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Effect of Fusion Method and Passage Culture of Hanwoo (Korean Cattle) Ear Skin and Fetal Fibroblasts on the Development of Nuclear Transfer Embryos (한우의 귀세포와 태아섬유아세포의 융합 방법과 Passage 배양이 복제수정란의 발달에 미치는 영향)

  • Yang Byoung-Chul;Im Gi-Sun;Lee Sang-Ki;Kim Se-Woong;Kim Dong-Hoon;Seong Hwan-Hoo;Yang Boh-Suk
    • Reproductive and Developmental Biology
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    • v.30 no.1
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    • pp.53-58
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    • 2006
  • The study was conducted to evaluate the effects of culture period and fusion method on the development of somatic cell nuclear transfer (SCNT) embryos reconstituted with Korean bovine fetal fibroblast cells (KbFF) and Korean bovine adult ear skin fibroblast cells (KbESF). KbFF were isolated from a day 51 Korean cattle (Hanwoo) fetus, and KbESF were isolated from a 28 month old Hanwoo calf. The cells were cultured up to 15 weeks (passage 15) in vitro for SCNT. Chamber and electrode needles were used for comparing fusion of reconstituted eggs. The doubling times of KbFF and KbESF were 17.3 hr and 24.3 hr, respectively. The fusion and cleavage rates were significantly higher in needle group (76.1 and 81.2% respectively, P<0.05) than those in chamber group. However, the blastocyst development rate was not different between both groups. Fusion and cleavage rates of NT eggs reconstituted with KbESF did not affected by passage number, however, blastocyst rates were lower in passage $1{\sim}4$ group (21.3%) than passage $5{\sim}8$ (39.4%) and $13{\sim}15$ groups (40.4%, P<0.05). Whereas, fusion rate was lower in passage $1{\sim}4$ group (61.5%) than those of passage $5{\sim}8$(75.0%) and $13{\sim}15$ (76.8%) groups, but cleavage and blastocyst rates were similar regardless of passage number in the KbFF. The results suggest that fusion method can affect the development of SCNT embryos, whereas the long term culture up to 15 passages may not affect the development of SCNT embryos.

A COMPARATIVE STUDY OF PRESERVING ABILITY OF HUMAN PERIODONTAL LIGAMENT CELLS STORED IN DIFFERENT TEMPERATURED STORAGE MEDI (저장용액의 온도에 따른 치주인대세포의 생존율)

  • Jo, Jae-Hyun;Kim, Seong-Oh;Choi, Hyung-Jun;Lee, Jae-Ho;Son, Heung-Kyu;Choi, Byung-Jai
    • Journal of the korean academy of Pediatric Dentistry
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    • v.34 no.1
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    • pp.36-42
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    • 2007
  • To compare the survival rate of periodontal ligament cells preserved in storage media with good availability at the time of an avulsion injury, periodontal ligament cells were incubated in ${\alpha}-MEM$ culture medium containing 10% FBS in condition of $37^{\circ}C$, 5% $CO_2$. These cells were then cultured in HBSS, ${\alpha}-MEM$, milk(S co., P. co.) and tap water at the temperature of 4, 25, $37^{\circ}C$ each in 60 min. The groups were measured by MTT assay. The results were as follows : 1. Among the storage media at $4^{\circ}C$, ${\alpha}-MEM$ and P-milk had the highest preserving ability of periodontal ligament cells, while that of HBSS S-milk and tap was low in order. 2. Among the storage media at $25^{\circ}C$, ${\alpha}-MEM$ had the highest preserving ability of periodontal ligament cells, while that of P-milk, HBSS, S-milk, tap water was low in order. 3. Among the storage media at $37^{\circ}C$, the preserving ability of periodontal ligament cells was very high in ${\alpha}-MEM$, P-milk, HBSS and S-milk, it's lowest in tap water. 4. The preserving ability of periodontal ligament cells in ${\alpha}-MEM$ was high at $4^{\circ}C$ and it's low in order of $25^{\circ}C$, $37^{\circ}C$, but in HBSS was high at $4^{\circ}C$ and it's low at $25^{\circ}C$, $37^{\circ}C$ 5. The preserving ability of periodontal ligament cells in S-milk and P-milk was high at $4^{\circ}C$, $25^{\circ}C$ and it s low at $37^{\circ}C$. In conclusion, HBSS is the storage medium of choice in an avulsion, but in this study it is preferable to choose milk at $4^{\circ}C$ for tooth since it is easy to get and affect cell viability.

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Change in the Korean Fertility Control Policy and its Effect (출산력 억제정책의 영향과 변천에 관한 고찰)

  • Hong, Moon-Sik
    • Korea journal of population studies
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    • v.21 no.2
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    • pp.182-227
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    • 1998
  • Korean government decided to adopt an explicit population control policy in 1961 and from the following year the establishment and operation of the national family planning programme was included in each of the Five-Year Economic Development Plans that began in 1962. This policy was pursued in the understanding that without proper population control measures korea could not be able to achieve economic development. Korean national family planning programme is characterized by contraceptive target system through public health network with distribution of free contraceptives by family planning field workers and clinical contraceptive services such as IUD, vasectomy and tubaligation at designated clinics by the government. In addition, IE&C activities by the Planned Parenthood Federation of Korea and programme evaluation and research by the Korea Institute for Health and Social Affairs contributed to the development of the government programme. Between 1960 and mid 1980s the nation's total fertility rate was reduced from 6.0 to population replacement level of 2.1 and thereafter it has been maintained at 1.6 to 1.7 of below replacement level. With a short period of less than three decades fertility transition was completed in Korea. It is estimated that if the current level of below replacement fertility continues, the population in Korea stabilize at around 52.78 million people by the year 2028, and it will begin to decrease thereafter. Under this circumstances, the government adopted new directions and strategies of the population policy in June 1996, focused primarily on population quality and social welfare than on demographic arenas. In spite of over 80 percent of high contraceptive prevalence among married women, high incidence of induced abortions is maintained. Moreover, the prevalence of sex selective induced abortions using procedures to determine the sex of the fetus has resulted in an imbalance in the sex ratio at birth. In order to overcome those problems associated with reproductive health new policy for population quality control and health promotion programme should be highly strengthened in the future.

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Recent Advancement in the Stem Cell Biology (Stem Cell Biology, 최근의 진보)

  • Harn, Chang-Yawl
    • Journal of Plant Biotechnology
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    • v.33 no.3
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    • pp.195-207
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    • 2006
  • Stem cells are the primordial, initial cells which usually divide asymmetrically giving rise to on the one hand self-renewals and on the other hand progenitor cells with potential for differentiation. Zygote (fertilized egg), with totipotency, deserves the top-ranking stem cell - he totipotent stem cell (TSC). Both the ICM (inner cell mass) taken from the 6 days-old human blastocyst and ESC (embryonic stem cell) derived from the in vitro cultured ICM have slightly less potency for differentiation than the zygote, and are termed pluripotent stem cells. Stem cells in the tissues and organs of fetus, infant, and adult have highly reduced potency and committed to produce only progenitor cells for particular tissues. These tissue-specific stem cells are called multipotent stem cells. These tissue-specific/committed multipotent stem cells, when placed in altered environment other than their original niche, can yield cells characteristic of the altered environment. These findings are certainly of potential interest from the clinical, therapeutic perspective. The controversial terminology 'somatic stem cell plasticity' coined by the stem cell community seems to have been proved true. Followings are some of the recent knowledges related to the stem cell. Just as the tissues of our body have their own multipotent stem cells, cancerous tumor has undifferentiated cells known as cancer stem cell (CSC). Each time CSC cleaves, it makes two daughter cells with different fate. One is endowed with immortality, the remarkable ability to divide indefinitely, while the other progeny cell divides occasionally but lives forever. In the cancer tumor, CSC is minority being as few as 3-5% of the tumor mass but it is the culprit behind the tumor-malignancy, metastasis, and recurrence of cancer. CSC is like a master print. As long as the original exists, copies can be made and the disease can persist. If the CSC is destroyed, cancer tumor can't grow. In the decades-long cancer therapy, efforts were focused on the reducing of the bulk of cancerous growth. How cancer therapy is changing to destroy the origin of tumor, the CSC. The next generation of treatments should be to recognize and target the root cause of cancerous growth, the CSC, rather than the reducing of the bulk of tumor, Now the strategy is to find a way to identify and isolate the stem cells. The surfaces of normal as well as the cancer stem cells are studded with proteins. In leukaemia stem cell, for example, protein CD 34 is identified. In the new treatment of cancer disease it is needed to look for protein unique to the CSC. Blocking the stem cell's source of nutrients might be another effective strategy. The mystery of sternness of stem cells has begun to be deciphered. ESC can replicate indefinitely and yet retains the potential to turn into any kind of differentiated cells. Polycomb group protein such as Suz 12 repress most of the regulatory genes which, activated, are turned to be developmental genes. These protein molecules keep the ESC in an undifferentiated state. Many of the regulator genes silenced by polycomb proteins are also occupied by such ESC transcription factors as Oct 4, Sox 2, and Nanog. Both polycomb and transcription factor proteins seem to cooperate to keep the ESC in an undifferentiated state, pluripotent, and self-renewable. A normal prion protein (PrP) is found throughout the body from blood to the brain. Prion diseases such as mad cow disease (bovine spongiform encephalopathy) are caused when a normal prion protein misfolds to give rise to PrP$^{SC}$ and assault brain tissue. Why has human body kept such a deadly and enigmatic protein? Although our body has preserved the prion protein, prion diseases are of rare occurrence. Deadly prion diseases have been intensively studied, but normal prion problems are not. Very few facts on the benefit of prion proteins have been known so far. It was found that PrP was hugely expressed on the stem cell surface of bone marrow and on the cells of neural progenitor, PrP seems to have some function in cell maturation and facilitate the division of stem cells and their self-renewal. PrP also might help guide the decision of neural progenitor cell to become a neuron.

Investigational Studies on Reproductive Failures of Slaughtered Cows (도살빈우의 번식장애사례 조사연구)

  • 이용빈;임경순
    • Korean Journal of Animal Reproduction
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    • v.6 no.1
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    • pp.19-30
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    • 1982
  • 1. The cows slaughtered at age of 3, 4, 6, 7, 8, and 9 years old were 1.5, 1.5, 15.0, 62.5 and 4.4% respectively. 2. The cows slaughtered at 351-450kg and more than 500kg were 60 and 28% respectively. 3. Best, very good, good and bad cows in nutritional condition were 1.6, 25.8, 62.9, and 9.7% respectively. Among the six cows which were bad nutrition, the two were with severe endometritis, the three were normal in genital function and one was on 70 days of pregnancy. 4. Holstein cows(55.2%) showed higher reproductive failure than the Korean cows(33.3%). 5. The slaughted ratio of the Korean cattle and Holstein cows was 36 and 64% respectively. 6. Pregnant cows were about 16% among the slaughtered one. 7. Reproductive failures were composed of 46% in uterus, 32% in ovaries, 8% in udder, 6% in oviduct, 4% in cervix of uterine, 2% in vagina and 2% inmummified fetus. 8. Forty six percentages of uterine diseases were as follows; horn, 13%, body of uterus, 32% and ovary diseases were 32%, that is, 12% of ovary atrophy, 8% of ovarycyst and 6% of lutealcyst. 9. The cows of reproductive failures were commonly infected with 1.6 kinds of diseases. 10. According to classification, six type of ovaries were as follows; normal, 58%, ovary-cyst, 11%, luteum cyst, 4%, coexistence of follicles and corpus luteum, 16%, weak function of ovaries, 10% and ovarian atrophy, 1%. 11. Major axis, minor axis and thickness of right ovary were larger than those of left one both in Korean cattle and Holstein cows. Holstein cow had generally larger size of ovary than these of the Korean cattle.. 12. The left and right oviducts showed no difference in length, but Holstein had longer oviduct than Korean cow. 13. There was no difference in the length of uterine horn between right and left in the Korean cows, but the right was longer than the left in Holstein cows. 14. Holstein had longer horn and body of uterine than the Korean cows. 15. The weight of right ovary was heavier than that of left in both breeds, but there was no differences in weight of left ovary between two breeds and right ovary of Holstein breed was heavier than that of the Korean cow. 16. The weight of right oviduct and uterine born was heavier than that of the left, and Holstein had heavier oviducts and uterine horns than the Korean cows. 17. Holstein had heavier uterine body and cervix of uterine than the Korean cows. 18. The length of reproductive systems of Korean cow is as follows; Major and minor diameter and thickness ofovary are 3.6${\pm}$0.7, 2.3${\pm}$0.4 and 1.6${\pm}$1.4 cm in left and 3.7${\pm}$0.6, 2.5${\pm}$0.5 and 1.8${\pm}$0.5 cm in right. Oviduct is 28.4${\pm}$3.1 cm in left and 27.8${\pm}$3.3 cm in right. Uterine horn is 27.4${\pm}$4.5 cm in left and 27.7${\pm}$4.9 cm in right. Uterine body and cervix are 3.4${\pm}$1.1 and 6.5${\pm}$1.7 cm. 19. The length of female reproductive systems ofHolstein cow is as follows; Major and minor diameter and thickness of ovary are 3.9${\pm}$1.3, 2.3${\pm}$0.5, and 1.5${\pm}$0.6 cm in left and 4.0${\pm}$0.8, 2.8${\pm}$0.6 and 1.8${\pm}$0.6 cm in right. Oviduct is 29.4${\pm}$4.2 cm in left and 29.3${\pm}$4.1 cm in right. Uterine horn is 30.2${\pm}$7.4 cm in left and 32.6${\pm}$8.4 cm in right. Uterine body and cervix are 4.5${\pm}$2.5 and 7.8${\pm}$2.9 cm. 20. The weight of reproductive systems of Korean cow is as follows; Ovary is 8.4${\pm}$4.1 g in left and 9.3${\pm}$3.6g in right. Oviduct is 1.5${\pm}$0.5 g in left and 1.6${\pm}$0.5 g in right. Uterine horn is 109${\pm}$27 g left and 118${\pm}$32 g in right. Uterine body and cervix are 30.4${\pm}$14.1 and 76.7${\pm}$38.4g. 21. The weight of reproductive systems of Holstein cow is as follows; Ovary is 8.2${\pm}$3.1 g in left and 12.5${\pm}$5.6 g in right. Oviduct is 1.7${\pm}$0.6 g in left and 1.9${\pm}$0.9 g in right. Uterine horn is 199${\pm}$14.2 g in left and 221${\pm}$111.2g in right. Uterine body and cervix are 58.2${\pm}$46.5 and 126.7${\pm}$103.3 g.

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A Study on Radiation Management Status and Exposure Anxiety Awareness of Dental Hygienist (치과위생사의 방사선 안전 관리 실태 및 피폭 불안감 인식)

  • Kang, Eun-Ju;Hyeong, Ju-Hee
    • Journal of dental hygiene science
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    • v.15 no.2
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    • pp.172-181
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    • 2015
  • This study intends to improve the radiation safety management and the recognition for handling radiation using structured questionnaires to dental hygienists working at Jeollabuk-do from September 1 to October 31 in 2014. As a result, 63% of respondents have not received education for radiation safety management. Moreover, the practical degree for radiation safety management was $2.58{\pm}1.11$, while the degree of knowledge was $3.74{\pm}0.83$ of total 5.0. The results of insecurity for radiation danger were high as $3.88{\pm}0.92$, and insecurity for fetus during pregnancy shows the highest value as $4.43{\pm}0.71$. From the results of statistical significance level, the knowledge degree of radiation safety management is affected by total numbers of radiograpy for a day (p<0.05), and the practical degree of radiation safety management is affected by age group, academic background, monthly income, continuous service year, practice area, present position, and status of radiography in present (p<0.05). In addition, the knowledge degree of radiation safety management have a negative correlation (r=-0.232) with the practical degree, but have a positive correlation (r=0.262) with the insecurity for radiation danger. The high knowledge degree of radiation safety management (${\beta}=0.252$, p<0.001) and the short radiography work period (${\beta}=-0.341$, p<0.05) were the influential factors to the insecurity for radiation danger. Consequently, countermeasures are necessary to encourage dental hygienists to put their radiation safety management knowledge into the practice and to reduce the insecurity degree for radiation danger. Furthermore, it is important to prevent psychological and physical risks by radiation exposure through the improvement of radiation safety management level and recognition for handling radiation to improve medical environment.

Down syndrome in women aged more than 35 Years positive detection rates (산전선별검사를 통한 35세이상 산모 다운증후군 양성률 비교 평가)

  • Oh, Taek Min;Kim, Ga-Yeon;Lee, Young ki
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.22 no.6
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    • pp.314-320
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    • 2021
  • With the increasing age of motherhood in recent years, attributed to late marriages due to social or environmental factors, the Down's syndrome screening test using biochemical markers has become essential for pregnant women. The process of diagnosing Down's syndrome pregnancy in the high-risk group subjects involves chromosomal analysis, which is performed on samples obtained through invasive procedures such as chorionic biopsy or amniotic fluid. Thus, to reduce unnecessary invasive tests and lower the risk to mother and fetus, it is important to identify a screening test with low risk and high Down's syndrome detection rate. Recently, as the average age of mothers has increased, numerous inspection agencies have classified high-risk mothers as women over the age of 35 years. This study evaluated a total of 36,436 pregnant women aged between 17 to 46 years, and who requested prenatal screening at an inspection agency in Yongin in 2018. Test (13,690 people) Four tests were conducted by applying the time-resolved fluoroimmunoassay method using the direct sandwich and indirect sandwich technology, and the immunoassay method using the sandwich method. We aimed to confirm the difference in positivity rate with increasing age of the subjects. We believe that in future, data obtained from this study will be very useful for the prevention and treatment of Down's syndrome risk at varied inspection institutions, and for prospective mothers.

Comparison of Ultrasound Image Quality using Edge Enhancement Mask (경계면 강조 마스크를 이용한 초음파 영상 화질 비교)

  • Jung-Min, Son;Jun-Haeng, Lee
    • Journal of the Korean Society of Radiology
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    • v.17 no.1
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    • pp.157-165
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    • 2023
  • Ultrasound imaging uses sound waves of frequencies to cause physical actions such as reflection, absorption, refraction, and transmission at the edge between different tissues. Improvement is needed because there is a lot of noise due to the characteristics of the data generated from the ultrasound equipment, and it is difficult to grasp the shape of the tissue to be actually observed because the edge is vague. The edge enhancement method is used as a method to solve the case where the edge surface looks clumped due to a decrease in image quality. In this paper, as a method to strengthen the interface, the quality improvement was confirmed by strengthening the interface, which is the high-frequency part, in each image using an unsharpening mask and high boost. The mask filtering used for each image was evaluated by measuring PSNR and SNR. Abdominal, head, heart, liver, kidney, breast, and fetal images were obtained from Philips epiq5g and affiniti70g and Alpinion E-cube 15 ultrasound equipment. The program used to implement the algorithm was implemented with MATLAB R2022a of MathWorks. The unsharpening and high-boost mask array size was set to 3*3, and the laplacian filter, a spatial filter used to create outline-enhanced images, was applied equally to both masks. ImageJ program was used for quantitative evaluation of image quality. As a result of applying the mask filter to various ultrasound images, the subjective image quality showed that the overall contour lines of the image were clearly visible when unsharpening and high-boost mask were applied to the original image. When comparing the quantitative image quality, the image quality of the image to which the unsharpening mask and the high boost mask were applied was evaluated higher than that of the original image. In the portal vein, head, gallbladder, and kidney images, the SNR, PSNR, RMSE and MAE of the image to which the high-boost mask was applied were measured to be high. Conversely, for images of the heart, breast, and fetus, SNR, PSNR, RMSE and MAE values were measured as images with the unsharpening mask applied. It is thought that using the optimal mask according to the image will help to improve the image quality, and the contour information was provided to improve the image quality.

In Vitro Development of Bovine Nuclear Transfer Embryos Reconstructed with Fetal Fibroblasts (태아 섬유아세포로 재구성된 핵치환 소 수정란의 체외발달)

  • Koo, D.B.;Choi, Y.H.;Park, J.S.;Kim, H.N.;Kang, Y.K.;Lee, C.S.;Han, Y.M.;Park, H.D.;Lee, K.K.
    • Korean Journal of Animal Reproduction
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    • v.24 no.4
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    • pp.407-417
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    • 2000
  • The present study was to examine effects of various electrical stimulus treatments used for electro-fusion on the preimplantation development of bovine nuclear transfer (NT) embryos with fetal fibroblast cells. Fetal fibroblast cells were isolated from one fetus at day 45 of gestation in Holstein cow, and passaged 3 to 4 times before being transferred into enucleated oocytes. Single fibroblast cells were individually placed into the perivitelline space of enucleated oocytes by using a micromanipulator. At first, the fusion and developmental rates of reconstructed oocytes were compared between different electric stimulation conditions. When fusion of the reconstructed oocyte was induced by different electric pulse periods (15, 30 and 45 $\mu$sec) at a DC pulse of 1.8 kV/cm, 15 (45.5%, 120/264) or 30 $\mu$ sec group (43.9%, 106/241) showed a higher fusion rate than 45 $\mu$sec group (23.2%, 58/250, P<0.05). However, no difference was detected in the development rate of the fused oocytes to blastocysts between groups. Next experiment was to examine the effects of different electrical field strengths (1.5, 1.8 and 2.1 kV/cm) for 15 $\mu$sec at electrofusion on in vitro development of the NT embryos. As results, there was no difference in the fusion and developmental rates of the NT embryos between electrical strength (P>0.05). Finally, developmental competence of bovine NT embryos with somatic cells was compared with IVF-derived embryos. Of enucleated oocytes fused with fibroblast cells, 27.4% (75/274) developed to the blastocyst stage, which is similar to that (24.5%, 58/237) of IVF-derived embryos. However, mean nuclei number of NT blastocysts was smaller than that of IVF-derived blastocysts. Thus, we have established an optimal condition (1.8 kV/cm, 15 $\mu$sec) for electric fusion of bovine NT oocytes with somatic cells. The present study indicates that bovine reconstructed embryos with somatic cells normally develop to blastocyst stage in vitro, although having smaller nuclei numbers of blastocysts as compared to IVF-derived embryos.

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Problems in the field of maternal and child health care and its improvement in rural Korea (우리나라 농촌(農村)의 모자보건(母子保健)의 문제점(問題點)과 개선방안(改善方案))

  • Lee, Sung-Kwan
    • 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.

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