• Child Health Nursing Research
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• 제25권3호
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• pp.255-261
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• 2019

Purpose: This study compared the pain-relieving effects of human milk, sucrose, and distilled water during examinations for retinopathy of prematurity. Methods: Forty-five preterm infants were randomly assigned to receive a pacifier dipped in one of three solutions: human milk (n=14), 24% sucrose (n=15), or distilled water (n=16), 2 minutes before an eye examination. Their pain score, pulse rate, and oxygen saturation were measured at three time points: 5 minutes before the examination, 30 seconds after speculum introduction, and 2 minutes after the examination. Results: The infants' mean gestational age and weight at birth were $33.1{\pm}2.1$ weeks and $1,842{\pm}470g$, respectively. There were no between-group differences in pain relief during the eye examination. The pain score significantly increased both during (p<.001) and after the examinations (p=.003). Oxygen saturation decreased during the examinations (p<.001); however, the infants in the 24% sucrose group showed higher oxygen saturation (p=.047) during the examinations than the infants in the other groups. Conclusion: Sucking on a pacifier dipped in human milk or 24% sucrose did not reduce the pain associated with eye examinations in preterm infants. Pacifiers dipped in sucrose can be used to maintain better oxygen saturation during these examinations.

• 제어로봇시스템학회:학술대회논문집
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• 제어로봇시스템학회 2004년도 ICCAS
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• pp.312-316
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• 2004

The paper presents a technique to identify the boundary of the optic disc in infant retinal digital images using an approach based on active contours (snakes). The technique can be used to be develop a automate system in order to help the ophthalmologist's diagnosis the retinopathy of prematurity (ROP) disease which may occurred on preterm infant,. The optic disc detection is one of the fundamental step which could help to create an automate diagnose system for the doctors we use a new kind of active contour (snake) method has been developed by Chenyang et. al. [1], based on a new type of external force field, called gradient vector flow, or GVF. GVF is computed as a diffusion of the gradient vectors of a gray-level or binary edge map derived from the image. The testing results on a set of infant retinal ROP images verify the effectiveness of the proposed methods. We show that GVF has a large capture range and it's able to move snakes into boundary concavities of optic disc and finally the optic disk boundary was determined.

• 제어로봇시스템학회:학술대회논문집
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• 제어로봇시스템학회 2004년도 ICCAS
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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.

• 한국전문물리치료학회지
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• 제6권1호
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• pp.47-61
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• 1999

The purpose of this study was to investigate factors influencing on the early treatment of children with developmental disability. Data was collected from 102 mothers of children with developmental disability who were treated at 4 rehabilitation facilities in Kyunggi-Do and Kangwon-Do. The results were as follows: 1) Of a total of 102, 63 children began to receive rehabilitation therapy during the period 0~12 months (early treatment group), 38 children after 1 year of age (delayed early treatment group). 2) There were statistically significant differences between the early treatment group and delayed early treatment group for prematurity, low birth weight, the time to discover developmental abnormalities, the time of first diagnosis, and first treatment (p<0.05). 3) There were no statistically significant differences in the two groups for level of education, economic status, risk factors (except prematurity and birth weight), home care, family's cooperation and commuting time (p>0.05). Based on this study, the important factors for early treatment were early detection, early diagnosis and constant follow-up for high-risk babies.

• Child Health Nursing Research
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• 제4권2호
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• pp.245-254
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• 1998

Prematurity is the main cause for respiratory disorders in neonates. The goal in respiratory management is to maintain respiration with adequate oxygenation. Chest vibration(CV) prior to on dotracheal suctioning(ETS) has been arbitrarily applied to ventilated premature infants without the scientific evaluation of its safety and efficacy. A repeated measure within subjects experimental study was conducted to investigate the effects of CV prior to 875 on oxygenation and lung secretions in twenty-one ventilated premature infants. The independent variable was the type of research protocol, the control type (275 without C.V) and t he intervention(ETS with CV). The dependent variables were oxygen saturation(SpO₂), heart rate (HR), measured by pulse oximeter, and the amount of lung secretions measured in gram. The results showed there was no difference in SpO₂ responses regardless CV employed before ETS. But there was a significant difference in HR responses between the control and the intervention, even without clinical significance. There was a significant difference in the amount of lung secretions retrieved during ETS with CV, compared to ETS without CV. This study suggested the safety of CV by demonstrating no clinically significant changes in SpO₂ and HR in premature infants. The efficacy of CV could be supported by the increases in the amount of sputum during ETS with CV compared to ETS without CV in premature infants.

• Child Health Nursing Research
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• 제14권3호
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• pp.261-268
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• 2008

Purpose: This study was conducted to estimate the prevalence of questionable development according to developmental screening testing for children, and to explore biological and environmental risk factors of developmental delays. Method: The study participants were 153 children under two years of age. A questionnaire and Home Observation for measurement of the Environment (HOME) inventory were used to collect data, and Korean Denver II was administered. Results: The overall prevalence of questionable development was 11.1%. Significant differences in biological factors between the normal development group and questionable development group were the rate of prematurity, twins, the educational level of mother and father's and the presence of an illness in the mother (p<.10). Maternal acceptance in HOME was significantly different between the two groups. The factors related to questionable development that were significant in the logistic regression analysis were prematurity (OR=3.56, p=.026), and maternal acceptance in HOME score (OR=.629, p=.028). Conclusion: Early developmental screening tests seem necessary for all children, especially for prematurely born children. Also, child rearing environments were identified as significant factors in the development of all children. These findings suggest that the HOME scores might be useful in identifying children at risk for developmental delays, and that interventions for these children will probably be more effective if their mothers are helped to provide a more appropriate social environment.

• Child Health Nursing Research
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• 제24권3호
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• pp.345-352
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• 2018

Purpose: The study was conducted to measure stratum corneum hydration (SCH) and pH (SCP) in high-risk newborns in the early postnatal period and to explore the features related to patterns of change in those parameters. Methods: SCH and SCP were measured on the dorsal hand in 99 hospitalized newborns during the first 14 days of life and the results were analyzed using a general linear model. Results: The mean hydration was 42.9% on day 1, which decreased to 34.6% by 2 weeks (F=15.61, p=<.001). An association was observed between SCH and prematurity (F=21.12, p<.001), as well as for their interaction (F=8.11, p<.001). The mean SCP was $6.2{\pm}0.3$ on day 1, and decreased to $5.7{\pm}0.2$ (F=95.75, p<.001), with no association with prematurity. After adjusting for birth weight, SCH was higher in newborns with vaginal delivery (F=9.07, p=.023) and who received phototherapy (F=11.81, p=.011). For SCP, only delivery type had a significant influence (F=6.40, p=.044). Conclusion: This study suggests that SCH is typically in the 30% range during the early postnatal period, and that an acid mantle on the SC surface is very unlikely to form; these findings could be applied to the nursing process for promoting skin integrity in high-risk neonates.

• Neonatal Medicine
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• 제28권1호
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• pp.7-13
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• 2021

Purpose: To evaluate the risk factors and effects of fluctuations in oxygen saturation on the occurrence and severity of retinopathy of prematurity (ROP). Methods: From January 1, 2013 to January 31, 2020, 260 patients hospitalized in the neonatal intensive care unit of Ajou University Hospital were retrospectively analyzed. Results: Sixty-six patients (25%) were diagnosed with ROP; of them 39 required treatment. In the multivariate regression analysis of ROP severity, the odds ratio (OR) of gestational age was 0.32 (95% confidence interval [CI], 0.22 to 0.47; P<0.0001). The OR of saturation of peripheral oxygen (SpO₂) fluctuations at the 4th week after birth was 1.02 (95% CI, 1.02 to 1.12; P=0.041). Conclusion: SpO₂ fluctuations in premature infants younger than 30 weeks' gestational age affects ROP severity, especially at the 4th week of life.

• Clinical and Experimental Pediatrics
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• 제52권1호
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• pp.50-55
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• 2009

목 적 : 최근 신생아 집중치료의 발전으로 미숙아의 생존율이 증가하면서 미숙아 망막병증도 증가하는 추세이다. 재태 연령 및 출생체중과 미숙한 망막이 중요한 위험인자이지만, 이 외에 무호흡, 패혈증, 인공호흡기의 사용, 장기간의 산소사용 역시 유의한 위험 인자로 알려져 있다. 이에 본 연구는 만성 폐질환 환아에서 nasal cannula를 통한 저농도 산소($FiO_2$ 25% 미만)의 사용 기간이 미숙아 망막병증의 진행에 미치는 영향을 알아보고, 미숙아 망막병증의 예방 및 진행의 완화에 도움을 주고자 본 연구를 시행하였다. 방 법 : 2001년 2월 1일부터 2006년 1월 31일까지 본원 출생아중 재태 연령 37주 미만이면서 출생체중 1,750 g 미만의 생존한 미숙아들로, 안저 검사를 받고 최소 6개월 이상 추적관찰이 가능했던 273명의 미숙아를 대상으로 의무기록을 기초로 후향적 분석을 통해 미숙아 망막병증의 발생에 영향을 미치는 여러 위험인자들을 검토하고, 저농도 산소의 사용 기간이 미숙아 망막병증의 발생과 임상경과 및 예후에 미치는 영향을 조사하였다. 만성 폐질환은 생후 28일 혹은 재태주령 36주가 되는 시점에 산소 의존도가 있었던 경우로 정의하였다. 결과 : 미숙아 망막병증의 발생에 가장 큰 영향을 미치는 인자로는 짧은 재태연령과 적은 출생체중이었고, 기타 무호흡, 표면활성제의 사용, 인공호흡기, 신생아 호흡곤란 증후군, 뇌실내 출혈 등의 순으로 상대적 위험도가 높았다. 저농도 산소 사용 기간이 길어질수록 미숙아 망막병증의 발생률은 높아지고, 미숙아 망막병증의 발병 시기는 지연되는 경향을 보였다. 수술적 치료를 받은 환아들에서 일단 미숙아 망막병증이 발병한 후에는 수술적 치료가 필요한 정도의 심각한 미숙아 망막병증으로 진행하는 기간 간격은 짧아지는 경향을 보였으며, 특히 만성 폐질환 환아군에서 산소를 투여하고 있는 기간 중보다는 산소를 중단한 이후에 미숙아 망막병증이 급격하게 진행되는 경향을 보였다. 결론 : 심각한 미숙아 망막병증의 발병 및 급속한 진행을 예방하기 위하여 가능한 한 저농도 산소라도 사용기간을 줄이고, 산소 사용 중단 이후에는 좀 더 적극적인 추적 안저 검사를 해야 할 것으로 생각된다.

• Journal of Yeungnam Medical Science
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• 제11권1호
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• pp.115-126
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• 1994

1991년 1월부터 1993년 2월까지 영남대학교 의과대학 부속병원에서 출생하여 신생아 중환자실에서 치료 받았던 12명의 미숙아를 대상으로 무작위로 대조군과 rHuEPO투여군으로 나누어 체중 kg당 100unit의 rHuEPO을 1주간 3회씩 4주동안 피하주사하고 rHuEPO투여 시작과 같이 체중 kg당 3mg의 elemental iron을 매일 경구투여 하였고 출생 후 수유가 가능할 때 부터 25unit씩의 비타민 E를 매일 경구투여 하였다. 망상적혈구, 혈색소치, 백혈구수, 혈소판수, 혈청 철, ferritin, 총 철결합능, erythropoietin농도, 활력징후, 체중, 간기능, 신장기능 및 피하주사부 위의 국소 부작용을 비교해 본 결과 치료 시작전 erythropoietin의 농도는 대조군과 rHuEPO투여군 사이에 차이는 없었으며 모두 정상 범위에 속했고 rHuEPO투여군에서는 치료 1주에서 3주사이에 급격한 망상적혈구의 경향이 관찰되었고 전반적으로 혈색소치, 백혈구수, 혈소판수, 혈청 철, ferritin, TIBC등에서는 차이가 없었다. 그리고 체중증가 및 활력증상, 간기능, 신장기능에서도 대조군과 rHuEPO투여군 사이에서 차이가 없었고 rHuEPO 투여 기간 동안 계속 정상적으로 유지되었다. 결론적으로 우리의 연구에서는 rHuEPO치료로 뚜렷한 혈색소치 및 헤마토크리의 증가를 볼 수 없었지만 망상적혈구가 치료 초기에 증가되는 경향이 관찰되었고 치료로 인한 특이할 만한 부작용이 없었으므로 첫째, 치료 기간 중의 예견할 수 없이 발생하는 패혈증, 무시할 수 없는 채혈량과 spontaneous endogenous erythropoietin생산이 rHuEPO의 반응에 미치는 영향, 둘째. rHuEPO의 가장 높은 효과를 얻기 위한 보다 적절한 투여용량, 기간 및 rHuEPO의 투여를 출생 후부터 바로 예방 목적으로 할 것인지 또는 출생 몇 주 후부터 rescue therapy로 할 것인지 투여 시작 시기, 셋째, 용량의 증가 및 감소에 동반되는 부작용의 정도등을 고려해서 앞으로 더 많은 미숙아를 대상으로 지속적인 연구를 한다면 rHuEPO을 이용해 더욱 더 활발하고 효과적으로 미숙아 빈혈을 치료할 수 있으리라 기대한다.