• Journal of Preventive Medicine and Public Health
• /
• 제23권2호
• /
• pp.167-177
• /
• 1990

모성보건관리대책수립을 위한 기초자료를 제공할 목적으로 부산지역에 거주하는 $20{\sim}30$세 사이의 건강한 비임신 여성 167명과 임신부 209명을 대상으로 혈청총코레스테롤 함량과 이에 영향을 미칠 수 있는 생리적 제 인자간의 관련성을 조사한 결과를 요약하면 다음과 같다. 1. 건강여성군과 임신부간에 체중의 증가에 따른 Broca's index의 상승을 제외할 신장, 수축기 및 이완기혈압치에는 큰 차이가 없었다. 2. 건강여성군의 혈청총코레스테롤함량은 165.9 mg/dl, 임신부는 212.6 mg/dl로서 유의한 차이가 있었으나 연령에 따른 차이는 관찰할 수 없었으며 함량별 분포양상은 양자 모두 정규분포형을 나타내었다. 3. 건강여성군에서는 혈청총코레스테롤함량과 체중 및 Broca's index간에 임신부에서는 체중, Broca's index 및 임신기간간에 통계적으로 유의한 상관성이 있었다. 4. 체중별 혈청총코레스테롤함량은 건강여성군은 $162.9{\sim}189.4mg/dl$, 임신부는 $167.2{\sim}246.2mg/dl$로서 체중이 증가됨에 따라 그치도 증가되는 경향이 있었으며 특히 임신부의 경우에 더욱 현저하였다. 5. 임신기간별 혈청총코레스테롤함량은 12주이하군 168.1 mg/dl, $13{\sim}26$주군 209.6 mg/dl, 27주이상군 235.4 mg/dl로서 임신이 진행됨에 따라 그 치도 높아지는 경향이 있었으며 함량별분포양상은 모두 정규분포형을 나타내었다.

• Journal of Preventive Medicine and Public Health
• /
• 제6권1호
• /
• pp.101-117
• /
• 1973

Socio-medical survey was carried out on six hundred and thirty Korean households in the cities of Tokyo, Osaka, Kyoto, and Nagoya in Japan from Nov. 1972 to Dec. 1972, and following results were obtained. 1. Age distribution of households showed the highest occurence in the group of 40 to 49 years of age in the both sexes. Families with five members showed highest occurence, and the average number of familial members was 5.7 persons per one household. 2. More than half of the householders were some independent enterprisers rather than to be the employees and most of the household had one familial member engaged in more or less liberal profession. 3. 19.4% of households moved into these cities from 1941 to 1945. 4. 40.5% of all the households had their own houses. The possession rate of one's own house was higher in the households which had long period of residence in Japan. 5. 83.5% of all households had various medical insurances. And the 6.2% of the household which had no insurance stated that the reason for not being affiliated was 'because to be the foreigner'. Household of shorter dwelling period had less tendency to be affiliated to the various insurances. 6. In 41.3% of all the households, average medical expenditure amounted to 1000-5000 Yen per month. And only 25.6% of household stated that they do not worry about the medical expenditure for the futures. 7. 66.3% of households were consulting to medical doctors for their sickness, such as toothache, severe coughing, profuse sputum, children's fever and stomach pain etc. 8. 59.4% of households were using the facilities of health center services. The health center service was used mainly for individual health service rather than the environmental aspect. And 19.8% of households were not aware of health center activities. 9. It was found that 23.5% of households received the screening test of the tuberculosis and adult diseases. Especially, the rate of screening test of the adult diseases showed as following ; stomach cancer, 8.9% ; hypertension, 7.9% ; diabetes mellitus, 2.1% ; and uterus cancer, 1.6%. 10. Birth control was carried out in 17.3% of households but not in 52.5%. The chief reason of birth control was 'because of poor maternal health' (40.0%) or 'should not be done' (5.4%). 11. Most of them are obtaining the knowledges and informations on family plannings. public nuisance problems and nutritions etc. by means of the mass communications, while those no preventing diseases and the environmental hygiene through the administrative organizations.

• Clinical and Experimental Reproductive Medicine
• /
• 제45권1호
• /
• pp.31-37
• /
• 2018

Objective: To evaluate the pregnancy rate and time to pregnancy after timed coitus with or without superovulation in infertile young women younger than 35 years old with low serum $anti-M{\ddot{u}}llerian$ hormone (AMH) levels ( < 25th percentile). Methods: A total of 202 patients younger than 35 years old were recruited retrospectively between 2010 and 2012. Ninety-eight women had normal serum AMH levels (25-75th percentile), 75 women had low serum AMH levels (5th ${\leq}$ & < 25th percentile) and 29 women had very low serum AMH levels ( < 5th percentile), according to reference values for their age group. Results: The clinical pregnancy rate was positively associated with AMH levels, but this trend did not reach statistical significance (43.9% vs. 41.3% vs. 27.6% in the normal, low, and very low AMH groups, respectively). The time to pregnancy was longer in the very low AMH group than in the normal AMH group ($13.1{\pm}10.9months$ vs. $6.9{\pm}6.1months$, p= 0.030). The cumulative live birth rate over 18 months was lower in the very low AMH group than in the normal AMH group, with marginal significance (20.0% vs. 55.9%, p= 0.051). The duration of infertility was negatively correlated with achieving pregnancy (odds ratio, 0.953; 95% confidence interval, 0.914-0.994; p= 0.026). Conclusion: Conservative management, such as timed coitus with or without superovulation, should be considered in young patients who have low ovarian reserve without any infertility factors. However, for women with a long duration of infertility or very low serum AMH levels, active infertility treatment should be considered.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• 제26권1호
• /
• pp.12-21
• /
• 2015

In an effort to expand working opportunities for women and encourage childbirth, the government of Korea introduced the free infant care policy in 2013. This policy, however, was controversial with regard to issues, such as budget shortages and dissatisfaction based on socioeconomic status. In addition, the lack of evidence-based data regarding adequate age criteria for the entry of children into childcare facilities was noted as a challenge. As child development professionals who are concerned with mental health issues, we investigated the influence and challenges of the free infant care policy with regard to infant mental health. In this review, we examined the policies enacted by developed countries, such as the United Kingdom (UK), and compared them with those in Korea. The childcare systems in Korea and the UK differ historically and socially, but show some similarities, such as maternal responsibility for parenting and household issues. Like Korea, the need for UK childcare facilities increased in the 1990's in response to market recovery and associated increase in female employment. Among the new policies in the UK, the Sure Start program has begun to provide integrated services for infants, particularly to those 0-4 years of age, who are vulnerable to social exclusion. Similar to the Dream Start program in Korea, it has been successful in providing family-related services, resulting in improvements in problematic behaviors of children, enhanced parenting skills, and decreased rates of severely injured children.

• Clinical and Experimental Reproductive Medicine
• /
• 제26권1호
• /
• pp.75-81
• /
• 1999

The beneficial effect of glucose and phosphate ions in culture medium on the development of human embryos in vitro has not been fully elucidated. The purpose of this study was to evaluate the influence of fertilization and culture of embryos in glucose/phosphate-free m-TALP medium on pregnancy rates in IVF-ET program. The patients in 244 IVF-ET cycles received GnRH agonist + HMG regimens. A does of 10,000 IU HCG was administered when two or more dominent follicles reached 18mm in diameter. Thirty-six hours after HCG, oocytes were recovered transvaginally using ultrasound guidance. Aspirated oocytes were matured for 4 to 6 h in TCM-199 supplemented with 10% follicular fluid (FF). Insemination was carried out with 50,000 motile spermatozoa in TCM-199 + 10% FF or m-TALP + 5% FF + 5% fetal cord serum (FCS) according to experimental design. After 6 h, oocytes were washed 3 to 4 times and cultured in each fresh medium. After 20 h, oocytes were freed from cumulus/corona cells and examined for the presence of pronuclei. Fertilized oocytes were transferred into each co-culture drops and cultured for further incubation. On day 3, embryo transfer was performed with grade 1 and 2 embryos. Monolayers for co-culture of embryos were prepared by plating $1{\times}10^5$ cumulus cells/ml in 10ul drop of TCM-199 + 10% FF or m-TALP + 5% FF + 5% FCS media 24 h prior to the onset of co-culture. Development to 4 to 16 cell stage was observed at 70x magnification following two days of incubation. Pregnancy was confirmed by detecting increasing serum ${\beta}$-hCG concentrations for 11 days following embryo transfer. Data were analyzed by ${\chi}^2$-test. Oocytes from 244 IVF-ET cycles were randomized. The number of cycles and mean age of patients were 97 and 147, 31.3 yrs and 31.2 yrs for TCM-199 (control) and m-TALP groups, respectively. The mean number of retrieved oocytes/cycle, fertilization rates, number of embryos transferred/ET and pregnancy rates were 11.1 and 10.3, 65.1% and 67.3%, 4.1 and 4.7, 28.9% and 43.8% for TCM-199 and m-TALP groups, respectively. Differences in the pregnancy rates were found between control and m-TALP groups (p<0.05). The pregnancy rate of patients divided according to maternal age groups of ${\leq}30$, 31-35, $36{\leq}$ were 44.4% and 49.0%, 26.1% and 41.3%, 29.2% and 41.2% for control and m-TALP groups, respectively. These data indicate that culture of human embryos in glucose/phosphate-free m-TALP medium improves pregnancy rates.

• Animal Bioscience
• /
• 제34권4호
• /
• pp.546-557
• /
• 2021

Objective: If fertilization does not occur within a specific period, the quality of unfertilized oocytes in the oviduct (in vivo aging) or in culture (in vitro aging) will deteriorate over time. Icariin (ICA), found in all species of Epimedium herbs, has strong antioxidant activity, and is thought to exert anti-aging effects in vitro. We asked whether ICA protects oocytes against age-related changes in vitro. Methods: We analyzed the reactive oxygen species (ROS) levels and expression of antioxidant, maternal, and estrogen receptor genes, and along with spindle morphology, and the developmental competence and quality of embryos in the presence and absence of ICA. Results: Treatment with 5 μM ICA (ICA-5) led to a significant reduction in ROS activity, but increased mRNA expression of glutathione and antioxidant genes (superoxide dismutase 1 [SOD1], SOD2, peroxiredoxin 5, and nuclear factor erythroid 2-like 2), during aging in vitro. In addition, ICA-5 prevented defects in spindle formation and chromosomal alignment, and increased mRNA expression of cytoplasmic maturation factor genes (bone morphogenetic protein 15, cyclin B1, MOS proto-oncogene, serine/threonine kinase, and growth differentiation factor-9). It also prevented apoptosis, increased mRNA expression of antiapoptotic genes (BCL2-like 1 and baculoviral IAP repeat-containing 5), and reduced mRNA expression of pro-apoptotic genes (BCL2 antagonist/killer 1 and activation of caspase-3). Although the maturation and cleavage rates were similar in all groups, the total cell number per blastocyst and the percentage of apoptotic cells at the blastocyst stage were higher and lower, respectively, in the control and ICA-5 groups than in the aging group. Conclusion: ICA protects oocytes against damage during aging in vitro; therefore, it can be used to improve assisted reproductive technologies.

• Pediatric Infection and Vaccine
• /
• 제28권3호
• /
• pp.149-159
• /
• 2021

목적: 산모의 산전 항생제 사용은 여러가지 면에서 태아 및 신생아에 영향을 미칠 수 있다. 본 연구에서는 극소 미숙아 또는 극소 저체중출생아에서 산모의 산전 항생제 투여 기간이 신생아 예후에 미치는 영향에 대해 조사하였다. 방법: 2015년 9월부터 2020년 12월까지 고려대학교 안암병원에서 출생한 재태주수 32주 미만 또는 출생 체중 1,500 gram 미만인 신생아 및 산모를 대상으로 의무기록을 후향적으로 분석하였다. 산모의 산전 항생제 투여 기간에 따라 미투여 군, 7일 이하 군, 7일 초과 군의 세 군으로 나누어 산모의 특성, 환아의 특성 및 합병증 등을 비교 분석하였다. 결과: 총 145명 중 93명의 환아가 산전 항생제에 노출되었으며, 그 중 35명(37.6%)는 7일 이하 군, 58명(62.4%)는 7일 초과 군이었다. 7일 초과 군은 미투여 군에 비해 재태 연령에 따른 출생체중의 Z-score가 교란변수 보정 후에도 유의미하게 높았다(beta, 0.258; standard error, 0.149; P<0.001). 다변량 로지스틱 회귀 분석에서 7일 초과 군은 사망(adjusted odds ratio [aOR], 8.926; 95% confidence interval [CI], 1.482-53.775), 그리고 사망, 괴사성 장염, 후기 패혈증의 복합 평가 결과와 연관이 있었다(aOR, 2.375; 95% CI, 1.027-5.492). 결론: 산모의 장기간 산전 항생제 투여는, 극소 미숙아 또는 극소 저체중출생아에서 재태 연령에 따른 출생체중의 Z score을 증가시키며, 사망 뿐 아니라 사망, 괴사성 장염, 후기 패혈증의 복합 평가 결과의 위험도를 증가시킬 수 있다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• 제34권1호
• /
• pp.37-44
• /
• 2023

Objectives: Tic disorders are highly heritable; however, growing evidence suggests that environmental factors play a significant role in their pathogenesis. Studies on these factors have been inconsistent, with conflicting results. Therefore, this study aimed to examine the associations of pre- and perinatal exposure to Tourette syndrome (TS) or chronic tic disorders (CTD) in Korean school-aged children. Methods: This case-control study used data from a large prospective cohort study. The primary outcome was TS/CTD diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria and Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version-Korean Version. Demographic, pre-, and perinatal information was obtained from the maternal questionnaires. Data between the TS/CTD and control groups were compared using the chi-squared or Student's t-test, as appropriate. Two-step logistic regression analyses were used to test the association between TS/CTD and pre- and perinatal risk factors. Results: We included of 223 children (78 with TS/CTD and 145 controls). Significant differences in the demographic data between the two groups were observed. The male sex ratio, mean parental age, parental final education level, and family history of tics were included as confounders. In the final adjusted multivariable model, TS/CTD was significantly associated with antiemetic exposure during pregnancy (odds ratio [OR]=16.61, 95% confidence interval [CI] 1.49-185.22, p=0.02) and medically assisted reproduction (OR=7.89, 95% CI 2.28-27.28, p=0.01). Conclusion: Antiemetic exposure and medically assisted reproduction are significantly associated with the risk of TS/CTD. These results should be replicated in future prospective and gene-by-environment studies.

• 대한한방부인과학회지
• /
• 제37권1호
• /
• pp.89-103
• /
• 2024

Objectives: This study analyzed an online survey targeting women and Korean medicine doctors who participated in the Yeosu City Postpartum Health Center Support Project. Through this, we would like to discuss the direction of support for postpartum health care support projects and new policies to encourage childbirth. Methods: In this study, we examined the results of an online survey from 73 women and 29 Korean medicine doctors. We examined 39 items, including basic information, childbirth-related items, Korean medicine treatment-related items, business satisfaction, and policies, answered by 73 women and 29 Korean medicine doctors who responded to the online survey. Results: The average age of women was 33.62±4.19 years, and the average age of Korean medicine doctors was 49.82±8.60 years. Musculoskeletal pain appeared most commonly in both maternal and Korean medicine doctors' online surveys. The visit date from the date of delivery was 36.87±27.06 days. Gungguijohyeol-um and Boheo-tang were widely used. The survey score of women whose main symptoms improved after taking herbal medicine was 3.04±1.15 points, and the survey score of Korean medical doctors was 4.13±0.74 points. The positive response to the policy was 73.7% for satisfaction with the overall policy to encourage childbirth, 54.8% for perceived support, and 65.7% for reduction of economic burden. Conclusions: Women who participated in the postpartum health care support project and received Korean medicine treatment and Korean medicine doctors who performed Korean medicine treatment were very satisfied. The most frequent postpartum symptom was musculoskeletal pain. The degree of improvement in main symptoms after taking herbal medicine was higher among Korean medicine doctors than among women. Among childbirth policies, the areas that should be prioritized are childbirth support projects and postpartum care projects.

• 한국산학기술학회논문지
• /
• 제22권6호
• /
• pp.314-320
• /
• 2021

최근 사회적으로 결혼연령이 높아짐에 따라 고령산모가 증가하면서 생화학적 표지물질을 이용한 다운증후군 선별검사는 산모들에게 필수적인 검사가 되었다. 다운증후군 임신을 진단하는 과정은 선별검사에서 고위험군으로 보고 되면 융모막 융모생검이나 양수검사 같은 침습적 검사를 통해 염색체 분석을 하는 단계로 진행이 되는데 이러한 확진검사는 비용이 많이 들고 태아손실의 위험도가 높다. 따라서 위험도는 낮고 다운증후군 발견율이 높은 선별검사를 선택하여 불필요한 침습적 검사를 줄여 산모와 태아의 위험도를 낮추는 것이 중요하다. 본 연구는 2018년 용인의 임상검사기관에 산전선별검사를 의뢰한 17세부터 46세까지 총 36,436명을 대상으로 triple test(185명), quad test(3,629명), integrated test(18,932명), sequential test(13,690명) 4가지 검사를 direct sandwich, indirect sandwich 기술을 이용한 Time-resolved fluoroimmunoassay 방법과 sandwich 방법을 이용한 면역측정 방법을 사용하여 35세 미만과 35세 이상 산모의 다운증후군 위험도를 분석하여 산모 연령이 증가함에 따른 양성률의 차이를 확인하였다. 검사결과 전체 산모의 다운증후군 고위험군은 triple test 36명, quad test 408명, integrated tset 1,441명, sequential test 924명 이었다. 이중 35세미만 산모의 고위험군은 triple test 7명(3.8%), quad test 141명(3.9%), integrated tset 644명(3.4%), sequential test 430명(3.4%)이었고, 35세이상 산모의 고위험군은 29명(15.7%), 267명(7.4%), 797명(4.2%), 494명(3.6%)으로 나타나 35세이상 산모가 훨씬 높은 고위험군을 나타내었다. 임상에 있어서 35세 미만과 35세 이상 산모의 위험도 분석을 한 연구는 국내외에 거의 희박하므로 본 연구는 향후 국내외의 많은 검사기관들과 예비 산모들에게 다운증후군 위험의 예방과 치료를 위한 매우 유용한 기초 자료가 될 것으로 생각된다.