• Proceedings of the KOSOMBE Conference
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• v.1992 no.05
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• pp.27-47
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• 1992

Engineers have developed new instruments that aid in diagnosis and therapy Ultrasonic imaging has provided a nondamaging method of imaging internal organs. A complex transducer emits ultrasonic waves at many angles and reconstructs a map of internal anatomy and also velocities of blood in vessels. Fast computed tomography permits reconstruction of the 3-dimensional anatomy and perfusion of the heart at 20-Hz rates. Positron emission tomography uses certain isotopes that produce positrons that react with electrons to simultaneously emit two gamma rays in opposite directions. It locates the region of origin by using a ring of discrete scintillation detectors, each in electronic coincidence with an opposing detector. In magnetic resonance imaging, the patient is placed in a very strong magnetic field. The precessing of the hydrogen atoms is perturbed by an interrogating field to yield two-dimensional images of soft tissue having exceptional clarity. As an alternative to radiology image processing, film archiving, and retrieval, picture archiving and communication systems (PACS) are being implemented. Images from computed radiography, magnetic resonance imaging (MRI), nuclear medicine, and ultrasound are digitized, transmitted, and stored in computers for retrieval at distributed work stations. In electrical impedance tomography, electrodes are placed around the thorax. 50-kHz current is injected between two electrodes and voltages are measured on all other electrodes. A computer processes the data to yield an image of the resistivity of a 2-dimensional slice of the thorax. During fetal monitoring, a corkscrew electrode is screwed into the fetal scalp to measure the fetal electrocardiogram. Correlations with uterine contractions yield information on the status of the fetus during delivery To measure cardiac output by thermodilution, cold saline is injected into the right atrium. A thermistor in the right pulmonary artery yields temperature measurements, from which we can calculate cardiac output. In impedance cardiography, we measure the changes in electrical impedance as the heart ejects blood into the arteries. Motion artifacts are large, so signal averaging is useful during monitoring. An intraarterial blood gas monitoring system permits monitoring in real time. Light is sent down optical fibers inserted into the radial artery, where it is absorbed by dyes, which reemit the light at a different wavelength. The emitted light travels up optical fibers where an external instrument determines O2, CO2, and pH. Therapeutic devices include the electrosurgical unit. A high-frequency electric arc is drawn between the knife and the tissue. The arc cuts and the heat coagulates, thus preventing blood loss. Hyperthermia has demonstrated antitumor effects in patients in whom all conventional modes of therapy have failed. Methods of raising tumor temperature include focused ultrasound, radio-frequency power through needles, or microwaves. When the heart stops pumping, we use the defibrillator to restore normal pumping. A brief, high-current pulse through the heart synchronizes all cardiac fibers to restore normal rhythm. When the cardiac rhythm is too slow, we implant the cardiac pacemaker. An electrode within the heart stimulates the cardiac muscle to contract at the normal rate. When the cardiac valves are narrowed or leak, we implant an artificial valve. Silicone rubber and Teflon are used for biocompatibility. Artificial hearts powered by pneumatic hoses have been implanted in humans. However, the quality of life gradually degrades, and death ensues. When kidney stones develop, lithotripsy is used. A spark creates a pressure wave, which is focused on the stone and fragments it. The pieces pass out normally. When kidneys fail, the blood is cleansed during hemodialysis. Urea passes through a porous membrane to a dialysate bath to lower its concentration in the blood. The blind are able to read by scanning the Optacon with their fingertips. A camera scans letters and converts them to an array of vibrating pins. The deaf are able to hear using a cochlear implant. A microphone detects sound and divides it into frequency bands. 22 electrodes within the cochlea stimulate the acoustic the acoustic nerve to provide sound patterns. For those who have lost muscle function in the limbs, researchers are implanting electrodes to stimulate the muscle. Sensors in the legs and arms feed back signals to a computer that coordinates the stimulators to provide limb motion. For those with high spinal cord injury, a puff and sip switch can control a computer and permit the disabled person operate the computer and communicate with the outside world.

• Journal of Preventive Medicine and Public Health
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• v.17 no.1
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• pp.251-257
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• 1984

Low birth weight baby, defined as the baby born with less than or equal to 2,500g of body weight by WHO has been a great concern in the fold of maternal and child health since the low birth weight is a major cause of high perinatal mortality. Any measure to prevent the low birth weight baby is most desirable not only for saving the life of a baby but also for levelling up the health of the whole society. The authors attempted to figure out how some known maternal risk factors are related to the low birth weight and to measure their strengh of associations in terms of relative risk using hospital birth records. For this study, hospital birth records of 66 low birth weight cases and sex-parity matched 198 normal controls were chosen from Kangnam St. Mary's Hospital, Catholic Medical Center, and the data were analyzed in regards to several maternal factors. The risk factors studied were mother's age, mother's ABO blood type, previous histories of abortion, low birth weight baby, fetal wastage, and maternal diseases represented by anemia, hypertension, proteinuria, and glucosuria. The results obtained in this study were as follows: 1. The mean body weight of the cases and controls were 1,955g and 3,251g, respectively, and the heights were 41cm for cases and 50cm for controls. Mean gestation periods of cases and controls were 34 weeks and 39 weeks, respectively. 2. Young mother(less than or equal to 20 years of age) or old mother(more than or equal to 30 years of age) experienced more frequently the delivery of low birth weight babies than mothers in between 21 and 29 years of age. But the difference was not statistically significant. 3. Mothers whose blood type was O tended to have slighty higher frequency of low birth weight babies while B mothers have lower frequency. But the difference was not statistically significant too. 4. Those mothers who had experienced low birth weight baby in the past tended to give more births of low birth weight babies. This factor is even statistically significant and the relative risk of the prior experience of low birth weight was 6.7. 5. Mothers with experience of fetal losses and mothers of more than two pregnancies had higher frequency of low birth weight than the mothers with no fatal losses and of first pregnancy, but the difference was not statistically significant. 6. Statistically significant higher frequency of low birth weight were found in mothers with hypertension(odds ratio=4.07), anemia(odds ratio=22,33), and proteinuria(odds ratio=2.79). In summary, these study results strongly suggest that in order to prevent the low birth weight, special care should be made when the mother is too young or too old, and when the mother has experienced deliveries of low birth weight and fetal deaths. Medical control for the maternal diseases such as anemia and hypertension is also needed before or during the pregnency.

• Journal of Environmental Health Sciences
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• v.38 no.1
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• pp.8-17
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• 2012

Objectives: Perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) are man-made, persistent global pollutants widely diffused throughout the environment. They have been even found in the cord blood and breast milk of humans. Furthermore evidence of developmental toxicity in animals exists. To assess the distribution of maternal and fetal exposure to PFOS and PFOA, we analyzed paired maternal blood, cord blood and breast milk samples. Methods: Maternal blood, cord blood and breast milk were collected from 150 volunteers from the general population (aged 20-40, mean $30.5{\pm}2.9$) of the city of Busan in 2009-2010. The samples were extracted using the weak anion exchange and solid-phase extraction methods and quantified by high-performance liquid chromatograph (HPLC, Agilent 1200 Series) coupled with an Triple Quad LC-MS/MS system (Agilent 6410). Results: Median PFOA and PFOS concentrations in maternal blood were 2.18 and 3.32 ng/ml, in cord blood were 0.83 and 0.58 ng/ml, and in breast milk were 0.13 and 0.11 ng/ml, respectively. PFOS and PFOA concentrations were significantly correlated among matrices (Spearson's ${\rho}=0.226$, p = 0.05 for maternal blood; ${\rho}=0.736$, p < 0.01 for cord blood; ${\rho}=0.493$ p < 0.01 for breast milk). The ratio of cord blood/maternal blood was 0.39 for PFOA and 0.19 for PFOS. The ratio of breast milk/maternal blood was 0.07 for PFOA and 0.06 for PFOS. Conclusions: Our findings suggest that PFOA and PFOS exposure through the placenta was more prominent than through breast milk among Korean neonates born in Busan. The transfer efficiency of maternal blood to breast milk was similar between PFOA and PFOS, but that of maternal blood to cord blood was higher in PFOA than PFOS.

• Asian-Australasian Journal of Animal Sciences
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• v.15 no.4
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• pp.504-508
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• 2002

The effects of fetal number (single or twin) on blood glucose and plasma NEFA during pregnancy and around parturition were studied on ten Alpine ${\times}$ Beetal crossbred goats in their first to third lactation. The animals were divided in-groups 1(carrying single fetus, n=4) and 2(twin fetus, n=6). The samples were drawn on day1 after estrus and then at 14 days interval (fortnight) for 10 fortnights. Around parturition the samples were taken on days -20, -15, -10, -5, -4, -3, -2, -1 prior to kidding and on day 0 and +1, +2, +3, +4, +5, +10, +15, +20 days post kidding. In twin bearing goats the blood glucose concentration continued to increase from 1st until 4th fortnight and thereafter gradually decline from 5th upto 8th fortnight. In single bearing goats there was increase in levels from 2nd upto 4th fortnight and thereafter it declined from 5th uptill 9th fortnight. The difference in sampling interval was highly significant (p<0.01) in both the groups. However the values were higher in single than in twin bearing goats. The plasma NEFA concentration was low in both the groups' upto 4th fortnight and thereafter it is continuously increased upto 9th fortnight. During prepartum period the blood glucose was higher in single than in twin bearing goats. The values were minimum on the day of kidding in both the groups. During postpartum period the values were significantly (p<0.01) higher in twin than in single fetus bearing goats. The plasma NEFA was significantly (p<0.05) higher in twin than in single fetus bearing goats. The blood glucose and plasma NEFA concentration can be used as index of nutritional status during pregnancy and around parturition in goats.

• Journal of Yeungnam Medical Science
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• v.8 no.1
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• pp.72-78
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• 1991

Ephedrine sulfate was administrated 30 healthy parturients undergoing elective repeat cesarean section under spinal anesthesia. Fifteen patients received ephedrine infusion (0.01% solution, beginning with approximately 5 mg/min) immediately after induction of spinal anesthesia to maintain maternal systolic blood pressure between 90% and 100% of the baseline systolic blood pressure (mean dose of ephedrine 31.6mg). Fifteen patients (contral group) received 20mg of ephedrine as an intravenous bolus, and additional 10mg increments, if neccessary, when systolic blood pressure decreased to 80% of the baseline systolic blood pressure (mean dose of ephedrine 26.8 mg). Nausea and/or vomiting occurred in seven women in the control group and one patient in the infusion group (p<0.001). Apgar scores, fetal blood gas tension, and time for onset of respiration was comparable in the two groups. The results suggest that prophylactic ephedrine infusion is safe and desirable in healthy parturients undergoing cesarean section under spinal anesthesia.

• Clinical and Experimental Pediatrics
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• v.51 no.7
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• pp.722-728
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• 2008

Purpose : This study was designed to examine the effects of adiponectin, leptin, insulin, insulin-like growth factor (IGF)-I and IGF binding protein (BP)-3 levels in cord blood on weight, length, and adiposity at birth in healthy term infants. In addition, we evaluated the mechanism to change the hormone levels in appropriate for gestational age (AGA) during the first month. Methods : We collected cord blood from 200 term neonates (109 males, 91 females) with no perinatal problems, and measured the hormone levels and anthropometric parameters including weight, length, and skin-fold thickness. Term neonates were divided into 3 groups as follows: birth weight appropriate for gestational age (AGA) (n=132), birth weight less for gestational age (SGA) (n=29), and birth weight more for gestational age (LGA) (n=39). Venous blood samples of 15 fullterm healthy neonates were obtained at 3, 7, and 30 d after birth. Results : The adiponectin, insulin, and IGF-I levels were significantly lower in the SGA group than in the AGA and LGA groups. The leptin levels were significantly higher in the LGA group than in the AGA and SGA groups. Cord blood adiponectin, leptin, insulin, IGF-I, and IGFBP-3 levels correlated significantly and positively with birth weight and the sum of the skin-fold thickness. A significant positive correlation was observed between adiponectin, leptin, and IGF-I levels and birth weight. Adiponectin level correlated significantly with that leptin level (r=0.191, P=0.038), but not with insulin, IGF-I and IGFBP-3 levels. IGF-I levels were higher in females than in males. At 7 d after birth, the leptin level decreased along with physiologic weight loss, and then increased. IGF-I, also decreased at 3 d, significantly increased 1 month later. Conclusion : We suggest that adiponectin, leptin, insulin, IGF-I, and IGFBP-3 play an important role in regulating fetal growth. Adiponectin may be involved in regulating fetal growth through mechanisms different from those mediated by insulin or IGF-I. High levels of IGF-I in female neonates indicates a gender difference which serves as evidence for in utero sexual dimorphism. It is likely that IGF-I has a more important role than that of hormones in postnatal growth.

• Kidney Research and Clinical Practice
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• v.37 no.4
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• pp.356-365
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• 2018

Background: Woman kidney donors face obstetric complication risks after kidney donation, such as gestational hypertension and preeclampsia. Studies on childbirth-related complications among Asian women donors are scarce. Methods: This retrospective cohort study included woman donors aged 45 years or younger at the time of kidney donation in a single tertiary hospital between 1985 and 2014. Pregnancy associated complications were investigated using medical records and telephone questionnaires for 426 pregnancies among 225 donors. Matched non-donor controls were selected by propensity score and the maternal and fetal outcomes were compared with those of donors. Primary outcomes were differences in maternal complications, and secondary outcomes were fetal outcomes in pregnancies of the donor and control groups. Results: A total of 56 cases had post-donation pregnancies. The post-donation pregnancies group was younger at the time of donation and older at the time of delivery than the pre-donation pregnancies group, and there were no differences in primary outcomes between the groups except the proportion receiving cesarean section. Comparison of the complication risk between post-donation pregnancies and non-donor matched controls showed no significant differences in gestational hypertension, preeclampsia, or composite outcomes after propensity score matching including age at delivery, era at pregnancy, systolic blood pressure, body weight, and estimated glomerular filtration ratio (odds ratio, 0.63; 95% confidence interval, 0.19-2.14; P = 0.724). Conclusion: This study revealed that maternal and fetal outcomes between woman kidney donors and non-donor matched controls were comparable. Studies with general population pregnancy controls are warranted to compare pregnancy outcomes for donors.

• Applied Microscopy
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• v.31 no.1
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• pp.71-83
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• 2001

Laminin, a kind of multidomain glycoproteins, is mainly localized in the basement membranes of various tissues. It is known that laminin plays an important part in mammalian lung morphogenesis. The authors have undertaken this study to investigate the changes in the distribution of laminin, and to find out cells which synthesize laminin during the organogenesis and differentiation of the lung. The fetal and neoantal rats (Sprague-Dawley strain) were used as experimental animals. The immunohisto-chemical methods were employed for detection of laminin within the developing lung tissue and the immunegold cytochemical methods were performed for detection of cells which synthesize laminin according to each stage of development. The results are as follows; 1. During fetal life, strong immunoreactivity for laminin is maintained in the basement membranes of the blood vessels and the bronchioles, the extracellular matrix of the mesenchyme, and basal lamina of the alveolar septum in the fetal rat lung. 2. After birth, laminin immunoreactivity at the alveolar septum is gradually reduced. 3. During fetal life, laminin is mainly detected within the cytoplasm of the mesenchymal cells, the endothelial cells of blood vessels and the fibroblasts in fetal rat lung. 4. According to the differentiation of type I and type II pneumocyte after birth, laminin is detected within cytoplasm of the type I pneumocytes, type II pneumocytes and fibroblasts. It is consequently suggested that laminin is largely expressed in the developing lung and laminin may be also synthesized by the type II pneumonocytes at early newborn stages.

• 한국생물공학회:학술대회논문집
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• 2003.10a
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• pp.347-350
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• 2003

Dialysis and renal transplantation, the current therapies for end-stage renal disease (ESRD), have many limitations including severe complications, organ shortage, and graft failure. To overcome the limitations, the present study investigated the reconstruction of renal tissue in vivo by transplanting isolated fetal renal cells using fibrin gel to the kidney of renal failure rat model. After 4 weeks from the transplantation, blood urea nitrogen(BUN) and creatinine were examined from blood samples and histological examination of the implanted tissues revealed formation of renal-like structures and restoration of renal function.

• Clinical and Experimental Pediatrics
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• v.54 no.11
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• pp.443-455
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• 2011

Neonatal mortality rate (NMR) or infant mortality rate (IMR) are the rate of deaths per 1,000 live births at which babies of either less than four weeks or of one year of age die, respectively. The NMR and IMR are commonly accepted as a measure of the general health and well-being of a population. Korea's NMR and IMR fell significantly between 1993 and 2009 from 6.6 and 9.9 to 1.7 and 3.2, respectively. Common causes of infantile death in 2008 had decreased compared with those in 1996 such as other disorders originating in the perinatal period, congenital malformation of the heart, bacterial sepsis of newborns, disorders related to length of gestation and fetal growth, intra-uterine hypoxia, birth asphyxia. However, some other causes are on the increase, such as respiratory distress of newborn, other respiratory conditions originating in the perinatal period, other congenital malformation, diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism. In this study, we provide basic data about changes of NMR and IMR and the causes of neonatal and infantile death from 1983 to 2009 in Korea.