• Journal of Veterinary Clinics
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• v.40 no.5
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• pp.354-359
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• 2023

This case report describes the clinical presentation and successful surgical repair of a diaphragmatic hernia-related small intestinal strangulation in a neonatal foal. A nine-day-old foal presented with colic signs and respiratory distress. History taking showed that the dam of the foal experienced difficulty during delivery, and the owner assisted in delivery by pulling on the foal. Radiography and ultrasonography confirmed the diaphragmatic rent and the presence of a small intestine within the thoracic cavity. Surgical intervention was required to repair the diaphragmatic defect and address the intestinal strangulation. The diaphragm was reconstructed, and the nonviable incarcerated portion of the small intestine was resected and anastomosed using an end-to-end technique. This unusual case report provides insights into the surgical repair and outcomes of an acquired diaphragmatic hernia in a neonatal foal.

• Child Health Nursing Research
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• v.19 no.1
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• pp.1-11
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• 2013

Purpose: This study was done to develop a scenario and evaluate student performance in simulation learning of care for children with respiratory distress syndrome in neonatal intensive care units. Methods: To test the application effect, a one group pre-test design was applied. The scenario based on actual patients and textbook material was developed through several meetings of experts. The scenario was used with 17 groups of 55 senior nursing students who participated voluntarily. Results: Contents were organized focusing on the nursing process for simulation learning. In the application of knowledge and skills, nursing students had high scores in the contents of observation of oxygen saturation, and care to relieve dyspnea. Participants' ability, especially in suction and oxygen supply in the evaluation of objective structured clinical examination was not adequate. There was a significant positive correlation between problem-solving ability and satisfaction in learning. Conclusion: The respiratory distress syndrome simulation scenario developed in this study was an effective tool to give students experience in problem solving and critical thinking ability under conditions similar to reality. The development of various scenarios for child nursing care is needed.

• Journal of Genetic Medicine
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• v.17 no.2
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• pp.108-111
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• 2020

Short stature homeobox-containing gene (SHOX) is a well-known causative gene for the short stature in Turner syndrome. The clinical manifestation of SHOX gene related disorders varies from SHOX haploinsufficiency, presenting with idiopathic short stature, disproportionate short stature, or Leri-Weill dyschondrosteosis (LWD) to recessive form of extreme dwarfism and limb deformity in Langer mesomelic dysplasia. LWD is usually diagnosed upon suspicion based on short stature and skeletal abnormalities, and it is rarely accompanied with respiratory failure in the neonatal period. Here, we report the case of a newborn infant with LWD presenting with severe micrognathia that caused respiratory distress, which was diagnosed using microarray testing. Even when the manifestation of Madelung deformity is not yet apparent, LWD should be considered as one of underlying diseases related to congenital micrognathia.

• Perinatology
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• v.29 no.4
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• pp.147-152
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• 2018

Objective: This study examines whether maternal group B Streptococcus (Streptococcus agalactiae, GBS) infection was associated with preterm births and premature neonatal outcomes. Methods: Maternal and neonatal outcomes were examined among singleton pregnant women with preterm birth (from $24^{+0}weeks$ to $36^{+6}weeks$) who were tested for GBS (n=203) during the pregnancy. Data were collected retrospectively from the medical records of women who delivered at our hospital from January 2015 to February 2017. We compared obstetrical factors (causes of preterm birth) and neonatal (gestational age at delivery, birth weight, Apgar score 1 min/5 min, hospitalization period, duration of mechanical ventilation, neonatal C-reactive protein within three days, and other complication [respiratory distress syndrome, neonatal deaths]) outcomes between GBS-infected and non-infected pregnant women. Results: There were 203 singleton pregnant women included in the study, 25 of whom were confirmed to have a GBS infection during the pregnancy. There was no difference in neonatal outcomes by GBS status. Preterm premature rupture of membranes (pPROM), as an obstetric factor, was associated with GBS infection (P=0.022). GBS infection raised the risk of pPROM by 3.6 times (odds ratio 3.648, 95% confidence interval 1.476-9.016, P=0.005). Conclusion: GBS infection in preterm birth was associated with pPROM but did not result in adverse neonatal outcomes. Continuous attention and evaluation of GBS infection, a major cause of neonatal sepsis and pneumonia, are needed.

• Clinical and Experimental Pediatrics
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• v.61 no.10
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• pp.315-321
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• 2018

Purpose: To investigate the effectiveness of transient intubation for surfactant administration and extubated to nasal continuous positive pressure (INSURE) for treatment of respiratory distress syndrome (RDS) and to identify the factors associated with INSURE failure in extremely premature infants. Methods: Eighty-four infants with gestational age less than 28 weeks treated with surfactant administration for RDS for 8 years were included. Perinatal and neonatal characteristics were retrospectively reviewed, and major pulmonary outcomes such as duration of mechanical ventilation (MV) and bronchopulmonary dysplasia (BPD) plus death at 36-week postmenstrual age (PMA) were compared between INSURE (n=48) and prolonged MV groups (n=36). The factors associated with INSURE failure were determined. Results: Duration of MV and the occurrence of BPD at 36-week PMA were significantly lower in INSURE group than in prolonged MV group (P<0.05), but BPD plus death at 36-week PMA was not significantly different between the 2 groups. In a multivariate analysis, a reduced duration of MV was only significantly associated with INSURE (P=0.001). During the study period, duration of MV significantly decreased over time with an increasing rate of INSURE application (P<0.05), and BPD plus death at 36-week PMA also tended to decrease over time. A low arterial-alveolar oxygen tension ratio (a/APO2 ratio) was a significant predictor for INSURE failure (P=0.001). Conclusion: INSURE was the noninvasive ventilation strategy in the treatment of RDS to reduce MV duration in extremely premature infants with gestational age less than 28 weeks.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.2
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• pp.246-250
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• 2009

Congenital diaphragmatic hernias (CDH) usually cause respiratory distress soon after birth and are associated with a high mortality rate in the early postnatal period. However, there is a milder form of CDH that does not manifest during the neonatal period. The late presenting CDH is characterized by a variable clinical picture. We present the case of an otherwise healthy 5-month-old girl, who was referred for evaluation of an 1-day history of vomiting and irritability. Chest simple X-ray and CT showed bowel loops in the left thoracic cavity, which was consistent with diaphragmatic hernia. At operation, she was found to have a small left posterolateral diaphagmatic defect with viable small bowel loops in the left thoracic cavity. After surgical reposition of the hernia, the symptoms such as vomiting and irritability subsided. The lack of typical manifestation of CDH such as respiratory distress may lead to delayed diagnosis. The possibility of late presenting CDH should not be overlooked even after the neonatal period.

• Clinical and Experimental Pediatrics
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• v.63 no.8
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• pp.284-290
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• 2020

Korea currently has the world's lowest birth rate but a rapidly inreasing number of preterm infants. The Korean Neonatal Network (KNN), launched by the Korean Society of Neonatology under the support of Korea Centers for Disease Control, has collected population-based data for very low birth weight infants (VLBWIs) born in Korea since 2013. In terms of the short-term outcomes of VLBWIs born from 2013 to 2016 registered in the KNN, the survival rate of all VLBWIs was 86%. Respiratory distress syndrome and bronchopulmonary dysplasia were observed in 78% and 30% of all VLBWIs, respectively. Necrotizing enterocolitis occurred in 7%, while 8% of the VLBWIs needed therapy for retinopathy of prematurity in the neonatal intensive care unit (NICU). Sepsis occurred in 21% during their NICU stay. Intraventricular hemorrhage (grade ≥III) was diagnosed in 10%. In terms of the long-term outcomes for VLBWIs born from 2013 to 2014 registered in the KNN, the post-discharge mortality rate was approximately 1.2%-1.5%, mainly owing to their underlying illness. Nearly half of the VLBWIs were readmitted to the hospital at least once in their first 1-2 years of life, mostly as a result of respiratory diseases. The overall prevalence of cerebral palsy was 6.2%-6.6% in Korea. Bilateral blindness was reported in 0.2%-0.3% of VLBWIs, while bilateral hearing loss was found in 0.8%-1.9%. Since its establishment, the KNN has published annual reports and papers that facilitate the improvement of VLBWI outcome and the formulation of essential healthcare policies in Korea.

• Clinical and Experimental Pediatrics
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• v.46 no.7
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• pp.655-660
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• 2003

Purpose : The relationship between chest X-ray findings and respiratory indices, including the arterial-alveolar oxygen partial pressure ratio($a/APO_2$) and the ventilatory index(VI), indicators of the clinical respiratory status in neonates with respiratory distress syndrome(RDS), was examined in the present study. Methods : The records of 50 neonates, randomly chosen from 174 neonates treated with pulmonary surfactant(PS) in the Neonatal Intensive Care Unit of Kyunghee University Hospital from 1996 to 2000 were analyzed retrospectively. Chest radiographs taken at the time after birth were classified into four groups according to Bomsel's classification. The $a/APO_2$ and VI values were calculated and compared with the corresponding chest radiographs. Results : Among the 50 cases of RDS examined, three cases were classified into grade I(6%), eight cases into grade II(16%), 20 cases into grade III(40%), and 19 cases into grade IV(38%). The mean $a/APO_2$ of the cases classified into grades I or II was 0.32 and the mean $a/APO_2$ of those classified into grades III and IV was 0.18 and 0.09, respectively. The mean VI was 0.049 for the cases classified into grades I or II and 0.076 and 0.161 for those classified into grades III and IV, respectively. Conclusion : The severity of RDS according to chest X-ray findings correlate to the values of respiratory indices, $a/APO_2$ and VI.

• Childhood Kidney Diseases
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• v.1 no.2
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• pp.161-165
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• 1997

Renal venous thrombosis (RVT) in neonatal period is a rare disease and usually complicated to clinical situations with reduced renal blood flow and hypercoagulability ; like acute blood loss, sepsis, shock, and birth asphyxia. RVT should be suspected in sick babies with hematuria, anemia, thrombocytopenia, enlarged kidney and acute renal failure. And the diagnosis can be confirmed by renal ultrasonography. We report two cases of neonatal renal venous thrombosis with review of literatures. One case, associated with E. coli sepsis, recovered completely, and the other, follwed respiratory distress in the neonate, revealed permanent renal functional impairment.

• Clinical and Experimental Pediatrics
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• v.53 no.6
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• pp.669-679
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• 2010

The risk of mortality and morbidity of patients with congenital heart defects (CHDs) is highest during neonatal period and increases when diagnosis and proper management are delayed. Neonates with critical CHDs may present with severe cyanosis, respiratory distress, shock, or collapse, all of which are also frequent clinical presentations of various respiratory problems or sepsis in the newborn. Early diagnosis and stabilization and timely referral to a tertiary cardiac center are crucial to improve the outcomes in neonates with CHDs. In this review, the clinical presentation of critical and potentially life-threatening CHDs is discussed along with brief case reviews to help understand the hemodynamics of these defects and ensure proper decision-making in critically ill patients.