• Clinical and Experimental Pediatrics
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• v.46 no.1
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• pp.24-32
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• 2003

Purpose : Nosocomial infection with Staphylococcus aureus, especially methicillin resistant S. aureus, has become a serious concern in the neonatal intensive care unit. The aim of this study is to investigate the virulence factors, and the relationship between the antibiotic resistance and the associated genes of Staphylococcus aureus isolated from nasal cavity of neonates. Methods : Fifty one isolates of S. aureus were obtained from nasal swab taken in 28 neonates in the NICU and nursery of Pusan National University Hospital between February and May, 2001. They were tested in regard to antibiotic susceptibility, coagulase test and typing, plasmid DNA profile, as well as reactivity to enterotoxin A-E(sea, seb, sec, sed, see) genes and toxic shock syndrome toxin-1(tst) gene by polymerase chain reaction(PCR). Associated genes such as mecA, mecR1, mecI, and femA were also determined by PCR. The origin of MRSA strains was assessed using DNA fingerprinting by arbitrarily-primed polymerase chain reaction(AP-PCR). Results : Twenty three(45.1%) and six(11.8%) isolates were resistant to oxacillin and vancomycin respectively. Multidrug resistance to three or more of the antibiotics tested was observed in 51.0% of the isolates. Forty two isolates were coagulase positive and twenty two isolates had mecA gene. Sixteen isolates had both mecA and femA genes and had type I-III plasmids. 64.7% of isolates carried sec gene, and 80.4% carried tst gene. DNA fingerprinting by AP-PCR for 12 MRSA strains showed 10 distinct patterns, suggesting different origins. Conclusion : We confirmed that the prevalence of nasal carriage of S. aureus and the incidence of antimicrobial-resistant S. aureus, especially vancomycin resistance, is very high in neonates who were admitted in NICU and nursery. It is possible that these pathogens are responsible for serious nosocomial infections in neonates. The need for improved surveillance and continuous control of pathogens is emphasized.

• Neonatal Medicine
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• v.18 no.2
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• pp.221-227
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• 2011

Purpose: The objectives were to identify the characteristics of neonates with hydrops fetalis, and to identify the risk factors associated with mortality. Methods: A retrospective review of AMC (Asan Medical Center) dataset was performed from January 1990 to June 2009. The characteristics of 71 patients with hydrops fetalis were investigated and they were divided into two groups: the survived group and the expired group. Various perinatal and neonatal factors in two groups were compared to find out risk factors associated with mortality based on univariate analysis, followed by multiple regression analyses (SPSS version 18.0). Results: Of those 71 neonates (average gestational age: 33 weeks, birth weight: 2.6 kg), 38 survived, 33 died, resulting in overall mortality rate of 46.5%. The most common etiology was idiopathic followed by chylothorax, cardiac anomalies, twin-to-twin transfusion, meconium peritonitis, cardiac arrythmias, and congenital infections. Factors that were associated independently with mortality in logistic regression analyses were low 5-minutes Apgar score, hyaline membrane disease and delayed in achieving 50th percentile ideal body weight for appropriate gestational age by 10 days. Conclusion: In this study, 5-minutes Apgar score, hyaline membrane disease and delayed in achieving 50th percentile ideal body weight for appropriate gestational age by 10 days were significant risk factors associated with mortality in hydrops fetalis. Therefore, the risk of death among neonates with hydrops fetalis depends on the illness immediately after birth and severity of hydrops fetalis. Informations from this study may prove useful in prediction of prognosis to neonates with hydrops fetalis.

• Journal of Yeungnam Medical Science
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• v.8 no.2
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• pp.128-137
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• 1991

Peritoneal dialysis has been widely considered to be the dialytic treatment of choice for acute renal failure in infants and young children, because the technique is simple, safe and easily adapted for these patients. Also peritoneal dialysis in infants might have more effective ultrafiltration and clearance than in adults. In certain circumstances associated with hemodynamic instability, ordinary volume peritoneal dialysis(30-50 ml/kg body weight per exchange) or hemodialysis may not be suitable unfortunately. But frequent cycled, low volume, high concentration peritoneal dialysis may be more available to manage the hemodynamically untable acute renal failure of newborns and infants. Seven infants underwent peritoneal dialysis for hemodynamically unstable acute renal failure with low exchange volume($14.2{\pm}4.2ml/kg$), short exchange time(30 to 45 minutes) and hypertonic glucose solution(4.25% dextrose). Age was $1.9{\pm}1.3$ months and body weight was $4.6{\pm}1.6kg $. Etiology of acute renal failure was secondary to sepsis with or without shock(5 cases) and postcardiac operation(2 cases). Catheter was inserted percutaneously with pigtail catheter or Tenkhoff catheter by Seldinger method. Dialysate was commercially obtained Peritosol which contained sodium, chloride, potassium, magnesium, lactate and calcium. Net ultrafiltration(ml/min) showed no difference between low volume dialysis and control($0.27{\pm}0.09$ versus $0.29{\pm}0.09$) Blood BUN decreased from $95.7{\pm}37.5$ to $75.7{\pm}25.9mg/dl$ and blood pH increased from $7.122{\pm}0.048$ to $7.326{\pm}0.063$ after 24 hours of peritoneal dialysis. We experienced hyperglycemia which were controlled by insulin(2 episodes), leakage at the exit site(2), mild hyponatremia(1) and Escherichia coli peritonitis(1). Two children of low volume dialysis died despite the treatment. In our experience, low volume and high concentration peritoneal dialysis with frequent exchange may have sufficient ultrafiltration and clearance without significant complications in the certain risked acute renal failure of infants.

• Neonatal Medicine
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• v.18 no.1
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• pp.117-123
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• 2011

Purpose: Congenital intrahepatic portosystemic shunts are rare disease and clinically asymptomatic shunts may be detected by chance on ultrasonogram before and after birth. We studied clinical course, treatment and prognosis of congenital intrahepatic portosystemic shunt at prenatal or neonatal period. Methods: Medical records of 8 patients which were diagnosed in intrahepatic portosystemic shunt in Cheil General Hospital from 2006 through 2010 were reviewed retrospectively. Results: Eight patients with congenital intrahepatic portosystemic shunts were identified. Six patients were diagnosed at prenatal radiological screening, including three cases of intrauterine growth restriction and two cases of preterm baby. One case with increased serum ammonia underwent coil embolization. In four cases including one case that presented elevated direct bilirubin, shunts were closed spontaneously within 11th month after birth. Two patients were diagnosed on abdominal sonogram after birth because of elevated direct hyperbilirubinemia, all of whom presented intrauterine growth restriction. Closure of shunts was confirmed during 4th month to 6th month. Conclusion: Congenital intrahepatic portosystemic shunts are clinically asymptomatic mostly and spontaneous closure is expected within 2 years age. But occasionally they have severe complication, so clinical and radiological observation is needed. Specially in cases of intrauterine growth retardation without evident cause, the possible diagnosis of congenital intrahepatic portosystemic shunts should be considered and prenatal and postnatal examination should be performed. When prenatal diagnosis is made, fetal wellbeing should be monitored periodically until spontaneous closure of shunts.

• Development and Reproduction
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• v.4 no.2
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• pp.137-145
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• 2000

The regulatory mechanisms of the initiation and the formation of ovarian follicles during fetal stage of mammals are largely unknown. In addition to the gonadotropins secreted from pituitary, various growth factors, and steroid hormones are believed to be involved in the differentiation and initiation of growth of primordial follicles consisting of primordial germ cells migrated from yolk sac and streamed cells from mesonephric somatic cells. In human, primordial follicles that have already initiated differentiation at fetal stage undergo either folliculogenesis to ovulate or atresia after growth. Some of primordial follicles remain without growth for 50 years or longer. The objective of this paper is to review the mechanism of the formation, growth arrest, and initiation of primordial follicles in human fetal and neonatal ovaries.

• Women's Health Nursing
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• v.21 no.4
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• pp.253-261
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• 2015

Purpose: The aim of this study was to examine differences in nutrition knowledge, eating habits during pregnancy, and neonatal health status between primipara for pregnant women of advanced maternal age in comparison to those under the age of 35. Methods: This study used a comparative survey design. Data were collected through self-report questionnaires and patients medical records. A total of 127 participants, mothers after delivery were recruited from metropolitan city B. Results: Primipara in advanced maternal age (n=32) reported significantly higher scores of eating habits (Z=-2.96, p=.003) than younger ages (n=95). There were no significant differences in scores of pregnancy nutrition knowledge (Z=-0.44, p=.660), duration of gestation (Z=-0.28, p=.778), neonatal birth height (Z=-0.10, p=.924), neonatal birth weight (Z=-0.28, p=.777), Apgar score 1 minute (Z=-0.53, p=.599) and 5 minutes (Z=-0.23, p=.816) between two groups. Conclusion: It concludes that age is not the obstacle to the best nutritional status of women and their newborns.

• Journal of Nutrition and Health
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• v.22 no.6
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• pp.547-556
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• 1989

This survey was carried out to investigate the nutritional status of 102 rural pregnant women after the 2nd trimester and the effect of pregnant nutritional status on newborn infant's anthropometric measurements. 102 rural pregant women's age was distributed 20 to 34. Pregnant height and prepregnant weight were 157.7$\pm$3.2cm and 50.7$\pm$5.4kg, respectively, which were similar to Korean standard, and pregnant weight gain per week after the 2nd trimester was 0.35$\pm$0.13kg, which was showed normal weight gain. Pregnant blood pressure were 112.6$\pm$12.7mmHg (systolic pressure) and 71.8$\pm$10.6(diastolic pressure), and energy and protein intake were 83.8$\pm$34.3% and 72.2$\pm$24.2% of RDA, respectively. Hemoglobin and blood protein level of 17 pregnant women who selected among total pregnant women were 11.8$\pm$1.0g / dl, 6.5$\pm$0.9g / dl, respectively. Height, weight, and head circumference of 17 newborn infants who delivered from 17 pregnant women were 50.1$\pm$1.9cm, 3.4$\pm$0.6kg, and 31.4$\pm$1.2cm, respectively, which were similar to Korean standard. Infant height, weight, and head circumference at birth were significantly correlated with pregnant higher than dietary intakes and weight gain per week during midpregnancy.

• Clinical and Experimental Pediatrics
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• v.50 no.7
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• pp.698-701
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• 2007

We report on two premature infants who developed nosocomial infection caused by Chryseobacterium meningosepticum in a neonatal intensive care unit (NICU). One premature infant developed sepsis, meningitis, and hydrocephalus, and was treated successfully with ciprofloxacin plus trimethoprim-sulfamethoxazole combination therapy for 4 weeks and with a ventriculoperitoneal shunt. The other premature infant, who was in a chronically debilitated state, had infection that had colonized only in the respiratory tract but had no clinical signs for 66 days. Extensive environmental surveillance demonstrated that the suction bottle apparatus was the source of infection. We prevented the spread of infection by closing the NICU temporarily, isolating the patients early in their infection, and eradicating the source of infection source.

• Childhood Kidney Diseases
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• v.7 no.1
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• pp.96-102
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• 2003

Acute hyperammonemia is a medical emergency in the newborn. Efficient, prompt removal of serum ammonia is essential in preventing irreversible brain damage in order to prevent the profound central nervous system dysfunction due to hyperammonia. We report a case of 2.3 kg, 5-day old girl with methylmalonic acidemia who presented with severe hyperammonemia and was successfully treated with continuous venovenous hemodiafiltration(CVVHDF). CVVHDF is an effective and safe method of ammonia removal in the newborn.

• Proceedings of the Korea Institute of Fire Science and Engineering Conference
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• 2011.11a
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• pp.474-477
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• 2011

본 논문은 산후조리원에서 화재 발생시 산후조리원에 재원하고 있는 산모의 피난경로를 분석한 연구이다. 화재 시 피난시간은 이동거리와 공간구조에 따라 달라질 수 있기 때문에 화재시 피난시간이나 피난거리 등의 연구가 매우 중요하다. 산후조리원에 생활하는 사람은 산모와 신생아로 화재시 피난활동에 적절한 대응을 하기 어려운 인원이 대부분 구성되어 있다. 본 연구에서는 전국의 산후조리원 중에서 40개의 산후조리원을 무작위로 추출하여 각 산후조리원의 피난거리와 피난경로 등을 분석하였다. 또한 선행 연구에서 제시하는 피난비용분석기법을 적용하여 40개 산후조리원에서의 피난지수를 산정하고 피난위험성을 분석하였다. 그 결과 피난경로는 피난거리와 공간구조를 파악하는 시지각적 요소가 중요한 것으로 나타났다.