Purpose : The relationship between chest X-ray findings and respiratory indices, including the arterial-alveolar oxygen partial pressure ratio($a/APO_2$) and the ventilatory index(VI), indicators of the clinical respiratory status in neonates with respiratory distress syndrome(RDS), was examined in the present study. Methods : The records of 50 neonates, randomly chosen from 174 neonates treated with pulmonary surfactant(PS) in the Neonatal Intensive Care Unit of Kyunghee University Hospital from 1996 to 2000 were analyzed retrospectively. Chest radiographs taken at the time after birth were classified into four groups according to Bomsel's classification. The $a/APO_2$ and VI values were calculated and compared with the corresponding chest radiographs. Results : Among the 50 cases of RDS examined, three cases were classified into grade I(6%), eight cases into grade II(16%), 20 cases into grade III(40%), and 19 cases into grade IV(38%). The mean $a/APO_2$ of the cases classified into grades I or II was 0.32 and the mean $a/APO_2$ of those classified into grades III and IV was 0.18 and 0.09, respectively. The mean VI was 0.049 for the cases classified into grades I or II and 0.076 and 0.161 for those classified into grades III and IV, respectively. Conclusion : The severity of RDS according to chest X-ray findings correlate to the values of respiratory indices, $a/APO_2$ and VI.
Sohn, Bongyeon;Kim, Hak Ju;Chang, Hyoung Woo;Lee, Jae Hang;Kim, Dong Jung;Kim, Jun Sung;Lim, Cheong;Park, Kay Hyun
Journal of Chest Surgery
/
v.53
no.6
/
pp.339-345
/
2020
Background: Iliac artery aneurysm is frequently found in patients undergoing surgical repair of an abdominal aortic aneurysm. The use of commercial bifurcated grafts is insufficient for aorto-biiliac replacement with complete iliac artery aneurysm resection. We evaluated the effectiveness of handmade composite grafts for this purpose. Methods: A total of 233 patients underwent open surgery for abdominal aortic aneurysm between 2003 and 2019, including 155 patients (67%) treated with commercial grafts and 78 patients (33%) treated with handmade composite grafts. Their operative characteristics, postoperative outcomes, and late outcomes were retrospectively reviewed. Results: The early mortality rate did not differ significantly between the groups. On average, the handmade composite graft technique took approximately 15 minutes longer than the commercial graft technique (p=0.037). Among patients who underwent elective surgery, no significant differences between the conventional and composite groups were observed in the major outcomes, including red blood cell transfusion volume (2.8±4.7 units vs. 3.1±4.7 units, respectively; p=0.680), reoperation for bleeding (2.7% vs. 3.1%, respectively; p>0.999), bowel ischemia (0% vs. 1.6%, respectively; p=0.364), and intensive care unit stay duration (1.9±6.6 days vs. 1.6±2.4 days, respectively; p=0.680). The incidence of target vessel occlusion also did not differ significantly between groups. Conclusion: The increased technical demand involved with handmade composite grafting did not negatively impact the outcomes. This technique may be a viable option because it overcomes problems associated with commercial grafts.
Kim, Ji Hye;Chung, Eun-Jin;Park, Hyun Kyung;Moon, Soo Ji;Choi, Su-Mi;Oh, Sung Hee
Clinical and Experimental Pediatrics
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v.52
no.9
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pp.1053-1058
/
2009
Cytomegalovirus (CMV) is one of the most commonly encountered viral pathogens in newborn infants and is found in 0.3-2.4% of all live births. It has been demonstrated that 40-96% of seropositive mothers shed the virus via their breast milk. Breast milk containing CMV can cause almost one-third of CMV infections occurring in infants. A case of postnatal CMV infection in an extremely premature infant (gestational age $24^{+5}$ weeks, birth weight 750 g) transmitted via breast milk is presented. For neonatal intensive care unit (NICU) management of severe thrombocytopenia, anemia, and sepsis syndrome, the infant received repeated transfusions of platelets; intravenous (IV) immunoglobulins; and gamma- irradiated, filtrated packed red cells and was fed her mother's breast milk since the second week of life. CMV infection was diagnosed with positive CMV immunoglobulin M (IgM) and positive urine CMV culture at the second month of life. Considering the negative CMV IgM and urine CMV culture at birth, postnatally-acquired CMV infection was suspected and confirmed with completely identical nucleotide sequence alignments of the infantile blood isolate and the maternal breast milk isolate. To our knowledge, this is the first case of proven postnatal CMV infection transmitted via breast milk in an extremely premature infant in Korea.
Purpose: To assess the validity of individual and combined prognostic effects of severe bronchopulmonary dysplasia (BPD), brain injury, retinopathy of prematurity (ROP), and parenteral nutrition associated cholestasis(PNAC). Methods: We retrospectively analyzed the medical records of 80 extremely low birthweight (ELBW) infants admitted to the neonatal intensive care unit (NICU) of the Severance Children's Hospital, and who survived to a postmenstrual age of 36 weeks. We analyzed the relationship between 4 neonatal morbidities (severe BPD, severe brain injury, severe ROP, and severe PNAC) and poor outcome. Poor outcome indicated death after a postmenstrual age of 36 weeks or survival with neurosensory impairment (cerebral palsy, delayed development, hearing loss, or blindness) between 18 and 24 months of corrected age. Results: Each neonatal morbidity correlated with poor outcome on univariate analysis. Multiple logistic regression analysis revealed that the odds ratios (OR) were 4.9 (95% confidence interval [CI], 1.0-22.6; $P$=0.044) for severe BPD, 13.2 (3.0-57.3; $P$<.001) for severe brain injury, 5.3 (1.6-18.1; $P$=0.007) for severe ROP, and 3.4 (0.5-22.7; $P$=0.215) for severe PNAC. Severe BPD, brain injury, and ROP were significantly correlated with poor outcome, but not severe PNAC. By increasing the morbidity count, the rate of poor outcome was significantly increased (OR 5.2; 95% CI, 2.2-11.9; $P$<.001). In infants free of the above-mentioned morbidities, the rate of poor outcome was 9%, while the corresponding rates in infants with 1, 2, and more than 3 neonatal morbidities were 46%, 69%, and 100%, respectively. Conclusion: In ELBW infants 3 common neonatal mornidifies, severe BPD, brain injury and ROP, strongly predicts the risk of poor outcome.
Background: Several recent studies have explored associations between pre-mir-218 polymorphism (rs11134527) and cancer risk. However, published data are still inconclusive. To obtain a more precise estimation of the relationship in the Chinese population, we carried out a meta-analysis for the first time. Materials and Methods: Through retrieval from the PubMed, Medline, Embase, Web of Science databases, China National Knowledge Infrastructure and the Chinese BioMedical Literature Database, a total of four studies were analyzed with 3,561 cases and 3,628 controls for SNP pre-mir-218 rs11134527. We calculated odds ratios (ORs) and 95% confidence intervals (95%CIs) to explore the strength of associations. Results: The results showed that the rs11134527 polymorphism was associated with decreased cancer risk in GG versus AA and GG versus AA+AG models tested ( GG vs AA: OR=0.82, 95%CI: 0.71-0.94; GG vs AA+AG: OR=0.84, 95%CI: 0.74-0.96), and significantly decreased cervical cancer risk was observed in GG versus AA and GG versus AA+AG models (GG vs AA: OR=0.79, 95%CI: 0.66-0.94; GG vs AA+AG: OR=0.80, 95%CI: 0.68-0.94). However, no significant association between the rs11134527polymorphism and hepatocellular carcinoma risk was observed in all comparison models tested (AG vs AA: OR=0.94, 95%CI: 0.79-1.11; GG vs AA: OR=0.88, 95%CI: 0.70-1.10; GG+AG vs AA: OR=0.92, 95%CI: 0.79-1.08; GG vs AA+AG: OR=0.91, 95%CI: 0.75-1.11). Conclusion: The findings suggest that pre-miR-218 rs11134527 polymorphism may have some relation to cancer development in Chinese. However, well-designed studies with larger sample size and more detailed data are needed to confirm these conclusions.
The Purpose of this study was to collect statistics of pediatric problems, and so to investigate the new effective oriental medicine treatments in pediatric disease and its clinical applicability. The Study was composed of 698 new patient who had been treated at the pediatric unit in th Dong Sea Oriental Medical Hospital for 1 year, from 1 September 2001 to 31 October 2002, and aged between 0 and 18 years. The Chief complaints and their care-givers. Result: 1. In the study, male children are 403 and female children are 295. So the sex ratio between male and female is 1.37 : 1. 2. In age distribution, 0-3 years : 317(45.4%), 4-6 years : 148(21.2%). 7-9 years 98(14.0%), 10-12 years: 66(9.5%), 13-15 years : 40(5.7%), 16-18 years 29(4.2%). 3. The chief complaint according to systemic division was Respiratory diseases covers 30.1%, Digestive diseases covers 20.8%, Physique diseases covers 10.6%. 4. The Respiratory diseases tended to increase in autumn and appeared mostly in the age group between 0 and 9 years. The Digestive diseases increase in summer and appeared mostly in the age group between 10 and 12 years. The physique diseases increase in winter and appeared mostly in he age group between 13 and 18 years. 5. Most of patient came to the hospital from diseases such as common cold, weakness, dyspepsia, atopic dermatitis, rhinitis, take a easy cold, short stature, sweating, Bell's palsy, abdominal pain, etc. Conclusion : 1. The chief complaint In pediatric diseases that needed an oriental medical treatment was mainly the disease that tends to take long time and the weakness, and appeared frequency in respiratory and digestive disease. 2. The oriental medical treatment was still preferred as a way to improve the weakness by patients, rather than a way to overcome their disease. in particular, the study shows that the oriental medical treatment should be emphasized in terms of preventing the disease. 3. The new disease, which were developed with change of human life and environment, should be investigated as a new fie of oriental medical treatment.
Purpose : To evaluate various sepsis screening tests, individually and in combination, to formulate a guideline for the diagnosis of neonatal sepsis. Methods : The study was a retrospective cohort study. It took place at the neonatal intensive care unit of the Paediatric Department, Il Sin Christian Hospital, Busan, Korea, over a period of 68 months from 1st, April, 2001 to 31st, December, 2005. This study evaluated 100 neonates having clinical features of sepsis and 100 normal asymptomatic neonates and used screening tests including C-reactive protein (CRP), total leukocyte count (TLC), absolute neutrophil count (ANC), immature neutrophils to total neutrophil count ratio (I/T ratio), thrombocytopenia, degenerative changes in the neutrophils and gastric aspirate cytology (GAC) for the diagnosis of neontal sepsis. Results : The sensitivity of CRP and ANC was high. CRP had 86 percent sensitivity for group-A (proven sepsis) and 74 percent sensitivity for group-B (probable sepsis) and 94 percent specificity for group-A, B. ANC had sensitivity of 72 percent for group-A and 62 percent for group-B and 86 percent specificity for group-A, B. For group-A, sensitivity, specificity of GAC for polymorphs was 74 percent and 94 percent respectively. As for sensitivity, specificity of platelet count for group-A was 64 percent and 89 percent respecively. The sensitivity, specificity and predictive values (PV) of the individual tests and different test combinations were also calculated for group-A and B. Conclusion : For the detection of culture negative cases in neonatal sepsis, screening tests including CRP, TLC, ANC, thrombocytopenia, cytoplasmic vacuolization in the neutrophils and GAC for polymorphs have high sensitivity. A combination of three tests has higher sensitivity.
Jeong, Jong Tae;Yun, Su Young;Lee, Ran;Hyun, Jae Ho;Jung, Gyu Young
Clinical and Experimental Pediatrics
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v.45
no.4
/
pp.449-453
/
2002
Purpose : Arterial blood gas analysis is frequently performed in neonatal intensive care unit (NICU) to evaluate ventilation and the metabolic state of critically ill infants. In occasions when umbilical arterial catheterization is not available, frequent arterial puncture is mandatory. This requires some technical skill and may occasionally have side effects. So we studied the validity of capillary blood gas analysis which can be performed conveniently compared with arterial blood. Methods : Twenty-four neonates admitted to NICU during April to Aug. 2001 were studied. They were more than two weeks old without indwelling arterial catheters. Thirty-six times, simultaneous arterial, and capillary blood gases were drawn by puncture and the pH, $pCO_2$ and $pO_2$ of each sample was measured. Blood pressure and body temperature was checked before sampling to rule out impaired peripheral circulation. Capillary blood was collected from warmed heels. Results : There was a strong correlation between capillary and arterial pH(r=0.91, P<0.05). The absolute value of the difference between arterial and capillary pH was less than 0.05. Also capillary $pCO_2$ showed correlation with arterial $pCO_2$(r=0.77, P<0.05). Despite a statistically significant correlation between capillary and arterial $pO_2$(r=0.68, P<0.05), the absolute value of the difference was more than 10 mmHg in 92% of cases. Conclusion : Capillary blood gases accurately reflected arterial pH and $pCO_2$ and showed a relative correlation with $pO_2$. Capillary blood gas analysis can be a useful alternative to arterial blood when continuation of the umbilical arterial catheter is no longer available.
Slowly, but surely, we are seeing the emergence of a variety of embedded systems that are employing Storage Class RAM (SCRAM) such as FeRAM, MRAM and PRAM, SCRAM not only has DRAM-characteristic, that is, random byte-unit access capability, but also Disk-characteristic, that is, non-volatility. In this paper, we propose a new software architecture that allows SCRAM to be used both for main memory and for secondary storage simultaneously- The proposed software architecture has two core modules, one is a SCRAM driver and the other is a SCRAM manager. The SCRAM driver takes care of SCRAM directly and exports low level interfaces required for upper layer software modules including traditional file systems, buddy systems and our SCRAM manager. The SCRAM manager treats file objects and memory objects as a single object and deals with them in a unified way so that they can be interchanged without copy overheads. Experiments conducted on real embedded board with FeRAM have shown that the SCRAM driver indeed supports both the traditional F AT file system and buddy system seamlessly. The results also have revealed that the SCRAM manager makes effective use of both characteristics of SCRAM and performs an order of magnitude better than the traditional file system and buddy system.
Total parenteral nutrition (TPN) is necessary to neonates in neonatal intensive care unit (NICU) for survival and growth because of impossible of enteral feeding. Long-term TPN can be associated with a broad spectrum of hepatobiliary disorder, ranging from mild hepatic dysfunction to severe end-stage liver disease. Cholestasis developed most commonly in neonate, ursodeoxycholic acid (UDCA) is widely used in adult with cholestatic and non-cholestatic liver diseases but there have been limited data on the effects in neonate with PNAC. This study was performed retrospectively to review all medical histories of the total 30 neonates with was administrated UDCA for treatment to parenteral nutrition associated cholestasis (PNAC) at Chungbuk National University Hospital NICU from April 2002 to December 2008. UDCA was administrated at bilirubin is over 2 mg/dl. The criterias for drug evaluation were included hepatic biochemical marker such as direct bilirubin, total bilirubin, AST, ALT, ALP and GGT, TPN therapy period, cholestasis development period, UDCA treatment period, UDCA dosage and adverse effect. In the results, Post-UDCA treatment significant was decreased direct bilirubin, total bilirubin, AST and ALP (p<0.05), and was decreased GGT (p>0.05) and slightly was increased ALT (p>0.05). Reffective timect biDCA was appear at mean $10.5{\pm}1.3$ days, iDCA administration period was mean $64.4{\pm}5.9$ days, cholestasis period was mean $71.9{\pm}6.4$ days and UDCA dosage was mean $22.9{\pm}0.9$ mg/kg/day. Common adverse effects is diarrhea, 5 patients arised mild diarrhea but it possible also related with increased enteral feeding. In conclusion, iDCA can decrease direct bilirubin that major parameter t bcholestasis and oher hepatic biochemical makers. UDCA is effective on PNAC without any serious side effect and cost-effective. Although no greatly shortening cholestasis period, but can protect to develop into severe liver disease and other complication or death. Based on these result, UDCA is recommended for treatment of cholestasis at direct bilirubin is over 2 mg/dl.
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