• 제목/요약/키워드: Postnatal life

검색결과 127건 처리시간 0.032초

산후우울증의 심리사회적 위험요인 (Psychosocial Risk Factors of Postpartum Depression)

  • 박시성;한귀원
    • 정신신체의학
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    • 제7권1호
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    • pp.124-133
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    • 1999
  • 연구목적 : 산후우울증은 여러 요인이 관여하여 발생하며, 이들 위험요인에는 다양한 심리사회적 요인이 포함된다. 이전의 여러 연구결과들을 통해 산후우울증의 위험요인이 알려지고 있지만 아직까지 국내에서 산후우울증을 대상으로 위험요인을 연구한 경우는 별로 없다. 본 연구는 국내에서 산후우울증의 심리사회적 위험요인으로는 어떤 것이 있는지를 알아보기 위하여 시행되었다. 방법 : 일신기독병원을 방문한 출산 후 약 6~8주에 있는 산모 119명을 대상으로 하였다. 설문지를 이용하여 산후우울증의 위험요인에 대하여 조사하고 산후우울의 정도를 측정하였다. 설문지는 이전 연구들을 통해 알려진 위험요인들을 참고하고 산모들의 스트레스와 관계되는 요인들을 추가하여 작성하였다. 산후 우울증을 평가하기 위해 EPDS(Edinburgh postnatal depression scale)를 번안해서 사용하였고, 산후우울의 정도는 측정된 EPDS 접수에 따라 판단하였다. 결과 : 총 대상 산모 119명 중 EPDS에 의해 산후우울증으로 진단될 수 있는 고위험군은 16명으로, 13.45%의 빈도를 보였다. 고위험군에서는 과거 우울증상을 경험한 경우와 결혼생활에 대한 만족도가 낮은 경우가 저위험군에 비해 유의하게 많았다, 또 과거 우울증상을 경험하였던 군, 임신중 우울과 불안증상을 경험한 군, 임신 및 산욕기동안 스트레스 생활사를 경험하였다고 보고한 군, 결혼생활에 대한 만족도가 낮은 군, 그리고 나이가 많을수록 EPDS 접수가 유의하게 높았다. 반면, 산모의 교육수준, 종교, 직업의 유무, 임신과 출산에 따른 직업중단 희망임신 여부 분만방법 수유방법, 유아의 입원여부, 그리고 기대했던 유아의 성별 및 실제 유아의 성별은 우울증상에 영향을 미치지 않았다. 결론 : 이상의 결과로 볼 때 산후우울증은 산후에 비교적 높은 빈도로 발생 가능하며, 우울증의 과거력, 임신동안 우울과 불안증상의 경험, 스트레스 생활사, 결혼생활에 대한 낮은 만족도, 그리고 산모의 연령과 같은 요소들이 산후우울증의 위험요인이었다. 임신과 산욕기 동안 산모에 대하여 적절히 정신의학적으로 개입함으로서 조기에 산후우울증을 발견하고 치료할 수 있으며, 산후우울증으로 인하여 산모와 유아에게 미치는 다양한 손실을 예방할 수 있을 것으로 생각된다.

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일 지역 중년여성의 폐경증상과 폐경관리와의 관계에 대한 연구 (An Analysis of the Relationship between Climacteric Symptoms and Management of Menopause in Middle-aged Women)

  • 송애리
    • 한국간호교육학회지
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    • 제7권2호
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    • pp.308-322
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    • 2001
  • The purpose of this study was to investigate the relationship between climacteric symptoms and management of menopause of middle -aged women. The subjects of this study were 261 women(40 to 60 years old). Data were collected from Jun. 1 to Jul. 15, 2001 by a structured questionnaire. The instruments employed were : 1) The Climacteric Symptoms Scale developed by Aeri Song and Eun soon Chung(1998). 2) The Management of Menopause Scale developed by Aeri Song(1997). The data were analyzed by the SPSS p.c. program using t-test, ANOVA and Pearson correlation coefficient. The results of the study were as follows : 1. Mean score of climacteric symptoms was $2.18{\pm}0.39$(Maximum 4, Minimum 1). The mean scores among the categories of climacteric symptoms, in descending order, were : a) physical and physiological reactions ($2.62{\pm}0.53$), b) social and family relationships ($2.23{\pm}0.50$), c) psychiatric and psychological reactions ($2.08{\pm}0.49$), d) relationship with sexual partner($1.73{\pm}0.54$), e) genitourinary reactions ($1.72{\pm}0.55$). 2. Mean score of management of menopause was $1.79{\pm}0.45$ (Maximum 4, Minimum 1). The mean scores among the categories of management of menopause, in descending order, were : a) dietary management($2.57{\pm}0.52$), b) self control ($2.24{\pm}0.57$), c) management of exercise and physical activity($2.14{\pm}0.75$), d) management of sex life($1.71{\pm}0.47$), e) management of professional health maintenance($1.61{\pm}0.59$). 3. There were statistically significant differences in the score of middle-aged women's self reported climacteric symptoms according to : a) occupation (t=-2.79, p<0.001) b) marriage state (t=-2.29, p<0.05) c) age of menarche (F=4.66, p<0.001) d) method of Sanhujori (post natal care & treatment) (F=4.22, p<0.001) e) hormone replacement therapy (t=-3.09, p<0.05). From the above statistics, several significant findings were noted : a) There were more climacteric symptoms from those who were unemployed, those who had no partner or were divorced and those who started a menarche earlier. b) There were less climacteric symptoms reported from those on hormone replacement therapy and those who followed their parents or parents-in-law advice regarding Sanhujori (postnatal care) 4. There were statistically significant differences in the score of middle-aged women's self reported management of menopause according to : The educational background (F=7.63, p<0.001), religion (F=3.74, p<0.001), income (F=3.65, p<0.001), number of parity (F=4.87, p<0.001), method of Sanhujori(postnatal care) (F=5.73, p<0.001), period of Sanhujori (postnatal care) (F=2.81, p<0.05), hormone replacement therapy (t=3.81, p<0.001). Women with higher educational background, strong religion, higher income, large number of parity, managed their post natal care well, were on HRT, managed their menopause significantly better than the others who took part in the survey. 5. It will be noted from the above that women's degree of climacteric symptoms showed a negative correlation to the management of menopause(r=-0.2146, p<0.001). The findings shown above suggest the need to develop a variable management of menopause, in order to improve climacteric symptoms of middle-aged women. It is hoped that the above findings will stimulate more detailed research into this matter, and thereby enable guidance to be given to women going through the menopause to cope with it in a less stressful way.

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쥐의 초기 난포 발달에 관여하는 Cell Size Growth 및 CCN Family 유전자에 관한 연구 (Characterization of Genes Related to the Cell Size Growth and CCN Family According to the Early Folliculogenesis in the Mouse)

  • 김경화;박창은;윤세진;이경아
    • Clinical and Experimental Reproductive Medicine
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    • 제32권3호
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    • pp.269-277
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    • 2005
  • Objectives: Previously, we sought to compile a list of genes expressed during early folliculogenesis by using cDNA microarray to investigate follicular gene expression and changes during primordialprimary follicle transition and development of secondary follicles (Yoon et al., 2005). Among those genes, a group of genes related to the cell size growth was characterized during the ovarian development in the present study. Methods: We determined ovarian expression pattern of six genes related to the cell size growth (cyr61, emp1, fhl1, socs2, wig1 and wisp1) and extended into CCN family (${\underline{c}}onnective$ tissue growth factor/${\underline{c}}ysteine$-rich 61/${\underline{n}}ephroblastoma$-overexpressed), ctgf, nov, wisp2, wisp3, including cyr61 and wisp1 genes. Expression of mRNA and protein according to the ovarian developmental stage was evaluated by in situ hybridization, and/or semiquantitative reverse transcriptase polymerase chain reaction (RT-PCR), and immunohistochemistry, respectively. Results: Among 6 genes related to the cell size growth, cyr61 and wisp1 mRNA was detected only in oocytes in the postnatal day5 mouse ovaries. cyr61 mRNA expression was limited to the nucleolus of oocytes, while wisp1 was expressed in the cytoplasm and nucleolus of oocytes, except nucleus. cyr61 mRNA expression, however, was found in granulosa cells from secondary follicles. The rest 4 genes in the cell size growth group were detected in oocytes, granulosa and theca cells. Cyr61 and Wisp1 proteins were expressed in the oocyte cytoplasm from primordial follicle stage. Especially, Cyr61 protein was detected in pre-granulosa cells, Wisp1 protein was not. By using RT-PCR, we evaluated and decided that Cyr61 protein is produced by their own mRNA in pre-granulosa cells that was not detected by in situ hybridization. cyr61 and wisp1 genes are happen to be the CCN family members. The other members of CCN family were also studied, but their expression was detected in oocytes, granulose and theca cells. Conclusions: We firstly characterized the ovarian expression of genes related to the cell size growth and CCN family according to the early folliculogenesis. Cyr61 protein expression in the pre-granulosa cells is profound in meaning. Further functional analysis for cyr61 in early folliculogenesis is under investigation.

우울증의 후성유전기전: BDNF 유전자의 히스톤 변형 및 DNA 메틸화의 역할 (Epigenetic Mechanisms of Depression: Role of Histone Modification and DNA Methylation in BDNF Gene)

  • 박성우
    • 생명과학회지
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    • 제28권12호
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    • pp.1536-1544
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    • 2018
  • 우울증은 심각하며 재발하는 흔한 정신질환이다. 우울증은 환경 요인과 유전 요인, 그리고 신경생물학적 체계의 구조 및 기능의 변화로 발병한다. 후성유전학적 변화가 우울증과 관련 된다는 여러 연구들이 보고되었다. 후성 유전은 환경 요인이 크로마틴 구조를 변화시켜 DNA 염기 서열 변화 없이 유전자 발현을 조절하는 기전으로 설명된다. DNA 메틸화와 히스톤 아세틸화 및 메틸화를 포함하고 있는 히스톤 변형이 주요 후성유전기전으로 알려져 있다. 우울증 동물모델연구에서는 생애 초기 스트레스 같은 스트레스 환경이 게놈에 지속적으로 후성유전표지를 남기게 되고 이로 인해 유전자 발현이 변화되고 결국 성체가 되었을 때 신경 기능이나 행동 기능에 영향을 미치게 된다고 설명하고 있다. BDNF는 우울증과 관련된 대표적인 유전자로 알려져 있다. 설치류가 출생 전, 후, 그리고 성체 기간에 스트레스에 노출되면 해마에서 BDNF 유전자의 히스톤 변형과 DNA 메틸화 패턴이 변화되고 이로 인해 BDNF 발현이 변화된다. 이러한 과정은 불안과 우울 행동에도 영향을 미치게 된다. 본 종설에서는 BDNF 유전자의 히스톤 변형 및 DNA 메틸화와 같은 우울증 발병에 관여하는 후성유전기전의 최신 지견에 대해 논의하여 우울증 치료의 새로운 타겟 개발에 도움이 되고자 한다.

Effects of Dietary Supplementation of Conjugated Linoleic Acid (CLA) on Piglets' Growth and Reproductive Performance in Sows

  • Park, J.C.;Kim, Y.H.;Jung, H.J.;Moon, H.K.;Kwon, O.S.;Lee, B.D.
    • Asian-Australasian Journal of Animal Sciences
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    • 제18권2호
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    • pp.249-254
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    • 2005
  • The objective of this study was to investigate effects of dietary level of CLA and the duration of feeding CLAcontaining diets on reproductive performance in sows and piglet growth rate. Tallow (3% in gestation diet and 5% in lactation diet, respectively) was incorporated as a fat source in control diet, and each 50% (dietary CLA level of 0.75% in gestation diet, and 1.50% in lactation diet, respectively) or 100% (dietary CLA level of 1.50% in gestation diet, and 2.50% in lactation diet, respectively) of tallow was replaced by a commercial CLA preparation containing 50% CLA isomers. Diets containing CLA were fed either from d 15 premating to weaning or d 74 post-mating to weaning. The level of dietary CLA and feeding duration did not affect litter size. High dietary level of CLA, however, decreased piglet weights at birth (p<0.01) and tended to decrease backfat thickness of sows at weaning. Longterm feeding of CLA-containing diets decreased piglet weights at weaning (p<0.05) and backfat thickness of sows at weaning (p<0.05). CLA supplemented in sow diet was transferred to fetus and piglets during pregnancy and nursing period, respectively. CLA contents of femoral muscle of piglets were 2.08 to 2.57 mg per g of fat at birth, and 2.36 to 4.47 mg at 10 days of age in CLA groups, while CLA was not detected in the control group. In conclusion, dietary supplementation of CLA tended to lower backfat thickness of sow and piglets' weight at birth or weaning, but did not affect total litter size. Dietary CLA was transferred efficiently during prenatal and postnatal periods of time through the placenta and milk, respectively.

출산 전후 어머니 스트레스 변화의 종단적 연구 (Longitudinal Study on the Changes of Mothers' Stress and Cortisol From Pregnancy to Postpartum Period)

  • 이현정;현온강;나종혜
    • 한국지역사회생활과학회지
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    • 제17권3호
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    • pp.109-121
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    • 2006
  • This study examines the relationship between mother's stress and cortisol level during late pregnancy and how it changes into postpartum periods. Thirty one families were recruited from Daejeon and Incheon in South Korea. The major findings were as follows: (1) The level of mothers' cortisol followed the typical diurnal pattern of decline throughout the day. Further longitudinal analysis revealed that the level of Korean mothers' cortisol steadily lowered from the 8th prenatal month to the 6th postnatal month. (2) During pregnancy, mothers reported to experience changes in physical activities, daily routines, eating habits, types or amount of social activities and sleeping habits. Among these they were stressed the most by changes in physical activities and social activities. (3) The results of postpartum depression tests conducted at two months after giving birth showed mothers at this time were mostly stressed from difficulty sleeping and unnecessary self criticism. (4) The level of psycho social stress in mothers at six months after giving birth was mainly on social roles and the questions about self reliance marked the highest points. (5) Overall, there was a tendency for the level of maternal stress to decrease definitely from before and after the delivery and even though the level of stress was steadily decreasing up to 6th postpartum month it was not as sharp as those of before and after the birth of the babies. The level of cortisol analysis also showed the same obvious tendency.

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고위험신생아의 생후 초기 구강 내 균집락 형성과 당농도 및 영향요인 (Flora Colonization and Oral Glucose Levels During the Early Postnatal Period in High-Risk Newborns)

  • 안영미;손민;전용훈;김남희
    • Child Health Nursing Research
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    • 제22권4호
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    • pp.379-389
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    • 2016
  • Purpose: A longitudinal study was conducted to explore flora colonization and oral glucose high-risk newborns during the first 7 days after birth. Methods: Oral secretions of hospitalized newborns were obtained for microbial cultures and glucose test at days 1-7 after birth. Results: Among the total 112 newborns, 40% were girls and 73% were premature. Mean gestational age was $34.4{\pm}3.2$ weeks and weight was $2,266{\pm}697.5$ grams. The most common flora included Streptococcus (28.2%), Methicillin-resistant Staphylococcus aureus (MRSA, 10.9%), Staphylococcus (6.0%) and Coagulase-Negative Staphylococcus (CNS, 4.0%). The average oral glucose level was $29.2{\pm}23.0mg/dL{\sim}58.2{\pm}39.5mg/dL$. Newborns with higher oral glucose than serum (crude odds ratio [ORc] =1.75; 95% confidence interval [CI] =1.03-2.97), phototherapy (ORc=3.30; 95% CI=2.29-4.76) and prone position (ORc= 2.04; 95% CI=1.13-3.69) were more likely to be colonized. Having oral tubes (ORc=0.42; 95% CI=0.29-0.59), parental nutrition (ORc=0.21; 95% CI=0.13-0.32) and antibiotics (ORc=0.51; 95% CI=0.36-0.73) had protective effects. For oral glucose statistical significances existed on time effect among newborns with Streptococcus (F=9.78, p=.024), MRSA (F=7.60, p=.037) or CNS (F=11.15, p=.019) and interaction between time and colonization among newborns with all of four flora (F=2.73, p=.029) or colonization with only Staphylococcus (F=2.91, p=.034). Conclusion: High-risk newborns develop flora colonization at an early period of life. Their clinical features were associated with types and time of oral flora colonization. They need close monitoring and multifaceted intervention to improve oral environment and infection control.

선천성 양측성 Sylvius 주위 피질 증후군의 병인론으로서의 뇌회반흔증에 대한 고찰 (A Study of Ulegyria as Pathognomonic Aspects of Congenital Bilateral Perisylvian Syndrome)

  • 김한웅;조규용;이민철;김형일;우영종;김명규
    • Journal of Korean Neurosurgical Society
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    • 제37권2호
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    • pp.124-128
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    • 2005
  • Objective: Congenital bilateral perisylvian syndrome(CBPS) has been defined as a characteristic malformative perisylvian polymicrogyria(PMG) in patients with clinical symptoms of pseudobulbar palsy and epileptic seizures. For the present study, we investigate clinicopathologic features of CBPS associated with timing of lesion formation. Methods: Clinicopathologic features of CBPS from 6 patients with surgical resection of the cerebral lesions due to medically intractable seizures were studied. Results: Seizure onset ranged from 1 to 10years (average 6.7years) of age, and average duration of seizure was 23years. All had complex partial seizures, and two patients had additional tonic clonic seizures. Magnetic resonance (MR) images showed polymicrogyria, atropic gyri with gliosis. In the histopathologic examination, the cortical lesions revealed features of ulegyria; atrophic and sclerotic gyri, laminar loss of neurons, extensive lobular gliosis throughout the gray and white matter, neuronoglial nodule formation, and many amyloid bodies. Unlayered or four-layered PMG was not identified. Conclusion: Above data suggest that CBPS might be caused by ulegyria resulting from developmental cortical defect during early fetal stage or acquired hypoxic/ischemic injury in prenatal or postnatal life.

신생아의 심한 일과성 고암모니아혈증 1례 (A case of severe transient hyperammonemia in a newborn)

  • 황민우;유승택;오연균
    • Clinical and Experimental Pediatrics
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    • 제53권4호
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    • pp.598-602
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    • 2010
  • 신생아 일과성 고암모니아혈증은 고암모니아혈증을 특징으로 하며 대부분 호흡곤란 치료를 받는 미숙아에서 발생한다. 발생원인은 정확히 알려져 있지 않으나 생후 2-3일에 호흡 곤란, 기면, 경련, 혼수 등의 임상 증상을 보이고, 생화학적 검사 상 혈중암모니아 농도가 현저히 증가하며 요소회로 효소 치는 정상을 보인다. 치료가 늦으면 사망에 이르는 응급을 요하는 질환이나 즉각적이고 적절한 치료 시 신경학적 손상을 남기지 않고 호전 가능하다. 저자들은 호흡곤란을 보여 호흡기 치료를 받던 35주 미숙아에서 48시간 내에 경련과 함께 혼수상태에 빠지고 검사상 고암모니아혈증을 보여 신투석 등의 치료 후 회복되었으며 2년 추적관찰에서 정상을 보인 환아를 보고하는 바이다.

Developmental Disability Animal Model Based on Neonatal Lipopolysaccharide with Altered 5-HT Function

  • Kim, Jae-Goo;Kim, Min-Soo;Lee, Se-Oul;Kim, Gun-Tae;Lee, Jong-Doo;Kim, Dong-Goo
    • The Korean Journal of Physiology and Pharmacology
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    • 제11권3호
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    • pp.113-119
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    • 2007
  • Developmental disability shows life-long behavioral abnormality with no significant physical malformation. This study was undertaken to develop an animal model for developmental disability by using two-factor approach. Lipopolysaccharide (LPS), a bacterial toxin, and NAN-190, a $5-HT_{1A}$ receptor antagonist, were administered to Sprague-Dawley rats on postnatal day (PND) 5 to induce inflammation and an altered 5-HT system, respectively. Long-term alteration of behavior occurred in the drug-treated groups. The LPS-treated group showed impaired motor coordination in the Rota-rod test. The LPS- treated or both LPS and NAN-190-treated groups showed impaired fore-paw muscle power in the wire maneuver test. These groups also showed decreased white matter volume and increased serotonergic fibers. The LPS and NAN-190-treated group also exhibited neurologic deficit in the placing reaction test and impaired equilibrium function in the tilt table test. The results showed that a variety of altered behaviors can be generated by two factor model, and suggested that combination of important etiologic factors and possible underlying defects is a promising strategy of establishing an animal model for developmental disabilities.