• Clinical and Experimental Pediatrics
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• 제59권4호
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• pp.165-173
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• 2016

Purpose: To identify the effects of modified parenteral nutrition (PN) and enteral nutrition (EN) regimens on the growth of very low birth weight (VLBW) infants. Methods: The study included VLBW infants weighing <1,500 g, admitted to Chungnam National University Hospital between October 2010 and April 2014, who were alive at the time of discharge. Subjects were divided according to 3 periods: period 1 (n=37); prior to the PN and EN regimen being modified, period 2 (n=50); following the PN-only regimen modification, period 3 (n=37); following both PN and EN regimen modification. The modified PN regimen provided 3 g/kg/day of protein and 1 g/kg/day of lipid on the first day of life. The modified EN regimen provided 3.5-4.5 g/kg/day of protein and 150 kcal/kg/day of energy. We investigated growth rate, anthropometric measurements at 40 weeks postconceptional age (PCA) and the incidence of extrauterine growth restriction (EUGR) at 40 weeks PCA. Results: Across the 3 periods, clinical characteristics, including gestational age, anthropometric measurements at birth, multiple births, sex, Apgar score, surfactant use and PDA treatment, were similar. Growth rates for weight and height, from time of full enteral feeding to 40 weeks PCA, were higher in period 3. Anthropometric measurements at 40 weeks PCA were greatest in period 3. Incidence of weight, height and head circumference EUGR at 40 weeks PCA decreased in period 3. Conclusion: Beginning PN earlier, with a greater supply of protein and energy during PN and EN, is advantageous for postnatal growth in VLBW infants.

• Child Health Nursing Research
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• 제5권3호
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• pp.250-261
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• 1999

This study has been conducted on the nonequivalent control group Pretest-posttest design in quasi experimental basis and newly born premature infants from intensive care unit of G Medical University Hospital in Inchon Metropolitan were selected in two groups of 21 infants each. The first group for experimental and the other for control. Data has been collected form October 30, 1997 to August 29, 1998. For the experimental group tactile and kinesthetic stimulation was applied 2 times a day for 10 days(10:00～ll:00 hours in the morning and 17:00～18:00 in the afternoon). As, a weight weighing instrument, electronic indicator scale(Cas Co. korea) was used. Collected data were analyzed with the SAS program using x²-test, student t-test, repeated measures ANOVA, Pearson correlated coefficient and Stepwise multiple regression. The result were as follow. 1. As for the daily weight gain, the experimental group showed first change in weight and this group also showed higher weight in the average weight than the control group. Statistically, however. there was no significant factor between the two groups. 2. In the correlation between general characteristics and weight gain, gestation Period. apgar score, admission Period before study, N.P.O. period after birth, recovery Period to birth weight showed statistical significance negative correlation with weight gam in the experimental group than control group. 3. In the factor with affected the weight gain by general characteristics showed recovery period to birth weight and head circumference in the experimental group, control group showed recovery period to birth weight, N. P. O. period after birth. admission period before study, feeding amount, weight of study. In conclusion. the sensory stimulation in this study showed a Positive aspect through there was no statistical significance in the weight gam. Tn the correlation of general characteristics and weight gam showed statistical significance negative correlation The main factor which affected the weight gain by general characteristics showed recover period to birth weight.

• Journal of Genetic Medicine
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• 제11권2호
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• pp.74-78
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• 2014

Sotos syndrome (SS, OMIM 117550) is characterized by prenatal and postnatal overgrowth with multiple congenital anomalies. However, there have been few cases of growth retardation caused by renal failure from infancy. We report a case of dysplasia of the bilateral kidneys with renal failure and poor postnatal growth. A 2-month-old boy visited the emergency room owing to poor oral intake and abdominal distension. He was born at the gestational age of 38 weeks with a birth weight of 4,180 g. After birth, he had feeding difficulty and abdominal distension. Upon physical examination, his height and weight were in less than the 3rd percentile, while his head circumference was in the 50th percentile on the growth curve. He also showed a broad and protruding forehead and high hairline. Blood laboratory tests showed severe azotemia; emergent hemodialysis was needed. Abdominal ultrasonography revealed bilateral renal dysplasia with multiple cysts and diffuse bladder wall thickening. A posterior urethral valve was suggested based on vesicoureterography and abdominal magnetic resonance findings. Results of a colon study to rule out congenital megacolon did not reveal any specific findings. The conventional karyotype of the patient was 46, XY. Array comparative genomic hybridization study revealed a chromosome 5q35 microdeletion including the NSD1 gene, based on which SS was diagnosed. We describe a case of SS presenting with end stage renal disease due to posterior urethral valve. The typical somatic overgrowth of SS in the postnatal period was not observed due to chronic renal failure that started in the neonatal period.

• Journal of Nutrition and Health
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• 제30권5호
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• pp.478-488
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• 1997

Omega-3 fatty acid, docosahexaenoic acid(DHA) is found in a high proportion in the structural lipids of cell membranes, in particular those of the central nervous system and the retina. Diet-induced changes in fatty acid composition in these tissues may affect physiochemical functions. This study was conducted to investigate whether supplements of DHA in infant formula has an effect on the composition of fatty acids in erythrocytes with regard to brain development. Experimental groups were breastmilk group(n=21), placebo formula group(n=15), and DHA supplemented formula (0.26%) group(n=16). Infants were selected by mothers who deliverecdd at Kyung Hee medical center from February to April, 1996. Infant body weight, length, and head circumference were similar among the experimental groups at 16 weeks of age. The levels of DHA in breastmilk, placebo formula, and DHA supplemented formula were 0.56, 0, and 0.26% of total fatty acids, respectively. There was a significant correlation between dietary DHA intake and erythrocyte DHA levels. The levels of arachidonic acid did not differ among the three expermental groups. The result of flash visual evoke potential(VEP) test was correlated with the erythrocyte levels and dietary DHA levels at 16 weeks of age. No other fatty acid was correlated with VEP test results. No differences were found in Bayley Mental and Psychomotor Development Index scores among the three groups at 20 weeks of age. DHA seems to be an essential nutrient for optimum growth and maturation of term infants. Relatively small amounts of dietary DHA supplementation significantly elevate DHA supplementation significantly elevate DHA content in erythrocytes, which in turn has an implication for better scores for infant's VEP test. Whether supplementation of formula-fed infants with DHA has long-term benefits remains to be elucidated.

• Journal of Korean Medical Science
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• 제33권50호
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• pp.318.1-318.10
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• 2018

Background: In this prospective cohort study, we investigated the association between fatty acid ethyl esters (FAEEs) in meconium as biomarkers of prenatal ethanol exposure and growth deficits, as birth outcomes, that constitute several of the key cardinal features of fetal alcohol syndrome. Methods: A total of 157 meconium samples were collected from enrolled infants within 24 hours of birth, and nine FAEEs were quantified using liquid chromatography/tandem mass spectrometry. The relationships between cumulative concentrations of nine species of FAEEs in meconium and birth parameters of growth (age-sex-specific centiles of head circumference [HC], weight, and length) and respective and combined birth outcomes of growth deficits (HC ${\leq}10th$ centile, weight ${\leq}10th$ centile, and length ${\leq}10th$ centile) were determined. Results: Multivariate logistic regression analysis demonstrated that higher cumulative concentrations of meconium FAEEs correlated with elevated risks for HC and length, both, 10th percentile or less (adjusted odds ratio [aOR], 2.94; 95% confidence interval [CI], 1.12-7.74; P = 0.029) and HC and weight and length, all of them, 10th percentile or less (aOR, 3.27; 95% CI, 1.12-9.59; P = 0.031). Conclusion: The elevated cumulative FAEEs in meconium were associated with combined growth deficits at birth, specifically HC and length, both, 10th percentile or less, which might be correlated with detrimental alcohol effects on fetal brain and bone development, suggesting a plausible alcohol-specific pattern of intrauterine growth restriction.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권6호
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• pp.536-544
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• 2019

Purpose: Proper nutrition is essential for brain development during infancy, contributing to the continued development of cognitive, motor, and socio-emotional skills throughout life. Considering the insufficient published data in the Middle East and North Africa, experts drafted a questionnaire to assess the opinions and knowledge of physicians on the impact of nutrition on brain development and cognition in early life. Methods: The questionnaire consisted of two parts: The first focused on the responders' demographic and professional characteristics and the second questioned the role of nutrition in brain development and cognition. Descriptive statistics were used to summarize respondents' characteristics and their responses to questions. Results: A total of 1,500 questionnaires were distributed; 994 physicians responded. The majority of the surveyed physicians (64.4%) felt that nutrition impacts brain development in early childhood (0-4 years), with almost 90% of physicians agreeing/strongly agreeing that preventing iron, zinc, and iodine deficiency would improve global intelligence quotient. The majority of physicians (83%) agreed that head circumference was the most important measure of brain development. The majority of physicians (68.9%) responded that the period from the last trimester until 18 months postdelivery was crucial for brain growth and neurodevelopment, with 76.8% believing that infants breast-fed by vegan mothers have an increased risk of impaired brain development. Conclusion: The results of this study show that practicing physicians significantly agree that nutrition plays an important role in brain and cognitive development and function in early childhood, particularly during the last trimester until 18 months postdelivery.

• Neonatal Medicine
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• 제25권4호
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• pp.153-160
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• 2018

Purpose: The aim of this study is to examine the tolerability and effect of early high-dose amino acid administration in extremely low birth weight infants (ELBWIs). Methods: This retrospective cohort study included ELBWI (birth weight <1,000 g, n=142). Biochemical, nutritional, and neurodevelopmental data were compared between infants who received conventional low amino acid (LAA; 1.5 g/kg/day) and those who received high amino acid (HAA; 3 g/kg/day) within the first 48 hours after birth. Neurodevelopmental data included weight, height, and head circumference at discharge, 12 to 14 and 18 to 24 months of corrected age and the Korean Bayley Scale of Infant Development II (K-BSID-II) score at 18 to 24 months of corrected age. Results: The HAA group demonstrated higher peak plasma albumin ($3.0{\pm}0.4$ vs. $3.2{\pm}0.5$, P<0.05) and lower serum creatinine ($1.7{\pm}0.9$ vs. $1.4{\pm}0.8$, P<0.05) during the first 14 days than the LAA group. Full enteral feeding was achieved significantly earlier in infants in the HAA group than in infants in the LAA group ($46.2{\pm}23.0days$ vs. $34.3{\pm}21days$, P<0.01). There was no difference between the two groups in the z score changes in all growth indicators from birth to discharge and at 12 to 14 and 18 to 24 months of corrected age, as well as in the K-BSID-II score at 18 to 24 months of corrected age. Conclusion: Aggressive administration of amino acids during the first 2 days of life in ELBWI was well tolerated and correlated with earlier full enteral feeding, but did not improve growth and neurodevelopment.

• 여성건강간호학회지
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• 제27권4호
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• pp.379-387
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• 2021

Purpose: This study aimed to determine the actual state of childbirth in Korean women with natural childbirth and the degree of damage to the perineum during childbirth. Methods: This retrospective study analyzed the medical records of mothers who had natural childbirth at a hospital in Seoul, Korea in 2018. Data from 358 women with cephalic births at greater than 37 gestational weeks were analyzed. To determine natural childbirth characteristics and the degree of damage to the perineum, descriptive statistics were done. The difference in the degree of perineal injury according to obstetric characteristics was analyzed using independent t-test and one-way analysis of variance. Results: The mean age was 33.18±3.68 years, and 49.2% were primiparas, while 39% gave birth with a doula. The degree of perineal damage differed by age (F=9.15, p<.001), parity (t=19.13, p<.001), number of births in multiparity (F=3.68, p=.027), previous vaginal delivery in multiparity (F=3.00, p=.032) and birthing posture (F=7.44, p<.001). Having received therapeutic procedures (t=-4.62, p<.001), specifically fluid administration (t=-2.72, p=.007), oxygen supply (t=-2.76, p=.006) and epidural anesthesia (t=-2.77, p=.006) were statistically significant for perineal damage. There were no differences, however, by gestational period, doula use, water room use in labor, baby head circumference, or birth weight. Conclusion: Study findings suggest that support for older women, primiparas, and those who require therapeutic procedures may help to decrease the possibility of perineal damage during childbirth. As perineal damage was also associated with birthing posture, this should be considered when providing intrapartum nursing care.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제27권5호
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• pp.313-321
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• 2024

Purpose: For neonates admitted to the neonatal intensive care unit (NICU), appropriate nutritional assessment and intervention are important for adequate growth. In this study, we aimed to determine whether there were changes in the nutritional supply and growth status of premature infants hospitalized in the NICU after the introduction of the Nutrition support team (NST). Methods: This study retrospectively analyzed premature infants admitted to the NICU for over 14 days. The average daily calorie, protein, and fat supply at 1 and 2 weeks after birth were compared before and after NST, and growth was evaluated by changes in length, weight, and head circumference z-scores at birth and 28 days after birth. Results: A total of 79 neonates were included in the present study, with 32 in the pre-NST group and 47 in the post-NST group. The average daily energy supply during the first (p=0.001) and second (p=0.029) weeks postnatal was significantly higher in the post-NST group than in the pre-NST group. Lipid supply for the first week was significantly higher in the post-NST group than in the pre-NST group (p=0.010). The change in the z-score for length was significantly higher in the post-NST group than in the pre-NST group (p=0.049). Conclusion: Nutrient supply and length z-score change increased significantly at 28 days after birth in the post-NST group. These results suggest that calorie calculators and NST activity can promote adequate growth and development in neonates.

• 수산해양기술연구
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• 제29권3호
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• pp.200-213
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• 1993

A model experiment on a midwater rope trawl net which is used in the North Pacific to catch alaska pollack is carried out in the circulating tank to examine the basic efficiency of the net. The prototype is the net used by M/S Hanil(1, 179GT, 2, 700PS), a Korean trawler. The model net was made according to the Tauti's Similarity Law of Fishing Gear in 1/100 scale by considering the condition of the tank. To measure the basic efficiency of the standard model net, the vertical opening and width between some points marked on the net were measured, and the hydrodynamic resistance were determined. Then the constructive conditions of the net were varied as follows and the factors were measured again to compare the efficiency of those nets with that of the standard net(A-1 type) front weight multiplied 1.5 times: A-2 type. buoyancy and depressing force multiplied 1.7 times: A-3 type. front weight multiplied 1.5 times on A-3 type: A-4 type. depressors rigged at ground rope: B type. cod-end stuffed with cashmylon wad: C type. The results obtained can be summarized as follows: 1. The vertical opening at the center of head rope was steeply decreased with the flow velocity increasing and the vertical opening H(m) can be expressed in H=1.2v super(-1.2)(v : flow velocity in m/sec). The width of the net varied a little when the flow velocity was over 0.4m/sec, and the width of net mouth showed about 37% of the distance between the fore tips of net pendant. The shape of net mouth was almost a circle at 0.2m/sec and then steeply flatted elliptically with the flow velocity increasing and the area of mouth S(m super(2)) can be expressed in S=(1.65-2.3v)$\times$10 super(-2). The hydrodynamic resistance of the net increased almost linearly with the flow velocity increasing and the resistance R(kg) can be expressed in R=3.2$\times$d/l$\times$abv. where d/l denotes the mean of d(diameter of netting twine) and l(length of a leg in a mesh) from wing tip to the end of bag-net except cod-end on the side pannel, and a denotes the strectched circumference of the net at the fore end of a meshed part and b the stretched length of the whole net from wing tip to the end of cod-end. 2. In the condition-varied nets, the vertical opening of head rope showed some increase in every type net except the C type, and the increase showed the greatest in the B type by 30~54%, whereas it showed decrease in the C type by 5~10%. Variation of the area of net mouth showed almost the same tendency as the vertical opening and the increase showed the greatest in the B type by 20%, whereas it showed decrease in the C type by 12%. Hydrodynamic resistance showed some increase in every type compared with the standard net, and the rate of increase indicated 5~10% in the A-2, A-3 and A-4 type, 22% in the B type and 3% in the C type.