• Clinical and Experimental Pediatrics
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• 제62권5호
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• pp.155-161
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• 2019

Following the first successful trial of surfactant replacement therapy for preterm infants with respiratory distress syndrome (RDS) by Fujiwara in 1980, several animal-derived natural surfactants and synthetic surfactants have been developed. Synthetic surfactants were designed to overcome limitations of natural surfactants such as cost, immune reactions, and infections elicited by animal proteins contained in natural surfactants. However, first-generation synthetic surfactants that are protein-free have failed to prove their superiority over natural surfactants because they lack surfactant protein (SP). Lucinactant, a second-generation synthetic surfactant containing the SP-B analog, was better or at least as effective as the natural surfactant, suggesting that lucinactant could act an alternative to natural surfactants. Lucinactant was approved by the U. S. Food and Drug Administration in March 2012 as the fifth surfactant to treat neonatal RDS. CHF5633, a second-generation synthetic surfactant containing SP-B and SP-C analogs, was effective and safe in a human multicenter cohort study for preterm infants. Many comparative studies of natural surfactants used worldwide have reported different efficacies for different preparations. However, these differences are believed to due to site variations, not actual differences. The more important thing than the composition of the surfactant in improving outcome is the timing and mode of administration of the surfactant. Novel synthetic surfactants containing synthetic phospholipid incorporated with SP-B and SP-C analogs will potentially represent alternatives to natural surfactants in the future, while improvement of treatment modalities with less-invasive or noninvasive methods of surfactant administration will be the most important task to be resolved.

• 대한간호학회지
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• 제4권2호
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• pp.57-66
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• 1974

This study was attempted for clinical investigation regarding with Apgar score changing phase of newborns and their sucking power related the score and weight. The data for this study obtained from 545 newborns who were born at Dept. of obstetric WooSok Hospital, Korea University from Jan. to Sept.. 1373. It is hoped that this study will contribute to nursing care planning of newborns in nursery. The Apgar score was checked in the delivery room at 1 minute after delivery by Doctor and rechecked at 30 minutes and 1 hour after delivery by nurses. The results obtained were as follows: 1. The total newborn numbers at 1 minute after delivery were 545, at 30 minutes were 542 (3 dead) and at 1 hour were 540. The babies were divided into 3 groups by the Apgar score. The frequency of group 1 (score 1 to 4) at each times were 5.0%, 0.9%, 0.4%, group 2 (score 5 to 7) 11.2%, 4.1%, 1.7% and group 3 (score 8 to 10) 83.8%, 95.0%, 97.9%. 2. The group I was found most frequently among the cases of less than 2, 500g and group 3 was found among the cases over 2.500g. It was found that there was a tendency of delaying in recovery process of low score among the premature and low birth weight newborns. 3. The type of delivery, breech and other I e was found worst and C-Section was the second, however normal spontaneous delivery was found the best. 4. In observation of sucking power of the newborn related its score and weight, good, fair, poor marks were given. But for convenience of statistical analysis. good and fair was collected together and poor alone evaluated. The result of group 1.2 examined statistically by F.E.T shown no relation between newborn weight and sucking power. however group 3, examined by X$^2$test shown very significant relation between newborn weight and sucking power. 5. The mortality rate of newborn while they were in hospital was found 2.6% to 545 of birth and all cases of dead belonged to group 1 at 1 minutes after delivery. 64.3% of the dead was found among the cases less than 2, 500g. 6. It was found that in this observation premature and Newborn asphyxia had influence to low score at birth. Conclusively, good anthemata carr should be emphasized in order to prevent main causes of these and should avoid abnormal delivery as possible.

• Child Health Nursing Research
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• 제8권1호
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• pp.97-109
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• 2002

This study was conducted to understand the degree and contents of stress which the mothers of high-risk infants can be experienced from the hospitalization of ICU for their new borns, and thus to offer the basic program to he nursing intervention program for these. Subjects were the 171 mother of hospitalized newborn in NICU of 1 University Hospital in Busan from June, 20, 2001 to September, 15, 2001, who agreed to take part in this study. The instruments used in this study were Parental Stressor Scale:NICU(PSS:NICU) developed by Miles et al. The questionnaire has 4 dimensions and 45 items ; sight and sounds of NICU(5 items), babies' appearance and behavior nursing intervention(19 items), parental role alteration and relationship with their baby(10 items), health team communication(11 items). The data was analysed as average, frequency, Standard Deviation, t-test, ANOVA, Pearson correlation coefficient by use of SPSS/PC+. The results of this study are as follows ; 1. The total perceived stress level score of mothers of high-risk infants was slightly high(3.44±0.71). The highest scored dimension was 'appearance and behavior of the baby'(4.06±0.80), and next were 'relationship with their baby and parental role change'(3.55±0.98), 'sight and sounds of NICU'(3.22±1.01), 'communication with health team'(2.93±0.91). 2. The total perceived stress level score was significantly correlated with birth weight (F=2.35, p<.05). 3. In sight and sounds of NICU, the perceived stress level score was significantly correlated with nursing in the incubator(t=2.28, p<.05) and birth weight(t=2.26, p<.05). In summary, information about physical environment of NICU, birth weight and nursing in the incubator must be included in nursing intervention program of mother's of high-risk infants in reducing the patents stress level. And, it is suggested that there need to find the coping mechanism of mother of high-risk infants.

• Clinical and Experimental Pediatrics
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• 제62권5호
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• pp.166-172
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• 2019

Purpose: This study aimed to evaluate vitamin D status at birth in very-low-birth-weight infants (VLBWIs: <1,500 g) and to determine the association between vitamin D level and respiratory morbidity. Methods: A retrospective study was conducted at Soonchunhyang University Bucheon Hospital between November 2013 and November 2017. We collected blood samples and data on respiratory morbidity from 230 VLBWIs on the first day of life. Patients who were transferred to other hospitals (n=19), died before 36 weeks of gestational age (n=18), or whose blood samples were not collected immediately after birth (n=5) were excluded. Finally, 188 patients were enrolled. VLBWIs with different vitamin D levels were compared with respect to demographic features, maternal diseases, respiratory morbidities, and other neonatal diseases. Results: The mean serum vitamin D level, as measured by 25-hydroxyvitamin D (25(OH)D), was $13.4{\pm}9.3ng/mL$. The incidence of vitamin D deficiency (<20 ng/mL) was 79.8%, and 44.1% of preterm infants had severe vitamin D deficiency (<10 ng/mL). Logistic analysis shows that a low serum 25(OH)D level (<20 ng/mL) was a risk factor for respiratory distress syndrome (odds ratio [OR], 4.32; P=0.010) and bronchopulmonary dysplasia (OR, 4.11; P=0.035). Conclusion: The results showed that 79.8% of preterm infants in this study had vitamin D deficiency at birth. Low vitamin D status was associated with respiratory morbidity, but the exact mechanism was unknown. Additional studies on the association between vitamin D level and neonatal morbidity are required.

• Journal of Yeungnam Medical Science
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• 제16권1호
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• pp.52-59
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• 1999

미숙아의 여러 가지 합병증 중에서도 선생아 호흡 곤란 증후군은 가장 빈도가 높고 사망률도 높은 질병이다. 이제까지 많은 저자들이 자궁내 성장기 동안에 폐 표면 활성제 생성을 증가시킴으로써 신생아 호흡 곤란 증후군을 예방할 수 있는 약제로 corticosteroid에 대한 연구를 하였으나, 산모와 태아 감염에 중요한 위협 요인이 되어 이 약의 사용이 제한적이다. 따라서 steroid의 부작용 때문에 태아의 폐를 성숙시킬 수 있는 ambroxol에 관심을 가지게 되었으며 이에 저자들은 출생 전 산모에게 투여한 ambroxol이 신생아 호흡 곤란 증후군의 발생 빈도에 어떤 영향을 미치는지와 그 부작용에 대해 알아보고자 하였다. 1996년 1월부터 1997년 12월까지 영남대학교 의과대학 부속 병원 산부인과에 입원하였던 36주 이전의 조산이 예견된 산모에게 ambroxol(Mucosolvan$^{(R)}$, Boehringer Ingelheim) 1,000mg을 5% glucose 용액에 녹여 2시간 이상 정주하며 3일에서 5일간 투여하였다. 또한 대조군에서는 생리 식염수를 정주하였다. 조기 분만의 원인이나 대상 환아 평균 재태 연령, 남녀비, 출생 체중과 1, 5분 Apgar 점수가 7점 미만인 미숙아의 수에는 양 군간의 의미있는 차이는 없었다. 그러나 대조군에서는 21명 중 13명에서 신생아 호흡 곤란 증후군이 발생하였고 ambroxol 사용군에서는 21명 중 6명에서 신생아 호흡 곤란 증후군이 발생하여 두 군간에 의미있는 차이가 있었다(p<0.05). 출생 후 산소 치료와 인공 환기를 필요로 했던 경우는 대조군에서는 각각 18, 12명이었고 ambroxol 사용군에서는 각각 9, 8명이었다. 산소치료를 요구된 시간은 ambroxol 군에서 낮았으나 인공 환기가 필요하였던 시간은 ambroxol 군에서 더 길었다. 그 외 미숙아에게 나타난 주산기 합병증의 빈도는 ambroxol 사용군과 대조군을 비교해 보면 두 군이 같거나 ambroxol 군이 더 적었다. Ambroxol 투여 전과 후의 산모의 혈액학적, 생화학적 검사에 의미있는 변화는 없었다. 그리고 ambroxol 사용군에서 산모가 호소하는 부작용으로는 경미한 오심이 3례 있었으나 구토, 두통이나 현기증, 알레르기 반응 등은 나타나지 않았다. 그러므로 본 연구에서는 미숙아 출생 전 산모에게 투여한 ambroxol은 신생아 호흡 곤란 증후군의 발생 빈도를 감소시킨다고 생각되며 이를 위해 산모에게 안전하게 사용할 수 있는 약제로 생각된다.

• 대한한방부인과학회지
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• 제20권4호
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• pp.87-100
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• 2007

Purpose: As body weight management is significantly important for women and newborn infants during pregnant and postpartum periods, there have been studies about changes of body weight during those periods. However, there are not enough studies about it which is based on the Sasang Constitution. The following is a result of the study which analyzes the changes with Sasang Constitution. Methods: This study investigated those who understand and agree this study#s purposes out of 109 primiparae who did normal delivery, who gave birth to a healthy infant and who are breastfeeding and who were treated by S postpartum care center from March 2005 to November 2005. The result of survey was collected from the questionnaires that included postpartum pattern and QSCC II. Results: There are remarkable changes of body weight and BMI based on the Sasang Constitution in pregnant and postpartum periods and they appear to be in order of Taeumin, Soyangin, Soeumin. In terms of the amount of milk according to the Constitution, there are no key changes between Soeumin and Taeumin, but there is a significance between Soyangin and Soeumin and Soyangin and Taeumin. In terms of the average body weight of infants according to the Constitution, there are no essential changes between Soeumin and Soyangin, but there is a magnitude between Soeumin and Taeumin and Soyangin and Taeumin. Conclusion: The changes of the body weight and BMI based on the Sasang Constitution appear to be the smallest for Soeumin, and the largest for Taeumin. The amount of milk from mothers did not affect on the changes and the weight of newborn infant did affect on the changes.

• Clinical and Experimental Pediatrics
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• 제61권8호
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• pp.253-257
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• 2018

Purpose: Child safety seats (CSS) are critical for the protection of children, in case of motor vehicle accidents. Although the national legislation mandates that all newborns must be placed in an appropriately installed CSS during transportation, people often do not perceive the importance of CSS and do not use it as recommended. The purpose of this survey was to understand the use of CSS for the safe transport of newborns from hospital to home. Methods: We interviewed parents of newborn infants, using a structured questionnaire, at the time of their discharge from Cheil General Hospital & Women's Health Care Center, between May 2014 and July 2014. Results: A total of 403 participants were interviewed. The rate of CSS use was only 14.9%. Overall, 76.4% of the families interviewed were not aware about the recommendations on CSS use for newborns when travelling in a car. The provision of education on using CSS significantly influenced their rate of use. Parents who were educated about mounting the CSS in a car used it more as compared with others (25.7% vs. 12.2%) (P=0.002). Furthermore, if parents had heard about the importance or necessity of CSS, they used it more than others did (19.5% vs. 10.6%, P=0.032). Conclusion: Despite the legal regulation, most parents transport their newborn infants without a CSS while traveling from hospital to their home. The rate of CSS use was influenced by parental education and their knowledge about its necessity. Education programs for parents must be reinforced to increase the CSS use.

• Neonatal Medicine
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• 제15권2호
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• pp.160-165
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• 2008

목 적: 두혈종과 두개내 혈종의 연관성을 조사하여 두혈종이 있는 신생아에 대한 뇌영상의 필요성에 대하여 알아보고자 하였다. 방 법 : 2002년 1월부터 2006년 6월까지 경북대학교 병원 신생아집중치료실에 입원한 신생아 중 두혈종이 있어 두부 전산화단층촬영술이나 자기공명영상을 시행하였던 18명을 대상으로 후향적 의무기록 분석을 시행하였다. 결 과 : 뇌영상 검사상 18명 중 6명(33.3%)에서 두개내 혈종이 관찰되었고 이 중 4례는 경막외 혈종, 2례는 경막하 혈종이었다. 두개내 혈종이 있었던 6례 중 2례는 신경학적 증상과 함몰 골절이 없었다. 두개내 혈종이 있던 신생아와 혈종이 없던 신생아 사이에 재태주령, 출생시 체중, 두위 및 두혈종의 크기 및 분만력에 유의한 차이가 없었다. 또한 신경학적 증상과 숫구멍 융기 소견의 발현 빈도에도 차이를 보이지 않았으며 황달, 빈혈의 빈도 역시 차이를 보이지 않았다. 결 론 : 두혈종이 있는 신생아에서는 두개내 혈종, 특히 경막외 혈종이 문헌에 보고된 발생 빈도보다 많이 발견되었다. 또한 신경학적 증상이나 함몰 골절이 없는 경우에도, 다른 원인이 없는 황달, 빈혈 등의 소견이 두혈종과 동반된 경우 두혈종에 합병된 두개내 혈종에 대한 임상의 관심이 요구되며 적절한 뇌영상 검사를 고려할 필요가 있을 것으로 생각된다.

• Advances in pediatric surgery
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• 제15권1호
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• pp.18-26
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• 2009

The survival of Very Low Birth Weight (VLBW) infants has been improved with the advancement of neonatal intensive care. However, the incidence of accompanying gastrointestinal complications such as necrotizing enterocolitis has also been increasing. In intestinal perforation of the newborn, enterostomy with or without intestinal resection is a common practice, but there is no clear indication when to close the enterostomy. To determine the proper timing of enterostomy closure, the medical records of 12 VLBW infants who underwent enterostomy due to intestinal perforation between Jan. 2004 and Jul. 2007 were reviewed retrospectively. Enterostomy was closed when patients were weaned from ventilator, incubator-out and gaining adequate body weight. Pre-operative distal loop contrast radiographs were obtained to confirm the distal passage and complete removal of the contrast media within 24-hours. Until patients reached oral intake, all patients received central-alimentation. The mean gestational age of patients was $26^{+2}$ wks ($24^{+1}{\sim}33^{+0}$ wks) and the mean birth weight was 827 g (490~1450 g). The mean age and the mean body weight at the time of enterostomy formation were 15days (6~38 days) and 888 g (590~1870 g). The mean body weight gain was 18 g/day (14~25 g/day) with enterostomy. Enterostomy closure was performed on the average of 90days (30~123 days) after enterostomy formation. The mean age and the mean body weight were 105 days (43~136 days) and 2487 g (2290~2970 g) at the time of enterostomy closure. The mean body weight gain was 22 g/day after enterostomy closure. Major complications were not observed. In conclusion, the growth in VLBW infants having enterostomy was possible while supporting nutrition with central-alimentation and the enterostomy can be closed safely when the patient's body weights is more than 2.3 kg.

• Clinical and Experimental Pediatrics
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• 제50권6호
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• pp.585-587
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• 2007

출생시에 나타나는 신생아 종아리신경병증은 아직 국내에는 보고된 적이 없는 매우 드문 질환으로, 대부분이 자연 치유되는 양성 경과를 취한다. 신생아의 홑신경병증은 대개 산과적 합병증이지만, 출생 전 원인도 고려하여야 한다. 저자들은 볼기태위로 인해 제왕절개술로 만기 태어난 신생아에서 발견된 발처짐을 보고한다. 생후 4일째 시행한 전기생리학적 검사에서 종아리신경의 복합근육활동전위 소실과 앞정간근과 긴엄지폄근의 탈신경전위가 관찰된 것으로 미루어 자궁 내에서 발병한 종아리신경병증으로 추정한다. 조기에 전기생리학적검사를 시행하고 추적검사를 하면 발병시기와 병리적 기전 및 예후를 판단하는데 도움이 된다.