• Title/Summary/Keyword: Neonatal status

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Iron status in small for gestational age and appropriate for gestational age infants at birth

  • Kim, Hyeon A;Park, Sook-Hyun;Lee, Eun Joo
    • Clinical and Experimental Pediatrics
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    • v.62 no.3
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    • pp.102-107
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    • 2019
  • Purpose: This study compared the iron statuses of small for gestational age (SGA) and appropriate for gestational age (AGA) infants at birth. Methods: The clinical data of 904 newborn infants admitted to the neonatal intensive care unit were reviewed. Blood samples were drawn from the infants within 24 hours after birth. Serum ferritin level was used as a marker of total iron status. Results: In this study, 115 SGA (GA, $36.5{\pm}2.9weeks$; birth weight [BW], $1,975{\pm}594.5g$) and 717 AGA (GA, $35.1{\pm}3.5weeks$; BW, $2,420.3{\pm}768.7g$) infants were included. The SGA infants had higher hematocrit levels ($50.6%{\pm}5.8%$ vs. $47.7%{\pm}5.7%$, P<0.05) than the AGA infants. No difference in serum ferritin level (ng/mL) was found between the groups (mean [95% confidence interval]: SGA vs. AGA infants, 139.0 [70.0-237.0] vs. 141.0 [82.5-228.5]). After adjusting for gestational age, the SGA infants had lower ferritin levels (147.1 ng/mL [116.3-178.0 ng/mL] vs. 189.4 ng/mL [178.0-200.8 ng/mL], P<0.05). Total body iron stores were also lower in the SGA infants than in the AGA infants (185.6 [153.4-211.7] vs 202.2 [168.7-241.9], P<0.05). Conclusion: The SGA infants had lower ferritin and total body iron stores than the AGA infants. The SGA infants affected by maternal hypertension who were born at late preterm had an additional risk of inadequate iron store. Iron deficiency should be monitored in these infants during follow-up.

Pathogenesis and Prevention of Intraventricular Hemorrhage in Preterm Infants

  • Pei-Chen Tsao
    • Journal of Korean Neurosurgical Society
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    • v.66 no.3
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    • pp.228-238
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    • 2023
  • Intraventricular hemorrhage (IVH) is a serious concern for preterm infants and can predispose such infants to brain injury and poor neurodevelopmental outcomes. IVH is particularly common in preterm infants. Although advances in obstetric management and neonatal care have led to a lower mortality rate for preterm infants with IVH, the IVH-related morbidity rate in this population remains high. Therefore, the present review investigated the pathophysiology of IVH and the evidence related to interventions for prevention. The analysis of the pathophysiology of IVH was conducted with a focus on the factors associated with cerebral hemodynamics, vulnerabilities in the structure of cerebral vessels, and host or genetic predisposing factors. The findings presented in the literature indicate that fluctuations in cerebral blood flow, the presence of hemodynamic significant patent ductus arteriosus, arterial carbon dioxide tension, and impaired cerebral venous drainage; a vulnerable or fragile capillary network; and a genetic variant associated with a mechanism underlying IVH development may lead to preterm infants developing IVH. Therefore, strategies focused on antenatal management, such as routine corticosteroid administration and magnesium sulfate use; perinatal management, such as maternal transfer to a specialized center; and postnatal management, including pharmacological agent administration and circulatory management involving prevention of extreme blood pressure, hemodynamic significant patent ductus arteriosus management, and optimization of cardiac function, can lower the likelihood of IVH development in preterm infants. Incorporating neuroprotective care bundles into routine care for such infants may also reduce the likelihood of IVH development. The findings regarding the pathogenesis of IVH further indicate that cerebrovascular status and systemic hemodynamic changes must be analyzed and monitored in preterm infants and that individualized management strategies must be developed with consideration of the risk factors for and physiological status of each preterm infant.

Functional Amino Acids and Fatty Acids for Enhancing Production Performance of Sows and Piglets

  • Kim, Sung Woo;Mateo, Ronald D.;Yin, Yu-Long;Wu, Guoyao
    • Asian-Australasian Journal of Animal Sciences
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    • v.20 no.2
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    • pp.295-306
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    • 2007
  • The growth and health of the fetus and neonate are directly influenced by the nutritional and physiological status of sows. Sows are often under catabolic conditions due to restrict feeding program during pregnancy and low voluntary feed intake during lactation. The current restrict feeding program, which aims at controlling energy intake during gestation, results in an inadequate supply of dietary protein for fetal and mammary gland growth. Low voluntary feed intake during lactation also causes massive maternal tissue mobilization. Provision of amino acids and fatty acids with specific functions may enhance the performance of pregnant and lactating sows by modulating key metabolic pathways. These nutrients include arginine, branched-chain amino acids, glutamine, tryptophan, proline, conjugated linoleic acids, docosahexaenoic acid, and eicosapentaenoic acid, which can enhance conception rates, embryogenesis, blood flow, antioxidant activity, appetite, translation initiation for protein synthesis, immune cell proliferation, and intestinal development. The outcome is to improve sow reproductive performance as well as fetal and neonatal growth and health. Dietary supplementation with functional amino acids and fatty acids holds great promise in optimizing nutrition, health, and production performance of sows and piglets. (Supported by funds from Texas Tech, USDA, NLRI-RDA-Korea, and China NSF).

Association between Periodontitis and Preeclampsia: a Systematic Review (임신기 치주질환과 자간전증 발생간의 연관성)

  • Ha, Jungeun
    • Journal of The Korean Society of Integrative Medicine
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    • v.6 no.1
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    • pp.55-62
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    • 2018
  • Purpose : Preeclampsia(PE) is a pregnancy-specific disease which is characterized by hypertension and proteinuria. This disease occurs in about 2-8 % of pregnancies in developing countries and remains among the major causes of maternal and neonatal mortality and morbidity throughout the world. Although the causes of PE are not fully understood, the infection has been considered as the main risk factor for this diseases. Periodontal disease may provide a chronic burden of endotoxin and inflammatory cytokines and the disease has been considered as risk factors of systemic illnesses including cardiovascular disease, atherosclerosis, and cerebrovascular ischemia. So, studies performed over the last 15 years have suggested that periodontal disease may be associated with adverse pregnancy outcomes such as PE. However, this association has not been found in all populations. The aim of this review article was to evaluate whether periodontal status and the presence of specific periodontal pathogens may influence the incidence of PE. Methods : Many research articles searched at the electronic databases(MEDLINE; 2000 to July 2017) including search term as periodontal disease and preeclampsia. Result : There were 10 case-control studies and 5 cohort studies meeting our inclusion criteria. The results showed that maternal periodontitis (adjusted odds ratio: 1.5 to 9.3) was associated with preeclampsia in 15 epidemiological studies. Conclusion : It is clear that maternal periodontitis is a risk factor associated with preeclampsia, emphasizing the importance of periodontal care in prenatal programs.

Effect of Vitamin E Supplementation on Lipid Distribution and Serum Insulin in Experimental Model Rats with Impaired Glucose Tolerance (내당능 장애 모델 흰쥐에서 Vitamin E의 과잉섭취가 지질 분포와 혈청 Insulin 농도변화에 미치는 영향)

  • 이영주
    • Journal of Nutrition and Health
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    • v.31 no.8
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    • pp.1226-1234
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    • 1998
  • The aim of the study was to determine whether vitamin E supplementation in three experimental model rats with impaired glucse tolerance could change serum insulin concentration and lipid distribution. The three groups were adult(AS) and neonatal (NS) streptozotocin-induced groups, and a high sucrose diet(HS) group. Each group was divided into control and vitamin E supplementatino groups at the age of 9 weeks. The level of vitamin E supplementation was 5g/kg diet. Blood and organ samples were taken at 5 and 10 weeks and were examined for changes in the level of serum insulin, glucose, lipids, liver lipids, and oxidative status. Vitamin E supplementation significantly reduced serum insulin in the HS group and caused the significant beneficial changes in serum lipids and triglycerides in As grouop at 10 weeks . In all groups, serum vitamin E was increased and malondialdehyde(MDA) in serumand liver were decreased significantly by vitamin E supplementation. The results suggest that vitamin E supplementation improves lipid distribution in adult streptozotocin-induced rats and serum insulin concentration in high sucrose diet-induced rats. Vitamin E might prevent on reduce oxidative injury in all experimental model rats with impaired glucose tolerance.

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A case of anemia caused by combined vitamin B12 and iron deficiency manifesting as short stature and delayed puberty

  • Song, Seung-Min;Bae, Keun-Wook;Yoon, Hoi-Soo;Im, Ho-Joon;Seo, Jong-Jin
    • Clinical and Experimental Pediatrics
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    • v.53 no.5
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    • pp.661-665
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    • 2010
  • Anemia caused by vitamin B12 deficiency resulting from inadequate dietary intake is rare in children in the modern era because of improvements in nutritional status. However, such anemia can be caused by decreased ingestion or impaired absorption and/or utilization of vitamin B12. We report the case of an 18-year-old man with short stature, prepubertal sexual maturation, exertional dyspnea, and severe anemia with a hemoglobin level of 3.3 g/dL. He had a history of small bowel resection from 50 cm below the Treitz ligament to 5 cm above the ileocecal valve necessitated by midgut volvulus in the neonatal period. Laboratory tests showed deficiencies of both vitamin B12 and iron. A bone marrow examination revealed dyserythropoiesis and low levels of hemosiderin particles, and a cytogenetic study disclosed a normal karyotype. After treatment with parenteral vitamin B12 and elemental iron, both anemia and growth showed gradual improvement. This is a rare case that presented with short stature and delayed puberty caused by nutritional deficiency anemia in Korea.

Evaluation of Clinical Practicum for Child Health Nursing (4년제 간호대학(과) 아동간호학 실습교육의 현황과 발전방향)

  • Park, Eun-Sook;Tak, Young-Ran;Kang, Kyung-Ah
    • Child Health Nursing Research
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    • v.12 no.1
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    • pp.5-14
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    • 2006
  • Purpose: The purpose of study was to describe and evaluate the educational status regarding clinical practicum for child health nursing to facilitate student's clinical compliance for the bachelor's degree in Korea. Methods: The study was a descriptive study and included data from 40 institutions among the 53 university nursing programs in Korea(75.5% response rate). Data were collected using mailed semi structured questionnaires and content analysis was done. Results: Findings show that most institutions have common learning objectives for the clinical practicum; neonatal care, high risk infant care, hospitalized child care, and advanced nursing practice. The mode for theoretical credits in child health nursing was 5 to 6 and 3 to 4 credits for clinical practice. The practice settings were prepared to provide diverse experiences, including childcare centers, and community centers with various learning activities. Evaluation for learning outcomes included faculty and instructors. It was pointed out that updating evaluation based on student and faculty feedback is important for a comprehensive practicum evaluation. Conclusions: Findings suggest that there is a -need for a generalized curriculum for clinical practicum and for the expanding role of advanced nursing practice-, a need for diverse clinical settings for practice, and effective guidance and learning activities. It is significantly noted that the attitude and teaching methodologies of clinical instructor's are highly important to effective clinical learning outcomes.

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Congenital heart disease in the newborn requiring early intervention

  • Yun, Sin-Weon
    • Clinical and Experimental Pediatrics
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    • v.54 no.5
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    • pp.183-191
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    • 2011
  • Although antenatal diagnostic technique has considerably improved, precise detection and proper management of the neonate with congenital heart disease (CHD) is always a great concern to pediatricians. Congenital cardiac malformations vary from benign to serious conditions such as complete transposition of the great arteries (TGA), critical pulmonary and aortic valvular stenosis/atresia, hypoplastic left heart syndrome (HLHS), obstructed total anomalous pulmonary venous return (TAPVR), which the baby needs immediate diagnosis and management for survival. Unfortunately, these life threatening heart diseases may not have obvious evidence early after birth, most of the clinical and physical findings are nonspecific and vague, which makes the diagnosis difficult. High index of suspicion and astute acumen are essential to decision making. When patent ductus arteriosus (PDA) is opened Widely, many serious malformations may not be noticed easily in the early life, but would progress as severe acidosis/shock/cyanosis or even death as PDA constricts after few hours to days. Ductus dependent congenital cardiac lesions can be divided into the ductus dependent systemic or pulmonary disease, but physiologically quite different from each other and treatment strategy has to be tailored to the clinical status and cardiac malformations. Inevitably early presentation is often regarded as a medical emergency. Differential diagnosis with inborn error metabolic disorders, neonatal sepsis, persistent pulmonary hypertension of the newborn (PPHN) and other pulmonary conditions are necessary. Urgent identification of the newborn at such high risk requires timely referral to a pediatric cardiologist, and timely intervention is the key in reducing mortality and morbidity. This following review deals with the clinical presentations, investigative modalities and approach to management of congenital cardiac malformations presenting in the early life.

A Congenital Giant Hepatic Hemangioendothelioma Treated with Interferon-$\alpha$ and Complete Tumor Resection (인터페론 투여 후 완전 절제를 시행한 거대 선천성 간내 혈관내피종)

  • Cho, Min-A;Yu, Jae-Eun;Park, Moon-Sung;Park, Jun-Eun;Hong, Jeong;Kim, Young-Bae
    • Neonatal Medicine
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    • v.15 no.2
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    • pp.183-189
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    • 2008
  • Infantile hepatic hemangioendotheliomas (IHHEs) are benign vascular tumors, but can be associated with the life-threatening complications, such as congestive heart failure, disseminated intravascular coagulation, and massive bleeding. Various therapeutic options have been developed and the treatment response depends on the patient's clinical status and the nature of the lesion. In the case of a symptomatic IHHE, a non-invasive and precise diagnosis should be performed promptly before the therapeutic method is chosen. Additionally, it should be kept in mind that the residual lesions have malignant potential. We report a case of a congenital giant IHHE that was successfully reduced in size by interferon-$\alpha$ and completely removed by surgical tumor resection with a hepatic lobectomy.

Comparison and Analysis of Response of Premature Infants to Auditory Stimulus (일변량 분산 분석과 이변량 시계열 분석을 이용한 미숙아의 목소리 자극에 대한 심박동수와 호흡수 반응의 비교)

  • Lee, Hye-Jung
    • Child Health Nursing Research
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    • v.15 no.3
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    • pp.261-270
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    • 2009
  • Purpose: The purpose of this study was to compare the result of one-way ANOVA with that of cross-correlation time series analysis in order to evaluate physiologic responses of premature infants to human voices. Methods: Four premature infants born prior to 32 weeks gestational age were included in the study. The Gould 4000TA Recording System recorded the preterm infant's heart and respiratory rate while they were listening to a pre-recorded voice recording. Each infant listened to both male and female voices (1 min each) at each testing session. Results: The results of both one-wayANOVA and cross-correlation time series analysis using heart and respiratory rate data were not consistent in some of premature infants. A cross-correlation time series analysis revealed that the responses of premature infant to vocal stimulation occurred at a varying number of seconds after the stimulus was presented and lasted for over 20-30 sec. Conclusion: The results indicate that a time series analysis can provide more detailed information on the rapidly changing physiologic status of premature infant to the auditory stimulus. In addition, the results provide an insight into an auditory responsitivity of premature infants to a naturally occurring sound, the human voice, in the neonatal intensive care unit.

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