• Journal of agricultural medicine and community health
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• v.1 no.1
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• pp.29-36
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• 1976

Introduction Recently, changes in the patterns and concepts of maternity care, in both developing and developed countries have been accelerating. An outstanding development in this field is the number of deliveries taking place in hospitals or maternity centers. In Korea, however, more than 90% of deliveries are carried out at home with the help of untrained relatives or even without helpers. It is estimated that less than 10% of deliveries are assisted by professional persons such as a physician or a midwife. Taking into account the shortage of professional person i11 rural Korea, it is difficult to expect widespread prenatal, postnatal, and delivery care by professional persons in the near future, It is unrealistic, therefore, to expect rapid development of MCH care by professional persons in rural Korea due to economic and sociological reasons. Given these conditions. it is reasonable that an educated village women could used as a "maternity aid", serving simple and technically easy roles in the MCH field, if we could give such a women incentive to do so. The midwife and physician are assigned difficult problems in the MCH field which could not be solved by the village worker. However, with the application of the village worker system, we could expect to improve maternal and child hoalth through the replacement of untrained relatives as birth attendants with educated and trained maternity aides. We hope that this system will be a way of improving MCH care, which is only one part of the general health services offered at the local health centre level. Problems of MCH in rural Korea The field of MCH is not only the weakest point in the medical field in our country hut it has also dropped behind other developing countries. Regarding the knowledge about pregnancy and delivery, a large proportion of our respondents reported having only a little knowledge, while 29% reported that they had "sufficient" knowledge. The average number of pregnancies among women residing in rural areas was 4.3 while the rate of women with 5 or more pregnancies among general women and women who terminated childbearing were 43 and 80% respectively. The rate of unwanted pregnancy among general women was 19.7%. The total rate for complications during pregnancy was 15.4%, toxemia being the major complication. The rate of pregnant women with chronic disease was 7%. Regarding the interval of pregnancy, the rates of pregnancy within 12 months and within 36 months after last delivery were 9 and 49% respectively. Induced abortion has been increasing in rural areas, being as high as 30-50% in some locations. The maternal death rate was shown 10 times higher than in developed countries (35/10,000 live births). Prenatal care Most women had no consultation with a physician during the prenatal period. Of those women who did have prenatal care, the majority (63%) received such care only 1 or 2 times throughout the entire period of pregnancy. Also, in 80% of these women the first visit Game after 4 months of gestation. Delivery conditions This field is lagging behind other public health problems in our country. Namely, more than 95% of the women deliveried their baby at home, and delivery attendance by a professional person occurred only 11% of the time. Attendance rate by laymen was 78% while those receiving no care at all was 16%. For instruments used to cut the umbilical corn, sterilized scissors were used by 19%, non-sterilized scissors by 63% and 16% used sickles. Regarding delivery sheets, the rate of use of clean sheets was only 10%, unclean sheets, vinyl and papers 72%, and without sheets, 18%. The main reason for not using a hospital as a place of delivery was that the women felt they did not need it as they had previously experience easy deliveries outside hospitals. Difficult delivery composed about 5% of the total. Child health The main food for infants (95%) was breast milk. Regarding weaning time, the rates within one year, up to one and half, two, three and more than three years were 28,43,60,81 and 91% respectively, and even after the next pregnancy still continued lactation. The vaccination of children is the only service for child health in rural Korea. As shown in the Table, the rates of all kinds of vaccination were very low and insufficient. Infant death rate was 42 per 1,000 live births. Most of the deaths were caused by preventable diseases. Death of infants within the neonatal period was 83% meaning that deaths from communicable diseases decreased remarkably after that time. Infant deaths which occurred without medical care was 52%. Methods of improvement in the MCH field 1. Through the activities of village health workers (VHW) to detect pregnant women by home visiting and. after registration. visiting once a month to observe any abnormalities in pregnant women. If they find warning signs of abnormalities. they refer them to the public health nurse or midwife. Sterilized delivery kits were distributed to the expected mother 2 weeks prior to expected date of delivery by the VHW. If a delivery was expected to be difficult, then the VHW took the mother to a physician or call a physician to help after birth, the VHW visits the mother and baby to confirm health and to recommend the baby be given proper vaccination. 2. Through the midwife or public health nurse (aid nurse) Examination of pregnant women who are referred by the VHW to confirm abnormalities and to treat them. If the midwife or aid nurse could not solve the problems, they refer the pregnant women to the OB-GY specialist. The midwife and PHN will attend in the cases of normal deliveries and they help in the birth. The PHN will conduct vaccination for all infants and children under 5, years old. 3. The Physician will help only in those cases referred to him by the PHN or VHW. However, the physician should examine all pregnant women at least three times during their pregnancy. First, the physician will identify the pregnancy and conduct general physical examination to confirm any chronic disease that might disturb the continuity of the pregnancy. Second, if the pregnant woman shows any abnormalities the physician must examine and treat. Third, at 9 or 10 months of gestation (after sitting of the baby) the physician should examine the position of the fetus and measure the pelvis to recommend institutional delivery of those who are expected to have a difficult delivery. And of course. the medical care of both the mother and the infants are responsible of the physician. Overall, large areas of the field of MCH would be served by the VHW, PHN, or midwife so the physician is needed only as a parttime worker.

• Journal of Korean Physical Therapy Science
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• v.13 no.4
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• pp.43-62
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• 2006

The survey was conducted with participation of the 289 handicapped persons residing at the rural area OOeup-gun in Kyungbook for the period of March 2 - May 31, 2006, to study the nature in general of the handicapped and the boundaries of their need. For the nature in general of the handicapped, the study was done by gender iscrimination, age, marital status, religion, educational level, occupation, monthly income, disability cause, disabled duration, disability type, disability level. For the boundaries of their need, the study was done by demand of financial support, educational demand, demand of voluntary workers, need of rehabilitation and medical treatment, job training, improvement of living conditions, or so. Using the Win.SPSS program, we made a frequency analysis and conclusions on the nature in general of the handicapped and the boundaries of their need on a 2-test. Conclusions are : 1. Nature in general of the handicapped The existence of the handicapped shows high at the age over 51 (71.6%), male-handicapped (65.1%), primary school graduates (62.9%), farming engaging (65.2%), monthly income less than one million Won (80.5%), cause by disease (53.8%), duration more than 10 years (61.6%), disability at level 3 (39.8%), extremity disability (66.4%). 2. Correlation of nature in general with demand of the handicapped a. In demanding the financial support, support for helper’s compensation shows high (p<0.05). In demanding the necessity of voluntary workers, the male-handicapped appears high during the absence of family assistance and the female-handicapped appears differently per week and also appears high during the absence of family assistance (p<0.05). b. In educational demand of the handicapped by their age, the age below 30 demands technical-job training and the age over 31 demands medical education for health care (p<0.01). c. In demanding the financial support by educational level, support for living cost shows high (p<0.05). d. In demanding improvement of living conditions by postnatal cause of disability, improvement of house structure shows high (p<0.05). e. In demanding assistance of voluntary workers by disabled duration, "No Need" shows high in the disabled duration more than 4 years (p<0.05). f. In demanding rehabilitation and medical treatment by disability type, home-visiting treatment, oriental medical treatment and physical therapy show high (p<0.001). g. In educational demand by disability level, medical education for health care shows high (p<0.01).

• Child Health Nursing Research
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• v.20 no.1
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• pp.20-29
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• 2014

Purpose: The purpose of this study was to develop a feeding protocol for premature infants and to evaluate the effects of protocol. Methods: The feeding protocol was developed through a literature review and discussions of an expert group. The developed feeding protocol was tested with 85 preterm infants in one neonatal intensive care unit in B city. A non-equivalent control group non-synchronized design was used. Data were collected from January 1 to April 30, 2013 for the control group and from June 1 to September 30, 2013 for the experimental group. The experimental group (n=38) received the feeding protocol, whereas the control group (n=47) had routine feeding care. Collected data were analyzed by t-test and -test using SPSS/WIN version 18.0. Results: First feeding time (t=2.22, p=.029) and full enteral feeding time (t=2.28, p=.026) were significantly decreased in the experimental group compared to the control group. There was no difference in incidence of complications (p>.05). Also no significant differences in weight reduction rate between the two groups were observed at the 7th postnatal day (t=-1.23, p=.222). Conclusion: The results indicate that the feeding protocol for preterm infants is effective in decreasing first feeding time and full enteral feeding time.

• Clinical and Experimental Pediatrics
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• v.50 no.6
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• pp.531-535
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• 2007

Purpose : Indomethacin treatment is successful in about 90% of patent ductus arteriosus (PDA) in premature infants, but in some, repeated administration or surgical closure is required. The object of the present study is to determine the factors affecting the efficacy of indomethacin treatment and to predict the treatment result. Method : The 29 preterm neonates, admitted to neonatal intensive care unit of Kyunghee university medical center and Eulji university hospital between September 2002 and April 2006 were diagnosed of PDA and treated with indomethacin. The risk factors that might affect the efficacy of treatment were studied retrospectively. Results : The single-administered group was 19 patients out of 29 (65.5%) and among the repeated-administered group, 5 patients (17.2%) had repeated indomethacin administration and the other 5 patients (17.2%) underwent surgery due to reopening of the duct after repeated medical treatment. In repeated-administered group, the diameter of PDA was significantly larger ($3.66{\pm}0.8mm$ vs $2.55{\pm}0.8mm$, P<0.01), especially when larger than 3.5 mm (sensitivity: 70%, specificity: 89%). Also, the mean postnatal age of the first indomethacin administration was significantly delayed in repeated-administered group (19.7 days vs 12.5 days, P<0.05). There were no significant differences in gestational age (32 wk 5 days vs 30 wk 8 days) and in birth weight (1598.9 g vs 1750.5 g). There were no significant differences in associated morbidities. Conclusion : In patients with larger diameter of PDA (>3.5 mm) and older postnatal age (>7 days), the effect of indomethacin was decreased. Therefore in such cases, repeated dose of indomethacin or surgical ligation should be considered earlier.

• Neonatal Medicine
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• v.15 no.2
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• pp.151-159
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• 2008

Purpose : This study determined the prenatal and postnatal factors associated with complications and prognosis in premature infants with leukemoid reaction. Methods : We retrospectively reviewed the medical records of premature infants with gestational ages <37 weeks and low birth weights (<2,500 g) who were admitted immediately after birth to the neonatal intensive care unit at the Dongguk University Ilsan Hospital between June 2005 and July 2006. A leukemoid reaction was defined as an absolute neutrophil count (ANC) >30,000/$mm^3$. The infants who had leukemoid reaction comprised the study group, while the remainder of infants made up the control group. The relationships between maternal and neonatal variables and ANC were studied. Results : Leukemoid reaction was detected in 3.1% of the study infants (8 of 252). Factors more frequently associated with infants with leukemoid reaction were as follows: maternal chorioamnionitis, high levels of maternal and infant C-reactive protein, gestational age <37 weeks, birth weight <2,500 g, low Apgar score, prolonged ventilator support, and a high incidence of bronchopulmonary dysplasia (BPD). However, there were no significant differences with respect to the antenatal usage of steroids, the incidences of patent ductus arteriosus, necrotizing enterocolitis, intraventricular hemorrhage, retinopathy of prematurity, and mortality between the two groups. Conclusion : Leukemoid reaction in premature infants was associated with chorioamnionitis and high levels of serum C-reactive protein in mothers and infants, and BPD in infants. These findings suggest that leukemoid reaction is secondary to inflammation caused by infection.

• Neonatal Medicine
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• v.17 no.1
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• pp.21-33
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• 2010

Purpose : The increased survival of preterm infants in the neonatal intensive care unit recently has resulted in an increased frequency of bronchopulmonary dysplasia (BPD), especially with atypical forms. However, there have been few studies compairing classic and atypical BPD. The aim of this study was to investigate the differences between these two types of BPD. Methods : Infants with a gestational age less than 32 weeks born at the Seoul National University Hospital and Bundang Seoul National University Hospital from May 2004 to April 2007 were included. The data were categorized in 2 groups, classic and atypical BPD. We determined the incidence of BPD, and compared perinatal factors and postnatal managements between two groups. Results : Among 260 study subjects, 141 (54.2%) infants had BPD. Classic BPD infants were 64 and atypical BPD infants were 77. Comparison of differences between 2 groups, classic BPD infants were associated with respiratory distress syndrome, patent ductus arteriosus, intrauterine growth restriction, more high-frequency ventilator (HFV) use, low 1 and 5 minute Apgar scores. Atypical BPD infants were associated with antenatal steroid use, maternal premature rupture of membrane and chorioamnionitis (CAM). In multivariate analysis, more HFV use was associated with classic BPD. Antenatal steroid use, clinical CAM and histological CAM were associated with atypical BPD. Conclusion : The results of this study showed that antenatal factors (antenatal steroid use, clinical CAM, histological CAM) were associated with atypical BPD and postnatal factors (HFV used more) were associated with classic BPD. Further studies are needed for prevention and treatment of BPD.

• Neonatal Medicine
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• v.18 no.2
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• pp.257-264
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• 2011

Purpose: The development of postnatal pneumothorax and its common causes and clinical aspects were studied to promote early diagnosis and proper management. Methods: A retrospective study of neonates who were hospitalized in the neonatal intensive care unit at Soonchunhyang University Bucheon Hospital from 2001 to 2010 was performed. Term neonates were divided into a spontaneous pneumothorax group and a secondary pneumothorax group. The secondary group was divided into term and preterm groups. Results: Of 4,414 inpatients, 57 (1.3%) were diagnosed with pneumothorax. Of term newborn patients, 28 (80%) had a secondary pneumothorax, and seven (20%) had a spontaneous pneumothorax. No differences were observed for gender, birth weight, resuscitation, or duration of admission between the spontaneous and control groups. The duration of treatment with a thoracostomy (20 patients, 57%) was longer in the spontaneous group (5.4${\pm}$2.9 days vs. 2.7${\pm}$2.0 days) than that in the control group. Patients with respiratory distress syndrome (RDS) developed a pneumothorax 22.8 hours after surfactant treatment, whereas patients with transient tachypnea of the newborn (TTN), pneumonia, and meconium aspiration syndrome (MAS) developed pneumothorax after 16.6 hours. Of 50 patients with a secondary pneumothorax, 19 (38%) had RDS, 11 (22%) had MAS, 7 (14%) had TTN, and six (12%) had pneumonia. Among term newborns, 42.9% were treated only with 100% oxygen. Among preterm newborns, 72.6% and 27.3% needed a thoracostomy or ventilator care, respectively. Conclusion: A pneumothorax is likely to develop when pulmonary disease occurs in neonates. Therefore, it is important to carefully identify pneumothorax and provide appropriate treatment.

• Korean Journal of Plant Resources
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• v.30 no.2
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• pp.240-264
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• 2017

The present study was carried out to identify traditional konwledges on Korean Campanulaceae plants and conduct a comprehensive review of them through analyzing phytochemistry and pharmacology of Korean Campanulaceae plants. According to the literature study, the ethnobotanical plants of Korean Campanulacae consisted of a total 18 taxa. Of them, 12 taxa including Platycodon grandiflorus, Adenophora triphylla var. japonica, Codonopsis lanceolata and others have been used as ethnomedicinal plants. These plants have been used for the treatment of 49 diseases such as cold, asthma and postnatal care. Phytochemical studies have identified the constituents present from Korean Campanulaceae (Adenophora, Codonopsis, Platycodon, Campanula and Asyneuma). A wide range of chemical compounds comprised 109 triterpenes, 8 sterols, 4 polyacetylenes, 21 alkaloids, 14 flavonoids, 14 phenolic acids, 11 phenolic glycosides, 8 phenylpropanoids and 22 other compounds. Pharmacological studies of these compounds have demonstrated immuno-stimulating, anti-inflammatory, anti-asthmatic, apophlegmatic and anti-allergic effects. They have also shown antioxidant, estrogenic, anti-diabetic, hepatoprotective, neuroprotective, antinociception and anti-tumor activities, as well as anti-obesity and cardiovascular effects. In light of traditional knowledge and phytochemical and pharmacological studies summarized, uses of Korean Campanulaceae based on traditional knowledge (for the treatment diseases and conditions of respiratory, pregnancy, childbirth, puerperium, genitourinary, circulatory, musculoskeletal and other systems) have been supported by phytochemical and pharmacological studies.

• Journal of Society of Preventive Korean Medicine
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• v.10 no.2
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• pp.81-93
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• 2006

This study was carried out to examine the actual condition of health promotion program through oriental medicine in the health center and to provide basic data to develop proper policy of oriental medical health promotion program for the community people. The data were collected from 26 health centers which have been implementing the oriental medical health promotion program, using selfadministered questionnaire for two weeks from 1 October to 15 October 2006. The results are as follows : Generally, the respondents have the positive views on the level of budget and facilities/equipments of the oriental medical health promotion program in health center. However, they have the negative views on the level of manpower and education/training of the program. And also more than 70% of the respondents have the negative opinion on capabilities of formulating and evaluating the oriental medical health promotion program. The respondents indicated that there was the lack of coordination between the oriental medical health promotion program and existing health promotion in health center, and that low rate of utilizing community resources. With regard to the method of selecting the target group for the program, there are differences according to the each program. Many programs tended to select the target group not through the criteria of life-course and illness group but through the efficiency of selecting group. And many programs such as stroke prevention program, constitutional medicine program, oriental medical prenatal program, oriental medical prenatal and postnatal program, oriental medical child care program are mainly composed of the development of educational program and lecture. Regarding the number of the present oriental medical health promotion programs, around 65% of respondents answered that the number of the programs was many and thus they needed to decrease to the proper level. And with regard to the priority of the need, effectiveness and the satisfaction for each programs, on the whole, Qui gong program, stroke prevention program, area-specialty program and oriental medical home visiting program have high score. In particular, oriental medical quit-smoking program has lowest score. From these results, it requires to develop and improve the oriental medical health promotion program in health center considering the need and characteristics of community.

• Korean Parent-Child Health Journal
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• v.3 no.1
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• pp.60-72
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• 2000

Studies are needed to determine the standard norms for sleep/activity patterns in new born baby and there have been no established reports of discrepancy of sleep/activity patterns in new born baby among various races. The purpose of this study is to determine whether the NCASA(Nursing Child Assessment Sleep Activity Record) would be suitable to evaluate and to provide the basic resources for a Korean model of sleep/activity patterns during the new born baby, and to provide a basis for nursing intervention for mothers of new born baby. The subjects of this study were 38 normal new born baby who visited the postpartum care center and two general hospitals located in pusan from January 1 to April 28, 2000. They all agreed to participate in this study. The method of data collection was through convenient sampling. Data were collected through questionnaires including demographic data, birth hi story, and general informations concerning the infant, mother and family. The instrument of this study was the NCASA translated by the Korean parent Child Health Academic Association. The collected data were analysed by mean. standard deviation, frequency, and percentage by use of SPSS/PC. The conclusions obtained from this study are summarized as follows: 1. The mean amount of daytime sleep was 10.23 hours. The mean amount of nighttime sleep was 5.53 hours. The mean amount of total daily sleep was 15.77 hours. The mean of the longest sleep period was 4.49 hours. The mean regularity of daytime sleep was 49.69%. The mean regularity of nighttime sleep was 66.98%. The mean regularity of total daily sleep was 55.81%. The mean frequency of nighttime wakenings was 3.09 times. 2. The mean amount of daytime awake periods was 6.12 hours. The mean amount of nighttime awake periods was 2.11 hours. The mean amount of daily total awake periods was 8.23 hours. The mean of the longest awake periods was 3.76 hours. 3. The mean frequency of daytime feeding was 5.71 times. The mean frequency of nighttime feeding was 2.65 times. The mean frequency of total daily feeding was 8.36 times. The mean frequency regularity of feeding was 62.50%. 4. The mean amount of a mother's day time was 16.36 hours. The mean amount of a mother's night time was 7.64 hours. In conclusion, The new born baby slept more during the daytime compare than nighttime and more active during the daytime. On the other hand. although nighttime sleeping the length of the mother was normal, but sleep was interrupted by the infant over 3 times on average. Therefore this research study will contribute to nursing practice and nursing research by its implication through postnatal educational nursing programs at hospital and nursing intervention programs that would help individual caring of early infant mothers at home.