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- 저자 : 오연균 (검색결과 79 건)
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신생아 호홉곤란증후군에서 Surfactant 투여군과 대조군의 임상적 비교관찰
오연균 圓光大學校 醫科學硏究所 1995 圓光醫科學 Vol.11 No.2
We performed a randomized clinical trial comparing intratracheal administration of surfactant with assisted ventilatiory treatment with mechanical ventilation alone for treatment of neonatal respiratory distress syndrome. Twenty two premature infants with respiratory distress syndrome were randomly assigned to surfactant-treated or control group. Thirteen infants (mean gestational age: 29.3±1.8weeks, mean birth weight: l,424±227.3gm) were given surfactant-TA. and nine infants received intermittent mandatory ventilation only. The results were as follows: 1) We investigated the severity of respiratory distress syndrome by grading .which were severe, intermediate and minimal, at each point. Intermediate and severe categories were more rapidly changed to minimal in the surfactant-treated group than the control. Especially, those were improved at the 24 hours after surfactant administration significantly(46.2 vs 0%) (p<0.05). 2) Within 6 to 96hours of replacement of surfactant, there were significantly improved oxygenation with decreased FiO2 and increased a/APO2 and diminished the need for respiratory support with decreased Ⅵ index and mean airway pressure in the surfactant-treated group than the control(p<0.05∼0.005). 3) A decrease in the need for respiratory support was also reflected by a shortening of the total duration in assisted ventilation(6.7 vs 11.5days), supplemental oxygen(17.5 vs 32.25days)and high supplemental oxygen over 40%(3.0 vs 4.7days) in the surfactant-treated group. 4) In the surfactant-treated group, sepsis, IVH, PDA and NEC occured more often, and pneumothorax, pulmonary interstitial emphysema, bronchopulmonary dysplasia and apnea occured less. But, the difference of these complications were not significant. 5) Infants in the surfactant-treated group had decreased mortality, but it was not significant. And, the major causes of death were pulmonary hemorrhage and sepsis in both groups, but there was no significant difference between two groups. We concluded that replacement of surfactant is effective therapy that can improve the pulmonary function with diminution the need for oxygen and respiratory support.
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극소 저체중 출생아(<1,250 g)에서 고나트륨혈증 발생 및 뇌출혈과의 관계
오연균,이수호,소철환,금승운,유승택,최두영 대한신생아학회 2011 Neonatal medicine Vol.18 No.1
Purpose: Hypernatremia most frequently occurs in the immature newborn and be severe in association with intraventricular hemorrhage (IVH). This study examined the frequency, onset and risk factors of hypernatremia, and the relationship between hypernatremia and IVH in very low birth weight (VLBW; <1,250 g) infants. Methods: We retrospectively reviewed the medical records of 55 VLBW infants admitted between January 2006 and December 2009 to the neonatal intensive care unit of Wonkwang University Hospital and who survived over 7 days. Serum sodium concentration,sodium intake, fluid and weight loss, as suggested risk factors of hypernatremia, and the incidence of IVH were evaluated. The infants were divided into a hypernatremia group (≥150 mEq/L) and nonhypernatremia group, and were compared. Results: Incidence of hypernatremia in the VLBW infants was 52.7%, and mean starting time of hypernatremia was 2.8±1.3 days. There were no differences in the sodium and fluid intake between the two groups. Weight loss at day 3 after birth was significantly higher in the hypernatremia compared to the nonhypernatremia group (P<0.05); thereafter weight loss was non-significantly higher. The incidence of IVH in VLBW infants was 38.2%, and the difference between the two groups was not significant. Conclusion: Hypernatremia occurs commonly in VLBW infants and is most commonly caused by weight loss in the early days after birth. Incidence of IVH is not likely influenced by hypernatremia with marginally elevated sodium concentration.
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Xanthine Oxidase Inhibitor가 저산소성-허혈성 뇌손상이 유도된 신생쥐에 미치는 영향
최대호,오연균,박승택,Choi, Dae-Ho,Oh, Yeon-Kyun,Park, Seung-Tak 대한소아청소년과학회 2002 Clinical and Experimental Pediatrics (CEP) Vol.45 No.6
Purpose : In order to evaluate the hypoxia-ischemia(H-I) induced neurotoxicity and the protective effect of xanthine oxidase(XO) inhibitor(allopurinol), cell number, cell viability, lactate dehydrogenase(LDH), protein synthesis(PS) and protein kinase C(PKC) activity were measured in cerebral neurons and astrocytes. Methods : Cytotoxic effect was measured by in vitro assay at 12-72 hours after H-I on cerebral neurons and astrocytes derived from 7-day old neonatal rats which were subjected to unilateral common carotid artery occlusion and exposed to hypoxic condition for 3 hours. The protective effect of XO inhibitor was examined by the cell number, cell viability, LDH and PS on 14 days after H-I with allopurinol intraperitoneal injection 15 minutes prior to H-I. In addition, the effect of allopurinol on PKC activity in hypoxic conditions was examined in neurons. Results : 72 hours from H-I, the cell numbers and viability were decreased significantly in time-dependent manner on neurons and those of astrocytes also decreased slightly, compared with control. In neonatal rats treated with H-I, the cell number, cell viability, and PS in neurons were decreased, but LDH was increased significantly compared with control. In neonatal rats pretreated with allopurinol, the cell number and viability, and PS in neurons were increased and LDH was decreased significantly compared with H-I. PKC was increased remarkably after hypoxic condition. But PKC was decreased significantly against hypoxic condition after allopurinol pretreatment. Conclusion : From these results, it is suggested that H-I is more toxic in neurons than astrocytes and allopurinol is very protective with increasing of PS, and decreasing of LDH and PKC in neurons from hypoxic-ischemic condition.
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