• Pediatric Infection and Vaccine
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• v.24 no.1
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• pp.65-70
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• 2017

Cytomegalovirus (CMV) infection is one of the most common congenital infections. The first case of discordant congenital CMV infection in twins occurred in Korea. A 31-year-old woman became pregnant with twins (dichorionic-diamniotic). An elective caesarean section was performed at 37 weeks. The first baby was male, weighing 2,410 g with an Apgar score of 8/9. The second baby was female, weighing 1,380 g with an Apgar score of 5/8. She had experienced intrauterine growth retardation, and presented with microcephaly, micrognathia, and joint stiffness. During the work-up for discordant twins, the second baby's serum test was positive for CMV immunoglobulin M. Her urine, blood, and cerebrospinal fluid (CSF) were CMV polymerase chain reaction positive. The first baby's CMV tests were negative. Ophthalmologic exam and audiometry performed on the second baby showed CMV retinitis and bilateral sensorineural hearing loss. She was treated with intravenous ganciclovir. Currently, she is bed-ridden and has significant developmental delay. Although the causes of discordant congenital CMV infection in twins are unclear, this case shows that discordant congenital CMV infection should be considered in twins with significant differences in intrauterine growth or clinical symptoms after birth.

• Journal of Chest Surgery
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• v.32 no.1
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• pp.70-74
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• 1999

Thrombosis in valve or left atrium after mechanical mitral valve replacement causes prosthetic valve dysfunction or thromboembolism. Early and adequate therapy is very important but clinically not easy. Thrombolysis can avoid reoperation-related risks and act as an optimal therapy for prosthetic valve thrombosis. This report describes three patients who were treated by using low molecular weight heparin (LMWH) and wafarin. Two patients, including one pregnant woman, had prosthetic valve thrombosis and immobility of valve leaflets, and one patient with recent cerebral infarction due to thromboembolism had thrombus in left atrium. Fraxiparine 0.3 cc (7,500 ICU AXa) was administrated subcutaneously twice or triple daily. At discharge, thrombosis in valve and left atrium were completely or near totally lysed and valve leaflets were normally mobile. During the period of thrombolysis and follow up, there were no complications in all patients.

• The Journal of Korean Medicine
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• v.16 no.2 s.30
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• pp.9-16
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• 1995

Forty four patients with Bell's palsy were treated with acupuncture from onset and clinical observation was carried on from March 1994 through Feburary 1995. Acupuncture treatment was done 3 times per week and the acupuncture points were LI4 Hapkok, ST36 Choksamni, LI20 Yonghyang, BL2 Ch'anjuk, TE17 Yep'ung, ST4 Chich'ang, ST6 Hyopko, GV26 Sugu, CV24 Sungjang, GB14 Yangbaek and Ex-HN4 Oyo. They were inserted to a depth of 0.5 to 1.0 cm. After insertion, manipulation was carried on until the patients felt strong numbness or De Qi sensation induced by rotating or twisting needles. Through-needling in lengths varying from 2.0 to 3.5 cm was also applied from ST4 Chich'ang to ST6 Hyopko, from GV26 Sugu or CV24 Sungjang to ST4 Chich'ang and from GB14 Yangbaek to Ex-HN4 Oyo. The mean age was 39.3 and 63.6% of the patients were women, including one pregnant woman. There was no recurrent palsy in this study. By applying the House-Brackmann facial nerve grading scales, patients were evaluated weekly from the first treatment to judged recovery or the 7th week of the treatment. 86.4% of the patients were recovered completely within 7 weeks and the average healing period was 3.7 weeks.

• Journal of Biomedical Engineering Research
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• v.25 no.6
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• pp.589-598
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• 2004

We propose a new algorithm to extract the fetal electrocardiogram (FECG) from a multi-channel electrocardiogram (ECG) recorded at the chest and abdomen of a pregnant woman. To extract the FECG from the composite abdominal ECG, the classical time-domain method based on singular value decomposition (SVD) has been generally used. However, this method has some disadvantages, such as its high degree of computational complexity and the necessary assumption that vectors between the FECG and the maternal electrocardiogram (MECG) should be orthogonal. The proposed algorithm, which uses SVD in a discrete cosine transform (DCT) domain, compensates for these disadvantages. To perform SVD with lower computational complexity, DCT coefficients corresponding to high-frequency components were eliminated on the basis of the properties of the DCT coefficients and the frequency characteristics of the FECG. Moreover, to extract the pure FECG with little influence of the direction of the vectors between the FECG and MECG, three new channels were made out of the MECG suppressed in the composite abdominal ECG, and the new channels were appended to the original multi-channel ECG. The performance of the proposed algorithm and the classical time-domain method based on SVD were compared using simulated and real data. It was experimentally verified that the proposed algorithm can extract the pure FECG with reduced computational complexity.

• Journal of Genetic Medicine
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• v.4 no.1
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• pp.80-83
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• 2007

A 36-year-old pregnant woman was referred for amniocentesis at 19.5 weeks gestation because of advanced maternal age and evidence of increased risk for Edward syndrome in the maternal serum screening test. Cytogenetic analysis of the cultured amniotic fluid cells revealed mosaicism for ring chromosome 11: 46,XX,r(11)[65]/ 45,XX,-11[16]/ 46,XX [34]. Parental karyotypes were normal. A targeted ultrasound showed intrauterine grow th restriction (IUGR). Cordocentesis was performed to characterize the ring chromosome and to rule out tissue specific mosaicism. Karyotype was confirmed as 46,XX,r(11) (p15.5q24.2)[229]/45,XX,-11[15]. And a few new form of ring w ere detected in this culture. The deletion of subtelomeric regions in the ring chromosome were detected by fluorescent in situ hybridization (FISH). The pregnancy was terminated. The fetal autopsy showed a growth-retarded female fetus with rocker bottom feet. We report a case of prenatally detected a de novo ring chromosome 11.

• Women's Health Nursing
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• v.4 no.1
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• pp.123-138
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• 1998

The purpose of this study was to describe perimenstrual symptom severity levels and perimenstrual distress patterns of women. The study performed the discriminant analysis in which included seven factors : age, pariety, social support, menstrual socialization(mother's symptom, sister's symptom, and menstrual effect), attitude of sex role and depression. The subjects were 283 women that they were not pregnant or lactating, had at least one period in past three months, would understand the purpose of study and willingly accepted the participation. The data analysis was done by pc-SAS program after data collection from Nov. 20, 1997 to Dec. 18, 1997. The descriptive analysis was done to explore general characteristics of the subjects and the stepwise discriminant analysis was done to verify factors in relation to perimenstrual symptom severity levels(severe vs mild menstrual symptom group) and perimenstrual distress patterns(spasmodic vs congestive menstrual symptom group). The instruments were selected for this study from Interpersonal Support Evaluation List(ISEL) by Cohen and Hoberman(1983), Center for Epidemic Studies Depression(CES-D) by Radloff(1977), and Sex Role Attitude Scale by Yunok Suh(1995), Mother's symptom and sister's symptom measurements by Woods, Mitchell & Lentz(1995), and menstrual effect by Brooks-Gun & Ruble(1980). The major findings of this study are as follows : 1. Of the 283 women, 93 women(32.9%) were assessed to severe perimenstrual symptom group and 190 women(67.1%) were assessed to mild perimenstrual symptom group. Results from the stepwise discriminant analysis showed three factors, such as depression, menstrual effect, and age, significantly related to perimenstrual symptom severity and they explained 20% of the total variance. The linear discriminant equation included three factors related to perimenstrual symptom groups was showed(Z=1.445 depression+0.174 menstrual effect-0.054 age). The cutting score(Z) was 2.809. We classified the severe perimenstrual symptom group by more than the cutting score 2.809 and the mild perimenstrual symptom by less or equal than the cutting score 2.809. The correctedness of posterior probability from discriminant equation was 72% as two perimenstrual symptom group classifications. 2. Of the 264 women, 139 women(52.7%) were assessed to spasmodic perimenstrual distress group and women(47.3%) were assessed to congestive perimenstrual distress group. Results from the stepwise discriminant analysis showed two factors, such as depression, age, significantly related to perimenstrual distress groups and they explained 8% of the total variance. The linear discriminant equation included two factors related to perimenstrual distress group was showed(Z=-0.084 age-0.776 depression). The cutting score(Z) was -3.759. We classified the spasmodic perimenstrual distress group by more than cutting score -3.759 and the congestive perimenstrual distress group by less or equal than cutting score -3.759. The correctedness of posterior probability from discriminant equation was 65% as two perimenstrual distress group classifications.

• (The)Study of the Eastern Classic
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• no.32
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• pp.311-362
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• 2008

This study aimed to make clear the education process, from antenatal training to early childhood education, of Joseon Royal Family. Centered on the successors to the throne and reviewed also the education of other Royal Family members, this study carried out comparative analysis on them. Antenatal training is pregnant woman's essential physical and mental attitude. It is indispensable to the health and good nature of unborn baby. Antenatal training had been based on the theory of Oriental medical science that fetus can sympathize what mother see and feel. Such theory, combined with Confucian self-culture theory, had taken very important position in Confucianism. Not to speak of Royal Family, noble family regarded antenatal training very essential as beginning of education and root of nature formation. For firstborn son and firstborn grandson, Boyangcheong (輔養廳, special nursery agency) was set up before their age became three, but not for other sons and grandsons of Royal Family. When firstborn son or firstborn grandson grew up to read letters, Ganghakcheong (講學廳) was set up for their early education. Other sons of king also learned in their early ages at Ganghakcheong while other grandsons of king learned at Gyohakcheong (敎學廳). Education courses were almost same between successors and non-successors but there were wide difference in the ranks of their tutors; firstborn son's tutor marked 2nd Jeong(正) class, firstborn grandson's tutor marked 2nd Jong(從) class and other royal sons' tutors were just 9th Jong(從) class.

• Women's Health Nursing
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• v.6 no.1
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• pp.153-165
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• 2000

The antenatal self-care, one of antenatal management, was almost done by a pregnant woman herself. But It's especially difficult for primigravidas to cope with the change of being pregnant, and they also had insufficient knowledge of pregnancy, The purpose of this study was to serve as a basis for antenatal management, by grasping how much primigravidas performed antenatal self-care, how much they had maternity-related knowledge, and what factors affected those two factors. The subjects of this study were the primigravidas, selected from among visitors to a general hospital and a hospital for obstetrics and gynecology located in the city of K. A questionnaire survey was carried out over them from July 16 to August 19, 1998, to collect data. The test instrument used in this study for antenatal self-care behavior was one that modified the measurement instrument employed in studies by Kim Hae Won(1996), Lee Mi La(1984), and Yoon Young Mi(1994). Another one for maternity-related knowledge was Kim, Hae Won(1996)'s instrument. The collected data were statistically analyzed by SAS PC+. Frequency and percentage were calculated to find out the primigravidas' general characteristics, and the mean and standard deviation, rank were estimated to determine the degrees of antenatal self-care behavior and maternity-related knowledge, t-test and ANOVA were carried out to identify the general characteristic that affected antenatal self-care and maternity-related knowledge. and the relationship of antenatal self-care behavior to maternity-related knowledge was tested by Pearson correlation coefficient. The findings of this study were as follows; First, the age of the subjects ranged from 18 to 37, and their mean age was 26.43. Their mean gestational period was 24.87 weeks. 45% of the subjects were in the third-term pregnancy. Second, their total mean score in antenatal self-care behavior ranged from 94, the highest, to 36, the lowest. Its average score was 63.81(SD 9.98). The total mean score in maternity-related knowledge ranged from 20, the highest, to 1, the lowest, and its average score was 10.91(SD 4.59, 54.55 percent). Third, the general characteristics that gave impact on the primigravidas' antenatal self-care behavior were age, educational background, gestational period, experience of natural miscarriage, and experience of infertility test. A higher score in antenatal self-care behavior was gained by the primigravida group who had better educational background(F=3.29, p=.02), who was in the late stage of pregnancy(F=4.31, p=.01), who experienced a natural miscarriage(t=2.06, p=.04), and who went through a infertility test(t=-2.19, p=.04). Fourth, the general characteristics that had an influence on maternity-related knowledge were identified as the religion, the term of marriage, and the gestational period. A higher score in maternity-related knowledge was got by the primigravida group who had a religion(t=-2.02, p=.04), and who was in the late stage of pregnancy(F=5.77, p=.003). The term of marriage also made a significant difference(F=3.46, p=.02). Fifth, the relationship of the total mean score between antenatal self-care behavior and maternity-related knowledge was found to be at r=.37(p=.0001). In this study, an attempt was made to affirm the subjects' characteristics, the degree of their antenatal self-care behavior, and the extent of their maternity-related knowledge, to confirm what characteristics affected significantly primigravida's antenatal self-care behavior and maternity-related knowledge, and to verify that there was a relationship between the two variables. The meaning of this study might be backed up by the fact that its findings would serve as a basis for primigravida's efficient antenatal management in the future.

• Journal of Radiation Protection and Research
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• v.21 no.4
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• pp.273-284
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• 1996

Embryos and fetuses are more sensitive to various environmental agents than are adults or children. The biological effects such as intrauterine death and malformation are closely connected with prenatal exposure very various agents. The sensitivity of these embryonic/fetal effects depends on the stage of pregnancy. From the viewpoint of fetal development, embryonic and fetal stages can be divided into three stages : Preimplantation, organogenetic and fetal. Each stage corresponds to 0 to 4.5days, 4.5 to 13.5days, and 13.5days of gestation in mice, respectively. Many studies on the biologcal effects of mice irradiated by ${\gamma}-rays$ at various stages during organogenesis and fetal period have been performed. Based on these results, the dose-effect and dose-response relationships in malformations, intrauterine death, or retardation of the physical growth have been practically modeled by the ICRP(International Commission on Radiological Protection) and other international bodies for radiation protection. Many experimental studies on mice have made it clear that mice embryos in the preimplantation period have a higher sensitivity to radiation for lethal effects than the embryos/fetuses on other prenatal periods. However, no eratogenic effects of radiation at preimplantation stages of mice have been described in many textbooks. It has been believed that 'all or none action results' for radiation of mice during the preimplantation period were applied. The teratogenic and lethal effects during the preimplantation stage are one of the most important problems from the viewpoint of radiological protection, since the preimplantation stage is the period when the pregnancy itself is not noticed by a pregnant woman. There are many physical or chemical agents which affect embryos/fetuses in the environment. It is assumed that each agents indirectly effects a human. Then, a safety criterion on each agent is determined independently. The pregnant ICR mice on 2, 48, 72 or 96 hours post-conception (hpc), at which are preimplantation stage of embryos, were irradiated whole body Cesium-gamma radiation at doses of 0.1, 0.25, 0.5, 1.5, and 2.5 Gy with dose rate of 0.2 Gy/min. In the embryos from the fetuses from the mice irradiated at various period in preimplantation, embryonic/fetal mortalities, incidence of external gross malformation, fetal body weight and sex ratio were observed at day 18 of gestation. The sensitivity of embryonic mortalities in the mice irradiated at the stage of preimplantation were higher than those in the mice irradiated at the stage of organogenesis. And the more sensitive periods of preimplantation stage for embryonic death were 2 and 48 hpc, at which embryos were one cell and 4 to 7 cell stage, respectively. Many types of the external gross malformations such as exencephaly, cleft palate and anophthalmia were observed in the fetuses from the mice irradiated at 2, 72 and 96 hpc. However, no malformations were observed in the mice irradiated at 48 hpc, at which stage the embryos were about 6 cell stage precompacted embryos. So far, it is believed that the embryos on preimplantation stage are not susceptible to teratogens such as radiation and chemical agents. In this study, the sensitivity for external malformations in the fetuses from the mice irradiated at preimplantation were higher than those in the fetuses on stage of organogenesis.

• Journal of Genetic Medicine
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• v.4 no.2
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• pp.186-189
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• 2007

More than 6,000 rare disorders including genetic diseases have been reported. Of them, 1,500 diseases (1,211 for clinical diagnosis and 289 for research only) are technically possible for genetic testing. In Korea, since 2005, only 63 genetic diseases is permitted for prenatal genetic testing by the "Bioethics and Biosafety Law". The article 25 in the law prescribes 63 genetic diseases without clear indication for its selection and inclusion criteria. In EU, USA, and other foreign countries, however, there is no provision in the statute on prenatal genetic testing; it is not restricted by a law. Recently, a woman (Mrs. L, 38y) who is a carrier for Menkes disease made an appeal to a government for an amendment of the "Bioethics and Biosafety Law" prohibiting the prenatal diagnosis of her pregnancy at risk for Menkes disease. Menkes disease (MNK) is an X-linked recessive disorder characterized by neurodegeneration, connective tissue defects and hair abnormalities, and no effective treatment is available yet. The prevalence rate of MNK is one in about 250,000 live births. Menkes syndrome patients fail to absorb copper from the gastrointestinal tract in quantities adequate for meeting nutritional needs. These needs seem particularly acute during the initial 12 month of life, when the velocity of brain growth and motor neurodevelopment. Most of pts. die around 3yrs. of age. Mrs. L had a boy with Menkes disease who died at 2y.o. in 2001. Subsequent pregnancy in 2003, she was able to have prenatal genetic testing for mutation of the Menkes (ATP7A) gene and delivered a healthy baby boy. Now, She is pregnant again and wants to have prenatal diagnosis. however, this time, she was not allowed to have any more because Menkes disease is not included in 63 genetic diseases permitted by the law for prenatal genetic testing, in spite of the fact that she is a Menkes disease carrier and her pregnancy is at risk to have an affected baby. This case shows the practical problem of the legal restriction for prenatal genetic testing in Korea. In this study, we report a arguable case and discuss the controversial issues in the legal restriction for prenatal genetic testing in Korea.