• Neonatal Medicine
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• v.16 no.2
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• pp.213-220
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• 2009

Purpose: Hearing loss is one of the common birth defects in humans, with a reported prevalence of 1-3 per 1000 newborns. We investigated the incidence of hearing loss and evaluated the use of neonatal hearing screening test in neonatal intensive care unit (NICU) graduates who are at greater risk for hearing loss than normal newborns. Methods: The neonates admitted to the NICU of Asan Medical Center from 1 March, 2003 to 30 March, 2008 who were available for follow-up were included. Those who failed the first auditory brainstem response prior to discharge were retested with the stapedial reflex test, auditory brainstem response and tympanometry in the Otolaryngology department. Results: Of 2,137 neonates, 2,000 (93.5%) neonates were tested prior to discharge. Sixty-seven neonates (3.4%) failed the first newborn hearing screening test. Of 67 infants, 52 infants were retested for a second hearing test. Excluding 10 infants (19.2%) who were lost during follow-up, 16 infants were confirmed to have hearing impairment of which 12 and 4 infants had unilateral and bilateral hearing loss, respectively. Of 16 infants, 5 did not meet the criteria set by the Korean National Health Insurance Corporation. Conclusion: The prevalence of hearing impairment in NICU graduates is about 0.8%, excluding those who were lost for follow up, necessitating a systemic and effective hearing assessment program among these high risk infants and more generous national insurance coverage.

• Neonatal Medicine
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• v.16 no.2
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• pp.190-196
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• 2009

Purpose: Candida infection has increased in neonatal intensive care units (NICU). However, recent reports on systemic candida infections in preterm newborns are rare in Korea. The aim of this study was to examine the epidemiological features of systemic candida infection in very low birth weight infants (VLBW) over the past five years. Methods: We retrospectively reviewed the medical records of 19 patients with systemic candida infections in VLBW that were admitted to the neonatal intensive care units of three hospitals affiliated with the College of Medicine, The Catholic University of Korea from January 2004 to December 2008. We analyzed the birth weight, gestational age, age at diagnosis, risk factors, co-morbidity, antifungal treatment, and mortality rates among the 19 patients. Results: Systemic candida infections occurred in 19 cases (4.7%) among the VLBW infants. The mean birth weight and gestational age were 959.0$\pm$255.9 g and 26.7$\pm$2.1 weeks. The isolated Candida species were C. albicans (4), C. parapsilosis (9), C. glabrata (2), C. famata (2), and unkown subspecies (2). Most patients had various associated risk factors, including a central venous catheter, broad spectrum antibiotics, parenteral nutrition, intravenous lipid emulsion, endotracheal intubation and $H_2$ blocker therapy. There was no significant difference in the risk factors between newborns that survived and those that died with regard to the systemic candida infection, except for gestational age. Nine (47.4%) out of 19 patients with a candida infection died and four cases (21.2%) were directly related to the candida infection. Conclusion: The prevalence of systemic candida infection is increasing in VLBW infants. The majority of Candida species has shifted to C. non-albicans, especially C. parapsilosis. Because of the high mortality associated with candida infection in the NICU, prophylaxis and early treatment based on epidemiological features is necessary.

• Clinical and Experimental Pediatrics
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• v.53 no.3
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• pp.349-357
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• 2010

Purpose : Transient tachypnea of the newborn (TTN) is usually benign and improves within 72 hours. However, it can also progress to prolonged tachypnea over 72 hours, profound hypoxemia, respiratory failure, and even death. The aim of this study is to find predictable risk factors and describe the clinical courses and outcomes of prolonged TTN (PTTN). Methods : The medical records of 107 newborns, >$35^{+0}$ weeks of gestational age with TTN, who were admitted to the NICU at Seoul Asan Medical Center from January 2001 to September 2007 were reviewed. They were divided into 2 groups based on duration of tachypnea. PTTN was defined as tachypnea ${\geq}72$ hours of age, and simple TTN (STTN) as tachypnea <72 hours of age. We randomly selected 126 healthy-term newborns as controls. We evaluated neonatal and maternal demographic findings, and various clinical factors. Results : Fifty-five infants (51%) with total TTN were PTTN. PTTN infants had grunting, tachypnea >90/min, $FiO_2$ >0.4, and required ventilator care more frequently than STTN infants. PTTN had lower level of serum total protein and albumin than STTN. The independent predictable risk factors for PTTN were grunting, maximal respiration rate >90/min, and $FiO_2$ >0.4 within 6 hours of life. Conclusion : When a newborn has grunting, respiration rate >90/min, and oxygen requirement >0.4 of $FiO_2$ within 6 hours of life, the infant is at high risk of having persistent tachypnea ${\geq}72$ hours. We need further study to find the way to reduce PTTN.

• Korean Journal of Childcare and Education
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• v.8 no.6
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• pp.29-55
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• 2012

The main purpose of this study is to examine the relationship between infants' early adjustment and later adjustment in childcare centers and to analyze the mothers' adjustment support strategies. The subjects consisted of 244 infants from newborns to 36 months old and their mothers and childcare teachers of public childcare centers. The results of the study were as follows. First, there was a significant difference according to infants' age in mothers' adjustment support strategies. The more mothers use appropriate strategies for adjustment earlier in childcare centers, the better infants showed adjustment according to infants' age respectively. Second, there was a significant difference between the early adjustment(Time1) and the later adjustment(Time2) of infants. Third, mothers' adjustment support strategies affected on infants' later adjustment in childcare centers. These results show that appropriate mothers' adjustment support strategies were related to infants' adjustment by age longitudinally. The implications of these results indicate that developing adjustment programs including effective strategies for infants' mothers in childcare centers considering their demographic characteristics and specified needs is needed.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.10 no.1
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• pp.115-125
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• 2000

Three major hospitals with over 500 beds located in and near Seoul were surveyed for airbone microorganisms from February 1, 1998 to February 18, 1998. The purpose of the study was to identify and quantify microbiological organisms circulating in the air of three different areas in the hospitals. For the study, a RCS air sampler was utilized equipped with two different collection media, the agar strip GK-A for bacteria and the agar strip HS for fungi. The areas investigated were the intensive care unit (ICU) in the Department of internal medicine, the Newborns room in the Department of Obstetrics, and the microbiology laboratory. The results were as follows; 1. The average numbers of general microbiological particles collected on the agar strip GK-A media were $205CFU/m^3$, $232CFU/m^3$, and $128CFU/m^3$ in each hospitals. The highest concentration of $387CFU/m^3$ was found in the ICU of A hospital at 15:00 during the day. Further analysis of the collected bioaerosols by gram staining, revealed that there were gram positive cocci (89.5%), gram positive bacilli (7.2%), gram negative bacilli (2.8%), and fungi (0.5%), in descending order of frequency. 2. Ten different genes were identified from the agar strip GK-A. The most frequently identified organisms were: the Coagulase negative staphylococcus (55.0%), Micrococcus (21.4%), Enterococcus species(10.4%), and Bacillus species (7.2%). A series of antibiotics susceptibility test were conducted against the aforementioned four(4) organisms. Ninety percent of coagulase negative stapylococcus were sensitive to Penicillins. Pathogenic microbes isolated include: Staphylococcus aureus, Acinetobacter species, Klebsiella pneumonia, Klebsiella oxytoca, and Pseudomonas aeroginosa. 3 Although 56.8% of the microorganisms grown on the strip HS media for fungi could not be identified, some of them were successfully identified. The most frequently found fungi were Aspergillus (35.3%), Yeast or Molds (6.2%), and Penicillium (0.7%). Based on the results obtained from the study, it was concluded that some areas in the hospitals had abnormally high bioaerosol concentrations which could be attributed to human activity. Therefore, it is recommended that periodic assessments of indoor bioaerosols aiming to identify the possible sources should be conducted in order to maintain clean indoor environment in the hospitals.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.7
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• pp.73-81
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• 2020

This study is a single-group study to check the effectiveness of nursing students on their communication credibility, communication confidence and clinical decision-making ability by implementing SBAR-applied simulation training to improve the difficulty of delivering clear information to medical personnel during transition. By combining simulation practices and SBAR training based on emergency situations of mothers and newborns, programs were developed and applied to communicate clearly and briefly to the medical staff about emergencies and to enhance communication skills. The subjects were 91 fourth-year nursing college students from one university in B metropolitan city. The data were collected from Feb. 18, 2019 to Feb. 28, 2019 and were analyzed using the SPSS/WIN 18.0 program as a paired t-test. The results revealed that the communication clarity measured after the simulation exercise (t=-3.99, p<.001), Communication Confidence (t=-8.60, p<.001), Clinical Decision Capacity (t=-4.66, p<.001) Statistically, it has increased significantly. Therefore, the purpose of this research is significant in that it seeks to promote the expertise of nursing college students by developing and applying simulation practical education programs to enhance the communication skills and clinical decision-making skills of nursing college students as prospective medical personnel.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.5
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• pp.417-425
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• 2020

This study was conducted to identify the effects of baby care using dolls on nursing students' major satisfaction, class satisfaction, and knowledge of newborn care. A quasi-experimental nonequivalent control group, pretest-posttest design was used. The subjects of the study were 95 nursing college students who agreed to participate. The control group (n=47) received lecture education consisting of watching newborn videos while the experimental group (n=48) received a practical education involving caring for a doll resembling an infant. Data were collected from March to May, 2019 and analyzed using descriptive statistics, χ²-tests, and t-tests with the SPSS/WIN 21.0 program. The major satisfaction score of the experimental group was higher than that of the control group, but it was not statistically significant (t=1.64, p=.107). The score for class satisfaction differed significantly between the experimental group and control group (t=2.08, p=.043). The knowledge of newborn care score for the experimental group was higher than that for the control group, and there was a statistically significant difference (t=-5.82, p<.001). Overall, the results show that baby care using a doll has positive effects on class satisfaction and knowledge of newborn care. In the future, it will be necessary to develop and apply effective teaching methods in line with the times.

• Clinical and Experimental Pediatrics
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• v.49 no.10
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• pp.1061-1066
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• 2006

Purpose : The purpose of this study was to research whether measurement of cow's milk specific IgE on the newborn would be helpful in the diagnosis of cow's milk allergy. We tried to find out the relation between cow's milk specific IgE and other allergy diseases by following up cases. Methods : We reviewed clinical features of 87 episodes in infants less than 4 weeks old who were positive in cow's milk specific IgE test. For the study group, history taking, physical examinations, elimination and cow's milk specific IgE tests were carried out. We investigated the connection among cow' milk specific IgE, allergic disease and family history in 40 of 87 patients we could follow up on. Results : The mean age of the study group was $17.2{\pm}5.4days$. The subjects were classified in four groups according into allergens : 87 milk allergy positive patients, 24 casein positive, 38 ${\alpha}$-lactoalbumin positive, and 75 ${\beta}$-lactoglobulin positive. The number of patients who had follow-ups for more than 6 months to was 40(45.9 percent). The patients whose parents had allergic disease numberred 10(25 percent). Fiften patients had allergic diseases, 4 had asthma and 11 atopic dermatitis. According to the follow-up study, there is a significant relation between casein positive patients and allergic disease. But there is no statistical and significant relation between cow's milk specific IgE and a family history of allergic disease. Conclusion : For the newborn babies, elimination tests and cow's milk specific IgE tests can be useful in the diagnosis of IgE-mediated or mixed milk allergies.

• Journal of Genetic Medicine
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• v.5 no.2
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• pp.111-118
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• 2008

Purpose: Neonatal screening tests are increasingly being used forearly diagnosis of inborn errors of metabolism (IEM) in the hope of avoiding the severe developmental delay, acute illness, and death that may result from these diseases. In this study, a cost-benefit analysis was performed on the neonatal screening of maple syrup urine disease, homocystinuria, galactosemia, and congenital adrenal hyperplasia in Korea. Materials and Methods: This study included 1,259,220 Korean newborns born between January 2005 to December 2007, who were screened for maple syrup urine disease, homocystinuria, galactosemia, and congenital adrenal hyperplasia. We calculated and compared the total costs in cases where these four screening tests were implemented, and those where they were not. Results: There were no benefits to screening for maple syrup urine disease or homocystinuria due to their low prevalence for these two tests, the costs exceeded the benefits at benefit:cost ratios of 0.5:1 and 0.6:1, respectively. In contrast, benefits far exceed costs at a ratio of 4.1:1 for galactosemia and 2.9:1 for congenital adrenal hyperplasia. The average benefit:cost ratio for all four tests was 2.0:1. Conclusion: Neonatal screening tests for maple syrup urine disease, homocystinuria, galactosemia, and congenital adrenal hyperplasia are financially viable.

• Neonatal Medicine
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• v.15 no.2
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• pp.160-165
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• 2008

Purpose : Cephalhematomas rarely lead to serious complications, such as skull fractures and intracranial hematomas, so CT and/or MRI scans are indicated only in cases in which depressed fractures are suspected or neurologic symptoms develop. Nevertheless, we have experienced several cases of cephalhematomas associated with intracranial hematomas in the absence of remarkable neurologic symptoms. The aim of this study was to evaluate the correlation between cephalhematomas and intracranial hematomas and determine the need for neuroimaging in infants with cephalhematomas. Methods : Infants who were admitted to the NICU with cephalhematomas and underwent neuroimaging (CT and/or MRI) between January 2002 and July 2006 were evaluated. Neuroimaging was done when the symptoms suggested the development of an intracranial hematoma. Results : Among 54 infants with cephalhematomas, 18 infants underwent neuroimaging. Six of 18 infants (33.3%) had intracranial hematomas, 4 infants had epidural hematomas, and 2 infants had subdural hematomas. Four of these 6 infants had neurologic symptoms or depressed skull fractures; 2 infants had no neurologic symptoms or depressed skull fractures. The neuroimaging was done to evaluate the cause of an excessive elevation of serum bilirubin and unexplained anemia. There were no remarkable differences between the infants with and without intracranial hematomas with respect to gestational age, birth weight, head circumference, diameter of the cephalhematoma, neurologic symptoms, and other clinical signs and symptoms. Conclusion : Based on this study, intracranial hematomas are common complications of cephalhematomas, thus more careful inspection and neuroimaging may be needed in cases of cephalhematomas in newborns.