• Title/Summary/Keyword: Multiple birth

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A Case of Miliary Tuberculosis Associated with Multiple Intracranial Tuberculoma (다발성 뇌결핵종을 동반한 속립결핵 1례)

  • Park, Sun Yung;Lee, Jung Hyun;Chung, Nak Gyun;Kim, Jin Tack;Chung, Seung Yun;Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.7 no.2
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    • pp.250-256
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    • 2000
  • The incidence of tuberculosis has been decreased, and especially the incidence of severe complicated tuberculosis has been markedly decreased as the result of widely used BCG vaccines. But tuberculosis is still an important community accquired infectiouse disease in the world despite continued worldwide efforts to control the disease. Miliary tuberculosis, the most serious complicated tuberculosis, can be occurred by lymphohematogenous dissemination of tuberculosis, and intracranial tuberculoma with or without tuberculosis meningitis can be developed in case of miliary tuberculosis. In general, serious tuberculosis infections such as miliary tuberculosis and CNS tuberculosis are developed especially in young infants and children in cases of delayed diagnosis and treatment despite receiving BCG vaccination, and usually those patients have contact sources. Intrcranial tuberculoma in children are usually found near infratentorial site at the base of cerebellum, and clinically symptoms and signs of increased intracranial pressure developed before treatment. Serial brain CT or MRI is a good non-invasive diagnostic modality of intracranial tuberculoma. Although surgical intervention was initially advocated as the mainstay of intracranial tuberculoma therapy, but many recent clinical studies indicate that intracranial tuberculoma can be cured with medical treatment alone. We experienced a case of 3 months old male patient, who was diagnosed as having miliary tuberculosis associated with multiple intracranial tuberculoma. He received BCG vaccination at 4 weeks after birth, and his father was confirmed as active pulmonary tuberculosis patient after this patient's admission. We report this case with a review of related literatures.

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Perceptions of Married Women on Childbirth and Sex Preference and Related Factors in Gyeongju, Korea (도농복합지역 기혼여성들의 출산과 성 선호에 대한 인식 및 관련요인)

  • Youm, Seog-Heon;Kang, Pock-Soo;Kim, Chang-Yoon;Lee, Kyeong-Soo;Hwang, Tae-Yoon;Hwang, In-Sob
    • Journal of agricultural medicine and community health
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    • v.35 no.3
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    • pp.260-273
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    • 2010
  • Objectives: The purpose of this study was to investigate the perceptions of married Korean women regarding marriage and childbirth, and their awareness of childbirth-related issues such as low birth rates, sex preferences and sex imbalances in Korea. Methods: A total of 453 married women aged 20 or older were randomly selected from four urban districts and five rural districts out of 25 districts in Gyeongju, a consolidated city located in Gyeongsangbuk-do Province, South Korea. The survey was conducted from December 2005 to February 2006. A total of 392 out of 453 questionnaires(86.5% response rate) were collected, and 44 incomplete questionnaires were excluded, leaving 348 completed questionnaires to be used for data analysis. Age was divided into three groups as below 49, 50-69, 70 or older. Results: Women's perceptions of marriage were associated with age(p<0.01). Perceptions about childbirth were also significantly related to age(p<0.01), type of residential area (p<0.01) and education level(p<0.05). Sex preferences were significantly related to age(p<0.05) and occupation(p<0.01). Of the respondents aged 49 or younger, 34.8% indicated that the ideal number of children is two, while 25.5% of respondents aged 50 to 69 and 15.3% of respondents aged 70 and 33.7% of respondents aged 70 or older considered four children to be the ideal number. Perceptions of sex imbalance were significantly related to socioeconomic status(p<0.01) and occupation(p<0.01). The largest number of respondents cited "economic burden" as the main reason for low birth rates. Multiple logistic regressions were performed for all three age groups using male sex preference as the dependent variable under the assumption that respondents can have only a single child. Socioeconomic status (p<0.01) and residential area (p<0.05) were significant variables for those aged 49 or below. Education level(p<0.05) and residential area (p<0.01) were statistically significant variables on preferring son in case of having only one child for respondents aged 50 to 69. We did not detect any significant independent variables in respondents who were 70 or older. Conclusions: Our results highlight the necessity of developing policies and public education programs to explain the consequences of low birth rates and sex imbalances in Korea. As increasing numbers of women work outside the home, it is important for the government and employers to provide social and working environments where women do not consider marriage and childbirth to be obstacles to social and business activities.

The Factors Affecting the Population Outflow from Busan to the Seoul Metropolitan Area (지역별 수도권으로의 인구유출에 영향을 미치는 요인 연구: 부산시 사례를 중심으로)

  • LIM, Jaebin;Jeong, Kiseong
    • Land and Housing Review
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    • v.12 no.2
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    • pp.47-59
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    • 2021
  • This study aims to review the trends of the population outflows in the metropolitan area of Busan and to investigate the factors that affect population out-migration to the Seoul metropolitan area. The following variables are considered for analysis: traditional population movement variables and quality of life variables, such as population, society, employment, housing, culture, safety, medical care, greenery, education, and childcare. The 'domestic population movement data', provided by the MDIS of the National Statistical Office, was used for this research. Out of the total of 57 million population movement data in the period 2012 - 2017, population outmigration from Busan to the Seoul metropolitan area was extracted. Independent variables were drawn from public data sources in accordance with the temporal and spatial settings of the study. The multiple linear regression model was specified based on the dataset, and the fit of the model was measured by the p-value, and the values of Adjusted R2, Durbin-Watson analysis, and F-statistics. The results of the analysis showed that the variables that have a significant effect on population movement from Busan to the Seoul metropolitan area were as follows: 'single-person households', 'the elderly population', 'the total birth rate', 'the number of companies', 'the number of employees', 'the housing sales price index', 'cultural facilities', and 'the number of students per teacher'. More positive (+) influences of the population out-movement were observed in areas with higher numbers of single-person households, lowers proportions of the elderly, lower numbers of businesses, higher numbers of employees, higher numbers of housing sales, lower numbers of cultural facilities, and lower numbers of students. The findings suggest that policies should enhance the environments such as quality jobs, culture, and welfare that can retain young people within Busan. Improvements in the quality of life and job creation are critical factors that can mitigate the outflows of the Busan residents to the Seoul metropolitan area.

Identification of Characteristics and Risk Factors Associated with Mortality in Hydrops Fetalis (태아수종의 특성 및 사망률과 연관된 위험인자)

  • Ko, Hoon;Lee, Byong-Sop;Kim, Ki-Soo;Won, Hye-Sung;Lee, Pil-Ryang;Shim, Jae-Yoon;Kim, Ahm;Kim, Ai-Rhan
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.221-227
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    • 2011
  • Purpose: The objectives were to identify the characteristics of neonates with hydrops fetalis, and to identify the risk factors associated with mortality. Methods: A retrospective review of AMC (Asan Medical Center) dataset was performed from January 1990 to June 2009. The characteristics of 71 patients with hydrops fetalis were investigated and they were divided into two groups: the survived group and the expired group. Various perinatal and neonatal factors in two groups were compared to find out risk factors associated with mortality based on univariate analysis, followed by multiple regression analyses (SPSS version 18.0). Results: Of those 71 neonates (average gestational age: 33 weeks, birth weight: 2.6 kg), 38 survived, 33 died, resulting in overall mortality rate of 46.5%. The most common etiology was idiopathic followed by chylothorax, cardiac anomalies, twin-to-twin transfusion, meconium peritonitis, cardiac arrythmias, and congenital infections. Factors that were associated independently with mortality in logistic regression analyses were low 5-minutes Apgar score, hyaline membrane disease and delayed in achieving 50th percentile ideal body weight for appropriate gestational age by 10 days. Conclusion: In this study, 5-minutes Apgar score, hyaline membrane disease and delayed in achieving 50th percentile ideal body weight for appropriate gestational age by 10 days were significant risk factors associated with mortality in hydrops fetalis. Therefore, the risk of death among neonates with hydrops fetalis depends on the illness immediately after birth and severity of hydrops fetalis. Informations from this study may prove useful in prediction of prognosis to neonates with hydrops fetalis.

The effects of neonatal ventilator care or maternal chorioamnionitis on the development of bronchopulmonary dysplasia (산모의 융모양막염 및 인공호흡기 치료가 미숙아 만성 폐질환의 발생에 미치는 영향)

  • Yun, Ki-Tae;Lee, Dong-Whan;Lee, Sang-Geel
    • Clinical and Experimental Pediatrics
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    • v.52 no.8
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    • pp.893-897
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    • 2009
  • Purpose : Advances in neonatal intensive care have improved the survival rate of low-birth-weight infants, but mild bronchopulmonary dysplasia (BPD) with the accompanying need for prolonged oxygen supplement remains problematic. Maternal chorioamnionitis and neonatal ventilator care affect the development of BPD. This study aimed to examine whether maternal chorioamnionitis or neonatal ventilator care affect the development of BPD dependently or independently. Methods : We performed a retrospective study of 158 newborn infants below 36 weeks of gestational age and 1,500 gm birth weight admitted to the neonatal intensive care unit of Daegu Fatima Hospital between January 2000 and December 2006. We analyzed the incidence of BPD according to maternal chorioamnionitis and neonatal ventilator care. Result : Histologic chorioamnionitis was observed in 50 of 158 infants (31.6%). There were no significant differences in the development of BPD (P=0.735) between the chorioamnionitis (+) and chorioamnionitis (-) groups. In the multiple regression analysis, ventilator care (OR=7.409, 95% CI=2.532-21.681) and neonatal sepsis (OR=4.897, 95% CI=1.227-19.539) affected the development of BPD rather than maternal chorioamnionitis (OR=0.461, 95% CI=0.201-1.059). Conclusion : Ventilator care or neonatal sepsis may play a role in the development of BPD rather than maternal chorioamnionitis.

Association between Ureaplasma urealyticum Colonization and Adverse Outcomes in Premature Infants (출생 시 Ureaplasma urealyticum 집락이 조산아의 임상 양상에 미치는 영향)

  • Yun, Jin-Sang;Chang, Sun-Jung;Jo, Heui-Seung;Lee, Kyu-Hyung
    • Neonatal Medicine
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    • v.16 no.1
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    • pp.47-54
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    • 2009
  • Purpose: Present evidences suggest that Ureaplasma urealyticum is a cause of pneumonia, septicemia, and bronchopulmonary dysplasia (BPD) in newborn infants, particularly those born prematurely. The purpose of this work was to examine the relationship between Ureaplasma urealyticum in the tracheal aspirates and adverse outcomes, such as BPD and early onset neonatal sepsis in premature infants. Methods: A polymerase chain reaction (PCR) was performed on tracheal aspirates collected within 24 hour after birth in 176 premature infants less than 35 weeks of gestation and admitted to the neonatal intensive care unit of Bundang CHA Hospital. Results: U. urealyticum was detected in 37 of 176 preterm infants (21.0%). Gestational age ($29^{+5}{\pm}2^{+5}$ wk vs. $30^{+6}{\pm}2^+{-5}$ wk, P=0.0l3) and birth weight (1.39${\pm}$0.44 kg vs. 1.59${\pm}$0.55 kg, P=0.037) were lower in the U urealyticum-positive group compared to the control group. The incidence of early onset neonatal sepsis (16.2% vs. 6.5%, P=0.045) and BPD (45.9% vs. 29.5%, P=0.047) was higher in the U urealyticum-positive group compared to the control group, but the severity of BPD was not different between two groups. However, multiple logistic regression analysis revealed that the presence of U. urealyticum was not independently related to the development of early onset neonatal sepsis and BPD. Conclusion: The results suggest that colonization of the lower respiratory tract by U. urealyticum might not be related to the development of neonatal sepsis and BPD directly in preterm infants.

Diagnostic testing for Duchenne/Becker Muscular dystrophy using Dual Priming Oligonucleotide (DPO) system (Dual Priming Oligonucleotide (DPO) system을 이용한 듀시엔/베커형 근이영양증 진단법)

  • Kim, Joo-Hyun;Kim, Gu-Hwan;Lee, Jin-Joo;Lee, Dae-Hoon;Kim, Jong-Kee;Yoo, Han-Wook
    • Journal of Genetic Medicine
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    • v.5 no.1
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    • pp.15-20
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    • 2008
  • Purpose : Large exon deletions in the DMD gene are found in about 60% of DMD/BMD patients. Multiplex PCR has been employed to detect the deletion mutation, which frequently generates noise PCR products due to the presence of multiple primers in a single reaction as well as the stringency of PCR conditions. This often leads to a false-negative or false-positive result. To address this problematic issue, we introduced the dual primer oligonucleotide (DPO) system. DPO contains two separate priming regions joined by a polydeoxyinosine linker that results in high PCR specificity even under suboptimal PCR conditions. Methods : We tested 50 healthy male controls, 50 patients with deletion mutation as deletion-positive patient controls, and 20 patients with no deletions as deletion-negative patient controls using DPO-multiplex PCR. Both the presence and extent of deletion were verified by simplex PCR spanning the promoter region (PM) and 18 exons including exons 3, 4, 6, 8, 12, 13, 17, 19, 43-48, 50-52, and 60 in all 120 controls. Results : DPO-multiplex PCR showed 100% sensitivity and specificity for the detection a deletion. However, it showed 97.1% sensitivity and 100% specificity for determining the extent of deletions. Conclusion : The DPO-multiplex PCR method is a useful molecular test to detect large deletions of DMD for the diagnosis of patients with DMD/BMD because it is easy to perform, fast, and cost-effective and has excellent sensitivity and specificity.

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Early stress hyperglycemia as independent predictor of increased mortality in preterm infants (미숙아에서 초기 스트레스성 고혈당과 예후 사이의 연관성)

  • Wee, Young Sun;Ahn, Gae Hyun;Yoo, Eun Gyong;Lim, In Sook;Lee, Kyu Hyung
    • Clinical and Experimental Pediatrics
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    • v.51 no.5
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    • pp.474-480
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    • 2008
  • Purpose : Stress hyperglycemia is common in critically ill adult patients. It is known as a predictor of increased mortality, and intensive insulin therapy has been shown to improve the prognosis in such patients. We have investigated the relationship between early stress hyperglycemia and clinical outcomes in preterm infants. Methods : In this study, 141 preterm infants with a gestational age of less than 30 weeks were enrolled. The hyperglycemic group was defined as that having maximum glucose of more than 150 mg/dL (n=61) during the first 48 h of life, and the non-hyperglycemic group was defined as that having maximum glucose of less than 150 mg/dL (n=80). Perinatal history, severity of illness using the Clinical Risk Index for Babies (CRIB) score, clinical outcomes, and mortality of the two groups were compared. Results : There was no significant difference in the gestational age between the two groups, but the birth weight (P<0.001) was significantly lower, and the CRIB score (P<0.001) was significantly higher in the hyperglycemic group. Disseminated intravascular coagulation (P<0.001) and clinically suspected sepsis (P=0.046) were more common in the hyperglycemic group. Mortality was markedly higher in the hyperglycemic group (11.3% vs. 41.0%, P<0.001). On performing a stepwise multiple logistic regression analysis, hyperglycemia (OR 3.787; 95% CI 1.324 to 10.829), the CRIB score (OR 1.252; 95% CI 1.047 to 1.496) and birth weight (OR 0.997; 95% CI 0.994 to 1.000) was independently associated with higher mortality. Conclusion : Stress hyperglycemia within the first 48 h of life is independently related to increased morbidity and mortality in preterm infants.

A Study on their Health Promotion Behavior Influenced by Primary School Students' Self-concept (초등학생의 자아개념이 건강증진행위에 미치는 영향)

  • Lee, Deog-Weon;Park, Young-Soo
    • The Journal of Korean Society for School & Community Health Education
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    • v.1 no.2
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    • pp.29-48
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    • 2000
  • This study was designed to diagnose the correlations between health promotion behavior and primary school students' demographic characteristics and their self-concept, and also this study was aimed at representing the basic data of proper instruction method and school health program with the respective to primary school students' health promotion behavior through the above things. For this, author selected as 5th, 6th graders, 400 persons at 5 elementary schools located on Kyonggi province. This data utilized ANOVA, multiple regression analysis and correlation analysis by SPSS program. The findings of this study were as follows; First, there showed meaningful differences concerning their health promotion behavior according to students' demographic traits. There were a birth date, living standard, domestic environments etc. as a factors which influenced on their health promotion behavior. With this, from ex-past-facto verification for these variable factors, as their birth date was faster, living standard was higher, domestic environments was better, as their health promotion behavior was more promotive. Second, students' health promotion behavior marked 3.61 among total 5 paint with the respective to its fulfillment degree, their self-concept marked 3.45 among total 5 paint. Their mental health promotion behavior marked 3.71 with the respective to inferior category of health promotion behavior, which was the highest score. In the other hands, their physical health promotion behavior marked 3.71, social health promotion behavior marked 3.45. contrary the disease prevention, first-aid & safety, oral health, health & nutrition(P>.05). Third, there show meaningful difference, in the level of p-value <.001 with the respective to the correlations between primary school students' health promotion behavior and their self-concept, more their self-concept was positive, more their more their whole health promotion behavior(r=.479), the fulfillment degree of physical health promotion behavior(r=.384), mental health promotion behavior(r=.543), social health promotion behavior(r=.372) were high. Fourth, with the respective to the results of difference verification concerning their fulfillment degree of health promotion behavior according to the upper, middle, inferior group of self-concept, there showed statistically meaningful difference, in the level of p-value<.001. In the long run, more their self-concept was positive, more their whole health promotion behavior was high. With this, from the results of $Scheff\acute{e}$ verification, there showed meaning differences among the upper and middle group, upper and inferior group, middle and inferior group. Fifth, self-concept played the role as the most important prognostic factor with the respective to primary school students' health promotion behavior(23.0%), in the other hands, there showed positive weight of 24.0% concerning the fulfillment of whole health promotion behavior by domestic environments(1.0%). From the above results, primary school students' the fulfillment degree of health promotion behavior didn't reach to middle or inferior level. In the other hands, there showed positive effects in the correlations between self-concept and the fulfillment degree of health promotion behavior, and also high self-concept group was much positive considering inferior group in the fulfillment degree of health promotion behavior. Accordingly, more their self-concept was positive, more their fulfillment degree of health promotion behavior was effective. Eventually, in the future, there have to make an efforts to develope positive, substantial programs through their self-concept enhancement etc. in the adequate planning or operation for primary school students' health education and school health program.

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Statistical Studies on the Gestation and Delivery of the Pregnant Women and on the Neonates (한국부인의 임신.분만 및 신생아에 대한 통계적 연구)

  • Choi, Joong-Myung
    • Journal of Preventive Medicine and Public Health
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    • v.17 no.1
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    • pp.193-202
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    • 1984
  • Clinical and statistical observations were performed on 1,930 cases of pregnant women who were admitted for delivery in the Department of Obstetrics, Kyung Hee University Hospital during 1 year (1982) and on 1,961 cases of neonates who were born to the former. The results were obtained as follows: 1. Concerning maternal age distribution, the commonest age group was that of $25{\sim}29$ and the proportion of the age group $20{\sim}29$ was 82.4% of all. 2. Concerning obstetrical history, the proportion of the women who had no prior experience of delivery nor abortion was the highest, 45.5%. 3. Concerning abortion history, 36.1% of the women had experienced it and the mean number was 1.8. 4. Type of delivery was as follows: Spontaneous delivery; 58.1%, Vacuum extracted delivery; 22.4%, Cesarean section; 18:8%, Breech delivery; 0.7%. 5. Gestational period distribution of the neonates was as follows: Under 37 weeks (Preterm); 7.1%, Between 38 and 42 weeks (Term); 87.2%, More than 43 weeks (Postterm); 5.7%. 6. Sex ratio of male to female of the neonates was 1.03:1. 7. Birth weight distribution was as follows: Under 2,500gm.; 9.0%, Between 2,501 and 4,000 gm.; 85.5%, More than 4,001gm.; 5.5%. 8. The measured growth data of neonates were as follows: Body weight; 3.28kg. for male, 3.18kg. for female, Body height; 50.40cm for male, 49.77cm for female, Chest circumference; 32.54cm for male. 32.17cm for female, Head circumference; 33.49cm for male, 33.11cm for female. 9. The mean values of Apgar score per 1 minute were 7.70 for male and 7.63 for female. 10. The incidence rate of neonatal jaundice was 50.0% and no difference in sex respectively, but more prevalent in preform baby. 11. The incidence rate of neonatal diseases was 8.9% and the commonest disease was neonatal infection (35.6%). 12. Concerning multiple pregnancy, ratio to single births was 1 : 64.3 and the sex ratio of male to female was 1 : 1.03. 13. The incidence rate of congenital anomaly was 2.4% and the commonest anomaly was digestive system anomaly (30.9%). 14. The neonatal mortality rate was 11.73 per 1,000 neonates, and the majority of neonatal deaths were in low birth weight and preform neonates (78.3%). 15. The causes of neonatal deaths in decreasing order of frequency were abnormal ventilation (39.1%), prematurity (30.4%), congenital anomaly (13.0%) and etc.

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