• Clinical and Experimental Pediatrics
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• v.59 no.11
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• pp.440-445
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• 2016

Purpose: This study aimed to identify prognostic factors of neurological outcomes, including developmental delay, cerebral palsy and epilepsy in late-preterm and term infants with perinatal asphyxia. Methods: All late-preterm and term infants with perinatal asphyxia or hypoxic-ischemic insults who admitted the neonatal intensive care unit of Inje University Sanggye Paik Hospital between 2006 and 2014 and were followed up for at least 2 years were included in this retrospective study. Abnormal neurological outcomes were defined as cerebral palsy, developmental delay and epilepsy. Results: Of the 114 infants with perinatal asphyxia, 31 were lost to follow-up. Of the remaining 83 infants, 10 died, 56 had normal outcomes, and 17 had abnormal outcomes: 14 epilepsy (82.4%), 13 cerebral palsy (76.5%), 16 developmental delay (94.1%). Abnormal outcomes were significantly more frequent in infants with later onset seizure, clinical seizure, poor electroencephalography (EEG) background activity, lower Apgar score at 1 and 5 minutes and abnormal brain imaging (P<0.05). Infants with and without epilepsy showed significant differences in EEG background activity, clinical and electrographic seizures on EEG, Apgar score at 5 minutes and brain imaging findings. Conclusion: We should apply with long-term video EEG or amplitude integrated EEG in order to detect and management subtle clinical or electrographic seizures in neonates with perinatal asphyxia. Also, long-term, prospective studies with large number of patients are needed to evaluate more exact prognostic factors in neonates with perinatal asphyxia.

• Korean Parent-Child Health Journal
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• v.5 no.2
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• pp.224-240
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• 2002

As social changes, there are growing number of instituted infants. Most of them were poor growth and developmental outcome due to situational and environmental vulnerability. Developmental interventions for this infants have been the subjects of debate for many years. The purpose of this study was to evaluate the effectiveness of massage intervention on the physical growth of orphaned infants during the first 6 month of life. This study utilized equivalent control group with repeated measuring by quasi experimental design. Fifty eight orphaned infants were randomly assigned to control(n=28), or an experimental(n=30) group. In addition to routine orphanage care, infants in the experimental group received 15 minutes of massage intervention twice a day, 5 days a week, for 4 weeks. Data has been collected from April 1st, 2000 to August 31st, 2002 and were analyzed using SPSS/PC(Version 10.0) with chi-square test, t-test, and repeated measures ANOVA to determine the effectiveness of massage intervention and to test the homogeneity of general characteristics between experimental and control group. The results were as follows; Compared to the control group, the experimental group has gained significantly more weight(F=33.52, p < .0001) and had larger increases in length(F=10.04, p < .0001) and head circumference(F=49.78, p < .000) after the 4-week intervention period and at 6 months of age. These data demonstrate that massage intervention may be effective in facilitating growth for newborn infants placed in orphanages during first 6 months of life.

• Child Health Nursing Research
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• v.8 no.1
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• pp.97-109
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• 2002

This study was conducted to understand the degree and contents of stress which the mothers of high-risk infants can be experienced from the hospitalization of ICU for their new borns, and thus to offer the basic program to he nursing intervention program for these. Subjects were the 171 mother of hospitalized newborn in NICU of 1 University Hospital in Busan from June, 20, 2001 to September, 15, 2001, who agreed to take part in this study. The instruments used in this study were Parental Stressor Scale:NICU(PSS:NICU) developed by Miles et al. The questionnaire has 4 dimensions and 45 items ; sight and sounds of NICU(5 items), babies' appearance and behavior nursing intervention(19 items), parental role alteration and relationship with their baby(10 items), health team communication(11 items). The data was analysed as average, frequency, Standard Deviation, t-test, ANOVA, Pearson correlation coefficient by use of SPSS/PC+. The results of this study are as follows ; 1. The total perceived stress level score of mothers of high-risk infants was slightly high(3.44±0.71). The highest scored dimension was 'appearance and behavior of the baby'(4.06±0.80), and next were 'relationship with their baby and parental role change'(3.55±0.98), 'sight and sounds of NICU'(3.22±1.01), 'communication with health team'(2.93±0.91). 2. The total perceived stress level score was significantly correlated with birth weight (F=2.35, p<.05). 3. In sight and sounds of NICU, the perceived stress level score was significantly correlated with nursing in the incubator(t=2.28, p<.05) and birth weight(t=2.26, p<.05). In summary, information about physical environment of NICU, birth weight and nursing in the incubator must be included in nursing intervention program of mother's of high-risk infants in reducing the patents stress level. And, it is suggested that there need to find the coping mechanism of mother of high-risk infants.

• Journal of Korean Clinical Nursing Research
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• v.21 no.2
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• pp.207-214
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• 2015

Purpose: This study was aimed to investigate the effect of an education program on inter-rater agreement of Neonatal/Infant Braden Q Scale for clinical nurses working at a neonatal intensive care unit (NICU). Methods: This was single-arm pre and post experimental study. The participants were 12 nurses and 128 hospitalized neonates at a NICU from December, 2012 to March, 2013. Twelve nurses were divided into four different groups; for two groups were assigned nurses with 3 to 5 years of clinical experiences, and for the others with less than 1 year of clinical experience. The interventions were given by one wound ostomy specialist and two NICU nurses with over 5 years of clinical experiences for 1 hour twice. The inter-rater agreement was measured by intraclass-correlation coefficient. Results: Overall inter-rater agreement was improved from .87(95% CI: .80~.92) at the pre-test to .94(.91~.96) at post-test. Each inter-rater agreement except moisture and nutrition was also improved. Conclusion: The developed education program on scoring for Neonatal/Infant Braden Q scale was effective to improve the inter-rater agreement among clinical nurses. We suggest to privide an education for NICU nurse before using the Neonatal/Infant Braden Q scale in clinical settings.

• Advances in pediatric surgery
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• v.15 no.1
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• pp.18-26
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• 2009

The survival of Very Low Birth Weight (VLBW) infants has been improved with the advancement of neonatal intensive care. However, the incidence of accompanying gastrointestinal complications such as necrotizing enterocolitis has also been increasing. In intestinal perforation of the newborn, enterostomy with or without intestinal resection is a common practice, but there is no clear indication when to close the enterostomy. To determine the proper timing of enterostomy closure, the medical records of 12 VLBW infants who underwent enterostomy due to intestinal perforation between Jan. 2004 and Jul. 2007 were reviewed retrospectively. Enterostomy was closed when patients were weaned from ventilator, incubator-out and gaining adequate body weight. Pre-operative distal loop contrast radiographs were obtained to confirm the distal passage and complete removal of the contrast media within 24-hours. Until patients reached oral intake, all patients received central-alimentation. The mean gestational age of patients was $26^{+2}$ wks ($24^{+1}{\sim}33^{+0}$ wks) and the mean birth weight was 827 g (490~1450 g). The mean age and the mean body weight at the time of enterostomy formation were 15days (6~38 days) and 888 g (590~1870 g). The mean body weight gain was 18 g/day (14~25 g/day) with enterostomy. Enterostomy closure was performed on the average of 90days (30~123 days) after enterostomy formation. The mean age and the mean body weight were 105 days (43~136 days) and 2487 g (2290~2970 g) at the time of enterostomy closure. The mean body weight gain was 22 g/day after enterostomy closure. Major complications were not observed. In conclusion, the growth in VLBW infants having enterostomy was possible while supporting nutrition with central-alimentation and the enterostomy can be closed safely when the patient's body weights is more than 2.3 kg.

• Child Health Nursing Research
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• v.24 no.2
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• pp.208-219
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• 2018

Purpose: The purpose of this study was to explore nursing students' experiences of debriefing after simulation-based learning and to obtain fundamental data to support the development of effective teaching strategies. Methods: Sixty-seven nursing students participated in this study from April to May, 2017. This was a descriptive study analyzing the content of students' descriptions of structured questions in 3 stages (description, analysis, and application) based on recorded videos. Results: The description stage was classified into 3 categories for problem recognition, 4 categories for the nursing plan, and 6 categories for the nursing intervention. The analysis stage was classified into 6 categories for satisfactory practice, 3 categories for experience and 4 categories for what they learned through practice. The application stage was classified into 5 categories, that were to be mastered, and 6 categories, that were important to recognize. Conclusion: This study succeeded in charaterizing learners' experiences of debriefing. During the debriefing, students watched recorded videos, and we found that self-evaluation through structured questionnaires could be a very effective way to strengthen students' core competencies. Our content analysis of the debriefing is expected to contribute to the development of effective strategies in simulation-based education for students and nurses.

• Journal of Chest Surgery
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• v.15 no.4
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• pp.432-439
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• 1982

Congenital posterolateral diaphragmatic hernia [Bochdalek hernia] is the result of a congenital diaphragmatic defect in the posterior costal part of the diaphragm in the region of the tenth and eleventh ribs. There is usually free communication between the thoracic and abdominal cavities. The defect is most commonly found on the left [90%], but may occurs on the right, where the liver often prevents detection. The male to female ratio is 2:1. Owing to the negative intrathoracic pressure, herniation of abdominal contents through the defects occurs, with resultant collapse of the lung. Shifting of mediastinum to the opposite side and compression of the opposite lung occurs. Most often these hernias are manifestated by acute respiratory distress in the newborn. A second, but less well recognized, group of patient with Bochdalek hernia survive beyond the neonatal period, usually present at a later time with "failure of thrive, intermittent vomiting, or progressive respiratory difficulty. " The diagnosis can often be made on clinical ground from the presence of respiratory distress, absence of breath sounds on the chest presence of bowel sounds over the chest . Roentgenogram of the chest confirm the diagnosis. Obstruction and strangulation have been reported but are rare. Treatment consists of early reliable identification of these congenital diaphragmatic hernia with high risk and surgical repairment. and postoperative pharmacological management with extracorporeal membranous oxygenation [=ECMO] support in the period of intensive care. On the surgical approach, for defects on left side, an abdominal incision is preferred, because of the high incidence of malrotation and obstructing duodenal bands. In the neonate, the operative mortality may be appreciable, but, later repair almost always is successful. During the period from 1972 to 1982, 4 cases of congenital Bochdalek hernia were experienced at the Kyung-Hee University Hospital.

• Journal of Medicine and Life Science
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• v.17 no.1
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• pp.29-32
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• 2020

As respiratory syncytial virus(RSV) is transmitted either via directly contact with an infected case or via indirectly contaminated fomites or skin, the major preventive measures are strict hand hygiene, early detection of transmitted sources, and rapid isolation of RSV patients. Especially early detection of hidden cases is the most critical control measure when an index case was notified in a postpartum center. The Guideline of Korea Centers for Diseases Control and Prevention defines potential contacts in an epidemiologic survey as admitted newborns, parents of index cases, center's workers, and visitors for 10 days before the first diagnosis day of index case. However, it needs to classify potential contacts in more detail in order to conduct a successful survey. Authors conducted to search related literatures and appraise the evidences. Firstly, potential contacts would be classified into RSV-related symptomatic contacts(SxC) and asymptomatic contacts. And then, mother, caring workers, and visitors of the index cases among asymptomatic contacts would be defined as the asymptomatic close contacts(ASCC). Finally, the rest would be defined as the asymptomatic regular contacts(ASRC). The defined test using reverse transcription-PCR is applied to SxC and ASCC, and decision of isolation or regular activities are made according to the results. The rapid antigen detection test kits are applied to ASRC. These suggestions might be helpful to detect hidden cases earlier and prevent a further infection.

• Clinical and Experimental Pediatrics
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• v.63 no.1
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• pp.25-29
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• 2020

Background: Pain during the developmental period may adversely affect developing neuronal pathways and result in adverse neurodevelopmental, cognitive, and behavioral effects in later life. Immunizations, e.g., hepatitis B vaccine (HBV), administered at birth are painful experiences to which neonates are universally subjected. Purpose: Here we aimed to study and compare the effectiveness of various nonpharmacological pain management methods in newborns to enable the development of safe and effective analgesic methods for newborns. Methods: This prospective study was conducted at a tertiary care hospital in the Himalayan region. Three hundred term healthy neonates were divided into 6 groups of 50 each. Groups 1-5 were intervention groups, patients of which received a nonpharmacological intervention (breastfeeding, nonnutritive sucking, rocking, 25% sucrose, or distilled water) before the intramuscular HBV, while patients in group 6 received no intervention. The pain response in each group after the HBV injection was assessed and compared using cry duration and Douleur Aigue Nveau-ne (DAN) score, a behavioral acute pain rating scale for newborns. Results: Cry duration was decreased in all intervention groups, significantly so in the sucrose (19.90 seconds), breastfeeding (31.57 seconds), and nonnutritive sucking (36.93 seconds) groups compared with controls (52.86 seconds). DAN scores decreased significantly (P<0.05) at one or more points i.e. 30, 60, or 120 seconds in the breastfeeding and 25% sucrose intervention groups compared with controls. Conclusion: Oral sucrose and nonnutritive sucking are simple yet underutilized nonpharmacological interventions that effectively reduce pain in newborns.

• Clinical and Experimental Pediatrics
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• v.64 no.3
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• pp.130-135
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• 2021

Background: The clinical significance of lip-tie, or a tethered maxillary frenulum, remains under debate. Clinicians and parents are often perplexed when deciding whether procedures available to relieve a seemingly tight or severe maxillary frenulum are needed. Purpose: No previous studies have assessed the consequences of not subjecting a tethered maxillary frenulum in newborns to surgical intervention. This study aimed to contribute the first prospective trial on this topic with a relatively extended follow-up of these newborn infants. Methods: This prospective observational questionnaire-based cohort trial was performed in a community setting and aimed to determine whether lip-tie is associated with an increased likelihood of eventual feeding or oral disorders. Results: The convenience sample comprised of 61 consecutively arriving infants with concomitant tethered frenula who were treated at the clinic for various reasons. This cohort was compared with a random sample of 66 age-matched children for a mean follow-up period of 6.42 years. Infants undergoing oropharyngeal procedures were excluded. Awareness of a deviation in oral structures was reported by 18% of the study group versus 0% of the controls. Mothers participating in the study group (24.6%) less frequently recalled painful nipples or discomfort during breastfeeding than those in the control group (47.0%) (P<0.01). There were no intergroup differences in other types of feeding difficulty, dental hygiene, pronunciation, or speech development. Conclusion: Our findings suggest that a tethered labial frenulum is not associated with an increase in breastfeeding disturbances or oral disorders. These data encourage clinicians to question the need to intervene in cases of tethered maxillary frenula.