 2003

Purpose: The purpose of this study was to evaluate the effectiveness of sensory stimulation therapy on the physical growth and behaviors of infants accommodated at two Korean orphanages. Method: Thirty-eight full term infants were assigned to a control (n=20) or an experimental (n=18) group within 14 dys of birth. In addition to routine orphanage care, infants in the experimental group received 15 minutes of massage twice a day, 5 days a week for 4 weeks. Result: Compared to the control group, the experimental group had gained significantly more weight and had larger increases in length and head circumference after the 4-week intervention period. In addition, the experimental group showed significantly better behavioral performance in the scoring of habituation (e.g., light), motor (e.g., motor maturity), and state range (e.g., peak of excitement, rapidity of build-up) behavioral clusters of Brazelton's NBAS. Conclusion: These data demonstrate that sensory stimulation therapy may facilitate the physical and behavioral development of the newborn infants placed in the orphanages.

• 말소리와 음성과학
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• 제5권3호
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• pp.55-60
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• 2013

The purpose of this study was to investigate the acoustic characteristics of crying infants according to the communication intents such as hunger and pain in terms of acoustic differences in the fundamental frequency ($F_0$), jitter, shimmer, noise-to-harmonic ratio(NHR), habitual pitch, and intensity. The subjects were 20 healthy, normal infants, less than seven days old, from the city of Seoul and were born after 38 to 42 weeks(full term) of pregnancy. The sound of crying was recorded for three minutes. The crying due to pain was induced by means of the inborn metabolism error test, whereas the crying due to hunger was verified by means of the rooting reflex by waiting for the designated eating time. The results were as follows: (1) the fundamental frequency, noise-to-harmonic ratio(NHR), and intensity of the infants' crying due to pain was higher than that by hunger, showing a significant difference between the mean values. (2) the infants' crying due to hunger and that by pain did not have a significant difference in the mean jitter and shimmer values but both of them were largely outside of the normal threshold values(jitter by 1.04% and shimmer by 3.81%). This study was significant in the sense that it showed the acoustic characteristics of infants' crying from hunger and pain were very different from each other according to the communication intents in terms of the six acoustic parameters.

• Journal of Yeungnam Medical Science
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• 제18권2호
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• pp.287-292
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• 2001

1999년 5월부터 1999년 8월까지 영남대학교 의과대학 부속병원 산부인과에서 정상적으로 출생한 여아 68명을 대상으로 출생당시부터 출생 4일 사이의 신생아들의 음핵크기와 너비를 측정하였다. 본원에서 측정한 신생아들의 평균 음핵 길이의 크기는 $4.7{\pm}1.93$ mm, 음핵귀두의 너비는 $2.6{\pm}1.48$ mm, 음핵귀두의 길이는 $2.4{\pm}1.14$ mm였다. 본 연구에서 재태 기간과 신생아 출생 사이의 음핵 크기 사이에는 유의한 상관관계가 없었고 출생 체중과 음핵 크기 비교에 있어 저체중출생아와 정상체중출생아 사이에는 유의한 상관관계가 있었으며 과체중출생아와 정상체중출생아 사이에는 유의한 역상관관계가 있었다. 태생기에 있어 성호르몬의 분비이상은 태아 성기관의 발달에 이상을 초래하게 되어 출생시에 외생식기의 이상을 나타나게 되는 이를 근거로 성호르몬 분비이상을 확인하게 되어 조기진단에 도움을 받을 수가 있다. 이를 위해 한국 신생여아의 음핵과 음핵귀두 크기의 기준치 설립은 음핵비대여아의 조기 발견에 유용한 지표가 될 수 있다.

• Clinical and Experimental Pediatrics
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• 제50권9호
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• pp.855-861
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• 2007

목 적 : 신생아기에 발생하는 급성 바이러스 장염의 원인중 가장 흔한 4종의 바이러스에 의한 장염의 임상적 특징, 증상, 양성률, 발생분포 등을 알아보고, 생활장소, 수유형태에 따른 차이점을 살펴보고자 하였다. 방 법 : 2004년 9월부터 2005년 8월까지 을지병원 소아과에 설사를 주증상으로 내원하여 급성 바이러스성 장염이 의심되어 입원하였던 이전에 건강했던 생후 4주 미만의 만삭 신생아 중에서 대변의 바이러스 검사가 가능했던 112명을 대상으로 하였다. 환아의 출생력, 임상적 특징, 임상 증상, 수유종류, 생활장소 등을 문진을 통해서 알아보고, 혈액검사, 소변검사, 방사선 검사, 대변에서 로타바이러스, 아스트로바이러스, 노로바이러스, 아데노바이러스 검사를 실시하였다. 결 과 : 112명의 입원 시 평균 나이는 $11.4{\pm}5.4$일, 평균 체중 감소는 $5.9{\pm}5.1%$, 평균 입원 기간은 $6.3{\pm}3.4$일이었고, 중등도 이상의 탈수는 51.7%, 대사성 산증을 동반한 경우는 13.4%였으며 입원 전까지 생활했던 장소는 조리원이 74.1%였고 수유 종류로는 혼합수유가 64.3%로 많았다. 대변에서 4종 바이러스 양성률은 33% 였고, 이중에서 로타바이러스가 59.5%, 아스트로바이러스가 29.7%, 노로바이러스가 10.8%를 차지하였고 아데노바이러스는 검출되지 않았다. 장소에 따른 바이러스 양성률에는 차이가 없었고, 두 곳 모두에서 로타바이러스가 주된 장염 바이러스로 확인되었고, 아스트로바이러스는 산후조리원에서, 노로바이러스는 집에서 각각 의미 있게 많이 검출되었다. 수유 종류에 따른 바이러스 양성률에는 차이가 없었다. 급성 장염의 발생분포는 대부분이 11월에서 12월에 집중되어서 발생하였고, 바이러스가 검출되었던 경우도 전체 분포와 유사한 양상을 보였다. 결 론 : 신생아시기에 바이러스 장염을 일으키는 흔한 4종의 바이러스 양성률은 33%였고, 이중 로타바이러스가 대부분을 차지하였으며, 생활장소나 수유형태에 따른 양성율의 차이는 보이지 않았고, 각 바이러스 간에 임상적 특징에도 차이가 없었다.

• Neonatal Medicine
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• 제25권1호
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• pp.7-15
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• 2018

We need to understand the outcomes into adulthood for survivors born either extremely low birthweight (ELBW; <1,000 g) or extremely preterm (EP; <28 weeks' gestational age), particularly their blood pressure and cardiovascular metabolic status,respiratory function, growth, psychological and mental health performance, and functional outcomes. Blood pressure is higher in late adolescence and early adulthood in ELBW/EP survivors compared with controls. In some studies, expreterm survivors have higher insulin and blood lipid concentrations than controls, which may also increase their risk for later cardiovascular disease. ELBW/EP survivors have more expiratory airflow obstruction than do controls. Those who had bronchopulmonary dysplasia (BPD) in the newborn period have even worse lung function than those who did not have BPD. As a group, they are unlikely to achieve their full lung growth potential, which means that more of them are likely to develop chronic obstructive airway disease in later life. Although they are smaller than term born controls, their weight gradually rises and ultimately reaches a mean z-score close to zero in late adolescence, and they ultimately attain a height z-score close to their mid-parental height z-score. On average, ex-preterm survivors have intelligence quotient (IQ) scores and performance on tests of academic achievement approximately 2/3 SD lower than do controls, and they also perform less well on tests of attention and executive function. They have similar high rates of anxiety and depression symptoms in late adolescence as do controls. They are, however, over-represented in population registries for rarer disorders such as schizophrenia and Autism Spectrum Disorder. In cohort studies, ex-preterm survivors mostly report good quality of life and participation in daily activities, and they report good levels of self-esteem. In population studies, they require higher levels of economic assistance, such as disability pensions, they do not achieve education levels as high as controls, fewer are married, and their rates of reproduction are lower, at least in early adulthood. Survivors born ELBW/EP will present more and more to health carers in adulthood, as they survive in larger numbers.

• Clinical and Experimental Pediatrics
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• 제57권2호
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• pp.75-78
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• 2014

Purpose: This study aimed to investigate the clinical features of macrocephaly at birth in Korea using ultrasonography. Methods: We retrospectively investigated the medical records of full-term birth neonates in Cheil General Hospital & Women's Healthcare Center from January 2000 to June 2012. The following parameters were recorded and analyzed: gestational age, sex, birth weight, height, occipitofrontal circumference (OFC), physical examination, perinatal problems, and ultrasonography results. Macrocephaly was diagnosed when the OFC was greater than two standard deviations, based on the 2007 Korean National Growth Charts. Results: There were 75 neonates with macrocephaly at birth (52 boys and 23 girls), with a mean OFC of $38.1{\pm}0.49cm$. A comparison of the birth weight and height with the OFC value showed that height was correlated with OFC (r=0.35) but birth weight was not correlated with OFC (r=0.06). There were no remarkable findings in 56 cases (75%). Germinal matrix hemorrhage was identified in 10 cases (13%). An enlarged cerebrospinal fluid space was found in 5 cases (6.7%). There were 3 cases of mega-cisterna magna (4%), 1 case of ventriculomegaly, and 1 case of an enlarged interhemispheric space (6 mm) among these patients. In addition, a choroid plexus cyst was seen in 1 case. Mineralizing vasculopathy in both basal ganglia with no evidence of congenital infection was found in 2 cases and an asymptomatic subarachnoid hemorrhage was found in 1 case. Conclusion: Our results indicate that macrocephaly at birth has benign ultrasonography findings and shows a pattern of male dominance.

• Journal of Yeungnam Medical Science
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• 제5권2호
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• pp.161-169
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• 1988

1. 성별 빈도는 남아 42례(1.12%), 여아 13례(0.44%)로 남아에서 여아보다 더 많이 발생 하였고 미숙아에서의 발생 빈도는 2.65%로 만삭아에서 0.76% 보다 높았다. (P<0.05) 2. 발병일 별로는 생후 4일내에 발생한 조기 발병형 신생아 패혈증은 26례(47.3%)였으며, 생후 5일 이후에 발생한 만기 발병형 신생아 패혈증은 29례(52.7%)였고, 조기발병형 신생아 패혈증에서 주산기 합병증의 빈도가 만기 발병형 신생아 패혈증보다 높았다(38.5% vs 10.3%, P<0.05). 3. 임상소견으로는 수유곤란 52.7%로써 가장 많았고 황달(45.5%), 설사(30.9%), 보챔(30.9%) 등의 순으로 나타났다. 4. 검사상 소견으로는 미성숙 백혈구수가 20% 이상인 경우와 CRP가 1+ 이상인 경우가 진단에 도움이 되었다. 5. 원인균으로는 그람 양성균이 37례, 그람음성균이 19례였으며 그람 양성균중에서는 Staphylococcus epidermidis가 23례(41.1%)로 가장 많았고 그람 음성균중에서는 E. coli가 9례(16.1%)로 가장 많았으며 조기 발병형 신생아 패혈증과 만기 발병형 신생아 패혈증간의 원인균의 차이는 없었다.

• Clinical and Experimental Pediatrics
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• 제52권10호
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• pp.1175-1180
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• 2009

신생아 폐고혈압 지속증은 치료가 힘들고 사망률이 높은 질환이나, 산화질소 흡입 치료가 시행된 이후 사망률의 많은 감소를 가져왔다. 그러나, 신생아 집중 치료실이 있는 병원이라도 이러한 산화질소 흡입 치료가 가능하지 않는 곳이 많고, 산화질소 투여에도 호전되지 않는 경우도 있다. 흡입 iloprost는 최근 원발성 혹은 이차성 폐고혈압 환자에서 사용이 늘고있는 폐동맥 확장제로, 신생아 폐고혈압 지속증에 사용한 증례가 외국에 보고된 바 있다. 환아는 출생시 심한 태변 착색과 출산 질식, 진행되는 저산소증을 보였으며, 신생아 폐고혈압 지속증으로 진단되었다. 환아는 지속적인 저산소증을 보였으며, 통상적인 지지 치료에도 호전되지 않았다. 당시 저자들의 병원에는 산화질소 흡입 치료가 가능하지 않아, iloprost 흡입 치료를 시도하였다. Iloprost 흡입 치료 이후 수시간 내에 산소 포화도가 증가하였으며, 심초음파상에는 동맥관을 통한 우좌 단락이 좌우로 바뀌었고, 우심실 압력이 감소하였다. Iloprost 흡입 치료를 하는 동안 특별한 부작용은 관찰되지 않았다. 저자들은 산화질소 흡입치료가 가능하지 않은 상황에서 신생아 폐고혈압 지속증 신생아의 치료로 iloprost 흡입 치료를 시도한 경험을 보고하는 바이다.

• Advances in pediatric surgery
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• 제5권2호
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• pp.146-151
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• 1999

Neurocristopathy originates from aberrant development of the neural crest by genetic abnormality. Dysgenetic or neoplastic neurocristopathy mayor may not combine at one or more organs. Congenital central hypoventilation syndrome (Ondine's curse) is characterized by the respiratory depression during sleep, although showing normal ventilation while awake, because the baby does not responde to hypercapnea or hypoxia. One newborn girl, full-term, 3,020 g of birth weight with neurocristopathy is reported. It showed poor respiration at birth, and temporary Improvement with oxygen and respiratory stimulations. Abdomen was distended. Abdominal x-ray revealed small bowel obstruction and calcified opacity at the right lower quadrant. Because transitional zone was noticed at the distal jejunum during laparotomy, jejunostomy was performed. Several times trial of extubation have failed becaused of the repeated apneas. Brain sonography and echocardiogram were normal. The patient died of sepsis at 37 days of age. Para-aortic ganglioneuroblastoma was found at autopsy. In this case, congenital central hypoventilation syndrome, Hirschsprung's disease and congenital ganglioneuroblastoma are combined as a neurocristopathy.

• Neonatal Medicine
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• 제28권3호
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• pp.133-138
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• 2021

Osteopetrosis refers to a group of genetic skeletal disorders characterized by osteosclerosis and fragile bones. Osteopetrosis can be classified into autosomal dominant, autosomal recessive, or X-linked forms, which might differ in clinical characteristics and disease severity. Autosomal recessive osteopetrosis, also known as malignant osteopetrosis, has an earlier onset, more serious clinical symptoms, and is usually fatal. We encountered a 1-day-old girl who was born full-term via vaginal delivery, which was complicated by meconium-stained amniotic fluid, cephalo-pelvic disproportion, and nuchal cord. Routine neonatal care was provided, in addition to blood tests and chest radiography to screen for sepsis, as well as skull radiography to rule out head injuries. Initial blood tests revealed hypocalcemia, which persisted on follow-up tests the next day. Radiographic examinations revealed diffusely increased bone density and a "space alien" appearance of the skull. Based on radiographic and laboratory findings, the infantile form of osteopetrosis was suspected and genetic testing for identification of the responsible gene. Eventually, a heterozygous mutation of the T cell immune regulator 1, ATPase H+ transporting V0 subunit a3 (TCIRG1) gene (c.292C>T) was identified, making this the first reported case of neonatal-onset malignant osteopetrosis with TCIRG1 mutation in South Korea. Early-onset hypocalcemia is common and usually results from prematurity, fetal growth restriction, maternal diabetes, perinatal asphyxia, and physiologic hypoparathyroidism. However, if hypocalcemia persists, we recommend considering 'infantile of osteopetrosis' as a rare cause of neonatal hypocalcemia and performing radiographic examinations to establish the diagnosis.