Journal Detail Information

1

Cite

Share

Comparison of Synthetic Surfactant with Modified Bovine Surfactant in Neonatal Respiratory Distress Syndrome.

Eun Kyung LEE ; Yong See JUN ; Won Soon PARK

Journal of the Korean Society of Neonatology.1999;6(2):154-161.

PROPOSE: This study was designed to compare the efficacy of a synthetic surfactant (Exosurf) and a modified bovine surfactant (SurfactenR) in the treatment of neonatal respiratory distress syndrome. METHODS: A total of 90 infants with respiratory distress syndrome who were admitted to neonatal intensive care unit at Samsung Medical Center between October 1994 to September 1996 were includeeach surfactant. RESULTS: There was no significant difference in between two groups regarding birth weight, gestational age, and initiation of treatment after birth. ExosurfR group received less supplemental oxygen therapy and ventilator care. Survival rate were 81.3R in Exosurf group and 79.2% in SurfactenR group. The incidences of patent ctus arteriosus in the ExosurfR and SurfactenR groups were 75% and 62.5%, grade 3-4 intcular hemorrhage were 18.8% and 10.4%, respectively,' retinopathy of prematurity were 9.4% and 18.8%, respectively. There was significant improvernent of a/APO2 and VI at 30 minutes and 2 hours after the treatment in SurfactenR group', 2 hours and 6 hours after the treatment in ExosurfR group, however, dynamic compliance and respiratory resistance did not improve during 24 hours. CONCLUSION: Although SurfactenR treatment appears to induce faster improvement in oxygenation and pulmonary function than ExosurfR treatment, this study does not reveal any difference in clinical outcomes among those who received two different surfactant preparations.
Birth Weight ; Compliance ; Gestational Age ; Hemorrhage ; Humans ; Incidence ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Oxygen ; Parturition ; Respiratory Distress Syndrome, Newborn* ; Retinopathy of Prematurity ; Survival Rate ; Ventilators, Mechanical

2

Cite

Share

Comparison of the Clinical Effects of the Different Ventilatory Care Strategies in the Neonates with Acute Respiratory Failure: High Flow Rate - Constant Flow Rate.

June Dong PARK ; Beyng Il KIM ; Jung Hwan CHOI

Journal of the Korean Society of Neonatology.1999;6(2):145-153.

PURPOSE: High flow rate (FR) and pressure limit (PL) strategy with time-cycled pressure-limited (TCPL) ventilator is employed routinely in the neonates. Theoretical basis of this strategy is the two-compartment theory that the lung with acute respiratory failure consists of units with different compliance and resistance. But such constant pressure strategy has the risk of ventilator induced lung injury. We compared the ventilatory indices and clinical outcomes of two different strategies, high FR-constant pressure and low FR-constant FR in the ventilator care of the neonates with acute respiratory failure. METHODS: For the neonates born in our hospital and treated with mechanical ventilation from March to August in 1997, two different ventilator strategies were employed randomly with flow control ventilator. In the high-FR group, the FR was fixed at 10 L/ min and the PL was adjusted according to the arterial blood gas analysis (ABGA) results. In the low-FR group, the FR was adjusted to 10 mL/kg of tidal volume. Sixty neonates were enrolled, 32 in high-FR and 28 in low-FR group. Ventilatory indices and clinical outcomes were statistically cornpared in the two groups. RESULTS: Perinatal factors were not different in the two groups. Initial ventilator settings, ABGA results and ventilatory indices were not different. The tidal volume, fraction of inspired oxygen, peak inspired pressure and oxygenation index were higher and dynamic compliance was lower in the high-FR group compared to the low-FR group after 3 to 72 hours of ventilator care. In clinical outcomes, incidences of pulmonary interstitial emphysema, pneumothorax and chronic lung disease were significantly lower in the low-FR group. CONCLUSION: Low-FR with constant FR strategy resulted in better clinical outcomes in the ventilator care of neonates. We conclude that constant FR strategy prevents damage of the better compliant lung units and decreases the incidence of acute and chronic complications of ventilator care.
Blood Gas Analysis ; Compliance ; Emphysema ; Humans ; Incidence ; Infant, Newborn* ; Lung ; Lung Diseases ; Oxygen ; Pneumothorax ; Respiration, Artificial ; Respiratory Insufficiency* ; Tidal Volume ; Ventilator-Induced Lung Injury ; Ventilators, Mechanical

3

Cite

Share

A Case of Congenital Complete Heart Block.

Dae Bong JEONG ; Young Ill RHO ; Kyoung Rae MOON ; Young Bong PARK ; Sang Kee PARK

Journal of the Korean Society of Neonatology.1999;6(1):133-144.

In complete heart block(CHB), there is a complete failure of the atrial impulse leading into a ventricular response, the atria and ventricles beat independently, with the latter having a slower rate. Approximately one-third of infants with congenital CHB have associated structural heart disease such as corrected transposition of the great arteries, single ventricle, and the heterotaxy syndrome. For those patients without associated anomalies in whom bradycardia causes heart failure unresponsive to drugs, a pacemaker is necessary. We report a case of congenital complete heart block showing a ventricular beat of 57 /min despite atrial beat of 125/min. The mother of the baby was asymptomatic but her serologic tests were positive for connective tissue disease. The patient had positive serologic tests for anti-Ro antibody and anti-La antibody but associated structural heart anomalies were not found. He remained well without signs and symptoms of heart failure and no treatment was required except 02 supply.
Arteries ; Bradycardia ; Connective Tissue Diseases ; Heart Block* ; Heart Diseases ; Heart Failure ; Heart* ; Heterotaxy Syndrome ; Humans ; Infant ; Mothers ; Serologic Tests

4

Cite

Share

A Case of Stickler Syndrome with Large Eyeballs.

Eun Sil LEE ; Jung A KIM ; Ghee Young JUNG ; Hyo Seon CHOI ; Seong Hee PARK

Journal of the Korean Society of Neonatology.1998;5(2):242-247.

Stickler syndrome is an autosomal dominant disorder of connective tissue with a wide range of expressivity and incomplete penetrance which is called hereditary progressive arthro-ophthalmopathy. Affected neohates may present with the Pierre-Robin syndrome, progressive myopia, retinal detachment, flat face, hypertelorism, progressive arthritis. Early recognition of the syndrome is important, not only for genetic counselling but also to offer a more precise prognosis and proper treatment of many serious disorders that may occur in affected children. We experienced a case of Stickler syndrome with large eyeballs in a 3-day-old female baby who showed Pierre-Robin anomaly, flat face, hypertelorism, epicanthal folds, long philtrum, micrognathia, deft palate, high congenital myopia, chorioretinal degeneration, thin habitus and hyperextensible joints.
Arthritis ; Child ; Connective Tissue ; Female ; Humans ; Hypertelorism ; Joints ; Lip ; Myopia ; Myopia, Degenerative ; Palate ; Penetrance ; Pierre Robin Syndrome ; Prognosis ; Retinal Detachment

5

Cite

Share

Two Cases of Neonatal Osteomyelitis due to Extended Spectrum beta-lactamase Producing Klebsiella pneumoniae.

Hye Kyung LEE ; Sung Ran CHO ; Soon Lee JUNG

Journal of the Korean Society of Neonatology.1998;5(2):237-241.

The most common etiologic agents of neonatal osteomyelitis in the last decades were Staphylococcus aureus, Group B streptococcus, and E. coli, but Klebsiella pneumoniae as a cause of neonatal osteomyelitis appears to be rare. Klebsiella pneumoniae is one of the most important organisms associated with hospital acquired infections in the neonate and outbreaks with multiresistant strains have been reported from neonatal intensive care units around the world. These multiresistant Klebsiella pneumoniae have been shown to produce tranferable plasmid mediated beta-lactamases that are able to hydrolyze oxyimmino- beta-lactamas and these confer resistance to the third generation cephalosporin and named extended spectrum beta-lactamase producing Klebsiella pneumoniae. We experienced two cases of neonatal osteomyelitis due to extended spectrum lactamase producing Klebsiella pneumoniae in our neonatal intensive care unit during the same period. To our knowledge this represents the first documented neonatal osteomyelitise to extended spectrum beta-lactamase producing Klebsiellae pneumoniae in Korea.
beta-Lactamases* ; Disease Outbreaks ; Humans ; Infant, Newborn ; Intensive Care Units, Neonatal ; Intensive Care, Neonatal ; Klebsiella pneumoniae* ; Klebsiella* ; Korea ; Osteomyelitis* ; Plasmids ; Pneumonia ; Staphylococcus aureus ; Streptococcus

6

Cite

Share

Down Syndrome with Transient Myeloproliferative Disorder, Hepatic Fibrosis, and Hemochromatosis.

Jie Yeon LEE ; Hwi Kyu IM ; Hwang Min KIM ; Baek Keun LIM ; Young UH ; Chan Il PARK

Journal of the Korean Society of Neonatology.2003;10(1):83-87.

Transient myeloproliferative disorder (TMD), which may mimic acute leukemia, occurs in neonates with Down syndrome along with hepatic fibrosis. TMD is recognized shortly after birth or in the neonatal period and is characterized by leukocytosis and thrombocytopenia, which resolve spontaneously in four to six weeks. And hepatic fibrosis is characterized by diffuse intralobular sinusoidal fibrosis, extramedullary hematopoiesis and hemochromatosis. A newborn male infant with Down syndrome, atrial septal defect and ventricular septal defect is reported. He showed abnormal myelopoiesis accompanying characteristic hepatic sinusoidal fibrosis. Knowing the cellular mechanism of hepatic fibrosis and its modulation by growth factors, a pathogenetic link between transient myeloproliferative disorder and the development of liver fibrosis in Down syndrome neonates, association of this triad no longer appears to be accidental.
Down Syndrome* ; Fibrosis* ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Hematopoiesis, Extramedullary ; Hemochromatosis* ; Humans ; Infant ; Infant, Newborn ; Intercellular Signaling Peptides and Proteins ; Leukemia ; Leukocytosis ; Liver Cirrhosis ; Male ; Myelopoiesis ; Myeloproliferative Disorders* ; Parturition ; Thrombocytopenia

7

Cite

Share

A Case of Transient Myeloproliferative Disorder with Down Syndrome, Presented Hepatosplenomegaly on Prenatal Sonography.

Keun Hye LEE ; Beom Su PARK ; Eun Hwan JEONG ; Bo Ra SON ; Mi Kyeong KIM ; Seung Woon LIM ; Hyeon Jin PARK

Journal of the Korean Society of Neonatology.2003;10(1):78-82.

Down syndrome (DS) is associated with a higher incidence of leukemia than general population; the subtype is acute megakaryoblastic leukemia (AMKL) in 50% of cases. DS is also strongly associated with transient myeloproliferative disorder (TMD), which is usually diagnosed during newborns and infants. Due to its difficulty in distinguishing TMD from acute leukemia (AL), the diagnosis of TMD should be made with extreme caution. Unlike AL, most cases of TMD resolve spontaneously within 3 months; blast cells disappear within 8 weeks in 80% and within 10 weeks in 90% of the surviving patients. Some infants with TMD, however, may have a severe complication leading into life-threatening clinical course with hepatosplenomegaly, lymphadenopathy, liver impairment, respiratory distress, anemia, infection and hemorrhage. Rarely, AL can develop after remission of TMD. We report a case of TMD with DS in newly born infant who presented hepatosplenomegaly on prenatal sonography and improved with exchange transfusion, steroid.
Anemia ; Diagnosis ; Down Syndrome* ; Hemorrhage ; Humans ; Incidence ; Infant ; Infant, Newborn ; Leukemia ; Leukemia, Megakaryoblastic, Acute ; Liver ; Lymphatic Diseases ; Myeloproliferative Disorders*

8

Cite

Share

A Case of Prenatally Detected Congenital Lobar Emphysema.

Keun Hye LEE ; Beom Soo PARK ; Il Un JI ; Jong Myeon HONG ; Il Heon BAE ; Keon Kook LEE

Journal of the Korean Society of Neonatology.2003;10(1):72-77.

Congenital lobar emphysema (CLE) is an overinflation of infantile pulmonary lobe caused by air trapping within the affected area. This is usually diagnosed on radiological findings postnatally. Most cases present in the neonatal period with signs of acute or chronic respiratory distress. There are only a few reports of CLE in the literature with prenatal sonographic feature documented. The routine use of prenatal sonography has helped to find fetal anomalies, such as fetal lung mass, that pose a challenge to early diagnosis, appropriate counselling, postnatal follow-up, and better outcome. A boy with CLE was detected by prenatal sonogram. He had a uniformly echogenic right lung with mediastinal shift to the left which was suspected type III congenital cystic adenomatoid malformation prenatally. He showed no evidence of respiratory distress at birth, but experienced progressive tachypnea and chest retraction. He had right middle lobectomy on the seventh postnatal day and pathologic diagnosis of CLE had been made. We report this rare case with brief review of literature. This is the first domestic case which was detected prenatally and confirmed pathologically after lobectomy.
Cystic Adenomatoid Malformation of Lung, Congenital ; Diagnosis ; Early Diagnosis ; Emphysema* ; Follow-Up Studies ; Humans ; Lung ; Male ; Parturition ; Tachypnea ; Thorax ; Ultrasonography

9

Cite

Share

Two Cases of Fetus in Fetu Diagnosed with Prenatal Ultrasonography.

Kun Song LEE ; Yoon Hee JEE ; Doo Sun LEE ; Jai Hyang GO ; Young Seok LEE ; Jong Min LEE ; Woo Sung PARK ; Young Pyo CHANG

Journal of the Korean Society of Neonatology.2003;10(1):67-71.

Fetus in fetu is a poorly understood and rare congenital malfomation. This is a rare form of monozygotic twin that asymmetric twin becomes internalized in the other twin thus acting endoparasitically. Fetus in fetu can be distinguised from teratoma, because of vertebral column, skeletal axis, and well-differentiated internal organs. We present the findings in the two cases of fetus in fetu that were diagnosed with prenatal ultrasonography. After birth, we removed fetus-like structures and confirmed by pathologic examination. Fetus-like structures were consisted of vertebral column, extremities, and other well-developed internal organs.
Axis, Cervical Vertebra ; Extremities ; Fetus* ; Humans ; Parturition ; Spine ; Teratoma ; Twins, Monozygotic ; Ultrasonography, Prenatal*

10

Cite

Share

A Study on the Incidence and Risk factors of Cystic Periventricular Leukomalacia in very Low Birth Weight Infants.

Soo Hyun LEE ; Sung Hye KIM ; Kye Hyang LEE ; Dong Kil YOU ; Suk Joo CHOI ; Jong Hee HWANG ; Chang Won CHOI ; Jae Won SHIM ; Sun Young KO ; Soon Ha YANG ; Yun Sil CHANG ; Won Soon PARK

Journal of the Korean Society of Neonatology.2003;10(1):61-66.

PURPOSE: Our study was carried out to estimate the incidence of cystic periventricular leukomalacia (CPVL) and to identify the risk factors for CPVL. METHODS: The medical records and cranial ultrasound scan were reviewed for 321 infants weighing less than 1, 500 g who lived more than 28 days and admitted to the NICU at Samsung Medical Center from October 1995 to December 2001. A multiple logistic regression was performed to identify which factors were independently associated with CPVL. RESULT: CPVL developed in 19 (5.9%) infants of 1, 188+/-236 g birth weight and 28(+6)+/-2(+4) weeks gestational age. Incidence of CPVL according to birth weight and gestational age were as follows respectively: <750 g 5.3%, 750-999 g 5.5%, 1, 000-1, 249 g 3.9%, 1, 250-1, 499 g 7.9% and <25weeks 8.3%, 25-26weeks 6.7%, 27-28weeks 6.5%, 29-30weeks 2.7%, 31-32weeks 11.1%. The mean day of diagnosis of CPVL was 41+/-33 days. Univriate analysis indicate that two clinical variables, prolonged ventilator duration (CPVL: control, 35+/-64 days vs 17+/-26 days, P=0.0184) and severe intraventricular hemorrhage (IVH) (21% vs 2.7%, P=0.0324), were significant predictors of CPVL. The odds ratio estimate and 95% confidence limits are 1.012 and 1.003 to 1.022, respectively for prolonged ventilator duration; 2.6 and 1.044 to 6.602, respectively for severe IVH. CONCLUSIONS: These data suggest that prolonged ventilator duration and severe IVH increase the risk for development of CPVL.
Birth Weight ; Diagnosis ; Gestational Age ; Hemorrhage ; Humans ; Incidence* ; Infant* ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Leukomalacia, Periventricular* ; Logistic Models ; Medical Records ; Odds Ratio ; Risk Factors* ; Ultrasonography ; Ventilators, Mechanical

DISPLAY OPTIONS

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share