• Child Health Nursing Research
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• 제23권4호
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• pp.494-504
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• 2017

Purpose: The aim of this study was to analyze Neonatal Intensive Care Unit nurses' behaviors while soothing newborns with bronchopulmonary dysplasia. Methods: An observational study was used to assess nurses' soothing behaviors. Data were collected from September, 2012 to March, 2013 using an audio-video recording system. Participants were eight babies and 12 nurses caring for those babies. After obtaining parental permission, the overall process of each episode from nurses' engagement in soothing to the end of soothing was recorded. Then a researcher interviewed each participating nurse. Data from 18 episodes were transcribed as verbal and nonverbal nursing behaviors and then categorized by two researchers. Results: There were 177 observed soothing behaviors which were classified with the five sensory-based categories (tactile, oral, visual, auditory, vestibular). Most frequently observed soothing behavior was 'Gently talking' followed by 'Removing irritant', and 'Providing non-nutritive sucking'. Nurses' perceived soothing behaviors were similar to the observed soothing behaviors except for 'Gently talking'. Conclusion: Nurses used diverse and mixed soothing behaviors as well as recognizing those behaviors as essential nursing skills. Nurses' soothing behaviors identified in this study can be used to comfort babies and to enhance their developmental potential in accordance with individual characterstics or cues.

• Tuberculosis and Respiratory Diseases
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• 제78권2호
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• pp.128-132
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• 2015

Bronchopulmonary dysplasia (BPD) is related to decreased lung function throughout life. However, the pathology and radiology pattern of BPD of adults are not documented well yet. In this case report, we present BPD case of an adult monozygotic twin showing nearly identical lesions on chest computed tomography (CT). CT images showed mixed areas of ground-glass and reticular opacities in both lungs. They had common histories of pneumonias requiring mechanical ventilations in period of infants. Pulmonary function test of one patient showed a pulmonary insufficiency with airway obstruction. Pathologic findings showed bronchiolar hyperplasia and peribronchiolar fibrosis which was similar to classic BPD patients. Our twin case report might help provide distinguishing pathology and radiology pattern of an adult pulmonary sequelaes of BPD. It might be reasonable to make close follow-up for BPD patients to evaluate the long-term outcomes of BPD survivors.

• Neonatal Medicine
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• 제15권1호
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• pp.6-13
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• 2008

• Clinical and Experimental Pediatrics
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• 제64권1호
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• pp.37-43
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• 2021

Background: Animal studies have shown that a leukocyte influx precedes the development of bronchopulmonary dysplasia (BPD) in premature sheep. The CXC chemokine receptor 2 (CXCR2) pathway has been implicated in the pathogenesis of BPD because of the predominance of CXCR2 ligands in tracheal aspirates of preterm infants who later developed BPD. Purpose: To test the effect of CXCR2 antagonist on postnatal systemic and pulmonary inflammation and alveolarization in a newborn Sprague-Dawley rat model of BPD. Methods: Lipopolysaccharide (LPS) was injected intraperitoneally (i.p.) into the newborn rats on postnatal day 1 (P1), P3, and P5 to induce systemic inflammation and inhibit alveolarization. In the same time with LPS administration, CXCR2 antagonist (SB-265610) or vehicle was injected i.p. to investigate whether CXCR2 antagonist can alleviate the detrimental effect of LPS on alveolarization by attenuating inflammation. On P7 and P14, bronchoalveolar lavage fluid (BALF) and peripheral blood (PB) were collected from the pups. To assess alveolarization, mean cord length and alveolar surface area were measured on 4 random nonoverlapping fields per animal in 2 distal lung sections at ×100 magnification. Results: Early postnatal LPS administration significantly increased neutrophil counts in BALF and PB and inhibited alveolarization, which was indicated by a greater mean cord length and lesser alveolar surface area. CXCR2 antagonist significantly attenuated the increase of neutrophil counts in BALF and PB and restored alveolarization as indicated by a decreased mean cord length and increased alveolar surface area in rat pups exposed to early postnatal systemic LPS. Conclusion: CXCR2 antagonist preserved alveolarization by alleviating pulmonary and systemic inflammation induced by early postnatal systemic LPS administration. These results suggest that CXCR2 antagonist can be considered a potential therapeutic agent for BPD that results from disrupted alveolarization induced by inflammation.

• Neonatal Medicine
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• 제18권2호
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• pp.280-287
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• 2011

목적: 미숙아에서 위액 내 Ureaplasma urealyticum 의 검출이 미숙아의 특징과 임상적 예후에 어떤 영향을 주는지를 알아보고자 하였다. 방법: 미숙아를 대상으로 출생 후 30분 이내에 첫 위액은 채취하였고, 위액 내 U. urealyticum 이 검출되는지를 확인하기 위해 24시간 이내에 배양을 실시하였다. 그리고 U. urealyticum 이 검출된 군을 양성군으로, 검출되지 않은 군을 음성군으로 나누었다. 결과: 91명의 미숙아 중에서 17명(19%)에서 위액 내 U. urealyticum 이 검출되었다. U. urealyticum 양성군에서 음성군보다 통계학적으로 30주 미만의 미숙아 수가 더 많았고(P=0.02), 1분과 5분 아프가 점수가 더 높았으며(P=0.017과 P=0.048), 그리고 질식 분만이 더 많았다(P=0.000). 두 군간에 기관지폐이형성증의 발생률은 차이가 없었지만, 이전에 신생아호흡 곤란증 진단 없이 기관지폐이형성증의 발생한 빈도는 음성군(1%)보다 양성군 (11%)에서 의미 있게 높았다(P=0.03). 결론: 위액 내 U. urealyticum 검출은 임신 기간 30주 미만 미숙아에서 높게 관찰되고, 미숙아에서 선행되는 신생아호흡곤란증후군이 없이도 발생할 수 있는 기관지폐이형성증을 예측하는데 도움이 된다.

• Clinical and Experimental Pediatrics
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• 제62권10호
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• pp.380-381
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• 2019

• Clinical and Experimental Pediatrics
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• 제59권10호
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• pp.389-394
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• 2016

The incidence of bronchopulmonary dysplasia (BPD) has not decreased over the last decade. The most important way to decrease BPD is by weaning the patient from the ventilator as soon as possible in order to reduce ventilator-induced lung injury that underlies BPD, and by using a noninvasive ventilator (NIV). Use of a heated, humidified, high flow nasal cannula (HHHFNC), which is the most recently introduced NIV mode for respiratory support in preterm infants, is rapidly increasing in many neonatal intensive care units due to the technical ease of use without sealing, and the attending physician's preference compared to other NIV modes. A number of studies have shown that nasal breakdown and neonatal complications were lower when using a HHHFNC than when using nasal continuous positive airway pressure (nCPAP), or nasal intermittent positive pressure ventilation. The rates of extubation failure during respiratory support were not different between patients who used HHHFNC and nCPAP. However, data from the use of HHHFNC as the initial respiratory support "after birth", particularly in extremely preterm infants, are lacking. Although the HHHFNC is efficacious and safe, large randomized controlled trials are needed before the HHHFNC can be considered an NIV standard, particularly for extremely preterm infants.

• Clinical and Experimental Pediatrics
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• 제58권11호
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• pp.415-420
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• 2015

Purpose: Bronchopulmonary dysplasia (BPD) is characterized by inflammation with proteolytic damage to the lung extracellular matrix. The results from previous studies are inconsistent regarding the role of proteinases and antiproteinases in the development of BPD. The aim of the present study was to investigate whether matrix metalloproteinase (MMP)-8, MMP-9, tissue inhibitor of metalloproteinase (TIMP)-2, and TIMP-1 levels in the serum of preterm infants at birth are related to the development of BPD. Methods: Serum was collected from 62 preterm infants at birth and analyzed for MMP-8, MMP-9, TIMP-2, and TIMP-1 by using enzyme-linked immunosorbent assay. MMPs and TIMPs were compared in BPD (n=24) and no BPD groups (n=38). Clinical predictors of BPD (sex, birth weight, gestational age, etc.) were assessed for both groups. The association between predictors and outcome, BPD, was assessed by using multivariate logistic regression. Results: Sex, birth weight, and mean gestational age were similar between the groups. BPD preterm infants had significantly lower TIMP-2 levels at birth compared with no BPD preterm infants ($138.1{\pm}23.0ng/mL$ vs. $171.8{\pm}44.1ng/mL$, P=0.027). No significant difference was observed in MMP-8, MMP-9, and TIMP-1 levels between the two groups. Multivariate logistic regression analysis indicated that the TIMP-2 levels were predictive of BPD after adjusting for sex, birth weight, gestational age, proteinuric preeclampsia, and intraventricular hemorrhage (${\beta}=-0.063$, P=0.041). Conclusion: Low TIMP-2 serum levels at birth may be associated with the subsequent development of BPD in preterm infants.

• 생명과학회지
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• 제18권9호
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• pp.1202-1206
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• 2008

본 연구에서 정상적인 baboon의 흉선조직 및 폐조직에서 HLA-DR과 PGP9.5항원에 대한 반응성을 나타내는 수지상세포 형태의 세포가 축적되는 것을 보았다. 하지만, 이런 세포들은 baboon 이 BPD즉 폐이형성증에 걸리게 되면 사라진다는 것을 확인하였다. 그리고 140일 제태기간보다 125일 제태 기간을 보낸 미성숙 baboon이 HLA-DR을 가지는 세포가 더 많아 진다는 것을 관찰할 수 있었고 이로 인해 BPD동물모델을 구축하는데 125일 제태 기간을 보낸 동물이 훨씬 적합하다는 것을 알았다. 또한 bombesin의 항체인 2A11을 처리한 baboon (125d-14d/PRN)의 폐조직에서는 정상수준의 HLA-DR positive세포들이 관찰되었다. 더욱이, Baboon의 흉선으로부터 분리한 thymocyte로 bombesin에 대한 chemotaxis를 수행한 결과 세포이동 반응성을 보였다. 이러한 결과들은 생체 내 BLP들을 차단하면 BPD에 의해 야기된 폐이형성증을 막을 수 있고 2A11항체가 수동 면역제로 폐이형성증을 치료할 수 있는 치료제로써의 가능성을 제시하는 것이다.

• Clinical and Experimental Pediatrics
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• 제56권11호
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• pp.477-481
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• 2013

Purpose: Ureaplasma colonization is related with perinatal complications in preterm infants. Little is known about the difference in virulence among various Ureaplasma urealyticum serovars. The aim of this study was to determine U. urealyticum serovars of preterm infants in order to assess whether any of the serovars were associated with bronchopulmonary dysplasia (BPD). Methods: Three hundred forty-four preterm infants with a gestational age less than 34 weeks admitted to Gangnam Severance Hospital neonatal intensive care unit from July 2011 to December 2012 were included in this study. Tracheal and gastric aspirations were conducted on infants to confirm Ureaplasma colonization. Ureaplasma colonization was confirmed in 9% of infants, of these, serovars were determined by real-time polymerase chain reaction. Results: A total of 31 infants (gestational age, $29.3{\pm}3.1$ weeks; birth weight, $1,170{\pm}790g$) were U. urealyticum positive. The Ureaplasma positive group treated for more days with oxygen and ventilation than the negative group (P<0.05). Histologic chorioamnionitis and moderate to severe BPD were more frequent in the Ureaplasma positive group than in the negative group (P<0.05). U. urealyticum isolates were either found to be a mixture of multiple serovars (32%), serovar 9 alone or combined with other serovars (39%), serovar 11 (26%), 2 (13%), 8 (10%), 10 (13%), and 13 (25%). No individual serovars were significantly associated with moderate to severe BPD and chorioamnionitis. Conclusion: This is the first study to describe the distribution of U. urealyticum serovars from Korean preterm infants. Ureaplasma -colonized infants showed higher incidence of BPD and chorioamnionitis.