• Title/Summary/Keyword: Neonatal status

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Effect of Selenium on Pulmonary Glutathione Peroxidase and Alveolarization of Neonatal Rats

  • Kim, Hye-Young
    • Korean Journal of Environmental Biology
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    • v.21 no.3
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    • pp.297-302
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    • 2003
  • This study was designed to determine whether selenium (Se) nutrition affects pulmonary glutathione peroxidase and alveolarization in the neonatal rat. Twenty-four female Sprague Dawley rats were bred and fed a semipurified Se-deficient (0.04 ppm, Se-) or a Se-adequate (0.5 ppm, Se+) diet through pregnancy and lactation. Pulmonary DNA synthesis was slightly higher in Se+ pups than in Se- pups on d 6 and d 9 of lactation, but significant difference was not found. As pulmonary alveolarization progressed, mean air space size decreased and internal surface area and lung volume increased. No difference in pulmonary alveolarization was found between Se- and Se+ pups by age. Pulmonary Se concentration was higher in Se+ pups than in Se- pups at all age. Glutathione peroxidase activity in lung tissur reflected Se status and was lower in Se- pups than in Se+ pups. In conclusion, selenium has no significant effect on alveolarization of neonatal lungs. but it is necessary for adequate supply of pulmonary antioxidant, glutathione peroxidase.

Effects of one-to-one Labor Support on Labor Pain, Labor Stress Response, Childbirth Experience and Neonatal Status for Primipara (일대일 분만지지간호가 초산모의 분만동통, 분만스트레스 반응, 분만경험 및 신생아 상태에 미치는 효과)

  • Hur, Myung-Haeng
    • Women's Health Nursing
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    • v.7 no.2
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    • pp.188-202
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    • 2001
  • This study was designed to investigate the effect of one-to-one labor support on labor pain, labor stress response, childbirth experience and neonatal status for primipara by a quasi experiment (nonequivalent control group pretest-posttest design), from April 30, 1999 to February 20, 2000. The subjects of this experiment consisted of eighty two primipara with single gestation, full term, uncomplicated pregnancies. Forty one were in the experimental group and forty one in the control group. Their mean age was 25.95 years, their mean gestation period was 39.9 weeks. A caring package of one-to-one labor support had three components. Physical support consisted of massage, back pressure, touch. Emotional support was provided by a continuous nurse's presence, acceptance and encouragement. Informational support involved teaching breathing skills, relaxation skills and knowledge about the labor process. Data assessed labor pain, pulse rate and blood pressure to measure labor stress response. Also, in measuring the value of labor stress response, plasma epinephrine, plasma norepinephrine and serum cortisol were measured. In the 24 hours after birth, the data for the postpartum mother's childbirth experiences was collected. Umbilical cord arterial blood pH, one minute and five minute Apgar score were measured after birth. Data was analyzed by t-test, $x^2$-test, repeated measures ANOVA, ANCOVA with SAS Program. The results were as follows; 1. Labor pain was significantly low in the experimental group(P=.016). 2. No significant group effects were found, but significant time effects were found for plasma epinephrine, norepinephrine, serum cortisol, pulse rate and blood pressure. 3. The childbirth experience of the experimental group was significantly more positive than the control group (P = .005). 4. The umbilical cord arterial blood pH of the experimental group was significantly higher than the control group(P=.014). There was no significant difference between the two groups in neonatal one minute and five minute Apgar scores. In conclusion, these findings indicate that one-to-one labor support could be effective in decreasing labor pain, and increasing positive childbirth experiences, also increasing the neonatal umbilical cord arterial blood pH for primipara. So, one-to-one labor support could be applied as an effective nursing treatment for primipara.

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Neonatal Diabetes Mellitus Due to KCNJ11 (KIR6.2) Mutation Successfully Treated with Sulfonylurea

  • Jang, Sehun;Yang, Misun;Ahn, So Yoon;Sung, Se In;Chang, Yun Sil;Park, Won Soon
    • Neonatal Medicine
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    • v.28 no.2
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    • pp.94-98
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    • 2021
  • Neonatal diabetes mellitus (NDM) is a rare disease that occurs at less than 6 months of age and is presumably caused by a mutation in the gene that affects pancreatic beta-cell function. Approximately 80% of NDM cases reveal a known genetic mutation, and mutations in potassium inwardly rectifying channel subfamily J member 11 (KCNJ11) and ABCC8 affecting the pancreatic beta-cell adenosine triphosphate-sensitive potassium channel may be treated with oral sulfonylurea. Early recognition of mutations in KCNJ11 and ABCC8 is important because early administration of sulfonylurea can not only control blood glucose levels but also improve neurodevelopmental outcomes. In the present study, we report a case of NDM that initially presented as diabetic ketoacidosis at the age of 1 month, accompanied by seizures during hospitalization. After confirmation of the KCNJ11 gene mutation (c.989A>C), we started administering oral sulfonylurea (glimepiride) at the age of 2 months. After gradually increasing the dosage of glimepiride, insulin was discontinued at the age of 3 months. To date, the infant's blood glucose levels have been well controlled without significant hypoglycemic events. No further episodes of seizures have occurred, and his developmental status is favorable.

Current status of neonatal intensive care units in Korea (한국에서 신생아 중환자실의 현황)

  • Shin, Son-Moon
    • Clinical and Experimental Pediatrics
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    • v.51 no.3
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    • pp.243-247
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    • 2008
  • Neonatal intensive care in Korea has improved remarkably since the 1990s, but there is still a shortage of facilities and equipment in NICUs. Only 71.1% of the beds needed for neonatal intensive care are available. Mechanical ventilators are not appropriately distributed to the NICUs that are equipped to handle neonatal intensive care. The number of doctors is far too small, making the number of patients per doctor very high. Nurses, too, need to take care of 7.7 patients per nurse, making it very difficult to provide adequate intensive care. All this is caused by insufficient investment by the hospitals, which, in turn, is caused by inadequate reimbursement from health insurance. Therefore, a government-sponsored effort is necessary to bring the level of neonatal intensive care up to par.

Clinical Characteristics of Neonatal Status Epilepticus (신생아 간질 중첩증의 임상 특성)

  • Jung, Kyeong Hun;Kim, Yun Hee;Kwon, Young Se;Jun, Yong Hoon;Kim, Soon Ki;Son, Byong Kwan
    • Clinical and Experimental Pediatrics
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    • v.48 no.12
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    • pp.1342-1347
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    • 2005
  • Purpose : Among perinatal risk factors, neonatal seizures are one of the strongest independent discriminators of adverse outcome, representing high risks of mortality and neurologic morbidity. This study was undertaken to evaluate the neurologic outcome of neonatal status epilepticus according to underlying etiology, seizure pattern, onset time, and duration. Methods : We reviewed retrospectively 36 neonates(19 males, 17 females) with status epilepticus who were admitted to the neonatal intensive care unit, Inha Hospital between July, 1988 and June, 2003. They were evaluated with neurologic examination, laboratory data, EEG findings, and neuroimaging studies etc. Results : The mean gestational period of the patients was $37.0{\pm}3.6$ weeks and birth weight was $2.70{\pm}0.82$ kilogram. Fifty two point eight percent of the neonates were male and 66.7 percent were born at term. The most common cause of neonatal status epilepticus was hypoxic-ischemic encephalopathy. In preterm babies, intracranial hemorrhages showed an especially high frequency(P=0.034). Gestational age and birth weight did not show a correlation with neurologic complications. The incidence of neurological sequelae were significantly related to prolonged seizures lasting more than 1 hour(P=0.002). Neonates with seizures within the first 72 hours tended to be more frequent among those who developed adverse outcomes(P=0.016). Generalized tonic seizures had the worst prognosis, whereas those children who had subtle seizures had better outcomes than any other type(P<0.05). Generalized tonic seizures were primarily represented on EEG by abnormal background, whereas subtle seizure showed a significantly more normal EEG than any other seizures(P<0.05). Conclusion : Our results indicate that neonatal status epilepticus with early onsets, prolonged durations. And generalized tonic types can predict an increased risk for neurologic sequelae. So, those seizures must be perceived as medical emergencies and treated aggressively with antiepileptic drugs.

Opening Status of the Korea Midwifery Birthing Centers and Development of Midwifery Practice Guideline (한국 조산원 개원실태 및 조산직무지침 개발)

  • Song, Ji Young;Park, Young-Joo
    • Journal of Korean Academy of Nursing
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    • v.50 no.4
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    • pp.583-598
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    • 2020
  • Purpose: This study was to investigate the operational status of the midwifery birthing centers (MBCs) and midwives' job status (Phase 1) and to develop midwifery practice guidelines (MPG) (Phase 2) in Korea. Methods: In the first phase, the subjects were 15 midwives who operated 11 of 14 MBCs that were opened as of August 2018. The questionnaire consisted of items to measure the operational status of the MBC and midwives' job status. In the second phase, the MPG was developed from literature review, interviews with five midwives opening their MBCs, surveys with 74 midwives, and a validity evaluation conducted by seven experts. Results: The distribution of operating MBCs was five in Gyunggi-do, two each in Seoul and Incheon, one each in Busan, Chungcheongbuk-do, Gyeongsangbuk-do, Gyeongsangnam-do and Jeju-do. The mean age of midwives was 54.3 and all were female. In 2017, a total of 762 births including 81 homebirths were performed by midwives. The job performance was highest in the order of neonatal care 3.81, childbirth care 3.56, and postpartal care 3.53, respectively. The MPG included seven areas of prenatal care, childbirth care, postpartal care, neonatal care, primary health care, law/ethics, and administration, with 56 tasks and 166 task elements. Conclusion: This study provides the valid basic data for the operational status of the MBC and the midwives' job status. The MPG describes the midwife's job and may be used as basic data for preparing policies for the development of midwifery practice in Korea.

A Neonatal Form of Alexander Disease Presented with Intractable Seizures and Obstructive Hydrocephalus

  • Yoo, Il Han;Hong, Won Gi;Kim, Hunmin;Lim, Byung Chan;Hwang, Hee;Chae, Jong-Hee;Kim, Ki Joong;Hwang, Yong Seung
    • Journal of Genetic Medicine
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    • v.10 no.2
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    • pp.113-116
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    • 2013
  • Alexander disease is a rare degenerative leukodystrophy caused by dominant mutations in glial fibrillary acidic protein (GFAP). The neonatal form of Alexander disease may manifest as frequent and intractable seizures or obstructive hydrocephalus, with rapid progression leading to severe disability or death within two years. We report a case of a 50-day-old male who presented with intractable seizures and obstructive hydrocephalus. His initial magnetic resonance imaging (MRI) suggested a tumor-like lesion in the tectal area causing obstructive hydrocephalus. Despite endoscopic third ventriculostomy and multiple administrations of antiepileptic drugs, the patient experienced intractable seizures with rapid deterioration of his clinical status. After reviewing serial brain MRI scans, Alexander disease was suspected. Subsequently, we confirmed the de novo missense mutation in GFAP (c.1096T>C, Y366H). Although the onset was slightly delayed from the neonatal period (50 days old), we concluded that the overall clinical features were consistent with the neonatal form of Alexander disease. Furthermore, we also suspected that a Y366 residue might be closely linked to the neonatal form of Alexander disease based on a literature review.

Parental concerns about their premature infants' health after discharge from the neonatal intensive care unit: a questionnaire survey for anticipated guidance in a neonatal follow-up clinic

  • Cho, Ji-Yun;Lee, Ju-Young;Youn, Young-Ah;Kim, Soon-Ju;Kim, So-Young;Sung, In-Kyung
    • Clinical and Experimental Pediatrics
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    • v.55 no.8
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    • pp.272-279
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    • 2012
  • Purpose: The aim of this study was to develop an appropriate nursing information guideline according to corrected age, after investigating parents' concerns about the growth, development, and diseases of their premature infants after discharge from the neonatal intensive care unit (NICU). Methods: The parents of premature infants (birth weight, <2,500 g; gestational age, <37 weeks) who went to a neonatal follow-up clinic after NICU discharge at Seoul St. Mary's Hospital from January 2005 to December 2009, were asked with regard to their concerns about their infants through a questionnaire survey. The results of physical examinations, including body measurements and neurodevelopmental status at 4, 8, 12, and 18 months of corrected age, were retrospectively reviewed in 390 infants. Results: The most common parental concerns were developmental delay, poor growth, and feeding and nutritional problems. Parental concerns about developmental delay, growth failure in improvement in body weight and length, and overweightness were high in specificity but very low in sensitivity. After NICU discharge, 30% of premature infants experienced infectious diseases before 18 months of corrected age, the most common of which was respiratory tract infection. Conclusion: For guiding of premature infants in outpatient day clinics after NICU discharge, it is necessary to identify the parents' highest concerns, to educate them about the possibilities of growth and neurodevelopmental disabilities in their infants and to provide them with handouts containing guidelines on the management of infectious diseases, especially respiratory infections.

Factors Influencing Post-traumatic Growth in Mothers with Premature Infants Admitted to the Neonatal Intensive Care Unit (신생아집중치료실에 입원 경험이 있는 미숙아 어머니의 외상 후 성장에 영향을 미치는 요인)

  • Lee, Hyeun Soo;Kang, Sook Jung
    • Child Health Nursing Research
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    • v.26 no.2
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    • pp.267-276
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    • 2020
  • Purpose: Caring for a vulnerable premature baby is a challenging task, but some mothers experience growth through that process. The purpose of this study was to investigate the factors influencing post-traumatic growth in mothers with premature infants admitted to the neonatal intensive care unit. Methods: A correlational research design was used and 105 mothers of premature infants were recruited from an online community. Data were collected from January 15 to January 25, 2019. Post-traumatic growth was measured using the Korean version of the Posttraumatic Growth Inventory. Data were analyzed using descriptive statistics, the t-test, analysis of variance, the Scheffé test, Pearson correlation coefficients, and hierarchical multiple regression. Results: The final model developed in this study explained 45.5% of post-traumatic growth (F=13.66, p<.001). Resilience (β=.54, p<.001) was the strongest predictor of post-traumatic growth, followed by the age of the mother when giving birth (β=.17, p=.028) and current employment status (β=.17, p=.049). Conclusion: For mother with premature infants to grow psychologically after their experience, it may be needed to support them to develop and strengthen their resilience through either education or their own support network.

Nursing Needs of the Parents of Infants in Neonatal Intensive Care Unit (신생아집중치료실 입원 환아 부모의 간호요구)

  • Park, Ji-Sun;Bang, Kyung-Sook
    • Journal of East-West Nursing Research
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    • v.20 no.2
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    • pp.136-144
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    • 2014
  • Purpose: The purposes of this study were to identify the perceived nursing needs and the differences by general characteristics of parents of infants in a neonatal intensive care unit (NICU) and to provide useful evidences developing a new intervention for family-centered care in NICU. Methods: A convenience sample of 121 parents of infants in NICU was used and the participants asked to complete the Korean version of NICU Family Needs Inventory (NFNI) from April to May, 2014. Data were analyzed using descriptive statistics, t-test and ANOVA. Results: The participants reported high average score in the perceived nursing needs. In subscales, needs for assurance rated highest score and needs for information, proximity, support, and comfort were followed. Mothers reported higher nursing needs score than fathers except the subscale of support. Conclusion: The findings suggest that nurses in NICU actively provide information about treatment, nursing, results of laboratory tests, and current status to give reassurance to parents. Not only providing informational support of parents of NICU infants, but also finding methods to contact to parents is necessary. In addition, nurses need to provide optimized intervention in current healthcare system and hospital environment.