Descending Aorta Blood Flow Characteristics before the Development of Necrotizing Enterocolitis in Preterm Neonates
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- Neonatal Medicine
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- 제25권2호
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- pp.78-84
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- 2018
Purpose: To investigate the hemodynamic risk factors for necrotizing enterocolitis (NEC), we analyzed the characteristics of descending aorta (DA) blood flow in preterm neonates, who later developed NEC. Methods: This was an observational case-control study on 53 preterm neonates at a tertiary referral center. Clinical and echocardiographic data were collected from 23 preterm neonates with NEC (NEC group), and compared with those of 30 preterm neonates without NEC (control group). Echocardiography was done at a median (interquartile range) of 5 (3-9) days after birth and 2 (1-2.5) days before the diagnosis of NEC. Results: Basic clinical characteristics including gestational age, birth weight, Apgar score, breast feeding status, use of umbilical catheters, and mode of invasive ventilator care were similar between the groups. Compared with the control group, the lowest diastolic velocity of DA was significantly decreased, whereas the diastolic reverse flow and the ratio of diastolic reverse to systolic forward flows were significantly increased in the NEC group. In addition, the resistive index (RI) of DA was significantly increased in the NEC group and showed a positive association with the development of NEC. Multivariate logistic regression analysis showed that increasing RI of DA was an independent risk factor for the development of NEC (P=0.008). Conclusion: Significant changes in DA flow characteristics including decreased diastolic velocity and increased diastolic reverse flow along with increased peripheral vascular resistance were observed before the development of NEC in preterm neonates. These findings may help clinicians stratify in advance neonates at a risk of developing NEC and may help improve outcomes in these neonates.
In this study, four different oils containing either CLA, GLA, GLA+Carnitine or corn oil (control) were supplemented to finishing pigs (average 70.8 kg initial BW) diet for 28 d of feeding period. To evaluate the values of the dietary fatty acids, especially in view of sensory and nutritional characteristics of pork; pig performances, carcass characteristics, serum cholesterol, neutrophil phagocytosis, TBARS, electronic nose flavor and fatty acids profile of pork were measured. There were no differences in daily gain and nutrients digestion among treatments, but daily feed intake of CLA enriched diet was lower (P<0.05) than that of other diets. There were no differences in backfat thickness, dressing percentage and carcass grade among pigs fed diets supplemented with different oils. Serum total cholesterol showed a tendency to be lowered in pigs fed GLA enriched diet. TBARS values during storage of pork were higher in belly from pigs fed control diet whereas the values of belly from pigs fed GLA+Carnitine diet were lower than others. However, difference in TBARS was not remarkable in adipose tissue and 4 weeks extended storage regardless of pork parts. Proportion of saturated fatty acids such as C16:0 and C18:0 were higher (P<0.05) in pork loin and thin skirt from pigs fed CLA enriched diet compared to those from other diets. There were no differences in fatty acids profiles of belly and adipose tissue. CLA accumulation in pork was increased by the dietary CLA supplementation and this could be also confirmed by a slight de novo synthesis of CLA in pork from pigs fed CLA free diets. GLA was selectively accumulated to pork adipose tissue and loin from pigs fed GLA enriched diets. There was no accumulation of GLA when GLA was not supplemented, indicating no de novo synthesis of GLA. Phagocytic activity was the highest (p<0.05) in neutrophil of pigs fed GLA+Carnitine supplemented diet, then, followed by pigs fed GLA supplemented diet. There was no difference in phagocytosis between control and CLA treatment although the phagocytosis was numerically lowest in pig fed CLA enriched diet. There were distinct differences in electronic nose flavor pattern among treatments regardless of the parts. This study showed that dietary supplementation of functional fatty acids like CLA or GLA was able to result in characteristic differences in feed intake, TBARS, fatty acids profile and flavor of pork, serum cholesterol regulation and neutrophil phagocytosis.
The subjects of the study were the 120 mothers who had children hospitalized in 6 hospitals in P city during the period from Feb. 1. to May 30. 1996. The purpose of the study are(1) the problems encountered when they carried out Home Care after discharge and (2) the degrees of demand that they had against Home Care Services. In order to investigate the purposes above-mentioned the researchers used the 55 items of Home Care services belonging to 10 areas selected by Korea Home-Care Association in 1994. The items were modified and supplemented to 4-point scale. The selected data were analyzed by SPSS : PC+ and the following results were derived. 1. The subjects payed great attention to 5 items such as 'pain control, OPD visits, diet-control problems' among the 15 sources of anxiety that they had against Home Care services after discharge. Especially, 'OPD visits and knowledge deficit' would to be overcome by the nursing activities of the Home Care Nurses. 2. The acknowledge level of the subjects to the Home Care Project that governmental plans to carry out was surveyed and found as under 50. 0% responded they heard about Home Care Nursing System. 60.8% said that they thought the system was 'very necessary' and 'somewhat necessary'. 65.0% said they would like to use the system. However, the acknowledge level of 50.0% is still low and is thought to need further national promotion and propagation. 3. The demand of the subjects against 55 Home Care Services was investigated and found as