• 대한치과교정학회지
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• 제24권2호
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• pp.331-348
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• 1994

The purpose of this study was to investigate changes in the shape and ultrastructure of the articular disc of the rat mandibular joint with aging. Mechanical stress applied to the articular disc changes during neonatal, suckling, juvenile, adult and senile stages. Mandibular joints of 6 groups of rats(1-, 7-, 17-, 27-, 55-day and over-1-year groups) were removed en bloc and processed for light and electro microscopic study. The changes in the shape of articular disc were examined by light microscope in each group. Structural and ultrastructural changes in the articular disc were examined by light and electron microscope in each group. The results were as follows : In the 1-day and 7-day groups, the articular disc was long and slender in shape and the articular disc was not fitted with the shape of the mandibular fossa and condyle. However' after that time, the anterior and posterior portions of the articular disc were more bulged and the middle portion was shorter and biconcave. Thus the articular disc was well fitted with the shape of the mandibular fossa and condyle. The cell density decreased with aging. In the l -day and 7-day groups, the Golgi apparatus, rough endoplasmic reticulum and free ribosome, which are involved in the synthesis of intracellular and extracellular matrix, were developed. In the 17-day, 27-day and 55-day groups, not only the cell organelles involved in the synthesis of the intracellular and extracellular matrix but also the cell organelles involved in the remodeling of the extracellular matrix(i.e., finger-like cell process, lysosome and mitochondria)were well developed. With advancing age, intracytoplasmic microfilaments were more accumulated and condroid cells increased. In the over-1-year group, the majority of cells of the articular disc were chondroid cells. The majority of cytoplasmic compartment were filled with intracytoplasmic microfilaments and cell organelles were not developed. Therefore, metabolic activities of the cell was markedly reduced and cells contained structures enduring mechanical stress, and cells which were in the process of degeneration were observed occasionally.

• Advances in pediatric surgery
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• 제16권2호
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• pp.162-169
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• 2010

남녀의 비는 1.8로 남아가 많았으며, 진단시 나이는 76.9 % 에서 4주 이내 신생아시기에 진단되었다. 임상증상은 복부팽만 84.6 %, 태변 배출지연이 46.1 %, 설사 와 변비가 23.1 % 였다. 무신경절의 범위가 89.7 %에서 직장 및 에스자형 결장에 한정되었으며, 전결장에 침범한 경우가 8 %였다. 69.2 %에서 결장조루술 후 근치적 수술을 시행하였으며, 30.8 %에서 바로 근치적 수술을 시행하였다. 수술 후 6개월 이상 추적은 54 % 였으며, 추적 관찰 환자 중 14.3 %에서 대변 지림을 보였고, 19.0 %에서 변비를 보였다.

• Advances in pediatric surgery
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• 제14권1호
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• pp.37-47
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• 2008

Recently, the survival rates of extremely low-birth-weight (ELBW) infants have improved with the development of neonatal intensive care. However, these infants were susceptible to intestinal perforation due to prematurity, fluid restriction, and injection of indomethacin, etc. Because of the risks of transportation, anesthesia and surgery itself, peritoneal drainage has been compared with laparotomy. Through our experience, we investigate the usefulness of peritoneal drainage retrospectively. From 1997 to 2007, six ELBW (M:F=5:1) underwent primary peritoneal drainage for intestinal perforation. Their median birth weight was 685g (405~870) and gestational age was $25^{+1}$ weeks ($24^{+3}{\sim}27^{+0}$). We noticed the intestinal perforation at median 10.5 days (8~18) after birth, and placed Penrose drain or Jackson-Pratt drain through right lower quadrant incision under local anesthesia. The cause of intestinal perforation was necrotizing enterocolitis in one patient, but that of the others was not clear. Three patients who showed normal platelet count and stable vital signs recovered uneventfully. Two patients (birth weight less than 500g) who showed unstable vital signs and low platelet count (12,000 / $mm^3$ to 30,000 / $mm^3$)expired despite aggressive resuscitation. One patient required laparotomy due to persistent intestinal obstruction after drain removal and survived. Our experience shows that peritoneal drainage was an acceptable treatment for ELBW infants and the prognosis was related to vital sign and platelet count at the time of intestinal perforation, and birth weight.

• Advances in pediatric surgery
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• 제13권2호
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• pp.135-143
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• 2007

Biliary atresia (BA) is an uncommon neonatal surgical disease that has a fatal outcome if not properly treated. The survival rates of the patients with native liver after Kasai's operation in countries outside Japan are not so good. We reviewed the results of 22 cases of biliary atresia treated in Kosin University Hospital between October 1987 and March 2001. There were 13 males and 9 females aged from 21 to 106 days (mean 52 days). There were 3 cases of Type I (13.6%), and 3 of Type II (13.6%), and 16 Type III (72.7%). The operative methods were resection of the common bile duct remnant and cyst followed by Roux-en-Y hepaticojejunostomy in 3 cases for Type I BA; Kasai I in 15 cases, Kasai II in 1 case, and Ueda's operation in 3 cases for Types II and III BA. There was no death within the first 30 days after operation. We were able to follow 21 of the 22 patients (95.4%) for more than 5 years. The actual 5 year survival rate (YSR) was 40.9%. One Type I case received a living-related liver transplantation at 6 years of age because of the multiple intrahepatic stones and liver cirrhosis. Five YSR after biliostomy group (Kasai II and Ueda op.) was 75 % (3/4) while that of Kasai I was 20% (3/15). One case had no bile duct in the resected fibrotic plaque on microscopic review and died 8 months after Kasai I operation, would have been a strong candidate for early liver transplantation. From the above result, our conclusions are as follows; (1) early liver transplantation should be considered for cases of no bile duct after pathologic examination of the resected specimen, (2) measures to prevent postoperative cholangitis and prevention of postoperative liver cirrhosis are needed, (3) liver transplantation program should be available for failed cases.

• 대한치과보철학회지
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• 제41권3호
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• pp.300-318
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• 2003

Statement of problem: The success of implants depends on intimate and direct contact of implant material on bone tissue and on functional relationship with soft tissue contact. Creation and maintenance of osseointegration depend on the understanding of the tissue's healing, repairing, and remodeling capacity and these capacities rely on cellular behavior. Altering the surface properties can modify cellular responses such as cell adhesion, cell motility, bone deposition, Therefore, various implant surface treatment methods are being developed for the improved bone cell responses. Purpose: The purpose of this study was to evaluate the responses of osteoblast-like cells to surface-modified titanium. Materials and Methods: The experiment was composed of four groups. Group 1 represented the electropolished surface. Group 2 surfaces were machined surface. Group 3 and Group 4 were anodized surfaces. Group 3 had low roughness and Group 4 had high roughness. Physicochemical properties and microstructures of the discs were examined and the responses of osteoblast-like cells to the discs were investigated. The microtopography was observed by SEM. The roughness was measured by three-dimension roughness measuring system. The microstructure was analyzed by XRD, AES. To evaluate cell responses to modified titanium surfaces, osteoblasts isolated from calvaria of neonatal rat were cultured. Cell count, morphology, total protein measurement and alkaline phosphatase activities of the cultures were examined. Results and Conclusion: The results were as follows 1. The four groups showed specific microtopography respectively. Anodized group showed grain structure with micropores. 2. Surface roughness values were, from the lowest to the highest, electropolished group, machined group, low roughness anodized group, and high roughness anodized group. 3. Highly roughened anodized group was found to have increased surface oxide thickness and surface crystallinity. 4. The morphology of cells, flattened or spherical, were different from each other. In the electropolished group and machined group, the cells were almost flattened. In two anodized groups, some cells were spherical and other cells were flattened. And the 14 day culture cells of all of the groups were nearly flattened due to confluency. 5. The number of attached cells was highest in low roughness anodized group. And the machined group had significantly lower cell count than any other groups(P<.05). 6. Total protein contents showed no difference among groups. 7. The level of alkaline phosphatase activities was higher in the anodized groups than electropolished and machined groups(P<.05).

• Child Health Nursing Research
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• 제3권2호
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• pp.178-189
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• 1997

This study was done to compare the breast-feeding primiparas' perceptions of their babies with bottle-feeding primiparas' at 2-3 days after delivery. The subjects of this study included 42 breast-feeding mothers and 56 bottle-feeding mothers. Data were collected by using the Neonatal Perception Inventory(NPI) devised by Broussard (1963) and added by Lee, Ja Hyung(1986) from December, 1996 to June, 1997. The results of this study are as follows, 1. Primiparas' perceptions of their babies according to their general characteristics. 1) There was no significant difference in mothers' perceptions according to mothers' age and whether they have a job or not. 2) There was a difference in mothers' perceptions according to their educational level (P<0.1). 2. The comparisons of breast-feeding mothers' perceptions of their babies with bottle-feeding mothers'. 1) There was no significant difference in the two groups' perceptions of other babies 2) There was no significant difference in the two groups' perceptions of their own babies. (1) Breast-feeding mothes' general perceptions of their own babies were better than bottle-feeding mothers', but there was no significant difference between the two groups. (2) Breast-feeding mothers' perceptions about the basic needs of their own babies were better than bottle-feeding mothers', and there was a significant difference between the two groups (P<0.05). (3) Breast-feeding mothers'perceptions about the sense and motor abilities of their own babies were better than bottle-feeding mothers', but there was no significant difference between the two groups. (4) Breast-feeding mothers' perceptions about the necessary care of their own babies were lower than bottle-feeding mothers', but there was no significant difference between the two groups. 3) There was no significant difference between the two groups' positive-negative perceptions of their babies (1) 69% of breast-feeding mothers and 69.9% of bottle-feeding mothers had positive perceptions about general conditions, but there was no significant difference between the two groups (2) 57.1% of breast-feeding mothers and 46.4% of bottle-feeding mothers had positive perceptions about the needs of babies, but there was no significant difference between the two groups. (3) 50% of breast -feeding mothers and 48.2% of bottle-feeding mothers had positive perceptions about the sense and motor abilities of babies, but there was no significant difference between the two groups. (4) 57.1% of breast-feeding mothers and 60.7% of bottle-feeding mothers had positive perceptions about the necessary care for babies, but there was no significant difference between the two groups. 3. 54.8% of breast-feeding mothers tried to feed their own babies on the 1st day after delivery. 83.3% of breast-feeding mothers chose the feeding method for themselves. Only 9.5% of breast-feeding mothers took recomendations for breast-feeding from nurses. 78.6% of breast-feeding mothers had no chance to learn about breast-feeding. 69% of breast-feeding mothers complained about the difficulties of breast-feeding. The most serious problems were : 'insufficient milk supply', 'lack of knowledge about feeding technique' and 'problems with nipples'.

• Child Health Nursing Research
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• 제6권1호
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• pp.32-50
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• 2000

A descriptive exploratory design was used in this study to evaluate the effects of sponge bathing on physiological(heart rate, heart period, vagal tone, oxygen saturation, respiration) and behavioral responses in newly born 40 preterm infants from intensive care unit of S University Hospital in Seoul. Data has been collected from October, 1997 to March, 1999. The infants were between 27-33 weeks gestational age at birth, and were free of congenital defects. The subjects entered the protocol when they were medically stable (determined by initiation of feeding and discontinuation of all respiratory support) but still receiving neonatal intensive care. The infants' physiologic parameters were recorded a 10 - minute before, during, and after bathing. Continuous heart rate data were recorded on a notebook computer from the infant's EKG monitor. The data were digitized off-line on software(developed by Lee and Chang in Wavelet program) which detected the peak of the R wave for each heart beat and quantified sequential R-R intervals in msec(i.e. heart periods). Heart period data were edited to remove movement artifact. Heart period data were quantified as : 1) mean heart period; 2) vagal tone. Vagal tone was quantitfied with a noninvasive measure developed by Porges(1985) in Mxedit software. To determine behavioral status, tools were developed by Scafidi et al(1990) were used. Collected data were analyzed with the SPSS program using paried t-test, ANOVA, and Pearson correlation. The result were as follow. 1. The results of the ANOVAs indicated that vagal tone were signifcantly lower during bathing than baseline and post-bathing. There were significant differences in heart period and heart rate levels across the bathing. But the mean oxygen saturations and respirations were no differences. Also, there were no significant differences on behavioral sign, motor activity, behavioral distress, weight changes, morbidity, and hospitalization period. 2. To evaluate the relation between vagal tone and subsequent parameters, the two groups (the high group had 19 subjects and low group had 21subjects) were divided by the mean baseline vagal tone. Vagal tone measured prior to bathing were significantly associated with respiration before bathing, vagal tone during bathing, and the magnitude of change in both vagal tone. But, other subsequent reactivities were no differences in two groups. 3. Correlations were also calculated between vagal tone and the subsequent physiological reactivities from baseline through after- bathing. Correlations were significant between baseline vagal tone and baseline heart rate, between baseline vagal tone and baseline heart period, between baseline vagal tone and oxygen saturation after bathing. In summary, the bathing in this study showed a stressful stimulus on premature infants through there was significance in the physiological parameters. In addition, our study represents the documentation that vagal tone reactivity in response to clearly defined external stimulation provides an index of infant's status.

• Child Health Nursing Research
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• 제21권1호
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• pp.37-45
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• 2015

목적 본 연구는 미숙아로 태어난 유아와 정상아로 태어난 유아의 건강 관련 삶의 질을 비교하고, 미숙아로 태어난 유아의 건강 관련 삶의 질에 영향을 미치는 요인을 파악하여, 이들의 유아기 건강 관련 삶의 질 향상에 기여하기 위하여 시도되었다. 방법 연구 방법은 자가보고식 설문지를 이용하였으며, 연구 대상자는 인터넷 카페에서 미숙아로 출생한 유아의 부모 80명과 정상아 부모 83명이었다. 연구 도구는 TNO-AZL에서 개발한 TAPQOL를 사용하였고, 수집된 자료는 SPSS 20.0을 사용하여 빈도, 백분율, 평균, 표준편차, t-test, ANOVA, 다중회귀분석을 이용하였다. 결과 미숙아로 태어난 유아의 삶의 질 점수는 100점 만점에 80.6점(${\pm}9.9$)이었으며, 정상아로 태어난 유아의 삶의 질 점수는 85.0점(${\pm}8.3$)으로, 미숙아 집단이 정상아 집단에 비해 삶의 질 점수가 4.4점(${\pm}1.4$) 낮았다. 미숙아 집단이 정상아 집단에 비해 삶의 질 점수가 낮은 영역으로는 운동기능, 불안, 긍정적 기분, 활기참 및 의사소통 등이었다. 두 집단간 삶의 질 점수 차이가 가장 큰 영역은 운동기능과 의사소통이었다. 미숙아로 태어난 유아의 건강 관련 삶의 질에 영향을 미치는 변수는 '신생아실 입원기간(7일 이상)'과 '출생체중(1,000 g 미만)'으로 나타났으며, 두 변수의 설명력은 17%였다. 즉, 신생아실 입원기간이 7일 미만이고, 출생 시 체중이 1,000 g 이상인 아동이 그렇지 않은 아동보다 건강 관련 삶의 질 점수가 높았다. 결론 미숙아로 태어난 아동의 건강 관련 삶의 질은 이들의 출생 시 체중 및 신생아실 입원기간 등이 영향을 미치므로 미숙아 추후 프로그램을 개발할 때 출생체중, 재태기간 및 신생아집중치료실 입원기간 등으로 고려해야 할 것이다.

• Child Health Nursing Research
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• 제21권1호
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• pp.1-10
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• 2015

목적 본 연구의 목적은 미숙아의 퇴원 시점에 미숙아 어머니의 산후우울 정도를 확인하고 미숙아와 어머니의 인구사회학적, 임상적 특성과 산후우울과의 관련성을 조사하는 것이다. 방법 본 연구는 자가 보고식 설문조사 방법과 의무기록 조사 방법을 사용하여 자료를 수집하였으며 연구 대상자는 서울시 2개 대학병원과 시립병원, 강릉시 1개 종합병원에서 미숙아로 출생하여 신생아중환자실에 입원한 환아 중에서 퇴원이 예정된 환아와 그 어머니 80명이다. 결과 미숙아 어머니의 산후우울 점수의 평균은 $9.75{\pm}5.06$점이었고 산후 우울의 위험이 있다고 판단되는 12점 이상군은 전체의 30.0%였다. 산후우울과 관련된 변수는 어머니의 교육 수준(F =3.493, p =.035)과 가정 내 월 소득(F=5.828, p =.004), 다태아 여부(t=2.141, p =.037), 융모양막염(t=2.349, p =.021), 양수과소증(t=-2.226, p =.029), 기관지폐이형성증(t=2.085, p =.040), 배기질출혈(t=2.259, p =.027) 여부, 개정판 NBRS 점수(t=-2.772, p =.007)였다. 그리고 산후우울과 미숙아의 입원 시 주요 건강문제의 개수의 합(r=.252, p =.024)과 개정판 NBRS 점수(r=.316, p =.004)와는 유의한 정적 상관관계를 보였다. 결론 미숙아 어머니들의 산후우울의 위험에 대한 관심이 요구되며 미숙아의 객관적 건강 상태뿐 아니라 사회경제적 수준 등 산후우울에 영향을 미칠 수 있는 다양한 변인을 고려하여 미숙아 어머니의 산후우울 정도를 감소시키기 위한 중재 전략이 마련되어야 할 것이다.

• Child Health Nursing Research
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• 제20권1호
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• pp.20-29
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• 2014

목적 본 연구는 미숙아를 위한 수유 프로토콜을 개발하고 적용하여 그 효과를 검증하기 위하여 시행되었다. 방법 미숙아 수유 프로토콜의 개발을 위해 전문가 집단을 구성하고, 문헌고찰과 협의를 통해 작성된 프로토콜에 대해 내용타당도 검증과 예비조사를 실시하여 확정하였다. 개발된 프로토콜은 비동등성대조군 전후시차설계로 B시의 P대학교병원에서 태어난 37주 미만의 미숙아 85명에게 적용되었다. 대조군(n=38)에게 2013년 1월부터 4월까지 일반적인 미숙아 수유관리가 시행되었고, 실험군(n=35)에게는 2013년 6월부터 9월까지 본 연구를 통해 개발된 미숙아 수유 프로토콜이 적용되었다. 수집된 자료는 SPSS 18.0 WIN program을 통하여 t-test와 ${\chi}^2$-test로 분석하였다. 결과 실험군은 대조군보다 첫 수유시간(t=2.22, p =.029)과 완전장관영양에 이르는 기간(t=2.28, p =.026)이 통계적으로 유의하게 감소하였다. 그러나 실험군과 대조군의 생후 7일째 체중 감소율(t=-1.23, p =.222)과 합병증 발생률(p >.05)은 통계적으로 유의한 차이가 없었다. 결론 미숙아 수유 프로토콜 적용을 통하여 미숙아들의 첫 수유시간과 완전장관영양에 이르는 기간이 단축되었다.