• Title/Summary/Keyword: Sudden infant death

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Surgical Treatment of Anomalous Connection of Left Coronary Artery to the Pulmonary Artery [ALCAPA] (주관상동맥-폐동맥 이상연결증의 외과적 수술요법)

  • 이정렬
    • Journal of Chest Surgery
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    • v.26 no.3
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    • pp.228-233
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    • 1993
  • Patients with anomalous connection of the left coronary artery to the pulmonary artery are at risk for myocardial infarction, and early or sudden death. Between 1986 to 1992, a total of 4 of these patients underwent surgical intervention with various operative techniques at our institution. Age at operation ranged from 2 months to 43 years. Three infant patients had congestive heart failure, 2 of them had mitral regurgitaion, and 1 had ST-T change on elctrocardiogram. Operative techniques included direct coronary artery transfer to the aorta[n=2], intrapulmonary tunnel from the aortopulmonary window[n=1], coronary artery bypass using saphenous vein[n=1]. One deaths occured at 2 weeks after direct coronary arterial transfer due to respiratory failure caused by Respiratory Syncitial virus pneumonia. Supravalvar pulmoanry stenosis occured after intrapulmoanry tunnel. We recommend direct aortic implatation of the anomalous coronary artery at the time of diagnosis. Intrapulmonary tunnel from aortopulmonary window or subclavian-coronary anastomosis could be alternatives in whom aortic implantation is not feasible anatomically.

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Perceptions of Parents and Directors on Safety, Injury Prevention, and Compensation at Child-care Centers (보육시설 안전사고 예방과 보상에 대한 부모와 보육시설장의 인식)

  • Kim, Hye-Gum
    • Korean Journal of Child Studies
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    • v.30 no.4
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    • pp.1-14
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    • 2009
  • This research examined perceptions of parents and directors of child-care centers about safety, injury prevention, and range and level of compensation. Subjects were 285 parents and 297 directors of child-care centersin Kyunggi Province.Data were analyzed by t-test. Results showed differences between perceptions of parents and directors : parents considered the content and frequency of safety education to be more important; directors considered preparation for safety and safety management of equipment for injury prevention to be more important. Parents thought that range of compensation should include travel to and from the child-care center; directors thought that range of compensation should include sudden infant death. There was no difference between parents and directors regarding amount, subject, and process of compensation.

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Development of an Infants' Sleep Health Program Using a Video for SIDS Prevention Education and Measurement of the Program's Effects (영아 수면건강 교육프로그램의 개발 및 효과)

  • Jang, Sook;Kim, Il-Ok
    • Child Health Nursing Research
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    • v.21 no.1
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    • pp.11-19
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    • 2015
  • Purpose: The purposes of this study were to develop an infant sleep health education program using a video for SIDS prevention education and to measure the effects of the program. Methods: The infant sleep health education program consisted of presentations and motor images. The formation of educational material was directed by the systematic design of instruction. Participants in this study were 59 primiparous women from postpartum care centers. The instruments used in this study were criterion referenced test items for knowledge about infant sleep health and confidence inventory. Experimental group I was given the treatment of infant sleep health education program. Experimental group II was given the program using a video reinforcement after 2 weeks. On the other hand, control group was given no treatment. Results: There was a significant increase in knowledge and confidence in the performance of mother's roles of both experimental group I and experimental group II over the control group. No significant difference was founds for knowledge and confidence in the performance of mother's roles between experimental group I and II. Conclusion: The results indicate that this program is a very effective intervention for better sleep health in infants by helping the mothers increase confidence in their role performance.

Open Heart Surgery in Infants Weighing Less than 3kg (체중 3kg 이하 소아에서의 개심술)

  • 이창하
    • Journal of Chest Surgery
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    • v.33 no.8
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    • pp.630-637
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    • 2000
  • Backgroud: There are well-known problems in the management of low weight neonates or infants with congenital heart defects. In the past, because of a perceived high risk of operations using cardiopulmonary bypass(CPB) in these patients, there was a tendency for staged palliation without the use of CPB. However, the recent trend has been toward early reparative surgery using CPB, with acceptable mortality and good long-term survival. Therefore we reviewed our results of the operations in infants weighing less than 3kg and considered the technical aspect of conducting the CPB including myocardial protection. Material and Method: Between Jan. 1995 and Jul. 1998, 28 infants weighing less than 3kg underwent open heart surgery for many cardiac anomalies with a mean body weight of 2.7kg(range; 1.9-3.0kg) and a mean age of 41days(range; 4-110days). Preoperative management in the intensive care unit was needed in 20 infants and preoperative ventilator support therapy in 11. Total correction was performed in 23 infants and the palliative procedure in 5. Total circulatory arrest was needed in 11 infants(39%). Result: There were seven hospital deaths(25%) caused by myocardial failure(n=3), surgical failure(n=2), multiorgan failure(n=1), and sudden death(n=1). The median duration of hospital stay and intensive care unit stay were 13days(range; 6-93days) and 6days(range; 2-77days) respectively. The follow-up was achieved in 21 patients and showed three cases of late mortality(15%) and a one-year survival rate of 62%. No neurologic complications such as clinical seizure and intracranial bleeding were noticed immediately after surgery and during follow-up. Conclusion: The early and late mortality rate of open heart surgery in our infants weighing less than 3 kg stood relatively high, but the improved outcomes are expected by means of the delicate conduct of cardiopulmonary bypass including myocardial protection as well as the adequate perioperative management. Also, the longer follow-up for the neurologic development and complications are needed in infants undergoing circulatory arrest and continuous low flow CPB.

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Congenital Long QT Syndrome Type 8 Characterized by Fetal Onset of Bradycardia and 2:1 Atrioventricular Block

  • Joo, Donghoon;Lee, Hyoung Doo;Kim, Taehong;Ko, Hoon;Byun, Joung-Hee
    • Neonatal Medicine
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    • v.28 no.1
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    • pp.59-63
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    • 2021
  • An important, albeit rare, cause of fetal bradycardia is long QT syndrome (LQTS). Congenital LQTS is an ion channelopathy caused by mutations in genes encoding cardiac ion channel proteins. Fetal onset of LQTS imposes high risk of life-threatening tachyarrhythmias and sudden cardiac death. Here, we report the case of a female newborn with fetal onset of bradycardia and a 2:1 atrioventricular (AV) block. After birth, a 12-lead electrocardiogram (ECG) revealed bradycardia with QT prolongation of a corrected QT (QTc) interval of 680 ms and pseudo 2:1 AV block. Genetic testing identified a heterozygous Gly402Ser (c.1204G>A) mutation in CACNA1C, confirming the diagnosis of LQTS type 8 (LQT8). The patient received propranolol at a daily dose of 2 mg/kg. Mexiletine was subsequently administered owing to the sustained prolongation of the QT interval and pseudo 2:1 AV block. One week after mexiletine inception, the ECG still showed QT interval prolongation (QTc, 632 ms), but no AV block was observed. There were no life-threatening tachyarrhythmias in a follow-up period of 13 months.

EXPERIMENTAL STUDY OF LARYNGEAL BRAIN STEM EVOKED RESPONSE IN CAT (고양이에서 상후두신경자극에 의한 후두뇌간유발반응에 대한 실험적 연구)

  • 김광문;김기령;윤주헌;김창규;박용재
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1991.06a
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    • pp.14-14
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    • 1991
  • 후두의 생리적 기능은 하기도를 보호하는 방어기능과 호흡기능 그리고 발성기능으로 대별할 수 있는데 이 가운데 계통발생적으로 가장 원시적이지만 중요한 기능은 하기도 방어기능으로 이는 다른 기능과 달리 전적으로 불수의적이고 반사적으로 이루어진다. 이 기능은 후두내 점막에 존재하는 촉각 수용체(tactile receptor)가 자극되면서 후두근육이 수축 반사를 일으켜 성문이 닫히는 성문폐쇄반사(glottic closure reflex)로서 다접합뇌간반사(polysynaptic brain stem response)이다. 현재까지 후두의 신경장애에서 그 부위나 정도 또는 신경재생 상태 등을 검사하는 방법으로 근전도검사가 주로 쓰여져 왔으나 그것이 주는 정보가 극히 제한되어 있다. 그러나 최근 청각뇌간유발반응과 같이 후두뇌간유발반응 이라 명명된 wave가 존재한다는 사실이 밝혀져 이에 대한 연구가 이루어지고 있어 이것이 임상에 쓰여질 수 있다면 현재 성문폐쇄반사의 소실이나 이상이 원인으로 사료되는 idiopathic laryngospasm, gastroesophageal reflux, spastic dysphonia, stuttering, sudden infant death syndrome과 같은 질환의 진단과 치료에 커다란 진전이 있을 것이다. 이에 저자들은 고양이 6마리를 이용하여 상후두신경을 전기적으로 자극하여 유발되는 반응을 far field recording을 이용 평균 가산법으로 그 wave를 측정하여 다음과 같은 결과를 얻었다. 1. 상후두신경자극(2㎃, stimuli frequency 3/s, Band filter 320-1000, 0.2 ㎳ duration)에 의한 반회신경에의 유발 반응을 기록하였고 그 잠복시간은 평균 8.2 ㎳ 였다. 2. 상후두신경을 자극하여 후두뇌간유발반응을 기록하였고 후두뇌간유발반응은 4개의 양 wave와 4개의 음 wave로 구성되었다. 3. 각 wave의 평균 잠복시간은 P1은 0.8㎳, P2는 2.3㎳, P3는 3.6㎳, P4는 4.3㎳였고 N1은 1.5㎳, N2 은 2.7㎳, N3는 3.9㎳, N4는 5.5㎳ 였다.

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A case of congenital vallecular cyst associated with gastroesophageal reflux presenting with stridor, feeding cyanosis, and failure to thrive (협착음과 수유시 청색증 및 성장 장애를 보인선천성 후두개 낭종(vallecular cyst) 1예)

  • Yang, Mi Ae;Kang, Min Jae;Hong, Jeana;Shin, Seung Han;Kim, Sang Duk;Kim, Ee-Kyung;Kim, Han-Suk;Choi, Jung-Hwan;Kwon, Tack Kyun;Kim, In-One
    • Clinical and Experimental Pediatrics
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    • v.51 no.7
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    • pp.775-779
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    • 2008
  • Vallecular cyst is an uncommon but potentially dangerous condition causing stridor and has been associated with sudden airway obstruction resulting in death due to its anatomical location in neonates. It may also present with various degrees of feeding problems resulting in failure to thrive. When a vallecular cyst is suspected clinically, endoscopic laryngoscopy is necessary to visualize it. Other conditions leading to neonatal stridor such as laryngomalacia and other laryngotracheal abnormalities should be ruled out. Marsupialization with a $CO_2$ laser is the most effective and safest treatment to prevent recurrence. We report a case of a 1-month-old male infant with a vallecular cyst synchronous with gastroesophageal reflux, and failure to thrive. He was referred to our hospital because of hoarseness, inspiratory stridor, feeding-cyanosis, chest retraction and failure to thrive. Diagnostic workup revealed a cyst at the tongue base, suggesting a vallecular cyst. The cyst was removed by laryngomicrosurgery with $CO_2$ laser. After the surgery, the symptoms improved and the body weight increased steadily. We report a successfully treated case of neonatal vallecular cyst with symptoms of upper respiratory obstruction, gastroesophageal reflux, and failure to thrive.

Health Risk Behaviors Affecting the Process of Pregnancy (임신경과에 영향을 미치는 건강위험행위)

  • Park, Chai-Soon;Mun, Mi-Seon;Hong, Gin-Hee;Lee, Jeoung-Eun
    • Women's Health Nursing
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    • v.6 no.4
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    • pp.549-565
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    • 2000
  • Comprehensive review of the literature was conducted to determine 1) selected risk factors and its impact that affect pregnancy outcome such as smoking, alcohol consumption, and substance abuse 2) these factors can facilitate future strategies for health promotion and prevention for both pregnant women and fetus. Review of literature were extracted from searching MEDLINE(1966 - Oct. 2000). CINAHL (1982 - Oct. 2000) and the domestic literature. The following factors were identified: 1. The effects of risk behaviors on pregnancy. ${\cdot}$Maternal smoking was associated with the occurrence of premature or LBW delivery, fetal growth retardation, extremities defects, heart defects and sudden infant death syndrome. ${\cdot}$Maternal alcohol consumption was associated with spontaneous abortion, premature or LBW delivery, morphologic/neurologic problems, especially fetal alcohol syndrome. ${\cdot}$Heroin was associated with withdrawal after birth in which were born to heroine addicts for gestational age and lung maturation in animal studies. ${\cdot}$Cocaine was associated with spontaneous abortion, abruptio placenta and a poor response to environmental stimuli. ${\cdot}$So far, the effects of caffeine on pregnancy was controversial, but severe caffeine consumption was associated with premature or LBW delivery, spontaneous abortion, still birth and dystocia. 2. Intervention methods and its effects identified were as follows ${\cdot}$Conducted intervention for smoking, alcohol and drug consumption were single or combined. ${\cdot}$Intervention methods were counseling, phone contact, mailing, use of educational videotape, booklet, support person and alternatives such as nicotine patch. ${\cdot}$The interventions increased the rates of smoking cessation during pregnancy and awareness of the risk of drug consumption, and decreased amount of alcohol consumption. ${\cdot}$The intervention outcome found positive effect on birth weight and length. 3. Our recommendations were as follows ${\cdot}$The personal and social cognition should be enhanced through education and the mass media. ${\cdot}$It's necessary to educate and give information of preconceptional care, planned pregnancy and early prenatal care for optimal pregnancy outcome. ${\cdot}$It's necessary to develop comprehensive assessment tool which is reliable and valid on smoking, alcohol consumption and substance abuse to identify supportive or interventional program.

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