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Biomedical subjects

A F Korner

Publications and source records attributed to A F Korner.

At least 37 records · Page 2Linked to original sources

Reduction of sleep apnea and bradycardia in preterm infants on oscillating water beds: a controlled polygraphic study.

The sleep and respiratory patterns of eight apneic preterm infants were polygraphically recorded for 24 hours. This polygraphic study was designed to test and extend our previous finding that gently oscillating water beds reduce apnea in premature infants. The infants who ranged in gestational age from 27 to 32 weeks and in birth weight from 1,077 to 1,650 gm served as their own controls, off and on the water bed. The 24-hour recordings were divided into four time blocks with the infant being placed on the water bed during alternate six-hour periods. Apnea was significantly reduced while the infants were on the oscillating water beds, with the longest apneic periods and those associated with severe bradycardia being reduced the most. Reduction of apnea was most consistent during indeterminate sleep and most pronounced during quiet sleep. Short respiratory pauses and periodic breathing were not significantly reduced. Reductions of central, obstructive, and mixed apneas were approximately equal.

Apnea↗

Individual consistency in behavioral states in neonates.

In this study we identified consistent characteristics of the sleep-wake state of newborn infants. Forty-one normal, full-term infants were observed in a warmer-skin temperature maintained at 36.1 degree C--located in a sound-attenuated room for 1 hr during 2 successive mid-feeding periods. The infant's state was recorded on a check-list every 10 sec using the following categories for sleep and wakefulness: Quiet Sleep A, Quiet Sleep B, Active Sleep Without REM, Active Sleep With REM, Active Sleep With Dense REM, Drowsy, Alert Inactivity, WAKING Activity, Fussing, Crying, and Indefinite State. Immediately following the completion of each observation, the 2 observers made independent judgments of the degree of organization shown by the infant, using a 6-point scale. Over the two 1-hr observations, only Quiet Sleep A, Quiet Sleep B, and Crying showed any consistency. Active Sleep as typically defined showed no consistency whatsoever. However, 2 of the 3 components of Active Sleep were significantly reliability measures for the 2 observations; in sleeping infants all 3 components of active sleep showed high reliability. These results indicate that Active Sleep may be a composite of at least 3 meaningful categories. To look at overall state organization in the neonate, including both sleep and wake states, we considered Active Sleep as 3 separate states and then combined the resulting 11 behavioral states into derived clusters such that each combination of states showed a test-retest reliability above .52. With these 5 state clusters we viewed each infant's state behaviors in terms of a profile depicting the percent of time spent in each state cluster. We found a close association between these profiles and the subjective judgments of sleep-wake state organization made by the observers. The results clearly indicate that a 1-hr observation provides reliable information on individual sleep-wake states in the newborn.

Child Behavior↗

The relative efficacy of vestibular-proprioceptive stimulation and the upright position in enhancing visual pursuit in neonates.

48 healthy neonates born to multiparae were randomly assigned to view a moving stimulus either in the horizontal or the upright position, with or without added vestibular stimulation and with or without pacifier sucking. The infant was shown a moving black line inside a strictly controlled visual environment provided by an apparatus which permitted horizontal and upright positioning and displacement of the infant. Visual tracking was recorded by a concealed TV camera positioned at a constant distance and angle from the infants' eyes in both positions. Quality of tracking during each of 4 trials was scored on a 7-point scale. Results indicate that vestibularproprioceptive stimulation provided to the infant either horizontally or semivertically significantly enhanced his visual tracking, whereas the upright position did not. Pacifier sucking also improved his performace.

Eye Movements↗

Effects of waterbed flotation on premature infants: A pilot study.

Two types of waterbeds were developed to impart compensatory vestibular-proprioceptive stimulation to premature infants. Twenty-one infants ranging in gestational age from 27 to 34 weeks and birthweights from 1,050 to 1,920 gm were included in this pilot study. Assignment to experimental and control groups was made by random design. The experimental group consisted of ten infants who were placed on a gently oscillating waterbed before the sixth postnatal day, where they remained for seven days. Their clinical progress was compared with that of a control group of 11 similar babies. Waterbed flotation was found to be a safe procedure; there was no significant effects on the infants' vital signs, weight, or frequency of emesis. Highly significant differences were found in the incidence of apnea between the two groups, with infants on the oscillating waterbed having significantly fewer apneic spells. Infants placed on the waterbed during the first four postnatal days benefited more than those placed later. A non-oscillating waterbed was found clinically useful for very small prematures with severe skin problems, for infants recovering from abdominal surgery, and for infants receiving parenteral nutrition.

Apnea↗