• Korean Journal of Health Education and Promotion
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• v.10 no.1
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• pp.98-105
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• 1993

최근 경제수준 향상과 소자녀 가치관의 확립, 그리고 전국민 의료보험 실시 등으로 인하여 모자보건 대상자의 대부분은 민간 의료시설의 전문인력으로부터 서비스를 제공받게 되었고, 모자보건 수준도 급격히 향상, 1992년 시설분만율의 경우, 99%에 도달하였다. 이렇듯 의료시설 이용의 증가와 의료기술의 발전에도 불구하고, 영아사망율 및 모성사망율이 최근 몇년동안 같은 수준에 머무르고 있음은, 보다 질적인 관리측면으로 사업의 방향이 전환되어야 함을 의미하는데 이는 곧 공공성을 띠고 있는 모자보건사업을 국가가 관리하여야 할 필요성을 더욱 크게 한다. 공공부문에서는 취약대상을 위하여 민간 전문인력과의 유기적인 연계체계를 마련하여 계속적인 관리를 제공할 수 있도록 하고, 보건교육 강화를 위한 관련 홍보물(모자보건수첩 활용, 모유수유 권장, 제왕절개수술 지양 등)을 제작하며 신경아세포종 검사 등과 같은 새로운 예방사업 개발에 중점을 두어야 할 것이다. 또한 영유아관리는 저체중아 및 장애아에 대한 추구관리서비스까지 확대되어야 할 것이다. 현 우리나라 주산기구급이송체계는 응급의료체계내에서 이루어지고 있다고 볼 수 있는데 주산기관리를 위한 의료여건이 성숙되어 있지 못하고 있는데다(이 시기의 집중관리를 통하여 사망 및 장애아 예방이 가능) 관련 제도마저 취약하여 민간의료부문에서는 영아사망 및 모성사망을 낮추기 위해서는 이 부문에 대한 노력이 집중되어야 할 것이다. 첫째, 주산기학, 신생아학 전문인력의 훈련제도 확립파 주산기 관리시설의 지역적 적정분배(분만 2,000건에 1개 시설마련), 둘째, 집중적인 인력과 고가장비가 투입되는 주산기 의료활동 강화를 위한 관련 의료제도의 수정 및 보완, 세째, 질적관리가 매우 중시되는 고위험 신생아의 집중관리를 위한 '표준 의료관리지침서' 마련, 네째, 동 시설 및 관리에 준하여 주산기 의료시설에 대한 감독 및 감시기능 강화를 위한 제도적 장치가 마련되어야 할 것이다.

• The Korean Nurse
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• v.20 no.4 s.112
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• pp.77-85
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• 1981

This study was undertaken in an attempt to identify level of birth and infant death in the KHDI demonstration areas. The objectives of this study are to collect available information on birth and infant death in the KHDI demonstration areas, and estimate

• Pediatric Infection and Vaccine
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• v.15 no.1
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• pp.30-35
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• 2008

Purpose : We evaluated clinical presentations of brain abscesses, including predisposing factors, causative organisms, and mortality rate in neonates and children. Methods : We retrospectively reviewed the medical charts of neonates and children with brain abscesses treated at Severance Hospital from January 1997 through December 2006. Results : Among 27 neonates and children with brain abscesses, overall mortality was 22 % and 38% of survivors developed neurologic sequelae. The mortality rate was 38% in 8 infants with brain abscesses. The most common location of brain abscesses were frontal and parietal lobes, followed by temporal lobe. There were 7 cases with multiple brain abscesses. Streptococci (33%), Staphylococci (27%), and Gram-negative enterics (20%) were commonly isolated. The common predisposing conditions were neurosurgical procedure (30 %), cyanotic congenital heart disease (15%), and sinusitis/otitis (7%). Fever (74%), headache (37%), nausea/vomiting (33%), and altered mental status (33%) occurred commonly. Compared with children older than 1 year of age, infants were associated with multiple brain abscesses (63%, P=0.011) and high rates of death or neurologic sequelae (88%, P= 0.033). Conclusion : We should have a high index of suspicion in order to recognize the condition as early as possible, especially in infancy with brain abscesses who presents vague or nonspecific symptoms and signs.

• Korea journal of population studies
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• v.31 no.1
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• pp.127-146
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• 2008

Over the past four decades reproductive behavior has changed slowly in much of the African countries. The average total fertility rate has fallen from six or more to near five today. Between 1960 and 2000 the largest fertility decline occurred in such Northern African countries as Algeria, Libya, and Morocco. The mortality rate has decreased in most African countries. The purpose of this study is to review the pattern of demographic transition in African countries. At first, this study focuses on the fertility transition. In Africa, the total fertility rate has decreased from 6.59 to 4.85 between 1960 and 2000. The mortality rate has also decreased in most of African countries. It is also interesting to find that there is a clear difference among African countries. In terms of infant mortality rate, Libya shows the lowest rate(17), while Mali and Somalia remain still high rate(142 and 133, respectively). This study tests a path model in which infant mortality rate acts as an intermediate variable between three socioeconomic variables and the fertility rate. The findings of this paper substantiate some of our hypotheses on the interrelationships among socioeconomic variables, infant mortality rate, and fertility rate. The result also shows the indirect effects of socioeconomic variables on fertility rate via infant mortality.

• Korea journal of population studies
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• v.12 no.2
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• pp.22-44
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• 1989

• Korea journal of population studies
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• v.28 no.1
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• pp.1-22
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• 2005

본 연구는 개발도상국에서의 출산력 변천과 그 결정요인을 검토하는데 그 목적이 있다. 구체적으로 본 연구는 출산력 감소의 속도와 인구변천 단계에서의 출산력 변화, 그리고 인구변천 후기에 출산력 수준에 영향을 주는 요인들에 초점을 맞추고자 한다. 이를 위해 본 연구는 우선 지난 40년간 개발도상국에서의 출산력 변화 추이를 검토하고자 한다. 그 다음으로 본 연구는 이러한 인구변천 과정을 사회경제적 변화에 관련시켜 분석하고자 한다. 분석 결과 사회경제 지표들과 영아사망률 및 출산력과의 관계는 대부분 예상했던 방향으로 나타나고 있으나, 그 관계의 통계적 유의성은 조사 시기에 따라 약간의 차이를 보이고 있다. 사회경제적 지표 중 문맹률은 조사 시기에 관계없이 모두 출산력과 통계적으로 유의미한 관계를 보이고 있어, 교육수준이 높을수록 출산력이 낮아진다는 일반적인 견해를 뒷받침하고 있다. 그러나 도시화율과 소득이 각각 출산력에 미치는 영향은 시기에 따라 통계적인 유의성을 달리 하고 있다. 연구 모형에서 중요한 매개변인으로 설정된 영아사망률은 출산력에 가장 큰 영향을 미치고 있는 것으로 나타나고 있으며, 사회경제적 변인들이 영아사망률을 통하여 출산력에 미치는 간접적인 영향도 비교적 잘 드러나고 있다.

• Clinical and Experimental Pediatrics
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• v.45 no.9
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• pp.1065-1074
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• 2002

Purpose : The purpose of this study is to analyze the epidemiologic characteristics of sudden unexpected death in infancy and to evaluate the importance of postmortem autopsy. Methods : We reviewed, retrospectively, medical records of 34 infants admitted to Kangnam General Hospital from January 1987 to December 2001 because of sudden unexpected death. We investigated the cause of death through medical history, death scene examination, autopsy findings, acylcarnitine and organic acid analysis. Results : Among the total 34 infants, 18 were male(52.9%) and 16 were female(47.1%). Thirty infants(88%) were below the six months of age. Winter was the most affected season(38.2%). Eighteen infants(52.9%) died between 6 and 12AM. The prone sleeping position was observed more frequently than the supine position at death; nine cases in the prone position, six cases in the supine position. The cause of death of 23 cases could not be found by only history and death scene examination. Autopsy was done in 13 cases. Seven cases of them were thought to be SIDS. In six cases, we explained the cause of death with autosy findings. They were an endocardial fibroelastosis, a nesidioblastosis, a subdural hematoma, a bronchopneumonia and two fatty changes of liver. Metabolic screening tests performed in three cases to rule out metabolic disorder since 2000 were all normal. Conclusion : We concluded that autopsy and metabolic screening test should be performed to find out the cause of death in sudden unexpected death in infancy.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.12 no.9
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• pp.1675-1681
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• 2008

Sudden infant death syndrome (SIDS) is the leading cause of unexplained death of an apparently healthy infant aged one month to one year. This paper presents an infant monitoring system which detects the movement of infants to prevent SIDS. The proposed system is composed of a movement tenting part and a motion detecting part. The movement sensing part uses a tri-axis accelerometer. The motion detecting part is based on the LVQ algorithm. The proposed monitoring system connects to an alarm for alerting a parent when an infant is in a predetermined position. We evaluated the performance of the monitoring system through experiments.

• Korea journal of population studies
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• v.26 no.2
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• pp.1-32
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• 2003

An analysis on cause-specific mortality at the provincial level provides essential information for policy formulation and makes it possible to draw hypotheses regarding various diseases and causes of death. Although the mortality level and causes of death at the provincial level are determined by the multiple effects of socioeconomic, cultural, medical and ecological factors, this study primarily intends to examine similarities and differences of cause-specific mortality at the provincial level. Utilizing the registered death and the registered population as of 1998, the delayed death registration and unreported infant deaths were supplemented at the provincial level and age-standardized death rates and life tables were calculated. Regarding the mortality level due to all causes, major findings were as follow: (1) For both sexes as a whole, Seoul showed the lowest mortality level, and Jeonnam showed the highest mortality level; and (2) The differences of the mortality level among provinces were greater for males than females and for those less than 65 years than those 65 years and over. Regarding the cause-specific mortality level revealed in all indicators (cause-specific age-standardized mortality rates and the probability of dying at birth due to a specific cause for males, females, and both sexes combined respectively), the major findings were as follow: (1) The mortality level due to heart diseases was the highest in Busan and the lowest in Gangweon; (2) The mortality level due to liver diseases was the highest in Chonnam; and (3) The mortality level due to traffic accidents was the highest in Chungnam and the lowest in Inchon. As the mortality differentials at the provincial level are related to various factors, exploratory statistical analysis is attempted for the 25 explanatory variables including socioeconomic variables and 90 mortality variables. Mortality due to all causes are related to socioeconomic variables. Among cause-specific mortality, mortality due to liver diseases and traffic accidents is related to socioeconomic variables. Finally, the need to improve the quality of death certificate is discussed.

• Journal of Chest Surgery
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• v.32 no.6
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• pp.510-517
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• 1999

Background: Total anomalous pulmonary venous connection (TAPVC) is still one of the more challenging congenital heart defects in newborns and young infants. The purpose of the study is to evaluate the early and midterm results of the surgical corrections for patients in early infancy with isolated TAPVC. Material and Method: Hospital records of 15 consecutive patients in early infancy (January 1993 to August 1998) were retrospectively reviewed. There were 8 boys and 7 girls whose ages ranged from 4 days to 3.5 months (median age 22 days). Their body weight ranged from 1.75 kg to 4.9 kg (mean 3.54 kg). The abnormal anatomical connections were supracardiac in 11, cardiac in 3, and infracardiac in 1. In 6 patients (40%), the pulmonary venous drainage was obstructive. Total circulatory arrest was used in 13 patients. Anastomosis between the common pulmonary vein and the left atrium was performed with a continuous suture technique using a fine nonabsorbable polypropylene suture through a lateral approach behind the right atrium. Result: There was one hospital death (6.5%) caused by a sepsis 17 days after the operation in a neonate who had supracardiac drainage and was dependent on a ventilator preoperatively. There were 2 late deaths. One died sudde`nly of an unknown cause at home 2.5 years after the operation and the other died of a recurrent pulmonary hypertension 3 months after the reoperation due to pulmonary venous obstruction (PVO). Two patients required reoperations because of PVO 5 months and 10 months respectively after the initial operation. Of these patients, one patient is alive at the present time with persistent pulmonary hypertension. All survivors without postoperative PVO (78.6%) were in NYHA functional class I at mean follow-up of 25.8 months (0.5∼67 months). Conclusion: Surgical correction of TAPVC in early infancy can be performed at low risk. However, there were 2 postoperative PVOs (14.3%) which had bad results. The survivors without postoperative PVO had excellent functional status.