• Title/Summary/Keyword: Neonatal Period

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Hematologic Status of Newborn Infants of Mother with Pregancy-induced Hypertension (임신성 고혈압 산모의 태아의 혈액상)

  • Lee, Doo-Jin;Koh, Min-Whan;Lee, Sung-Ho
    • Journal of Yeungnam Medical Science
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    • v.11 no.2
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    • pp.352-362
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    • 1994
  • To evaluate the effects of pregnancy-induced hypertension (PIH) to the iron status of fetuses, umbilical cord blood of 35 newborn infants borne by PIH mothers and of 37 normal term infants delivered at Yeungnam University Hospital from September 1, 1993 to September 30, 1994, were studied. The serum hemoglobin concentration of women with PIH was significantly higher than normal full-term pregnant women. There was no significant difference in serum hemoglobin concetration between women with PIH and normal full-term pregnant women and their newborn infants. There was no significant difference in serum hemoglobin concentration beween infants of women with PIH and normal full-term infants. The serum iron concentration of newborn infants of women with PIH was higher and the serum ferritin concentration of newborn infants of women with PIH was lower than normal full-term infants, but there were no significant difference between the two groups. The serum total iron-binding capactity and unsaturated iron-binding capacity of infants of women with PIH were significantly higher than normal full-term infants. The newborn infants of PIH women seemed that they might have occult depletion of iron store and need meticulous follow up during early neonatal period.

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Acid Steatocrit in Korean Infants (한국 영아의 Acid Steatocrit에 대한 연구)

  • Park, Ji He;Chung, So Chung;Song, Jun Soup;Kim, Kyo Sun
    • Clinical and Experimental Pediatrics
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    • v.45 no.3
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    • pp.320-324
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    • 2002
  • Purpose : Steatorrhea tests have been developed using various methods. Acid steatocrit is a simple method to detect steatorrhea and has very high sensitivity and specificity. This present study was designed to establish the normal values of acid steatocrit in Korean infants and to find the difference according to the various feeding methods. Methods : Acid steatocrit tests were conducted on 128 infants who were under 12 months of age and who had non-specific gastrointestinal diseases between May 1998 and April 2001. The results were classified into neonatal ages(79 neonates), 1-6 months(28 infants), 7-12 months(21 infants). This included formula-fed(46 neonates) and human milk-fed(33 neonates), 1-6 months formula-fed (18 infants) and human milk-fed(10 infants), 7-12 months formula-fed(11 infants) and human milk-fed(10 infants). Results : The acid steatocrit values decreased by infant age in months. Acid steatocrit values decreased much more after 7 months of ages. The acid steatocrit values of human milk-fed infants were significantly lower than those of formula-fed infants. Conclusion : Our study confirms that a physiologic steatorrhea was found in the infant period and decreases by infant age of months. The acid steatocrit test might be useful for the evaluation of gastrointestinal milk fat malabsorption disorders and therapeutic effects.

Partial Budget Modeling of Economic Losses of Aujeszky's Disease (부분예산분석을 이용한 오제스키병 발생 농가의 경제적 손실 추정)

  • Pak, Son-Il;Park, Choi-Kyu;Moon, Oun-Kyong;Yoon, Hachung;Lee, Byeong-Yong;Lee, Sang-Jin
    • Korean Journal of Veterinary Research
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    • v.49 no.4
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    • pp.329-334
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    • 2009
  • Aujeszky's disease (AD) is a respiratory, infectious viral illness associated with high mortality, especially in neonatal piglets and has frequently been considered an economically important disease in many endemic countries. Although AD is still occurring in a geographically defined region in Korea, little attention has been paid to the economics of AD. In this study, partial budget technique was used to develop a simulation model to measure financial losses following the disease epidemic in a swine operation utilizing stochastic or deterministic parameters from the literatures and the index case herd of AD occurred in 2005, where available and applicable. For the infected case herd with a 12500-pig, the total economic loss for this operation was estimated to be about 199 million Korean won (95% confidence interval [CI] 148,645,000-250,741,000). Given net loss due to death of a pig at sow level was 119,000 won, total loss for the case herd with 1200 sows accounted for 143 million won (95% CI 92,599,000-193,729,000). The net loss of the death of one pig at growing and fattening level resulted in loss of 46,000 won (95% CI 40,000-53,000) and 126,000 won (95% CI 122,000-131,000), respectively. Taking into account for the number of pigs raised in the case herd, total loss amounted to 8 million won (95% CI 7,167,000-9,347,000) and 12 million won (95% CI 11,959,000-12,891,000), for growers and fatteners, respectively, assuming 63% of saved feed intake when a pig dies halfway through the respective period. Under the model's assumptions, suckling pig mortality was the major factors of loss in estimating the economic consequences (approximately 71.8% of the total loss). The high economic losses of a herd infected with AD suggest that the effective and region-specific control measures should be implemented in disease endemic foci.

Surgical Ligation on Significant Patent Ductus Arteriosus in Very Low Birth Weight Infants: Comparison between Early and Late Ligations

  • Lee, Jun Ho;Ro, Sun Kyun;Lee, Hyun Ju;Park, Hyun Kyung;Chung, Won-Sang;Kim, Young Hak;Kang, Jeong Ho;Kim, Hyuck
    • Journal of Chest Surgery
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    • v.47 no.5
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    • pp.444-450
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    • 2014
  • Background: We aimed to evaluate the efficacy and safety of early surgical ligation (within 15 days of age) over late surgical ligation (after 15 days of age) by a comparative analysis of very low birth weight (VLBW) infants undergoing surgical correction for symptomatic patent ductus arteriosus (PDA) over the course of 6 years in our hospital. Methods: We retrospectively reviewed all the medical records in the neonatal intensive care unit at Hanyang University Seoul Hospital, from March 2007 to May 2013, to identify VLBW infants (<1,500 g) who underwent surgical PDA ligation. Results: The gestational age (GA) in the late ligation (LL) group was significantly younger than in the early ligation (EL) group (p=0.010). The other baseline characteristics and preoperative conditions did not differ significantly between the two groups. The intubation period before surgery (p<0.001) and the age at surgery (p<0.001) were significantly different. The postoperative clinical outcomes of the study patients, including major morbidity and mortality, are summarized. There were no significant differences in bronchopulmonary dysplasia, sepsis, or mortality between the EL and the LL groups. However, the LL group was significantly associated with an increased risk of necrotizing enterocolitis (p=0.037) and with a prolonged duration of the total parenteral nutrition (p=0.046) after adjusting for GA. Conclusion: Early surgical ligation for the treatment of PDA that failed to close after medical treatment or in cases contraindicated for medical treatment might be desirable to reduce the incidence of necrotizing enterocolitis and to alleviate feeding intolerance in preterm infants.

The Efficacy and Safety of High Dose Amino Acid Administration to Preterm Infants in the Early Neonatal Period (미숙아의 출생초기에 고용량 아미노산 투여의 유효성 및 안전성 평가)

  • Yoon, Ji-Hye;Park, Hyo-Jung;Han, Chae-Won;Chang, Hyo-In;Chung, Seon-Young;In, Yong-Won;Lee, Young-Mi;Sohn, Kie-Ho
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.4
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    • pp.316-323
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    • 2012
  • 미숙아는 단백질 대사 속도가 빠르기 때문에 성장이 충분히 이루어질 수 있도록 ASPEN 가이드라인에서는 아미노산 초기용량을 1-2 g/kg/day로 투여하도록 권장하고 있다. 또한 최근 여러 연구에서 출생초기 고용량 (1.5-4 g/kg/day) 아미노산 투여에 대해 보고하고 있다. 이를 근거로 하여 삼성서울병원 신생아 중환자실에서도 2009년 6월부터 아미노산 초기용량을 0.5 g/kg/day에서 1.5~2 g/kg/day으로 증량하여 투여하고 있다. 본 연구에서는 신생아 중환자실에서 정맥영양요법을 받은 미숙아를 대상으로 고용량 아미노산 공급 효과를 평가하고자 하였다. 2009년 6월 기준으로 출생 후 48시간 이내에 0.5 g/kg/day로 아미노산을 투여 받은 저용량 환아군(38명: 대조군)과 1.5~2 g/kg/day로 투여 받은 고용량 환아군(38명: 시험군)의 전자의무기록을 후향적으로 검토하였다. 고용량 아미노산 공급 효과를 체중증가량 및 총 정맥영양기간, 경구 및 경장 영양 시작 시기, 재원기간으로 평가하였고, 안전성 평가를 위해 혈액화학검사 및 합병증을 조사하였다. 또한 두 군의 인구학적 및 주산기 인자, 영양 공급량 등에 대해 조사하였다. 두 군의 인구학적 및 주산기 인자는 재태기간에서만 차이를 보였으며, 시험군에서 재태기간이 길었다(p < 0.05). 초기 아미노산 용량만이 생후 28일간 일평균 체중증가량에 영향을 미치는 인자였으며 시험군의 일평균 체중증가량이 대조군보다 유의하게 큰 것으로 나타났다($12.6{\pm}4.5$ g/day vs $9.8{\pm}4.5$ g/day, p < 0.05). 목표 체중증가량에 도달한 비율도 시험군이 높았다(65.8% vs 47.4%). 총 공급열량, 총 정맥영양 공급 기간과 경구 및 경장 영양 시작 시기는 두 군간 차이가 없었으나 시험군에서 목표열량 도달시간, 신생아 중환자실 재원기간이 단축되었다(p < 0.05). 혈액화학검사 결과 및 대사성 산증, 호흡곤란증후군, 괴사성장염 발생은 두 군간 차이가 없었으며 고혈당 및 감염, 기관지폐이형증, 뇌실내출혈 발생률은 대조군에서 유의하게 높았다(p < 0.05). 연구 결과, 미숙아에서 출생 초기 고용량 아미노산 공급은 혈액화학검사 이상이나 합병증 없이 체중증가와 재원기간 감소에 효과가 있음을 확인하였다. 따라서 미숙아에 대한 출생초기 영양지원으로 1.5~2 g/kg/day 아미노산 공급은 안전하고 효과적이라고 사료된다.

Diagnostic Strategy Using Barium Enema and Rectal Suction Biopsy with Acetylcholinesterase Histochemistry in Neonates with Suspious Hirschsprung's Disease (신생아 Hirschsprung's Disease에서 Barium Enema와 Acetylcholinesterase 조직화검사법을 이용한 진단적 접근)

  • Choi, Young-Il;Choi, Soon-Ok;Park, Woo-Hyun
    • Advances in pediatric surgery
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    • v.7 no.2
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    • pp.105-111
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    • 2001
  • To investigate the diagnostic accuracy and applicability of barium enema(BE) and rectal suction biopsy with acetyl cholinesterase(AChE) histochemistry in the diagnosis of neonatal Hirschsprung's disease(HD), we retrospectively reviewed the findings of BE and AChE staining in 96 neonates with suspected HD during a 10-year period from January 1991 to December 2000. Sixty-nine cases of HD(58 males and 11 females) and 27 cases of non-HD are included in this study. In regard to BE, HD was based on definite transitional zone, suspicious HD on reversed rectosigmoid index(RSI <1), and non-HD on normal RSI(RSI>1). The histochemical criterion used for the diagnosis of HD was that of Chow et al(1977), i.e., the presence of many coarse discrete cholinergic nerve fibers in the muscularis mucosae and in the immediately subjacent submucosa regardless of infiltration of cholinergic nerve fibers in the lamina propria. Of 66 neonates with HD who underwent BE, transitional zone was identified in 33 cases(50 %) and reversed RSI in 19 cases(21 %), microcolon in 4 cases and normal finding in 10 cases(15 %) while of 27 neonates with non-HD, there was normal finding in 16 cases and reversed RSI in 9 cases(41 %). Thus diagnostic accuracy based on transitional zone was 64 %. The positive predictive value of reversed RSI for the diagnosis of HD was 68 %. Of 42 neonates with HD who underwent AChE histochemistry, there were 41 AChE-positive reactions and one AChE-negative reaction in a neonate with total colonic aganglionosis, while of 27 cases of non-HD, there were one equivocal AChE-positive reaction and 26 AChE-negative reactions. Thus AChE histochemical study showed a 97 % diagnostic accuracy with a 98 % sensitivity and a 96 % specificity. In conclusion, we believe that BE is valuable as a first diagnostic step since about 80 % of neonates with HD show significant radiologic findings such as a transitional zone or reversed RSI. AChE histochemical study was a more reliable diagnos tic tool showing a 97 % diagnostic accuracy, and is part.

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Regional outbreak of staphylococcal scalded skin syndrome in healthy children (건강한 소아에서 포도알균화상피부증후군의 지역적 유행)

  • Do, Hyun Jeong;Park, Eun Sil;Lim, Jae Young;Park, Chan Hoo;Woo, Hyang Ok;Youn, Hee Shang;Seo, Ji Hyun
    • Clinical and Experimental Pediatrics
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    • v.53 no.1
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    • pp.48-55
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    • 2010
  • Purpose : Staphylococcal scalded skin syndrome (SSSS) is a relatively uncommon superficial blistering skin disease that is due to Staphylococcus aureus. We had experienced a regional outbreak of SSSS over 3 years in healthy children. Methods : We retrospectively reviewed the medical records of those patients diagnosed as SSSS. Most of neonatal cases were nosocomial infections and excluded from the analysis. The clinical features, laboratory findings, the isolation and antibiotic resistance of S. aureus, the antibiotic management and other supportive treatments were analyzed. Results : Fifty-five patients with SSSS were admitted to our hospital from October 2001 to September 2004. The median age of patients was 3.0 years. Of the 55 patients, 9 were the generalized type, 13 were the intermediate type and 33 were the scarletiniform rash. All the patients were living in neighborhood of the Jinju area. S. aureus were isolated from 9 of the patients and all of the isolated S. aureus were methicillin resistant. All the patients except two were treated with intravenous flocloxacillin or nafcillin and/or cefotaxime. All the patients recovered during the follow-up period of 2 to 3 weeks. Conclusion : We experienced a regional outbreak of SSSS in previous healthy children. Further study for finding the carriers of S. aureus caused SSSS and preventing the spread of this disease is needed. Additionally, guidelines for treating SSSS due to methicillin resistant S. aureus should be established.

The Effects of Phone Counseling on Maternal Role in Primiperous Mothers (전화 상담이 초산모의 모성 역할에 미치는 영향)

  • Kang So-Jeong
    • Child Health Nursing Research
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    • v.7 no.4
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    • pp.405-420
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    • 2001
  • The main purpose of this study was to identify the effect of phone counseling carried out to promote the role of the primiperous mothers. The data were collected from march 20 to may 30, 1998. The subjects for the study were the mothers of 60 first bon neonates admitted to and discharged from Sam-sung Medical Center's neonatal ward. Thirty subjects were assigned to the experimental group and thirty to the control group. A measure of maternal identity as well as level of self confidence in taking care of an infant after giving birth was taken. Informational supportive nursing was then provided to the mothers through phone counseling for a total of four times at 2~3 days, 7~8days, 12∼13days and 18∼1days after discharged. The level of self confidence in taking care of an infant was then remeasured. The control group was not provided with supportive nursing through phone counseling instead the level of confidence in taking care of an infant was measured at 3 weeks. Taking previous study documentary evidence into consideration the researcher developed a supportive nursing telephone counseling program that provided both informational and emotional support suitable to primiperous mothers. A semantic differential scale developed according to Osgood and translated and adapted by Koh Hyo-Jung was used as the maternal self identity measurement tool. The tool used to measure self confidence in taking care of infant was the developed by Bak Mi Suk which includes 13 items from Pharis's self confidence scale The data were analyzed using χ²-test, t-test and paired t-test. The result of the study are as follows 1. First hypothesis The level of self confidence in taking care of an infant for the group of primiparas who received phone counseling in the postpartum period would be higher than that of the primiparas who did not receive phone counselling : As the experimental group's level of self confidence in taking care infants was significantly higher than that of the control group this hypothesis is accepted 2. Second hypothesis The level of maternal identity will be higher for the group of primiparas who received phone counseling than that of primiparas who did not received phone counseling As the experimental group's level of maternal identity was significantly higher than that of the control group this hypothesis is accepted In looking at the results of the study as a whole, it can be concluded that emotional and informational nursing support provided through phone counselling is an effective strategy in promoting the role of new mothers.

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A case of Smith-Lemli-Opitz syndrome diagnosed by identification of mutations in the 7-dehydrocholesterol reductase (DHCR7) gene (7-dehydrocholesterol reductase (DHCR7) 변이로 진단된 Smith-Lemli-Opitz 증후군 1예)

  • Park, Mee Rim;Ko, Jung Min;Cheon, Chong-Keun;Kim, Gu-Hwan;Yoo, Han-Wook
    • Clinical and Experimental Pediatrics
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    • v.51 no.11
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    • pp.1236-1240
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    • 2008
  • Smith-Lemli-Opitz syndrome (SLOS) is a rare, autosomal recessive disease caused by an inborn error in cholesterol synthesis. Patients with this disease suffer from multiple malformations due to reduced activity of 7-dehydrocholesterol reductase (DHCR7), which increases 7-dehydrocholesterol (7DHC) and 8-dehydrocholesterol (8DHC) concentrations and decreases cholesterol concentration in body fluids and tissue. The SLOS phenotypic spectrum ranges from a mild disorder with behavioral and learning problems to a lethal disease characterized by multiple malformations. Here, we describe a newborn male with ambiguous genitalia who was diagnosed to have type II SLOS during the neonatal period. A clinical examination revealed low levels of unconjugated estriol in the maternal serum, and a variety of fetal ultrasound anomalies, including prenatal growth retardation. After birth, the infant was diagnosed to have congenital heart disease (Tetralogy of Fallot with severe pulmonary artery stenosis), cleft lip and palate, micrognathia, postaxial polydactyly, ambiguous genitalia, and cataracts. Clinical investigation revealed extremely low plasma cholesterol levels and the presence of mutation (homozygote of p.Arg352Gln) in the DHCR7 gene. The patient underwent palliative heart surgery (to widen the pulmonary artery) and received intravenous lipid supplementation. Cholesterol levels increased slightly, but not to normal values. The patient died from cardiopulmonary failure and sepsis 72 days after birth. This report provides the first description of a Korean patient with SLOS confirmed by verification of DHCR7 gene mutation and illustrates the need for early recognition and appropriate diagnosis of this disease.

Genetic Polymorphisms of Candidate Loci and Inheritance Ppatterns of Gray Coat Color in Jeju Horses. (제주마에서 총마 모색의 유전 양성과 후보 유전좌위의 유전적 다형성)

  • Han, Sang-Hyun;Lee, Chong-Eon;Kim, Nam-Young;Ko, Moon-Suck;Jeong, Ha-Yeon;Lee, Sung-Soo
    • Journal of Life Science
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    • v.19 no.6
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    • pp.793-798
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    • 2009
  • This study was undertaken to reveal the relationship between genetic variations and inheritance patterns and the development of a systemic white coat color frequently observed in Jeju horses. It was determined that the white coat color occurred in all basic coat colored (black, bay and chestnut) horses by combining the phenotype and MC1R genotypes. There were no polymorphisms found in Jeju horses tested for mutational loci in the KIT gene, which were previously reported as potential mutations of the congenital dominant white coat color in other horse breeds in heterogeneity. The horses that had the 4.6-kb duplication in the STX17 intron 6 specifically showed the depigmented white coat color. Based on observation and STX17 genotypes, this depigmented whitening is defined as 'Chongma' (whitening, progressive graying with age-Gray) in Jeju horses. Pedigrees showed that this is an autosomal dominant inheritance pattern distinct from the bovine albinism caused by an autosomal recessive passion eye color. Because the gray phenotype is generally not completely expressed early in Jeju horses, it often makes them indistinguishable from other horses. Further studies are recommended for classification between the gray coat color and its similar phenotypes, such as the roan with its mixed hair colors appearing since neonatal period, acquired white hairs on wounded skin by veterinary treatment, and vitiligo-like skin pigmentation. However, study results revealing the relationship between the gray phenotype and genetic background suggested that useful information may be provided in regards to molecular breeding of Jeju horses.