Group B Streptococcal sepsis and/or meningitis is one of the most serious and common diseases in the neonatal period with high mortality and frequent complications. We have experienced a case of late onset type group B streptococcal sepsis and meningitis with a complication of subclavian vein catheterization catheterization. This 29-day-old male neonate was admitted to intensive care unit with the presentation of fever and septic shock. He was born with Cesarean delivery at 36 weeks and 3 days of gestational age. He showed multiple episodes of seizure after admission and group B streptococcus was isolated from blood. CSF profiles 10 days after admission showed the features of bacterial meningitis without organism isolated. Diffuse cerebral infarction was detected on brain CT 24 days after admission. In the 13th hospital day, the complication of subclavian vein catheterization occurred; Guide wire was cut during insertion and the distal portion of it(2.5cm) was retained in the left subclavian vein. We removed the retained guide wire with goose-neck snare catheter via right femoral vein. This case was presented with a brief review of the literatures.
Objectives : This study was conducted to explore the relating factors with the delivery of low-birth-weight infants in Pyungtaek city. Methods : A questionnaire survey was obtained from 51 mothers with low-birth-weight babies and 90 mothers with full-term normal babies from April to October in 2001. Questionnaire consisted of demographic characteristics, dietary habits including alcohol. drugging, and smoking, past and present disease, prenatal risk factors and prenatal check-up, and complications related to labor and delivery. Results : 1. In the low-birth-weight infants group, father's education level and mother's height were significantly lower, and proportion of old age mothers was significantly higher than those of the normal infant group. 2. Mothers with low-birth-weight infants experienced more premature rupture of membrane, placenta previa, ecclampsia, and twin pregnancy than mothers with normal infants. Gestational period of mothers with low-birth-weight infants was significantly shorter than that of mothers with normal infants. 3. No differences were found in eating habit, alcohol and drug ingestion, smoking, exposing to dangerous materials in two groups, but both groups were highly exposed to indirect smoking, although mothers rarely smoke. Conclusion : The findings of this study indicate that high risk group such as less educated, or older mothers need more prenatal health assessment and support from public health services. Addition to determine the risk factors related to the delivery of low-birth-weight infants, public health nurses pay more attention and develop efficient management system for vulnerable women and infants.
Successful management of duodenal obstruction in newborn infant implies not only satisfactory nutrition but also achievement of normal growth. To aid early diagnosis and management, we evaluated the diagnostic methods, operative interventions and clinical characteristics of thirty-nine infants with congenital duodenal obstructions. In the 11-year period from July 1986 through June 1997, thirty-nine patients with congenital duodenal obstruction (23 males and 16 females) were treated and reviewed at the Department of Pediatric Surgery, Yeungnam University Hospital. The ratio of male to female was 1.4:1, and 29 cases(74.1%) among total 39 patients were newborn. There were 5 premature patients and 16 patients of small for gestational age. The most common causes of the congenital duodenal obstruction was malrotation (26 cases, 66.7%) and followed by annular pancreas (9 cases, 23.1 %), type 1 atresia (3 cases, 7.7%) and wind-sock anomaly (1 case, 2.6%). Common symptoms were vomiting, abdominal distention, jaundice. Plain abdominal X-ray study combined with upper gastrointestinal series was the most commonly used diagnostic method. The operative procedures were performed by same pediatric surgeon utilizing Ladd's procedure in 26, duodenoduodenostomy in 8, duodenojejunostomy in 4, excision of wind-sock membrane in 1. A total of 15 associated congenital anomalies were found in 9 patients. Postoperative complications occurred in 13(33.3%). Overall mortality was 2.6%(1/39). Bilious vomiting and plain abdominal radiologic study were most useful for the diagnosis of congenital duodenal obstruction. Early diagnosis and operative intervention were important to prevent complications such as sepsis and peritonitis.
Yang, Joo Yun;Cha, Jihei;Shim, So-Yeon;Cho, Su Jin;Park, Eun Ae
Clinical and Experimental Pediatrics
/
제57권4호
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pp.171-177
/
2014
Purpose: Eosinophilia is common in premature infants, and its incidence increases with a shorter gestation period. We investigated the clinical significance of eosinophilia in premature infants born at <34 weeks gestation. Methods: We analyzed the medical records of premature infants born at <34 weeks gestation who were admitted to the neonatal intensive care unit at Ewha Womans University Mokdong Hospital between January 2003 and September 2010. Eosinophilia was defined as an eosinophil percentage of >3% of the total leukocytes. Perinatal parameters and clinical parameters were also analyzed. Results: Of the 261 infants born at <34 weeks gestation, 22.4% demonstrated eosinophilia at birth. The eosinophil percentage peaked in the fourth postnatal week at 7.5%. The incidence of severe eosinophilia increased after birth up to the fourth postnatal week when 8.8% of all patients had severe eosinophilia. Severity of eosinophilia was positively correlated with a lower gestational age, birth weight, and Apgar score. Respiratory distress syndrome, bronchopulmonary dysplasia, nephrocalcinosis, intraventricular hemorrhage, and sepsis were associated with a higher eosinophil percentage. The eosinophil percentage was significantly higher in infants with bronchopulmonary dysplasia from the first postnatal week and the percentage was the highest in the fourth postnatal week, with the maximal difference being 4.1% (P<0.001). Conclusion: Eosinophilia is common in premature infants and reaches peak incidence and severity in the fourth postnatal week. The eosinophil percentage was significantly higher in bronchopulmonary dysplasia patients from the first postnatal week. Severe eosinophilia was significantly associated with the incidence of bronchopulmonary dysplasia even after adjusting for other variables.
This study was performed to evaluate developmental and estrogenic activity of bisphenol A (BPA) and butyl benzyl phthalate (BBP) to the second generation of Sprague-Dawley rats ingested during gestational or lactational periods. Rats were given BPA 20$\mu\textrm{g}$/kg BBP 100mg/kg of pregnancy or lactation periods. Maternal body weight and neonatal body weight were recorded. The rats were sacrificed on day 21 after birth. Reproductive organs of dam and neonate were utilized for receptor binding assay. The plasma concentrations of BPA and MBep, one of the major metabolites of BBP were analyzed with HPLC. The co-administration of BPA and BBP induced slow weight gain compared with single administration in dams. Also, such mixture induced low neonatal body weights in next generation. The dams treated with BPA and BBP during lactational periods showed significant organ weight changes in liver and spleen. The dams exposed during lactational periods showed significant organ weight changes not only in liver and spleen but also in kidney, uterus and ovary. The F1 female rats exposed during lactation periods showed significant organ weight changes in liver, spleen, ovary. The F1 male rats showed significant organ weight changes in liver, kidney, epididymis, vesicular glands, prostate. However, no clear synergistic effects of BPA and BBP were noted. There was no significantly different ER$\alpha$ expression pattern between control and treated groups. However, ER$\alpha$ expression were increased in F1 male testis and female uterus. PI male showed distinct ER$\alpha$ expression, especially in the group of lactational combined exposure. Synergistic ER$\alpha$ expression was found by combined treatment of BPA and BBP. We could not find any evidences of synergistic effects on BPA and/or BBP combined administration on dams and their fetuses, except in ER$\alpha$ expression of F1 male.
This is a nonequivalent control group pretest- posttest design in quasi experimental basis to assess how the thermal head and feet support influences on early stage weight gain in premature neonates. The clients were selected among the premature infants with the weight under 2000gms and with the gestational period under 37 weeks, admitted over 15 days in K university hospital, Seoul. The control group of 29 were selected from January 1998 to August 1998, who were without head and feet thermal support, and the experimental group of 30 were selected from September 1998 to May 1999, who were with the two thermal interventions. The results of the study follow, 1.The experimental group with thermal interventions showed more weight gain than the control group without thermal interven- tions, which was statistically significant between the two groups. 2.The physiological weight loss after birth showed less in the experimental group than in the control group. 3.The recovery of the birth weight after the physiologic weight loss showed no statistical difference between the experimental group and the control group. Consequently, the thermal head and feet supportive nursing intervention could be applied as a nursing intervention program to help the premature neonates' development. With the results above we should like to suggest the following: 1) A continuous application in the practice of our thermal supportive intervention for the premature neonates, a development of the content through evaluation, and a comparision of the results through a long time study. 2) A neccessity of deveopment of various study and cross comparision. 3) A neccessity of multi-angular study on the premature infants' characteristics influencing the thermal therapy and the study of the individual differences of the clients.
This study was performed to investigate effects of dietary folic acid supplementation on plasma homocysteine levels, thiobarbituric acid reactive substance s (TBARS) level s and liver SAM/SAH ratio in hyperhomocysteinaemia-induced pregnant rats. Forty-two female Sprague-Dawley rats were divided three groups (C: control diet, HFD: $0.3\%$ homocystine and 0 mg folic acid diet, HFS: $0.3\%$ homocystine and 8 mg/kg folic acid diet) according to homocystine and folic acid levels in the diet. They were fed experimental diets for 5 weeks prior to the mating and also during the entire period of pregnancy till gestational day 20. Dietary folic acid supplementation caused a significant decrease in plasma homocysteine levels which had been increased by a homocystine-diet, with a concomitant increase in plasma and liver folate levels. Liver TBARS levels in homocysteine-folic acid-deficient group (HFD) were higher than those in control group. Dietary folic acid supplementation increased hepatic SAM/SAM ratio in homocysteine-folic acid- sopplemetantion group (HFS) when compared to the HFD (p < 0.05). These data suggest that folate depletion and elevated plasma homocysteine may promote oxidative stress in rat livers and influence the remethylation cycle of the homocysteine metabolism detrimentally. In conclusion, dietary folic acid supplementation was found to be effective for lowering plasma homocysteine levels, relieving oxidative stress, and improving the methylation status in the body.
The purpose of this study were to determine the folate status of pregnant women living in kwangju, Korea and to assess the relationships between folate status and pregnancy outcome. Eighty-one women took part in the study: 26 in their first trimester of pregnancy, 23 in the second, and 32 in the final trimester. The folate intake data both from their diets and supplementasage was obtained using a 24-hour recall method and by measuring the use of supplements. Folate levels of serum and erythrocytes were determined by a microbiological assay using Lactovacillus casei(ATTC 7469) as the test organism. A series of determinations for pregnancy outcome was conducted, including birth weight, length, Apgar score at 5 min after birth, and gestational period. The dietary folate intake in each trimester was 118$\pm$85, 148$\pm$117, and 137$\pm$69ug/d, respectively. All levels were far below the Korean recommended diet allowances(RDA)for folate. Eighty-four percent of the subjects consumed supplemental folate after the 20th week of pregnancy until delivery. the supplemental folate intakes in the second and third trimester were 651$\pm$142 and 688$\pm$150ug/d, respectively. Therefore, the women who took folate supplements consumed more folate than the RDA. Serum folate levels for each trimester were 9.0$\pm$3.8, 11.4$\pm$6.0, and 16.3$\pm$11.0ng/ml respectively, greadually increasing as the pregnancy progressed; the serum folate level in the third trimester was significantly higher(p<0.05) than that in first trimester. The erythrocyte folate concentrations in each trimester were recorded as 369.8$\pm$108.8, 396.2$\pm$107.5, and 420$\pm$7 162.6ng/ml respectively. There was no significant differences among the erythrocyte folate concentrations unlike the serum folate levels. There was no significant difference among the erythrocyte folate concentrations unlike the serum folate levels. There was no signifcant correlation between trimester to be important in maintaining adequate folate status, however these results imply that the serum and erythrocyte folate levels were adequate to support the growth of the fetus.
A 4-month-old female patient admitted because of hydrocephalus. She was premature infant with germinal matrix hemorrhage at gestational period 27 wks. A ventriculoperitoneal shunt with a low-pressure type valve was placed. Follow-up CT scan obtained 3 months after VP shunt placement, revealed a new Lt. middle cranial fossa cyst. The girl was readmitted to hospital at 7 months after VP shunt placement, complaining of lethargy and vomiting. A CT scan was demonstrated a increase in size of a cyst, She subsequently underwent a left-sided pterional craniotomy with partial excision of membrane and cyst fenestration into the basal cisterns. Follow-up CT scan after 18 months revealed reaccumulation of cyst, the girl was reoperated on. After 2 months, the size of cyst was not decreased. Finally, She underwent a cystoperitoneal shunt. Follow-up CT scan after 5 months was demonstrated disappeared cyst and reexpansion of brain parenchyma. We report the development of a symptomatic sylvian fissure arachnoid cyst developed after ventriculoperitoneal shunt.
Lee, Yae Heun;Lee, Yoo Jung;Jung, Sun Young;Kim, Suk Young;Son, Dong Woo;Seo, Il Hye
Perinatology
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제29권4호
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pp.147-152
/
2018
Objective: This study examines whether maternal group B Streptococcus (Streptococcus agalactiae, GBS) infection was associated with preterm births and premature neonatal outcomes. Methods: Maternal and neonatal outcomes were examined among singleton pregnant women with preterm birth (from $24^{+0}weeks$ to $36^{+6}weeks$) who were tested for GBS (n=203) during the pregnancy. Data were collected retrospectively from the medical records of women who delivered at our hospital from January 2015 to February 2017. We compared obstetrical factors (causes of preterm birth) and neonatal (gestational age at delivery, birth weight, Apgar score 1 min/5 min, hospitalization period, duration of mechanical ventilation, neonatal C-reactive protein within three days, and other complication [respiratory distress syndrome, neonatal deaths]) outcomes between GBS-infected and non-infected pregnant women. Results: There were 203 singleton pregnant women included in the study, 25 of whom were confirmed to have a GBS infection during the pregnancy. There was no difference in neonatal outcomes by GBS status. Preterm premature rupture of membranes (pPROM), as an obstetric factor, was associated with GBS infection (P=0.022). GBS infection raised the risk of pPROM by 3.6 times (odds ratio 3.648, 95% confidence interval 1.476-9.016, P=0.005). Conclusion: GBS infection in preterm birth was associated with pPROM but did not result in adverse neonatal outcomes. Continuous attention and evaluation of GBS infection, a major cause of neonatal sepsis and pneumonia, are needed.
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