• 가정간호학회지
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• 제29권1호
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• pp.105-115
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• 2022

Purpose: This study aims to determine the factors that affect the breastfeeding of late preterm infants (gestation age 34⁺⁰~36⁺⁶) in South Korea. Method: A cross-sectional and questionnaire-based survey was conducted on 178 mothers of 209 late preterm infants discharged from a university hospital. We collected data on participants' demographics, breastfeeding-related characteristics and current status of breastfeeding and analyzed them using SPSS. Results: Breastfeeding duration varied significantly according to the number of babies born (t=3.691, p<.001), birth order (F=6.416, p=.002), type of feeding planned (F=8.691, p<.001), planned breastfeeding period(F=24.779, p<.001), previous baby's breastfeeding type(F= 8.510, p<.001), previous baby's breastfeeding duration(F=10.589, p<.001). The mothers with incomes of 3-5 million won a month were less likely to continue breastfeeding than those with incomes over 5 million won (CI: 0.049-0.086: p=0.035). Conclusion: Our results are meaningful in that we revealed that mother's monthly income influenced breastfeeding continuation, first-time mothers and mothers of multiples were at risk of breastfeeding difficulties. Interventions for helping late preterm infants' mothers establish breastfeeding and maintain an adequate milk supply are vital.

• Neonatal Medicine
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• 제16권1호
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• pp.36-46
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• 2009

목적 : 본 저자들은 국내 57개 병원을 대상으로 2007년 한 해 동안 원내출생아의 특성과 분포 및 신생아 중환자실 입원 환자의 특성과 분포, 그리고 사망률을 조사하였다. 방법 : 2008년 3월 신샹아 중환자실을 갖춘 곳 중 전국 57개 개 병원으로부터 2007년 한해 동안 발생하였던 신생아 출생 및 사망에 관한 설문을 보내고 회신을 받아 그 결과를 분석하였다. 그 내용에는 1) 원내 총 출생아의 재태기간별, 출생체중별 분포, 2) 신생아중환자실 입원 환자의 재태기간별, 출생체중별 분포 및 사망률이 포함되어 있었으며, 이 결과를 1996년 및 2002년에 조사되었던 한국의 결과와 비교하였다. 결과 : 총 40,433의 신생아 원내출생이 57개 병원으로부터 조사되었으며, 미숙아, 만삭아, 과숙아는 각각 24.2%, 75.6%, 0.2%의 출생빈도를 차지하였다. 또한, 저체중 출생아, 정상체중아, 과체중아는 각각 22.0%, 74.6%, 3.4%로 조사되었는데, 특히 국소 저체중출생아와 초극소 저체중출생아는 각각 4.6%와 1.7%이었다. 2007년 한 해 동안 전국 57개 병원의 신생아 중환자실에서 입원치료를 받은 환자의 분포를 보면, 재태기간에 따라 조사된 총 인원수는 21,957명, 출생체중에 따라 조사된 총 인원수는 21,356명으로 조사되었다. 이들의 사망률은 미숙아, 만삭아, 과숙아에서 가각 4.5%, 0.7%, 3.7%이었고, 특히 재태기간 32주 미만에서는 11.3%, 보다 작은 재태기간 28주 미만에서는 26%의 높은 사망률을 보이고 있었다. 1996년과 2002년의 국내 자료와 비교하여 보면, 미숙아, 저체중출생아, 초극소 저체중출생아의 출생수는 현저히 증가하고 있었으며, 이들의 사망률은 감소하는 양상을 확인할 수 있었다. 결론 : 본 저자들은 과거 1996년과 2002년의 국내 조사 결과와 2007년의 본 연구 결괄ㄹ 비교해 보았을 때 미숙아, 저체중출생아와 초극소 저체중츨생아의 빈도가 증가하고 있으며, 이들의 사망률은 현저히 감소하고 있음을 확인하였다. 비록 한국 미숙아 진료의 결과가 개선되고 있는 것으로 조사되었으나, 아직도 초미숙아의 사망률은 높기 때문에 이들의 치료에 보다 많은 노력을 기울여야 할 것으로 생각된다.

• 한국식생활문화학회지
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• 제16권3호
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• pp.203-214
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• 2001

Maternal stress was very common symptom that every pregnant women could have experienced during pregnant period. We found that the causative factors of stress for subjects were physical change(50.8%), family relationship(13.6%), change of body image(7.4%), concern baby(6.8%), economic difficulties(6.4%), depress(4.3%), morning sickness(3%), and miscellaneous(3.5%). According to our study, maternal stress during the first trimester negatively correlated with food and nutrients intake of pregnant women and gave low weight gain during pregnancy and low birth weight of infants. It also significantly correlated with monthly income(p<0.001) and monthly food cost(p<0.001) during pregnant period. Mean intake of Calcium and Iron were $47{\sim}60%$ of RDA and $35{\sim}48$ of RDA, respectively. With the Iron supplement the total intake of Iron exceeded 100% of RDA. We also found majority of food items, except seaweeds, fruits and vegetables, were negatively correlated with maternal stress during three trimesters. Additional support system projected by professionals in health-care field could mediate maternal stress and lead to healthy pregnancy outcome.

• Neonatal Medicine
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• 제25권1호
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• pp.23-28
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• 2018

Purpose: Abdominoperineal solid tumors presenting in neonates often require surgical intervention during the neonatal period. Although we report our single-center experience, this study would be meaningful to understand the clinical implications of these neoplasms. Methods: We retrospectively reviewed and analyzed the clinical data and characteristics of 22 patients (${\leq}28$ days old) diagnosed with histopathologically confirmed abdominoperineal solid neoplasms (benign or malignant) after surgical resection. Results: The mean gestational age and postnatal age at the time of operation were $38.3{\pm}1.8weeks$ and $13.5{\pm}8.3days$, respectively. Most patients (18/22, 81.8%) were diagnosed during antenatal care visits; however, 4 (18.2%) were identified after birth. The mean tumor size was $6.4{\times}5.3cm$ (3.5-17.0 cm), and tumors occurred most frequently within the sacrococcygeal region (8/22, 36.4%). Histopathologically, 14 patients (63.6%) demonstrated benign tumors and 8 (36.4%) demonstrated malignant tumors. Germ cell tumors and hepatoblastomas were the most commonly observed tumors. Fortunately, all patients showed a localized pattern of tumor involvement without distant metastasis. No recurrence or mortality was observed during the follow-up period (mean $66.4{\pm}44.2months$). Conclusion: Abdominoperineal solid tumors occurring in neonates show variable clinical patterns during the antenatal and postnatal monitoring/screening periods. We conclude that aggressive and multidisciplinary approaches could achieve good clinical results in these patients.

• Advances in pediatric surgery
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• 제15권1호
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• pp.38-43
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• 2009

With the widespread use of the obstetrical ultrasound, identification of a fetal suprarenal mass becomes more common. Most of these masses prove to be congenital neuroblastomas (CNB) postnatally. However, the diagnosis is often confused with other benign lesions and the post-natal management remains controversial. The medical records of 13 patients that underwent primary surgical excision for an antenatally detected adrenal CNB, between January 1995 and April 2009, were reviewed retrospectively. The clinical, radiological, surgical, and pathological data on the suprarenal mass were collected. Staging evaluation was performed after histological confirmation of the CNB. Most of the CNBs were stage I (N=11), with 1 stage IV and 1 stage IV-S. Four patients (3 stage I and 1 stage IV-S) had N-myc gene amplification. The stage I patients were cured by surgery alone, and stage IV patients underwent 9 cycles of adjuvant chemotherapy and currently have no evidence of disease after 39 months of follow-up. The patient with stage IV-S is currently receiving chemotherapy. There were no post-operative complications. For early diagnosis and treatment, surgical excision should be considered as the primary therapy for an adrenal CNB detected before birth. The surgery can be safely performed during the neonatal period and provides a cure in most cases. Surgical diagnosis and treatment of CNB is recommended in neonatal period.

• 한국발생생물학회지:발생과생식
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• 제19권2호
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• pp.69-77
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• 2015

Cell-cell direct communication through channel-forming molecules, connexin (Cx), is essential for a tissue to exchange signaling molecules between neighboring cells and establish unique functional characteristics during postnatal development. The corpus epididymis is a well-known androgen-responsive tissue and involves in proper sperm maturation. In the present research, it was attempted to determine if expression of Cx isoforms in the corpus epididymis in the adult is modulated by exposure to estrogenic or anti-androgenic compound during the early postnatal period. The neonatal male rats at 7 days of age were subcutaneously injected by estradiol benzoate (EB) at low-dose ($0.015{\mu}g/kg$ body weight) or high-dose ($1.5{\mu}g/kg$ body weight) or flutamide (Flu) at low-dose ($500{\mu}g/kg$ body weight) or high-dose (50 mg/kg body weight). The corpus epididymis collected at 4 months of age was subjected to evaluate expressional changes of Cx isoforms by quantitative real-time PCR. Treatment of low-dose EB resulted in increases of Cx32, Cx37, and Cx45 transcript levels, while exposure to high-dose EB decreased expression of Cx26, Cx30.3, Cx31, Cx31.1, Cx32, Cx40, Cx43, and Cx45. Treatments of Flu caused significant decreases of expression of all examined Cx isoforms, except Cx37 and Cx43 shown no expressional change with high-dose Flu treatment. These findings imply that expression of most Cx isoforms present in the corpus epididymis would be transcriptionally regulated by actions of androgen and/or estrogen during postnatal period.

• Journal of Genetic Medicine
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• 제7권1호
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• pp.87-90
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• 2010

신생아 시기의 고암모니아혈증은 고암모니아성 뇌병증에 의하여 심각한 뇌기능의 장애를 일으킬 수 있다. 이 중 신생아 일과성 고암모니아혈증 (transient hyperammonemia of newborn, THAN)은 신생아 시기에만 일시적으로 고암모니아 혈증을 보이고, 신생아시기에 적절한 진단과 치료를 통해 양호한 예후를 보이는 질환이다. 그러나 일부에서는 고도의 고암모니아 혈증을 보여 이에 대한 응급치료를 요하기도 한다. 본 증례 보고에서는 신생아 시기에 고암모니아혈증이 발견되어, 신대치요법과 약물치료 후호 전된 1례를 기술하고자 한다. 환아는 이후 생후9개월까지 정상 식이와 약물치료 없이 정상발달을 보이며, 고암모니아혈증의 재발이 없었다.

• Clinical and Experimental Pediatrics
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• 제50권11호
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• pp.1067-1071
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• 2007

목 적 : 초극소저출생체중아의 생존율 향상에 따라 장기 신경발달 장애가 감소했는지 여부와 이들의 장기 신경발달의 예후 인자에 대해 알아보고자 하였다. 방 법 : 1994년 11월부터 2004년 7월까지 삼성서울병원 신생아중환자실에서 입원 치료 받은 초극소저출생체중아 중 교정나이 18개월에 외래에서 추적관찰이 가능하였던 134명을 대상으로 하였으며 외래 방문 시 진찰소견과 의무기록을 후향적으로 분석하였다. 대상 환아를 1994년 11월부터 1999년 12월까지인 제 I기와 2000년 1월부터 2004년 7월까지인 제 II기로 나누었으며 각각 36명과 98명이 해당되었다. 결 과 : 제 I기에 비하여 제 II기에 재태연령과 출생체중이 낮았지만 생존율은 향상되었으며(제 I기: 60.0%, 제 II기: 74.7%) 뇌성마비는 감소하였고(제 I기: 22.2%, 제 II기: 8.2%) 따라잡기 성장은 향상되었다(제 I기: 25.0%, 제 II기: 51.0%). 뇌실주위 백질연화증, 패혈증과 기관지폐 이형성증의 이환율은 제 II기에 감소하였다. 뇌성마비의 가장 큰 위험요인은 3도 이상의 고도 뇌실내출혈, 따라잡기 성장의 실패와 뇌실주위 백질연화증이었다. 결 론 : 초극소저출생체중아의 생존율 향상은 장기적인 예후의 향상과 관련되어 있으며 신생아 관리의 질향상과 관련된 뇌실주위 백질연화증의 감소, 고도 뇌실내출혈의 감소, 더 나은 영양공급이 장기적인 예후의 향상과 관련된 것으로 보인다.

• Journal of Chest Surgery
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• 제20권4호
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• pp.780-785
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• 1987

Pulmonary atresia with VSD is uncommon congenital anomaly with high mortality in neonatal period. Recently we experienced surgical correction of 2 cases of pulmonary atresia with VSD. The first case was 7-year old female patient and diagnosed as pulmonary atresia with VSD combined PDA. So, total correction was undertaken which consisted of PDA ligation, patch repair of VSD, transannular enlargement of RVOT with woven Dacron vascular graft, and closure of PFO. Postoperative systemic Rt. ventricular and radial artery pressure ratio was 0.44 and her postoperative course was uneventful. The second case was 6-year old male patient diagnosed as pulmonary atresia with VSD and large systemic-pulmonary collateral arteries. There were two large systemic-pulmonary collaterals, one was simply controlled by ligation, but the other was considered to supply Rt. upper lung. So end to side anastomosis was performed to the RVOT patch. Postoperative systolic Rt. ventricular and radial artery pressure ratio was 0.54. During the follow up period he showed clinical picture of Rt. heart failure, which is relatively well controlled with anticongestive therapy.

• 한국임상수의학회지
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• 제19권2호
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• pp.211-214
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• 2002

The mortalities of exotic felids that have been raised in Everland Zoological Gardens within a designated period (1976∼2001) were retrospectively analyzed based on the clinical charts and/or autopsy reports. During that period, a total of 154 exotic folios from 5 species were died. Noninfectious and traumatic factors, respiratory and digestive disorders account for the majority of cause of death. 40% of the death was concentrated in the winter season. The mortality of female and male was 55% and 45% respectively. The mortality of newborn folios(57%) were significantly higher than that of adult(32% and juvenile felids(11%) due to neonatal problems.