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1.
Neonatal Medicine ; : 131-135, 2018.
Artigo em Inglês | WPRIM | ID: wpr-716552

RESUMO

Hyponatremia is defined as a plasma sodium concentration of < 135 mEq/L. It is a common electrolyte imbalance in newborns. We report the case of a term neonate with cleft lip, cleft palate, imperforate anus, normal male karyotype, and chronic hyponatremia. On the 4th day of life, he showed hyponatremia (plasma sodium concentration 130 mEq/L) with low serum osmolality (275 mOsm/kg), high urine sodium (116.7 mEq/L), and high urine osmolality (412 mOsm/kg). His thyroid and adrenal functions were normal. Despite intravenous and oral sodium supplementation and hydrocortisone treatment, hyponatremia persisted. Brain magnetic resonance imaging showed normal results. He was diagnosed as having reset osmostat, a rare subtype of the syndrome of inappropriate secretion of antidiuretic hormone characterized by a subnormal threshold for antidiuretic hormone secretion, with hypotonic hyponatremia.


Assuntos
Humanos , Recém-Nascido , Masculino , Anus Imperfurado , Encéfalo , Fenda Labial , Fissura Palatina , Hidrocortisona , Hiponatremia , Síndrome de Secreção Inadequada de HAD , Cariótipo , Imageamento por Ressonância Magnética , Concentração Osmolar , Plasma , Sódio , Glândula Tireoide
2.
Pediatric Gastroenterology, Hepatology & Nutrition ; : 49-52, 2013.
Artigo em Inglês | WPRIM | ID: wpr-22225

RESUMO

Antral web is a rare cause of gastric outlet obstruction in neonate. It is a 2-4 mm thin mucous membrane that can be found anywhere from 1 to 7 cm proximal to the pylorus. The baby was born at gestational age of 32(+1) weeks with 1,880 g as 2nd baby of dizygotic twin. After birth, the baby had constant non-bilious vomiting without feeding while he didn't show abdominal distension or discoloration. The infantogram showed distended stomach with distal small bowel gas. Upper gastrointestinal series revealed that the antrum was abruptly narrowed at 1 cm proximal to pylorus. We performed laparotomy at the 10th day after birth and excised the 2 mm-thick web circumferentially. He began milk feeding after 6 days and discharged uneventfully at postoperative 35 days with corrected age of 38(+4) weeks with body weight 2,420 g. The antral web should be considered in the case of non-bilious vomiting in neonate.


Assuntos
Humanos , Recém-Nascido , Peso Corporal , Carbamatos , Obstrução da Saída Gástrica , Idade Gestacional , Laparotomia , Leite , Mucosa , Compostos Organometálicos , Parto , Piloro , Estômago , Gêmeos Dizigóticos , Vômito
3.
Yonsei Medical Journal ; : 65-73, 2011.
Artigo em Inglês | WPRIM | ID: wpr-146144

RESUMO

PURPOSE: Granulocyte colony stimulating factor (G-CSF) has been known to increase neutrophil production and have anti-inflammatory properties, but the effect of G-CSF on pulmonary system is in controversy. We investigated whether G-CSF treatment could attenuate hyperoxia-induced lung injury, and whether this protective effect is mediated by the down-modulation of inflammatory responses in a neonatal rat model. MATERIALS AND METHODS: Newborn Sprague-Dawley rats (Orient Co., Seoul, Korea) were subjected to 14 days of hyperoxia (90% oxygen) beginning within 10 h after birth. G-CSF (20 microg/kg) was administered intraperitoneally on the fourth, fifth, and sixth postnatal days. RESULTS: This treatment significantly improved hyperoxia-induced reduction in body weight gain and lung pathology such as increased mean linear intercept, mean alveolar volume, terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling positive cells. Hyperoxia-induced activation of nicotinamide adenine dinucleotide phosphate oxidase, which is responsible for superoxide anion production, as evidenced by upregulation and membrane translocation of p67phox was significantly attenuated after G-CSF treatment, as were inflammatory responses such as increased myeloperoxidase activity and mRNA expression of transforming growth factor-beta. However, the attenuation of other proinflammatory cytokines such as tumor necrosis factor-alpha and interleukin-6 was not significant. CONCLUSION: In sum, G-CSF treatment significantly attenuated hyperoxia-induced lung injury by down-modulating the inflammatory responses in neonatal rats.


Assuntos
Animais , Feminino , Gravidez , Ratos , Animais Recém-Nascidos , Western Blotting , Fator Estimulador de Colônias de Granulócitos/uso terapêutico , Hiperóxia/complicações , Marcação In Situ das Extremidades Cortadas , Interleucina-6/genética , Pulmão/efeitos dos fármacos , Lesão Pulmonar/tratamento farmacológico , NADPH Oxidases/metabolismo , Peroxidase/metabolismo , Distribuição Aleatória , Ratos Sprague-Dawley , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Fator de Crescimento Transformador beta/genética , Fator de Necrose Tumoral alfa/genética , Aumento de Peso/efeitos dos fármacos
4.
Korean Journal of Perinatology ; : 122-128, 2011.
Artigo em Inglês | WPRIM | ID: wpr-101453

RESUMO

PURPOSE: This study investigated the effects of early enteral feeding on the morbidities of extremely low birth weight infants (ELBWI) weighing less than 1,000 g. METHODS: We conducted a retrospective review of the medical records of sixty one ELBWI who were admitted to the neonatal intensive care unit of Inje University Busan Paik Hospital from January 2007 to October 2009. ELBWI were divided into two groups; the control group included ELBWI from January 2007 to March 2008, for whom enteral feeding was started beyond 3 days and the early feeding group included ELBWI from April 2008 to October 2009, for whom enteral feeding was started within 3 days. RESULTS: Gestational age and birth weight did not differ between the two groups. In the early feeding group, start day of enteral feeding (control group vs. early feeding group; 7+/-2days vs. 2+/-1days), time to achieve full enteral feeding (68+/-6 days vs. 22+/-2 days), and the duration of parenteral nutrition (58+/-6 days vs. 22+/-2 days) were significantly shorter, and weight gain at postnatal day 28 was significantly higher than that of the control group (P<0.001). No differences were observed in the incidence of sepsis and necrotizing enterocolitis and duration of hospitalization; however, the incidence of total parenteral nutrition induced cholestasis (44% vs. 7%) and bronchopulmonary dysplsia (78% vs. 24%) was significantly lower in the early feeding group. CONCLUSION: Early enteral feeding in ELBWI shortened the time to achieve full enteral feeding, improved weight gain, and decreased the incidence of brochopulmonay dysplasia and cholestasis.


Assuntos
Humanos , Lactente , Recém-Nascido , Peso ao Nascer , Colestase , Nutrição Enteral , Enterocolite Necrosante , Idade Gestacional , Incidência , Recém-Nascido de Baixo Peso , Terapia Intensiva Neonatal , Prontuários Médicos , Nutrição Parenteral , Nutrição Parenteral Total , Estudos Retrospectivos , Sepse , Aumento de Peso
5.
Journal of the Korean Society of Neonatology ; : 148-152, 2011.
Artigo em Inglês | WPRIM | ID: wpr-147651

RESUMO

Necrotizing fasciitis is a rare, but life-threatening infection. Prompt diagnosis and early aggressive intervention is required for survival. However, there has been frequently occurred in delays of diagnosis and treatment due to its non-specific nature. Therefore, a high index of suspicion is needed to ensure timely intervention. We report a case of necrotizing fasciitis in a 7-day-old term healthy neonate.


Assuntos
Humanos , Recém-Nascido , Sacarose Alimentar , Fasciite Necrosante
6.
Korean Journal of Pediatrics ; : 358-363, 2010.
Artigo em Coreano | WPRIM | ID: wpr-155220

RESUMO

PURPOSE: The aim of this study was to determine the efficacy of Synagis(R) (palivizumab) in reducing the respiratory syncytial virus (RSV) readmission rate in very low birth weight infants (VLBWI ) and the subgroup that showed the most effective vaccination. METHODS: We enrolled 350 VLBWI who had been discharged alive from the neonatal intensive care unit of Samsung Medical Center from January 2005 to December 2007 and were followed up for at least one year. A retrospective study based on medical records was performed for a period of one year after discharge. RSV readmission rate was investigated according to BPD (bronchopulmonary dysplasia, requiring oxygen at postnatal day 28) and Synagis(R) prophylaxis. We categorized the subgroups by the severity of BPD gestational age, and birth weight and compared the RSV readmission rates between subgroups. RESULTS: Eleven VLBWI were readmitted. Synagis(R) prophylaxis resulted in a 86% reduction in the rate of readmission due to RSV infection (prophylaxis group, 0.7% and no prophylaxis group, 5.0%; P=0.02). Readmission rate in BPD patients was also reduced in the prophylaxis group (0.7% in the prophylaxis group vs. 5.2% in the no prophylaxis group, P=0.03). The readmission rate in patients without BPD was reduced in the prophylaxis group (0% in the prophylaxis group vs. 4.9% in the no prophylaxis group, P=1.00), but this was not statistically significant. CONCLUSION: Synagis(R) prophylaxis was effective at reducing RSV readmission in VLBWI. Its efficacy was verified irrespective of BPD, gestational age, or birth weight.


Assuntos
Humanos , Lactente , Recém-Nascido , Anticorpos Monoclonais Humanizados , Peso ao Nascer , Idade Gestacional , Recém-Nascido de muito Baixo Peso , Terapia Intensiva Neonatal , Prontuários Médicos , Oxigênio , Vírus Sinciciais Respiratórios , Estudos Retrospectivos , Vacinação , Palivizumab
7.
Korean Journal of Pediatrics ; : 167-172, 2010.
Artigo em Coreano | WPRIM | ID: wpr-125481

RESUMO

PURPOSE: With improved survival of extremely low birth weight infants (ELBWI), there is an increase in the incidence of necrotizing enterocolitis (NEC) requiring laparotomy, and the risk of morbidity and mortality in these ELBWI is increased. Thus, we determined the prognostic factors in ELBWI who underwent laparotomy for NEC. METHODS: We retrospectively reviewed the medical records of 35 ELBWI who underwent laparotomy for NEC from January 2001 to December 2008 at Samsung Medical Center. RESULTS: Of 480 ELBWI, 35 required laparotomy for NEC; the mortality rate was 20% (Alive group n=28, Dead group n=7). The values of preoperative score for neonatal acute physiology-II (P=0.022) and fraction of inspired oxygen (P<0.001) were significantly higher in the dead group and values of base excess (P=0.004) were significantly lower in the dead group. Values of preoperative heart rate, respiration rate, mean blood pressure, pH, CO2, and potassium ion were not significantly different between the study groups. Intraoperative fluid volume was significantly higher in the alive group than in the dead group (P=0.045). Postoperative infusion rate was significantly lower in the alive group than in the dead group (P=0.022). CONCLUSION: Good preoperative condition, more intraoperative fluid infusion, and stable postoperative hemodynamic condition were factors associated with favorable prognosis of laparotomy for NEC in ELBWI.


Assuntos
Humanos , Lactente , Recém-Nascido , Pressão Sanguínea , Enterocolite Necrosante , Frequência Cardíaca , Hemodinâmica , Concentração de Íons de Hidrogênio , Incidência , Recém-Nascido de Baixo Peso , Laparotomia , Prontuários Médicos , Oxigênio , Potássio , Prognóstico , Taxa Respiratória , Estudos Retrospectivos
8.
Korean Journal of Pediatrics ; : 1228-1233, 2009.
Artigo em Coreano | WPRIM | ID: wpr-143537

RESUMO

PURPOSE: This study aimed to evaluate whether a shorter time from the arrival at a hospital to delivery is related to the occurrence of cerebral palsy in premature infants of less than 34 weeks of gestational age. METHODS: We studied 142 newborns of less than 34 weeks of gestational age. The time from the arrival at the hospital to delivery was measured. The correlation between the time required for delivery and the occurrence of cerebral palsy was elucidated by diagnosing cerebral palsy in neonates using the Korean Infant Development Screening Test and neurological examination. RESULTS: Preliminary result suggested that a shorter time from hospital arrival to delivery was related to a lower development score for gross motor activity and to a higher frequency of cerebral palsy occurrence. Moreover, it was responsible for a tendency of obtaining lower Apgar scores at 1 and 5 minutes. The shorter delivery time was associated with a higher probability of respiratory distress syndrome (RDS) occurrence when the length of delivery time was less than 6 hours and there was a higher probability of a shorter gestation period. However, the multifactor analysis revealed that there was little impact of delivery time on the occurrence of cerebral palsy. Conclusions: The length of hospital arrival time to delivery did not significantly influence the occurrence of cerebral palsy in premature infants of less than 34 weeks of gestational age.


Assuntos
Criança , Humanos , Recém-Nascido , Gravidez , Paralisia Cerebral , Desenvolvimento Infantil , Idade Gestacional , Recém-Nascido Prematuro , Programas de Rastreamento , Atividade Motora , Exame Neurológico
9.
Korean Journal of Pediatrics ; : 1228-1233, 2009.
Artigo em Coreano | WPRIM | ID: wpr-143528

RESUMO

PURPOSE: This study aimed to evaluate whether a shorter time from the arrival at a hospital to delivery is related to the occurrence of cerebral palsy in premature infants of less than 34 weeks of gestational age. METHODS: We studied 142 newborns of less than 34 weeks of gestational age. The time from the arrival at the hospital to delivery was measured. The correlation between the time required for delivery and the occurrence of cerebral palsy was elucidated by diagnosing cerebral palsy in neonates using the Korean Infant Development Screening Test and neurological examination. RESULTS: Preliminary result suggested that a shorter time from hospital arrival to delivery was related to a lower development score for gross motor activity and to a higher frequency of cerebral palsy occurrence. Moreover, it was responsible for a tendency of obtaining lower Apgar scores at 1 and 5 minutes. The shorter delivery time was associated with a higher probability of respiratory distress syndrome (RDS) occurrence when the length of delivery time was less than 6 hours and there was a higher probability of a shorter gestation period. However, the multifactor analysis revealed that there was little impact of delivery time on the occurrence of cerebral palsy. Conclusions: The length of hospital arrival time to delivery did not significantly influence the occurrence of cerebral palsy in premature infants of less than 34 weeks of gestational age.


Assuntos
Criança , Humanos , Recém-Nascido , Gravidez , Paralisia Cerebral , Desenvolvimento Infantil , Idade Gestacional , Recém-Nascido Prematuro , Programas de Rastreamento , Atividade Motora , Exame Neurológico
10.
Journal of the Korean Society of Neonatology ; : 163-171, 2009.
Artigo em Coreano | WPRIM | ID: wpr-76831

RESUMO

PURPOSE: This study was conducted to determine the incidence, causative pathogens, risk factors and mortality for early onset sepsis in the first three days in very low birth weight infants. METHODS: The medical records of 1,124 very low birth weight infants admitted to the neonatal intensive care unit of Samsung Medical Center between November 1994 and December 2008 were retrospectively reviewed. The incidence, causative pathogens, risk factors, and mortality for early onset sepsis in the first 3 days of life in very low birth weight infants were evaluated. RESULTS: Early onset sepsis, as confirmed by positive blood cultures, was present in 17 of 1,124 infants (1.5%). Sixty-four percent of the isolated pathogens were gram-positive bacteria and 35% of the isolated pathogens were gram-negative bacteria. The dominant pathogens of early onset sepsis included Staphylococcus aureus (23.5%), Esherichia coli (23.5%), and Enterococcus (17.6%). Vaginal delivery (adjusted odds ratio [OR], 3.7; 95% confidence interval [CI], 1.3-10.3; P=0.01) was associated with early onset sepsis. The overall mortality (adjusted hazard ratio, 3.0; 95% CI, 1.4-6.5; adjusted P=0.0039) and mortality within 72 hours of life (adjusted hazard ratio, 6.5; 95% CI, 2.2-18.9; adjusted P=0.0005) of infants with early onset sepsis were higher than that of uninfected infants. CONCLUSION: Early onset sepsis remains an uncommon, but potentially lethal problem among very low birth weight infants. Knowledge of the likely causative organisms and risk factors for early onset sepsis can aid in instituting prompt and appropriate therapy, in order to minimize mortality.


Assuntos
Humanos , Lactente , Recém-Nascido , Enterococcus , Bactérias Gram-Negativas , Bactérias Gram-Positivas , Incidência , Recém-Nascido de muito Baixo Peso , Terapia Intensiva Neonatal , Prontuários Médicos , Razão de Chances , Estudos Retrospectivos , Fatores de Risco , Sepse , Staphylococcus aureus
11.
Yonsei Medical Journal ; : 619-626, 2007.
Artigo em Inglês | WPRIM | ID: wpr-96536

RESUMO

PURPOSE: Amphotericin B is considered the treatment of choice for systemic candidiasis, but adverse effects may limit its use. An alternative option for the treatment of candidiasis includes lipid preparations of amphotericin B. This study investigated the safety and efficacy of AmBisome(R), a lipid formulation of amphotericin B containing liposomal structures, for the treatment of systemic candidiasis in very low birth weight infants (VLBWI). MATERIALS AMD METHODS: Data from 26 VLBWI treated with AmBisome(R) in the study group (AmBisome group) from October 2003 to July 2006 were compared with data from 20 VLBWI treated with amphotericin B as a historical control (Amphotericin group). This study was a prospective, historical control, multi-center trial. RESULTS: Candida spp. was isolated in 73% (19/26) of the cases for the AmBisome group and 90% (18/20) of the cases for the Amphotericin group. The fungal eradication rate and the time to eradication was 84% (16/19) and 9+/-8 days in the AmBisome group, and 89% (16/18) and 10+/-9 days in the Amphotericin group, respectively (p=0.680 vs p=0.712). The major adverse effects were lower in the AmBisome group (renal toxicity, 21% vs 55%, p=0.029; hepatotoxity, 25% vs 65%, p=0.014, AmBisome group vs Amphotericin group, respectively). There was no significant difference in mortality attributed to systemic candidiasis (12% in the AmBisome group, 10% in the Amphotericin group, p=0.868). CONCLUSION: AmBisome(R) is effective and safe for treating systemic fungal infections in VLBWI.


Assuntos
Feminino , Humanos , Recém-Nascido , Masculino , Anfotericina B/efeitos adversos , Candidíase/tratamento farmacológico , Recém-Nascido de muito Baixo Peso
12.
Journal of Korean Medical Science ; : 1042-1047, 2007.
Artigo em Inglês | WPRIM | ID: wpr-92065

RESUMO

This study was done to determine whether recombinant human erythropoietin (rhEPO) treatment could attenuate hyperoxia-induced lung injury, and if so, whether this protective effect is mediated by the down-modulation of inflammation in neonatal rats. Newborn Sprague Dawley rat pups were subjected to 14 days of hyperoxia (>95% oxygen) within 10 hr after birth. Treatment with rhEPO significantly attenuated the mortality and reduced body weight gain caused by hyperoxia. With rhEPO treatment, given 3 unit/gm intraperitoneally at 4th, 5th, and 6th postnatal day, hyperoxia- induced alterations in lung pathology such as decreased radial alveolar count, increased mean linear intercept, and fibrosis were significantly improved, and the inflammatory changes such as myeloperoxidase activity and tumor necrosis factor-alpha expression were also significantly attenuated. In summary, rhEPO treatment significantly attenuated hyperoxia-induced lung injury by down-modulating the inflammatory responses in neonatal rats.


Assuntos
Animais , Feminino , Ratos , Animais Recém-Nascidos , Citoproteção , Modelos Animais de Doenças , Eritropoetina/uso terapêutico , Hiperóxia/patologia , Inflamação/tratamento farmacológico , Pulmão/efeitos dos fármacos , Peroxidase/metabolismo , Ratos Sprague-Dawley , Taxa de Sobrevida , Fator de Necrose Tumoral alfa/genética
13.
Journal of Korean Medical Science ; : 490-494, 2006.
Artigo em Inglês | WPRIM | ID: wpr-47127

RESUMO

We have previously shown that cycloheximide significantly inhibited apoptosis, and reduced ensuing cerebral infarction in a newborn rat model of cerebral hypoxiaischemia. This study was performed to determine the therapeutic window for cycloheximide therapy. Seven day-old newborn rat pups were subjected to 100 min of 8% oxygen following a unilateral carotid artery ligation, and cycloheximide was given at 0, 6, 12 and 24 hr after hypoxia-ischemia (HI). Apoptosis or necrosis was identified by performing flow cytometry with a combination of fluorescinated annexin V and propidium iodide, and the extent of cerebral infarction was evaluated with triphenyl tetrazolium chloride (TTC) at 48 hr and 72 hr after HI, respectively. With cycloheximide treatment at 0 hr after HI, both apoptotic and necrotic cells by flow cytometry were significantly reduced, only necrotic cells were significantly reduced at 6 and 12 hr, and no protective effect was seen if administration was delayed until 24 hr after HI compared to the HI control group. Infarct volume, measured by TTC, was significantly reduced by 92% and 61% when cycloheximide was given at 0 or 6 hr after HI respectively; however, there was an insignificant trend in infarct reduction if cycloheximide was administered 12 hr after HI, and no protective effect was observed when administration was delayed until 24 hr after HI. In summary, cycloheximide was neuroprotective when given within 6 hr after HI in the developing newborn rat brain.


Assuntos
Ratos , Humanos , Animais , Ratos Sprague-Dawley , Inibidores da Síntese de Proteínas/uso terapêutico , Oxigênio/metabolismo , Fármacos Neuroprotetores/uso terapêutico , Necrose , Hipóxia-Isquemia Encefálica/tratamento farmacológico , Hipóxia Encefálica , Citometria de Fluxo , Cicloeximida/uso terapêutico , Isquemia Encefálica , Apoptose , Animais Recém-Nascidos
14.
Journal of the Korean Society of Neonatology ; : 17-23, 2006.
Artigo em Coreano | WPRIM | ID: wpr-102590

RESUMO

PURPOSE: The rehospitalization rate after discharge from neonatal intensive care unit (NICU) has been used as an indicator of morbidity of very low birth weight infants (VLBWI). We investigated the rate and the causes of rehospitalization of VLBWI who were discharged from our NICU, and analyzed the risk factors of their rehospitalization caused by respiratory illness. METHODS: 276 VLBWI who was discharged from NICU of Samsung Medical Center from January 2001 to December 2003, and followed up at least for 1 year were enrolled. Our study was based on the retrospective review of the medical records. RESULTS: The rehospitalization rate of VLBWI was 28%. The number of VLBWI rehospitalized was 106 in total. Causes of rehospitalization were respiratory illness (56%), genitourinary problem (20%), infectious problem (9%), and gastro-intestinal problem (7%) in order of frequency. 79% of rehospitalization had occurred within six months after discharge from NICU. In respiratory group, four patients required mechanical ventilation, one patient had expired, and the rate of respiratory syncytial virus (RSV) infection was 32%. The respiratory group had been younger in the gestational age, longer in the duration of hospitalizaton and the ventilator care period. And the respiratory group had been higher in the ratio of bronchopulmonary dysplasia than the control group. CONCLUSION: For reduced rehospitalization caused by respiratory illness of VLBWI, we suggest some programs that will decrease the incidence of bronchopulmonary dysplasia. This program will enable inpatients to make early discharge from NICU, whereas efforts for effective aftercare following the discharge from NICU are required.


Assuntos
Humanos , Lactente , Recém-Nascido , Assistência ao Convalescente , Displasia Broncopulmonar , Idade Gestacional , Incidência , Recém-Nascido de muito Baixo Peso , Pacientes Internados , Terapia Intensiva Neonatal , Prontuários Médicos , Respiração Artificial , Vírus Sinciciais Respiratórios , Estudos Retrospectivos , Fatores de Risco , Ventiladores Mecânicos
15.
Journal of Korean Medical Science ; : 337-341, 2006.
Artigo em Inglês | WPRIM | ID: wpr-12252

RESUMO

This study was done to determine the neuroprotective effect of cycloheximide on neonatal hypoxic-ischemic brain injury. Seven day-old newborn rat pups were subjected to 90 min of 8% oxygen following a unilateral carotid artery ligation. The extent of cerebral infarction was evaluated at 1 and 4 week of recovery. Apoptosis was identified by performing terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) staining and flow cytometry with a combination of fluoresceinated annexin V and propidium iodide. Brain infarction area was significantly increased at 4 week compared to 1 week after hypoxia-ischemia in the control group. With cycloheximide treatment, the number of TUNEL positive cells in the ipsilateral cerebral cortex at 48 hr and peri-infarct area at 1 and 4 week of recovery was significantly reduced, both apoptotic and necrotic cells by flow cytometry 48 hr after the injury were significantly reduced, and the extent of cerebral infarction at 1 and 4 week of recovery was also significantly attenuated compared to the hypoxia-ischemia control group. In summary, our data suggest that apoptosis plays an important role in the development of delayed infarction, and inhibition of apoptosis with cycloheximide significantly reduces the ensuing cerebral infarction in a newborn rat pup model of cerebral hypoxia-ischemia.


Assuntos
Ratos , Animais , Fatores de Tempo , Ratos Sprague-Dawley , Propídio , Fármacos Neuroprotetores/farmacologia , Marcação In Situ das Extremidades Cortadas , Hipóxia-Isquemia Encefálica/tratamento farmacológico , Cicloeximida/farmacologia , Infarto Encefálico/patologia , Apoptose/efeitos dos fármacos , Anexina A5/metabolismo , Animais Recém-Nascidos
16.
Korean Journal of Pediatrics ; : 959-965, 2006.
Artigo em Coreano | WPRIM | ID: wpr-181336

RESUMO

PURPOSE: The purpose of this study was to investigate the effect of prophylactic indomethacin on reduction of patent ductus arteriosus(PDA) and intraventricular hemorrhage(IVH) in extremely low birth weight infants(ELBWI). METHODS: Retrospective review of 84 ELBWI who were admitted to our neonatal intensive care unit from June 2004 to April 2006 was performed. Patients were divided into prophylactic group(n=28) and control group(n=56), where prophylactic indomethacin were given within 6 hours after birth. Clinical outcomes were compared between these groups. RESULTS: There were no significant differences in gestational age, birth weight, incidence of hemodynamically significant PDA and severe IVH, and mortality between prophylactic group and control group. However, there were more frequent indications for therapeutic indomethacin, higher incidence of intestinal perforation, and longer time to achieve full enteral feeding in prophylactic group than control group. The incidence of other adverse events attributed to indomethacin prophylaxis did not differ between two groups. CONCLUSIONS: Prophylactic indomethacin may not prevent hemodynamically significant PDA and severe IVH in ELBWI. On the contrary, it may be associated with increased risk of adverse events. Further efforts should be investigated to decrease PDA and severe IVH in ELBWI.


Assuntos
Humanos , Lactente , Recém-Nascido , Peso ao Nascer , Permeabilidade do Canal Arterial , Nutrição Enteral , Idade Gestacional , Incidência , Indometacina , Recém-Nascido de Baixo Peso , Terapia Intensiva Neonatal , Perfuração Intestinal , Mortalidade , Parto , Estudos Retrospectivos
17.
Korean Journal of Pediatrics ; : 939-945, 2005.
Artigo em Coreano | WPRIM | ID: wpr-202883

RESUMO

PURPOSE: The purpose of this study was to report outcome of fetal infants with birth weight below 500 g known as lower limit of viability and to evaluate treatment characteristics and short-term morbidity of their survivors. METHODS: We retrospectively analyzed the medical records of all fetal infants with birth weight below 500 g who were delivered at Samsung Medical Center (SMC), or transferred to neonatal intensive care unit (NICU) of SMC within 24 hrs after birth between 1994 and 2004. Data for all interventions and morbidity outcome were analyzed for infants who were admitted to the NICU and were compared between NICU survivors and deaths. RESULTS: Among 53 infants with birth weights of 400 to 499 g who were born in SMC during the study period, 8 (15.1%) infants were admitted to the NICU and one was transferred to NICU from other hospital. Overall, 4 (44%) of 9 survived and were discharged from the NICU. The smallest infant who survived weighed 439 grams. The least gestational age was 23 (+3) among the survivors. Compared with NICU deaths, NICU survivors had larger gestational age (24 (+2) +/-1 (+3) vs. 25 (+4) +/-2 (+3) ) and birth weight (424+/-17 vs. 453+/-19) (P< 0.05). Median survival duration of NICU deaths was 15 days. None of NICU survivors had severe IVH, but 3 (75%) had laser therapy for retinopathy of prematurity and bronchopulmonary dysplasia, respectively. CONCLUSION: Fetal infants with birth weight below 500 g known as lower limit of viability survived successfully. Study for their long-term follow-up will be needed to define our limit of viability and indication for their active resuscitation.


Assuntos
Humanos , Lactente , Recém-Nascido , Peso ao Nascer , Displasia Broncopulmonar , Seguimentos , Idade Gestacional , Terapia Intensiva Neonatal , Terapia a Laser , Prontuários Médicos , Parto , Ressuscitação , Retinopatia da Prematuridade , Estudos Retrospectivos , Taxa de Sobrevida , Sobreviventes
18.
Korean Journal of Pediatrics ; : 1324-1329, 2005.
Artigo em Inglês | WPRIM | ID: wpr-35663

RESUMO

PURPOSE: The aim of this study was to evaluate recent improvements in the survival rate of extremely low birth weight (ELBW) infants and to identify perinatal and management factors that are associated with improved survival. METHODS: Two groups of ELBW infants who were admitted to our neonatal intensive care unit (NICU) during two distinct eras: November 1994-December 1999 (Period 1: n=100) and January 2000-April 2004 (Period 2: n=166) were retrospectively reviewed. RESULTS: Despite the younger gestational age and smaller birth weight of the ELBW infants in period 2, not only did their survival rate increased to 75 percent from 60 percent in period 1, but their incidence of morbidities such as bronchopulmonary dysplasia, confimed sepsis and intraventricular hemorrhage (> or =Grade III) also declined. Factors significantly associated with improved survival included the use of antenatal steroids, a longer duration of nasal continuous positive airway pressure and the absence of intraventricular hemorrhage (> or =Grade III). CONCLUSION: We believe that optimized clinical practice, that emphasized less invasive care, contributed to the recent improvements in the survival rate of ELBW infants.


Assuntos
Lactente , Masculino , Feminino , Recém-Nascido , Humanos , Incidência
19.
Journal of the Korean Society of Neonatology ; : 144-151, 2004.
Artigo em Coreano | WPRIM | ID: wpr-111820

RESUMO

PURPOSE: In twin pregnancies with single fetal death after 20th weeks, the surviving co-twin has an ischemic change of multiple organ, neurological abnormality, high perinatal morbidity and mortality. The purpose of this study was to evaluate the clinical status and the outcome of live co-twins and to compare them with the normal viable twins. METHODS: A retrospective analysis by evaluating medical records was done for those twin pregnancies with single fetal demise after 20 weeks (n=20) during January 2000 to June 2003 at Samsung Cheil Hospital. Normal viable twins (n=847) born during the same study period were used as a control group. RESULTS: 867 of 31, 219 live deliveries were documented as twin births. 20 twin pregnancies were complicated by the death of one fetus after 20th weeks. In these 20 twin pregnancies, two surviving co-twins died after birth. There was an increased incidence of monochorionic placenta, prematurity, VLBW (very low birth weight), admission rate in neonate and mortality among the surviving co-twins as compared to the normal viable twins (P<0.001). However, there was no significant difference between surviving co- twins with dichorionic placenta and normal viable twins. CONCLUSION: The perinatal morbidity and mortality of surviving twins were higher than the normal twins in the monochorionic twins whose co-twin's death occurred after 20th weeks suggests that chorionicity of placenta might be an important factor to predict the outcome of surviving co-twin's.


Assuntos
Humanos , Recém-Nascido , Córion , Morte Fetal , Feto , Incidência , Prontuários Médicos , Mortalidade , Parto , Placenta , Gravidez de Gêmeos , Estudos Retrospectivos
20.
Korean Journal of Perinatology ; : 409-415, 2003.
Artigo em Coreano | WPRIM | ID: wpr-29754

RESUMO

OBJECTIVE: In this study, we tested the correlation between the body temperature measured by non-contact temporal artery thermometer which has been developed recently and the rectal temperature using conventional glass mercury thermometer, also evaluate the reliability of non-contact temporal artery thermometer by comparing with other methods of temperature measurement. METHODS: One-hundred-and-seventeen newborn infants who were born at Samsung Cheil Hospital were included in this study. Tympanic and forehead temperatures were taken three times each with tympanic thermometer and non-contact infrared temporal artery thermometer respectively on a newborn infant by two authors. we also measured the rectal and axillary temperatures by using a mercury-in-glass thermometer. RESULTS: The normal body temperature measured by non-contact temporal artery thermometer was 36.2 +/- 0.22degrees C, and rectal, axillary and tympanic temperatures were 36.8 +/- 0.30degrees C, 36.7 +/- 0.30 and 36.1 +/- 0.27degrees C, respectively. There was a significant correlation between temperatures measured by non-contact temporal artery thermometer and rectal temperature (p<0.01, r=0.891). The differences between repeated measurements by non-contact temporal artery thermometer were significantly less than those by tympanic thermometer (p<0.01). CONCLUSION: Forehead temperature measured by non-contact temporal artery thermometer is correlated with rectal temperature and has good reproducibility. It can be used to measure body temperature in newborn infants.


Assuntos
Humanos , Recém-Nascido , Temperatura Corporal , Testa , Vidro , Artérias Temporais , Termômetros
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