• 대한지역사회영양학회지
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• 제10권6호
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• pp.860-868
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• 2005

Anemia diagnosed early in pregnancy is associated with increased risks of low birth weight and preform delivery. The purposes of this study were to assess the maternal iron status during pregnancy and to evaluate the relationships between the iron indices of maternal-umbilical cord serum iron and ferritin levels and pregnancy outcomes. Dietary intakes of the pregnant women were estimated by 24 hour-recall (3 times). Serum iron and ferritin levels in maternal blood and umbilical cord were measured at 1st-, 2nd-, 3rd- trimester and delivery, respectively. The mean of maternal se겨m iron levels of the trimester and delivery were $124.27\;{\mu}g/dl,\;97.03\;{\mu}g/dl,\;94.32\;{\mu}g/dl,\;and\;145.53\;{\mu}g/dl$. Those maternal levels were significantly lower than that of umbilical cord blood ($222.59\;{\mu}g/dl$). Serum ferritin levels of maternal trimester and delivery were 22.68 $22.68\;{\mu}g/l,\;11.09\;{\mu}g/l,\;14.18\;{\mu}g/l,\;and\;\;24.54\;{\mu}g/l$, which were significantly lower than those of umbilical cord blood ($184.35\;{\mu}g/l$) (p < 0.0001). This prevalence of anemia of total subjects was $30.3\%$ by WHO criteria (Hb < 11.0 g/dl, Hct < $33\%$). Iron levels of 2nd-trimester was significantly higher in the normal group than in the anemia group. And ferritin levels of 3rd-trimester and delivery was significantly higher in the normal group than in the anemia group. Therefore, we suggest for successful pregnancy outcome and delivery differential iron supplementation programs will be carried out with individual Pregnant women on the basis of pre-Pregnancy nutrition. (Korean J Community Nutrition 10(6) : $860\∼868$, 2005)

• Neonatal Medicine
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• 제18권2호
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• pp.399-403
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• 2011

신생아의 뇌 농양은 극히 드문 경우로 특정 선행 요인을 가지고 있는 경우가 많다. 가장 흔한 원인 균주는 그람 음성 균주이며 치료법의 발달로 사망률은 감소하였지만 반신 마비, 경련, 발달 장애 등의 후유증이 남을 수 있다. 39일 된 남아가 하루 전부터 시작된 발열을 주소를 내원하였다. 환아는 조산, 저 체중 출산아로 신생아 중환자실에 입원했던 경력이 있었다. 신체 검진상 대천문이 팽창된 것 외에 다른 신경학적 증후는 보이지 않았다. 신경 촬영 검사상 양측 전두엽에 정중선이 오른쪽으로 치우쳐 있는 뇌 농양으로 의심되는 거대한 병변이 있었다. 뇌 농양이 매우 컸음에도 불구하고 수술장으로 이동하지 않고 환자의 침상에서 직접 단순 흡입 치료를 시행하였고 항생제 치료를 병행하였다. 원인균은 Enterobacter cloacae로 판명되었고 meropenem을 8주간 투여 하였다. 환아는 빠른 회복을 보이며 이후 어떤 신경학적 휴유증도 보이지 않았다. 저자들은 Enterobacter cloacae 감염에 의한 거대한 뇌 농양이 발견된 신생아를 단순 흡입과 항생제 만으로 치료 하였고 이후 좋은 경과를 보인 1례를 경험하였기에 보고하는 바이다.

• Neonatal Medicine
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• 제18권2호
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• pp.409-411
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• 2011

In Korea, pulmonary surfactant (PS) replacement therapy in respiratory distress syndrome (RDS) was started in 1991 since when Surfacten$^{(R)}$ was imported from Japan. At the present time, Surfacten$^{(R)}$, Newfactan$^{(R)}$, Curosurf$^{(R)}$, and Infasurf$^{(R)}$ are available in Korea. The governmental health insurance covers the expense for multiple dose treatment since 2002 and the early prophylactic treatment (BW: <1,250 g or GP: <30 wks) since 2011. We undertook a multi-institutional collective study to evaluate the outcomes of PS over past 20 years in Korea (Period-I; 1990/91, P-II; 1996, P-III; 2002, and P-IV; 2007, P-V; 2010). There were 60 RDS neonates with PS treatment in P-I (16 hospitals), 1,179 in P-II (64), 1,595 in P-III (62), 1,921 in P-IV (57), and 3,160 in P-V (72). Decreased mortality rate, defined as the percentage of neonates who died within 28 days of birth, was seen between periods, P-V vs P-I, II, III, and IV (mortality rate: 10.1% vs. 40.0%, 30.0%, 18.7%, and 14.3%). We conclude that PS therapy contributed to improve remarkable outcome in RDS neonates over the last 20 years in Korea. However, more efforts should be made to optimize PS therapy for better outcome. Multiple PS doses for relapse and poor response, early prophylactic use, and better supportive care for pre-term infants are mandatory.

• Journal of Nutrition and Health
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• 제39권3호
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• pp.264-273
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• 2006

Elevated maternal plasma homocysteine concentrations have been associated with adverse pregnancy outcomes. Serum homocysteine levels may be affected by the MTHFR genotypes and the nutritional status of B vitamins including vitamin $B_2,\;B_6$, folate and vitamin $B_{12}$. We investigated whether postnatal growth measurements were influenced by maternal MTHFR genotypes and their mid-pregnancy serum vitamin B and homocysteine levels. In 130 pregnant women of 24-28 wks of gestation, the MTHFR genotypes, serum B vitamins and homocysteine concentrations were analyzed. Physical growth status was assessed in their offsprings by measuring height, weight, and head and chest circumferences from birth up to 24 months. Serum homocysteine levels were higher in the subjects with T/T genotype than those with the C/T or C/C. Heights and head and chest circumferences of offsprings from the T/T mothers were significantly lower than those from the C/C or C/T mothers only when the serum homocysteine levels were above the median. The mean height of offsprings from the T/T mothers was significantly lower than those from the C/C and C/T mothers. The mean weight and head circumferences of offsprings born from the mothers whose mid-term pregnancy PLP levels were in the lowest quartile was significantly lower than those from mothers in the highest quartile. Heights and head circumferences of offsprings from the T/T mothers were significantly lower than those from the C/C or C/T mothers only when the serum FAD levels were in the lowest quartile. These results suggest that postnatal growth up to 24 months may be influenced by the maternal C677T MTHFR genotypes, and mid-pregnancy serum homocysteine and vitamin B status.

• 대한한의학회지
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• 제35권2호
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• pp.1-11
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• 2014

Objectives: To evaluate the effect of acupuncture as an adjunct treatment to increase the success rate of in vitro fertilisation (IVF). Methods: A review of the English and Korean literature was conducted to identify studies on acupuncture as an adjunct treatment to IVF. The main outcome measures were the biochemical pregnancy rate (BPR), the implantation rate (IR), the clinical pregnancy rate (CPR), the miscarriage rate (MR), the on-going pregnancy rate (OPR) and the live birth rate (LBR). Results: Nine meta-analyses of 11 systematic reviews (SRs) were included in this review. In four SRs, the overall IVF outcomes regardless of the procedural steps were documented; two of these SRs reported a significant effect on the CPR. One SR reported that acupuncture at the time of controlled ovarian hyperstimulation had a significant effect on the BPR. Seven SRs reported that acupuncture had no significant impact on transvaginal oocyte retrieval (TVOR). In eight SRs, significant impacts on the CPR, LIBR and OPR were reported when acupuncture was performed around the time of embryo transfer (ET). The results of repeated acupuncture after ET were included in two SRs, which included the same primary studies. The results of the SRs showed that acupuncture had a positive effect on the CPR. Conclusions: When the complete IVF procedure is analysed, there is conflicting evidence in that some reviews have found that acupuncture leads to an increased CPR but others have not. In addition, the reviews presented no evidence to suggest that acupuncture has any specific risks.

• Asian Pacific Journal of Cancer Prevention
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• 제16권15호
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• pp.6557-6559
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• 2015

Background: Cervical human papillomavirus (HPV) infection among young women (20-25 years of age) is common and normally transient. There are growing concerns that referral to a colposcopy clinic may lead to unnecessary treatment with an increased risk of obstetric complications. Therefore, the purpose of this study was to determine the level of intervention for cervical abnormalities in this age group of the Northern Ireland population. Materials and Methods: A review of all serial new patients under 25 years of age, who were referred to colposcopy clinics in Northern Ireland between January 1, 2009 to June 30, 2009 formed the basis of this study. Results: During the study period, a total of 4,767 women under 25 years of age were screened. Two-hundred-and-thirty-four (4.9%) cases were referred to the colposcopy clinics. The cervical cytology results were: high-grade abnormality in 35%, and low-grade abnormality in 31% of these cases. One-hundred-and-seventy-eight (76%) of the referred women received at least one treatment. One-hundred-and-twenty-one of 234 (51.5%) women underwent an excisional treatment with histology showing the presence of high-grade abnormalities (CIN2-3) in 52%, CIN1 in 28%, and Koilocytosis or normal tissue in 20% of this sub-group of cases. Conclusions: Screening women under the age of 25 years cause unnecessary referral for colposcopy. This may also result in considerable anxiety and psychosexual morbidity. It leads to an over-treatment with a potential of negative impact on the future pregnancy outcomes (including pre-term delivery, low birth weight, and pre-term premature rupture of membranes).

• Clinical and Experimental Pediatrics
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• 제60권11호
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• pp.353-358
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• 2017

Purpose: To develop and evaluate a simple screening tool to assess hearing loss in newborns. A derived score was compared with the standard clinical practice tool. Methods: This cohort study was designed to screen the hearing of newborns using transiently evoked otoacoustic emission and auditory brain stem response, and to determine the risk factors associated with hearing loss of newborns in 3 tertiary hospitals in Northern Thailand. Data were prospectively collected from November 1, 2010 to May 31, 2012. To develop the risk score, clinical-risk indicators were measured by Poisson risk regression. The regression coefficients were transformed into item scores dividing each regression-coefficient with the smallest coefficient in the model, rounding the number to its nearest integer, and adding up to a total score. Results: Five clinical risk factors (Craniofacial anomaly, Ototoxicity, Birth weight, family history [Relative] of congenital sensorineural hearing loss, and Apgar score) were included in our COBRA score. The screening tool detected, by area under the receiver operating characteristic curve, more than 80% of existing hearing loss. The positive-likelihood ratio of hearing loss in patients with scores of 4, 6, and 8 were 25.21 (95% confidence interval [CI], 14.69-43.26), 58.52 (95% CI, 36.26-94.44), and 51.56 (95% CI, 33.74-78.82), respectively. This result was similar to the standard tool (The Joint Committee on Infant Hearing) of 26.72 (95% CI, 20.59-34.66). Conclusion: A simple screening tool of five predictors provides good prediction indices for newborn hearing loss, which may motivate parents to bring children for further appropriate testing and investigations.

• Journal of Genetic Medicine
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• 제13권1호
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• pp.31-35
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• 2016

Antley-Bixler syndrome (ABS) is a rare form of syndromic craniosynostosis with additional systemic synostosis, including radiohumeral or radioulnar synostosis. Another characteristic feature of ABS is mid-facial hypoplasia that leads to airway narrowing after birth. ABS is associated with mutations in the FGFR2 and POR genes. Patients with POR mutations present with either skeletal manifestations or congenital adrenal hyperplasia with ambiguous genitalia. We report here two cases of ABS caused by mutations in FGFR2 and POR. Although the patients had craniosynostosis and radiohumeral synostosis in common and cranioplasty was performed in both cases, the male with POR mutations showed an elevated level of $17{\alpha}$-hydroxyprogesterone during newborn screening and was diagnosed with congenital adrenal hyperplasia by adrenocorticotropic hormone stimulation. This patient has been treated with hydrocortisone and fludrocortisone. He had no ambiguous genitalia but had bilateral cryptorchidism. On the other hand, the female with the FGFR2 mutation showed severe clinical manifestations: upper airway narrowing leading to tracheostomy, kyphosis of the cervical spine, and coccyx deformity. ABS shows locus heterogeneity, and mutations in two different genes can cause similar craniofacial and skeletal phenotypes. Because the long-term outcomes and inheritance patterns of the disease differ markedly, depending on the causative mutation, early molecular genetic testing is helpful.

• 교육시설 논문지
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• 제21권5호
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• pp.3-12
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• 2014

The purpose of this study is to propose a framework to analyse the educational effects and outcome of the boarding middle school established following the merger and abolition of small schools in rural area. According to the decrease in birth rate and reduction of population in rural area, primary schools have brought about many problems for decrease of number of student, and environment of education have became deteriorated. Accordingly, primary schools be required improvement, and it should be altered placement of schools because it change number of student, distance and time of attending school, and formation of school zone are changed by alternating of human and physical environment. Merger and abolition of primary school is inevitable for change of placement standard to primary school and qualitative improvement of environment of education in rural area. This study suggests 1)educational effects and outcome, 2)changes and benefits of student's living conditions, 3)social effects to local community, and 4)economical efficiency analysis as a new framework to evaluate the validity of establishing a school. It sets up a hypothesis that the students, parents and community satisfy the boarding school in rural area, a school record be improved and the abolition of schools have little effect on community. Finally, it emphasizes that in order to success the policy of the merger of small schools and the boarding middle school, it be attributed to the social-cultural environment based on local residents and community and required provision of a variety of utilization plans reflecting local specifics and guarantee of local residents' participation and selection.

• 한국인구학
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• 제17권2호
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• pp.77-97
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• 1994

Despite the fact that the national family planning program in korea has accomplished its primary goals of fertility reduction and universal contraceptive use, the induced abortion is still high and there has been an increasing trend in the population sex ratio at birth. It seems that the changes in the imbalance of sex ratio have originated from traditonal boy preference. This indicates that much of the current family planning program can be overhauled, so that the program quality could be better controlled, by preventing the number of unwanted pregnancies and the imbalance of sex ratios. This paper aims, therefore, to examine the determinants of induced abortion through the investigation of pregnancy outcomes and their changes over time and to study the interaction between induced abortion, boy preference and the imbalance of sex ratio in Korea. The abortion rate had increased rapidly until the mid-1980s when there were about the same number of abortions as live births. Thereafter, the abortion rate has been maintained at this high level. By parity it shows a much higher abortion rate for a higher parity at all time. From the first parity, the sex composition of previous children stands out as the most important factor in deciding the pregnancy outcome at all time. The probability of a pregnancy ending in an abortion increases substantially when parents already had a son. The decline of the desired family size and the sustained strong son preference has made the sex of children a more important factor in the determination of the pregnancy outcome. Women's education has had consistently positive effects on the probability of a pregnancy ending in an abortion, but the effect shows a steady decline over time. The premarital pregnancy and urban residence also increase the abortion probability. This study suggests that the main concerns of the family planning program should be to strengthen the social support policies so as to weaken the son preference value leading to a balanced sex ratio and prevention of induced abortions.