• Clinical and Experimental Pediatrics
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• v.52 no.11
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• pp.1216-1220
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• 2009

Purpose:To analyze and compare various cases in which peritoneal drainage was used as the primary treatment method in preterm infants with intestinal perforation. Methods:Among the preterm infants of less than 28 weeks of gestation who were admitted to the neonatal intensive care unit (NICU) at the Gangnam Severance Hospital from April 2006 to April 2009, 7 who had developed intestinal perforation were studied retrospectively. We investigated the clinical characteristics, secondary operation performances, morbidities, complications, and mortalities. Results:Among the 7 infants, 5 survived. Of the 5 cases, 3 received laparotomy, of which 2 were confirmed as having necrotizing enterocolitis. Of the 2 infants who died, 1 had received laparotomy before 48 h of peritoneal drainage, while the other had not received any subsequent treatment. Of the 7 children, 4 had patent ductus arteriosus (PDA), of which 3 had received indomethacin injection. Five infants had begun enteral feeding before they developed intestinal perforation. Of the 5 infants who survived, 4 were diagnosed with cholestasis. Of the 7 infants, 4 developed periventricular leukomalacia (PVL) and 3 developed rickets. Conclusion:Although the use of peritoneal drainage as the primary management of intestinal perforation in preterm infants is controversial, we suggest that it can be used for treating extreme premature neonates. Further randomized controlled study will be required to determine the feasibility of using this method.

• Neonatal Medicine
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• v.18 no.2
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• pp.182-188
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• 2011

Purpose: Recently in Korea, there have been significant improvements in neonatal mortality rate (NMR) and infant mortality rate (IMR). This study aimed to investigate the proportion of the NMR among IMR, with the goal of discerning the influence of improved NMR on the reduction of IMR in the last 5 years in Korea. Methods: All data were from Statistics Korea. Changes in the NMR percentage among IMR and the percentage of the death by the distribution of the birth weight and gestational were investigated. Results: The total birth rate decreased, but the total number of preterm and low birth weight infants increased. These was a large decrease in NMR and IMR. The proportion of NMR among INR exceeded 50%. Early NMR was higher than late NMR. Among the total infant death, the mortality of preterm and low birth weight infants was high. Conclusion: Between 2005 and 2009, the total birth has declined in Korea, but the frequency of low birth weight infants is trending upward. The improvements in NMR and IMR, and the downtrend of the NMR percentage in IMR, are encouraging. It seems that the continued decrease of mortality of preterm and LBWI is required for better improvements NMR and IMR in Korea. This result is expected to be used for the basic data to improve the management of the newborns in Korea.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.1
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• pp.39-45
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• 2009

Purpose: Preterm infants are very susceptible to malnutrition because of a lack of storage of nutrients, immature digestion and metabolism, and accompanying diseases associated with prematurity. The purpose of this study was to evaluate the effects of nutritional support by the pediatric nutritional support team (pNST) on the clinical course of preterm infants in the neonatal intensive care unit (NICU). Methods: Between July 2003 and July 2006, 48 preterm infants who were admitted to the NICU at Seoul National University Bundang Hospital were included. The subjects were divided into the following two subgroups according to the presence of NST activity; pre-NST group (n=23) and NST group (n=25). Hospital records were reviewed retrospectively. Results: Forty-eight preterm babies were included (M：F=27：21; gestational age, 25~33 weeks). A dietician, pharmacists, or the pNST participated in the prescription of total parenteral nutrition (TPN) more rapidly in the NST group (p=0.000). The fasting periods and TPN administration periods were significantly decreased in the NST group compared to the pre-NST group (p=0.017 & p=0.001, respectively). The doses of calories, protein, and lipids administered via TPN were significantly increased in the NST group compared to the pre-NST group (p=0.016, p=0.000, and p=0.000, respectively). The total period on antibiotic therapy was significantly decreased in the NST group compared to the pre-NST group (p=0.007). Conclusion: Because nutritional support by the pNST is of benefit to the clinical course of preterm infants in the NICU, the pNST should recommend to improve the nutritional status and clinical outcome of preterm infants.

• Journal of Chest Surgery
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• v.40 no.12
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• pp.837-842
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• 2007

Background: Closure of the ductus arteriosus is often delayed in premature infants, which creates a hemodynamically significant left to right shunt that exerts an adverse effect on the normal development and growth of these babies. We reviewed out experience on surgical closure of patent ductus arteriosus via axillary minithoracotomy in premature infants. Material and Method: From April 2002 to October 2006, 20 premature infants whose gestation was under 37 weeks underwent surgical closure of patent ductus arteriosus as a result of complications or contra-indications for the use of indomethacin. Their mean gestational age was 28.8+3.4 weeks, ranging from 25+3 to 34+6 weeks, and the average age at operation was $15.6{\pm}6.3$ days. The mean body weight at operation was $1,174{\pm}416\;g$, ranging from 680 to 2,100g; 16 infants were under 1,500 and 9 infants were under 1,000 g. The procedures were performed in the newborn intensive care unit via $2{\sim}3\;cm$ long axillary minithoracotomy with the infant in the lateral position with left arm abduction. The mean size of the patent ductus arteriosus was $3.8{\pm}0.3\;mm$. For the most part, the ductus was closed with clips; 2 infants in whom the ductus was ruptured while dissection was being performed underwent ductal division. Result: Ten of twelve infants who had been ventilator dependent preoperatively could be successfully weaned from the ventilator at a mean duration of 9.7 days after the operation. There was no procedure-related complication or death. Two infants eventually died of the conditions not related to the operation; one from sepsis at postoperative 131 days and the other from pneumonia at postoperative 41 days, respectively. Conclusion: Surgical closure of the patent ductus arteriosus improved the hemodynamic instability and so promoted the successful growth and normal development of premature infants. Considering the low surgical risk along with the reduced invasiveness, early and aggressive surgical intervention is highly recommended.

• Journal of the Korean Society of Food Science and Nutrition
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• v.40 no.1
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• pp.70-77
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• 2011

This study was conducted to evaluate the efficacy of human milk fortifier (HMF) on growth and nutritional status in growing rats fed infant formula supplemented with HMF. Three week-old male Sprague-Dawley rats were divided into three groups and fed regular formula (RF), premature formula (PF) and regular formula fortified with HMF (RF+HMF) diets for 3 weeks. There was no significant difference in weight gain among groups. However, a significant increase of food intake was observed in PF and RF+HMF groups compared with RF group. With increasing food intake, the intakes of carbohydrate and protein were significantly increased in PF and RF+HMF groups. The weight of perirenal fat was significantly increased in rats fed RF+HMF; however, the weights of liver, kidney and spleen were not significantly different among groups. Although total lipids, total cholesterol, HDL-cholesterol concentrations of serum were not significantly different among groups, triglyceride was significantly increased in PF group. The triglyceride and total-cholesterol of liver were significantly increased in rats fed regular formula fortified with HMF and PF compared with RF group. Glutamic pyruvic transaminase (GPT), glutamic oxaloacetic transaminase (GOT), creatinine (Cre) and blood urea nitrogen (BUN) in serum showed no significant difference among groups. The concentration of growth hormone was significantly increased in PF group compared with other groups. The concentration of hemoglobin was significantly increased in rats fed PF and RF+HMF. These results suggest that the supplementation of human milk fortifier in growing rats may promote growth as increasing food intake and lipid contents in tissues and prevent the anemia of infants.

• Journal of Chest Surgery
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• v.32 no.8
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• pp.702-708
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• 1999

Background: Surgical closure of the PDA in premature infants with complications or contraindications to indomethacin use, or recurrence of symptomatic PDA is a safe and effective procedure with low operative risk and minimal complications. Material and Method: From April 1996 to August 1998, 11 premature infants with body weight under 1.5 kg at operation underwent operation for a symptomatic PDA (male:5, female: 6). Associated dise ases were congenital heart disease(7), hyaline membrane disease(6), intraventricular hemor rhage(4), pneumonia(4), pneumothorax(3), hyperbilirubinemia(2), necrotizing enterocolitis(2), renal failure(1), epilepsy(1), and hydrocephalus(1). Surgical techniques are hemoclipping(8) and ligation(3). The size of PDA was 3~6 mm (5.0$\pm$1.2). Result: Systolic and diastolic blood pressure rised and heart rates decreased after PDA closure. ABGA improved postoperatively. There were no surgical complications. Six infants with improved ABGA data were weaned from mechanical ventilatory support. The follow-up durations after discharge were 3 month to 12 month. Five deaths were not related to operation. The causes of death were hyaline membrane disease(2), bronchopulmonary dysplasia with pneumonia(1), sepsis(1), and con gestive heart failure with respiratory distress syndrome(1). Conclusion: Early operative closure is the treatment of choice in most premature infants with a hemodynamically significant shunt(PDA), recurrence of symptomatic PDA, complications of Indomethacin, or contraindi cations to Indomethacin.

• Clinical and Experimental Pediatrics
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• v.51 no.7
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• pp.704-712
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• 2008

Purpose : A prospective, controlled trial was conducted to evaluate growth, efficacy, safety and nutritional status for very low birth weight infants fed with human milk fortified with Maeil human milk fortifier (Maeil $HMF^{(R)}$; Maeil Dairies Co., Ltd.). Methods : We enrolled 45 premature infants with a birth weight <1,500 g and gestational age <33 weeks, who were born at Dong-A University Hospital from October, 2006 through December, 2007. They were divided into 2 groups: infants in one group were fed with human milk fortified with $HMF^{(R)}$, and the second were fed with preterm formula. Growth, biochemical indices, feeding tolerance, and other adverse events in each group were assessed serially and compared relatively. Follow-up data were also collected after discharge at 1, 3, and 6 months corrected age. Results : Characteristics of the 2 groups including average gestational age, birth weight, sex, respiratory distress syndrome, patent ductus arteriosus, and other adverse events (sepsis, retinopathy of prematurity, and intraventricular hemorrhage) showed no significant difference. Average feeding start day ($8.00{\pm}3.27d$ vs. $8.86{\pm}5.37d$) (P=0.99) and the number of days required to reach full feeding after start feeding ($41.78{\pm}20.47d$ vs $36.86{\pm}20.63d$) (P=0.55) were not significantly different in the group fed human milk fortified with $HMF^{(R)}$ when compared with the group that was fed preterm formula. The duration of total parenteral nutrition and the incidence of feeding intolerance also showed no differences between the 2 groups. Although infants fed with human milk fortified with $HMF^{(R)}$ showed faster weight gain than those fed with preterm formula at the end stage of the admission period, other growth indices of the two groups showed no significant difference. No significant correlations were found between the 2 groups with regard to weight gain velocity, height gain velocity, head circumference velocity, and post-discharge follow up growth indices. Conclusion : Premature infants fed human milk fortified with $HMF^{(R)}$ showed no significant difference compared with those fed preterm formula in growth, biochemical indices, and adverse events. Using human milk fortifier can be an alternative choice for very low birth weight infants, who need high levels nutritional support even after discharge from NICU.

• Journal of the Korean Society of Food Science and Nutrition
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• v.40 no.3
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• pp.343-349
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• 2011

The chemical composition and antioxidative activity of kiwifruit varieties in Jeju, such as Jecy Gold (Actinidia chinensis var. 'Jecy Gold'), Halla Gold (A. chinensis var. 'Halla Gold'), Jecy Sweet (A. deliciosa var. 'Jecy Sweet') and Hwabuk 94 (A. deliciosa var. 'Hwabuk 94') were investigated. The crude protein, crude lipid, and pH showed no differences among variety and maturity whereas the moisture contents showed differences among the variety and maturity. Jecy Sweet in mature stage showed the highest values in soluble solid, crude protein, crude lipid, and crude ash. The changes in chemical components of kiwifruit by maturity stage were as follows: during ripening, the glucose and the fructose contents increased considerably with the decrease of sucrose content. Potassium, phosphorus, sodium, and magnesium were estimated as the major minerals in kiwifruit and Jecy Sweet contained the highest amounts of potassium and magnesium. At maturity stage, ascorbic, malic and lactic acid were increased with the decrease of citric acid content. The polyphenol contents were 26.81~56.10 ${\mu}g/g$ and 8.64~26.45 ${\mu}g/g$, respectively, in immature and mature fruits. During ripening, the polyphenol content was decreased. The DPPH radical scavenging activity of methanol extracts were 84.47~89.37% and 43.94~76.96% at 500 ppm, respectively, in immature and mature fruits. The immature varieties of kiwifruit have a high DPPH radical scavenging activity. Therefore the chemical composition and physiological activity of kiwifruit was affected by variety and maturity.

• Journal of Korean Academy of Nursing
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• v.43 no.6
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• pp.704-713
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• 2013

Purpose: This study was done to identify the parenting experience of mothers of premature infants in order to provide basic data for educational solutions and desirable directions. Methods: Q-methodology was used as it provides a method of analyzing the subjectivity of each item. The participants were 33 mothers of premature infants who sorted 34 selected Q-statements which were then classified into the shape of a normal distribution using a 9-point scale. Subjectivity on parenting experience among the mothers was analyzed using the pc-QUANAL program. Results: Four types of parenting experience were identified. Type I was named 'struggling', type II, 'self blame', type III, 'information collecting', and type IV, 'self-introspection'. Conclusion: The results of this study indicate that different approaches to educational programs are needed for mothers of premature infants based on the four types of parenting experience.

• Pediatric Infection and Vaccine
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• v.23 no.2
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• pp.137-142
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• 2016

Severe cytomegalovirus (CMV) infection involving multiorgan is very rare except in very low-birth weight infants, or in immunocompromised pediatric patients. We report an unusual case of severe CMV infection involving multiple organs including the central nervous system, liver, lung, and gastrointestinal tract in a late-preterm infant at 2 months of age.