• Title/Summary/Keyword: infant death

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Mortality Forecasting for Population Projection (장래인구추계를 위한 사망률 예측)

  • Kim, Tai-Hun
    • Korea journal of population studies
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    • v.29 no.2
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    • pp.27-51
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    • 2006
  • In this paper, I have tested various kinds of methods for mortality projection and chose Lee-Carter method for projection of Korean mortality by age and sex. I reviewed the trends of life tables and life expectancies by age and sex from 2005 to 2050 projected by Lee-Carter method and found that the method was very applicable for Korean mortality projection. The differences between reported and estimated data for the period of 1971-2003 were small enough for both sexes and for all of the age groups. The projected life expectancies in 2051 were 82.73 years for males and 89.41 for females, and the differences decreased from 7.06 years in 2005 to 6.68 years. Because of the limitation of Korean infant mortality rate, I adopted the Japanese estimated IMR in 2050 as Korean object level in 2051. When the time series of IMR become long enough, we can use Korean IMR directly for the mortality projection. In addition, if we can estimate the changes of the main cause of death correctly in future, the mortality projection will be more correct and reliable. This will be available when we can produce a long series of life tables by cause of deaths.

A case of congenital vallecular cyst associated with gastroesophageal reflux presenting with stridor, feeding cyanosis, and failure to thrive (협착음과 수유시 청색증 및 성장 장애를 보인선천성 후두개 낭종(vallecular cyst) 1예)

  • Yang, Mi Ae;Kang, Min Jae;Hong, Jeana;Shin, Seung Han;Kim, Sang Duk;Kim, Ee-Kyung;Kim, Han-Suk;Choi, Jung-Hwan;Kwon, Tack Kyun;Kim, In-One
    • Clinical and Experimental Pediatrics
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    • v.51 no.7
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    • pp.775-779
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    • 2008
  • Vallecular cyst is an uncommon but potentially dangerous condition causing stridor and has been associated with sudden airway obstruction resulting in death due to its anatomical location in neonates. It may also present with various degrees of feeding problems resulting in failure to thrive. When a vallecular cyst is suspected clinically, endoscopic laryngoscopy is necessary to visualize it. Other conditions leading to neonatal stridor such as laryngomalacia and other laryngotracheal abnormalities should be ruled out. Marsupialization with a $CO_2$ laser is the most effective and safest treatment to prevent recurrence. We report a case of a 1-month-old male infant with a vallecular cyst synchronous with gastroesophageal reflux, and failure to thrive. He was referred to our hospital because of hoarseness, inspiratory stridor, feeding-cyanosis, chest retraction and failure to thrive. Diagnostic workup revealed a cyst at the tongue base, suggesting a vallecular cyst. The cyst was removed by laryngomicrosurgery with $CO_2$ laser. After the surgery, the symptoms improved and the body weight increased steadily. We report a successfully treated case of neonatal vallecular cyst with symptoms of upper respiratory obstruction, gastroesophageal reflux, and failure to thrive.

Effect of severe neonatal morbidities on long term outcome in extremely low birthweight infants

  • Koo, Kyo-Yeon;Kim, Jeong-Eun;Lee, Soon-Min;NamGung, Ran;Park, Min-Soo;Park, Kook-In;Lee, Chul
    • Clinical and Experimental Pediatrics
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    • v.53 no.6
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    • pp.694-700
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    • 2010
  • Purpose: To assess the validity of individual and combined prognostic effects of severe bronchopulmonary dysplasia (BPD), brain injury, retinopathy of prematurity (ROP), and parenteral nutrition associated cholestasis(PNAC). Methods: We retrospectively analyzed the medical records of 80 extremely low birthweight (ELBW) infants admitted to the neonatal intensive care unit (NICU) of the Severance Children's Hospital, and who survived to a postmenstrual age of 36 weeks. We analyzed the relationship between 4 neonatal morbidities (severe BPD, severe brain injury, severe ROP, and severe PNAC) and poor outcome. Poor outcome indicated death after a postmenstrual age of 36 weeks or survival with neurosensory impairment (cerebral palsy, delayed development, hearing loss, or blindness) between 18 and 24 months of corrected age. Results: Each neonatal morbidity correlated with poor outcome on univariate analysis. Multiple logistic regression analysis revealed that the odds ratios (OR) were 4.9 (95% confidence interval [CI], 1.0-22.6; $P$=0.044) for severe BPD, 13.2 (3.0-57.3; $P$<.001) for severe brain injury, 5.3 (1.6-18.1; $P$=0.007) for severe ROP, and 3.4 (0.5-22.7; $P$=0.215) for severe PNAC. Severe BPD, brain injury, and ROP were significantly correlated with poor outcome, but not severe PNAC. By increasing the morbidity count, the rate of poor outcome was significantly increased (OR 5.2; 95% CI, 2.2-11.9; $P$<.001). In infants free of the above-mentioned morbidities, the rate of poor outcome was 9%, while the corresponding rates in infants with 1, 2, and more than 3 neonatal morbidities were 46%, 69%, and 100%, respectively. Conclusion: In ELBW infants 3 common neonatal mornidifies, severe BPD, brain injury and ROP, strongly predicts the risk of poor outcome.

Health Risk Behaviors Affecting the Process of Pregnancy (임신경과에 영향을 미치는 건강위험행위)

  • Park, Chai-Soon;Mun, Mi-Seon;Hong, Gin-Hee;Lee, Jeoung-Eun
    • Women's Health Nursing
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    • v.6 no.4
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    • pp.549-565
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    • 2000
  • Comprehensive review of the literature was conducted to determine 1) selected risk factors and its impact that affect pregnancy outcome such as smoking, alcohol consumption, and substance abuse 2) these factors can facilitate future strategies for health promotion and prevention for both pregnant women and fetus. Review of literature were extracted from searching MEDLINE(1966 - Oct. 2000). CINAHL (1982 - Oct. 2000) and the domestic literature. The following factors were identified: 1. The effects of risk behaviors on pregnancy. ${\cdot}$Maternal smoking was associated with the occurrence of premature or LBW delivery, fetal growth retardation, extremities defects, heart defects and sudden infant death syndrome. ${\cdot}$Maternal alcohol consumption was associated with spontaneous abortion, premature or LBW delivery, morphologic/neurologic problems, especially fetal alcohol syndrome. ${\cdot}$Heroin was associated with withdrawal after birth in which were born to heroine addicts for gestational age and lung maturation in animal studies. ${\cdot}$Cocaine was associated with spontaneous abortion, abruptio placenta and a poor response to environmental stimuli. ${\cdot}$So far, the effects of caffeine on pregnancy was controversial, but severe caffeine consumption was associated with premature or LBW delivery, spontaneous abortion, still birth and dystocia. 2. Intervention methods and its effects identified were as follows ${\cdot}$Conducted intervention for smoking, alcohol and drug consumption were single or combined. ${\cdot}$Intervention methods were counseling, phone contact, mailing, use of educational videotape, booklet, support person and alternatives such as nicotine patch. ${\cdot}$The interventions increased the rates of smoking cessation during pregnancy and awareness of the risk of drug consumption, and decreased amount of alcohol consumption. ${\cdot}$The intervention outcome found positive effect on birth weight and length. 3. Our recommendations were as follows ${\cdot}$The personal and social cognition should be enhanced through education and the mass media. ${\cdot}$It's necessary to educate and give information of preconceptional care, planned pregnancy and early prenatal care for optimal pregnancy outcome. ${\cdot}$It's necessary to develop comprehensive assessment tool which is reliable and valid on smoking, alcohol consumption and substance abuse to identify supportive or interventional program.

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A Study on Social Support and the Quality of Life in the Elderly(The comparative analysis between home residents and institution residents) (노인의 사회적 지지와 삶의 질에 관한 연구 -일반가정노인과 양로원노인을 대상으로-)

  • 채수원;오경옥
    • Journal of Korean Academy of Nursing
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    • v.22 no.4
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    • pp.552-568
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    • 1992
  • Recent improvements in the standard of living, national income and medical care, and a decline in the infant death rate which have occurred related to economic growth and modernization, have led to a longer average life-span and a higher ratio of elderly people in the total population, Therefore, not only in the field of nursing science, but also in the field of many other discipline, issues concerning the elderly have been given increasing interest. A great deal of effort has been spent on increasing the quality of life for elderly people. This study was conducted to analyze the correlation between social support and quality of life. The sample consisted of III subjects residing at home and 107 subjects residing in institutions all of whom were over 65 years of age. The data collection period was from October 23, 1990 to January 26, 1991. Social support was measured using the Norbeck social Support Questionnaire developed by Norbeck, translated by Oh, Ka Sil and quality of life was measured using the QOL scale developed by No, You Ja. Data were analyzed using pereentages, t-test, Pearson Correlation Coefficient and ANOVA. The results of this study are as follows : 1. There was a statistically signifivant difference in the level of social support between the two groups (t=-8.83, p<.001), The elderly at home reported a much higher level of social support. 2. There was a statistically significant difference in the level of QOL between the two groups (t=-5.77, p<.001) . The elderly at home reported a much more positive quality of life. 3. There was a positive correlation between social support and QOL for the elderly at home ard it was statistically significant (r=.32, p<.001). 4. There was a postitive collealtion between social support and QOL for the elderly in institutions and it was also statistically significant (r=.19, p<.05). 5. The relationship between the general characteristics of the elderly at home and the variables of social support and of QOL were as follows ; 1) according to sex(t=10.57, p<.01) and the number of offspring(F=6.19, p<.01), there was a statistically significant difference in social support. 2) according to amount of Pocket money, there was a statistically significant difference in QOL(F=2.98, p<.05). 6. The relationship between the general characteristics of the elderly in institutions and the two variables were as follows ; 1) according to sex(t=6.24, p<.05), the number of offspring(F=6.16, p<.001) and religion (F=2.58, p<.05), there was a statistically significant difference in social support. 2) according to religion, there was a statistically significant difference in QOL(F=2.90, p<.05). In conclusion, it can be said that social support is an important variable related to QOL in the elderly and that social support levels are higher for the elderly residing at home. Therefore, more specific and objective approaches and efforts are needed to effectively use resources to maintain the elderly at home and to enhance social support available to the elderly in institutions and thereby increase QOL regardless of residence.

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Comparison of Clinical Courses According to the Existence of Patent Ductus Arteriosus in Respiratory Distress Syndrome (신생아 호흡곤란 증후군에서 동맥관 개존 동반유무에 따른 임상적 경과 비교)

  • Seong, Ju Hee;Lee, Hyeon Joo;Hong, Hyun Kee;Bae, Chong-Woo;Choi, Yong-Mook
    • Clinical and Experimental Pediatrics
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    • v.46 no.11
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    • pp.1080-1084
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    • 2003
  • Purpose : To compare perinatal characteristics, clinical courses, and overall morbidity between respiratory distress syndrome(RDS) with patent ductus arteriosus(PDA) and RDS without PDA in neonates. Methods : Eighty-three neonates who were diagnosed and treated for RDS in the neonatal intensive care unit(NICU) from Jan. 2000 to Dec. 2002 were included in this study. RDS was complicated with PDA(group A) in 17 patients and not complicated in 66(group B). PDA was diagnosed by echocardiogram in neonates with congestive heart failure symptom, cardiac murmur or chest X-ray findings of cardiomegaly or pulmonary edema. A retrospective study was undertaken of the perinatal characteristics and overall morbidity in group A and group B. Results : The birth weight and gestational periods of group A were less compared with group B. There was more perinatal asphyxia in group A. Incidence of overall morbidity such as bronchopulmonary dysplasia, intraventricular hemorrhage and death was higher in group A. Intravenous indomethacin was administered in 17 PDA infants. Conclusion : The perinatal characteristics in the two groups showed a significant difference. Incidence of overall morbidity in the two groups showed significant differences, however, there is no simple conclusion to draw because we didn't do multifactorial analyses to rule out other many risk factors affecting morbidity, such as gestational weeks or birth weight.

Clinical Features of Brain Abscesses in Neonates and Children: A Single Center Experience from 1997 to 2006 (단일기관에서 조사한 소아 뇌농양의 임상양상(1997-2006))

  • Lee, Teak Jin;Chu, Jin-Kyong;Kim, Ki Hwan;Kim, Khi Joo;Kim, Dong Soo
    • Pediatric Infection and Vaccine
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    • v.15 no.1
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    • pp.30-35
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    • 2008
  • Purpose : We evaluated clinical presentations of brain abscesses, including predisposing factors, causative organisms, and mortality rate in neonates and children. Methods : We retrospectively reviewed the medical charts of neonates and children with brain abscesses treated at Severance Hospital from January 1997 through December 2006. Results : Among 27 neonates and children with brain abscesses, overall mortality was 22 % and 38% of survivors developed neurologic sequelae. The mortality rate was 38% in 8 infants with brain abscesses. The most common location of brain abscesses were frontal and parietal lobes, followed by temporal lobe. There were 7 cases with multiple brain abscesses. Streptococci (33%), Staphylococci (27%), and Gram-negative enterics (20%) were commonly isolated. The common predisposing conditions were neurosurgical procedure (30 %), cyanotic congenital heart disease (15%), and sinusitis/otitis (7%). Fever (74%), headache (37%), nausea/vomiting (33%), and altered mental status (33%) occurred commonly. Compared with children older than 1 year of age, infants were associated with multiple brain abscesses (63%, P=0.011) and high rates of death or neurologic sequelae (88%, P= 0.033). Conclusion : We should have a high index of suspicion in order to recognize the condition as early as possible, especially in infancy with brain abscesses who presents vague or nonspecific symptoms and signs.

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Necrotizing Enterocolitis in Term Infants (만삭아에 발생한 괴사성 장염)

  • Kim, Dae-Yeon;Kim, Seong-Chul;Kim, Kyung-Mo;Kim, Ellen Ai-Rhan;Kim, Ki-Soo;Pi, Soo-Young;Kim, In-Koo
    • Advances in pediatric surgery
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    • v.9 no.1
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    • pp.19-23
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    • 2003
  • Necrotizing Enterocolitis (NEC) is usually a disease of premature infants, but occasionally it affects the term neonate. Twenty-five infants with NEC were treated at Asan Medical Center between January 2000 and December 2002, and 13 of them were term infants. In each case, the diagnosis of NEC was established by a clinical illness fulfilling the Bell's stage II or III NEC as modified by Walsh or by surgical findings. There were six males and seven females. The birth weight was from 1,960 to 3,700 g. The age at diagnosis was from 1 to 40 days. Four patients had congenital heart disease: one of who had hypothyroidism and cleft palate. Abdominal distension was present in all, and bloody stools in four. One patient had history of hypoglycemia, three had Rota viral infection. Eight patients had leucopoenia (<$5.0{\times}10^9/L$), seven had thrombocytopenia (<$100{\times}10^9/L$), and three severe thrombocytopenia (<$50{\times}10^9/L$). Laparotomy was required in 10 of the 13 patients. Indications for operation in the acute phase were failure to respond to aggressive medical therapy in five, and perforation in three patients. There were two late phase operations for intestinal stricture and fistula. There were no operative complications. Ten of thirteen patients survived (76.9%). Two patients died of septic complication. There was a delayed death due to heart failure. There was a significant difference in survival according to platelet count ($50{\times}10^9/L$) (p<0.05). Congenital heart disease and Rota viral infection are associated with NEC in term infants and thrombocytopenia and leucopoenia may be surgical indications.

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Enhanced γ-aminobutyric acid and sialic acid in fermented deer antler velvet and immune promoting effects

  • Yoo, Jiseon;Lee, Juyeon;Zhang, Ming;Mun, Daye;Kang, Minkyoung;Yun, Bohyun;Kim, Yong-An;Kim, Sooah;Oh, Sangnam
    • Journal of Animal Science and Technology
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    • v.64 no.1
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    • pp.166-182
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    • 2022
  • Deer antler velvet is widely used in traditional medicine for its anti-aging, antioxidant, and immunity-enhancing effects. However, few studies have reported on the discovery of probiotic strains for deer antler fermentation to increase functional ingredient absorption. This study evaluated the ability of probiotic lactic acid bacteria to enhance the concentrations of bioactive molecules (e.g., sialic acid and gamma-aminobutyric acid [GABA]) in extracts of deer antler velvet. Seventeen strains of Lactobacillus spp. that were isolated from kimchi and infant feces, including L. sakei, L. rhamnosus, L. brevis, and L. plantarum, and those that improved the life span of Caenorhabditis elegans were selected for evaluation. Of the 17 strains, 2 (L. rhamnosus LFR20-004 and L. sakei LFR20-007) were selected based on data showing that these strains increased both the sialic acid and GABA contents of deer antler extract after fermentation for 2 d and significantly improved the life span of C. elegans. Co-fermentation with both strains further increased the concentrations of sialic acid, GABA, and metabolites such as short-chain fatty acids and amino acids. We evaluated the biological effects of the fermented antler velvet (FAV) on the antibacterial immune response in C. elegans by assessing worm survival after pathogen infection. The survival of the C. elegans conditioned with FAV for 24h was significantly higher compared with that of the control worm group fed only normal feed (non-pathogenic E. coli OP50) exposed to E. coli O157:H7, Salmonella typhi, and Listeria monocytogenes. To evaluate the protective effects of FAV on immune response, cyclophosphamide (Cy), an immune-suppressing agent was treated to in vitro and in vivo. We found that FAV significantly restored viability of mice splenocytes and immune promoting-related cytokines (interleukin [IL]-6, IL-10, inducible nitric oxide synthase [iNOS], interferon [IFN]-γ, and tumor necrosis factor [TNF]-α) were activated compared to non-fermented deer antlers. This finding indicated the protective effect of FAV against Cy-induced cell death and immunosuppressed mice. Taken together, our study suggests that immune-promoting antler velvet can be produced through fermentation using L. rhamnosus LFR20-004 and L. sakei LFR20-007.

Changes in Incidence, Survival Rate and Morbidity of Very Low Birth Weight Infants (극소 저출생 체중아의 빈도와 생존율 및 예후 변화)

  • Kim, Young Ok;Kim, Sun Hui;Cho, Chang Yee;Choi, Young Youn;Kook, Jin Hwa;Hwang, Tae Ju
    • Clinical and Experimental Pediatrics
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    • v.46 no.8
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    • pp.769-776
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    • 2003
  • Purpose : The survival rate of very low birth weight infants(VLBWI) has improved by virtue of specialized neonatal care. This study was performed to analyze the changes in incidence, survival rate and morbidity of VLBWI who admitted to Chonnam National University Hospital from 1996 to 2001. Methods : We enrolled 565 VLBWI, and compared the incidence and the survival rate according to the birth weight or gestational weeks between period I(1996 to 1998) and period II(1999 to 2001). The mortality rate according to the postnatal age, cause of death, morbidity and days of hospital stay were also compared. Morbidity is categorized into 'short term' which is curable until discharge, and 'long term' causing any types of sequelae after discharge. Results : Incidence of VLBWI significantly increased in period II over period I(6.0% vs. 11.0%, P< 0.001). The survival rate also increased in period II(71.8% vs. 80.1%, P<0.05), especially in 1,000 to 1,249 gm of birth weight(P<0.001) and in 28 to 30 weeks of gestation(P<0.001). The most common cause of death was respiratory distress syndrome in period I; however it was sepsis in period II. Although overall and short term morbidity rate increased, long term morbidity and days of hospital stay didn't increase in period II. Conclusion : Although the incidence of VLBWI significantly increased and the survival improved in period II compared to period I, especially in 1,000 to 1,249 gm of birth weight and 28 to 30 weeks of gestation, 'long term' morbidity rate and hospital days didn't increase.