• Clinical and Experimental Pediatrics
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• 제49권6호
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• pp.686-690
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• 2006

심장압전을 동반하는 흉막 및 심낭삼출은 신생아, 특히 극소 저출생체중아에서 흔히 시행되는 제대정맥도관의 드물게 발생하는 치명적인 합병증으로서 신속한 진단과 치료를 요한다. 저자들은 극소저출생체중아에서 제대정맥도관의 합병증으로 발생한 흉막삼출과 심장압전을 동반한 심낭삼출을 흉관삽입과 심낭도관술로 치유한 1례를 경험하고, 아직 국내에는 보고된 적이 없어 문헌고찰과 함께 보고하는 바이다.

• Neonatal Medicine
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• 제16권2호
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• pp.121-130
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• 2009

Over the past 20 years, neonatal mortality rates for preterm infants, particularly those born extremely preterm and with a very low birth weight, have decreased steadily. As more very immature preterm infants survive, provision of enteral feeding has become a major focus of concern. According to many experts on neonatal nutrition, the goal for the nutrition of preterm infants should be to achieve a postnatal growth rate approximating that of a normal fetus of the same gestational age. Total parenteral nutrition for maintaining nutritional integrity is mandatory before successful transition to enteral feeding. Early initiation of trophic enteral feeding is vital for postnatal adaptation. Recently published randomized controlled trials provide no evidence to support the practice of postponing enteral feeding to reduce the incidence of necrotizing enterocolitis. Early trophic feeding yields demonstrable benefits and there is currently no evidence of any adverse effects following early feeding. Preterm milk from the infant's own mother is the milk of choice, which can always be supplemented with a human milk fortifier. Here we review over 50 randomized controlled trials and over seven systematic reviews published on neonatal parenteral and enteral feeding of preterm infants. Neonatologists must make use of the evidence from these studies as a reference for feeding protocols for preterm infants in their NICUs are to be based.

• Human Ecology Research
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• 제60권4호
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• pp.595-607
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• 2022

This study aims to clarify the relationship between family policy and children's quality of life through an international comparison and to determine which family policy factors contribute to children's quality of life. The research question is "How can family policies be combined to improve children's quality of life in terms of health and economy?" It includes nine categories of family policies related to money, service, and leave. Measures of children's quality of life include low birth weight, infant mortality, and child poverty. Using the OECD Family Database, and the OECD Child Well-being Data, fuzzy-set Qualitative Comparison Analysis (fsQCA) was used among 20 OECD countries. Combinations of family policies significant to the children's quality of life were derived from the results. This study contributes to the literature by revealing the effectiveness of states' investment in family policy. In addition, the study indicates that since family policies interact with each other, those policies combine to improve children's quality of life.

• 대한간호학회지
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• 제42권2호
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• pp.181-189
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• 2012

Purpose: This study was done to compare breast feeding rates and factors influencing feeding practice between late preterm ($34{\leq}GA<37$) and preterm infants (GA<34). Methods: A survey was done of 207 late preterm and 117 preterm infants in neonatal intensive care units (NICU) of 4 university hospitals in D city. Data were collected from July 2009 to June 2010 from 324 medical records in the NICU. Breast-feeding at home was checked either by telephone survey or questioning during hospital visits. Results: Rate of breast feeding for late preterm infants was significantly lower than for preterm infants. There was no significant difference in breast-feeding at home. We found differences in factors influencing breast feeding between the two groups. Factors influencing feeding for late preterm infants were type of delivery, mothers' occupation, feeding type during hospitalization, time elapse from hospital discharge, total admission days, infant's body weight at first feeding and length of NPO (nothing by mouth). Factors influencing feeding for preterm infants were birth order, maternal disease and obstetric complications, and one-minute Apgar score. Conclusion: Results of the study show low rates of breast-feeding for late preterm infants indicating a need for breast-feeding education for mothers of these infants.

• Child Health Nursing Research
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• 제12권3호
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• pp.386-397
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• 2006

Purpose: This study was performed to compare the difference of maternal attachment and the maternal role confidence between mother who feeds the child with mother's milk in sanitary pack by a nurse instead of her and mother who feeds the child with artificial milk. Methods: The subjects of this study consisted of mothers of premature baby who was in NICU and can not be fed with mother's milk directly. In the sample, 21 mothers were the breast feeding group and 20 were the bottle feeding group. Data were collected from April 3, 2004 to November 2, 2005, and were analyzed using SPSS WIN 10.0. Results: The degree of maternal attachment and maternal role confidence of the breast milk feeding group was higher than that of the bottle feeding group. In accordance with general characteristics, the difference was found in maternal attachment and maternal role confidence both breast feeding group and bottle feeding group. Conclusion: More systematic nursing mediation is required for the lactation of mother's milk in sanitary pack is planned to do positive interaction between mother and the child, which has an influence on the formation of maternal attachment and the of maternal role confidence after hospitalization.

• 대한유전성대사질환학회지
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• 제16권1호
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• pp.18-23
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• 2016

TMS가 확산되고 검사가 많아짐에 따라 위양성 건수도 증가하고 있다. 본 연구에서는 2012년 1월 1일부터 2014년 12월 31일까지 단일 기관에서 출생한 신생아를 대상으로 시행한 TMS의 위양성율을 조사하고 관련된 요인들을 분석하였다. 총 검사 대상자 중 남아는 8,942명(51.7%), 여아는 8,350명(48.3%)이었고, 평균 제태연령은 $38.6{\pm}1.7$주 였다. 평균 출생 체중은 $3,155.6{\pm}502.4g$, 평균 출생 신장은 $49.1{\pm}2.9cm$, 평균 체질량지수는 $13.0{\pm}3.8kg/m^2$ 이었다. 질식 분만은 9,713 (56.2%)건, 제왕절개는 7,579 (43.8%)건이었다. 평균 검사 시행일은 $2.8{\pm}1.1$일이었다. 위양성을 포함하여 TMS에서 양성으로 확인된 224명은 전체 대상자의 1.3%였다. 다중 로지스틱 회귀분석을 통해 분석한 결과 27주 이하의 초미숙아에서 위양성으로 나타날 odds ratio가 6.957 (95% CI: 1.273-38.008), 1,000 g 이하의 극저체중아에서 5.616 (95% CI: 1.134-27.820)로 나타났다. 위양성 대상자들 중에서는 지방산 대사이상 질환(fatty acid oxidation dis-orders)이 104명(47%), 아미노산 이상질환(amino-acidopathy)가 75명(34%), 유기산 이상 질환(organic aciduria)가 43명(19%)이었다. 전국적인 자료를 모아 평가한다면 국내 발생률에 대한 정확한 평가 및 접근이 가능할 것으로 생각한다.

• 대한한의학회지
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• 제38권1호
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• pp.125-133
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• 2017

Objectives: The purpose of this study is to investigate the correlation between postpartium joint diseases and maternal season. So it can prevent postpartum joint diseases and provide fundamental data about postpartum health care. Methods: The subject of the present study was 219 women (142 women who completed vaginal delivery and 77 women who delivered by cesarean section) who completed labor between November 1, 2013 and November 31, 2016, at the clinic of OB&GYN. They have been taking good care of their health at postpartum clinic in Andong Woori Women Hospital. We investigated the various symptoms and situation which occurred from the moment of hospital to postnatal admission health care period and oriental doctor examined the patients. We classified the symptoms by the age of patients, the method of delivery, the term of pregnancy, the body weight of infant, the weight change of mother and the way of feeding. Through data analysis, we investigated the correlation between maternal season and postpartum joint diseases. Results: Postpartum joint diseases were the most common among all symptoms after childbirth. Postpartum joint diseases were classified into shoulder area pain and low back pain. In low back pain, there was no significant difference between maternal season and postpartum joint diseases. In shoulder, wrist and finger pain, pain was the most severe at winter delivery. It was the most painful in winter, followed by autumn, spring and summer. Conclusion: There was a close correlation between postpartum joint disease manifestations and maternal season.

• 한국발생생물학회지:발생과생식
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• 제16권2호
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• pp.95-100
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• 2012

Bisphenol A(BPA)는 약한 estrogen 활성도를 보이는 화학물질로서 착상 전 배아나 태아에 영향을 미쳐, 출생 후 그들의 신체발달에 변화를 초래한다고 알려져 있다. 본 연구는 인체에서 임신 중기에 양수 내 BPA 농도를 측정하였으며, 측정된 농도에 따라 임신결과에 영향을 미치는지 여부를 알아보고자 하였다. 임신 15주에서 20주 사이에 유전학적 적응증으로 양수천자 검사를 시행 받았던 120명의 임신부 양수를 연구대상으로 ELISA 방법으로 농도를 측정하였다. 양수천자의 가장 많은 적응증은 35세 이상의 고령 임신부였다. BPA는 모든 양수에서 검출이 가능하였으며, 그 농도는 최저치 0.89 ng/mL부터 최고치 37.13 ng/mL까지의 분포를 보였고, 평균치는 7.24 ng/mL이었다. 양수 내 BPA 농도가 여러 임신결과들과 관련성이 있는지를 알아보기 위해 임신부 나이 35세 이상 대 미만, 남자 태아 대 여자 태아, 분만 당시 재태 연령 37주 이상 대 미만, 출생 당시 신생아 체중 2.5 kg 이상 대 미만으로 각각 나누어, 두 군간에 농도를 비교한 결과, 통계학적으로 유의한 차이는 없었다. 본 연구는 한국인 임신부를 대상으로 최초로 양수 내 BPA 농도에 관한 보고이다. 본 연구결과 BPA 농도는 임신부 나이나 태아성별에 따라 차이를 보이지 않았으며, 조산이나 저체중아의 발생과도 관련이 없음을 알 수 있었다. 향후 산전 BPA 노출이 배발생에 영향을 미치는지에 대한 연구가 필요하다고 사료된다.

• Advances in pediatric surgery
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• 제18권2호
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• pp.68-74
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• 2012

Colonic atresia (CA) is the rare cause of intestinal obstruction, and diagnosis of CA is difficult. But only few research has been performed, so little information has been available. The purposes of this study was to analyze the clinical findings of CA so that help physicians make decision properly. Children with CA who were treated at the division of pediatric surgery at Asan Medical Center in the period from January 1989 to December 2011 were evaluated retrospectively. A total of 6 children were treated with CA. These accounted for 2.7% of all gastrointestinal atresias managed in Asan Medical Center. Only one child was premature and low birth weight, the others were fullterm neonates and showed normal birth weight. Vomiting and abdominal distension were common symptoms and simple X-ray and barium study were used for diagnose of CA. But only 66.7% of the babies were diagnosed as CA pre-operatively. And 2 children out of 6 underwent re-operation due to missed CA at the time of the first operation. In aspect of types of atresia, the type IIIa were two, type IV were two, type I was one case, and one child showed rectal stenosis due to rectal web. Various operations were done according to individual findings and associated diseases. The 50% (n=3) of children underwent the primary anastomosis and the others (n=3) underwent colostomy first and staged operation later for missed CA or associated disease. All of them were recovered any significant complications. Therefore, the prognosis of CA is satisfactory if diagnosis and surgical management could be made properly. But because of the low incidence of CA, delay of diagnosis and treatment may occur. To prevent delay of diagnosis, we suggest prompt evaluation of doubtful infant and careful inspection of distal patency of bowel including whole colon and rectum when operating patients with intestinal atresia at any level.

• Journal of Chest Surgery
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• 제47권5호
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• pp.444-450
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• 2014

Background: We aimed to evaluate the efficacy and safety of early surgical ligation (within 15 days of age) over late surgical ligation (after 15 days of age) by a comparative analysis of very low birth weight (VLBW) infants undergoing surgical correction for symptomatic patent ductus arteriosus (PDA) over the course of 6 years in our hospital. Methods: We retrospectively reviewed all the medical records in the neonatal intensive care unit at Hanyang University Seoul Hospital, from March 2007 to May 2013, to identify VLBW infants (<1,500 g) who underwent surgical PDA ligation. Results: The gestational age (GA) in the late ligation (LL) group was significantly younger than in the early ligation (EL) group (p=0.010). The other baseline characteristics and preoperative conditions did not differ significantly between the two groups. The intubation period before surgery (p<0.001) and the age at surgery (p<0.001) were significantly different. The postoperative clinical outcomes of the study patients, including major morbidity and mortality, are summarized. There were no significant differences in bronchopulmonary dysplasia, sepsis, or mortality between the EL and the LL groups. However, the LL group was significantly associated with an increased risk of necrotizing enterocolitis (p=0.037) and with a prolonged duration of the total parenteral nutrition (p=0.046) after adjusting for GA. Conclusion: Early surgical ligation for the treatment of PDA that failed to close after medical treatment or in cases contraindicated for medical treatment might be desirable to reduce the incidence of necrotizing enterocolitis and to alleviate feeding intolerance in preterm infants.