• Neonatal Medicine
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• v.17 no.1
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• pp.94-101
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• 2010

Purpose:In recent years, Korea has showed a steady increase in the frequency of teenage birth, while the overall birth rate has declined. As the teenage birth is known as a high risk pregnancy itself, we examined perinatal complications of teenage mothers and whose neonates in aspects of medical problem, and social status and support. Methods:We examined the perinatal characteristics of teenage mothers and whose babies, who were hospitalized at Korea University Ansan Hospital from January 2004 to July 2009 using medical records retrospectively. Twenty-seven teenage mothers and their 28 babies were enrolled in this study. Results:Teenage mothers were all unmarried and showed high rates of preterm labor, maternal anemia, and unexpected delivery. Among them, 11 (40.7%) were from families that were separated. Eleven mothers (40.7%) did not have any antenatal care. There were high rates of prematurity and low birth weight (60.7% and 64.3%, respectively). The complication included: respiratory distress syndrome, patent ductus arteriosus and necrotizing enterocolitis. Fourteen babies (51.9%) were not going to be brought up by their biological parents. Conclusion:Teenage pregnancy had high rates of preterm labor and associated complications, often caused by the lack of proper antenatal care. Babies from unmarried mothers were likely to be adopted and this could be a social burden. Therefore, to reduce unplanned teenage pregnancy and births, sex education and social supports should be provided to all teenagers.

• Korean Journal of Community Nutrition
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• v.7 no.1
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• pp.121-129
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• 2002

Osteoporosis, the typical metabolic bone disease of the elderly, is characterized by a reduction in bone mineral density (BMD) and increased fracture risk. Genetic and environmental factors are known to play a key role in bone metabolism, and diet is also considered to be one of the important factors. The purpose of the present study was to investigate the relationship among the factors affecting BMD, including stature, body weight, age, time period since onset of menopause, and biochemical markers of bone turnover in postmenopausal women. Seventy-eight postmenopausal women who visited health promotion center for health examinations volunteered to participate in this study and they were divided into two groups according to the time period since onset of menopause : women with a time period since onset of menopause of less than 5 years (Group 1) and women with a time period since onset of menopause of 5 years or more (Group 2). The demographic characteristics and dietary intake were surveyed using a questionnaire. BMDs of the lumbar spine and femoral neck of subjects were measured by dual energy X-ray absorptiometry. Serum levels of 25-hydroxy-vitamin D and parathyroid hormone (PTH), known to be indicators of bone related hormone status, were anlyzed. Serum samples were measured for calcium, phosphorus, alkaline phosphatase, and osteocalcin as bone formation indicators, and urine was analysed for deoxypyridinoline, creatinine, calcium, and sodium as bone resorption indicators. The results are as follow : The mean BMDs of the lumbar spin and femoral neck were $1.02 \pm 0.02 g/cm^2 and 0.81 \pm 0.02 g/cm^2 respectively, and the BMD level of Group 2 was significantly lower than tat of Group 1 (p<0.01, p<0.05, respectively). The mean daily intake of energy was 1838 $\pm$ 55 kcal. When nutrient intake was compared with the recommended dietary allowances (RDA) of the subjects, only calcium, vitamin A and riboflavin intake showed means lower than the RDA. The nutrient intake did not show any significant differences between Group 1 and 2 Serum and urine levels of biochemical markers of bone turnover did not show any significant differences between Group 1 and 2, and all were within the normal range. However, the PTH and deoxypyridinoline levels showed a tendency to be higher, and the osteocalcin level to be lower in Group 2 than in Group 1. Although age and years after menopause (YAM) showed negative correlations with lumbar spine bone mineral density (LBMD) (r= -0.38, p<0.001, and r= -0.26, p< 0.05, respectively), no correlation was found with femoral neck bone mineral density (NBMD). While height, body weight and body mass index (BMI) showed a positive correlation with LBMD (r= 0.32, p<0.001, r= 0.38, p<0.001, r= 0.22, p= 0.05, respectively), only body weight and BMI showed a positive correlation with NBMD (r= 0.30, p<0.01, and r= 0.27, p<0.05, respectivley). There was no significant corealtion between BMDs and the nutrient intake of subjects, except in the case of carbohydrates (r= 0.22, p<0.05). Also, serum and urine levels of bone turnover markers showed no significant correlation with nutrient intake. On the other hand, serum osteocalcin had a positive correlation with vitamin C intake (r= 0.22, p= 0.05), and urine deoxypyridinolin showed a negative correlation with niacin intake (r= -0.22, p= 0.05). Urinary na was negatively correlated with protein intake(r= -0.23, p= 0.05). The results suggested that it is difficult to prevent the decrease in bone mass among postmenopausal women eating the usual Korean diet. However, the BMDs of the lumbar spine and femoral neck were positively related to body weight ad BMI in postmenopausal women. Therefore, this study confirmed that one of the most effective ways to minimize bone loss in postmenopausal women would be to maintain an adequate body weight with balanced nutrient intake and activity in the pre-and postmenopausal periods.

• Journal of Chest Surgery
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• v.44 no.2
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• pp.115-122
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• 2011

Background: The intramural coronary artery has been known as a risk factor for early death after an arterial switch operation (ASO). We reviewed the morphological characteristics and evaluated the early and mid-term results of ASO for patients with an intramural coronary artery. Materials and Methods: From March 1994 to September 15th 2010, 158 patients underwent ASO at Dong-A and Pusan National University Hospitals for repair of transposition of the great arteries and double outlet right ventricle. Among these patients, 14 patients (8.9%) had an intramural coronary artery. Mean age at operation was $13.4{\pm}10.2$ days (4 to 39 days) and mean body weight was $3.48{\pm}0.33$ kg (2.88 to 3.88 kg). All patients except one were male. Eight patients had TGA/IVS and 4 patients had an aortic arch anomaly. Two patients (14.3%) had side-by-side great artery relation, of whom one had an intramural right coronary artery and the other had an intramural left anterior descending coronary artery. Twelve patients had anterior-posterior relation, all of whom had an intramural left coronary artery (LCA). The aortocoronary flap technique was used in coronary transfer in 8 patients, of whom one patient required a switch to the individual coronary button technique 2 days after operation because of myocardial ischemia. An individual coronary button implantation technique was adopted in 6, of whom 2 patients required left subclavian artery free graft to LCA during the same operation due to LCA injury during coronary button mobilization and LCA torsion. Results: There was 1 operative death (7.1%), which occurred in the first patient in our series. This patient underwent an aortocoronary flap procedure for coronary transfer combining aortic arch repair. Overall operative mortality for 144 patients without an intramural coronary artery was 13.2% (19/144). There was no statistical difference in operative mortality between the patients with and without an intramural coronary artery (p>0.1). There was no late death. The mean follow-up duration was $52.1{\pm}43.0$ months (0.5 to 132 months). One patient who had a subclavian artery free graft required LCA stenting 6.5 years after surgery for LCA anastomotic site stenosis. No other surviving patient needed any intervention for coronary problems. All patients had normal ventricular function at latest echocardiography and were in NYHA class 1. Conclusion: The arterial switch operation in Transposition of Great Arteries or Double Outlet Right Ventricle patients with intramural coronary can be performed with low mortality; however, there is a high incidence of intraoperative or postoperative coronary problems, which can be managed with conversion to the individual coronary button technique and a bypass procedure using a left subclavian free graft. Both aortocoronary flap and individual coronary button implantation techniques for coronary transfer have excellent mid-term results.

• Korean Journal of Community Nutrition
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• v.25 no.5
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• pp.416-429
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• 2020

Objectives: This study examined the personal, interpersonal and community factors related to food sufficiency and variety among Korean adults using data from the 2017 Community Health Survey. Methods: A total of 228,310 adults aged ≥ 19 years were classified into three groups: food sufficiency with variety, food sufficiency without variety and food insufficiency. Personal factors included sociodemographic characteristics, health behavior and health status. Interpersonal factors included social networking and social activities, and community factors included safety, natural environment, living environment, availability of public transportation and health care services. The association of food sufficiency and variety with interpersonal and community factors was assessed using multivariable logistic regression analyses. Results: Of the total sample, the food-sufficiency-without-variety group and food insufficiency group accounted for 31.5% and 3.2%, respectively. The sociodemographic factors associated with food insufficiency and non-variety were women, ≥ 65 years of age, with low education level, low household income, unemployed, single, and living in areas of small population sizes. There were significant differences in health behavior and health status, interpersonal and community factors among the three groups. Multivariable logistic regression analyses conducted after adjusting for confounding factors showed that lack of social networking and social activities and lower satisfaction derived from community environments were associated with the risk of food insufficiency and non-variety. Conclusions: Our results showed that interpersonal and community factors as well as personal factors were related to food sufficiency and variety. Therefore, public policies to help build social networks and participation in social activities, and improve community environment are needed together with food assistance to overcome the problems of food insufficiency and non-variety.

• Journal of Food Hygiene and Safety
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• v.25 no.4
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• pp.367-375
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• 2010

The bacteriological and physiochemical analysis of sea water and sediments in Tongyeong harbor was conducted to evaluate sanitary conditions. The samples were collected at 8 stations established once a month from June, 2008 to May, 2009. During the study period, the range of temperature was from 6.7 to $25.2^{\circ}C$, transparency ranged from 1.2 to 2.6 m, chemical oxygen demand ranged from 1.90 to 2.92 mg/L, dissolved oxygen ranged from 6.2 to 10.5 mg/L, dissolved nitrogen ranged from 0.052 to 0.098 mg/L, phosphate ranged from 0.044 to 0.065 mg/L, respectively. Seafood, if eaten raw, carries the risk of food poisoning. Seafood poisoning is often cause by pathogenic microorganism originating from fecal contamination, such as Salmonella sp., Shigella sp. and norovirus. Fecal coliforms are an important indicator of fecal contamination. Therefore, data on fecal coliform are very important for evaluating the safety of fisheries in coastal areas. So, we investigated the sanitary indicate bacteria. The coliform group and fecal coliform MPN's of sea water in Tongyeong harbor were ranged from < 1.8~22,000/100 mL (GM 164.9 MPN/100 mL) and < 1.8~7,900 MPN/100 mL (GM 33.7 MPN/100 mL), respectively. Total coliform were detected 97.0% in 96 of samples and 68.9% of total coliforms were fecal coliforms. These results similar to another seawater detection ratio of total coloforms and fecal coliforms. The Vibrios was isolated and identified with VITEK system. Four hundred eighty strains that were obtained from sea water samples in Tongyeong harbor Detection ratio Vibrio alginolyticus, 34.2%, Vibrio parahaemolyticus, 13.8%, Vibrio vulnificus 10.0%, and V. mimicus 12.5% respectively. Vibrio cholerae O1, was not detected. During the study period, the ranges of water content, ignition loss, COD, and acid volatile sulfates in sediments in Tongyeoung harbor were 41.0~57.4%, 7.8~10.5%, 6.51~9.30 mg/g, 0.04~0.09 mg/g, respectively. Heavy metals in sediment of Tongyeoung harbor were Cd, $0.10{\pm}0.05$; Cu, $4.79{\pm}8.20$; As, $1.95{\pm}0.17$; Hg, $0.10{\pm}0.07$; $Cr^{6+}$, $0.34{\pm}0.12$; Zn, $125.33{\pm}16.40$; Ni, $16.43{\pm}1.93$ mg/kg.

• KDI Journal of Economic Policy
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• v.31 no.1
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• pp.105-138
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• 2009

Although the decline in fertility rate is generally observed along the history of economic development throughout the world, the continuing decline hitting below the replacement level in Korea over the recent years gathered serious social concerns on the ground that it accelerates the process of population aging. The total fertility rate in Koreareached 2.08 in 1983, and gradually fell to the levels of 1.08 in 2005 and 1.26 in 2007. The policy debate over the role of the government has been focused mainly on the level of theoretical discussion without substantial basis on firm empirical evidence and the determinants of fertility. The objective of the paper is to empirically investigate the fertility effect of the female wage, which is understood as one of the most important determinants of fertility in Koreasince 1980 focusing on one aspect of fertility, namely birth spacing. Using the Korean National Fertility Survey conducted in 2006, I estimate a duration model of first and second births taking into account individual heterogeneity, which turned out to be an important factor to control for. Compared with previous studies in the literature on the Korean fertility, the study has an advantage of using the complete pregnancy history of women in a more representative sample. Unlike the previous studies, the analysis also deals with the endogeneity of marriage by treating a certain age, rather than age at marriage, as the time in which a woman becomes exposed to the risk of pregnancy. The study shares the common problem in the literature on birth spacing of lacking relevant wage information for respondents in a retrospective survey. I estimate the wage series as a function of the basic characteristics using the annual Wage Structure Survey from 1980 to 2005, which is considered as a nationally representative sample for wage information of employees. The results suggest that the increase in female wage by 10 percent leads to a decrease in second birth hazard by 0.56~0.92 percentage points and that the increase in spouse's wage by the equal amount is accompanied by the increase in second birth hazard by 0.36~1.13 percentage points. These estimates are more precisely estimated and of smaller magnitude than those presented by the previous studies. The results are robust to the different specifications of the wage equation. The simulation analysis based on the predicted values shows that about 17% of the change in the second birth hazard over the period 1980 to 2005 was due to the change in the female wage. Although there is some limitation in data, the results can be viewed as one estimate of the role of female wage on the recent fertility decline in Korea. The question raised by the paper is not a normative one of whether a government should promote childbearing but a positive one thatexplains fertility decline. Therefore, if there is a wide consensus on promoting childbearing, the finding suggests that the policies designed to reduce the opportunity cost of women in the labor market would be effective. The recent movement of implementing a wide range of family-friendly policies including child care support, maternity leave, parental leave and tax benefit in developed countries should be understood in this context.

• Journal of the Korean Society for Marine Environment & Energy
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• v.9 no.4
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• pp.193-202
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• 2006

The Consultative Meeting of the Convention on the Prevention of Marine Pollution by Dumping of Wastes and other matter, 1972 (London Convention 1972) has requested to International Maritime Organization (IMO) Marine Environmental Protection Committee to collaborate and help clarify a boundary issue between International Convention for the Prevention of Pollution from Shops, 1973 as modified by the Protocol of 1978 (MARPOL) and the London Convention concerning 'dumping' versus 'discharges' during normal operations of ships in 2004, and subsequently established a Joint London Convention/MEPC Correspondence Group. The Contracting Parties to London Convention expressed their environmental concerns on the broad interpretation of the "cargo-associated wastes" by the States, which could be discharged by ships under MARPOL. Regulatory regimes for the cargo residues appear to vary among states. Some countries require fur ships to discharge their cargo wastes into the port reception facility and IMO also recommends doing so. This paper examines the related current national and international legal texts for the regulation of disposal of wastes from ships in order to analyze the current global concern on the marine pollution associated with waste discharge during operations of ships. In particular, we attempt to evaluate the likely marine environmental consequences arising from the disposal of cargo residue using an hypothetical case for the coal cargo residue among bulk cargos in this paper, since location, magnitude and frequency of the discharge of coal cargo residues into the sea adjacent to Korean Peninsula are not readily available. The cargo residues may be discharged to the sea according to MARPOL 73/78; however, its marine environmental consequences can be significant depending upon the characteristics and amounts of wastes to be discharged. Also the public tolerance of the environmental consequences would be widely different among nations. Multilateral environmental agreements, in general, more strictly apply their rules if there are other options to disposal at sea, i.e. port reception facility in this case. Therefore, port reception facilities for the wastes generated by ships are recommended to be further constructed in major national ports in order to reduce the risk of environmental damages during the operations of ships.

• Journal of the Korean Institute of Landscape Architecture
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• v.44 no.6
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• pp.60-72
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• 2016

This study aims to suggest strategies of development and management for large parks by examining experimental cases of park governance models related to a shift away from public administration. The shifts towards governance as well as public-private partnership in city parks have involved the need for new public management. This study has analyzed two exemplary cases of Presidio Park and Sydney Harbour National Park in the aspects of planning process and management strategies, as the results derived the meaning and effect of park governance management and is also an essential prerequisite for the achievement of the model. There are six dimensions of research frames--namely policy, governance, partnership, finances and funds, design and maintenance-management, and evaluation-monitoring-taken as the basis for this study. Through the analysis, several key characteristics of these cases were elicited. First, the park planning process must be consistent in carrying a policy from planning to implementation, and furthermore, an independent operation body which can properly authorize an execution and uphold its responsibility from the public could serve in adaptable park services. Second, it has been suggested to build various partnerships with PAs and NGOs, private corporations, community groups, and academic institutes that allow it to expand the diversity of the park activities. Third, there has been experimental exploration to achieve a financially self-sufficient model by establishing internal revenue models and hence allow the reduction of reliance on public finances. The result of this type of park management would allow for improving park quality and make the park space a vital part of the local economy. Fourth, the strategies for a local community's participation are needed to allow the community to become a producer as well as a consumer. This study shows that the direction and significance of the park governance model regarding the fact that the plans sought by the two parks are extending the layout of public-centered discussion to the private sector and the third non-governmental sector including to the local community group. This shows both implications and limitations, such as the risk of privatization through non-governmental activities at the park or the violation of essential functions as a public good due to a profit-generating management policy for securing financial self-sufficiency. At the current point in which plans are under way for the development and management of large parks, a park governance model requires continuous study and expansion of discussion in the future.

• Research in Community and Public Health Nursing
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• v.7 no.1
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• pp.80-99
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• 1996

Young black men(YBM) have the most severs levels of high blood pressure(HBP) and, in all reports but one, the lowest of HBP control of any age /sex /race group. To increase entry into care, remaining in care, and BP control for young(18-49 years) Black men, It is needed to review socio-demographic, medical characteristics, and behaviors(importance of and difficulty with HBP control behaviors, or worry about mdication) for experimental intervention study(educational- behavior strategies) of hypertensive urban young black men. The 204 participants had an average age of 38.8+7.0 years and an average educational level of $11.0{\pm}2.4$ years; only 23.1% were employed full- or part-time while 26% were on disability ; and 6% were married. Only 35.3% had an MD for HBP care and 37.3% had some form of health insurance. The average BP of those men currently being in care on medication(35.3%) was $148.2/95.1{\pm}19.5/11.3$ compared to those men not taking HBP care $153.7/99.1{\pm}14.0/9.8(p<.05)$. The average creatinine level was 1.3(excluding 3 marked elevations of 15.9, 9.6, and 7.7) for the 163 men consenting to have their blood drawn. Self-reported co-morbidity induded heart disease 7.8%, diabetes 8.9%, high cholesterol 18.2%, CVA 3.4%, alcohol and drug related problems 27.9% and 22.5% respectively. The kidney disease of those men currently being in care & on medication was 9.7 compared to those men not taking HBP care 0.8(p<.05). The problems of with sex life, physicl activity and dearly thinking of those men currently being in care & on medication was higher compared to those men not taking HBP care(p<.05). Questions of 'during the past month, on how many days did you have 5 or more drinks (bottles) of any alcoholic beverag?' and smoking of those men currently being in care & on medication was 18.1% and 72.2% compared to those men not taking HBP care 27.3 and 82.6%, respectively. HBP control behaviors was assessed with 1-5 point Likert subscales(5=extreme, 1-none at all), In general, th men reportd low levels of perceived psychological barrier to HBP care and control behaviors; importance of and difficulty with HBP control behaviors, or worry about mdication. For example, on a five point scale(1=none at all, 5=extreme), average ratings for perceived important and difficulty with BP care and behaviors were 2.8(SD=1.2) and 2.5(SD=1.1). Average ratings for perceived benefit with BP care and behaviors worry about medication of those men currently being in care on medication was 4.0(SD=0.9) and 2.2(SD=1.1) compared to those men not taking HBP care 3.6(SD=0.8), 2.8 (SD=1.6) respectively(p<.05). These data support the need for educational-behavioral strategies of community health nurse to improve high blood pressure control in this high risk group through perceived barriers to treatment, health care skills and use of resources, and social support.

• Sleep Medicine and Psychophysiology
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• v.11 no.1
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• pp.22-28
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• 2004

Objective: The purpose of this study is to investigate the prevalence rate of OSA in subjects whose main sleep complaint is insomnia and to find differential factors of OSA in these insomniac subjects. Method: We reviewed the medical records and polysomnographic findings of patients referred to the Sleep Laboratory at Seoul National University Hospital from January 1996 to December 2002. Four-hundred and seventy subjects complained of insomnia as their main sleep problem (235 males and 235 females, mean age $53.6{\pm}12.4\;years$). First, we investigated the prevalence rate of OSA in these insomniac patients. Second, we compared the clinical and demographic characteristics of the OSA-associated group with those of the non-associated group. Third, we examined whether the degree or presence of differential factors within the OSA group correlate with severity of OSA, as determined by the respiratory disturbance index (RDI). Results: Among 470 insomniac subjects, 125 subjects (26.6%) were diagnosed as OSA by nocturnal polysomnography. OSA-associated subjects were significantly older ($58.4{\pm}12.3\;years$ vs. $51.8{\pm}11.2\;years$, p<0.01), and had significantly higher body mass index (BMI) ($23.4{\pm}3.3\;kg/m^2$ vs. $22.5{\pm}3.1\;kg/m^2$, p=0.44) than non-associated subjects. The OSA-associated group had more subjects with male gender (64.0% vs. 44.9%, p<0.01), hypertension (20.0% vs. 9.3%, p<0.01) or snoring (96.0% vs. 63.5%, p<0.01). Within the OSA-associated group, age had a significant positive correlation with RDI (p=0.01). Conclusion: We found that a considerable portion of patients complaining of insomnia as their main sleep problem were diagnosed as OSA. Snoring, old age, male gender, obesity, and comorbid hypertension were found to be differential factors of OSA in insomniac patients. We suggest that diagnostic efforts including nocturnal polysomnography are needed for insomniac patients with any of the above risk factors of OSA.