• Title/Summary/Keyword: Premature Infants

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Clinical Characteristics of Bronchopulmonary Dysplasia by Type and Severity (기관지폐이형성증의 유형 및 중증도에 따른 임상적 특징)

  • Shim, Gyu-Hong;Lee, Hyun-Ju;Kim, Eun-Sun;Lee, Jin-A;Choi, Chang-Won;Kim, Ee-Kyung;Kim, Han-Suk;Kim, Beyong-Il;Choi, Jung-Hwan
    • Neonatal Medicine
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    • v.17 no.1
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    • pp.21-33
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    • 2010
  • Purpose : The increased survival of preterm infants in the neonatal intensive care unit recently has resulted in an increased frequency of bronchopulmonary dysplasia (BPD), especially with atypical forms. However, there have been few studies compairing classic and atypical BPD. The aim of this study was to investigate the differences between these two types of BPD. Methods : Infants with a gestational age less than 32 weeks born at the Seoul National University Hospital and Bundang Seoul National University Hospital from May 2004 to April 2007 were included. The data were categorized in 2 groups, classic and atypical BPD. We determined the incidence of BPD, and compared perinatal factors and postnatal managements between two groups. Results : Among 260 study subjects, 141 (54.2%) infants had BPD. Classic BPD infants were 64 and atypical BPD infants were 77. Comparison of differences between 2 groups, classic BPD infants were associated with respiratory distress syndrome, patent ductus arteriosus, intrauterine growth restriction, more high-frequency ventilator (HFV) use, low 1 and 5 minute Apgar scores. Atypical BPD infants were associated with antenatal steroid use, maternal premature rupture of membrane and chorioamnionitis (CAM). In multivariate analysis, more HFV use was associated with classic BPD. Antenatal steroid use, clinical CAM and histological CAM were associated with atypical BPD. Conclusion : The results of this study showed that antenatal factors (antenatal steroid use, clinical CAM, histological CAM) were associated with atypical BPD and postnatal factors (HFV used more) were associated with classic BPD. Further studies are needed for prevention and treatment of BPD.

The Measurement of Blood Flow of Anterior Cerebral Artery in Premature Newborns Using Duplex Doppler Ultrasonography (이중 초음파 검사를 이용한 미숙아의 전 뇌동맥 혈류 측정)

  • Hwang, Mi-Soo;Bae, Kyeung-Kug;Lee, Jae-Kyo
    • Journal of Yeungnam Medical Science
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    • v.14 no.1
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    • pp.77-84
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    • 1997
  • We measured the blood flow velocity of the anterior cerebral artery via anterior fontanelle approach of fifty five preterm neonates with duplex Doppler sonography and analyzed the waveform and calculated pulsatility index, resistive index. Intracranial velocities and pulsatility indexes were increased with increasing gestational age, birth weight, and age of the neonate, but resistive indices decreased. In sick babies, characteristic resistive index increment were seen in patients with intraventricular hemorrhage, but no statistical difference was seen in patients with respiratory distress syndrome. Our results suggest that duplex Doppler sonography is a useful noninvasive means of monitoring cerebrohemodynamics in normal preterm neonates and flow change of sick babies.

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Neurophysiology of the Sensory System and Clinical Applications (감각신경계의 신경생리와 임상적 이용)

  • Seo, Dae-Won
    • Annals of Clinical Neurophysiology
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    • v.12 no.2
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    • pp.35-46
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    • 2010
  • Various electrophysiological tests have provided a large body of valuable information on neuronal responses to a presented stimulus. The special and general somatic sensory pathways are main targets of evoked potentials. Two types of evoked potentials, exogenous and endogenous, are commonly used. Exogenous evoked potentials of general and special somatic sensory systems will be reviewed. One of general somatic sensory functional pathways, proprioception, can be evaluated by general somatosensory evoked potentials with electrical stimulation on nerves. The special somatosensory functional pathways, including vision, and audition, can be evaluated by visual evoked potentials and auditory evoked potentials. Also laser-evoked potentials are newly developed for pain pathway, including lateral spinothalamic pathway, and vestibular myogenic evoked potentials for sacculocollic pathways. The evoked potentials of sensory system have maximal clinical utility in evaluating functional deficits along the sensory pathways. They are used for evaluating comatose patients, hysterical patients, premature infants, patients with suspected demyelinating diseases or neoplasms, and research. We discuss the neurophysiologic tests of sensory systems in views of practical points. The organized evaluation of sensory electrophysiologic tests can be helpful in detecting and estimating the abnormalities in neurological diseases.

Automated Vessels Detection on Infant Retinal Images

  • Sukkaew, Lassada;Uyyanonvara, Bunyarit;Barman, Sarah A;Jareanjit, Jaruwat
    • 제어로봇시스템학회:학술대회논문집
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    • 2004.08a
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    • pp.321-325
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    • 2004
  • Retinopathy of Prematurity (ROP) is a common retinal neovascular disorder of premature infants. It can be characterized by inappropriate and disorganized vessel. This paper present a method for blood vessel detection on infant retinal images. The algorithm is designed to detect the retinal vessels. The proposed method applies a Lapalacian of Gaussian as a step-edge detector based on the second-order directional derivative to identify locations of the edge of vessels with zero crossings. The procedure allows parameters computation in a fixed number of operations independent of kernel size. This method is composed of four steps : grayscale conversion, edge detection based on LOG, noise removal by adaptive Wiener filter & median filter, and Otsu's global thresholding. The algorithm has been tested on twenty infant retinal images. In cooperation with the Digital Imaging Research Centre, Kingston University, London and Department of Opthalmology, Imperial College London who supplied all the images used in this project. The algorithm has done well to detect small thin vessels, which are of interest in clinical practice.

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A Case of Infantile Hemangioendothelioma of the Liver Treated with Hepatic Embolization and Lobectomy (간동맥 색전술과 간엽 절제술로 치료한 영아 간내 혈관내피종 1례)

  • Kim, Jae Seon;Moon, Soo Kyung;Yoon, Hye Seon;Lee, Tae Seok
    • Clinical and Experimental Pediatrics
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    • v.48 no.6
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    • pp.660-664
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    • 2005
  • Infantile hemangioendothelioma(IHE) of the liver is the most common vascular tumor in infants before the age of 6 months. It is a histologically benign tumor with potentially life-threatening complications. The clinical manifestations are variable, ranging from asymptomatic forms to intractable high-output heart failure. In addition, abdominal mass, intraperitoneal hemorrhage due to rupture of mass, respiratory distress, hematologic abnormalities and jaundice can occur. Diagnostic work-up is through doppler ultrasound sonography, computed tomography scan, magnetic resonance imaging and angiography. Treatment consists of medical treatment, interventional therapy, surgical resection and liver transplantation. We experienced symptomatic IHE in a premature neonate who presented with high output heart failure and respiratory distress. Initial medical treatment and steroid therapy failed to improve his condition. Coil embolization of left hepatic artery resulted in improvement of respiratory symptoms. However, a left lobectomy was performed because the mass size was not decreased with development of collateral vessels. The infant was well, after a successful discharge from the hospital.

Oxidative stress and the antioxidant enzyme system in the developing brain

  • Shim, So-Yeon;Kim, Han-Suk
    • Clinical and Experimental Pediatrics
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    • v.56 no.3
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    • pp.107-111
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    • 2013
  • Preterm infants are vulnerable to the oxidative stress due to the production of large amounts of free radicals, antioxidant system insufficiency, and immature oligodendroglial cells. Reactive oxygen species (ROS) play a pivotal role in the development of periventricular leukomalacia. The three most common ROS are superoxide ($O2^{\cdot-}$), hydroxyl radical ($OH^{\cdot}$), and hydrogen peroxide ($H_2O_2$). Under normal physiological conditions, a balance is maintained between the production of ROS and the capacity of the antioxidant enzyme system. However, if this balance breaks down, ROS can exert toxic effects. Superoxide dismutase, glutathione peroxidase, and catalase are considered the classical antioxidant enzymes. A recently discovered antioxidant enzyme family, peroxiredoxin (Prdx), is also an important scavenger of free radicals. Prdx1 expression is induced at birth, whereas Prdx2 is constitutively expressed, and Prdx6 expression is consistent with the classical antioxidant enzymes. Several antioxidant substances have been studied as potential therapeutic agents; however, further preclinical and clinical studies are required before allowing clinical application.

The Effects of Chest Vibration Prior to Endotracheal Suctioning on Oxygenation and the Amount of Lung Secretions in Premature Infants with Respiratory Distress Syndrome (호흡곤란증 미숙아에 있어 기관지 흡인술전의 흉곽진동법이 산소화와 기관지 분비물의 양에 미치는 영향)

  • Ahn, Young Mee
    • Journal of Korean Academy of Nursing
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    • v.28 no.3
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    • pp.591-601
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    • 1998
  • 미숙아에 있어 주로 표면활성제의 부족으로 인한 호흡곤란증은 미숙아 사망의 주원인이 된다. 호흡곤란증의 치료목적은 적절한 환기를 통해 체내 산소화를 유지시키는 것이다. 인공호흡기 치료를 받는 미숙아에게 필수적인 간호중재인 기관지 흡인술은 그 효과를 극대화하기 위해 흉곽진동법과 같이 사용될 수도 있다. 그러나 미숙아를 대상으로 하는 흉곽진동법은 그 중재의 안전성이나 효과에 대한 과학적 검증 없이 시행되고 있는 실정이다. 이에 본 연구는 호흡곤란증 미숙아에 있어 기관지 흡인술 이전에 행하여지는 흉곽진동법이 산소화와 기관지 분비물에 미치는 영향을 연구하기 위해 실시되었다. 이를 위해 20명의 호흡곤란증 미숙아를 대상으로 대상자내 반복실험연구가 설계되었다. 독립변수는 기관지흡인술이전에 흉곽진동이고 종속 변수는 산소 포화도, 심박동수, 그리고 기관지 분비물의 양이었다. 각 대상자는 무작위 순서에 따라 한번은 흉곽진동없이 흡인을, 나머지 한번은 흉곽진동과 흡인의 두 가지 형태의 흡인을 경험 하였다. 연구 결과, 기관지 흡인술이전에 흉곽진동을 실시하든, 안하든 산소포화도와 심박동수의 변화양상에는 차이가 없었다. 그러나, 융곽진동법을 실시한 경우가 실시안한 경우에 비해 더 많은 양의 기관지 분비물을 흡인하였다. 이는 기관지 흡인술 이전에 실시하는 흉곽진동법이 미숙아의 체내에 부가적 산소소모를 초래하지 않는 반면, 기도로부터 더 많은 분비물을 흡인하는데 효과적임을 시사한다.

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Knowledge and Beliefs about Kangaroo Care among Nursing Students (간호대학생의 캥거루 돌보기에 대한 지식과 신념)

  • Park, So-Young;Koo, Sang-Mi;Choi, Sun-Mi;Kim, Tae-Im
    • Child Health Nursing Research
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    • v.22 no.1
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    • pp.61-69
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    • 2016
  • Purpose: This study was conducted to investigate nursing students' knowledge and beliefs about Kangaroo care (KC). Methods: A cross-sectional descriptive design was used. Undergraduate students enrolled in departments of nursing (n=322) from three universities in D city participated. Knowledge and beliefs about KC were measured using the Kangaroo Care Questionnaire (KCQ). Results: The overall level of nursing students' knowledge about KC was very low with a mean score of 6.9 out of 17. The mean score for nursing students' beliefs about KC was 87.4 out of 100, indicating relatively positive beliefs. The students who had both education and exposure to KC had higher scores for knowledge and more positive beliefs about KC compared to students with no experience or exposure to KC. There was a positive correlation between knowledge and beliefs about KC (r=.371, p<.001). Conclusion: The results suggest that there is a need to develop educational programs for nursing students in order to increase their knowledge and develop positive beliefs about KC.

Probiotics in the Prevention and Treatment of Necrotizing Enterocolitis

  • Seghesio, Eleonora;Geyter, Charlotte De;Vandenplas, Yvan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.24 no.3
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    • pp.245-255
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    • 2021
  • Necrotizing enterocolitis (NEC) is a disease with high morbidity and mortality that occurs mainly in premature born infants. The pathophysiologic mechanisms indicate that gastrointestinal dysbiosis is a major risk factor. We searched for relevant articles published in PubMed and Google Scholar in the English language up to October 2020. Articles were extracted using subject headings and keywords of interest to the topic. Interesting references in included articles were also considered. Network meta-analysis suggests the preventive efficacy of Bifidobacterium and Lactobacillus spp., but even more for mixtures of Bifidobacterium, Streptococcus, and Bifidobacterium, and Streptococcus spp. However, studies comparing face-to-face different strains are lacking. Moreover, differences in inclusion criteria, dosage strains, and primary outcomes in most trials are major obstacles to providing evidence-based conclusions. Although adverse effects have not been reported in clinical trials, case series of adverse outcomes, mainly septicemia, have been published. Consequently, systematic administration of probiotic bacteria to prevent NEC is still debated in literature. The risk-benefit ratio depends on the incidence of NEC in a neonatal intensive care unit, and evidence has shown that preventive measures excluding probiotic administration can result in a decrease in NEC.

Analysis of the supportive care needs of the parents of preterm children in South Korea using big data text-mining: Topic modeling

  • Park, Ji Hyeon;Lee, Hanna;Cho, Haeryun
    • Child Health Nursing Research
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    • v.27 no.1
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    • pp.34-42
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    • 2021
  • Purpose: The purpose of this study was to identify the supportive care needs of parents of preterm children in South Korea using text data from a portal site. Methods: In total, 628 online newspaper articles and 1,966 social network service posts published between January 1 and December 31, 2019 were analyzed. The procedures in this study were conducted in the following order: keyword selection, data collection, morpheme analysis, keyword analysis, and topic modeling. Results: The term "yirundung-yi", which is a native Korean word referring to premature infants, was confirmed to be a useful term for parents. The following four topics were identified as the supportive care needs of parents of preterm children: 1) a vague fear of caring for a baby upon imminent neonatal intensive care unit discharge, 2) real-world difficulties encountered while caring for preterm children, 3) concerns about growth and development problems, and 4) anxiety about possible complications. Conclusion: Supportive care interventions for parents of preterm children should include general parenting methods for babies. A team composed of multidisciplinary experts must support the individual growth and development of preterm children and manage the complications of prematurity using highly accessible media.