Purpose: This study aimed to investigate and report the current status of physical therapy (PT) performed in Korean neonatal intensive care units (NICU) to present foundational data that promotes the advances in neonatal PT in Korea. Methods: Based on the Health Insurance Review and Assessment (HIRA) data, we administered a questionnaire survey to 74 hospitals (39 tertiary and 35 general hospitals) in Korea equipped with a NICU and pediatric PT unit. We developed a 32-item questionnaire with reference to previous Korean studies. The questionnaires were distributed and retrieved via regular mail and an online system. Results: Of the 74 hospitals, 58 (78%) practiced neonatal PT and the duration of each session significantly differed according to the hospital rating. PT was given, depending on clinical symptoms, to infants who were preterm and low birth-weight (96.5%), had brain and spinal cord diseases (84.5%), had pathological tonus (94.8%), with respiratory problems (65.5%), for range of motion exercises (82.8%), for neurodevelopment approaches (72.4%), and for positioning (70.7%). Interdisciplinary meetings were held to share clinical decisionmaking in 17.2% of the hospitals surveyed and parent-participating education to ensure a family-centered approach was offered in 63.8% of the hospitals. The barriers of neonatal PT included low insurance fees, insufficient awareness of colleagues, and the severity of the patient. Conclusion: This study is the first report of the current status of neonatal PT in Korea. The findings of this study will serve as foundational data to review the current neonatal PT practice and promote further advances.
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.
The aim of this study was to identify the effect of suspension unloading (SU) and electrical stimulation upon the development of neonatal muscular system. For this study, the neonatal rats were randomly divided into three groups: a control group, an experimental group I, and an experimental group II. The SU for experimental group I and II was applied from postnatal day (PD) 5 to PD 30. The electrical stimulation for soleus muscle of experimental group IIwas applied from PD 16 to PD 30 using neuromuscular electrical stimulation (NMES), which gave isometric contraction with 10 pps for 30 minutes twice a day. In order to observe the effect of SU and ES, this study observed myocyte enhancer factor 2C (MEF2C) and vascular endothelial growth factor (VEGF) immunoreactivity in the soleus muscles at PD 15 and PD 30. In addition, the motor behavior test was performed through footprint analysis at PD 30. The following is the result. At PD 15, the soleus muscles of experimental group Iand II had significantly lower MEF2C, VEGF immunoreactivity than the control group. It proved that microgravity conditions restricted the development of the skeletal muscle cells at PD 15. At PD 30, soleus muscles of the control group and experimental group II had significantly higher MEF2C, VEGF, immunoreactivity than experimental group I. It proved that the NMES facilitated the development of the skeletal muscle cells. At PD 30, it showed that SU caused the decrease in stride length of parameter of gait analysis and an increase in toe-out angle, and that the NMES decreased these variations. These results suggest that weight bearing during neonatal developmental period is essential for muscular development. They also reveal that NMES can encourage the development of muscular systems by fully supplementing the effect of weight bearing, which is an essential factor in the neonatal developmental process.
The development of neonatal neuromuscular system is accomplished by the functional interaction between the spinal neurons and its target cells, skeletal muscle cells, and the intrinsic and extrinsic factors affecting this process. The aim of this study was to identify the effect of suspension unloading (SU) and neuromuscular electrical stimulation (NMES) upon the development of the neonatal spinal cord. For this study, the neonatal rats were randomly divided into three groups: a control group, an experimental group I, and an experimental group II. The SU for experimental group I and II was applied from postnatal day (PD) 5 to PD 30, and the NMES for experimental group II was applied from PD 16 to PD 30 using NMES that gave isometric contraction with 10 Hz for 30 minutes twice a day. In order to observe the effect of SU and NMES, this study observed neutrophin-3 (NT-3) and microtubule associated protein 2 (MAP2) immunoreactivity in the lumbar spinal cord (L4-5) at the PD 15 and PD 30. The results are as follows. At PD 15, lumbar spinal cord of experimental group I and II had significantly lower NT-3 and MAP2 immunoreactivity than control group. It proved that a microgravity condition restricted the spinal development. At PD 30, lumbar spinal cord of control group and experimental group II had significantly higher NT-3 and MAP2 immunoreactivity than experimental group I. It proved that the NMES facilitated the spinal development by spinal cord-skeletal muscle interaction. These results suggest that weight bearing during the neonatal developmental period is essential for the development of neuromuscular development. Also, the NMES on its target skeletal muscle can encourage the development of the spinal cord system with a full supplementation of the effect of weight bearing, which is an essential factor in neonatal developmental process.
Purpose: The purpose of this study was to trace the development of premature babies who had undergone neurodevelopmental treatment in the neonatal intensive care unit and to identify the effects of early neurodevelopmental treatment on the development of premature babies. Methods: Fifty-one premature babies, who had been hospitalized in the neonatal intensive care unit and received an infant motor performance test and Bayley scales-III evaluation of their developments during the six months of corrected age were included. They were divided into three groups: the intervention group (n=16), control group (n=23), and comparison group (n=12), depending on the risk of developmental delays and the existence of an intervention. The results of this study were analyzed using SPSS 22.0 for windows. The statistical significance level was set at ${\alpha}=0.05$. Results: Regarding the infant motor performance test scores for each group before the intervention, at two weeks after the start of intervention, and at post-conception of 40 weeks, the intervention group showed a significantly higher improvement than the control or comparison group (p<0.01). With respect to the Bayley scales-III at the corrected age of six months, the intervention group exhibited statistically significant differences from the control group in the domains of language and fine movements (p<0.01). Conclusion: The findings of this study could confirm that the early neurodevelopmental treatment of premature babies in the neonatal intensive care unit has continuous effects on the development of premature babies even after being discharged from the hospital.
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.
The purpose of this study was to test that motor skill training enhance motor function and cerebellar development. Using an animal model of fetal alcohol syndrome-which equates peak blood alcohol concentrations across developmental period-critifical periods for the effect of alcohol on body and cerebellar weigh was examined. The effect of motor skill training on motor function and cerebellar development of rat exposed alcohol on postnatal days 4 through 10 were studied. Newborn rats were assigned to one of two groups: (1) Control group (CG), via artificial rearing to milk formula and (2) experimental groups (EG), via 4.5g/kg/day of ethanol in a milk solution. After completion of the treatments, the pups were fostered back to lactating dams, and wearing they were raised in standard caged until they were postnatal 48 days. Rats from experimental group of postnatal treatment then spent 10 days in one of two groups: Experimental group II (EGII) was had got motor skill training (training traverse a set of 6 elevated obstacles) for 4 weeks. Experimental group I (EGI) was not trained. Before sacrificing, the rat got examined two behavioral test, body weigh and cerebellar weigh, then coronal sections were processed. The section was investigated the Purkije cell in the cerebellum using light microscope. The results of this study were as follows. 1. In body weight test, the outcome of alcohol groups were significantly lower than the normal group. 2. In cerebellar weight test, the outcome of EGI were significantly lower than CG and EGII. 3. In motor behavioral test, the outcome of EGI was significantly lower than NG and EGII. 4. In Purkinje cells counting test, the outcome of EGI was significantly lower than the NG and EGII. These result suggest that improved motor function induced by motor skill training after postnatal exposure is associated with dynamically altered expression of Purkinje cells and that is related with cerebellar function. Also, these data can potentially serve as a model for therapeutic intervention.
Purpose: This study aimed to identify the effects of nursing intervention programs for women with gestational diabetes mellitus (GDM) through a critical review of recent studies. Methods: Studies related to effects of nursing intervention programs for women with GDM published in English or Korean between 2000 and 2019 were extracted from 10 electronic databases. The quality of the studies was evaluated and double-checked for accuracy by two reviewers using the Revised Cochrane Risk-of-Bias tool for randomized controlled trials. Results: Twenty studies were selected, of which 19 had a low risk of bias and one had a high risk of bias. Interventions fell into six main groups: (1) integrated interventions, (2) self-monitoring of blood glucose levels, (3) dietary interventions, (4) exercise, (5) psychotherapy, and (6) complementary therapy. This review found that nursing interventions for GDM were of many types, and integrated interventions were the most common. However, low-carbohydrate diets and blood glucose monitoring interventions did not show statistically significant results. Evidence shows that various nursing intervention programs applied to GDM improved diverse aspects of maternal, fetal, and neonatal health, including both physical and psychological aspects. Conclusion: The composition and delivery of integrated interventions continue to evolve, and these interventions affect physical and psychological indicators. Although interventions affecting physical health indicators (e.g., blood glucose levels, diet, and exercise) are important, many studies have shown that programs including psycho-emotional nursing interventions related to anxiety, depression, stress, self- efficacy, and self-management are also highly useful.
The purposes of this study were to test that complex motor training enhance motor function significantly, to test change in cerebellum, and to test the synaptic plasticity into the immunohistochemistry response of synaptophysin. Using an animal model of fetal alcohol syndrome - which equates peak blood alcohol concentrations across developmental period - the effects of alcohol on body weight during periods were examined. The effect of complex motor training on motor function and synaptic plasticity of rat exposed alcohol on postnatal days 4 through 10 were studied. Newborn rats were assigned to one of two groups: (1) normal group (NG), via artificial rearing to milk formula and (2) alcohol groups (AG), via 4.5 g/kg/day of ethanol in a milk solution. After completion of the treatments, the pups were fostered back to lactating dams, where they were raised in standard cages (two-and three animals per cage) until they were postnatal 48 days. Rats from alcohol group of postnatal treatment then spent 10 days in one of two groups: Alcohol-experimental group was had got complex motor training (learning traverse a set of 6 elevated obstacles) for 4 weeks. The alcohol-control group was not trained. Before consider replacing with "the experiment/study", (avoid using "got" in writing) the rats were examined during four behavioral tests and their body weights were measured, then their coronal sections were processed in rabbit polyclonal antibody synaptophysin. The synaptophysin expression in the cerebellar cortex was investigated using a light microscope. The results of this study were as follows: 1. The alcohol groups contained significantly higher alcohol concentrations than the normal group. 2. The alcohol groups had significantly lower body weights than the normal group. 3. In alcohol groups performed significantly lower than the normal group on the motor behavioral test. 4. In alcohol-control group showed significantly decreased immunohistochemistric response of the synaptophysin in the cerebellar cortex compared to the nomal group. These results suggest that improved motor function induced by complex motor training after postnatal exposure is associated with dynamically altered expression of synaptophysin in cerebellar cortex and that is related with synaptic plasticity. Also, these data can potentially serve as a model for therapeutic intervention.
Childhood epilepsy which has high prevalence rate and inception rate is one of the commonest problem encountered in pediatrician. In contrast with epilepsy of adult, in childhood epilepsy, more variable and varying manifestations are found because the factors of age, growth and development exert their influences in the manifestations and the courses of childhood epilepsy. Moreover epileptic children have associated problems such as physical and mental handicaps, psychologicaldisorders and learning disability. For these reasons pediatrician who deals with epileptic children experiences difficulties in making diagnosis and managing them. In order to improve understanding and management of childhood epilepsy, authors reviewed 103 cases of epileptic patients seen at pediatric department of Yeungnam University Hospital retrospectively. The patients were classified according to the type of epileptic seizure. Suspected causes of epilepsy, associated conditions of epileptic patients, age incidence and the findings of brain CT were reviewed. Large numbers of epileptic patients (61.2%) developed their first seizures under the age of 5. The most frequent type of epileptic seizure was generalized ionic-clonic, tonic, clonic seizure (49.5%), followed by simple partial seizure with secondary generalization (17.5%), simple partial seizure (7.8%), a typical absence (5.8%) and unclassified seizure (5.8%). In 83.5% of patients, we could not find specific cause of it, but in 16.5% of cases, history of neonatal hypoxia (4.9%), meningitis (3.9%), prematurity (1.9%), small for gestational age (1.0%), CO poisoning (1.0%), encephalopathy (1.0%), DPT vaccination (1.0%), cerebrovascular accident (1.0%) and neonatal jaundice (1.0%) were found, 30 cases of patients had associated diseases such as mental retardation, hyperactivity, delayed motor milestones or their combinations. The major abnormal findings of brain CT performed in 42 cases were cortical atrophy, cerebral infarction, hydrocephalus and brain swelling. This review stressed better designed classification of epilepsy is needed and with promotion of medical care, prevention of epilepsy is possible in some cases. Also it is stressed that childhood epilepsy requires multidisplinary therapy and brain CT is helpful in the evaluation of epilepsy with limitation in therapeutic aspects.
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