• Journal of Korean Society of Environmental Engineers
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• v.34 no.1
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• pp.7-15
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• 2012

The levels of indicator PCBs were determined in 132 human milk samples (Colostrum, 30th days after delivery, 60th days after delivery) collected in 2006 according to World Health Organization's (WHO) protocol. In addition, concentrations of indicator polychlorinated biphenyls (PCBs) were measured by the isotope dilution method with high resolution gas chromatograph/high resolution mass detector (HRGC/HRMS), which gave accurate and precise data for estimations of international trend and comparisons. Average daily intakes (ADIs) of all analytes were calculated. The median level of total indicator PCBs was 14 ng/g lipid, which is significantly lower than the level found in individuals from other countries. PCB congeners 138, 153 and 180 accounted for about 65% of the sum of the indicator congeners analyzed. The concentration of the most abundant PCB 153 is positively correlated with the concentration of the sum indicator PCBs (p<0.001). In this study, concentrations of total indicator PCBs significantly decreased with increasing number of children for a mother, indicating that parity and breast-feeding period an important role in the accumulation and elimination of these compounds in lactating women. The ADI for the median of total indicator PCBs for an infant was evaluated at $0.077{\mu}g/kg{\cdot}bw/day$ from birth to 6 months of age. The present study shows that concentrations of PCB 118 primipara breast milk have decreased 25~35 since 1998, and that this trend is continuing.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.3
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• pp.599-610
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• 2016

This paper reports the results of a systematic review (SR) and meta-analysis research to compare the effect of Kangaroo care, targeting mothers and premature infants. A randomized clinical trial study was performed until February 2015. The domestic literature contained the non-randomized clinical trial research without restriction according to the level of the study design. A search of the Ovid-Medline, CINAHL, PubMed and KoreaMed, the National Library of KOREA, the National Assembly Library, NDSL, KISS and RISS. Through the KMbase we searched and combined the main term ((kangaroo OR KC OR skin-to-skin) AND (care OR contact)) AND (infant OR preterm OR Low Birth Weight OR LBW), ((kangaroo OR kangaroo OR kangaroo) AND (care OR nursing care OR management OR skin contact)) was made; these were all combined with a keywords search through the selection process. They were excluded in the final 25 studies (n=3051). A methodology checklist for randomized controlled trials (RCTs) designed by SIGN (Scottish Intercollegiate Guidelines Network) was utilized to assess the risk of bias. The overall risk of bias was regarded as low. In 16 studies that were evaluated as a grade of "++", 9 studies were evaluated as a grade of "+". As a result of meta-analysis, kangaroo care regarding the effects of premature mortality, severe infection/sepsis had an insignificant effect. Hyperthermia incidence, growth and development (height and weight), mother-infant attachment, hypothermia incidence, length of hospital days, breast feeding rate, sleeping, anxiety, confidence, and gratification of mothering role were considered significant. In satisfaction of the role performance, depression and stress presented contradictory research results for individual studies showing overall significant difference. This study has some limitations due to the few RCTs comparing kangaroo care in the country. Therefore, further RCTs comparing kangaroo care should be conducted.

• Clinical and Experimental Pediatrics
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• v.50 no.9
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• pp.912-918
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• 2007

Purpose : Breast milk contains several components that provide specific immunity and affect the maturation of the infant's immune system. Allergic disease (AD), including atopic eczema, asthma, allergic rhinitis, and food allergy is characterized by an imbalance between cytokines produced by distinct T-helper cell subtypes. The aim of the study was to investigate the concentrations of cytokines and chemokines that were involved in allergic reactions in breast milk from allergic and nonallergic mothers and then analyse the effect of breastfeeding duration on the prevalence of allergic disease in the age of two. Methods : The breast milk samples were collected from mothers with AD (n=88) and without AD (n=47). Breast milk was collected at the second day (colostrum) and four weeks later (mature milk).The level of Interlukine (IL)-4, IL-5, IL-6, IL-8, IL-10, IL-13, $TGF-{\beta}1$, $TGF-{\beta}2$, RANTES in breast milk were determined by commercially available enzyme-linked immunosorbent assay (ELISA) kits according to the manufacturer's instructions. Results : Mothers with AD had a higher concentration of IL-8 in colostrum compared with those without AD (P=0.021). But, $TGF-{\beta}1$ and $TGF-{\beta}2$ were higher concentrated in colostrum of mother without AD (P=0.013, P=0.001). Whereas concentrations of other cytokines were not significantly different between the two groups. There was no association between levels of cytokines and chemokines in the breast milk and allergic development during the first 2 years of life in the infants. Conclusion : The higher concentration of $TGF-{\beta}1$ and $TGF-{\beta}2$ in colostrum from non-allergic mothers may explain the protective effect. But, the higher concentrations of IL-8 in colostrum from allergic mothers may in part explain the controversial results on the protective effect of breastfeeding against allergic diseases. We conclude that there is no convincing evidence form a relation between cytokines in breast milk and allergic diseases in infants. Longer follow-up are necessary to evaluate the effects of breast milk components on AD.

• Journal of Preventive Medicine and Public Health
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• v.1 no.1
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• pp.9-23
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• 1968

A survey was conducted by the staff of the College of Medicine and School of Public Health, Seoul National University in cooperation with Seoul Special City from 1 December 1967 through 28 February 1968, on such events as delivery, death, abortion and pregnancy. The survey directed to a total population of 47,811 residing in 9,157 households led us to the following findings: 1. Two year averages of crude birth rate, crude death rate and natural increase rate were 30.1, 5.6 and 24.5, respectively. 2. Of all deliveries, home and hospital deliveries constituted 61.1 per cent and 35.5 per cent, respectively. 3. Deliveries other than hospital deliveries were found to be attended more often by mother-in-laws (26.5 per cent) than by doctors or midwives(23.4 per cent). 4. About 51 per cent of all women having experiences in pregnancy during the last two years had an experience of consulting a doctor at least one time throughout whole period of pregnancy. 5. In most cases scissors were used to cut umbilical cords, of which 71.0 per cent were not sterilized and only 20.3 per cent sterilized. 6. In many cases placenta was incinerated(48.2 per cent) and on many other occasions it was thrown away into water(28.3 per cent). 7. Cement bags(37.4 per cent), gauze and absorbent cotton(29.8 per cent) were found to be most frequently used to receive new-born babies. 8. In 1966 8. 8 per cent of the women had at least one abortion induced and in 1967 the percentage was 9.2 per cent. 9. Nearly all(95.8 per cent) of the induced abortions reportedly were done at doctor's clinics. 10. Of all the abortions induced 65.3 per cent were done by specialists in obstetrics, 30.3 per cent by general practitioners and 2.7 per cent by midwives. 11. Those who experienced spontaneous abortions were 1.9 per cent of all women both in 1966 and 1967. 12. About 9.2 per cent of women investigated were found to be currently pregnant. 13. Age specific death rate turned out to be highest among those under 1 year of age. 14. Ten major causes of death in their order of frequency were: 15. Places of death can be classified into homes(75.3 per cent) and hospitals(13.2 per cent). 16. Method of disposing of corpses comprised burials(54.2 per cent) and cremations(44.6 per cent). 17. Infant, neonatal and hebdomadal mortality rates have been computed at 32.2, 18.9 and 13.7, respectively. 18. Infants were found to have died either at homes(81.5 per cent) or at hospitals(18.5 per cent). 19. Birth registrations had been done for about 18.5 per cent of the dead infants.

• Journal of Genetic Medicine
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• v.8 no.1
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• pp.71-75
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• 2011

A male infant was diagnosed with obstetric brachial plexus injury, congenital muscular torticollis and cleft palate 17 days after birth. His mother presented with gestational diabetes and premature rupture of membranes. Although it is possible that these three disorders arose independently, it is very likely that all three have the same etiologic cause, and we propose that a possible mechanism for this concurrence is related to maternal gestational diabetes. Maternal hyperglycemia mostly affects fetal structures deriving from the neural crest, including the palatine bone, and may have caused the cleft palate observed in this case. Gestational diabetes is also associated with increased frequency of large for gestational age infants and, by extension, with increased risk of birth injuries such as obstetric brachial plexus injury or congenital muscular torticollis associated with large for gestational age infants. Since the children of mothers with gestational diabetes are at increased risk for congenital defects such as cleft palate as well as being large for gestational age, precautions indicated for each respective disorder must be taken during prenatal testing and during birth. However, further studies of more cases are required to evaluate whether the concurrence of obstetric brachial plexus injury, congenital muscular torticollis and cleft palate in this case are complications specifically associated with gestational diabetes or just a simple coincidence.

• Clinical and Experimental Pediatrics
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• v.49 no.4
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• pp.381-387
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• 2006

Purpose : Neonatal lupus is characterized by congenital complete heart block(CCHB), cutaneous rash, and laboratory abnormalities in infants born to mothers with systemic lupus erythematosus(SLE). This study aims to examine the incidence of CCHB and clinical outcome in neonates born to mothers with SLE. Methods : The study group consisted of 49 neonates, born from 57 pregnancies of 55 women with SLE, diagnosed at Hanyang University Hospital for the period between January 1997 and January 2005. Clinical and laboratory data were retrospectively identified from medical record. Results : There were 5(8.8 percent) spontaneous abortions and one(1.8 percent) still births among 57 pregnancies of 55 mothers. Of 49 live births, 15(26.3 percent) were premature and eight(12.3 percent) were small for their gestational age. There was one(1.8 percent) CCHB suspected during pregnancy on fetal echocardiograpy in a fetus of mother with systemic lupus erythematosus and the fetus was not born by artificial abortion because of mother. There was no CCHB among EKG findings of 49 newborns. Laboratory testing showed hematologic abnormalities among 25.6 percent(10/39) of the babies. 5.1 percent(2/39) and 7.7 percent(3/39) of them were diagnosed as neutropenia, and thrombocytopenia was seen respectively. Anti-SSA(Ro) and antiphospholipid antibodies were predictive factors for prematurity(P=0.003, P=0.049). Anticardiolipin antibodies were predictive factors for ventilatory care(P=0.018). Conclusion : The incidence of CCHB among neonates born to mothers with SLE, which was measured in this study, was lower than that in earlier studies. A high incidence of hematologic abnormalities was found in our study. It is suggested that careful examination should be made of skin for the diagnosis of neonatal lupus.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.1
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• pp.21-30
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• 2005

Purpose: The aim of this study was to identify the clinical features and natural history of dietary protein induced proctocolitis (DPIPC) and to detect the causative foods of DPIPC, and to evaluate the effect of elimination of the foods on the course of the disease. Methods: Between March 2003 and July 2004, data from 30 consecutive patients with DPIPC who were followed for over 6 months, was reviewed. The diagnostic criterion used for DPIPC was an increase in the number of eosinophils in the lamina propria (${\geq}60per$ 10 high-power fields). In breast feeding mothers, 5 highly allergenic foods were eliminated from the maternal diet for 7 days, namely, allergenic food groups such as dairy products, eggs, nuts and soybean, fish and shellfish, and wheat and buckwheat. We observed the disappearance or appearance of hematochezia after elimination or challenge with the offending foods. Results: Before diagnosis infants were breast-fed (93.3%) or formula-fed (6.7%). Mean age at symptom onset was $11.5{\pm}5.1$ (5~24) weeks, and mean age at diagnosis was $17.8{\pm}9.5$ (8~56) weeks. Duration from symptom onset to diagnosis was $6.3{\pm}6.7$ (0~36) weeks. Mean peripheral blood eosinophil count was $478{\pm}320$ (40~1,790)/$mm^3$ and eosinophilia (> $250/mm^3$) was observedin 90.0% of patients. None of patients were found to have an increased serum IgE level. Of 15 patients that received sigmoidoscopy, nodular hyperplasia with erosion was observed in 93.3%. Of 27 patients whose mother ate the diet eliminated the 5 food groups, hematochezia diappeared in 74.1% of patients. Offending foods were identified as dairy products (37.5%), wheat and buckwheat (27.5%), fish and shellfish (20.0%), nuts and soybean (7.5%) and eggs (7.5%). A free maternal diet without patient's clinical symptoms was achieved at $29.4{\pm}8.7$ (9~44) weeks of patient's age, and a free baby diet without blood in stools was achieved at $37.5{\pm}9.7$ (12~56) weeks of age. Conclusion: DPIPC commonly occurs in exclusively breast-fed babies. Elimination of the above-mentioned 5 hyper-allergenic food groups from the maternal diet for 7days enables the detection of the offending foods. DPIPC is a transient disorder and 96.0% of patients can tolerate the offending foods at 12 months of age.

• Clinical and Experimental Pediatrics
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• v.52 no.11
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• pp.1207-1215
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• 2009

Purpose:To review and determine the complications in 76 child abuse cases recorded by a multidisciplinary hospital-based child protection team between 1987 and 2007. Methods:We retrospectively reviewed the reports and medical records of child abuse cases maintained by a university hospital-based child protection team. We devised a questionnaire for standardized interviews with the victims' guardians to determine the current physical and mental status of the children; questionnaires were answered by social workers of the child protection team who interviewed the present fosterers of 24 (35.8%) children. Results:Of the 76 children, 6 were infants, 10 were 1-3 years old, were 3-10 years old, and 19 were over 10 years old. Seven children (9.2%) were neglected and 27 (35.5%) and 44 (57.9%) were sexually and physically abused, respectively. In more than half of the cases, the perpetrators were the father or mother of the children. Most children (41 cases, 53.9%) were abused at their homes. The mean follow-up duration from the time of abuse infliction was $54.3{\pm}49.2$ months, and the current mean age of the children was $8.3{\pm}6.4$ years. Moderate and severe developmental delay and physical disability were observed in 6 (25.0%) and 3 (12.5%) cases, respectively. In 13 children (54.2%), the Global Assessment of Functioning Scale (GAF) score was less than 60, which indicates mild mental disability. Conclusion:A hospital-based child protection team may witness the different proportion of abuse types and patterns by conducting a nation-wide survey of child abuse cases.

• Journal of Nutrition and Health
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• v.8 no.4
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• pp.15-26
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• 1975

The purpose of this paper is to investigate the nutrients intake situation and the physical growth and development of junior high school girls in cheju island, the peculiar area in Korea, and to study every possible correlation ketween daily food intake and growth rate of them. Further, it made an attempt to research nutrition problems for them in this area and assist in their growth and development through proper nutritional marragement. The survey was conducted in seven sample schods selected randomly from all three districts -this is Bukcheju-gun, Namcheju-gun and cheju city-of cheju Island. Four hundred eighteen girls, aged thirteen years ald, in second year grade of junior high schools, were provided with prepared questionnaires. For six days, July $16{\sim}21$ in 1975, the respondents filled out the questionnaires. They were asked to keep record of what they ate each meat. Their mitrients intake were analyzed in accordance with their daily food intake records during a six day period. On the other side, including physical growth index calculated by means of weight and hight of the respondents, their school records were also investigated. Critical Ratio as well as percentage calculation were included for statistical analysis. The findings and results abtained are summarized as follows: (1) Living circumstance a) Average numbers of brother and sister in sampled pupils' family were five. b) Niety percent of the respondents were brought up by mother's milk at their infants and 45 percent of them were weaned at the age of 13 to 24 months. c) Fourty-six percent of them revealed irregulity in their meal time. d) The most favorite main dish was boiled rice mixed other cereals (34%), next bread (31%) and boiled noodle (26%), and kimchi was the most papular side dish (64%). (2) Nutrition survey a) The average calorie intake of a pupil per day was 1,783 cal. and the total calorie intake was composed of carbohydrate 73%, pratein 15%, fat 12% respectively. b) Carolie and nutrients were lower than the recommended level, except vitamins A,$B_1$ and Niacin, c) Average protein intake per day was 68g, which was relatively near to the recommended level, but in fact, most of them came from grain which is lacking in essential amino acids. The ratio of animal protein intake to tatal protein intake was 36%. d) Their average animal food intake was proportionated in 14% in their total food intake and the cereals consumed in the largest quantity at the level of 63% out of whole food groups. (3) The results of statistical analysis a) The correlation between the calorie intake and the physical growth index revealed statistical significancy at the level of P<.005. b) The correlation between the protein intake and the physical growth index revealed statistical significancy at the level of .01

• Pediatric Infection and Vaccine
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• v.16 no.2
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• pp.191-198
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• 2009

Purpose : Breastfeeding should be recommended for infants born to mothers with chronic hepatitis B Infection after postexposure prophylaxis. However, high proportion of these mothers are reluctant to engage in breastfeeding in Korea. This survey was taken to identify the cause of that reluctance. Method : Questionnaires were given to mothers with chronic hepatitis B infection who were registered at the 'Hepatitis B Perinatal Transmission Prevention Program' operated by Korea Center for Disease Control and Prevention. They visited a community health center for blood sample collection and signed a consent paper. The questionnaires were sent to the mothers. Result : Among 839 mailed questionnaires, 114 were returned marked 'address unknown'. The overall reply rate was 17% (n=125). Among responders, 52% (n=62) were breastfeeding and 48% (n=60) were formula-feeding. The most influential factor for breastfeeding was the mother's own decision (75%) and the obstetrician's recommendation (17%). For formulafeeding mothers, their decisions were influenced by obstetricians (57%), and by their own thinking (28%). The relationship between breastfeeding and perinatal prophylaxis failure was recognized as 45% 'related' and 50% 'not-related'. A total of 91% of breastfeeding mothers replied that they will breast-feed again. Among formula-feeding mothers, 78% answered that they will breast-feed if they were known that 'there is no direct relationship between breastfeeding and perinatal prophylaxis failure'. Conclusion : Despite the fact that there is no direct relationship between breastfeeding and perinatal prophylaxis failure, many were reluctant to breast-feed. Healthcare professionals have influence over the mothers for decision making. It will be necessary to educate healthcare personnel so that they can make a conceptual change as well as to promote the fact to the general public.