미숙아와 만삭아에서의 비후성 유문 협착증의 임상적 차이

이석구,김성환,이우용,김현학,Lee, Suk-Koo,Kim, Seong-Hwan,Lee, Woo-Yong,Kim, Hyun-Hahk 대한소아외과학회 1998 소아외과 Vol.4 No.1

Infantile hypertrophic pyloric stenosis(IHPS) is common in full-term babies, and relatively rare in prematures. The diagnosis of IHPS in premature infants may be obscured because of the lack of classic symptoms and signs and the absence of the standard criteria for ultrasonic diagnosis. The purpose of this study is to discover the clinical differences between premature and full-term infants with pyloric stenosis, and determine the appropriate diagnostic methods for early diagnosis in premature infants. The clinical records of 52 IHPS patients who had been operated upon from October, 1994 to April, 1997 were reviewed. The incidence of IHPS in premature infants was 25 %. The onset of symptom was 4.7 weeks of age in premature, and 2.9 weeks in full-term babies. Diagnosis was established by typical symptoms. signs. and diagnostic imaging studies. In two premature infants, diagnosis was confirmed by upper gastrointestinal(GI) series, because ultrasonography did not meet the diagnostic criteria. Two premature infants initially diagnosed as gastroesophageal reflux by esophagography. were found to have IHPS by upper GI series. For the diagnosis of IHPS, a new set of criteria for premature babies has to be developed.

미숙아로 태어난 첫 자녀를 둔 아버지의 역할

정서혜(Chung, Seo Hye),윤신애(Yoon, Shin Ae),정승은(Chung, Seung Eun) 한국보건기초의학회 2021 한국보건기초의학회지 Vol.14 No.2

To understand the role experiences of fathers with premature infants is needed as the father’s roles are changing in our society. The purpose of this study is to explore intrinsic theme and meaning of the role experiences of fathers whose first child was born premature. This phenomenological research was processed in the form of in-depth interviews with the fathers until the data is saturated. The analysis of collected data used 7 steps according to Colaizzi (1978). The results were as follows: The role experiences of fathers who first child was born premature infant displayed three themes: ‘the emotions which began after becoming the father of a premature infant’, ‘taking responsibility in caring the infant and the wife’ and ‘leading the family as the center of a family with positive mind set.’ This study was focused on the role experiences of the fathers who first child was born premature using phenomenological analysis method and will provide basic data in developing nursing intervention for effective role performance of the fathers with premature infant.

신생아 중환자실에서 감각운동자극이 저체중 미숙아의 발달에 미치는 효과

이은주 ( Eun Ju Lee ),박소현 ( So Hyun Pack ),오태영 ( Tae Young Oh ),박래준 ( Tae Jun Pack ) 대한물리의학회 2010 대한물리의학회지 Vol.5 No.3

Purpose:The purpose of this study was to investigate the effect of sensorimotor stimulation on the development of infant with low birth weight premature Methods:Ten infants with low birth weight premature and ten normal infants participated in this study. We carried out test TIMP(Test of Infants Motor Performance) according pre intervention, post 3 weeks, PCA 40 week and normal infants. The intervention of sensorimotor stimulation applied to infants with low birth weight premature four times a week and fifteen minutes a once time. There was no intervention for normal infants The collected dada were analyzed by ANOVA using by SPSS/PC 17.0 ver. program. Results:There was significant difference among three differential test period to improved developmental value in infants with low birth weight premature. According over time, numbers of observed items presented significant difference among test period, and elicited total score and total raw score was significant value(p=.00). There was no significant value that means sensorimotor stimulation affected on development of infants with low birth weight premature. Conclusions:In conclusion, sensorimotor stimulation had affects on the development of infants with low birth weight premature.

청소년 내담자의 조기종결 관련 변인

김현미,권현용 미래를 여는 청소년학회 2009 미래청소년학회지 Vol.6 No.2

본 연구는 청소년 상담에서 내담자의 조기종결에 영향을 미치는 변인을 규명하기 위하여 청소년 내담자 86명(조기종결 내담자 47명, 상담지속 내담자 39명))을 대상으로 상담자, 내담자, 상담과정 변인이 상담의 조기종결에 어떠한 영향을 미치는지 검증하였다. 수집된 자료는 차이검증, 위계적선형모형분석(HLM)을 실시하였다. 본 연구의 주요결과는 다음과 같다. 첫째, 상담의 조기종결 및 지속에 영향을 미치는 상담자 변인으로 상담자의 학력과 상담경력이 확인되었다. 둘째, 내담자의 상담동기와 상담기대는 상담의 조기종결 및 지속에 영향을 미치는 중요한 요인으로, 나타났다. 셋째, 상담을 지속하는 내담자의 자아존중감과 상담동기는 작업동맹에 영향을 미치고, 상담회기평가와 상담자평가도 작업동맹에 영향을 미치는 것으로 나타났다. 청소년 상담의 실제에서 상담자는 전문적인 상담능력을 배양하기 위한 지속적인 노력을 해나감과 동시에 상담 초기에 내담자의 상담동기를 높이기 위한 다양한 전략을 개발하고, 상담과 상담자에 대한 긍정적인 기대를 가질 수 있도록 하기 위해 개입함으로써 조기종결을 예방할 수 있을 것이다.. The purpose of this study is to investigate psychological characteristics of premature-terminated adolescent clients, counselor and counseling process variables in adolescent individual counseling. Clients who participated in this study were selected the total sample(N=86) of Youth Counseling Center. A sample of 47 premature terminated clients was compared with a sample of 39 continued clients. The results of the study are as follows: First, Counselor's career and professional degree variables was significantly associated with premature termination. Second, Adolescent client's self-rating of counseling of motivation and expectancies for counseling showed significant relationships between premature termination and continue counseling. Third, Clients rating of counseling process variables was significantly associated with premature termination. These results show that the relationship between the counselors and the clients was well established, and the relationship with counselor is a important factor to prematured or continued counseling.

우리나라 모자보건 정책사업 분석 - 미숙아와 저체중출생아를 중심으로 -

이혜정,이광옥,신미경 한국아동간호학회 2009 Child Health Nursing Research Vol.15 No.1

In recent years, reductions in infant mortality have mainly been accomplished by improving the survival of premature and low birth weight infants, however premature infants still remain at great risk. The purpose of this study was to review the maternal child health service related to premature infants and to provide a future direction for improving maternal child health (MCH) in Korea. We reviewed two MCH services which are directly related to premature infants: 1) a registry and financial support program for families with a premature infant, and 2) financial support to build neonatal intensive care units in rural public hospitals. Suggestions are made for the development of a national vital signs record system to identify high risk infants and to monitor the trends in infant mortality due to prematurity. Prevention efforts and preconception care for childbearing women is also an important strategy to reduce the rate of preterm births. Finally, we need consider long-term follow-up plans for premature infants for a successful transit to the special education system. Developing MCH policy related to premature infants that decreases the occurrence of premature may decrease infant mortality, and also improve maternal and child health services.

미숙아에서의 갑상선기능 장애

홍기배,박지윤,장영표,유지숙 대한소아청소년과학회 2009 Clinical and Experimental Pediatrics (CEP) Vol.52 No.9

Purpose:Thyroid hormone is essential for development of the brain in early life. Thyroid dysfunction is more common in the first 2-4 postnatal weeks of life in premature infants than in term infants. This study aimed to identify the prevalence and clinical course of thyroid dysfunction in prematurity. Methods:Premature infants admitted to and given neonatal screenings at Dankook University Hospital between April 1999 and March 2008 were included in this study. We retrospectively reviewed medical records and categorized subjects into six groups: normal, hypothyroidism, hyperthyrotropinemia, hypothyroxinemia, delayed onset of hypothyroidism, and delayed onset of hyperthyrotropinemia. Results:Among 599 subjects, 136 (23%) had initially abnormal thyroid function test (TFT); transient hypothyroxinemia was the most frequent condition (118, 20%). In addition, 8 (17%) of 46 subjects with initially normal TFT levels showed delayed onset of hyperthyrotropinemia with or without low free thyroxine (fT4). Thyroxine was prescribed for 10 patients (1.7%) due to low fT4 levels but was discontinued in 9 patients during follow-up. Thyroid scan confirmed ectopic thyroid in one patient. Conclusion:Thyroid dysfunction was frequently seen in premature infants, but most of the conditions were transient. In addition, some infants showed delayed TSH elevation on routine follow-up. Therefore, a recheck of the thyroid function of premature infants at 3-4 weeks is recommended, even if normal thyroid function is initially seen, especially in prematurity of less than 33 weeks of gestational age or birth weight of less than 2,500 grams. 목적:갑상선호르몬은 소아에서 뇌의 발달에 매우 중요한 호르몬이므로 갑상선기능이상에 대한 조기진단 및 치료는 중요하다. 미숙아에서는 이러한 갑상선의 기능이상이 만삭아에 비해 많이 발생한다. 본 연구의 목적은 미숙아에서의 갑상선기능이상의 빈도, 임상양상 및 경과 등을 알아보고자 하였다. 방법:1999년 4월에서 2008년 8월까지 단국대학교병원 신생아중환자실에 입원한 37주 미만의 미숙아 802명 중 초기 갑상선기능검사의 결과를 확인 할 수 있었던 599명의 환아를 대상으로 의무기록을 통해 후향적으로 연구하였다. 1, 2차 검사의 결과에 따라 정상군, 일차성 갑상선기능저하증군, 고갑상선자극호르몬혈증군, 저티록신혈증군, 지연된 일차성 갑상선기능저하증군, 지연된 고갑상선자극호르몬혈증군의 6군으로 나누었다. 각 군 간의 임상특징, APGAR 점수 및 여러 위험인자들, 검사결과 등을 비교하였고 갑상선기능이상의 빈도 및 경과, 위험요소 등을 분석하였다. 결 과:599명중 1차 갑상선기능이상을 보인 환아는 136명(23%)이었고 저티록신혈증이 20%로 가장 많았다. 처음 NST는 정상이었으나 생후 3-4주경 2차 검사를 시행한 46명 중 8명(17%)에서 갑상상선기능이상을 보였다. 갑상선호르몬은 총 10명에서 투여되었고, 9명에서는 호전을 보여 중단이 가능하였다. 1명은 이소성 갑상선으로 지속적인 복용이 필요한 상태이다. 결 론:미숙아에서 갑상선기능 이상은 매우 흔하였고, 대부분 일시적이었다. 때로는 초기 검사에서 정상이었다가 뒤늦은 이상을 보일 수 있으므로 미숙아의 경우 특히 33주 미만 또는 2,500 g 미만의 경우 처음 검사가 정상이더라도 3-4주경에 재검하는 것은 필요하다고 생각한다.

한국 폐경 여성의 조기/이른 폐경 시기에 따른 삶의 질의 차이

소은선 인문사회 21 2022 인문사회 21 Vol.13 No.1

The Differences of Quality of Life According to Premature/EarlyMenopausal Timing Among Korean Menopausal WomenEunsun So Abstract: This study was conducted to identify the differences of Quality Of Life (QOL) according to menopausal timing of premature/early/normal menopause among Korean menopausal women. This study utilized the 2014-2019 Korea National Health Nutrition Survey data with the total of 4,266 women aged 20-65 years who answered “have presnetly menopaused” and it’s age of menopause, These subjects were grouped those who menopaused -39, 40-44, and 45-54 years old into premature, early, and normal menopause, and to analyze the differences of QOL according to these groups, used complex sample logistic regression analysis. As a result, the premature, early, and normal menopause of the study subjects comprised 1.2%, 5.0%, and 93.8% respectively. Statistical differences of QOL according to menopausal timing were not shown. However, statistical differences of QOL according to a period after menopause were shown; whereas QOL of -5 years after menopause were not significantly different from the comparison with 16- years after menopuase, QOLs of 6-10 years and 11-15 years after menopause showed significantly better (β=0.02, 0.03, p=.048, .005 respectively). Intervention is necessary focusing on the period after menopause rather than menopausal timing to improve QOL among menopausal women. Key Words: Quality Of Life, Premature Menopause, Postmenopause, Korea, Women 한국 폐경 여성의 조기/이른 폐경 시기에 따른 삶의 질의 차이소 은 선** 요약: 본 연구는 한국 폐경 여성의 조기/이른/정상 폐경인 폐경시기에 따른 삶의 질의 차이를 규명하고자 시행되었다. 본 연구는 2014-2019년 국민건강영양조사 자료를 활용하여 현재 자연폐경이면서 폐경 연령에 응답한 20~65세 여성 중 폐경 연령이 54세 이전에 온 총 4,266명을 대상으로 하였다. 또한, 이들 대상자들의 폐경 연령에 따라 -39, 40-44, 45-54세에 폐경한 조기폐경, 이른 폐경, 정상 폐경으로 군을 구분하였고, 이들 군별 삶의 질과의 차이를 분석하는데 복합표본 선형 회귀분석을 사용하였다. 연구결과, 연구대상자는 자연폐경 시기에 따라 조기 폐경, 이른 폐경, 정상 폐경이 각각 1.2%, 5.0%, 93.8%였다. 폐경 시기에 따라 삶의 질은 유의한 차이를 보이지 않았다. 폐경 후 시기에 따라 삶의 질에 유의한 차이를 보였는데, 폐경 후 16년 이상이 경과한 군과 비교하여 폐경 후 5년 이내에서는 유의한 차이가 없었던 반면, 폐경 후 6-10년, 11-15년에는 유의하게 삶의 질이 나아졌다(각각 β=0.02, 0.03, p=.048, .005). 폐경 여성의 삶의 질을 향상하기 위해서는 폐경 시점 보다는 폐경 후 시기에 따른 중재가 요구된다. 핵심어: 삶의 질, 조기 폐경, 폐경후, 한국, 여성 □ 접수일: 2022년 2월 7일, 수정일: 2022년 2월 14일, 게재확정일: 2022년 2월 20일* 이 논문은 2021년도 전북대학교 연구기반 조성비 지원에 의하여 연구되었음. ** 전북대학교 간호학과 교수(Professor, Jeonbuk National Univ., Email: soeunjee@naver.com)

지지간호가 미숙아 어머니의 산후 우울에 미치는 효과

김은숙,김은영,이지연,김진경,이현주,이승희,김지영,원하연 병원간호사회 2009 임상간호연구 Vol.15 No.3

Purpose: This quasi-experimental study was conducted to investigate the effects of supportive nursing management on postpartum depression in the mothers with premature infants. Methods: The subjects were 21 mothers who delivered premature babies in a university hospital. The experimental group of 10 mothers was provided with supportive nursing management program by nurses in neonatal ICU and the control group of 11 mothers was provided with usual management only. The designed programs were given 4 times to the experimental group while their babies were hospitalized, and telephone consultation was provided 3 times after discharge. The stress, anxiety, identity, support from their husbands & family members, and postpartum depression were measured 3 times using Edinburgh Postnatal Depression Scale (the 4th day of premature's hospitalization, the day of discharge and the day of 4 weeks after discharge). Results: There was no significant difference in general characteristics and the influential factors of postpartum depression between the two groups, so they were homogeneous. There was no significant difference in depression (F=0.01, p=.917). However there was significant difference over time (F=6.74, p=.003) and the interaction between measurement time and treatment (F=3.59, p=.037). Conclusion: The supportive nursing management on postpartum depression of mothers with premature infants is considered effective and useful in reducing postpartum depression. Further research is warranted to investigate paternal depression and the program's long-term effects.

미숙아에서 중재적 시술을 통한 중심정맥 카테터 절편의 제거: 증례 보고

박지원,조정현,박병호 대한영상의학회 2007 대한영상의학회지 Vol.57 No.6

The fracture of a central venous catheter is a rare but potentially serious complication. Moreover, removal of the broken catheter pieces is considerably challenging, especially for premature infants. We report 3 case studies of the percutaneous transcatheter retrieval of broken catheter parts in 3 premature infants. We confirmed the location of the catheter fragments via a DSA venogram with diluted contrast media. Using the minimum amount of contrast, and extreme caution, we made certain no contrast-induced nephrotoxicity or air embolism occured during catheter manipulation. In addition, when the broken fragment was curled or attached to the cardiac wall, we used a hook-shaped catheter to facilitate the capturing of the catheter with a loopsnare. This report demonstrates the feasibility of removing a retained catheter fragment in a premature infant using a percutaneous transcatheter approach. 중심정맥 카테터의 골절은 드물지만 심각한 합병증을 일으킬 수 있다. 특히 미숙아에서 이를 제거하려면 상당한 주의가 필요하다. 저자들은 미숙아에서 끊어진 중심정맥 카테터 절편의 경피적 제거를 3예 경험하였기에 이를 보고하고자 한다. 희석된 조영제를 이용한 디지털감산혈관조영술로 카테터 절편의 위치를 확인하였고, 조영제로 말미암은 신독성과 공기 색전증을 예방하고자 최소한의 조영제를 매우 신중히 사용하였다. 카테터 절편이 얽히거나 심장벽에 붙어있는 경우, pigtail catheter로 골절된 카테터 절편을 잡을 수 있게 한 다음 loop snare 기법으로 안전하게 제거하였다. 이 증례를 통해 인터벤션 시술을 통한 중심정맥 카테터 절편의 제거가 미숙아에게서도 유용함을 알 수 있다.

Analysis of High-Risk Infant Births and Their Mortality: Ten Years' Data from Chonnam National University Hospital

최영륜,Eun Song Song,김윤하,송태복 전남대학교 의과학연구소 2011 전남의대학술지 Vol.47 No.1

Prematurity and low birth weight are major factors associated with neonatal morbidity and mortality, and their incidence is not decreasing despite an annual decrease in the total number of live births in Korea. The objective of this study was to establish a strategy to reduce neonatal mortality by analyzing the clinical characteristics of high-risk infant births along with their mortality and causes of death. We retrospectively surveyed the medical records of infants born at Chonnam National University Hospital and of patients admitted to the neonatal intensive care unit (NICU) for 10 years from October 1999 to December 2008. Premature and low birth weight infants were almost half of the live births, and their NICU admission rate increased with increases in the numbers of outborns and multiples. Also, their mortality decreased dramatically over the past 10 years. About 60% of deaths occurred within 1 week of life, and the causes of death were mostly related to prematurity. Perinatal asphyxia was the major cause of death in infants less than 1 week old, whereas sepsis was the major cause after 4 weeks of age. The major cause of death was sepsis in premature or low birth weight infants and perinatal asphyxia in term or normal weight infants. The major cause of death was sepsis in inborns and perinatal asphyxia in outborns. Our results suggest that medical personnel training for immediate postnatal care including neonatal resuscitation, infection control, and a systematic team approach to regionalization are all needed to reduce the mortality rate.