• Clinical and Experimental Pediatrics
• /
• v.53 no.3
• /
• pp.349-357
• /
• 2010

Purpose : Transient tachypnea of the newborn (TTN) is usually benign and improves within 72 hours. However, it can also progress to prolonged tachypnea over 72 hours, profound hypoxemia, respiratory failure, and even death. The aim of this study is to find predictable risk factors and describe the clinical courses and outcomes of prolonged TTN (PTTN). Methods : The medical records of 107 newborns, >$35^{+0}$ weeks of gestational age with TTN, who were admitted to the NICU at Seoul Asan Medical Center from January 2001 to September 2007 were reviewed. They were divided into 2 groups based on duration of tachypnea. PTTN was defined as tachypnea ${\geq}72$ hours of age, and simple TTN (STTN) as tachypnea <72 hours of age. We randomly selected 126 healthy-term newborns as controls. We evaluated neonatal and maternal demographic findings, and various clinical factors. Results : Fifty-five infants (51%) with total TTN were PTTN. PTTN infants had grunting, tachypnea >90/min, $FiO_2$ >0.4, and required ventilator care more frequently than STTN infants. PTTN had lower level of serum total protein and albumin than STTN. The independent predictable risk factors for PTTN were grunting, maximal respiration rate >90/min, and $FiO_2$ >0.4 within 6 hours of life. Conclusion : When a newborn has grunting, respiration rate >90/min, and oxygen requirement >0.4 of $FiO_2$ within 6 hours of life, the infant is at high risk of having persistent tachypnea ${\geq}72$ hours. We need further study to find the way to reduce PTTN.

• Clinical and Experimental Pediatrics
• /
• v.50 no.8
• /
• pp.740-745
• /
• 2007

Purpose : There is a dominant opinion that in vitro fertilization (IVF) leads to an increased incidence of twins, low birth weight (LBW) infants, prematurity and mortality. On the other hand, technical development of IVF and improvement of neonatal intensive care have increased the survival rate of neonates. The purpose of this study was to verify the tendency by comparing the clinical aspects of IVF and spontaneously conceived twins, and to establish methods to increase the survival rate of neonates after IVF. Methods : Retrospective reviews were performed on all twin infants who were admitted to the nursery and NICU at Kangnam Sacred Heart Hospital, Hallym University from January 1, 2000 to December 31, 2006. Medical records of IVF twins (study group, n=92) and spontaneously conceived twins (control group, n=265) were analyzed and compared. Neonatal outcomes and complications, as well as obstetric outcomes, were analyzed and compared. Results : Mean gestational age and birth weight of the study group ($34.6{\pm}3.5$ weeks, $2,203.9{\pm}617.2g$) were considerably lower than those of the control group ($36.3{\pm}2.4$ weeks, $2,367.0{\pm}517.9g$). The frequency of prematurity less than 37 weeks (68.5% vs 51.3%) and extremely LBW (15.2% vs 6.4%) were also significantly higher in the study group. Other neonatal outcomes were all insignificant. The obstetric characteristics, maternal age ($32.6{\pm}3.3$ years vs $30.3{\pm}3.9$ years) and the frequency of cesarean delivery(95.7% vs 79.9%) were significantly higher in the study group. Other obstetric outcomes were insignificant except for the frequency of incompetent internal os of cervix (36.2% vs 3.6%) and cerclage operation (38.3% vs 4.3%). Conclusion : Based on the above results, clinical outcomes of twin infants will be further improved by careful attention and thorough antenatal care of the IVF twins.

• Advances in pediatric surgery
• /
• v.16 no.1
• /
• pp.1-10
• /
• 2010

The members of the Korean Association of Pediatric Surgeons conducted a retrospective study of two hundred and twenty-two cases of intestinal atresia for the period from January 1, 2007 to December 31, 2009. Seventeen hospitals were involved. There were 76 duodenal, 65 jejunal, and 81 ileal atresias (3 colonic). The male to female ratio was 0.85:1 in DA and 1.34:1 in JIA. Ninety-four patients(43.3 %) were premature babies (DA 40.3 %, JA 64.6 %, IA 28.8 %), and 70 babies (32.0 %) had low birth weight (DA 38.7 %, JA 44.4 %, IA 16.0 %). Antenatal diagnosis was made in 153 cases (68.9 %). However, 27 infants (17.6 %) with antenatal diagnosis were transferred to the pediatric surgeon's hospitals after delivery. Maternal polyhydramnios was observed in 81 cases (36.59 %) and most frequent with proximal obstruction. In forty-four cases (19.8 %), only simple abdominal film was taken for diagnostic study. The associated malformations were more frequently observed in DA - 61.8 % in DA and 22.6 % in JIA. Meconium peritonitis, small bowel volvulus and intussusception were more frequently associated with ileal atresia. The overall mortality rate was 3.6 %. (Abbreviations: DA;duodenal atersia, JA;jejunal atresia, JIA;jejunoileal atresia, IA;ileal atrsia).

• Journal of Yeungnam Medical Science
• /
• v.7 no.2
• /
• pp.67-77
• /
• 1990

This study was intended to analyse the relation between the psychic traumatic experience and the psychological health of the aged. The authors carried out this study by means of the combined anxiety-depression scale(CADS) and the preadolescence traumatic experience scale(PTES) with 278 aged men and women residing in Taegu from September to October 1988. The results were as follows : 1. Based on the scores avaluated by CADS, the scores of the both groups showed that comparative group was accounted for $40.15{\pm}6.19$, while the experimental group for $57.75{\pm}6.37$, which showed significantly higher score in the experimental group(p<0.001). 2. The experimental group showed significantly higher early experience score than the comparative group in the dietary difficulty, alcoholism among family members, disunion between husband and wife, trouble between mother and children, early mother loss, parent's indifference and unwanted birth(p<0.001). 3. The experimental group showed higher early experience score than the comparative group by sex, age, marital status and grown location(p<0.001). 4. When the subjects were included in the unemployed and in the middle or low classes and their parents were engaged in agriculture and commercial business and believing in buddhism or non-religion, showed higher experience score (p<0.001).

• Clinical and Experimental Reproductive Medicine
• /
• v.34 no.4
• /
• pp.285-291
• /
• 2007

Objective: To evaluate the outcomes of in vitro fertilization and embryo transfer (IVF-ET) in women over 40 years of age. Methods: A total of 170 patients (271 cycles) over 40 years of age who underwent IVF-ET at Seoul Women's Hospital (Incheon, Korea) were analyzed in this study retrospectively. The patients were grouped into the women <44 years old group and the women $\geq$44 years old group. Statistical analysis was performed using Student's t-test and Fisher's exact test as appropriate. Results: An overall clinical pregnancy rate per retrieval was 11% (30/271). Of these, clinical miscarriage rate were 33% (10/30) and the overall delivery rate was 7.4% (20/271) per retrieval, respectively. The women $\geq$44 years old group had significantly higher cancellation rate (13% vs. 25%), lower number of retrieved oocytes (6.17$\times$4.62 vs. 4.13$\times$4.07), decreased number of 2PN (4.83$\times$3.61 vs. 3.46$\times$3.12), and reduced embryos for transfer (3.52$\times$1.72 vs. 2.81$\times$1.83) than the women <44 years old group. We found significantly lower clinical pregnancy rate (13.0% vs. 2.1%) and live birth rate (9.0% vs. 0.0%) in the women $\geq$44 years old group than the women <44 years old group. Conclusion: The present study has shown that IVF outcome is seriously impaired in the women $\geq$44 years old.

• Journal of Preventive Medicine and Public Health
• /
• v.9 no.1
• /
• pp.11-24
• /
• 1976

This study was a part of large scale of a prospective study on attitudes of professional students in medicine, nursing and teaching toward population related issues in Korea. The study was first conducted in May 1974 and then in May 1975 for the 1974 class cohot using a questionaire consisted of attitude scales and other items developed by Lee. The purpose of stuay was twohold, namely, to determine the difference in students among specializations on one hand and between the first and second years in the 1974 class cohot regarding tile subject matter. A one-way analysis of variance was used for attitude scale, and absolute and relative frequency were computed for the analysis of non-attitude scale items by employing Fishers' Ratio and Duncan's multiple range test at 5% level and chi square test at 5% level as significance tests. The hypothesis 'students in health profession are more likely to have positive attitudes toward population related issues progressively as class year advances than students in teaching profession' was tested and the following results were obtained: 1) Nursing students were more likely to display favarable attitudes toward family planning than medical or teaching students although the class cohot showed slightly negative improvement in the second year. Medical and teaching students apperaed to have slightly improved attitudes in the second year. 2) Respondents in general perceived national family planning program as a means of population control and this tendency was more true among nursing students as the class year advances than two other professional groups of students. Students in teaching profession appeared to perceive it more as a means to improve individual family welfare while health students were likely to see as to improve maternal and child health. This tendency was progressively improved as the class year advanced. 3) The majority of students regardless of their respective specializations believed that family planning program should be directed toward the improvement of individual family welfare. No progressive changes in the class cohot were observed. 4) About the plan to use contraceptives in future, no singnificant differences were observes among different specializations nor in different class years. However, the majority was confirmed to have a plan to use contracepives in future. An increasing proportion of the undecided category was observed, as class year advanced among health students. 5) Students in health profession were found to be more favorable about 'more leisure opportunities' as motive for limiting number of children whereas education students indicated the reasons as 'facilitate ambitions' and 'economic base' The progressive changes toward positive direction in both groups were observed as the class years advanced. 6) Attitudes toward induced abortions of the health students were observed to be positively related to class years while an inverse relationship was found in teaching students who showed much less favor in the subject matter than health students. This phenomenon may be due to the different exposure to learning environments unique to respective specializations. 7) Health students were found to have more favorable attitudes toward population education in general than the teaching students. The teaching students appeared to have changed more to the negative direction when they became the second year while no such development was observed in health students. The teaching students seemed to hold a very conservative position with regard to sex education in schools. 8) About the equality of sexes, the nursing group was found to be most favorable while the reverse was true in the teaching group. A change in the negative direction as the class year advanced was found in the teaching group. 9) About questions related to fertility values-the 10 percent of respondents regardless of specialization indicated that they would maintain their single status in future, however no change was observed in the second year. The desired number of children was found to be two by the majority of students in nursing, medicine and teaching in order of high proportion. No changes in a different class year were observed. The childless marriage was seen by nursing students as a problem more than other students, but a slight change in positive direction was found when the nursing students became the second year. In summing, as data supported in the above, students in health profession demonstrated more favorable attitudes toward population related issues than the teaching students and this tendency became more apparent in the second year. It was noticed that health students were more conscious about the health aspect of population and family planning program while the teaching students gave more attention to the socioeconomic aspect. The sex variable seemed to have operated in the item related to the equality of sexes. In conclusion, as data presented in the above, the hypothesis of this study was accepted except in the few items. It should be noted that the limitation of this study is the short duration of the observation in measuring the possible attitude changes. It should include curriculum analysis for the respective specializations in order to indentify the area of curriculum impact on students in future study.

• Journal of Preventive Medicine and Public Health
• /
• v.9 no.1
• /
• pp.55-64
• /
• 1976

This paper presents the results of a survey for the causes of sensori-neural hearing impairment in Korea, The subjects were 1,676 children of total 2,928 enrolled in 16 Deaf Schools; two schools in each area of Seoul, Busan, Kyoungbook, Kyoungnam, Kyounggi and Chunbug, and each one in Chungnam, Chungbug, Chunnam and Jaeju. The data were collected by questionaire with 28 items distributed to their parents. The filling in the check lists were performed by their class teachers, interviewer, for 18 months from September, 1975 to february, 1976. The questionable or missed problems were reaffirmed. The results obtained were as follows. Most of the reasons, 78.5% were acquired characters that could be developed during pregnant period, the time of delivery and the time of after birth. The pure hereditary reasons except the cases complexed with one or two were only 11.3%. Those who could not be defined with any reasons were 10.2%. Among the acquired causes, 5.8% of total subjects were developed for pregnancy: 3.3%, during delivery; and 69.7%, after birth. In the pregnant period, the drug intoxications were 2.4% of total subjects, several diseases such as influenja, bleeding, surgical operation, venereal diseases and rubella etc. were about one percent, and the accompanied with some symptoms of pregnancy intoxication and traumatic events were 2.4%, During time, the cases with delayed rhythmical pain were 16 persons, the immaturities were 11, the asphyxial cases were nine, the errors of forceps delivery were seven, the cases of low body weight inspite of full term were four, the cases with cesarian section were three, the head injuries were two, and the accompanied with three kinds of above reasons were three. During after birth, the cases with acute communicable diseases were 35.4% of total subjects, the fever unknown origin were 16.1%, the chronic otitis media were 3.7%, the meningitis were 3.5%, the gastric and nutritional diseases were 3.5%, the drug intoxications were 4.8%, the blood diseases were 0.3% and the other causes were 2.2%. Here by acute communicable diseases, some importants were measle, 10.1% of total subjects; meningitis, 7.3%; convulsion with some reasons, 4.9%; poliomyelitis. 3.2%; encephalitis, 2.4%; and mumps, rubella, pertusis, scarlet fever, and small pox were somewhat played a role in. Among 59 cases with train diseases, 53 were concussion by the accidents, such as traffic and falling or sliping down etc., the cerebral paralysis and hydrocephalus were two, respectively. And the blood diseases were severe newjaundice in all five cases. If we were summarized with the above mentioned, most of the hearing impairments were introduced by the combined reasons with familial or hereditary factors and the acquired, than by a simple disease. Among the congenital or hereditary hearing impairments classified to now a day, we suppose that the many cases with the acquired causes during pregnancy, delivery and after birth were complexed. Subsequently, the maternal and child health should be more and more developed in our country, also.

• Korean Journal of Community Nutrition
• /
• v.13 no.4
• /
• pp.555-564
• /
• 2008

Essential fatty acids are important essential nutrients during pregnancy. The objective of this study was to compare fatty acid composition of serum phospholipids and essential fatty acid intakes between Korean pregnant women with a single baby and Korean pregnant women with twins. A total of 116 pregnant women who had maintained their health without any symptoms of pregnancy complications participated in the study. The subjects consisted of 57 women of singleton pregnancy and 58 women of twin pregnancy at the 1st, 2nd, or 3rd trimester of pregnancy. A 24-hour dietary recall was administered to each subject to obtain dietary information. The mean ages of the singleton pregnancy group and the twin pregnancy group were 31.44 years and 32.27 years, respectively, and the mean height values were 161.86 cm and 160.64 cm, respectively. The mean daily energy intakes in the singleton pregnancy group were 1639.95 kcal, 1904.71 kcal, and 1882.82 kcal for the 1st, 2nd, and 3rd trimester group, respectively. The mean daily energy intakes in the twin pregnancy group were 1745.99 kcal, 2203.46 kcal, and 2092.26 kcal for the 1st, 2nd, and 3rd trimester group, respectively. There were no significant differences in the mean fatty acid intakes by the type of pregnancy (i.e., singleton vs. twins) and the stage of pregnancy (i.e., 1st vs. 2nd vs. 3rd trimester). However, the mean total fatty acid intake of those at the 1st trimester among the singleton pregnancy group tended to be higher than that of those at the 1st trimester among the twin pregnancy group. Such a trend seemed to be retro-versed. That is, the mean total fatty acid intakes of the twin pregnancy group were higher compared to the singleton pregnancy group for the 2nd and 3rd trimester group. The LA and total n6 concentrations of serum phospholipids of the singleton pregnancy group were significantly higher as the gestational age increased(p<0.05). The $\alpha-LNA$(p<0.05), EPA(p<0.05), and total n3(p<0.001) concentrations of serum phospholipids of the twin pregnancy group were significantly lower as the gestational age increased. The $\alpha-LNA$ concentrations of serum phospholipids in the singleton pregnancy group at the 3rd trimester were significantly higher than that in the twin pregnancy group at the same trimester(p<0.05). The serum phospholipids levels of AA and DHA of the twin pregnancy group were generally higher compared to those of the singleton pregnancy group. Particularly the differences reached at the level of statistical significance for those at the 1st trimester(p<0.01). It is concluded that the study findings imply that fatty acid metabolism may meaningfully differ by the type and stage of pregnancy. Future research needs to be conducted to more elucidate grounding etiology and possible roles of dietary fatty acid intake levels in relation to the study findings.

• Development and Reproduction
• /
• v.13 no.1
• /
• pp.1-11
• /
• 2009

Implantation itself is governed by an array of endocrine, paracrine and autocrine modulators, of embryonic and maternal origin. Window of implantation is the unique temporal and spatial expression of factors allows the embryo to implant via signaling, appositioning, attachment, and invasion in a specific time frame of $2{\sim}4$ days. When the embryo has arrived in the uterine cavity, a preprogrammed sequence of events occurs, which involves the production and secretion of a multitude of biochemical factors such as cytokines, growth factors, and adhesion molecules by the endometrium and the embryo, thus leading to the formation of a receptive endometrium. Cytokines such as LIF, CSF-1, and IL-1 have all been shown to play important roles in the cascade of events that leads to implantation. Integrin, L-selectin ligands, glycodelin, mucin-1, HB-EGF and pinopodes are involved in appositioning and attachment. The embryo also produces cytokines and growth factors (ILs, VEGF) and receptors for endometrial signals such as LIF, CSF-1, IGF and HB-EGF. The immune system and angiogenesis play an important role. The usefulness of these factors to assess endometrial receptivity and to estimate the prognosis for pregnancy in natural and artificial cycles remains to be proven. Integrins, pinopodes, glycodelin and LIF (from biopsies) are promising candidates; from uterine flushings, glycodelin and LIF are also candidates. The ideal serum marker is not available, but VEGF, glycodelin and CSF have some clinical implications. Further evaluation that includes larger groups of infertile women and fertile controls are needed to elucidate whether their presence in plasma, flushing fluid, or endometrial samples can be used as some kind of a screening tool to assess endometrial function and prognosis for pregnancy before and after artificial reproductive therapy. A better understanding of their function in human implantation may lead to therapeutic intervention, thereby improving the success rate in reproduction treatment. New molecular techniques are becoming available for measuring both embryonic and endometrial changes prior to and during implantation. The use of predictive sets of markers may prove to be more reliable than a single marker. Ultimately, the aim is to use these tools to increase implantation in artificial cycles and consequently improve live-birth rates.

• Journal of Animal Science and Technology
• /
• v.54 no.4
• /
• pp.267-274
• /
• 2012

The method of sexing based on differences in the rate of feather growth provides a convenient and inexpensive approach. The locus of feather development gene (K) is located on the Z chromosome and can be utilized to produce phenotypes that distinguish between the sexes of chicks at hatching. To establish the auto-sexing native chicken strains, this study analyzed the genotype frequency of the feathering in domestic chicken breeds. The method of classification of slow- and rapid-feathering chickens was also investigated. In the slow-feathering chicks, the coverts were either the same length or longer than the primary wing feathers at hatching. However, the rapid-feathering chicks had the primary wing feathers that were longer than the coverts. The growth pattern of tail feather also distinctively differed between the rapid- and slow-feathering chicks after 5-days. The accuracy of wing feather sexing was about 98% compared with tail sexing. In domestic chicken breeds, Korean Black Cornish, Korean Rhode Island Red, and Korean Native Chicken-Red had both dominant (K) and recessive ($k^+$) feathering genes. The other breeds of chickens, Korean Brown Cornish, Ogol, White Leghorn, Korean Native Chicken-Yellow, -Gray, -White and -Black had only the recessive feathering gene ($k^+$). Consequently, feather sexing is available using the domestic chicken breeds. Establishing the maternal stock with dominant gene (K-) and paternal stock with recessive gene ($k^+k^+$), the slow-feathering characteristic is passed from mothers to their sons, and the rapid-feathering characteristic is inherited by daughters from their fathers.