• Title/Summary/Keyword: Neonates

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Incidence and Clinical Manifestations of Rotaviral Infections in a Neonatal Intensive Care Unit (신생아중환자실 내 로타바이러스 감염의 발생 및 임상 양상)

  • Baek, Jae-Moon;Kim, Hee-Young;Lee, Jang-Hoon;Choi, Byung-Min;Lee, Jung-Hwa;Lee, Kwang-Chul;Hong, Young-Sook
    • Neonatal Medicine
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    • v.16 no.1
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    • pp.55-63
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    • 2009
  • Purpose: This study was conducted to investigate the incidence and clinical manifestations of rotaviral infections in the neonatal intensive care unit (NICU). We also investigated whether neonates referred from other hospitals cause outbreaks of rotaviral infections in the NICU. Methods: Neonates diagnosed wit rotaviral infections in the NICU at Korea University Ansan Hospital between January 2002 and December 2006 were evaluated retrospectively. Results: Of 1,501 neonates admitted to the NICU, the number of rotaviral infections was 94 (6.3%) and the prevalence was 4.9 cases per 1,000-hospital days. Of 223 neonates referred from other hospitals to our NICU, 24 (10.8%) were confirmed to have rotaviral infections at the time of referral. Common symptoms of rotaviral infections were jaundice diarrhea or loose stools, vomiting, fever, apnea, irritability, seizures, and moaning sounds. Necrotizing enterocolitis of stage II or more was diagnosed in 3 premature neonates, accounting for 3.2% of total infected neonates and 6.8% of premature infected patients. There were no statistically significant differences in the prevalence of symptoms between term and preterm neonates, except for jaundice that is more frequent in premature infants. In time series analysis, the admission of neonates who were born at other hospitals and diagnosed with rotaviral infections were associated 1 month later by increased cases of neonates with rotaviral infections who were born at our hospital, whereas new cases of rotaviral infections among inborn neonates were decreased 2 and 4 months later (P<0.05). Conclusion: Rotaviral infections in NICU were not rare and showed vague symptoms. Three cases (3.2%) were diagnosed with stage II or more necrotizing enterocolitis. The referred neonates with rotaviral infections may induce outbreaks in the NICU, therefore awareness and strict surveillance for rotaviral infections should be performed at the time of referral.

Predisposing factors to nipple confusion (모유 수유에서 유두 혼란에 영향을 주는 인자)

  • Kim, Ji Hyun;Cha, Og Ryeon;Seo, Yu Kyung;Lee, Sun Ju;Cho, Sung Min;Park, Byung Chan
    • Clinical and Experimental Pediatrics
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    • v.51 no.4
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    • pp.362-366
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    • 2008
  • Purpose :The purpose of this study is to investigate the predisposing factors for nipple confusion by using questionnaires. Methods :From October, 2005 to October, 2006, we performed a survey on guardians of neonates who had been admitted to the nursery at Dongguk University Medical Center and were discharged 10 to 14 days before the survey. We reviewed their medical records retrospectively. The neonates were categorized into two groups; nipple-unconfused group and nipple-confused group. Results :There were 71 neonates in the nipple-unconfused group and 29 neonates in the nipple-confused group. In the nipple-confused group, 12 neonates (41.4%) had nipple-suckling experience before admission, whereas in the nipple-unconfused group, 54 neonates (76.1%) had nipple-suckling experience before admission; showing a difference that was statistically significant (P=0.001). Regarding to breast-feeding experience before admission, 11 neonates (37.9%) had experience in the nipple-confused group, whereas 49 neonates (69.0%) had in the nipple-unconfused group. This also showed a statistically significant difference (P=0.004). However, the relationship between the duration of breast-feeding prior to hospitalization was not different (P=0.151). Conclusion :In this study, we believe that the suckling experience and the breast-feeding of neonates before admission may be factors affecting the development of nipple confusion. This study particularly revealed that neonates who had only nipple suckling experience, regardless of breast-feeding, had less nipple confusion. Thus, allowing neonates enough time to make an attempt at nipple suckling may be helpful to prevent nipple confusion.

Diagnostic Strategy Using Barium Enema and Rectal Suction Biopsy with Acetylcholinesterase Histochemistry in Neonates with Suspious Hirschsprung's Disease (신생아 Hirschsprung's Disease에서 Barium Enema와 Acetylcholinesterase 조직화검사법을 이용한 진단적 접근)

  • Choi, Young-Il;Choi, Soon-Ok;Park, Woo-Hyun
    • Advances in pediatric surgery
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    • v.7 no.2
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    • pp.105-111
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    • 2001
  • To investigate the diagnostic accuracy and applicability of barium enema(BE) and rectal suction biopsy with acetyl cholinesterase(AChE) histochemistry in the diagnosis of neonatal Hirschsprung's disease(HD), we retrospectively reviewed the findings of BE and AChE staining in 96 neonates with suspected HD during a 10-year period from January 1991 to December 2000. Sixty-nine cases of HD(58 males and 11 females) and 27 cases of non-HD are included in this study. In regard to BE, HD was based on definite transitional zone, suspicious HD on reversed rectosigmoid index(RSI <1), and non-HD on normal RSI(RSI>1). The histochemical criterion used for the diagnosis of HD was that of Chow et al(1977), i.e., the presence of many coarse discrete cholinergic nerve fibers in the muscularis mucosae and in the immediately subjacent submucosa regardless of infiltration of cholinergic nerve fibers in the lamina propria. Of 66 neonates with HD who underwent BE, transitional zone was identified in 33 cases(50 %) and reversed RSI in 19 cases(21 %), microcolon in 4 cases and normal finding in 10 cases(15 %) while of 27 neonates with non-HD, there was normal finding in 16 cases and reversed RSI in 9 cases(41 %). Thus diagnostic accuracy based on transitional zone was 64 %. The positive predictive value of reversed RSI for the diagnosis of HD was 68 %. Of 42 neonates with HD who underwent AChE histochemistry, there were 41 AChE-positive reactions and one AChE-negative reaction in a neonate with total colonic aganglionosis, while of 27 cases of non-HD, there were one equivocal AChE-positive reaction and 26 AChE-negative reactions. Thus AChE histochemical study showed a 97 % diagnostic accuracy with a 98 % sensitivity and a 96 % specificity. In conclusion, we believe that BE is valuable as a first diagnostic step since about 80 % of neonates with HD show significant radiologic findings such as a transitional zone or reversed RSI. AChE histochemical study was a more reliable diagnos tic tool showing a 97 % diagnostic accuracy, and is part.

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Dietary Value of Neonates from Rotifer, Brachionus plicatilis and B. rotundiformis Resting Eggs for Flounder and Parrot Fish Larvae (넙치 및 돌돔 자어 사육에 있어서 Brachionus plicatilis와 B. rotundiformis 내구란에서 갓 부화한 rotifer의 먹이효율)

  • 허성범;이상민;박흠기
    • Journal of Aquaculture
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    • v.12 no.1
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    • pp.31-38
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    • 1999
  • The dietary value and fatty acids composition for the hatched neonates from the resting eggs of marine roofers, Brachionus plicatilis and B. rotundiformis were compared with that for mass-cultured rotifers (control) by feeding them to larvae of flounder (Paralichthy olivaceus) and parrot fish (Oplegnathus fasciatus). Resting eggs were mass-produced in $1~4m^3$tanks by feeding Chlorella sp. and baker's yeast. The B. plicatilis and B. rotundiformis eggs were preserved at $5^{\circ}C$ in darkness for 3 and 5 months, respectively, and hatched at $28^{\circ}C$ under continuous light. The hatched neonates from the resting eggs and mass-cultured rotifer, which was used as a rontrol were fed to fish larvaes. The growth and survival rates of parrot fish larvae fed on the neonates from the resting eggs of B. rotundiformis were similar to those of fish larvae fed on the control rotifer. And the growth and survival rates of the flounder larvae with neonates from the resting eggs of B. plicatilis were similar or higher than those fed the control rotifer. Also the fatty acids composition of the neonates from the resting eggs of B. plicatilis and B. rotundiformis were similar to those from the control rotifers. This results showed that the hatched neonates from resting eggs of rotifer could be used as an effective diet for flounder and parrot fish larvae.

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Influencing Factors on Family Stress, Family Meaning and Family Adaptation in Families with High Risk Neonates (고위험 신생아 가족의 스트레스, 가족의미 및 적응에 영향을 미치는 요인)

  • Lee, Joung-Ae;Park, In-Sook;Moon, Young-Sook;Lee, Nam-Hyeong
    • Journal of Korean Academy of Nursing
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    • v.37 no.4
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    • pp.431-441
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    • 2007
  • Purpose: The purpose of this study was to identify the relationship among family stress, family meaning and family adaptation of families with high risk neonates. Method: The date was collected on the basis of self- report questionnaires (August 2004 to March 2005); Tow-hundred twelve parents, who had high risk neonates in C hospital's neonatal intensive care unit, participated on request. Results: Family sense of coherence, family meaning, social support, family stress, marital communication and patient condition had a significant, direct effect on family adaptation. Family cohesion, religion, confidence in the health professional, and length of stay had a significant, direct effect on family meaning. Conclusion: The results of this study suggest the consequences associated with high risk neonates may be alleviated by a family support intervention designed to improve parental communication skills as well as to maintain family cohesiveness. Medical care could also encourage more emotional support of parents towards their neonate.

Studies in Impedance Audiometry on Neonates (신생아의 Impedance audiometry)

  • Oh, Pyung;Cheon, Kyung-Doo;Song, Jae-Woo;So, Jin-Myung
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1977.06a
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    • pp.4.2-4
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    • 1977
  • There are varying opinions about theories that the middle ear of Neonates is filled with mucous or other Material that interference with normal mobility of the middle ear system. DeDMon reported on the acoustic reflex as a tool for Neonatal screening, and Keith investigated the Middle ear function of Neonates during first few hours of life with an Electroacoustic impedance bridge. There are no reports on Neonstes in Impedance Audiometry in Korea. We tested 100 Neonates less than 24 hours old and this paper is dealt with its study related with tympanogram, static compliance and acoustic reflex.

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Clinical Characteristics and Outcomes of the First Episode of Urinary Tract Infection in Neonates and Infants Younger than 2 Months of Age

  • Cheng, Jackie Ying-Wai
    • Childhood Kidney Diseases
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    • v.21 no.2
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    • pp.94-100
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    • 2017
  • Purpose: The American Academy of Pediatrics provides guidelines for managing febrile urinary tract infection (UTI) in infants and children 2-24 months old, but little guidance is offered regarding UTIs in those younger than 8 weeks of age. The definition of UTI is unclear and whether to proceed with micturating cystourethrography (MCUG) or $^{99m}$technetium-dimercaptosuccinic acid (DMSA) scintigraphy scan in this age group is controversial. Methods: We retrospectively analyzed 29 neonates and infants younger than 2 months of age who underwent late DMSA scans 9 months following the first episode of febrile or symptomatic UTI between July 2009 and June 2016. Results: In total, 192 children aged 0-24 months underwent ultrasound and DMSA scans (MCUG in 174/192). Neonates and infants younger than 2 months of age were significantly less likely to develop fever, and had a lower fever peak, shorter duration of fever before admission and after starting antibiotics, longer hospitalization period, lower C-reactive protein, and greater incidence of nonEscherichia coli infection. There was no difference in pyuria response at diagnosis. The prevalence rates of an ultrasound abnormality (28%), vesicoureteral reflux (28%), UTI recurrence (38%), and renal scarring (10%) in infants younger than 8 weeks of age were similar to those in children 2-24 months old. Conclusion: Neonates and infants younger than 2 months of age with UTI warrant special consideration because the fever response used for diagnosis in older children may be absent or blunted. Clinical guideline is needed for the diagnosis and management of UTI in this age group.

Total Parenteral Nutrition(TPN) via Peripheral Veins in Neonatal Surgical Patients (신생아 외과환아에서 말초혈관을 통한 전비경구적 영양요법에 대한 고찰)

  • Lee, Jong-In;Jung, Poong-Man
    • Advances in pediatric surgery
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    • v.4 no.1
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    • pp.16-26
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    • 1998
  • Parenteral nutrition has been an essential part of postoperative care of neonates requiring major surgery who are unable to tolerate enteral feeding for long periods during the postoperative period. However, TPN via central venous catheters(central TPN), used in increasing trend, still presents significant morbidity. To find out whether TPN via peripheral veins(peripheral TPN) could be used as a viable alternative for postoperative parenteral nutrition in neonates, a clinical study was carried out by a retrospective analysis of 53 neonates subjected to peripheral TPN for more than 7 days after surgery. Operations consisted of procedures for esophageal atresia with tracheoesophageal fistula, gastroschisis and omphalocele. Surgery was performed at the Division of Pediatric Surgery, Department of Surgery, Hanyang University Hospitall, from 1983 to 1994. The mean total duration of TPN was 13.3 days (range; 7-58 days), the average daily total fluid intake was 117.6 ml/kg during TPN and 158.6 ml/kg during subsequent oral feeding. The average daily total calorie intake was 57.7 kcal/kg during full strength TPN and 101.3 kcal/kg during subsequent oral feeding. The mean urine output was maintained at 3.5 ml/kg/ hour during TPN and at 3.6 ml/kg/hour during subsequent oral feeding. The increment of body weight observed during TPN was 132 g in TEF, 53 g in gastroschisis and 3 g in omphalocele patients, while loss of body weight was not observed. The mortality rate was 5.7 %(3/53) and was related to the underlying congenital anomalies, not the TPN. The most common complication of peripheral TPN observed was laboratory findings suggestive of liver dysfunction in 23 cases(43.4 %) with no significant clinical symptom or signs in any case, transient pulmonary edema in one case, and generalized edema in one case. None of the major complications usually expected associated with central TPN were observed. The result of this study suggest that peripheral TPN can be used for adeguate postoperative nutritional support in neonates requiring 2 to 3 weeks of TPN.

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Clinical Features of Respiratory Syncytial Virus Infection in Neonates: A Single Center Study

  • Chang, Sung Hui;Jang, Gwang Cheon;Yoon, Shin Won
    • Neonatal Medicine
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    • v.25 no.4
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    • pp.144-152
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    • 2018
  • Purpose: The aim of this study was to investigate the clinical characteristics of Respiratory syncytial virus (RSV) infection during the neonatal period to provide information that is useful in clinical practice and suggest extension of the palivizumab administration. Methods: Neonates admitted to the National Health Insurance Service Ilsan Hospital neonatal intensive care unit due to respiratory symptoms and for whom multiplex reverse transcription-polymerase chain reaction and multiplex real time-polymerase chain reaction tests were performed between October 2011 and May 2016 were included in this study. Medical records were retrospectively reviewed, and data was collected for 156 neonates. Results: Among the 156 neonates, RSV was detected in 114 (73.1%), non-RSV in 25 (16%), and no virus in 17 (10.9%). The majority were full term infants (92.4%) and peak incidence of RSV infection was in January. Post-natal care center infection was more common in the RSV group (46.6%) than that in the other virus groups (24%, P=0.0243). Clinical symptoms were severe in the RSV group in contrast to that in the non-RSV or others groups. The RSV group frequently needed oxygen therapy (P=0.0001) and the duration of hospital stays were longer (P=0.0001). Conclusion: RSV is a significant cause of respiratory infection in neonates and the severity is higher in contrast to that with other viral causes of infection. Infants in post-natal care centers have a high-risk of developing RSV infections; therefore, palivizumab administration may be considered in this group to prevent hospitalization and reduce the duration of hospital stay.

A Study of Serum HBV Markers in Term Pregnant Women and Their Neonates (만삭임부 및 신생아의 혈청 B형간염 바이러스 표식자에 관한 연구)

  • Lee, Tae-Hyung;Park, Wan-Seok;Kim, Sung-Rim;Lee, Kang-Wan;Lee, Sung-Ho;Chung, Wun-Young
    • Journal of Yeungnam Medical Science
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    • v.4 no.2
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    • pp.121-129
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    • 1987
  • To evealuate the status of hepatitis B virus infection in the mothers and neonates and to determine the maternal-neonatal transmission of hepatitis B virus, 2,276 term pregnant women were screened for the presence of serum HBsAg, at the Department of Obstetrics and Gynecology, Yeungnam University Hospital, during the period of 18 months from Jan. 1986 to Jun. 1987, and the sera of sixty-six HBsAg carrier mothers and their neonates were tested for HBV markers and liver enzymes. The results were as follows : 1. The prevalence rate of asymptomatic HBsAg carrier in the term pregnant women was 4.7%(53/1,279). 2. Positive rates of HBsAg and anti-HBs 10 the sera of sixty-six neonates born to asymptomatic HBsAg carrier mothers were 12.1% and 9.1%, respectively. Transient elevation of SGOT(three to four times of upper normal limit) was detected in one of eight HBsAg-positive neonates and one of six anti-HBs positive neonates. 3. Positive rates of anti-HBc, HBeAg and anti-HBe to the sera of sixty-six asymptomatic HBsAg carrier term pregant women were 93.9%, 45.5% and 50%, respectively. The rates of transmission of maternal anti-HBc, HBeAg and anti-HBe to the neonates were 85.5%(53/62), 90%(27/30) and 87.9%(29/33). respectively. 4. Serum HBsAg was detected in four of thirty neonates born to HBeAg positive HBsAg carrier mother, three of thirty-three neonates born to anti-HBe positive HBsAg carrier mothers, and one of three neonates born to both HBeAg and anti-HBe negative HBsAg carrier mothers.

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