• Clinical and Experimental Pediatrics
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• 제63권6호
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• pp.226-231
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• 2020

Background: Probiotics and prebiotics have strain-specific effects on the host. Synbiotics, a mixture of probiotics and prebiotics, are proposed to have more beneficial effects on the host than either agent has alone. Purpose: We performed a randomized controlled trial to investigate the effect of Lactobacillus and Bifidobacterium together with oligosaccharides and lactoferrin on the development of necrotizing enterocolitis (NEC) or sepsis in very low birth weight neonates. Methods: Neonates with a gestational age ≤32 weeks and birth weight ≤1,500 g were enrolled. The study group received a combination of synbiotics and lactoferrin, whereas the control group received 1 mL of distilled water as placebo starting with the first feed until discharge. The outcome measures were the incidence of NEC stage ≥2 or late-onset cultureproven sepsis and NEC stage ≥2 or death. Results: Mean birth weight and gestational age of the study (n=104) and the control (n=104) groups were 1,197±235 g vs. 1,151±269 g and 29±1.9 vs. 28±2.2 weeks, respectively (P>0.05). Neither the incidence of NEC stage ≥2 or death, nor the incidence of NEC stage ≥2 or late-onset culture-proven sepsis differed between the study and control groups (5.8% vs. 5.9%, P=1; 26% vs. 21.2%, P=0.51). The only significant difference was the incidence of all stages of NEC (1.9% vs. 10.6%, P=0.019). Conclusion: The combination of synbiotics and lactoferrin did not reduce NEC severity, sepsis, or mortality.

• 한국인구학
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• 제26권2호
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• pp.1-32
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• 2003

시도의 사망원인별 사망력 분석은 정책수립에 필수적인 정보를 제공하고, 각종 질병 및 사망 원인에 대한 가설을 설정하게 한다. 사회경제적, 문화적, 의료적, 생태학적 이유 등 다양한 원인이 시도의 사망원인별 사망수준에 복합적으로 영향을 주지만, 이 연구에서는 시도의 사망원인별 사망력에 대한 설명보다는 공통점과 차이점 파악을 주 목적으로 하였다. 이를 위하여 1998년 기준 사망신고 및 주민등록인구 자료를 활용하여, 시도별로 지연신고와 영아사망 신고누락을 보완하고, 연령표준화사망률과 생명표를 작성하였다. 모든 사인에 의한 사망수준 관련 주요 결과는 다음과 같다: (1) 남녀전체를 합하여 서울이 가장 낮은 사망수준을 전남은 가장 높은 사망수준을 보였다: (2) 시도간 사망수준의 차이가 여자보다 남자에게서, 65세 이상보다 604세 이하 연령층에서 더 컸다. 사망원인별 사망력 관련 남녀별 및 남녀 전체를 합하여 연령표준화 사망률이나 출생시 사망확률이라는 지표 모두에서 일관된 유형을 보이는 주요 결과는 다음과 같다: (1) 심장질환에 의한 사망수준은 부산에서 최고, 강원도에서 최저를 나타냈고: (2) 간질환에 의한 사망수준은 전남에서 최고를; (3) 운수사고에 의한 사망수준은 충남에서 최고 인천에서 최저로 나타났다. 시도의 사망수준 차이에는 다양한 요인이 관련되어 있으므로 사회경제적 변수를 포함한 25개의 설명 변수와 총90개의 사망력 변수에 대한 탐색적 통계분석을 실시하였다. 모든 사인에 의한 사망력은 사회경제적 변수와 밀접한 관련이 있으며, 사망원인별로는 간질환 및 운수사고에 의한 사망력이 사회경제적 변수와 관련이 있는 것으로 나타났다. 끝으로 사망신고 자료의 질 개선 필요성을 논의하고 있다.

• Clinical and Experimental Pediatrics
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• 제60권9호
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• pp.273-281
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• 2017

To date, preterm infants with respiratory distress syndrome (RDS) after birth have been managed with a combination of endotracheal intubation, surfactant instillation, and mechanical ventilation. It is now recognized that noninvasive ventilation (NIV) such as nasal continuous positive airway pressure (CPAP) in preterm infants is a reasonable alternative to elective intubation after birth. Recently, a meta-analysis of large controlled trials comparing conventional methods and nasal CPAP suggested that CPAP decreased the risk of the combined outcome of bronchopulmonary dysplasia or death. Since then, the use of NIV as primary therapy for preterm infants has increased, but when and how to give exogenous surfactant remains unclear. Overcoming this problem, minimally invasive surfactant therapy (MIST) allows spontaneously breathing neonates to remain on CPAP in the first week after birth. MIST has included administration of exogenous surfactant by intrapharyngeal instillation, nebulization, a laryngeal mask, and a thin catheter. In recent clinical trials, surfactant delivery via a thin catheter was found to reduce the need for subsequent endotracheal intubation and mechanical ventilation, and improves short-term respiratory outcomes. There is also growing evidence for MIST as an alternative to the INSURE (intubation-surfactant-extubation) procedure in spontaneously breathing preterm infants with RDS. In conclusion, MIST is gentle, safe, feasible, and effective in preterm infants, and is widely used for surfactant administration with noninvasive respiratory support by neonatologists. However, further studies are needed to resolve uncertainties in the MIST method, including infant selection, optimal surfactant dosage and administration method, and need for sedation.

• Journal of Chest Surgery
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• 제32권11호
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• pp.1042-1045
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• 1999

Background: Recently, open heart surgerys using homograft are progressively increasing in complex cardiac anomalies, and even though the use of homograft tissues harvested from hearts of transplant recipients and brain-death patients are allowed and their use is increasing, the supply of homograft tissue is very limited. Material and Method: The large diameter homografts are difficult to apply directly for RVOT reconstruction of small neonatal and infant hearts due to the size mismatching. Therefore, were surgically down-sized the large diameter tricuspid homograft into bicuspid conduits by means of a longitudinal incision of the oversized homograft, excision of one cusp, and oversewing of the“Bicuspid homograft”wrapped around a Hega dilator of the appropriate size. Result: 3 patients(Male 1, Female 2: tetralogy of Fallot with pulmonary atresia), ranging in age from 5 months to 4 years and ranging in weight from 5.5Kg to 12.95Kg underwent reconstruction of the RVOT with bicuspid conduits obtained by appropriate tailoring from large-diameter homografts. The mean follow-up period was 4.3 months(range, 2 to 6 months). There were no complications related to the homograft tissues. Conclusion: In the short term follow-up, the bicuspid homografts provided good competence and excellent hemodynamics although a long term follow-up is needed to assess the functions of the bicuspid homografts in RVOT. We believe this technique may be a more effective alternative than the use of synthetic conduits when the use of an appropriate-sized homograft is not possible.

• Clinical and Experimental Pediatrics
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• 제57권6호
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• pp.251-256
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• 2014

Severe intraventricular hemorrhaging (IVH) in premature infants and subsequent posthemorrhagic hydrocephalus (PHH) causes significant mortality and life-long neurological complications, including seizures, cerebral palsy, and developmental retardation. However, there are currently no effective therapies for neonatal IVH. The pathogenesis of PHH has been mainly explained by inflammation within the subarachnoid spaces due to the hemolysis of extravasated blood after IVH. Obliterative arachnoiditis, induced by inflammatory responses, impairs cerebrospinal fluid (CSF) resorption and subsequently leads to the development of PHH with ensuing brain damage. Increasing evidence has demonstrated potent immunomodulating abilities of mesenchymal stem cells (MSCs) in various brain injury models. Recent reports of MSC transplantation in an IVH model of newborn rats demonstrated that intraventricular transplantation of MSCs downregulated the inflammatory cytokines in CSF and attenuated progressive PHH. In addition, MSC transplantation mitigated the brain damages that ensue after IVH and PHH, including reactive gliosis, cell death, delayed myelination, and impaired behavioral functions. These findings suggest that MSCs are promising therapeutic agents for neuroprotection in preterm infants with severe IVH.

• Journal of Yeungnam Medical Science
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• 제10권2호
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• pp.493-505
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• 1993

저자들은 1예의 선천성 피부결손증을 경험하고 국소피판술과 피부이식으로써 치료하고 술후 발생된 부분적 괴사는 습윤치료로써 자연치유시켜 만족스러운 결과를 얻었고, 4예의 craniosynostosis 환자를 진단하고 modified Marchac's method, Persing's method를 이용하고 교정하였고 CT를 이용한 뇌용적 측정으로 예후를 판정할 수 있었다.

• Journal of Chest Surgery
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• 제27권1호
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• pp.24-30
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• 1994

Eighteen infants with a large ventricular septal defect[VSD] underwent primary surgical repair from January 1986 to December 1992. Operation was done because of failure to thrive, medically intractable heart failure, recurrent pneumonia, increased pulmonary vascular resistance[PVR]. Four patients[22.2%] died in the early postoperative period. Relief of heart failure and normalization of growth and weight gain was evident in all survivor. There was no late postoperative death. The results of primary surgical repair of VSD in infancy are compared with those of palliative pulmonary artery banding[PAB] and of VSD closure after PAB. Twenty-seven patients with isolated VSD or with VSD associated with atrial septal defect, patent ductus arteriosus, or coarctation of the aorta underwent initial palliative PAB. There were 3 early postoperative deaths[11.1%]. Severe elevation of PVR persisted in two patients. Closure of VSD and pulmonary artery debanding was done in twenty patients, with 2 early postoperative deaths[10.0%]. Placement of the PAB too close to the pulmonary annulus necessitated trasannular patching in one patient, but any problem caused by migration of the band was not developed. It is concluded that primary surgical repair of VSD in infancy is reasonable and that PAB is indicated only for those patients less than 6 months old with a complicated defect or in an emergency situation.

• 대한구순구개열학회지
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• 제8권2호
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• pp.81-86
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• 2005

Cleft palate patients with congenital anomalies have an increased risk of airway problems following palatoplasty. Factors that were related included presence of associated congenital anomalies, duration of surgery, age at time of surgery, history of previous airway problem, and excessive pressure exerted on the base of the tongue by Dingman retractor. This report described a complication of post-operative Pneumonia after palatoplasty (Furlow technique), which resulted in a life-threatening acute airway obstruction in an infant with cleft palate. Patient has a history of previous mild airway problems. In addition to this problem, we speculate that Furlow technique involves more extensive surgical dissection than other techniques may increase risk for upper airway obstruction. Awareness of this risk permits identifying those patients prior to surgery so that they can be monitored and managed properly, minimizing the likelihood of major complications or possibility of death.

• 부모자녀건강학회지
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• 제10권1호
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• pp.77-90
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• 2007

Purpose: Motor vehicle crashes are the leading cause of death among children younger than 14 years old. The purposes of this study were to 1) provide a basic overview of child safety seats, 2) review car seat safety usage and misuse, 3) suggest interventions to motivate the usage of child safety seats. Method: The design was a descriptive study with literature review. Previous studies were searched of PUBMED, ProQuest and KERIS. Result: Child safety seats and automobile safety belts protect children in a crash if they are used correctly, but if a child does not fit in the restraint correctly, it can lead to injury. A child safety seat should be used until the child correctly fits into an adult seat belt. Conclusion: To improve child passenger's safety, educational, legislational and environmental enforcements are needed: educational interventions to promote use of child safety seats, strengtened legislation to mandate use of child safety seats, establishment of public acquirements.

• Journal of Chest Surgery
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• 제27권8호
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• pp.650-655
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• 1994

The author analyzed 99patients with VSD weighting less than 10kg of body weight who underwent surgical correction from 1981 to 1992 at cardiovascular department of Hanyang University hospital. Patients occupied 29.3% of total cases who were underwent surgical corrections for congenital heart diseases during that time. Of the 99 patients, 51 patients were male [52%] and 48 patients[48%] were female. Age ranged from 28 days to 36 months with mean age of 13.6 months. Mean body weight was 7.53kg. According to Kirklin`s anatomical classification, type II defect was most common [61.6%]. Associated anomaly was found in 48 patients [48.5%]. Patent foramen ovale was most commonly associated cardiac anomaly [14.1%] and followed by atrial septal defect [12.1%], patent ductus arteriosus [10.1%]. Cardiac catheterization data were analyzed. The most common range of Qp/Qs, Rp/Rs, Pp/Ps were above 3.0, 0.1 - 0.25, and above 0.75 respectively. Among the indications of surgical correction, there were pulmonary hypertention in 69 patients, congestive heart failure in 44 patients, frequent respiratory infection in 47 patients, growth retardation in 33 patients. The most common surgical approach and method for VSD closure were right atriotomy[48.3%] and dacron patch closure[93.3%]. Complication rate was 13.1% [13 cases], and overall mortality was 17.1% [17 cases]. The cause of death consisted of low cardiac output syndrome[11 cases], acute renal failure[3 cases], sepsis[2 cases] and pulmonary insufficiency[1 case] in order of frequency.