• 제목/요약/키워드: Newborn and infant

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신생아의 조기수유에 관한 실험적 연구 (An Experimental Study on the Early Feeding of Infants)

  • 하영수
    • 대한간호학회지
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    • 제5권1호
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    • pp.1-16
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    • 1975
  • The newborn human is the only mammalian whose mother does not have a food supply ready for it's offspring at birth. From two to four days usually elapse before the mother's supply If milk appears, and during this period, some kind of artificial feeding should be supplied to the infants. Because of this factor, there has been continued debate fog the past hundreds of years as to when the first feeding should be started Accordingly, many experiments were carried out by scholars and because of these, Pre-lateral feedings were believed to be necessary. Many types of pre-lateral feedings were tried and the conclusion was reached that glucose water was the best food for the first infants'feedings. Traditionally, This has been started 12 hours after birth. The causes for the 12 hours delay were thought to (1) provide rest for the infants: (2) prevent regurgitation ana vomiting which tended to be prevalent during this tine: (3) in cases of low weight infants, prevention of aspiration pneumonia. From recent studies of newborn physiology and as pediatric medicine has been rapidly advancing, many studies hare been carried out concerning the improvement of infant nutrition and the early feeding of infants has been emphasized. This author believes it would be very beneficial to try two different kinds of feedings for the infant. (1) experimental feedings ana (2) comparative feeding, and during this period to investigate and compare the infants blood sugar level, hematocrit, gamma globulin level weight changes and to observe the infant reaction ill order to search for a more desirable feeding program. This study was conducted from January to March 1974 with data related to 40 healthy newborn infants (male 21, female 19: weight, 2.79∼4.20㎏ : gestation, 39∼40 weeks) born at Ewha Womens University Hospital and the results obtained were as follows : 1. At time of birth the blood sugar level from the cord sample averaged 88.99㎎/100㎖, but the blood sugar level rapidly dropped after 2 to 3 hours and reached the lowest point after 10 to 11 hours (54.48㎎/100㎖) and rose again by the 24 hour time period (76.80㎎/100㎖). Changes in the blood sugar level of the experiments: groups and the compare-five group was not significantly different until the 6 to 7 hour period, but by the 10 to 11 hour period the blood sugar levels of the experimental group (49,10㎎/100㎖) and the comparative group (49.70㎎/100㎖) were lower than the remainder of the experimental groups. 9. There ware no significant weight changes between the two groups. Average weight at birth was 3.35㎏, but at the 24 hours period birth weight averaged 3.29㎏. (1.8% reduction of birth weight). It continually lowered until at 48 hours, average weight was 3.26㎏ (2.7% reduction from birth weight.) 3. Hematocrit readings showed no significant difference between the groups. Hematocrit, the average value at birth, was 28.07% and abruptly elevated to average 64.35% at the 2 to 3 hour period, then slowly lowered to an average of 59.67% at the 6 to 7 hour period, 55.10% at the 10 to 11 hour period, ana 53.70% at the 24 hour period. 4. At birth, average gamma globulin value averaged 1,39㎎/100㎖. and at the 24 hour period averaged 1,52㎎/100㎖ revealing no significant difference between the two feeding groups. 5. Such factors as voiding, passing of meconium, regurgitation and vomiting showed no significance between the two feeding groups. However, the number of infants voiding and passing meconium in the experimental groups during the first 12 hours was slightly greater. In general there was an increased tendency for regurgitation and. vomiting among a small group of the infants during the first 24 hours which thereafter decreased. 6. Fluid intake averaged 24.38cc at the first feeding and increased to average 30.48cc at the third feeding and further increased to 73. 00cc at the fifteenth feeding. Finally it was suggested that the most reasonable method of early feeding is to give less than 25cc of 5% glucose water and/or 8% powdered milk at 8 to 9 flours after birth in order to prevent hypoglycemia and dehydration.

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Oral findings and its association with prenatal and perinatal factors in newborns

  • Perez-Aguirre, Brenda;Soto-Barreras, Uriel;Loyola-Rodriguez, Juan Pablo;Reyes-Macias, Juan Francisco;Santos-Diaz, Miguel Angel;Loyola-Leyva, Alejandra;Garcia-Cortes, Obed
    • Clinical and Experimental Pediatrics
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    • 제61권9호
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    • pp.279-284
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    • 2018
  • Purpose: This study aimed to determine the frequency of abnormalities in the newborn oral cavity and to evaluate the association with prenatal and perinatal factors. Methods: This cross-sectional study evaluated 2,216 newborns. Oral findings were assessed in the first 24 hours of life using visual examination. Sex, weight, length, gestational age, and medical disorders at birth were recorded. Maternal demographic and medical information was also obtained. Results: The most common oral findings were Bohn's nodules, Epstein's pearls, and dental lamina cysts. Other intraoral findings included odontogenic cysts, ankyloglossia, and natal teeth, among others. In logistic regression analyses, folic acid consumption during pregnancy was significantly associated with Bohn's nodules (odds ratio [OR], 1.79; 95% confidence interval [CI], 1.23-2.55; P=0.002), Epstein's pearls (OR, 1.63; 95% CI, 1.14-2.33; P=0.007), and dental lamina cysts (OR, 1.45; 95% CI, 1.02-2.05; P=0.038). Moreover, preterm births were negatively associated with prevalence of Bohn's nodules (OR, 0.63; 95% CI, 0.50-0.80; $P{\leq}0.0001$). Comparison between newborns with and without oral inclusion cysts showed that maternal folic acid and iron intake were significantly different (P<0.05). Conclusion: Maternal folic acid and iron intake were associated with the prevalence of oral inclusion cysts.

선천성 십이지장 폐쇄증의 임상적 연구 (Clinical Study of Congenital Duodenal Obstruction)

  • 허영수;임명국;박성규
    • Journal of Yeungnam Medical Science
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    • 제15권1호
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    • pp.67-74
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    • 1998
  • Successful management of duodenal obstruction in newborn infant implies not only satisfactory nutrition but also achievement of normal growth. To aid early diagnosis and management, we evaluated the diagnostic methods, operative interventions and clinical characteristics of thirty-nine infants with congenital duodenal obstructions. In the 11-year period from July 1986 through June 1997, thirty-nine patients with congenital duodenal obstruction (23 males and 16 females) were treated and reviewed at the Department of Pediatric Surgery, Yeungnam University Hospital. The ratio of male to female was 1.4:1, and 29 cases(74.1%) among total 39 patients were newborn. There were 5 premature patients and 16 patients of small for gestational age. The most common causes of the congenital duodenal obstruction was malrotation (26 cases, 66.7%) and followed by annular pancreas (9 cases, 23.1 %), type 1 atresia (3 cases, 7.7%) and wind-sock anomaly (1 case, 2.6%). Common symptoms were vomiting, abdominal distention, jaundice. Plain abdominal X-ray study combined with upper gastrointestinal series was the most commonly used diagnostic method. The operative procedures were performed by same pediatric surgeon utilizing Ladd's procedure in 26, duodenoduodenostomy in 8, duodenojejunostomy in 4, excision of wind-sock membrane in 1. A total of 15 associated congenital anomalies were found in 9 patients. Postoperative complications occurred in 13(33.3%). Overall mortality was 2.6%(1/39). Bilious vomiting and plain abdominal radiologic study were most useful for the diagnosis of congenital duodenal obstruction. Early diagnosis and operative intervention were important to prevent complications such as sepsis and peritonitis.

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Compound heterozygous mutations of ACADS gene in newborn with short chain acyl-CoA dehydrogenase deficiency: case report and literatures review

  • An, Se Jin;Kim, Sook Za;Kim, Gu Hwan;Yoo, Han Wook;Lim, Han Hyuk
    • Clinical and Experimental Pediatrics
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    • 제59권sup1호
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    • pp.45-48
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    • 2016
  • Short-chain acyl-CoA dehydrogenase deficiency (SCADD) is a rare autosomal recessive mitochondrial disorder of fatty acid ${\beta}$-oxidation, and is associated with mutations in the acyl-CoA dehydrogenase (ACADS) gene. Recent advances in spectrometric screening for inborn errors of metabolism have helped detect several metabolic disorders, including SCADD, without symptoms in the neonate period. This allows immediate initiation of treatment and monitoring, so they remain largely symptomless metabolic disease. Here, we report a 15-month-old asymptomatic male, who was diagnosed with SCADD by newborn screening. Spectrometric screening for inborn errors of metabolism 72 hours after birth revealed an elevated butyrylcarnitine (C4) concentration of $2.25{\mu}mol/L$ (normal, < $0.99{\mu}mol/L$). Urinary excretion of ethylmalonic acid was also elevated, as detected by urine organic acid analysis. To confirm the diagnosis of SCADD, direct sequencing analysis of 10 coding exons and the exon-intron boundaries of the ACADS gene were performed. Subsequent sequence analysis revealed compound heterozygous missense mutations c.164C>T (p.Pro55Leu) and c.1031A>G (p.Glu344Gly) on exons 2 and 9, respectively. The patient is now growing up, unretarded by symptoms such as seizure and developmental delay.

Transient Neonatal Diabetes Mellitus Managed with Continuous Subcutaneous Insulin Infusion (CSII) and Continuous Glucose Monitoring

  • Kim, Min Soo;Kim, Sung Eun;Lee, Na Yeong;Kim, Seul Ki;Kim, Shin Hee;Cho, Won Kyoung;Cho, Kyoung Soon;Jung, Min Ho;Suh, Byung-Kyu;Ahn, Moon Bae
    • Neonatal Medicine
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    • 제28권1호
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    • pp.41-47
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    • 2021
  • Neonatal diabetes mellitus can be categorized as transient, permanent, or syndromic, and approximately half of the cases are transient. We present a case involving a term newborn who showed overt progression of transient neonatal diabetes mellitus, with complete remission within 6 months. On the second day of life, the patient presented with tachypnea, hyperglycemia, and decreased serum levels of C-peptide and insulin. Continuous subcutaneous infusion of insulin and continuous glucose monitoring were well tolerated. The patient showed a normal growth pattern, with no hyperglycemic or hypoglycemic episodes at 6 months of age. As it is rare and often asymptomatic, hyperglycemia may be attributed to various factors, including intrauterine environment, perinatal stress, and diverse genetic background. Therefore, consistent blood glucose monitoring and prompt early insulin therapy are crucial for any term newborns with persistent hyperglycemia, to prevent further diabetic complications. Moreover, continuous subcutaneous insulin infusion and the utilization of continuous glucose monitoring devices are the most effective and practical management strategies.

산욕부의 가정간호 요구도에 관한 연구 (A Study on the Home Health Care Needs of Postpartum Women)

  • 유연자
    • 여성건강간호학회지
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    • 제7권4호
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    • pp.579-595
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    • 2001
  • This study was carried out to understand the home health care needs of postpartum women during the postpartum period. The goal of this study was to obtain data needed to develope postpartum home health care programs and to improve the nursing quality for postpartum women. A convenient sample of 105 healthy women who were discharged after delivery at a maternity hospital in Ulsan, Korea were studied from January 25 to April 15, 2001. Data collection was done with a structured questionnaire (maternal concerns questionnaire) by mailing. Data was collected from 1 to 4 weeks after delivery. The Results of this study were as follows: 1. The mean score of home health care need of postpartum women was 2.51. The degree of nursing need according to the category of home health care needs was 'concerns about the infant ($2.91{\pm}.68$)', 'maternal physical and emotional concerns ($2.62{\pm}.52$)', 'concerns related to the husband ($2.45{\pm}.73$)', 'concerns related to the family ($2.16{\pm}.64$)', 'concerns related to the community ($2.03{\pm}.60$)' in rank. Among the items, 'recognizing illness in the newborn ($3.36{\pm}.83$)', 'normal growth and development ($3.33{\pm}.92$)' were high. 2. Among items of concerns about infant ($2.91{\pm}.68$), 'recognizing illness in the newborn ($3.36{\pm}.83$)', 'normal growth and development ($3.33{\pm}.52$)' showed high nursing needs. 3. Among items of maternal physical and emotional concerns ($2.62{\pm}.52$), 'being a good mother ($3.31{\pm}.86$)', 'return of their figures to normal ($3.04{\pm}1.05$) showed high nursing needs. 4. Among items of concerns about husband ($2.45{\pm}.73$), 'husband being a good father ($2.84{\pm}1.00$) shows high nursing needs. 5. Among items of concerns related to the community ($2.03{\pm}.60$), 'getting to health care facilities ($2.69{\pm}.90$) shows high nursing needs. 6. On considering the relationship between the postpartum women s home health care needs and their general characteristics, parity (t=2.436, p=.017) and delivery type (t=2.074, p=.041) were statistically significant.

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신생아기에 발견된 편측 다낭성 신이형성이 동반된 Klinefelter 증후군 1례 (A Case of Klinefelter Syndrome associated with Unilateral Multicystic Dysplastic Kidney in a Newborn Infant)

  • 하경아;정선미;최은진;김진경;노은석;박재신;김우택;권영대
    • Clinical and Experimental Pediatrics
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    • 제45권9호
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    • pp.1141-1145
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    • 2002
  • Klinefelter 증후군에서는 여러 가지 선천성 기형을 동반하지만 신장의 기형은 드믄 편이며 현재까지 49, XXXXY 증후군에서 다낭성 신이 동반된 경우가 있었고, 47, XXY 증후군에서는 편측성 신 형성부전이 동반된 경우가 보고되었으나 다낭성신 이형성의 보고는 없었다. 따라서 저자들은 신생아기에 발견된 편측 다낭성 신이형성이 동반된 Klinefelter 증후군 1례를 경험하였기에 보고하는 바이다.

신생아 B형 간염 예방 접종 후 하지 부종이 발생한 환아 치험 1례 (A Case Report of Extensive Limb Swelling in Newborn After Vaccination: Unusual Thigh Swelling After Hepatitis B vaccination)

  • 한주희;김덕곤;이진용
    • 대한한방소아과학회지
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    • 제28권1호
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    • pp.52-60
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    • 2014
  • Objectives The purpose of this study is to report the clinical effects of oriental medical treatment on Extensive limb swelling which is rare adverse reaction of vaccination. Methods A 11 months old infant who appealed unilateral thigh swelling after immunization and signs of local inflammation was administered a complex herbal medicine consisting of five decoctions; Gwakhyangjunggisan, Binsosan, Danggwisusan, Samchulgunbitang and Gwibitang. The length of the constant regions of the thigh circumference was measured every visit. Each process was recorded by photograph. After one year from the first visit, phone call was conducted to follow-up. Results The length of the thigh after administration of herbal medicine did not change much, but the part where swelled hard became little bit softer. A year later, patient's growth and walking was normal but the swollen part not changed. Since then the similar adverse effects did not recur on booster doses vaccines. Conclusions The adverse reactions of vaccination are rarely reported and there is no specific treatment for swelling from Hepatitis B vaccine. It will be more helpful to study if more cases reported about any adverse drug reactions or any side effects from the immunization.

자발성 종격동 기흉: 작게 청진된 심음을 주소로 내원한 신생아 (Decreased heart sound in a healthy newborn: Spontaneous multiseptated cystic pneumomediastinum with delayed respiratory distress)

  • 최영준;김은선;김이경;김한석;천정은;김우선;김인원;최중환
    • Clinical and Experimental Pediatrics
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    • 제53권2호
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    • pp.244-247
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    • 2010
  • 자발성 종격동 기흉은 신생아기에 발생하는 호흡곤란의 드문 원인 중의 하나이며 대부분의 증례에서는 인공호흡, 출산손상, 태변흡입 등이 선행하는 경우가 많으며, 또한 대다수가 미숙아로 알려져있다. 저자들은 신생아 진찰 중 심음이 적게 들리는 소견으로 발견되었던, 위와 같은 위험인자가 없는 건강한 만삭아에서 발생한 자발성 종격동 기흉 1예를 경험하였기에 이를 보고하는 바이다.

Acute treatment of hyperammonemia by continuous renal replacement therapy in a newborn patient with ornithine transcarbamylase deficiency

  • Kim, Hyo-Jeong;Park, Se-Jin;Park, Kook-In;Lee, Jin-Sung;Eun, Ho-Sun;Kim, Ji-Hong;Shin, Jae-Il
    • Clinical and Experimental Pediatrics
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    • 제54권10호
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    • pp.425-428
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    • 2011
  • Ornithine transcarbamylase (OTC) deficiency is well known as the most common inherited disorder of the urea cycle, and 1 of the most common causes of hyperammonemia in newborns. We experienced a case of a 3-day-old boy with OTC deficiency who appeared healthy in the first 2 days of life but developed lethargy and seizure soon afterwards. His serum ammonia level was measured as > $1,700{\mu}g/dL$ (range, 0 to $45{\mu}g/dL$). Continuous renal replacement therapy (CRRT) in the mode of continuous venovenous hemodiafiltration was immediately applied to correct the raised ammonia level. No seizure occurred after the elevated ammonia level was reduced. Therefore, CRRT should be included as 1 of the treatment modalities for newborns with inborn errors of metabolism, especially hyperammonemia. Here, we report 1 case of successful treatment of hyperammonemia by CRRT in a neonate with OTC deficiency.