• Title/Summary/Keyword: 신생아 상태

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Surgical Correction of Total Anomalous Pulmonary Venous Connection in Early Infancy (조기 영아에서 전폐정맥연결이상의 외과적 교정)

  • 성시찬;방정희;전희재;조광조;최필조;우종수;이인규;이형두
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.510-517
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    • 1999
  • Background: Total anomalous pulmonary venous connection (TAPVC) is still one of the more challenging congenital heart defects in newborns and young infants. The purpose of the study is to evaluate the early and midterm results of the surgical corrections for patients in early infancy with isolated TAPVC. Material and Method: Hospital records of 15 consecutive patients in early infancy (January 1993 to August 1998) were retrospectively reviewed. There were 8 boys and 7 girls whose ages ranged from 4 days to 3.5 months (median age 22 days). Their body weight ranged from 1.75 kg to 4.9 kg (mean 3.54 kg). The abnormal anatomical connections were supracardiac in 11, cardiac in 3, and infracardiac in 1. In 6 patients (40%), the pulmonary venous drainage was obstructive. Total circulatory arrest was used in 13 patients. Anastomosis between the common pulmonary vein and the left atrium was performed with a continuous suture technique using a fine nonabsorbable polypropylene suture through a lateral approach behind the right atrium. Result: There was one hospital death (6.5%) caused by a sepsis 17 days after the operation in a neonate who had supracardiac drainage and was dependent on a ventilator preoperatively. There were 2 late deaths. One died sudde`nly of an unknown cause at home 2.5 years after the operation and the other died of a recurrent pulmonary hypertension 3 months after the reoperation due to pulmonary venous obstruction (PVO). Two patients required reoperations because of PVO 5 months and 10 months respectively after the initial operation. Of these patients, one patient is alive at the present time with persistent pulmonary hypertension. All survivors without postoperative PVO (78.6%) were in NYHA functional class I at mean follow-up of 25.8 months (0.5∼67 months). Conclusion: Surgical correction of TAPVC in early infancy can be performed at low risk. However, there were 2 postoperative PVOs (14.3%) which had bad results. The survivors without postoperative PVO had excellent functional status.

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Healing patterns after guided bone regeneration in human extraction sockets (인간의 발치와 내에서 골유도재생술 후의 치유양상)

  • Jang, Hyun-Seon;Yeom, Chang-Yeob;Park, Joo-Cheol;Kim, Su-Gwan;Kim, Heung-Joong;Kook, Joong-Ki;Kim, Chong-Kwan;Kim, Byung-Ock
    • Journal of Periodontal and Implant Science
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    • v.35 no.4
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    • pp.949-959
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    • 2005
  • 이 연구는 임플란트를 식립하기를 원하는 전신건강상태가 양호하며 구강위생상태가 좋은 14명 환자(남자:8명, 여자:6명, 평균나이 : 44세)의 20개의 발치와 내에 흡수성 차폐막(BioMesh. Sam Yang Corporation, Korea)과 함께 탈회냉동 건조동종 골(dem-ineralized freezedried bone allografts, $250-500{\mu}m$. Pacific Coast Tissue Bank, U.S.A.)과 이종골(Bovine-Bone, Bio-Oss 0.25-1.0 mm, Geistlich, Biomaterials and Osteohealth, Switzerland)을 1:1(부피)로 혼합하여 이식한 후 그 치유양상을 관찰하고자 조직학적 및 면역조직화학적으로 평가하였다. 이직재가 탈락되는 것을 방지하기 위하여 발치한 후 1개윌이 경과된 후에 이식재와 차폐막을 위치시켰다. 표본제작을 위하여 이식술을 시행한 지 약 6개윌 후에 임플란트를 식립하기 직전 식립부위에서 trephine bur로 골을 채취하였는데, 20증례 중 7증례에서 임플란트를 식립하기 전에 차폐막이 노출되었다. 차폐막이 노출되지 않은 것을 대조군으로, 노출된 것을 실험군으로 설정하였다. 조직학적인 관찰을 위하여 통상적인 방법에 따라 탈회 표본을 제작하였고, alkaline phosphotase(ALP)틀 이용하여 면역조직화학적 염색을 시행한 후 골 형성 상태를 평가하여 다음과 같은 결과를 얻었다. 본 연구에서는 발치와내에서 골유도재생술 후 나타나는 치유 형태를 5가지 형태로 분류할 수 있었다. Type I, II와 III는 새로운 골 형성을 나타내지 않았고, 면역조직화학적 검사 시 ALP 음성 소견을 나타내었다. Type V는 새로운 골 형성과 ALP 양성 소견을 나타내었으나 염증, 괴사, 결합조직의 증식 등은 없었다. Type IV와 Type V의 차이는 결합조직의 증식여부로 구분되었다. 막이 노출되지않은 증례들 중 7 증례에서는 Type V의 치유 형태를, 2증례에서는 Type IV의 치유 형태를 나타내었다. 막이 노출되었던 증례에서는 Type I, II, III의 다양한 치유 형태를 나타내었다. 본 연구결과, 발치와 내에 골유도재생술을 시행한 후 차폐막의 노출 여부가 신생골 형성에 중요한 영향을 미칠 것으로 사료되며, 본 연구에서 분류한 치유 형태가 향후 골유도재생술 후의 결과 분석에 활용될 수 있을 것으로 사료된다.

Parenting Stress in Mothers of Premature Infants (미숙아를 출산한 어머니의 양육스트레스)

  • Hwang, Hyun-Sook;Kim, Hee-Soon;Yoo, Il-Young;Shin, Hyun-Sook
    • Child Health Nursing Research
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    • v.19 no.1
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    • pp.39-48
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    • 2013
  • Purpose: The purposes of this study were to assess the parenting stress in mothers of premature infants and stress related characteristics of mothers and infants. Methods: The methodology was a cross sectional survey study using self-report questionnaires. Participants in this study were 36 mothers of infants with corrected ages of 4 months to 12 months who were born prematurely. Data were analyzed using t-test, ANOVA, and Pearson correlation with the SPSS WIN 19.0 program. Results: The mean score for parenting stress in mothers of premature infants was $74.639{\pm}17.570$, indicating that the mothers actually experienced stress. When mothers were able to have some private time, parenting stress was statistically significantly lower. When the residential status was having one's own house and the local community provided informational support regarding child nurturing, there was a statistically significant decrease in the sub-category of particular infant temperament. There was a statistically significant positive correlation between mothers' depression and parenting stress. Conclusion: These results indicate that there is a need for nursing interventions to increase mothers' private time and to include informational support regarding health management of children including developmental status assessment from local communities.

A Case of Palliative Chemotherapy of Advanced Gastric Cancer with Multiple Hepatic Metastasis (다발성 간 전이가 동반된 진행성 위암의 고식적 항암치료 1례)

  • Hae Jin Shin;Hyun Yong Jeong;Hee Seok Moon;Jae Kyu Sung;Sun Hyung Kang
    • Journal of Digestive Cancer Research
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    • v.3 no.1
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    • pp.30-34
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    • 2015
  • We report a case of a 55-year-old man who diagnosed with advanced gastric cancer (AGC), with A review of the literature. A 55-year old man was transferred to our hospital for further evaluation and treatment after being diagnosed with adenocarcinoma through endoscopic biopsy during a regular health examination. An abdominal computed tomography (CT) showed AGC, stage IIA (T3N3M0), while an endoscopic examination showed AGC, Borrmann type 2. The patient is currently under observation after undergoing radical subtotal gastrectomy with gastroduodenostomy and subsequent administration of oral chemotherapeutic agents. As an abdominal CT response assessment performed after surgery revealed new metastasis to the liver, the patient received palliative chemotherapy as progressive disease was suspected. After receiving chemotherapy in the order of FOLFOX (5-fluorouracil (5-FU)) + Leucovorin + Oxaliplatin), FOLFIRI (5-FU + Leucovorin + Irinotecan), EAP-II (Etoposide + Doxorubicin + Cisplatin), ELF (Etoposide + Leucovorin + 5-FU), TS-1 (Tegafur + Gimeracil) + Cisplatin, an abdominal CT response assessment showed progressive disease for which the regimen was altered to PFL (Paclitaxel + 5-FU + Leucovorin). The patient has currently completed his second cycle of chemotherapy and after an abdominal CT response assessment, further course of therapy will be decided.

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Effects of NG-monomethyl-L-arginine and L-arginine on cerebral hemodynamics and energy metabolism during reoxygenation-reperfusion after cerebral hypoxia-ischemia in newborn piglets (급성 저산소성 허혈성 뇌손상이 유발된 신생자돈에서 재산소-재관류기 동안 NG-monomethyl-L-arginine과 L-arginine이 뇌의 혈역학 및 에너지 대사에 미치는 영향)

  • Ko, Sun Young;Kang, Saem;Chang, Yun Sil;Park, Eun Ae;Park, Won Soon
    • Clinical and Experimental Pediatrics
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    • v.49 no.3
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    • pp.317-325
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    • 2006
  • Purpose : This study was carried out to elucidate the effects of nitric oxide synthase(NOS) inhibitor, NG-monomethyl-L-arginine(L-NMMA) and nitric oxide precursor, L-arginine(L-Arg) on cerebral hemodynamics and energy metabolism during reoxygenation-reperfusion(RR) after hypoxia-ischemia(HI) in newborn piglets. Methods : Twenty-eight newborn piglets were divided into 4 groups; Sham normal control(NC), experimental control(EC), L-NMMA(HI & RR with L-NMMA), and L-Arg(HI & RR with L-Arg) groups. HI was induced by occlusion of bilateral common carotid arteries and simultaneously breathing with 8 percent oxygen for 30 mins, and followed RR by release of carotid occlusion and normoxic ventilation for one hour. All groups were monitored with cerebral hemodynamics and cytochrome $aa_3$ (Cyt $aa_3$) using near infrared spectroscopy(NIRS). $Na^+$, $K^+$-ATPase activity, lipid peroxidation products, and tissue high energy phosphate levels were determined biochemically in the cerebral cortex. Results : In experimental groups, mean arterial blood pressure, $PaO_2$, and pH decreased, and base excess and blood lactate level increased after HI compared to NC group(P<0.05). These variables subsequently returned to baseline after RR except pH. There were no differences among the experimental groups. In NIRS, oxidized hemoglobin($HbO_2$) decreased and hemoglobin(Hb) increased during HI(P<0.05) but returned to base line immediately after RR; 40 min after RR, the $HbO_2$ had decreased significantly compared to NC group(P<0.05). Changes of Cyt $aa_3$ decreased significantly compared to NC after HI and recovered at the end of the experiment. Significantly reduced cerebral cortical cell membrane $Na^+$, $K^+$-ATPase activity and increased lipid peroxidation products(P<0.05) were not improved with L-NMMA or L-Arg. Conclusion : These findings suggest that NO is not involved in the mechanism of HI and RR brain damage during the early acute phase of RR.

Research Strategy on Columnar Joint in South Korea (우리나라 주상절리에 대한 연구 전략)

  • Ahn, Kun Sang
    • Journal of the Korean earth science society
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    • v.35 no.7
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    • pp.501-517
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    • 2014
  • Based on a summary of the previous studies on columnar joints, this study presents research strategies and subjects to understand a formation of columnar joints, and its application in South Korea as follows; geometry of colonnade and entablature, formation mechanism and pattern change, surface morphology and internal structure, platy joint at the top and the bottom of columnar joints, crack patterns in drying starch-water slurries, using numerical models and computer graphics on joint formation, scale and geometry concerned with occurrence of volcanic rock, petrological and mineralogical study of the host rock. Additionally, more research is needed, such as deformation of column pattern during the hot state, secondary landform by alteration and weathering on the Earth's surface such as rock stream, tor and tafoni. This study will take an active role in research of columnar joint and the Cenozoic lava flow of South Korea. Results of this study will be useful to the activation of geotourism and geological field study.

The Effects of Vitamin $B_{2}$ Deficiency on Stored Fuel Utilization during 3 Days Fasting or 6 Days Underfeeding in Rats (Vitamin $B_2$ 결핍이 3일간 금식 또는 6일간 감식 흰쥐의 에너지대사물 농도에 미치는영향)

  • 조윤옥;설승민;최성숙
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.25 no.2
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    • pp.181-187
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    • 1996
  • 본 연구에서는 비타민 $B_{2}$ 결핍이 3일간 금식과 6일간 감식시 체내 저장연료 이용에 어떠한 영향을 미치는 가를 알아본 결과, -B2군은 pair-feeding을 감식시켰음에도 불구하고 +B2군에 비해 체중이 유의적으로 낮게 나타났으며 식이 이용효율도 낮았다. 모든 장기, 특히 간장 무게는 -B2군이 +B2군에 비해 무겁게 나타났으며, 감식과 금식시에도 -B2군의 장기무게가 가벼워졌으나 여전히 유의하게 무거웠으며 -B2군의 간장 중성 지방이 높게 나타나 지방간 증상으로 간장이 비대해진 것으로 추정된다. 혈장 포도당과 단백질 함량은 섭식, 금식 및 감식시 +B2군과 -B2군 사이에 유의적인 차이가 없었다. 혈장 중성지방 수준은 +B2군에 비해 -B2군이 섭식시는 높은 수준을 나타냈으나 금식 및 감식시에는 유의적인 차이를 나타내지 않았다. 간장 중성 지방도 이와 유사한 경향을 나타내었다. 혈장 유리지방산 수준은 섭식시에는 +B2군과 -B2군 사이에 유의적인 차이가 없었으나, 금식으로 인해 +B2군은 유리지방산 수준이 증가하였고 -B2군은 오히려 감소하여 -B2군이 +B2군 보다 낮게 나타났다. 그러므로 비타민 $B_{2}$ 결핍으로 인해 이 유리지방산의 유리가 원활히 일어나지 않았거나, 비타민 $B_{2}$ 결핍으로 인해 지방산화가 저해된 것이 금식으로 지방이 에저지원으로 이용되어야만 하는 상황이 발생하여 감소된 지방산 산화가 다소 회복된 것으로 추정된다. 금식 및 감식시 +B2군에 비해 -B2군이 근육단백질 수준은 높은 경향을 나타내었고 근육 글리코겐 수준은 낮은 경향을 나타내어 -B2군이 심각한 비타민 $B_{2}$ 결핍으로 저지방이나 근육단백질을 이용하지 못하게 됨에 따라 근육 글리코겐을 이용한 것으로 추정된다. 이는 +B2군에 비해 -B2군의 뇨중 총질소 배설량이 적은 것으로도 재확인되었다. 그러므로 금식이나 감식시 체지방이나 체단백질을 이용하는 에너지 보충 적응기전이 일어나야 하나 비타민 $B_{2}$ 결핍상태에서는 이러한 체내 열량공급이 지장을 받게 되며, 체단백질 이용저하로 포도당 신생이 영향을 받아 장기간의 금식 또는 감식시에는 혈장 포도당 수준도 낮아질 것으로 예상된다.

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Case Report; Tetanus, Differential Diagnosis with Trismus (개구장애 환자에서의 감별진단, 파상풍 환자의 증례보고)

  • Lim, Hyun-Dae;Lee, You-Mee
    • Journal of Oral Medicine and Pain
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    • v.36 no.2
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    • pp.117-121
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    • 2011
  • Tetanus is fatal neurological disease caused by Clostridium tetani on contaminated wound that is characterised by muscle spasm, muscle pain, and autonomic dysfuction. C. tetani exist on contaminated wound frequently that developed clinical tetanus under low oxygen condition. Tetanus have four symptomatic form: generalized, localized, cephalic, and neonatal. The incubation period is about 7 days and mortality is high. The commonest presenting symptom is trismus and other is stiffness of neck and back(opisthotonos), muscle spasm, dysphagia, facial pain, risus sardonicus. Trismus is primary presenting symptom in 50~75% of the cases and this have high possibility of initial visit to dental office. This case report of a patient who visit in our department with trismus as chief complaint.

Associated Factors in Pediatric Nurse Parent Partnership (아동간호사의 환아 부모와의 파트너십 영향요인)

  • Choi, Miyoung;Kim, Jisoo
    • Child Health Nursing Research
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    • v.20 no.3
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    • pp.176-184
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    • 2014
  • Purpose: The purpose of this study was to investigate pediatric nurse parent partnership and factors associated with this partnership. Methods: A survey was conducted with 158 nurses working in pediatric practice at one of 7 hospitals in Seoul, Incheon, and Chungcheongbuk Province. Data were collected from September to December 2013, and analyzed with SPSS Windows 21.0. Results: In hierarchial multiple regression analysis, self-efficacy (${\beta}$=.19, p=.016), clinical decision making (${\beta}$=.15, p=.046), and empowerment (${\beta}$=.29, p=.001) were associated with pediatric nurse parent partnership, after adjusting for marital status, children, education, position and satisfaction with work unit. These factors accounted for 44.0% of the variance in the pediatric nurse parent relationship. Conclusion: These results suggest that pediatric nurse parent partnership could be influenced by the predictors. Ultimately, intervention programs focusing on these factors should be effective in helping pediatric nurses improve partnership with parents.

Iron Status in Pregnant Women and Their Newborn Infants (임신부와 신생아의 철분 영양상태에 관한 연구)

  • 김은경
    • Journal of Nutrition and Health
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    • v.32 no.7
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    • pp.793-801
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    • 1999
  • The purposes of this study are to assess iron status in mothers and their newborn infants at birth and to analyze the influence of maternal iron status on their newborn babies. Venous bloods samples were drawn from 144 pregnant women just before delivery and cord bloods of their newborn babies were collected immediately after birth for measurement of hemoglobin, hematocrit, serum iron, ferritin, total binding capacity and transferrin saturation. The values of hemoglobin and hematocrit were significantly lower in the mothers(10.9$\pm$1.43g/dl and 33.7$\pm$3.67%) than in their newborn infants(14.7$\pm$1.43g/dl and 45.3$\pm$4.76%)(p<0.0001). At delivery, serum iron levels in cord blood were about twice as high as those in the maternal blood, and serum ferritin levels in the cord blood were about four times higher than those in the maternal blood. The serum ferritin levels of multigravidas were higher than those of primigravidas,. but there was no difference between the serum ferritin levels of their infants. The serum ferritin levels of the mothers and their infants were higher in maternal group with iron supplement regularly than in other maternal group without iron supplement during pregnancy. Among the mothers, 26.4% had a serum ferritin levels below 12ng/ml(i.e. depleted iron stores)and 78.9% had a hemoglobin below 12g/dl(i.e.iron deficient anemia). When the maternal group was classified according to their serum ferritin levels by 9ng/ml, 12ng/dl or 20ng/ml, there was no significant difference in the iron status of their newborn infants among the three groups. The hemoglobin and serum ferritin levels of the mothers were well correlated with those of their babies. The maternal hemoglobin values negatively correlated with infant birth weight. It is possible that the demands of iron of the mother might be increased in the case of a newborn infant of greater size. The results of this study provide useful information regarding establishment of RDA for iron in pregnant women and guidance about the need for iron supplement during pregnancy.

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