• Title/Summary/Keyword: High risk Infant

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Comparision of Maternal Charcteristics and Birth Weight among Five Different Categories of Medical Facility for Delivery in Taegu (대구시내 각급 의료기관에서 분만하는 산모들의 특성 및 출산결과의 비교 분석)

  • Song, Jung-Hup;Park, Jung-Han;Kim, Gui-Yeon;Kim, Jang-Rak
    • Journal of Preventive Medicine and Public Health
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    • v.21 no.1 s.23
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    • pp.10-20
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    • 1988
  • This study was conducted to compare the maternal charactristics, and birth weight of infants delivered at five different categories of medical facility in Taegu to examine the risk level of pregnant women and children by the medical facility for delivery. The study population included 1,410 pregnant women who delivered a baby at one of nine medical facilities (3 university hospitals, 2 general hospitals, 2 private clinics, 1 midwife clinic, 1 MCH center) in Taegu in April, 1987(April and May, 1987 for K university hospital), Pregnant women were interviewed to ask the age and educational level of woman, payment of medical fee, birth order, delivery method. Birth weight of infant was obtained from medical record. Mean ages of the women delivering at the university hospitals(27.5 years) and at general hospitals(26.7 years) were higher than those at midwife clinic(25.4 years) and at MCH center(26.1 years). Also, mean years of school education were higher in women of university hospitals(12.7 years) and general hospitals (12.2 years) than in women of midwife clinic(9.2 years) and MCH center (9.3 years). The percentages of women covered by the medical insurance were far greater in the university hospitals(78.1%) and general hospitals(82.9%) than in private clinics(44.3%) , midwife clinic(29.1%) and MCH center (5.4%). Infants born at the MCH center were mostly the second birth (47.3%) while 56.0% to 61.7% of infants born at all the other medical facilities were the first birth more women delivering at the university hospitals had history of spontaneous abortion as well as still birth than the women delivering at the other medical facilities. The preform birth rate (11.4%) and low birthweight incidence rates(5.8-13.0%) in university hospitals were significantly higher than those of other medical facilities. Accordingly, c-section rates showed a wide variation among the medical facilities. Study findings revealed that most of women delivering at the university hospitals and general hospitals are in the middle of or upper socio-economic class and obstetrically high risk group regardless of socioeconomic class while the wome delivering at the midwife clinic and MCH center are low risk group of low socioeconomic class. Therefore, the data of a specific medical facility are highly limited in interpretation and can not be generalized.

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Systemic Candida Infection in Very Low Birth Weight Infants : Epidemiological Features Over 5 Years (극소 저체중 출생아에서 전신성 칸디다 감염 : 5년간의 역학적 특성)

  • Lee, Seung-Woo;Lee, Jeong-Eun;Lee, Ju-Young;Lee, Hyun-Seung;Lee, Jung-Hyun;Sung, In-Kyung
    • Neonatal Medicine
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    • v.16 no.2
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    • pp.190-196
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    • 2009
  • Purpose: Candida infection has increased in neonatal intensive care units (NICU). However, recent reports on systemic candida infections in preterm newborns are rare in Korea. The aim of this study was to examine the epidemiological features of systemic candida infection in very low birth weight infants (VLBW) over the past five years. Methods: We retrospectively reviewed the medical records of 19 patients with systemic candida infections in VLBW that were admitted to the neonatal intensive care units of three hospitals affiliated with the College of Medicine, The Catholic University of Korea from January 2004 to December 2008. We analyzed the birth weight, gestational age, age at diagnosis, risk factors, co-morbidity, antifungal treatment, and mortality rates among the 19 patients. Results: Systemic candida infections occurred in 19 cases (4.7%) among the VLBW infants. The mean birth weight and gestational age were 959.0$\pm$255.9 g and 26.7$\pm$2.1 weeks. The isolated Candida species were C. albicans (4), C. parapsilosis (9), C. glabrata (2), C. famata (2), and unkown subspecies (2). Most patients had various associated risk factors, including a central venous catheter, broad spectrum antibiotics, parenteral nutrition, intravenous lipid emulsion, endotracheal intubation and $H_2$ blocker therapy. There was no significant difference in the risk factors between newborns that survived and those that died with regard to the systemic candida infection, except for gestational age. Nine (47.4%) out of 19 patients with a candida infection died and four cases (21.2%) were directly related to the candida infection. Conclusion: The prevalence of systemic candida infection is increasing in VLBW infants. The majority of Candida species has shifted to C. non-albicans, especially C. parapsilosis. Because of the high mortality associated with candida infection in the NICU, prophylaxis and early treatment based on epidemiological features is necessary.

Respiratory syncytial virus infection cases in congenital heart disease patients (선천성심장병 환아에서의 Respiratory syncytial virus 감염례 관찰)

  • Shim, Woo Sup;Lee, Jae Yeong;Song, Jin Yong;Kim, Soo Jin;Kim, Sung Hye;Jang, So Ick;Choi, Eun Yong
    • Clinical and Experimental Pediatrics
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    • v.53 no.3
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    • pp.380-391
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    • 2010
  • Purpose : Respiratory syncytial virus (RSV) is one of the main pathogens causing lower respiratory infections (LRI) in young children, usually of limited severity. However, in congenital heart disease (CHD) patients, one of the high-risk groups for RSV infection, RSV can cause serious illnesses and fatal results. To elucidate the effects of RSV infection in CHD patients, we observed RSV infection cases among CHD patients and non-CHD patients. Methods : On admission of 343 LRI patients over 3 years, 77 cases of RSV infection were detected by the RSV antigen rapid test of nasopharyngeal secretion. We compared RSV infection cases among groups of CHD and non-CHD patients. Results : During the winter season, RSV caused 20-0% of LRI admissions in children. In patients with completely repaired simple left to right (L-R) shunt diseases such as ventricular septal defect, atrial septal defect, and patent ductus arteriosus, RSV infections required short admission days similar to non-CHD patients. In patients with repaired CHD other than simple L-R shunt CHD, for whom some significant hemodynamic problems remained, RSV infection required long admission days with severe clinical course. In children with unrepaired CHD, RSV infection mostly occurred in early infant age, with long admission days. RSV infections within a month after cardiac surgery also required long admission days and severe clinical course. Conclusion : To avoid the tragedic outcome of severe RSV infection in the CHD patients, efforts to find the subgroups of CHD patients at high risk to RSV infection are needed, and effective preventive treatment should be applied.

Analysis of the Risk Factors Influencing the Severity of Injury in Pediatric Multiple Trauma Patients (소아 다발성 외상 환자의 중증도에 영향을 미치는 위험인자에 관한 분석)

  • Lee, Gang-Wook;Kim, Sun-Pyo;Kim, Seong-Jung;Cho, Soo-Hyung;Cho, Nam-Soo
    • Journal of Trauma and Injury
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    • v.23 no.2
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    • pp.68-74
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    • 2010
  • Purpose: The purpose of this study is, first, to analyze the risk factors that influence the severity of injury in pediatric multiple trauma patients and, second, to present solutions for the problems related to the treatment of such patients. Our living situations are so complicated that the danger of accidents is truly open to children who are not prepared. We need to draw attention to the increased numbers of various accidents involving children. Methods: We studied patients who visited the Emergency Medical Center at Chosun University Hospital from January 1, 2006, to December 31, 2008. Using medical records, we evaluated the general characteristics: the mechanism of injury, the vital signs, the revised trauma score (RTS), the injury severity score (ISS), and the hemoglibin value, which was checked at the time of visit, and the presence or the absence of emergent on regular surgery. We divided the level of injury as follows: light level (1-8 points), mid level (9-15 points), and serious level (above 16 points). We analyzed the medical data by using SPSS 17.0 for windows. Results: The average age of the patients examined was 8.6 years. The number of 6- to 11-year-old patients was 96, which was the largest, but the degree of injury severity was the highest among infant (0-2 years), according to ISS 7.95(${\pm}6.85$). The frequency of accidents was highest on sunny days, and most accidents occurred from 16:00 to 20:00. The cause of multiple trauma for children was the greatest in the traffic accident, (95 patients, 49.0%). In addition, the trauma caused by traffic accidents showed the highest ISS value ($9.02{\pm}6.42$) and the most serious degree (P=0.004). The ISS level of injury ($8.40{\pm}6.64$) for patients moved from a secondary hospital was higher than that ($6.49{\pm}5.57$) for patients who visited the medical center directly. The severity of injury was highest for patients who used a 119 ambulance ($8.84{\pm}5.80$). According to the injured parts of body, Injuries to the arms and the feet most frequent (79 patients, 40.7%), but the level of injury was the highest for internal organs and chest, $16.42{\pm}8.56$ and $11.23{\pm}6.97$, respectively. Conclusion: We used Abbreviated Injury Scale (AIS) in order to examine the characteristics by injured body part for pediatric multiple trauma patients. Because the degree of injury was the highest for internal organs or the chest, we need to more seriously examine and provide for patients who are suspected of having injuries to the internal organs or the chest. We need to quickly determine the need for surgery in patients with serious injuries to the arms and the feet, which is the greatest in frequency. In particular, we need to consider the surgical care of patients who are not very high in the severity of injury to their brains.

Risk Factors of Catheter-related Bloodstream Infection Due to Methicillin-resistant Staphylococcus aureus in Very Low Birth Weight Infants (극소저체중 출생아에서 메티실린 내성 포도상구균으로 인한 카테터 연관 혈류감염의 위험인자)

  • Cho, Il-Hyun;Jung, Tae-Woong;Lee, Ju-Young;Moon, Se-Na;Bin, Joong-Hyun;Lee, Hyun-Seung;Lee, Jung-Hyun;Kim, So-Young;Sung, In-Kyung
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.288-292
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    • 2011
  • Purpose: The incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection has increased in children and in neonates, and is particularly associated with frequent use of central venous catheter in very low birth weight (VLBW) infants. It is known that the morbidity and mortality of MRSA infection are low in neonates, as compared with adults. The objective of this study was to examine the difference in clinical characteristics between VLBW infants that survived and those that did not, a catheter-related bloodstream infection (CRBSI) of MRSA. Methods: Thirty-four VLBW infants had laboratory-confirmed bloodstream infection with S. aureus. We examined the incidence, mortality and morbidity of CRBSI, and predictive factors associated with mortality. Results: Twenty-six infants had same pathogen (24 MRSA, 2 Methicillin-sensitive Staphylococcus aureus) in the blood and in the catheter tip. Eight infants (25.8%) died in the CRBSI and they all had MRSA blood infections. Sex ratio, gestational age, duration between blood collection and identification of pathogens, and WBC and platelet count were not significantly different between patients that died from and patients that survived CRBSI of MRSA. C-reactive protein (CRP) was significantly higher in VLBW infants that died. Mean age of onset and hospital day was earlier (9.1${\pm}$6.6 vs. 26.9${\pm}$20.2; P=0.005) and shorter for patients that died (10.1${\pm}$7.0 vs. 73.0${\pm}$32.4; P=0.000). Two survivors had complications of pyogenic arthritis of the lower extremities and soft tissue infection, respectively. Conclusion: Mortality of CRBSI was likely to be high in VLBW infants and might be anticipated by CRP and early onset of disease.

The significance of corpus callosal size in the estimation of neurologically abnormal infants (신경학적인 결함이 있었던 영아의 예후 판단에서 뇌량 크기의 중요성)

  • Yu, Seung Taek;Lee, Chang Woo
    • Clinical and Experimental Pediatrics
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    • v.51 no.11
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    • pp.1205-1210
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    • 2008
  • Purpose : The development of the corpus callosum occupies the entire period of cerebral formation. The myelination pattern on magnetic resonance imaging (MRI) is very useful to evaluate neurologic development and to predict neurologic outcome in high risk infants. The thickness of the corpus callosum is believed to depend on the myelination process. It is possible to calculate the length and thickness of the corpus callosum on MRI. Thus, we can quantitatively evaluate the development of the corpus callosum. We investigated the clinical significance of measuring various portions of the corpus callosum in neonate with neurologic disorders such as hypoxic brain damage and seizure disorder. Methods : Forty-two neonates were evaluated by brain MRI. We measured the size of the genu, body, transitional zone, splenium, and length of the corpus callosum. Each measurement was divided by the total length of the corpus callosum to obtain its corrected size. The ratio of corpus callosal length and the anteroposterior diameter of the brain was also measured. Results : There was no statistical significance in the sample size of each part of the corpus callosum. However, the corrected size or the ratio of body of the corpus callosum correlated with periventricular leukomalacia and hypoxic ischemic encephalopathy. Conclusion : The abnormal size of the corpus callosum showed a good correlation with periventricular leukomalacia and hypoxic ischemic encephalopathy in neonates. We can predict clinical neurological problems by estimation of the corpus callosum in the neonatal period.

SON PREFERENCE AND FAMILY BUILDING DURING FERTILITY TRANSITION (IMPLICATIONS ON CHILD SURVIVAL) (출산력 전환기의 남아선호와 출산형태)

  • Kim, Minja -Choe;Kim, Seung-Kwon
    • Korea journal of population studies
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    • v.21 no.1
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    • pp.184-228
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    • 1998
  • This study reviews the relationship between son preference and fertility behavior, and infant and chlid mortality in the context of fertility and mortality decline. In Korea the situation reveals that fertility can decline to a very low level even in the presence of strong son preference, but son preference has certain effects on fertility and childhood mortality. The effect of son preference on fertility increased as the level of fertility declined. Our findings show that son preference causes excess female childhood mortality both directly and indirectly through fertility. Also, in Korea, the analysis reveals that female children suffer excessively high level of mortality and part of the excess mortality is due to parents' behavior on family building related to the effort to secure the birth of a son.

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A Study on the Born Global Venture Corporation's Characteristics and Performance ('본글로벌(born global)전략'을 추구하는 벤처기업의 특성과 성과에 관한 연구)

  • Kim, Hyung-Jun;Jung, Duk-Hwa
    • Journal of Global Scholars of Marketing Science
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    • v.17 no.3
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    • pp.39-59
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    • 2007
  • The international involvement of a firm has been described as a gradual development process "a process in which the enterprise gradually increases its international involvement in many studies. This process evolves in the interplay between the development of knowledge about foreign markets and operations on one hand and increasing commitment of resources to foreign markets on the other." On the basis of Uppsala internationalization model, many studies strengthen strong theoretical and empirical support. According to the predictions of the classic stages theory, the internationalization process of firms have been recognized and characterized gradual evolution to foreign markets, so called stage theory: indirect & direct export, strategic alliance and foreign direct investment. However, termed "international new ventures" (McDougall, Shane, and Oviatt 1994), "born globals" (Knight 1997; Knight and Cavusgil 1996; Madsen and Servais 1997), "instant internationals" (Preece, Miles, and Baetz 1999), or "global startups" (Oviatt and McDougall 1994) have been used and come into spotlight in internationalization study of technology intensity venture companies. Recent researches focused on venture company have suggested the phenomenons of 'born global' firms as a contradiction to the stages theory. Especially the article by Oviatt and McDougall threw the spotlight on international entrepreneurs, on international new ventures, and on their importance in the globalising world economy. Since venture companies have, by definition. lack of economies of scale, lack of resources (financial and knowledge), and aversion to risk taking, they have a difficulty in expanding their market to abroad and pursue internalization gradually and step by step. However many venture companies have pursued 'Born Global Strategy', which is different from process strategy, because corporate's environment has been rapidly changing to globalization. The existing studies investigate that (1) why the ventures enter into overseas market in those early stage, even in infancy, (2) what make the different international strategy among ventures and the born global strategy is better to the infant ventures. However, as for venture's performance(growth and profitability), the existing results do not correspond each other. They also, don't include marketing strategy (differentiation, low price, market breadth and market pioneer) that is important factors in studying of BGV's performance. In this paper I aim to delineate the appearance of international new ventures and the phenomenons of venture companies' internationalization strategy. In order to verify research problems, I develop a resource-based model and marketing strategies for analyzing the effects of the born global venture firms. In this paper, I suggested 3 research problems. First, do the korean venture companies take some advantages in the aspects of corporate's performances (growth, profitability and overall market performances) when they pursue internationalization from inception? Second, do the korean BGV have firm specific assets (foreign experiences, foreign orientation, organizational absorptive capacity)? Third, What are the marketing strategies of korean BGV and is it different from others? Under these problems, I test then (1) whether the BGV that a firm started its internationalization activity almost from inception, has more intangible resources(foreign experience of corporate members, foreign orientation, technological competences and absorptive capacity) than any other venture firms(Non_BGV) and (2) also whether the BGV's marketing strategies-differentiation, low price, market diversification and preemption strategy are different from Non_BGV. Above all, the main purpose of this research is that results achieved by BGV are indeed better than those obtained by Non_BGV firms with respect to firm's growth rate and efficiency. To do this research, I surveyed venture companies located in Seoul and Deajeon in Korea during November to December, 2005. I gather the data from 200 venture companies and then selected 84 samples, which have been founded during 1999${\sim}$2000. To compare BGV's characteristics with those of Non_BGV, I also had to classify BGV by export intensity over 50% among five or six aged venture firms. Many other researches tried to classify BGV and Non_BGV, but there were various criterion as many as researchers studied on this topic. Some of them use time gap, which is time difference of establishment and it's first internationalization experience and others use export intensity, ration of export sales amount divided by total sales amount. Although using a mixed criterion of prior research in my case, I do think this kinds of criterion is subjective and arbitrary rather than objective, so I do mention my research has some critical limitation in the classification of BGV and Non_BGV. The first purpose of research is the test of difference of performance between BGV and Non_BGV. As a result of t-test, the research show that there are statistically efficient difference not only in the growth rate (sales growth rate compared to competitors and 3 years averaged sales growth rate) but also in general market performance of BGV. But in case of profitability performance, the hypothesis that is BGV is more profit (return on investment(ROI) compared to competitors and 3 years averaged ROI) than Non-BGV was not supported. From these results, this paper concludes that BGV grows rapidly and gets a high market performance (in aspect of market share and customer loyalty) but there is no profitability difference between BGV and Non_BGV. The second result is that BGV have more absorptive capacity especially, knowledge competence, and entrepreneur's international experience than Non_BGV. And this paper also found BGV search for product differentiation, exemption strategy and market diversification strategy while Non_BGV search for low price strategy. These results have never been dealt with other existing studies. This research has some limitations. First limitation is concerned about the definition of BGV, as I mentioned above. Conceptually speaking, BGV is defined as company pursue internationalization from inception, but in empirical study, it's very difficult to classify between BGV and Non_BGV. I tried to classify on the basis of time difference and export intensity, this criterions are so subjective and arbitrary that the results are not robust if the criterion were changed. Second limitation is concerned about sample used in this research. I surveyed venture companies just located in Seoul and Daejeon and also use only 84 samples which more or less provoke sample bias problem and generalization of results. I think the more following studies that focus on ventures located in other region, the better to verify the results of this paper.

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