• Clinical and Experimental Pediatrics
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• 제45권12호
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• pp.1512-1518
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• 2002

목 적 : 쌍태 임신에서 일측 태아가 자궁내 사망한 경우 생존아의 사망률이 높고 범발성 혈관내 응고병증, 패혈증 및 뇌손상 등을 증가시킨다고 알려져 있다. 본 연구는 일측 태아의 자궁내 사망 후 생존아들의 주산기 합병증 및 이와 연관된 위험 인자들에 대해 알아보고자 하였다. 방 법 : 1995년 1월부터 2000년 12월까지 쌍태 임신 중 일측 태아가 자궁내 사망한 후 생존 출생한 15례의 의무 기록지를 후향적으로 분석하였다. 생존아에서는 말초 혈액과 혈액 응고계 검사, 두부 초음파 및 뇌 자기공영상 검사를, 그리고 산모에서는 말초 혈액과 혈액 응고계 검사 및 임신과 관련된 합병증에 대해 의무 기록지를 통하여 후향적으로 조사하였고, 생존아에서 주산기 합병증에 대한 위험 인자로 융모막 상태, 출생 체중, 재태 주령 및 일측 태아의 자궁내 사망 후 분만까지의 기간에 대해 관찰하였다. 결 과 : 1) 일측 태아의 자궁내 사망 후 생존 출생아 15례의 재태 주령은 $33.7{\pm}3.2$주, 출생 체중은 $1,992{\pm}592g$, 분만까지의 기간은 $32.4{\pm}29.5$일이었고, 조산아 11례(73.3%), 만삭아 4례(26.7%)로 조산의 원인은 조기 진통과 조기 양막 파수가 주였다. 2) 산모에서 시행한 혈액 검사상 범발성 혈관내 응고병증은 1례도 없었고, 산모의 말초 혈액 검사(백혈구수, 혈소판수, PT, aPTT, fibrongen, FDP) 소견과 생존아의 범발성 혈관내 응고병증 및 뇌연화증 발생과는 연관이 없었다. 3) 생존아 총 15례 중 6례(40.0%)는 정상이었고, 범발성 혈관내 응고병증 3례(20.0%), 뇌연화증 3례(20.0%), 자궁내 발육 지연 1례, 쌍태아간 수혈 증후군(recepient) 1례, 선천성 심장기형(심방 중격 결손 및 폐동맥 협착)이 동반된 경우 1례 있었다. 4) 생존 출생아에서 범발성 혈관내 응고장애 및 뇌연화증의 발생은 융모막 상태, 출생 체중, 재태 주령 및 일측 태아의 자궁내 사망 후 생존아 분만까지의 기간과 통계학적 유의성이 없었다. 결 론 : 본 연구에서는 자궁내에서 일측 태아가 사망한 경우 산모에서 혈액학적 이상은 발견할 수 없었고 생존아에서 주산기 합병증을 예측할 수 있는 의의 있는 위험 인자를 발견할 수 없었지만 약 20.0%에서 뇌연화증 및 범발성 혈관내 응고병증이 발생하였기에 쌍태 임신 중 임신 제2, 3기에 일측 태아가 자궁내 사망한 경우 생존 출생아에 대한 면밀한 혈액학적 및 신경학적 검사가 필요하다고 사료되었다.

• 여성건강간호학회지
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• 제8권1호
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• pp.55-68
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• 2002

While the survival rate of preterm infants and employment rates of mothers with infants have been dramatically increasing, little is known about the impact of maternal employment and having premature infants on maternal health recovery after delivery. The purpose of this longitudinal study was to examine differences in postpartum health by mother's employment and infant's prematurity over time during the first 3 months postpartum. The study used a longitudinal design and was secondary data analysis from a large study. A convenience sample of 132 mothers was recruited with mothers who had fullterm or preterm infants through the postpartum unit. They were followed up for 3 times (at 1-2 days, 6 weeks, and 3 months) during the first 3 months postpartum period. Level of fatigue and hysical symptoms were indicators for postpartum physical health; Positive affect and negative affect were assessed for postpartum mental health, and role functional status after childbirth was for role performance. Finding indicated that health indicators changed significantly over time but there was no main or interaction effect for maternal employment status. There were main effects of infant's prematurity on positive affect, negative affect, and role functional status (self-care and social and community activities). This study enhanced the understanding of postpartum health of mothers with preterm infants as well as those with fullterm infants during the postpartum period.

• Clinical and Experimental Reproductive Medicine
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• 제39권4호
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• pp.187-192
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• 2012

Heterotopic pregnancy is rare event and the risk is increased with assisted reproductive technology procedures. Heterotopic cervical pregnancy is even more unusual. We report a rare case of heterotopic cervical pregnancy that was managed successfully. A 36-year-old women who conceived by IVF-ICSI was diagnosed with heterotopic cervical pregnancy. She visited the emergency room with vaginal bleeding at 5 weeks of gestation and underwent careful intracervical gestational sac reduction with forceps under abdominal guidance the next day. The postoperative course was uneventful and with regular check-ups, the intrauterine pregnancy (IUP) progressed unremarkably through 41 weeks with delivery of a healthy newborn. We reviewed a total of 37 cases of heterotopic pregnancy that have been reported in the English language literature. There have been many attempts to eliminate the cervical embryo while preserving the IUP, and complete cervical evacuation is important in order to avoid infection, bleeding, and premature birth.

• 대한간호학회지
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• 제34권8호
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• pp.1468-1476
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• 2004

Purpose: A quasi-experimental study was performed to investigate the effects of a home visiting discharge education program on the maternal self-esteem, attachment, postpartum depression and family function in 35 mothers of neonatal intensive care unit (NICU) infants. Methods: Twenty-three mothers in the intervention group received the home visiting discharge education while 12 mothers in the control group received the routine, hospital discharge education. Baseline data was collected in both groups one day after delivery. The intervention group received the home visiting discharge education while the control group did the routine hospital-based discharge education. The questionnaire including the data on maternal self-esteem, attachment, postpartum depression and family function were collected within 1 week after the discharge by mail. Results: The scores of maternal self-esteem, and attachment were significantly increased, and the postpartum depression and the family function score were decreased after the home visiting discharge education in intervention group. There were no changes in these variables before and after the routine hospital-based discharge education in control group. Conclusion: These results support the beneficial effects of home visiting discharge education on the maternal role adaptation and family function of the mothers of NICU infants.

• 여성건강간호학회지
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• 제15권4호
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• pp.280-293
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• 2009

Purpose: This study was to identify the relationship between physical suffering, emotional state, and nursing needs of pregnant women in preterm labor and the difference depending on general characteristics. Methods: The participants in this descriptive survey, selected by convenience sampling, were 126 pregnant women who were hospitalized after being diagnosed with preterm labor at 3 university hospitals. Results: The level of personal hygiene was assessed in physical suffering, level of fear was assessed by the emotional state, and level of perterm labor was assessed by the nursing cares. In the analysis, physical suffering, emotional state, and nursing needs in the subjects all showed a significantly positive correlation. Differences in physical suffering, emotional state, and nursing needs depending on general characteristics were as follows; age, job, family type, economic condition, smoking, drinking admission days, previous delivery type, and artificial insemination. Conclusion: Based on the results of this study, the nurse should focus on the domain of personal hygiene, and teaching contents specific for abdominal breathing exercises for relieving the women's fear and anxiety should be added.

• 대한간호학회지
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• 제42권4호
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• pp.477-485
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• 2012

Purpose: This study was done to evaluate the effects of antenatal depression on birth outcomes. Methods: The participants were 255 pregnant women who were followed in a prospective study. Of these, 197 cases were examined included birth weight, Apgar scores at 5 minute, premature contraction, complication of labor, delivery types and laboratory data. Descriptive statistics, ANOVA, Chi square test of linear by linear association, Kruskal Wallis test, Relative Risk, univariate and adjusted multiple logistic regression were used for data analysis with SPSS/Win. Results: Level of antenatal depression was associated with low birth weight ($x^2$=7.69, p=.010). High risk pregnancy was a predictor of low birth weight (OR=6.98 [1.21-40.30]) and baby's weight (OR=2.12, [1.05-4.28]). Prepregnancy body mass index (BMI) was a predictor of complications in labor (OR=3.59, [1.03-12.48]). But there were no significant effects of antenatal depression on other birth outcomes. Conclusion: The results of this study indicate that women with antenatal depression, high risk pregnancy, prepregnancy $BMI{\geq}23kg/M^2$ should be monitored and managed to ensure favorable birth outcomes.

• 한국발생생물학회지:발생과생식
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• 제19권4호
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• pp.167-180
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• 2015

Arsenic is a toxic metalloid that exists ubiquitously in the environment, and affects global health problems due to its carcinogenicity. In most populations, the main source of arsenic exposure is the drinking water. In drinking water, chronic exposure to arsenic is associated with increased risks of various cancers including those of skin, lung, bladder, and liver, as well as numerous other non-cancer diseases including gastrointestinal and cardiovascular diseases, diabetes, and neurologic and cognitive problems. Recent emerging evidences suggest that arsenic exposure affects the reproductive and developmental toxicity. Prenatal exposure to inorganic arsenic causes adverse pregnancy outcomes and children's health problems. Some epidemiological studies have reported that arsenic exposure induces premature delivery, spontaneous abortion, and stillbirth. In animal studies, inorganic arsenic also causes fetal malformation, growth retardation, and fetal death. These toxic effects depend on dose, route and gestation periods of arsenic exposure. In males, inorganic arsenic causes reproductive dysfunctions including reductions of the testis weights, accessory sex organs weights, and epididymal sperm counts. In addition, inorganic arsenic exposure also induces alterations of spermatogenesis, reductions of testosterone and gonadotrophins, and disruptions of steroidogenesis. However, the reproductive and developmental problems following arsenic exposure are poorly understood, and the molecular mechanism of arsenic-induced reproductive toxicity remains unclear. Thus, we further investigated several possible mechanisms underlying arsenic-induced reproductive toxicity.

• 부모자녀건강학회지
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• 제2권
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• pp.64-82
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• 1999

This study was conducted to test the reliability and validity of Maternal Self-Report Inventory that was developed by Shea and Tronick for measuring maternal self-esteem. The subjects were 154 mothers. The construct validity for the scale was tested by factor analysis with five factor loading solution based on the previous study. One item was excluded because total-item correlation was too low, so that the number of total items were twenty-five, the analysis yielded five well defined factors: confidence on the maternal role, general ability of maternal role, caretaking ability, readiness on maternal role, and feeling on the pregnancy and deli very. These five factors explained 52.38% of the variance in the maternal self-esteem. Maternal self-esteem was not affected by maternal age, educational level, occupation, religion, delivery type, or parity. The reliability of the scale was determined with Cronbach's alpha coefficient and Guttman split-half coefficient. Cronbach's alpha was .82, for 26 items, and .83 if one item was deleted. Guttman split-half cofficient was .75. In subscale analysis, Cronbach's alpha was .63~.84. In conclusion. Maternal Self-Report Inventory showed a high degree of validity and reliability, suitable in Korean mothers for measuring maternal self-esteem. In the further study, it would be necessary to compare the maternal self-esteem between mothers with normal babies and premature babies, for confirming the criterion-related validity of the inventory.

• Journal of Digestive Cancer Research
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• 제1권2호
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• pp.82-88
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• 2013

Cancer is the first leading cause of death in Korea and the second leading cause of death in the USA. There is extensive research into prevention of cancer and the support of oncology patients with diet or dietary supplements. In vitro and in vivo animal studies have indicated that antioxidants, including beta-carotene, alpha-tocopherol, and ascorbic acid, can yield anti-cancer effects in addition to providing protection against oxidative damage. Although many observational studies have shown that consuming fruits and vegetables can reduce the risk of some cancers, the results of several large-scale human intervention trials testing the benefits of a single or combined higher-dose of individual micronutrients have been inconsistent. Cancer can cause profound metabolic and physiological changes which may affect patients' nutrient requirements. Although the optimal route of nutrient delivery is through diet, cancer patients often suffer symptoms that disrupt their food intake, including anorexia, premature satiety, altered taste and smell, and changes in bowel mobility. In particular, micronutrient deficits can slow postoperative healing, contribute to depression symptoms, and decrease immune competence. Cancer patients are generally motivated to take dietary supplements to improve responses to treatment and quality of life. The Physician's Health Study II (PHS II) randomized controlled trial reported recently that daily multivitamin supplementation significantly, albeit modestly, reduced the risk of total cancer. Although evidence of multivitamin use benefits is limited in cancer patients, taking dietary supplements with constituents in the range of the recommended daily allowance according to the Dietary Reference Intake (DRI) recommendation is generally considered to be safe.

• Journal of Preventive Medicine and Public Health
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• 제22권1호
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• pp.146-152
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• 1989

대구시 남구 보건소 모자 보건 센터의 조산원들이 고위험 임부로 판정하여 타의료 기관으로 의뢰한 것이 어느 정도 타당한지를 알아 보기 위해 1985년 4월 1일에서 1987년 3월 31일 사이에 분만을 위해 모자 보건 센터를 방문한 임부 6,017명을 대상으로 센터에 도착하는 즉시 본 연구를 위한 전임 요원이 일반적 특성과 산과력을 면접 조사하고 임신 결과를 추적 조사하였다. 추적 조사가 가능했던 5,820명 가운데 704명(12.1%)이 의뢰되었는데 분만 결과가 불량(사산, 저체중아, 신생아 사망)했던 경우는 의뢰된 임부 가운데 4.4%로 센터에서 분만한 임부의 2.2%보다 유의하게 높았으며 (p<0.01) 조산원들의 임상적 소견으로 의뢰 여부를 판정한 것이 분만 결과와의 일치율은 86.5%였다. 의뢰 이유는 조기 파수(46.5%)와 아두 골반 불균형(20.2%)이 가장 많았는데 이들도 제왕 절개 분만율이 각각 10.1%, 17.6%로 대부분 정상아를 분만하였다. 임산 소견을 제외한 임부의 특성과 산과력으로 임신 결과를 판별 분석한 결과 재태기간이 가장 높은 판별 계수(0.88)를 보였고 그 다음이 출산 회수(0.37), 임부의 교육 수준(0.30)의 순이었으며 이 세가지 요인으로 임신 결과를 옳게 판정할 수 있는 비율이 65.6%로 조산원들이 판단하 일치율보다 낮았다. 조산원들이 임상적 경험에 의해 고위험 산모를 판정하고 있는 것은 타당한 것으로 평가되나 그들의 판정 기준을 체계적으로 조사한 결과와 임부의 일반적 특성과 산과력을 모두 독립 변수로 하고 불량한 임신결과에 꼭 필요한 제왕 절개 분만, 임신 및 분만의 합병증을 포함하여 종속 변수로 한 판별 분석을 한다면 우리 나라 모자 보건센터에 적합한 위험치 사정표를 개발할 수 있을 것이다.