• Journal of Trauma and Injury
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• v.33 no.4
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• pp.256-259
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• 2020

Although traumatic posterior fossa subdural hematoma (TPFSH) in neonates immediately after birth is extremely rare, it can pose a serious clinical problem in the neonatal period. Here, the author presents the case of a 3-day-old male infant who underwent emergency surgical treatment of TPFSH with a favorable outcome. Debate continues about surgical versus conservative treatment of TPFSH in neonates. The clinical symptoms, extent of hemorrhage, early diagnosis, and prompt and appropriate surgery are the most important factors in the treatment of TPFSH in neonates. Therefore, neurosurgeons should establish treatment strategies based on the newborn's clinical condition, the size and location of the TPFSH, and the potential of the hematoma to cause long-term complications.

• Clinical and Experimental Pediatrics
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• v.65 no.3
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• pp.115-126
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• 2022

Retinopathy of prematurity (ROP) is among the most common causes of childhood blindness. Three phases of ROP epidemics have been observed worldwide since ROP was first described in the 1940s. Despite advances in neonatal care, the occurrence of ROP and associated visual impairment has been increasing somewhere on Earth and remains difficult to control. Conventional treatment options for preventing ROP progression include retinal ablation using cryotherapy or laser therapy. With the emergence of anti-vascular endothelial growth factor (anti-VEGF) treatment for ocular diseases, the efficacy and safety of anti-VEGF therapy for ROP have recently been actively discussed. In the advanced stage of ROP with retinal detachment, surgical treatment including scleral buckling or vitrectomy is needed to maintain or induce retinal attachment. At this stage, the visual outcome is usually poor despite successful anatomical retinal attachment. Therefore, preventing ROP progression by timely screening examinations and treatment remains the most important part of ROP management.

• Journal of Korean Academy of Nursing
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• v.50 no.3
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• pp.459-473
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• 2020

Purpose: This study was conducted to identify the effects of a lifestyle intervention program on weight gain, dietary habits, fatigue and pregnancy stress, blood pressure, and neonatal birth weight, using Cox's interaction model of client health behavior for overweight and obese women. Methods: This was a quasi-experimental research with a non-equivalent control group pre-post test design. A total of 52 patients who met the selection criteria, including 25 in the experimental group and 27 in the control group, were the subjects of the study; they comprised overweight and obese pregnant women who were receiving prenatal care at A and B women's hospital in J province. The lifestyle intervention program ran for 12 weeks in total and consisted of interactions involving affective support, health information, and professional/technical competencies. The data collection period was from February 1, 2017 to August 31, 2017. Results: This study showed differences in the appropriate weight gain rate (χ²=6.17, p=.013), suppression of an increase in fatigue (t=-2.32, p=.012), and an increase in pregnancy stress (t=-1.87, p=.034). Yet, no differences in physical activity, dietary habits change, blood pressure, and neonatal birth weight (p>.05) were found. Conclusion: The study findings indicate that this program could be an effective intervention for the control of appropriate weight gain, fatigue, and pregnancy stress. Therefore, a lifestyle intervention program based on Cox's interaction model of client health behavior could be an efficient strategy for a positive health outcome of overweight and obesity pregnant women.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.24 no.3
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• pp.167-180
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• 2017

Purpose: The aim of this study was to synthesize the best available evidence for active warming interventions during cesarean section. Methods: A database search was done for randomized controlled trials utilizing active warming interventions. Maternal temperature, shivering and neonatal temperature were evaluated as outcome variables. Data were analyzed using Cochrane Review Manager software Version 5.3. Results: Thirteen studies including 1306 patients were reviewed. The degree of lowering of maternal temperature decreased in the warmed fluids (MD 0.51; p=.004) and warming mattress interventions (MD 0.22; p<.001) compared with control groups. Incidence of shivering was also lower in the active warming group (OR 0.55; p=.003). There was no statistically significant difference in maternal temperature with a forced air warming intervention (MD 0.64; p=.15) or in neonatal temperature (MD 0.12; p=.26). Conclusion: Findings show that with warmed fluids and warming mattresses applied during cesarean sections maternal temperature decline was reduced and also the incidence of shivering declined, but no significant effect was observed for forced air warming interventions. These findings provide a basis for developing a warming guideline for women having a cesarean section and will help to improve the quality of care for cesarean section patients.

• Advances in pediatric surgery
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• v.15 no.1
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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.

• Neonatal Medicine
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• v.15 no.2
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• pp.123-133
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• 2008

Purpose: The purpose of this study was to determine the outcomes of extremely low birth weight infants (ELBWI) who were born at the Asan Medical Center and evaluate the recent status of neonatal intensive care and associated problems. Methods:We retrospectively evaluated 120 inborn ELBWI who were admitted to the NICU of the Asan Medical Center between 2003 and 2006. The survival rate, neurodevelopmental outcomes, maternal and infant factors, and infant mordibities were evaluated and the relationships with survival and catch-up growth were investigated. Results:The survival rate of the ELBWI was 82% at a mean gestational age of 27+2 weeks, and with a mean birth weight of 801.3${\pm}$129.0 g. The duration of hospitalization was 85.7${\pm}$27.2 days, the duration of O2 use was 43.9${\pm}$35.4 days, and the duration of ventilatory support was 20.9${\pm}$20.9 days among the survivors. The incidence of respiratory distress syndrome, chronic lung disease, severe intraventricular hemorrhage, and periventricular leukomalacia were 41.8%, 61.2%, 3%, and 4%, respectively. The mean mental developmental index and psychomotor development index of Bailey Scales of Infant Development (II) at follow-up were 83.4${\pm}$18.2 and 83.3${\pm}$20.3, respectively. Among the infants who had >18 months of follow-up, 50.8% had catch-up growth at 12 months. Conclusion:The survival rate of ELBWI has improved; however, the morbidities remain high, thus indicating further efforts must be implemented to reduce morbidity and improve neurodevelopmental outcomes.

• Child Health Nursing Research
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• v.16 no.3
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• pp.211-219
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• 2010

Purpose: The study was done to measure the effects of maternal heart sound on body weight, physiologic reactions (heart rate [HR] and cortisol) and behavioral states of preterm infants. Methods: Thirty-five preterm infants were recruited from a neonatal intensive care unit at a university hospital. Institutional Review Board approval and informed consent were obtained. The infants were assigned to an experimental group (n=18) with an auditory stimulation for 7 days of life, a continuous delivery of maternal heart sound using MP3 attached inside the incubator, or to a control (n=17) without any auditory stimulation. The outcome variables, daily variations in weight, HR and behavioral states, and differences in cortisol were analyzed. Results: There were differences in variations of daily weights (F=3.431, p=.011) and in cortisol (t=3.184, p=.006) between groups, but no difference in variations of daily HR (F=0.331, p=.933) and behavioral states (F=1.842, p=.323). Conclusion: The findings support the safety of continuous maternal heart sound as no changes in HR and behavioral states occurred, and the efficacy as weight increased and cortisol decreased. This auditory simulation may lead to more efficient utilization of energy in preterm infants by consistently providing familiar sounds from intrauterine life and blocking noxious sounds from NICU environments.

• Child Health Nursing Research
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• v.24 no.2
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• pp.252-261
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• 2018

Purpose: This study aimed to evaluate the effects of an empowerment program on maternal stress, anxiety, depression and parenting confidence. Methods: A total of 44 mothers of preterm infants were assigned into an experimental or a control group (n=22 each). The experimental group received the usual nursing care and 7 sessions of an empowerment program. The control group only received the usual care. The program was implemented from June to December, 2016 in the neonatal intensive care unit of K university-affiliated hospital in Daegu, Korea. The outcome variables measured were parental stress (PSS: NICU), anxiety (STAI), depression (CES-D) and parenting confidence. Data were analyzed using t-test or repeated measures ANOVA. Results: Scores for both parental stress (t=3.07 p=.004) and depression (F=3.76, p=.26) were significantly lower in the experimental group than in the control group. However, there were no significant differences in anxiety between the groups (F=0.79, p=.505). Parenting confidence scores (F=9.05, p=.001) were significantly higher in the experimental group than in the control group. Conclusion: A maternal empowerment program can be an effective means of reducing parental stress and depression as well as enhancing parenting confidence, for mothers of preterm infants.

• Journal of Korean Medical Science
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• v.33 no.48
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• pp.309.1-309.13
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• 2018

Background: The aim of this study was to observe long-term outcomes of very low birth weight infants (VLBWIs) born between 2013 and 2014 in Korea, especially focusing on neurodevelopmental outcomes. Methods: The data were collected from Korean Neonatal Network (KNN) registry from 43 and 54 participating units in 2013 and 2014, respectively. A standardized electronic case report form containing 30 items related to long-term follow up was used after data validation. Results: Of 2,660 VLBWI, the mean gestational age and birth weight were $29^{1/7}{\pm}2^{6/7}$ weeks and $1,093{\pm}268g$ in 2013 and $29^{2/7}{\pm}2^{6/7}$ weeks and $1,125{\pm}261g$ in 2014, respectively. The post-discharge mortality rate was 1.2%-1.5%. Weight < 50th percentile was 46.5% in 2013 and 66.1% in 2014. The overall prevalence of cerebral palsy among the follow up infants was 6.2% in 2013 and 6.6% in 2014. The Bayley Scales of Infant Developmental Outcomes version II showed 14%-25% of infants had developmental delay and 3%-8% of infants in Bayley version III. For the Korean developmental screening test for infants and children, the area "Further evaluation needed" was 5%-12%. Blindness in both eyes was reported to be 0.2%-0.3%. For hearing impairment, 0.8%-1.9% showed bilateral hearing loss. Almost 50% were readmitted to hospital with respiratory illness as a leading cause. Conclusion: The overall prevalence of long-term outcomes was not largely different among the VLBWI born between 2013 and 2014. This study is the first large national data study of long-term outcomes.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.17 no.1
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• pp.31-37
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• 2017

Carbamoyl phosphate synthetase 1 deficiency (CPS1D) is an autosomal recessive disorder of the urea cycle that causes hyperammonemia. Two forms of CPS1D are recognized: a lethal neonatal type and a less severe, delayed-onset type. Neonatal CPS1D cases often present their symptoms within the first days of life. Delayed-onset cases are predominantly adolescents or adults, and infantile delayed-onset cases are rare. Severe hyperammonemia in the neonatal period leads to serious brain damage, coma, and death if not treated promptly. Therefore, early diagnosis and acute treatment are crucial. Despite the improvement of treatments, including continuous hemodialysis, ammonia-lowering agents, and a low-protein diet, the overall outcome of severe forms of hyperammonemia often remains disappointing. As the liver is the only organ in which ammonia is converted into urea, liver transplantation has been considered as an elegant and radical alternative therapy to classical dietary and medical therapies. However, liver transplantation has many disadvantages, such as a considerable risk for technical complications and perioperative metabolic derangement, especially in neonates. Additionally, there is a lack of suitable donor organs in most countries. According to recent studies, liver cell transplantation is a therapeutic option and serves as a bridge to liver transplantation. Here, we report a Korean CPS1D patient with novel mutations in CPS1 who was treated by liver cell transplantation after being diagnosed in the neonatal period and showed a good neurodevelopmental outcome at the last follow-up at six months of age.