• Obstetrics & gynecology science
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• 제61권6호
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• pp.688-692
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• 2018

Listeriosis is a rare foodborne infection caused by Listeria monocytogenes. It is 12-20 times more prevalent in pregnant women compared to the general population, with a 20-40% mortality rate in neonates. Early treatment with appropriate antimicrobial agents is critical for pregnancy outcomes; however, the infection is difficult to control because the nonspecific clinical manifestations and rarity of the disease often preclude early diagnosis. We encountered 2 cases of pregnancy-associated listeriosis that occurred at 29 and 37 weeks of gestation. Both neonates were delivered by emergent cesarean section due to fetal condition, and one of the preterm infants died immediately after birth. Pregnancy-associated listeriosis should be considered in the management of unexplained fever or inflammatory conditions in pregnant women.

• 웰빙융합연구
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• 제6권1호
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• pp.9-15
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• 2023

Purpose: This study aimed to implement safe and suitable kangaroo mother care with healthy mothers and newborns immediately after childbirth. In addition, it aimed to assess its effects on maternal attachment, maternal role confidence, and maternal role satisfaction. Research design, data and methodology: A quasi-experimental design was used with pre and posttests. A total of 58 participants were selected by convenience sampling through public notifications at a women's hospital. The control group performed routine care without providing kangaroo contact, and a posttest was performed four weeks after the pretest. The experimental group comprised healthy mothers who had given birth by cesarean section. They performed kangaroo mother care twice a day (60 min each) for four weeks for their newborns after the protocol was validated by an expert. Results: The results showed significantly higher maternal attachment, maternal role confidence, and maternal role satisfaction in mothers who participated in kangaroo mother care than those who did not. Our findings suggested that kangaroo mother care has a positive effect on the enhancement of maternal attachment and facilitation of maternal role confidence and satisfaction. Conclusions: Thus, the expansion and implementation of kangaroo mother care are necessary to promote healthier mother-child relationships.

• Journal of Yeungnam Medical Science
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• 제41권2호
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• pp.128-133
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• 2024

Aortic dissection in pregnant patients results in an inpatient mortality rate of 8.6%. Owing to the pronounced mortality rate and speed at which aortic dissections progress, efficient early detection methods are crucial. Here, we highlight the importance of early chest computed tomography (CT) for differentiating aortic dissection from pulmonary embolism in pregnant patients with dyspnea. We present the unique case of a 38-year-old pregnant woman with elevated D-dimer and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, initially suspected of having a pulmonary embolism. Initial transthoracic echocardiography did not indicate aortic dissection. Surprisingly, after an emergency cesarean section, a chest CT scan revealed a DeBakey type I aortic dissection, indicating a diagnostic error. Our findings emphasize the need for early chest CT in pregnant patients with dyspnea and elevated D-dimer and NT-proBNP levels. This case report highlights the critical importance of considering both aortic dissection and pulmonary embolism in the differential diagnosis of such cases, which will inform future clinical practice.

• 한국발생생물학회:학술대회논문집
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• 한국발생생물학회 2003년도 제3회 국제심포지움 및 학술대회
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• pp.82-82
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• 2003

Offspring have been produced from somatic cells in a number of species. This biotechnology introduced a new phenomenon in reprogramming and differentiation of somatic cell, namely totipotency. However, birth of oversized calves and perinatal abnormalities such as increased gestation length, lack of spontaneous parturition, higher incidence of dystocia, and reduced perinatal viability of offspring are frequently observed in pregnancies of cloned bovine fetuses. Disturbance of feto-placenta has been proposed as likely causes for abnomal growth. However. Little is known the mechanism responsible for the perinatal problems. Therefore, we focused on gestation length in somatic cell nuclear recipient cows. To solve this issues, placental tissues of control and cloned bovine were obtained by a cesarean section (C-section) before 5 days of paturition. Total RNA from control and cloned bovine placenta was extractd by TRIzol reagent. GeneFishing DEG kits (Seegene) were used to identify differentially expression genes. Total RNA (3 ug) were synthesized by M-MLV reverse transcriptase (200 u/ul) with 10 uM dT-annealing control primer (ACP1) at 42C for 90 min. Then, first-strand cDNA (50 ng) was amplified using the 5 uM arbitary ACP (1-20) and 10 uM dT-ACP2 primers. Some specific expression genes were amplified, Now, we are cloning and sequencing. These finding strongly can be support to solve the problems for parturition delay in nuclear transfer cows, suggest that placenta specific proteins are key indicators for the aberration of gestation and placental function in cows.

• 한국의료질향상학회지
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• 제7권2호
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• pp.190-202
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• 2000

Background : The objectives of this study were to examine patients' satisfaction with the DRG based payment method and its association with their awareness of the method, to examine patient reported changes in doctors' caring attitude, level of their out-of-pocket payments, providers' acceptance of patients' request for additional services after the program, and to examine changes in service utilization recorded in medical records. Method : One hundred-four patients who had cesarean sections before and after the demonstration program at two hospitals located in Seoul participated in the study. Patients were surveyed before discharges when their charges were finalized. Their medical records were reviewed as well to collect data for service utilization during hospital stays. The association between patients' satisfaction with the payment method and their awareness of the method was analyzed by ${\chi}^2$-test, and the significance of changes in providers' acceptance of patients' request for additional services and service utilization after the program were examined by ${\chi}^2$-test and t-test, respectively. Results : A large proportion of patients did not know of the DRG based payment method at the time of survey and a significantly larger proportion of patients who came to the hospitals with the knowledge satisfied with the method. About the same proportion of patients reported improvement and deterioration in doctors' caring attitude compare to the previous hospitalizations and a similar result was found concerning out-of-pocket payments. Providers' acceptance of patients' request for medication, PCA and painless delivery decreased significantly after the program whereas the acceptance for additional hospital days and laboratory and radiology tests did not. Length of stay, the numbers of days on antibiotics and antianemic medication, and the number of blood tests decreased significantly after the program, however, decreases in the rate of antianemic medication and the number of urine analyses were not statistically significant. Re-operation, in-hospital death, and complications were not observed before and after the program. Conclusion : The study findings indicated a need for better patient education and publicity about the newly introduced payment method to improve their satisfaction with the system. Other study findings concerning service utilization and quality of care indicators were consistent with the government funded evaluation studies.

• Pediatric Infection and Vaccine
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• 제14권2호
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• pp.145-154
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• 2007

목 적 : 로타바이러스는 전 세계적으로 영유아 및 소아 설사의 흔한 원인이며, 신생아의 원내 감염 중 가장 중요한 원인체로 알려져 있다. 본 연구는 출생한 병의원에서 퇴원 후에 즉시 산후 조리원으로 입소한 정상 신생아를 통해 출생한 병의원으로부터 기원한 로타바이러스 원내 감염을 분석하여 로타바이러스 항원 양성률, 연관인자, 증상 발현율, 임상 증상 및 감염 통제 방법에 대해 알고자 시행하였다. 방 법 : 2005년 3월부터 2006년 9월까지 서울위생병원 부설 산후 조리원에 입소한 정상 신생아 957명 중 입소하여 24시간 이내에 시행한 대변 내 로타바이러스 항원검사에서 양성을 보인 신생아 216명을 대상으로 하였다. 로타바이러스 항원검사는 면역 크로마토그래피법을 이용하여 시행하였다. 신생아에 대한 정보는 간호 기록지를 후향적으로 검토하여 입소 신생아의 성별, 출생 체중, 재태 연령 및 월별 로타바이러스 항원 양성률, 출생한 병의원, 분만 방법, 수유 방법, 증상 발현율 및 임상증상 등에 대해 조사하였다. 결 과 : 1) 입소 24시간 이내에 로타바이러스 항원 양성을 보인 신생아는 총 216명(22.6%)으로 남아가 126명(58.3%), 여아가 90명(41.7%)이었고, 출생 체중 및 재태 연령에 따른 차이는 없었다. 2) 입소한 신생아의 월별 로타바이러스 항원 양성률은 10-36%이었고, 출생한 병의원에 따른 로타바이러스 항원 양성률은 3.5-53.6%로 다양한 분포를 보였다. 3) 총 957명 중 정상 질식 분만으로 출생한 신생아는 655명(68.4%)으로 평균 재원기간은 2.4일이었고 제왕절개 분만으로 출생한 신생아는 302명(31.6%)으로 평균 재원기간은 5.7일이었다. 로타바이러스 항원 양성률은 정상 질식 분만군은 17.6%, 제왕 절개 분만군은 33.4%로 정상 질식 분만군에 비해 제왕 절개 분만군에서 로타바이러스 항원 양성률이 유의하게 높았다(P<0.001). 4) 입소 전 수유 방법에 따른 로타바이러스 항원 양성률은 모유 수유군 27명(12.5%), 분유 수유군 101명(46.8%), 혼합 수유군 88명(40.7%)이었고, 대조군에서는 모유 수유군 83명(38.4%), 분유 수유군 47명(21.8%), 혼합 수유군 86명(39.8%)으로 모유 수유군에서 로타바이러스 항원 양성률이 유의하게 낮았다(P<0.001). 5) 로타바이러스 항원 양성자 중 무증상군 및 증상군은 각각 65.3%, 34.7%이었다. 임상 증상으로 가장 많이 나타난 것은 설사로 69명(92.0%)에서 관찰되었고 수유부진 34명(45.3%), 열 30명(40.0%), 구토 19명(25.3%), 체중 증가의 지연 9명(12.0%), 소변양의 감소가 4명(5.3%)에서 나타났다. 대변의 양상은 수양변이 43명(61.3%)으로 가장 많았다. 입원 치료가 필요했던 경우는 24명(11.1%)이었고 중증 질환으로 진행된 경우는 없었다. 결 론 : 산후 조리원에 입소하는 신생아들 중 일부는 이미 출생한 병의원의 신생아실에서 로타바이러스 원내감염이 된 상태에서 입소하는 경우로 산후 조리원에서 신생아의 관리가 제대로 이루어지지 못할 때에는 2차적으로 산후 조리원 내 감염으로 급속히 전파될 수 있다. 따라서 로타바이러스의 감염 전파를 예방하기 위하여 모유 수유를 권장하고, 최근 증가하는 산후 조리원의 상황을 인지하여 항원 양성자를 격리하여 관리하는 것이 도움이 될 것으로 생각된다. 또한 산후 조리원에 대한 규제와 관리, 철저한 위생 교육 및 앞으로 좀 더 많은 연구가 필요하다.

• Clinical and Experimental Reproductive Medicine
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• 제36권2호
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• pp.121-127
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• 2009

목 적: 임신 능이 확인된 가임 여성에서 다능성 세포가 화생되거나 이전에 존재하던 골반 내 자궁내막증으로부터 발생하는 deciduosis의 발생빈도와 분포, 자궁내막증과의 관계를 알아보고자 하였다. 연구방법: 1990년 1월부터 2003년 12월까지 만삭임신에 이른 154명에서 제왕절개술시 의심되는 병변에서 조직검사를 시행하여 deciduosis의 빈도를 조사하였다. 결 과: 여러 다른 장기의 ectopic decidua는 94명 (94/154, 61%)에서 조사되었고, 이 중 66명 (66/94, 70.2%)에서 조직 검사상 deciduosis로 진단되었다. 발생빈도는 난소 (65/94, 69.1%), 난소와 자궁장막 (12/94, 12.8%), 자궁장막 (9/94, 9.6%), 복막 (2/94, 2.1%) 순이었다. 이 중 27예 (27/66, 40.9%)는 임신 전에 이미 자궁내막증으로 진단받아 다른 치료를 받았던 경력이 있던 여성이었고, 39예 (39/66, 59.1%)는 임신 전 자궁내막증으로 진단받지 않았던 경우였다. 임신 중에 deciduosis로 조직학적 확진을 받았지만 자궁내막증의 기왕력이 없었던 38명을 대상으로 2008년 4월 전화연락을 시도한 결과 통화 가능했던 18명 중 12명 (66.6%)이 다른 증상이 없어 특별한 치료 없이 지내고 있었다. 결 론: 본 연구에서 임신 시 조직학적으로 deciduosis가 확인된 대부분의 경우 자궁내막증으로의 진행은 없었다.

• Advances in pediatric surgery
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• 제17권2호
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• pp.179-187
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• 2011

Experimental tracheal ligation (TL) has been shown to reverse the pulmonary hypoplasia associated with congenital diaphragmatic hernia (CDH) and to normalize gas exchange. The purpose of this study was to determine whether the TL would correct the surfactant deficiency present in the fetal rabbit model of CDH by using lamellar body count. Lamellar bodies are synthesized and secreted by the type II pneumocytes of fetal lung. The phospholipids present in these bodies constitute the major component of pulmonary surfactant. Twenty-one pregnant New Zealand rabbits underwent hysterotomy and fetal surgery on gestational day 24. Two fetuses of each pregnant rabbit were operated. In the fetus of one end of bicornuate uterus, left DH was created by excision of fetal diaphragm through open thoracotomy (DH Group). In the fetus of the other end of bicornuate uterus, left DH and TL were created (TL Group). The fetuses were delivered by Cesarean section on gestational day 31. Fourteen in control group, 12 in the DH group and 13 in TL group were born alive. En bloc excision of lungs, bronchi and trachea was done in all newborn rabbits. A five Fr catheter was inserted through trachea and repeated irrigations with 10 cc normal saline were done. The irrigated fluid was centrifuged at $280{\times}g$ for 5 minutes and the lamellar bodies were counted with the upper level fluid in platelet channel of electronic cell counter. The average lamellar body counts were $37.1{\pm}14.2{\times}10^3/{\mu}L$ in control group, $11.5{\pm}4.4 {\times}10^3/{\mu}L$ in DH group, and $6.5{\pm}0.9{\times}10^3/{\mu}L$ in TL group. Lamellar body count in DH group was lower than in control group and did not increase after TL. This study shows TL has no therapeutic effect on decreased surfactant level of CDH and the pregnant rabbit is appropriate for the animal model of CDH.

• 대한한방부인과학회지
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• 제26권3호
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• pp.59-72
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• 2013

Objectives: The aim of this study was to assess the duration of lochia in women hospitalized at Korean medical postpartum care center and to identify factors that influence duration of lochia. Methods: On the obstetric variables of 315 cases, the duration of lochia was analyzed. In the postpartum care center, the obstetric variables were asked of 315 cases of women, and who examined a body composition. After discharge, women were surveyed for the duration of lochia by telephone. Results: The median duration of lochia was 30 days and the range was 18~53 days. Maternal age, parity and mode of delivery were associated with its duration. So, its duration was longer on women over the age of 35, multipara and women had a Cesarean section. Its duration was correlated with gestational age and BMI before pregnancy, but not neonatal gender, birth weight, maternal BMI change during pregnancy, maternal body weight gain, BMI before delivery. Conclusions: It was 30 days that the median duration of lochia of women who had been got Korean medical postpartum care management, and which was slightly different from previous studies. And it was influenced by maternal age, parity, mood of delivery, gestational age and BMI before pregnancy. In future more studies or surveys for the duration of lochia of women with no treatment, lochial pattern and so on should be done.

• Pediatric Infection and Vaccine
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• 제6권2호
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• pp.261-266
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• 1999

VRE 감염증은 항균제의 과다한 사용 후 출현하는 새로운 형태의 감염성 질환으로, 현재 심각한 임상 문제로 대두되고 있다. 최근 국내에서도 신경학적 장에나 당뇨병, 종양 등의 기저질환을 가진 성인 환자들에서 소수의 감염 예가 보고되고 있으나 소아기, 특히 신생아에서의 감염증은 잘 알려지지 않았다. 저자들은 생후 4일된 신생아에서 발생한 vancomycin 내성 E. faecalis 패혈증 l례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.