• Advances in pediatric surgery
• /
• v.2 no.1
• /
• pp.68-71
• /
• 1996

Esophageal atresia(EA) with a double tracheoesophageal fistula(TEF) is rare. It accounts for only 0.7% of all cases of EA and TEF. A male newborn weighing 2860g was born by normal vaginal delivery at 41 weeks' gestation to a 27-year-old mother who had a normal pregnancy. But immediately developed recurrent choking and respiratory distress. Feeding tube was inserted and chest X ray showed the feeding tube coiled in the proximal pouch(T-2 level). With a preoperative diagnosis of EA and distal TEF, the thoracotomy was performed on the third day of life. At thoracotomy, TEF was proved to be a double fistula. Both fistulas were divided and an esophageal anastomosis was performed. The postoperative course was uncomplicated until the eighth postoperative day when a minor anastomotic leak. The patient was discharged at 103 days of age.

• Journal of Korean Neurosurgical Society
• /
• v.56 no.4
• /
• pp.334-337
• /
• 2014

Objective : The purpose of this study is to identify the risk factors associated with the development of germinal matrix-intraventricular hemorrhage (GM-IVH) and the relationship of the severity of disease and prematurity. Methods : A total of 168 premature neonates whose birth weight ${\leq}1500g$ or gestational age ${\leq}34$ weeks were examined by cranial ultrasound (CUS) for detection of GM-IVH among the babies admitted between January 2011 and December 2012 in our medical center neonatal intensive care unit. The babies were divided into two groups : GM-IVH and non-IVH. Clinical presentations, precipitating factors of the patients and maternal factors were analyzed. Results : In univariate analysis, gestational age, birth weight, delivery method, presence of premature rupture of membrane (PROM) and level of sodium and glucose were statistically meaningful factors (p<0.05). But only two factors, gestational age and presence of patent ductus arteriosus (PDA) were statistically meaningful in multivariate logistic regression (p<0.05). Delivery method [normal vaginal delivery (NVD) to Caeserean section] was borderline significant (p<0.10). Conclusion : Presence of PDA and gestational age were the important risk factors associated with development of GM-IVH.

• Women's Health Nursing
• /
• v.11 no.3
• /
• pp.202-208
• /
• 2005

Purpose: This study was conducted to discover the related factors of neonatal suckling in the initiation of breastfeeding in primiparous mothers and to provide basic data for promoting nursing intervention strategies to improve the practice of breastfeeding. Method: The subjects of this study were 71 primiparous mothers who had normal vaginal deliveries at one obstetric hospital in P metropolitan city and one delivery center in J city. The collected data was analyzed using the SPSS program. Result: The average IBFAT(Infant Breastfeeding Assessment Tool) score was 9.6$\pm$2.3. The general characteristics studied that had a significant influence on neonatal suckling in the initiation of breastfeeding were the place of delivery (ex: Hospital, Postnatal Unit), whether oxytocin was used, no usage of analgesic medication, amount of satisfaction after the first breastfeeding weight of the newborns and the Apgar score at one minute. Conclusions: A higher IBFAT score was related to primiparous mothers who had a hospital delivery, received oxytocin, received maternal labour analgesics, neonatal weight, Apgar score at one minute, and satisfaction after the first breastfeeding.

• Women's Health Nursing
• /
• v.24 no.1
• /
• pp.58-70
• /
• 2018

Purpose: To provide accurate information on induced labor and find strategies to enhance women's childbirth satisfaction. Methods: Participants were pregnant women expected to have normal vaginal delivery. A total of 113 women with induced labor and 61 women with spontaneous labor were surveyed. Data were collected using a questionnaire and electronic medical records. Results: The following variables related to labor progress showed significant differences between the induced labor group and the spontaneous labor group: length of the first stage of labor in primigravidas, use of analgesic, incidence of uterine hyperstimulation, incidence of fetal distress, and medical treatment for the expectant mother. Delivery type and the incidence of postpartum complications showed significant difference between the two groups. Induced labor women's childbirth satisfaction was mainly affected by the process of labor whereas spontaneous labor women's childbirth satisfaction was affected by the outcome of childbirth. Conclusion: Medical staff should have accurate information on the risk of induced labor and the benefits of a natural delivery. Moreover, medical staff should provide necessary information and environment for women to participate in the decision-making process.

• Childhood Kidney Diseases
• /
• v.11 no.2
• /
• pp.195-202
• /
• 2007

Purpose : The normal flora, which was suggested to prevent infection, is acquired first from the birth canal and develops by dietary factors. Here presents a case-control study, aimed to evaluate the postnatal acquisition factors relating to the achievement of the normal flora in infants with urinary tract infection (UTI). Methods : 115 UTI infants, admitted at Ewha Womans University Mokdong Hospital from 2004 to 2005 and 116 age-matched control infants, who had visited well baby clinic, were evaluated. The suggested postnatal acquisition factors of the normal flora such as vaginal delivery, breast feeding, probiotics and yogurt intake and their relationship with UTI were evaluated. Results : The rate of vaginal delivery was 50%(58/l15) in UTI infants, which was not significantly different from 60%(69/116) in control infants(P>0.05). In the infants with UTI, the feeding pattern(breast milk 19%, mixed 26%, formula 55%) was significantly different from that(44%, 19%, 37%) in control infants(P<0.05). This significant difference was shown only in infants less than 6 months of age, but was not in infants over 6 months of age. The rate of probiotics intake in UTI infants was 4%(4/115), which was significantly lower than 27% (32/116) in control infants(P<0.05). The rate of regular intake of yogurt in UTI infants over 6 months of age was 27%(6/23), which was not significantly different from 35%(8/23) in control infants(P>0.05). The odds ratios of breast feeding and probiotics intake against UTI were significantly low as 0.30 (95% Cl 0.17-0.55)(P<0.01) and 0.03 (95% Cl 0.01-0.07)(P<0.01). Conclusion : The significantly lower rates of breast feeding and probiotics intake in UTI infants suggest that these dietary factors might have preventive effects in infants with UTI.

• Journal of Korean Neurosurgical Society
• /
• v.47 no.5
• /
• pp.399-402
• /
• 2010

Osteoporosis is a worldwide problem and it mainly affects postmenopausal women. Osteoporosis associated with pregnancy or lactation is a rare condition. The incidence and mechanism of this phenomenon has not been clarified, but it can cause one or more vertebral compression fractures with severe, prolonged back pain in the affected women. We experienced this uncommon case, treated it with percutaneous vertebroplasty. A 35-old-woman visited our hospital with complaints of severe back pain and flank pain 2 months after normal vaginal delivery. She was diagnosed with osteoporotic vertebral compression fractures on the T5, 8, 9 and 11 vertebral bodies and we performed percutaneous vertebroplasty on the T8, 9 and 11 vertebrae with a good result. We present here an unusual case of pregnancy-associated compression fractures treated by percutaneous vertebroplasty.

• Advances in pediatric surgery
• /
• v.1 no.1
• /
• pp.95-99
• /
• 1995

Neuroblastoma is the most common solid malignancy in childhood. However, a neuroblastoma presenting as bilateral and multifocal is very rare. A male newborn weighing 2.7 kg was born by normal vaginal delivery at 39 weeks' gestation to a 27-year-old mother who had a normal pregnancy. He was in good condition at birth but presented palpable masses in the both upper abdomen and both side of the neck. Ultrasound examination showed the lesions to be $3{\times}3cm$ sized calcified mass in right suprarenal area and $5{\times}3cm$ sized homogenous mass in left suprarenal area. The abdominal mass was also examined by computed tomography with similar findings. With the impression of bilateral neuroblastoma or metastatic spread, the laparotomy was performed on the 13th day of life. Frozen section of biopsy of the left neck mass was obtained, which showed neuroblastoma. Intraoperative findings revealed bilateral adrenal masses which were distinct and anatomically separate. Bilateral adrenalectomy was accomplished and the initial postoperative course was uneventful. The patient was discharged for hopeless and expired at age 45 days. We present bilateral adrenal neuroblastoma considered to be simultaneous occurrence rather than metastases from one site to another.

• The Korean Journal of Pain
• /
• v.14 no.1
• /
• pp.61-67
• /
• 2001

Background: Usually, lumbar epidural block is performed on the $L_{3-4}$ interspace. This study was designed to evaluate the analgesic efficacy and shortening of labor duration comparing the $L_{1-2}$ and $L_{3-4}$ interspace epidural blocks in nulliparous normal vaginal deliveries and then investigates side effects following the blocks. Methods: Eighty healthy nulliparous women were divided into two groups, $L_{1-2}$ (n = 40) and $L_{3-4}$ (n = 40). Epidural blocks, lumbar epidural block were performed at the $L_{1-2}$ and $L_{3-4}$ interspace with a catheter advancing 3 cm cephalad. The initial dose of 12 ml (0.167% bupivacaine, fentanyl $50{\mu}g$ and clonidine $75{\mu}g$) was injected epidurally at 4 cm dilatation of cervix and severe pain of labor. If a visual analogue scale (VAS) score was more than 4 points, an additional dose was administered epidurally using the same volume as the above mentioned, but with the exception that the bupivacaine was diluted to 0.1 percentage. The maternal blood pressure, pulse rate, respiration rate and fetal heart rate were measured at 10 min intervals for the first 30 min, at 15 min interval for the next 30 min and at 30 min interval for the last one hour following the blocks. The duration of the first (active) and second stages of labor was counted and the neonatal Apgar score was recorded at one and five min after delivery. The degree of motor block, pruritus, nausea and vomiting were also noted. Results: The patients in group $L_{1-2}$ had lower pain scores than group $L_{3-4}$ at 5, 20, 30, 60 mins. The duration of 1st and 2nd labor stage in the $L_{3-4}$ epidural block were $272{\pm}33.5$ min, $49.2{\pm}27.4$ min respectively but those in the $L_{1-2}$ epidural block were $253.5{\pm}32.5$ min, $37.3{\pm}22.3$ min, respectively. Conclusions: We concluded the analgesic efficacy and shortening of labor duration in $L_{1-2}$ epidural block was better than those in $L_{3-4}$ epidural block. Maternal hemodynamic change, motor block. pruritus, nausea, vomiting and Apgar score showed no significant differences between the two groups.

• Women's Health Nursing
• /
• v.8 no.4
• /
• pp.559-569
• /
• 2002

The study examined the effects of San-Yin-Jiao(SP-6) acupressure treatment on labor pain, length of delivery and anxiety for women in the labor. The effects of using SP-6 acupressure were evaluated by comparing two groups, a SP-6 acupressure group (22) and a control group (17), for a total of 39 women in labor who had a normal vaginal delivery. Data were collected using a structured questionnaire which included general characteristics, a subjective labor pain scale, measurement of duration of delivery time and a subjective anxiety scale. Data were collected before treatment (pre) and after treatment (post). The results of this study are summarized as follows : 1. The post-scores for total labor pain increased over the pre-scores but the difference between the two groups was not statistically significant(p=0.219). Wilcoxon signed rank test of the difference in pre-post labor pain scores for the SP-6 acupressure group was not statistically significant (p=0.081) but the increase for the control group was statistically significant (p=0.001). 2. The length of time for the delivery in the group which had the SP-6 acupressure was shorter (143.91${\pm}$67.77) than the control group (197.94${\pm}$89.64). The difference between the two groups was statistically significant (p=0.028). 3. The post-scores for anxiety increased over the pre-scores but the difference between the two groups was not statistically significant (p=0.426). The scores of SP-6 acupressure group did not show a significant increase by the Wilcoxon signed rank test (p=0.194) but in the control group showed a significant increase (p=0.008).This study showed that SP-6 acupressure was effective in relation to labor pain, length of time for delivery and anxiety for labor women. But it is necessary to replicate the study with a larger number of participants to generalize the results.

• 모자간호학회지
• /
• v.4 no.1
• /
• pp.12-23
• /
• 1994

This study was done to determine the situations of stress incontinence(SI) and the differences in general characteristics, obstetrical history and SI related variables between women with stress incontinence and normal women. The design for study was a descriptive study. The number of subjects consisted of 156 women who were selected by systematic random sampling in Kwangju city. Data collection was done with the modified Hendrickson's Stress Incontinence Scale(1981) which was analyzed using frequency and percentiles. The results were as follows : 1. The stress incontinence (SI) rate of the sample was 64.1% and the majority of the women(40.9%) had experienced SI for a period of five years(the mean period was 2.7 years) without any treatment or care(83.0%). The amount of SI was from one drop(40.0%) to one teaspoon(16.7%) daily. 2. Items on the SI scale had the scores ranging from 4 to 44 with a mean score of 13.7 which showed mild SI. 3. The priority of provocative factors for SI were abdominal tightening(83%), coughing(58%), laughing(52%), sneezing(40%), steeping(18%), sudden standing(17%), nose blowing(13%), heavy exercise(11%), rapid walking up-stairs(10%) and excitment (9%) in that order. 4. There were no significant differences in age, education, spouse, job and income between the women with SI and the normal women. 5. There were no significant differences in the age at the last delivery, age of last baby. number of vaginal, or cesarean deliveries, or abdominal operations between the women with SI and the normal women. It can be concluded that SI in women has a high incidence nth various provocative factors but it is relatively mild SI on a daily basis and generally there has been no treatment. It is suggested that a descriptive study of emotional problems and precipitating variables in SI women will increase the knowledge of SI.