• Clinical and Experimental Pediatrics
• /
• v.64 no.7
• /
• pp.313-321
• /
• 2021

Here we describe the neurodevelopmental outcomes of very low birth weight (VLBW) infants (birth weight ≤1,500 g) at 3 years of age in the Neonatal Research Network of Japan (NRNJ) database in the past decade and review the methodological issues identified in follow-up studies. The follow-up protocol for children at 3 years of chronological age in the NRNJ consists of physical and comprehensive neurodevelopmental assessments in each participating center. Neurodevelopmental impairment (NDI)-moderate to severe neurological disability-is defined as cerebral palsy (CP) with a Gross Motor Function Classification System score ≥2, visual impairment such as uni- or bilateral blindness, hearing impairment requiring hearing amplification, or cognitive impairment with a developmental quotient (DQ) of Kyoto Scale of Psychological Development score <70 or judgment as delayed by pediatricians. We used death or NDI as an unfavorable outcome in all study subjects and NDI in survivors using number of assessed infants as the denominator. Follow-up data were collected from 49% of survivors in the database. Infants with follow-up data had lower birth weights and were of younger gestational age than those without follow-up data. Mortality rates of 40,728 VLBW infants born between 2003 and 2012 were 8.2% before discharge and 0.7% after discharge. The impairment rates in the assessed infants were 7.1% for CP, 1.8% for blindness, 0.9% for hearing impairment, 15.9% for a DQ <70, and 19.1% for NDI. The mortality or NDI rate in all study subjects, including infants without follow-up data, was 17.4%, while that in the subjects with outcome data was 32.5%. The NRNJ follow-up study results suggested that children born with a VLBW remained at high risk of NDI in early childhood. It is important to establish a network follow-up protocol and complete assessments with fewer dropouts to enable clarification of the outcomes of registered infants.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.27 no.5
• /
• pp.313-321
• /
• 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.

• Journal of Animal Science and Technology
• /
• v.63 no.1
• /
• pp.1-15
• /
• 2021

As a result of intensive breeding, litter size has considerably increased in pig production over the last three decades. This has resulted in an increase in farrowing complications. Prolonged farrowing will shorten the window for suckling colostrum and reduce the chances for high-quality colostrum intake. Studies also agree that increasing litter sizes concomitantly resulted in decreased piglet birth weight and increased within-litter birth weight variations. Birth weight, however, is one of the critical factors affecting the prognosis of colostrum intake, and piglet growth, welfare, and survival. Litters of uneven birth weight distribution will suffer and lead to increased piglet mortality before weaning. The proper management is key to handle the situation. Feeding strategies before farrowing, management routines during parturition (e.g., drying and moving piglets to the udder and cross-fostering) and feeding an energy source to piglets after birth may be beneficial management tools with large litters. Insulin-like growth factor 1 (IGF-1)-driven recovery from energy losses during lactation appears critical for supporting follicle development, the viability of oocytes and embryos, and, eventually, litter uniformity. This paper explores certain management routines for neonatal piglets that can lead to the optimization of their colostrum intake and thereby their survival in large litters. In addition, this paper reviews the evidence concerning nutritional factors, particularly lactation feeding that may reduce the loss of sow body reserves, affecting the growth of the next oocyte generation. In conclusion, decreasing birth weight and compromised immunity are subjects warranting investigation in the search for novel management tools. Furthermore, to increase litter uniformity, more focus should be placed on nutritional factors that affect IGF-1-driven follicle development before ovulation.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.18 no.2
• /
• pp.160-167
• /
• 2011

Purpose: The purpose of this study was to identify the effects of an oral stimulation program on premature infant's transition from tube feeding to bottle feeding, decrease in desaturation during feeding, and early discharge. Methods: This quasi-experimental study was performed in one neonatal intensive care unit (NICU) of an university hospital. The control group data (n=69) were obtained from June 2008 to May 2009, and the experimental group data (n=67), from June 2009 to May 2010. The oral stimulation program (OSP) was provided daily before feeding for the experimental group until transition to bottle feeding was completed. Results: The OSP group began bottle feeding earlier and were on complete bottle feeding earlier than control group. Discharge delay due to feeding desaturation was lower than for the control group. Conclusion: The results indicate that OSP for premature infants was helpful in transition from tube feeding to bottle feeding and early discharge and thus can contribute health and development in premature infants.

• Reproductive and Developmental Biology
• /
• v.31 no.1
• /
• pp.55-60
• /
• 2007

Aging causes thymus involution, and genes in thymus play an important role in the development of the immune system. In this study, we compared genes expressed in thymus of neonatal and peripubertal rats using annealing control primers (ACPs)-based GeneFishing polymerase chain reaction (PCR) and semiquantitative reverse transcription (RT)-PCR. We identified 10 differentially expressed genes (DEGs) with 20 ACPs. Of 10 DEGs, bystin-like, collagen type V alpha 1 (COL5A1), and T-cell receptor beta-chain segment 2 (TCRB2) that are related to immune-function were detected in rat thymus. Bystin-like and TCRB2 were up-regulated, while COL5A1 was down-regulated in peripubertal thymus. Semiquantitative RT-PCR confirmed postnatal changes in expression of bystin-like, COL5A1, and TCRB2. These results suggest that bystin-like, COL5A1, and TCRB2 could regulate immune function controlled in thymus as age increases.

• The Journal of Korean Physical Therapy
• /
• v.15 no.3
• /
• pp.251-264
• /
• 2003

Alcohol exposure during development leads to significant long-term neurobehavior dysfunction and central nervous system alteration. The purpose of this study was to determine the effects of enriched enviroment in developmental period through motor behavior test and expression of BDNF. Neonatal rat exposed to alcohol on postnatal days 4 through 10 were studied. Female Sprague-Dawley pups were assigned to two groups. Experimental group(EG) via 4.5 g kg-1day-1 of ethanol was housed in enriched enviornment for 9 weeks. The main result of this study were as follows: 1. There was significant difference in the mean of weight change between control and experimental group. 2. In motor behavior test, there was significant difference in the mean of weight change between control and experimental group. 3. Regarding the immunoreactivity of BDNF were higher appeared experimental group than control group. In conclusion, the present results reveals that enriched enviroment in developmental period is to be extremely useful in neuronal reprganization and motor behavior improvement after alcohol exposure.

• Clinical and Experimental Pediatrics
• /
• v.54 no.4
• /
• pp.179-182
• /
• 2011

Transient neonatal diabetes mellitus (TNDM) is a rare form of diabetes mellitus that presents within the first 6 months of life with remission in infancy or early childhood. TNDM is mainly caused by anomalies in the imprinted region on chromosome 6q24; however, recently, mutations in the ABCC8 gene, which encodes sulfonylurea receptor 1 (SUR1), have also been implicated in TNDM. Herein, we present the case of a male child with TNDM whose mutational analysis revealed a heterozygous c.3547C>T substitution in the ABCC8 gene, leading to an Arg1183Trp mutation in the SUR1 protein. The parents were clinically unaffected and did not show a mutation in the ABCC8 gene. This is the first case of a de novo ABCC8 gene mutation in a Korean patient with TNDM. The patient was initially treated with insulin and successfully switched to sulfonylurea therapy at 14 months of age. Remission of diabetes had occurred at the age of 16 months. Currently, the patient is 21 months old and is euglycemic without any insulin or oral hypoglycemic agents. His growth and physical development are normal, and there are no delays in achieving neurological and developmental milestones.

• Korean Journal of Clinical Pharmacy
• /
• v.30 no.3
• /
• pp.143-148
• /
• 2020

Objective: This study aimed to investigate pharmaceutical care for critically ill neonates and suggest targeted strategies compatible with the Korean health-system pharmacy. Methods: Articles that reported pharmacy practices for critically ill neonates were reviewed. Pharmaceutical care practices and roles of neonatal pharmacists were identified, and criteria were developed for neonates in need of specialized care by clinical pharmacists. Results: Neonatal pharmacists play many roles in the overall medication management pathway. For clinical decision support, multidisciplinary ward rounds, clinical pharmacokinetic services, and consultation for pharmacotherapy and nutrition support were conducted. Prevention and resolution of drug-related problems through review of medication charts contributed to medication safety. Pharmaceutical optimization of intravenous medication played an important role in safe and effective therapy. Information on the use of off-label medicine, recommended dosage and dosing schedules, and stability of intravenous medicine was provided to other health professionals. Most clinical practices for neonates in Korea included therapeutic drug monitoring and nutrition support services. Reduction in medication errors and adverse drug reactions, shortening the duration of weaning medicines, decreasing the use and cost of antimicrobials, and improvement in nutrition status were reported as the outcomes of pharmacist-led interventions. The essential criteria of pharmaceutical care, including for patients with potential high-risk factors for drug-related problems, was developed. Conclusion: Pharmaceutical care for critically ill neonates varies widely. Development and provision of standardized pharmaceutical care for Korean neonates and a stepwise strategy for the expansion of clinical pharmacy services are required.

• Child Health Nursing Research
• /
• v.13 no.2
• /
• pp.147-156
• /
• 2007

Purpose: The purpose of this study was to investigate the sleep/activity patterns of premature babies. Method: The subjects were 55 premature babies who were hospitalized in the Neonatal Intensive Care Unit (NICU) of one University Hospital in Daejeon from September 1, 2004 to March 31, 2006. The sleep/activity patterns of the premature babies were observed for 24 hours a day for 7 days. The observations were made and recorded by the researcher and 5 trained research assistants using NCASA records developed by Barnard et al. (1979). For statistical analysis, frequency, average, t-test, and Pearson correlation coefficients were used. Results: The infants slept more and had less awake periods during daytime than full-term infants. As the hospital stay of the premature babies increased, the amount of daytime sleep and total daily sleep decreased, and the amount of daytime awake periods increased. Conclusions: The findings suggest that the level of physical and physiological maturity of premature babies is one of the major variables that affect their sleep/activity patterns. Furthermore, the findings of this study will provide information about the sleep/activity patterns of premature babies, and present baseline data to develop the nursing intervention programs which support optimum development for the premature babies.

• Child Health Nursing Research
• /
• v.25 no.1
• /
• pp.38-47
• /
• 2019

Purpose: The purpose of this study was to investigate the influence of perceptions of death, end-of-life (EOL) care stress, and emotional intelligence on attitudes toward EOL care among nurses in the neonatal intensive care unit (NICU). Methods: The participants were 111 nurses working in a NICU who had experienced EOL care at least once. Data were analyzed using the t-test, Pearson correlation coefficient, and stepwise multiple regression analysis in SPSS for Windows. Results: The mean score for perceptions of death was 3.16 out of 5, the mean score for EOL care stress was 3.61 out of 5, the mean emotional intelligence score was 4.66 out of 7, and the average score for EOL care attitudes was 2.77 out of 4. The factors affecting attitudes towards EOL care were academic degree, anxiety regarding death, negativity towards death, experiences of patient death, and emotional intelligence. The explanatory power of these variables for attitudes towards EOL care was 24.7%. Conclusion: The results of this study are expected to serve as a basic reference for the development of nursing education programs and EOL care protocols to improve attitudes toward EOL care among NICU nurses.