• 제목/요약/키워드: premature

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Optimal oxygen saturation in premature infants

  • Chang, Mea-Young
    • Clinical and Experimental Pediatrics
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    • 제54권9호
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    • pp.359-362
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    • 2011
  • There is a delicate balance between too little and too much supplemental oxygen exposure in premature infants. Since underuse and overuse of supplemental oxygen can harm premature infants, oxygen saturation levels must be monitored and kept at less than 95% to prevent reactive oxygen species-related diseases, such as retinopathy of prematurity and bronchopulmonary dysplasia. At the same time, desaturation below 80 to 85% must be avoided to prevent adverse consequences, such as cerebral palsy. It is still unclear what range of oxygen saturation is appropriate for premature infants; however, until the results of further studies are available, a reasonable target for pulse oxygen saturation ($SpO_2$) is 90 to 93% with an intermittent review of the correlation between $SpO_2$ and the partial pressure of arterial oxygen tension ($PaO_2$). Because optimal oxygenation depends on individuals at the bedside making ongoing adjustments, each unit must define an optimal target range and set alarm limits according to their own equipment or conditions. All staff must be aware of these values and adjust the concentration of supplemental oxygen frequently.

신생아의 산-염기 균형과 대사성 산증 (Acid-base Balance and Metabolic Acidosis in Neonates)

  • 이병섭
    • Neonatal Medicine
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    • 제17권2호
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    • pp.155-160
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    • 2010
  • Metabolic acidosis is commonly encountered issues in the management of critically ill neonates and especially of preterm infants during early neonatal days. In extremely premature infants, low glomerular filtration rate and immaturity of renal tubules to produce new bicarbonate causes renal bicarbonate loss. Higher intake of amino acids, relatively greater contribution of protein to the energy metabolism and mineralization process in growing bones are also responsible for higher acid load in premature infant than in adult. Despite widespread use of sodium bicarbonate in the management of severe metabolic acidosis, use of sodium bicarbonate in premature infants should be restricted to a reasonable but unproven exception such as ongoing renal loss. Despite concern about the low pH value (<7.2) which can compromise cellular metabolic function, no treatment guideline has been established regarding the management of metabolic acidosis in premature infants. Appropriately powered randomized controlled trials of base therapy to treat metabolic acidosis in critically ill newborn infants are demanding.

자동차용 깊은홈 볼베어링의 조기파손 : 1보 - 파손기구의 규명 (Premature Failure of Deep Grooved Ball Bearing for Automobiles : Part 1 - A Failure Mechanism)

  • 현준수;박태조
    • 한국윤활학회:학술대회논문집
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    • 한국윤활학회 2003년도 학술대회지
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    • pp.388-394
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    • 2003
  • This paper deals with a premature failure mechanism of deep grooved ball bearing for automobiles. A close examination of used bearings revealed that the premature failure could be arose by dents on the ball. Universal testing machine with specially designed tools is used to simulate the practical dents on the ball and test bearings are assembled with dented balls and new hearing components. The endurance test results showed that the dents on the balls were printed on the races and these phenomena come to premature failure.

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Clinical Feature and General Management of Post-Hemorrhagic Hydrocephalus in Premature Infants

  • Shunsuke Ichi
    • Journal of Korean Neurosurgical Society
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    • 제66권3호
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    • pp.247-257
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    • 2023
  • Recently, the survival of the high-risk population of preterm infants has steadily improved, and the severity of prematurity is a growing threat of gestational-age-related fatal conditions. Posthemorrhagic hydrocephalus (PHH) is the most common but serious neurological complication in premature infants, which can have life-threatening consequences during the acute phase in the neonatal period and life-long psychomotor and cognitive sequelae in their later life. Although neonatologists, pediatric neurologists, and pediatric neurosurgeons have investigated a diversified strategy for several decades, a consensus on the best management of PHH in premature infants still must be reached. Several approaches have tried to reduce the incidence of intraventricular hemorrhage (IVH) and mitigate the effect of IVH-related hydrocephalus. This paper reviews and discusses the clinical feature of PHH in premature infants, general/nonsurgical management of prematurity for IVH prevention, and posthemorrhagic management, and how and when to intervene.

조기 수축의 진단과 치료 (Diagnosis and Treatment of Premature Atrial or Ventricular Complexes)

  • 안진희
    • The Korean Journal of Medicine
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    • 제99권1호
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    • pp.17-24
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    • 2024
  • Premature atrial complex (PAC) and premature ventricular complex (PVC) are the most common arrhythmias. Most of them are benign, whereas some could be an initial sign of any underlying significant heart disease. Evaluation of daily burden and the presence of any association with underlying medical conditions are essential for proper assessment. Recently, newly developed electrocardiogram smart devices are widely available to document arrhythmias and identify correlations with symptoms. Management is required if the daily burden is high, patients are highly symptomatic, or significant structural heart disease is present. Antiarrhythmic drugs (AADs) are the first-line treatment, but if arrhythmias are drug-refractory or the patients are intolerable to AADs, catheter ablation is considered a good alternative in selected cases. In this paper, the proper diagnosis and management for PAC and PVC will be comprehensively reviewed.

호르몬 검사를 통하여 확인한 조기난소부전 환자 2례의 임상 경과 보고 (A Clinical Study on 2 Cases of Premature Ovarian Failure by Serum Hormone Assay)

  • 박은영;권형근;공복철;김동철
    • 대한한방부인과학회지
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    • 제26권1호
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    • pp.109-120
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    • 2013
  • Objectives: The purpose of this study is to report the effects of oriental medicine on 2 patients with premature ovarian failure. Methods: The patients who had amenorrhea caused by premature ovarian failure were treated by oriental medicine such as herb medication, acupuncture and moxibustion. We evaluated the results of treatments by change of symptoms, serum hormone assay, basal body temperature and Kupperman's Index. Results: After oriental medicine, the patients could have their normal menstrual cycle. Also serum hormone assay, basal body temperature and Kupperman's Index were improved. Conclusions: This study shows that oriental medicine has effects on patients with premature ovarian failure. And serum hormone assay, basal body temperature and Kupperman's Index would be valid measurement to evaluate the effect of treatments for premature ovarian failure.

신생아집중치료실 내 인큐베이터 간호를 받는 미숙아가 경험하는 소음 수준 및 빈도 (Noise Level and Frequency Experienced by Premature Infants Receiving Incubator Care in the Neonatal Intensive Care Unit)

  • 주소현;김태임
    • Child Health Nursing Research
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    • 제26권2호
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    • pp.296-308
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    • 2020
  • Purpose: The purpose of this study was to identify the noise level and frequency experienced by premature infants receiving incubator care in the neonatal intensive care unit (NICU). Methods: The participants were 20 premature infants receiving incubator care in the NICU of a university hospital in Daejeon Metropolitan city. The noise level was measured using a professional sound-level meter (ET-958, FLUS, Shenzhen, China) based on a noise classification table developed by the author. The data were analyzed with descriptive statistics, the t-test, analysis of variance, and Pearson correlation coefficients using SPSS for Windows version 22.0. Results: The average noise level experienced by premature infants receiving incubator care in the NICU was 51.25 dB (range: 45.0~81.7 dB). The frequency of noises was highest for factors related to nursing activities (40.3%), followed by human factors (29.1%), machine alarm sounds (20.1%), incubator operation (6.6%), and internal environmental factors (3.9%). Conclusion: According to the above results, the noise level experienced by premature infants receiving incubator care in the NICU exceeded the recommendations of the American Academy of Pediatrics. Therefore, it is necessary to develop an interventional program to reduce noise in the NICU, and to conduct follow-up studies to verify its effectiveness.

신생아집중치료실에 입원 경험이 있는 미숙아 어머니의 외상 후 성장에 영향을 미치는 요인 (Factors Influencing Post-traumatic Growth in Mothers with Premature Infants Admitted to the Neonatal Intensive Care Unit)

  • 이현수;강숙정
    • Child Health Nursing Research
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    • 제26권2호
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    • pp.267-276
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    • 2020
  • Purpose: Caring for a vulnerable premature baby is a challenging task, but some mothers experience growth through that process. The purpose of this study was to investigate the factors influencing post-traumatic growth in mothers with premature infants admitted to the neonatal intensive care unit. Methods: A correlational research design was used and 105 mothers of premature infants were recruited from an online community. Data were collected from January 15 to January 25, 2019. Post-traumatic growth was measured using the Korean version of the Posttraumatic Growth Inventory. Data were analyzed using descriptive statistics, the t-test, analysis of variance, the Scheffé test, Pearson correlation coefficients, and hierarchical multiple regression. Results: The final model developed in this study explained 45.5% of post-traumatic growth (F=13.66, p<.001). Resilience (β=.54, p<.001) was the strongest predictor of post-traumatic growth, followed by the age of the mother when giving birth (β=.17, p=.028) and current employment status (β=.17, p=.049). Conclusion: For mother with premature infants to grow psychologically after their experience, it may be needed to support them to develop and strengthen their resilience through either education or their own support network.

Cerebral Hemodynamics in Premature Infants

  • Rhee, Christopher J.;Rios, Danielle R.;Kaiser, Jeffrey R.;Brady, Ken
    • Neonatal Medicine
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    • 제25권1호
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    • pp.1-6
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    • 2018
  • Extremely low birth weight infants remain at increased risk of intraventricular hemorrhage from the fragile vascular bed of the germinal matrix; the roles of hypotension (ischemia) and reperfusion (hyperemia) in the development of intraventricular hemorrhage are still debated. Cerebrovascular pressure autoregulation protects the brain by maintaining constant cerebral blood flow despite changes in blood pressure. The ontogeny of cerebrovascular pressure autoregulation has not been well established and uncertainty remains about the optimal arterial blood pressure required to support brain perfusion. Another important aspect of premature cerebral hemodynamics is the critical closing pressure--the arterial blood pressure at which cerebral blood flow ceases. Interestingly, in premature infants, the critical closing pressure approximates the mean arterial blood pressure. Often in this unique population, cerebral blood flow occurs only during systole when the diastolic arterial blood pressure is equal to the critical closing pressure. Moreover, the diastolic closing margin, a metric of cerebral perfusion that normalizes diastolic arterial blood pressure to the critical closing pressure, may be a better measure than arterial blood pressure for defining cerebral perfusion in premature infants. Elevated diastolic closing margin has been associated with intraventricular hemorrhage. This review summarizes the current state of understanding of cerebral hemodynamics in premature infants.

조기난소부전증 환자에서의 면역학적 연구;I. 입파구아형외 변화 (Immunologic Study in Women with Premature Ovarian Failure;I. Peripheral Blood Lymphocyte Subpopulations)

  • 김정구;이진용;장윤석
    • Clinical and Experimental Reproductive Medicine
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    • 제16권2호
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    • pp.147-152
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    • 1989
  • The purpose of this study is to detect certain change in peripheral blood lymphocyte subpopulations in women with premature ovarian failure. The B cells, T cells and subsets were counted in 21 women with premature ovarian failure and 30 age-matched normal control women. The B cells were measured by identifying lymphocyte with surface membrane immunoglobulin and T cells and subsets by indirect immunofluorescence technique with the monoclonal antibodies OK T3, OK T4, and OK T8. The results were as follows. 1. No significant difference in the absolute number of B cells, T cells and subsets between women with premature ovarian failure and normal control women was observed. 2. The percentage of B cells, T cells and OK T8(+) cells in women with premature ovarian failure was not significantly different from that in normal control subjects respectively. 3. The percentage of OK T4(+) cells and OK T4/0K T8(+) ratio was significantly higher in women with premature ovarian failure than in control subjects.

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