• Child Health Nursing Research
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• 제4권1호
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• pp.86-96
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• 1998

Newborn period is a transitional stage for independent adaptation from intrauterine to extrauterine life by maintaining respiration, temperature and nutrition. In general, the adaptability of the newborn is proportional to the gestational age(GA), so knowing the accurate GA is critical to develop nursing process in the newborn nursery. A newborn ma turity rating, a Ballard examination, has been used to measure GA by assessing the maturity of new-born. It consists a total of 12 items, which is the 6 items for the neuromuscular maturity and the 6 items for the physical maturity A total of 75 new-born were assessed for the maturity and GA using the Ballard examination. The results are follows : 1) The score of each item of Ballard examination is propotional to GA using the Ballard examination as well as LMP. 2) There was a greater positive relationship between neuromuscular, physical and total maturity, and the GA measured by Ballard examination, than the GA measured by LMP. 3) Any stressful environment to the newborn could influence to the maturity of newborn. In summary, the study showed the Ballard examination Is more reliable and clincially feasible method to measure the accurate G4 compared to the GA by LMP. Therefore, it suggests the application of Ballard examination to measure the new born maturity and GA is beneficial in developing nursing process. The expansion of the study with the variety of the subject characteristics nil on hance the clinical applicability of the examination.

• Child Health Nursing Research
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• 제24권2호
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• pp.128-137
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• 2018

Purpose: To investigate factors that may affect the method of feeding among preterm infants at 4 weeks after discharge. Methods: This study included 222 mother-infant dyads born before a gestational age of 37 weeks. The feeding method and general medical characteristics of the participants were assessed at 4 weeks after discharge using a structured questionnaire. Multinomial logistic regression analysis was used to examine which factors were associated with breastfeeding at home. Results: Of the 222 infants who qualified for the study, 71 (32.9%) continued to receive breastmilk at 4 weeks post-discharge. Multinomial logistic regression analysis showed that breastfeeding at 4 weeks post-discharge was associated with higher breastfeeding self-efficacy, vaginal delivery (experience), direct breastfeeding in the neonatal intensive care unit (NICU), gestational age between 30 and 34 weeks, and breastmilk consumption in the NICU. The following factors were associated with mixed feeding at 4 weeks post-discharge: being employed, having higher breastfeeding self-efficacy, and direct breastfeeding in the NICU. Conclusion: NICU nurses should provide opportunities for direct breastfeeding during hospitalization and support breastfeeding to enhance breastfeeding self-efficacy. These factors may help to ensure the continuation of breastfeeding after discharge. Moreover, factors that affect breastfeeding should be considered when providing interventions.

• Child Health Nursing Research
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• 제15권3호
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• pp.299-305
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• 2009

Purpose: Multiple studies have documented that high resting levels of cardiac vagal tone suggest higher levels of self-regulation. The aim of this study was to evaluate cardiac vagal tone as an indicator of autonomic nervous function in healthy newborn and premature infants. Methods: This study was conducted using a descriptive comparison design and a convenience sampling strategy. The participants were 72 healthy and 62 premature infants delivered in a university hospital. Continuous heart rate data recordings from the infant's ECG were analyzed and Mxedit software was used to calculate mean heart period and an index of cardiac vagal tone. Results: The healthy infants had significantly higher cardiac vagal tone than the premature infants, when the influence of gestational age was removed using analysis of covariance. However, there were no significant differences in heart rate and heart period between the two groups when the influence of gestational age was removed using analysis of covariance. Conclusion: The results of this study show that cardiac vagal tone may be used as an index for determining infant's autonomic nervous function. Nursing staff in pediatric departments can use cardiac vagal tone with ease, as this index can be calculated in a noninvasive method from the ECG.

• 대한간호학회지
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• 제40권4호
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• pp.561-570
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• 2010

Purpose: This was a cross sectional descriptive study to introduce the Infants Coma Scale (ICS), describe mental status of high risk infants using ICS and explore the relationships between ICS and clinical variables in infants hospitalized in a neonatal intensive care unit of a university hospital in Korea. Methods: After ICS was developed and tested by the authors, a research nurse evaluated the mental status of the infants using the English version of ICS and obtained clinical information on the infants from their medical records. Results: Data from 88 infants were analyzed. About 60% were male, 90% were preterm births, and 40% had pathologic abnormalities. Their mean gestational age was 32.4 (${\pm}3.50$) weeks and the mean birth weight was 1,842 (${\pm}728.6$) grams. The Cronbach's alpha for the ICS was .78. There was a statistically significant positive correlation between ICS total score and five clinical variables including gestational age, birth weight, 1 and 5 min Apgar scores and respiration status. Conclusion: Mental status is an important parameter in nursing assessment. ICS is a valid and reliable instrument, which clinicians can easily use to evaluate the mental status of high risk infants.

• Child Health Nursing Research
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• 제8권4호
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• pp.391-399
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• 2002

Purpose: Knowing the accurate gestational age(GA) is critical in nursing care of premature infants. A descriptive study was performed to examine the reliability and clinical applicability of the New Ballard examination(NBE) in premature infants. Method: A NBE was performed to measure GA by assessing the neuromuscular and physical maturity in the course of physical examination of a convenient sample of 74 premature infants. Result: 1. The highest item of NBE score was posture (mean=2.82) and the lowest item was breast (mean=1.84). 2. There was a highly correlation between both the GA by LMP(GA-LMP) and GA by NBE (GA-NBE)(r=.844, p=.000). 3. There was a greater positive relationship in neuromuscular maturity than physical maturity in the GA-NBE of the premature infants(r=.786 vs r=.933). 4. There was a positive correlation between neuromuscular, physical, total maturity, GA-LMP and GA-NBE in the birth weight, length, 1, 5 minute apgar score. 5. There was no significant difference neuromuscular, physical, total maturity in NBE by delivery history. Conclusion: The study supports the reliability a clinical relevance of NBE in assessment of the accurate GA in premature infants.

• Child Health Nursing Research
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• 제13권4호
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• pp.436-443
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• 2007

Purpose: An exploratory study was done to examine the validity of the new Ballard scale with extended scoring system(eNBS) in estimating gestational age(AG) in full-term newborns. Method: The eNBS scoring system was extended to include all numbers of total score of NBS and GA to allow a 3-days variation in GA estimatio compared to the original scale which has a 2-week variation due to the application of a 5-score interval for the total NBS score and only even numbers for GA. GA by eNBS(GA-eNBS) was compared with GA by LMP(GA-LMP) and GA by standard NBS(GA-sNBS) in 133 full-term newborns. Difference between GA-LMP and GA-eNBS was analyzed for each GA. Results: Positive correlations were observed in GA-sNBS and GA-eNBS with GA-LMP. There was no difference between GA-LMP and GA-eNBS at 39GA and 40GA. At 37GA and 38GA, GA-eNBS overestimated GA-LMP up to 1 week, while underestimating up to 1 week at 41GA. Conclusions: The accuracy of eNBS was validated within 3 days of variation in GA estimation at 39-40GA. Overestimation by eNBS suggests the possible acceleration of fetal maturity in premature newborns, while underestimation, of the deceleration of fetal maturity in postterm newborns.

• 대한간호학회지
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• 제13권3호
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• pp.51-60
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• 1983

Currently changing trends of child health care is demand total health assessment of child including growth and development. This study concentrates on the growth & developmental status of low birth weight infant for help their growth & development. Thus it can be provide a direction for scientific health education and counseling materials by investigating factor of growth & development. The subjects for this study were made up of 40 low birth weight infant who attended the well baby clinic of E university Hospital. The study method used was a questionnaire ＆ anthropometric assessment and DDST for normative data of development. The period for data collection was from July 1st to August 31th, 1982. Analysis of the data was done using percentages, $\chi$$^2$-test Stepwise Multiple Regression. The results of study were as follows. 1. The mean weight of birth was 2,068gm and mean of gestational period was 35.65 weeks. 2. The age at which weight ; 32.5%, head circumference : 67,5% chest circumference : 55.0%, height : 50. 0％ was normal range of physical growth. 3. The reverse age at which social development ; 87.5%, fine motor & adaptive development ; 70.0%, gross motor development ; 72.5% of children Passed by DDST to determine of normal range of development. 4. In the among variables, it was found that the infant who were the higher emotional & verbal response of mother and stimulus environment was the more normal range of weight & development than who was not. 5. The stepwise Multiple Regression between developmental status and predictors-birth order, weight at birth, sex, antenatal care, gestational period-are accounts for 34.1%.

• Journal of Interdisciplinary Genomics
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• 제5권2호
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• pp.18-23
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• 2023

Conventional evaluation method for identifying the organic cause of short stature has a low detection rate. If an infant who is small for gestational age manifests postnatal growth deterioration, triangular face, relative macrocephaly, and protruding forehead, a genetic testing of IGF2, H19, GRB10, MEST, CDKN1, CUL7, OBSL1, and CCDC9 should be considered to determine the presence of Silver-Russell syndrome and 3-M syndrome. If a short patient with prenatal growth failure also exhibits postnatal growth failure, microcephaly, low IGF-1 levels, sensorineural deafness, or impaired intellectual development, genetic testing of IGF1 and IGFALS should be conducted. Furthermore, genetic testing of GH1, GHRHR, HESX1, SOX3, PROP1, POU1F1, and LHX3 should be considered if patients with isolated growth hormone deficiency have short stature below -3 standard deviation score, barely detectable serum growth hormone concentration, and other deficiencies of anterior pituitary hormone. In short patients with height SDS <-3 and high growth hormone levels, genetic testing should be considered to identify GHR mutations. Lastly, when severe short patients (height z score <-3) exhibit high levels of prolactin and recurrent pulmonary infection, genetic testing should be conducted to identify STAT5B mutations.

• Asian Pacific Journal of Cancer Prevention
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• 제16권14호
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• pp.5913-5916
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• 2015

Gestational trophoblastic neoplasia (GTN) is the malignant form of gestational trophoblastic disease. In non-metastatic GTN, the outcomes of treatment are impressive with methotrexate (MTX) or actinomycin D. We retrospectively reviewed the outcomes of non-metastatic GTN treated at our center from January, 1999 to December, 2013. One hundred and nine patients were recruited to the study. The median age was 33.1 years and over 90% were referral cases. Abnormal vaginal symptoms developed in 37.6% while 56.4% were asymptomatic. The most common antecedent pregnancy was a complete mole (92.7%) with the median interval time from antecedent pregnancy to GTN development being 2.0 months. The median pretreatment B-hCG was 5,624 mIu/ml. The most common first line treatment was methotrexate (MTX) and folinic acid (91.7%) followed by weekly MTX (4.6%), etoposide+ MTX+actinomycin D (EMA) (2.8%), and actinomycin D (0.9%), with the median number of cycles at 5.0. The positive response to first line chemotherapy was 73.8%. The patients were given subsequent chemotherapeutic regimens after resistance to the first line therapy and showed a final remission rate of 89.9%.The significant factor that was frequently found in patients who were non-responders to the first line treatment was a hysterectomy procedure. Two patients developed lung metastasis and brain metastasis at one and four years after the first treatment, respectively. In conclusion, the outcomes of non-metastatic GTN were excellent. However, the patients need long term follow up due to the possibility of developing multiple organ metastases.

• 대한수의학회지
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• 제36권1호
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• pp.235-245
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• 1996

Serial ultrasonographic examinations were performed on 9 pregnant Korea Jin-do bitches that were the Korean native breed, from days 15 to 60 pregnancy to determine the time of first detection and ultrasonographic appearance of the fetal and extra-fetal structures of pregnancy. Gestational age was timed from the day of ovulation (Day 0), which was estimated to occur when plasma progesterone concentration was first increased above 4.0 ng/ml. Gestational ages at earliest detection of the following fetal and extra-fetal structures were; gestational sac at days 17 to 22; placental layers in the uterine wall at days 20 to 24; zonary placenta at days 25 to 28; yolk sac membrane at days 22 to 24; amnionic membrane at days 27 to 29; embryo initial detection at days 21 to 23; fetal heartbeat at days 21 m 25; bipolar shape embryo at days 25 to 26; fetal movement at days 28 to 31; limb buds at days 31 to 35; anechoic area in head at days 31 to 36; stomach at days 34 to 37; urinary bladder at days 34 to 37; skeleton at days 36 to 38; dorsal sagittal tubular structure in vertebrae at days 36 to 38; lung hyperechoic vs liver at days 37 to 39; liver hypoechoic vs abdomen at days 37 to 40 and kidney at days 43 to 48, respectively.