No abstract available.
Fetal Development*

No Abstract available.
Enterocolitis, Necrotizing* ; Heart Defects, Congenital* ; Humans ; Infant, Newborn* ; Nutritional Support*

No abstract available.
Infant, Newborn ; Humans

Agrowing number of premature infants including those with extremely low birth weight (birth weight <1,000g) are surviving in recent years with advances in neonatal intensive care. The infant follow-up program is a service that provides a continuum of care to high-risk infants who have increased risk for major and minor neuro-developmental impairments after they have been discharged from the hospital's intensive care unit. The goals of the outpatient clinic include the followup of the growth and development, identification of medical, neurological, developmental or psychological abnormalities, referral and consultation services as needed, and the enhancement of infant-parental bonding. All high-risk premature infants who are at risk for developmental delays should be evaluated with the Bayley Scales of Infant Development at corrected 7~8, 18, and 24 months and appropriate developmental assessment tools later in life to identify problems and to make appropriate referrals for early interventional therapies such as physical, occupational, speech, hearing, feeding and play group.
Ambulatory Care Facilities ; Child ; Child Development ; Continuity of Patient Care ; Follow-Up Studies* ; Growth and Development ; Hearing ; Humans ; Infant* ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature* ; Intensive Care Units ; Intensive Care, Neonatal ; Referral and Consultation ; Weights and Measures

Clinician must consider several factors when advising a breastfeeding mother on the compatibility of her medications to breastfeeding infants: the benefit the medication will give to the mother; the risk of discontinuation of breastfeeding to the baby, the risk of medication to the baby and the risk of medication to the maternal milk supply. In almost all situations, there are numerous medications that can be safely used for specific symtoms and should be carefully chosen with the breastfeeding mother in mind. The transfer of medication from the maternal serum into milk depends on the drug's oral availability, lipid solubility, molecular weight, protein binding and half life. One must remember when the mother uses medication, that medication needs to be absorbed into the bloodstream of the mother, be able to cross into milk, be orally available to the infant, absorbed by infant's GI tract, be able to get into the infant's bloodstream and be at an infant dose which is generally very small.
Breast Feeding ; Gastrointestinal Tract ; Half-Life ; Humans ; Infant ; Milk ; Molecular Weight ; Mothers ; Protein Binding ; Solubility

Neonatal infections are frequent complications of neonates receiving intensive care unit. In particular, large cohort study has suggested that neonatal infections among extremely low birth weight infants are associated with poor neurodevelopmental and growth outcomes in early childhood. This review article will focus on the rational use of empirical antibiotics/antifungal therapy for early and late onset sepsis/fungemia, duration of antibiotic treatment, highlight clinically relevant aspects of the antibiotics commonly used in the treatment of sepsis, antibiotics requiring therapeutic dose monitoring, and management of antibiotic-resistant infection in the neonate.
Anti-Bacterial Agents ; Cohort Studies ; Drug Monitoring ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Intensive Care Units ; Sepsis

No abstract available.

With the advances in neonatal intensive care, pediatric surgeons experience very low birth weight infants, weighing <1,500 g, more frequently. We report our 14 cases of very low birth weight infants with intestinal perforations without congenital causes, at the Asan Medical Center during the 11-year period from 1989 to 2000. The average birth weight was 919 g (563-1,490), and average gestational age was 206 days (161-286). There were nine males and five females. Operation was performed at an average age of 14.0 days (3-38). Ten neonates with symptomatic PDA were given indomethacin in an attempt to close the ductus. Bowel perforation involved the jejunum in two and ileum in twelve. At laparotomy, there were seven focal intestinal perforations, five typical NEC, one intussusception, and an unknown cause. Four neonates underwent resection and anastomosis of the bowel, and nine underwent exteriorization. One underwent resection and anastomosis after peritoneal drainage. Four patients had postoperative complications; two leakage of anastomosis, one stoma necrosis, and one internal herniation. Seven of fourteen patients survived (50.0%). Seven patients died of septic complication. There was a significant difference in the birth weight and gestational age in survivors compared with those who died (p<0.05). There was an increased risk of bowel perforation in indomethacin treatment for PDA. Careful clinical observation and keen judgment are essential for this particular group of infants.
Birth Weight ; Chungcheongnam-do ; Drainage ; Female ; Gestational Age ; Humans ; Ileum ; Indomethacin ; Infant* ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Intensive Care, Neonatal ; Intestinal Perforation* ; Intussusception ; Jejunum ; Judgment ; Laparotomy ; Male ; Necrosis ; Postoperative Complications ; Survivors

No abstract available.
Humans ; Infant* ; Infant, Very Low Birth Weight* ; Lung Diseases* ; Lung* ; Vitamin A* ; Vitamins*

PURPOSE: To compare the usefulness of contrast-enhanced voiding ultrasonography(US) with that of radiographic voiding cystourethrography(VCUG) for the diagnosis of vesicoureteral reflux(VUR) in children. MATERIALS AND METHODS: Ninety-five kidney-ureter units of 47 patients referred for investigation of VUR underwent contrast-enhanced voiding US followed by radiographic VCUG. After baseline US examination of the urinary tract, residual urine in the bladder was drained through an inserted Foley catheter and the bladder was gravity filled at a height of 1 m with normal saline. A galactose-based, microbubble-containing echo-enhancing agent (Levovist; Schering, Berlin, Germany) was then administered. The amount of this was approximately 10% of bladder capacity, and VUR was diagnosed when microbubbles appeared in the ureter or pelvo-calyceal system. Using radiographic VCUG as a reference point, the accuracy with which contrast-enhanced voiding US detected VUR was calculated. RESULTS: In 87 of 95 kidney-ureter units (91.6%), the two methods showed similar results regarding the diagnosis or exclusion of VUR, which was detected by both in 12 units, but by neither in 75. VUR was shown to occur in a total of 20 units, but in eight of these by one method only. In two units, VUR detected by contrast-enhanced voiding US was not demonstrated by radiographic VCUG; in six units, the reverse was true. In the detection of VUR, contrast-enhanced voiding US showed a sensitivity of 66.7%, a specificity of 97.4%, a positive predictive value of 85.7%, and a negative predictive value of 92.6%. CONCLUSION: Contrast-enhanced voiding US is highly specific and has high positive and negative predictive values; its sensitivity, however, is not sufficiently high. The modality appears to be a useful diagnostic tool for the detection of VUR without exposure to ionizing radiation, though to be certain of its value, more experience of its use is first required.
Berlin ; Catheters ; Child* ; Diagnosis ; Gravitation ; Humans ; Microbubbles ; Radiation, Ionizing ; Sensitivity and Specificity ; Ultrasonography* ; Ureter ; Urinary Bladder ; Urinary Tract ; Vesico-Ureteral Reflux*