• The Korean Journal of Pain
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• 제14권1호
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• pp.61-67
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• 2001

Background: Usually, lumbar epidural block is performed on the $L_{3-4}$ interspace. This study was designed to evaluate the analgesic efficacy and shortening of labor duration comparing the $L_{1-2}$ and $L_{3-4}$ interspace epidural blocks in nulliparous normal vaginal deliveries and then investigates side effects following the blocks. Methods: Eighty healthy nulliparous women were divided into two groups, $L_{1-2}$ (n = 40) and $L_{3-4}$ (n = 40). Epidural blocks, lumbar epidural block were performed at the $L_{1-2}$ and $L_{3-4}$ interspace with a catheter advancing 3 cm cephalad. The initial dose of 12 ml (0.167% bupivacaine, fentanyl $50{\mu}g$ and clonidine $75{\mu}g$) was injected epidurally at 4 cm dilatation of cervix and severe pain of labor. If a visual analogue scale (VAS) score was more than 4 points, an additional dose was administered epidurally using the same volume as the above mentioned, but with the exception that the bupivacaine was diluted to 0.1 percentage. The maternal blood pressure, pulse rate, respiration rate and fetal heart rate were measured at 10 min intervals for the first 30 min, at 15 min interval for the next 30 min and at 30 min interval for the last one hour following the blocks. The duration of the first (active) and second stages of labor was counted and the neonatal Apgar score was recorded at one and five min after delivery. The degree of motor block, pruritus, nausea and vomiting were also noted. Results: The patients in group $L_{1-2}$ had lower pain scores than group $L_{3-4}$ at 5, 20, 30, 60 mins. The duration of 1st and 2nd labor stage in the $L_{3-4}$ epidural block were $272{\pm}33.5$ min, $49.2{\pm}27.4$ min respectively but those in the $L_{1-2}$ epidural block were $253.5{\pm}32.5$ min, $37.3{\pm}22.3$ min, respectively. Conclusions: We concluded the analgesic efficacy and shortening of labor duration in $L_{1-2}$ epidural block was better than those in $L_{3-4}$ epidural block. Maternal hemodynamic change, motor block. pruritus, nausea, vomiting and Apgar score showed no significant differences between the two groups.

• Nutrition Research and Practice
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• 제9권4호
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• pp.433-438
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• 2015

BACKGROUND/OBJECTIVES: Breast milk is the best available food for optimum growth and development of infants and the breastfeeding rate is increasing in Korea. The purpose of this study is to measure the concentrations of macronutrients and to evaluate their changes according to lactation period in breast milk from lactating Korean women. SUBJECTS/METHODS: Milk samples were obtained from 2,632 healthy lactating women (mean age; $32.0{\pm}3.3years$), where the lactating period was up to a period of 8 months, who also volunteered to participate in the Human Milk Macronutrient Analysis Research. Lactose, protein, fat and water content in the breast milk samples were analyzed with infrared spectrometry using MilkoScan FT-2. RESULTS: The mean macronutrient composition per 100 mL of mature breast milk was 7.1 g for lactose, 1.4 g for protein and 3.0 g for fat, and energy content was 61.1 kcal. The protein concentration was significantly lower in milk samples at 1-2 weeks (2.0 g/dL) to 2-3 months (1.4 g/dL) than those at 0-1 week (2.2 g/dL), but it was similar among samples from 3-4 months to 7-8 months (1.3 g/dL). Mean lipid levels varied among different lactational period groups (2.7-3.2 g/dL), but presented no significant difference. Lactose concentration in the milk samples did not differ with lactation period. Maternal body mass index was positively related to protein and lipid breast milk contents, but was negatively related to lactose content. General linear models examining the associations between maternal variables and milk macronutrient content revealed that lactation period had a major impact on protein and lipid, but not on lactose content in breast milk. CONCLUSIONS: These results warrant future studies to explore factors that may be associated with changes in macronutrient content in human milk.

• 농촌의학ㆍ지역보건
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• 제12권1호
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• pp.54-62
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• 1987

This study was performed as a part of survey for the operation and interim evaluation of the on-going pilot project of community health in Jeomdong-Myon, Yeoju-Gun, Kyunggi-Province since 1982. Seven Villages (Ri) were selected purposively for the survey from a total of 26 villages in Jeomdong-Myon, target area, under the consideration of the socio-economic background and the distribution of health resources. The target population was the women in age group of 15-44 years in that area and a total of 156 women were interviewed. This study was done by the interview survey using questionnaire which was composed with questions about MCH and FP. The results were as follows; 1) ln the status of maternal health, (1) the proportion of receiving antenatal care was relatively high (67.1%) in this area, but the starting time of antenatal care was delayed to 7 months or more of gestational period in 22 percent. Therefore some intervention would be necessary for advancing the time of antenatal care. (2) The proportion of home delivery was decreased according to the rank of birth-order. And more than 50 percent of delivery attendants were mothers-in-law or neighbors. The fact indicates that the health education for non-professional delivery attendents would be necessary for improving home delivery and the content of education would be preferable to focussing to the method of hygienic delivery attending. (3) The comprehensive health service and education would be recommended for the postnatal care, because of the extremely low rate of postnatal care in this area. 2) In the status of child health, (1) the pro-portion of breast feeding was 90.2 percent, and the weaning started after 12 months of birth in 12.7 percent. This indicates the necessity of education about the weaning program. (2) The proportion of completed basic vaccination was 39.6% and the main reason of missing vaccination was poor accessibility in terms of time. For that, the supply of vaccine to primary health care units (health subcenters) should be continuous, not infrequent nor occassional. 3) The proportion of respondants who were using contraceptive methods currently was 79.8 percent and in 44.7 percent they accepted the permanent contraceptive methods. Those results are distinct in this area. But it seems a serious health problem that 53.2 percent of respondants were experienced the induced abortion for birth control.

• 모자간호학회지
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• 제2권1호
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• pp.5-20
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• 1992

This study was undertaken to identify the levels and affecting factors of the maternal role attainment(MRA) in the primipara during the postpartum period. The healthy ninety primiparous from the one university hospital and two local clinics in KwangJu city were selected and two Semantic Differential Scales (SD-Myself as Mothers, SD-My Baby) and the Pharis Self Confidence Scale were used in this study. Questionnaires were distributed at the 3rd days and the 4-6 weeks of the primiparous not showing any complication after normal delivery. The data collected were analysed statistically using t-test, Pearson's Product Moment Correlation Coefficient and ANOVA. The results obtained were summarized as follows; 1) On the 3rd day after the delivery, the scores of SD-myself as mother, SD-baby and Pharis Self Confidence were 70.6 points, 73.6 points and 78.6 points, respectively, showing the low level of MRA. 2) On the 4-6 weeks after delivery, the score of SD-myself as mother, SD-baby and Pharis Self Confidence were 72.8 points, 77.9 points, and 86.9 points, respectively, indicating the moderate level of MRA. 3) The mean scores of the SD scale and the Pharis Self Confidence during the postpartum periods were higher than those of the 3rd days, showing the SD-myself as mother (t=-2.09, P<.05), SD-baby(t=-4.12, P<.001), Pharis Self Confidence(t=-6.59, P<.001), respectively. 4) Positive correlations (r=.24$\sim$.69) were shown in the concepts related to the MRA and the cognitive-motor skill components and cognitive-affective skill components of the MRA became harmonious over time. 5) The relationships between the score of the MRA and the demographic and obstetric variables were as follows ; a) the score of the MRA in the twenties was higher than those of the thirties. b) the group with higher educational background showed higher MRA socres than the group with lower one. c) those who wanted pregnancy sustenance had higher MRA scores than those who did not. d) the group that did think of festus-feature represented higher MRA scores than those who did not. e) the group of mothers who have the daughters showed higher MRA scores than those who have boys. It can be concluded from the results that the MRA in the primiparous increased gradually, and that the cognitive-motor skills and cognitive-affective skills became harmonious over time. The level of the MRA was affected partly by the mothers general, obstetrical variables. Following suggestion were made oil the basis of the present study ; a) The longitudinal study on the MRA is needed. b) Multivariate analyses should be done for the identification of the factors influcening on the MRA. c) Education program for primiparous mother should be designed and developed to improve the MRA.

• 지역사회간호학회지
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• 제11권2호
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• pp.499-512
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• 2000

The number of deliveries by cesarean section has increased internationally. However, The cesarean section rate is different by country to country. It is because each country has different social and cultural background and. practices its unique delivery policies. Hence, it is very important to understand the uniqueness that one country faces related with the cesarean section. In Korea, there have been many researches on the clinical. maternal. hospital and community factors and so on. However, few studies have attempted to reveal the physician factors in Korea because it is difficult to approach hospital records. So, in this study, the physician factors that influence the increase of cesarean section rate in Korea was investigated, and preliminary research agenda for policy establishment to keep the cesarean section rate from excessive increase was provided. In this study, all 2744 cesarean section deliveries performed by 36 physicians at the hospital was considered. and detailed delivery records of 12 months selected randomly from January 1996 to August 1998 was reviewed retrospectively. Chi-square analysis is used to examine the homogeneity of distribution of maternal, fetal, and clinical factors. In addition, multiple regression analysis is used to examine the effect of physician characteristics on the cesarean section rate. Physician characteristics as independent variable and the cesarean section rate as dependent variable was put in this analysis. Follows are the results of this study. 1) Total cesarean section rate is 34.8%. primary cesarean section rate is 12.5 % and repeated cesarean section rate is 22.3 %. Among the indications for the primary cesarean section, 15.6 % is for breech presentation. 40.2 % is for dystocia. 7.6 % is for fetal distress. and 36.6 % is for others. 2) There is positive correlation between physician's age and the cesarean section rate (p<0.001). And statistically significant correlation is found between the physician's educational attainment and the cesarean section rate (p<0.001). A physician with Ph.D degree has lower cesarean section rate than a physician with B.A only and M.A. degree (p<0.001). However. physician's gender, location of graduated university. position at the hospital, and the religious belief were not shown statistically significant relations with the cesarean section rate. 3) Among all cesarean sections in this study, only 15.4 % is performed during weekend. While 18.2 % is performed on monday only. This suggests that physicians may not prefer weekend operation of cesarean section. In addition, 86.1 % among all cesarean section operations is performed from 6 a.m. to 6 p.m. So the cesarean section rate could be related with a day of the week and a time of the day. From this results. there is a possibility that the physicians' personal comfort may influence the cesarean section rate.

• 농촌의학ㆍ지역보건
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• 제15권2호
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• pp.97-106
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• 1990

1. Background Women's health and their involvement in health care are essential to health for everyone. If they are ignorant, malnourished or over-worked, the health &-their families as well as their own health will suffer. Women's health depends on broad considerations beyond medicine. Among other things, it depends upon their work in farming. their subordination to their families, their accepted roles, and poor hygiene with poorly equipped housing and environmental sanitation. 2. Objectives and Contents a. The health status of rural women : physical and mental complaints, experience of pesticides intoxication, Farmer's syndrome, experiences of reproductive health problems. b. participation in and attitudes towards housework and farming c. accessibility of medical care d. status of maternal health : fertility, family planning practice. induced abortion, and maternal care 3. Research method A nationwide field survey, based on stratified random sampling, was conducted during July, 1986. Revised Cornell Medical index(68 out of 195 items). Kawagai's Farmers Syndrome Scale, and self-developed structured questionnaires were used to rural farming wives(n=2.028). aged between 26-55. 4. Characteristics of the respondents mean age : 40.2 marital status : 90.8% married mean no. of household : 4.9 average years of education : 4.7 yrs. average income of household : \235,000 average years of residence in rural area : 36.4 yrs average Working hours(household and farming) : 11 hrs. 23 min 5. Health Status of rural women a. The average number of physical and mental symptoms were 12.4, 4.7, and the rate of complaints were 22.1%, 38.8% each. revealing complaints of mental symptomes higher than physical ones. b. 65.4% of rural women complained of more than 4 symptoms out of 9, indicating farmer's syndrome. 11.9 % experienced pesticide overdue syndrome c. 57.6% of respondents experienced women-specific health problems. d. Age and education of respondents were the variables which affect on the level of their health 6. Utilization of medical services a. The number of symptoms and complaints of respondents were dependent on the distance to where the health-care service is given b. Drug store was the most commonly utilized due to low price and the distance to reach. while nurse practitioners were well utilized when there were nurse practitioner's office in their villages. c. Rural women were internalized their subordination to husbands and children, revealing they are positive(93%) in health-care demand for-them but negative(30%) for themselves d. 33.0% of respondents were habitual drug users, 4.5% were smokers and 32.3% were alcohol drinkers. and 86.3% experienced induced-abortion. But most of them(77.6%) knew that those had negative effects on health. 7. Maternal Health Care a. Practice rate of contraception was 48.1% : female users were 90.9% in permanent and 89.6% in temporary contraception b. Induced abortions were taken mostly at hospital(86.3%), while health centers(4.7%), midwiferies(4.3%). and others(4.5%) including drug stores were listed a few. The repeated numbers of induced abortion seemed affected on the increasing numbers of symptoms and complaints. c. The first pre-natal check-up during first trimester was 41.8%, safe delivery rate was 15.6%, post-natal check-up during two months after delivery. Rural women had no enough rest after delivery revealing average days of rest from home work and farming 8.3 and 17.2. d. 86.6% practised breast feeding, showing younger and more educated mothers depending on artificial milk 8. Recommendations a. To lessen the multiple role over burden housing and sanitary conditions should be improved, and are needed farming machiner es for women and training on the use of them b. Health education should begin at primary school including health behavior and living environment. c. Women should be encouraged to become policy-makers as well as administrators in the field of women specific health affairs. d. Women's health indicators should be developed and women's health surveillance system too.

• Tuberculosis and Respiratory Diseases
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• 제46권4호
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• pp.548-554
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• 1999

연구배경: 천식은 임신과 관련된 가장 흔한 호흡기 발작이다. 임신은 천식의 임상 경과에 영향을 미치는 것으로 되어 있으며, 약 1/3에서 임신 전에 비해 증세가 악화된다. 이 때 적절한 치료를 받지 못 할 경우 산모나 태아에게 중대한 영향을 미칠 수 있다. 본 연구에서는 임신 중 천식이 악화되어 내원한 환자를 대상으로 천식의 임상 경과 및 악화된 원인에 대해 후향적 고찰을 시행하였다. 방 법: 1989년 1월부터 1998년 4월까지 임신 중 천식이 악화되어 고대 안암병원 및 구로병원에 내원하였던 27명의 천식 환자를 대상으로 하였다. 이 중 2명은 각각 임신 6주와 25주에 임신 중절을 하였고, 나머지 25명은 정상 분만을 하였다. 정상 분만한 25명을 대상으로 후향적 고찰과 환자 면담을 시행하여 다음과 같은 결과를 얻었다. 결 과: 환자의 평균 연령은 29.2세(24-38세)였다. 임신 중 악화된 시기는 8-36주까지 다양하였으나, 임신 20-28주 사이에 14명(56%)이 악화되어 가장 많았다. 36-40주 사이에 악화된 경우는 없었다. 악화된 환자들은 경구 프레드니손, 흡입용 베타2-항진제, 아미노필린 치료 후 호전되었으며, 임신 중 악화된 환자들 모두 분만 4주 전에는 호전되었다. 임신 때와 비교하여 25명 중 20명(80%, p<0.002)이 분만 후 호전되어 다시 임신 이전 상태로 돌아갔으며, 나머지 5명(20%)은 임신 때와 비교하여 변화가 없었다. 임신 중 악화된 원인을 추정하면 감기 증세가 있은 후 악화된 경우가 7명(28%), 임신 후 약 복용을 중단하여 악화된 경우가 10명(40%), 원인을 모르는 경우가 8명(32%)으로 나타났다. 정상 분만한 25명의 태아는 모두 건강하였고, 선천적 기형이나 분만 중 천식으로 인한 이상은 없었다. 2 회 이상 임신한 경험이 있는 8명의 여성을 대상으로 다른 임신 때와 비교하여 천식의 임상 경과를 조사해본 결과 이전과 같은 경우가 3명, 이전보다 악화된 경우가 5명으로 나타났다. 이 중 2명은 첫 번째 임신때는 천식증세가 없었으나 두 번째 임신 때 천식이 악화되어 내원하였고, 나머지 3명은 첫 번째와 두 번째 임신 때는 증세가 미약했으나 세 번째 임신 때 증세가 악화되어 내원하였다. 결 론: 임신 중 천식이 악화되는 경향이 있는 환자는 임신 중반기 특히, 임신 20-30주 사이를 주의 관찰하는 것이 필요하다. 또한 임신 중 천식 약을 중단하는 것이 천식이 악화되는 흔한 원인이므로 천식 환자에게 충분한 교육과 함께 임신기간 중에도 적극적인 치료를 받도록 하는 것이 필요하다.

• Journal of Animal Science and Technology
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• 제59권12호
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• pp.25.1-25.7
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• 2017

Background: Rabbit breeding with high performance imported ones would be of benefit for genetic diversity and improvement of performance in domestic rabbit breeds. The rearing of more productive rabbit breeds could be pathway to improve the productivity and reduce the production cost. Maternal nutritional status exert a great influence on reproductive functions of does, which may expand from conception, through gestation and parturition and development of kits to puberty. Methods: Four breeds of rabbit were evaluated for their parturition, weaning and pubertal differences among the rabbit population in Ibadan, Nigeria. The breed consist of Fauve De Bourgogne (FDB), Chinchilla (CHA), British Spot (BS) and New Zealand White (NZW) rabbits. A total of 60 bucks and 360 does consisting of 15 bucks and 90 does per breed were mated in 6 mating cycles, three each of natural mating and artificial insemination. All does were synchronized for estrus with 20 IU pregnant mare serum gonadotropin 48 h prior to mating. The does after parturition were assessed for milk yield (g) and kit survival rate (%) till weaning, weight changes of kits from birth to puberty. At puberty, the pubertal age (days) and weight (g) of the offspring were assessed. Result: Results obtained reveals that British Spot doe had highest milk yield among the breeds which significantly increased growth of kit and weight at weaning in British Spot rabbits. Survival rates of Chinchilla kits were significantly (p < 0.05) higher than Fauve de Bourgogne, British Spot and New Zealand White kits. Puberty attainment of the rabbits indicates that British spot does and Fauve de Bourgogne bucks are early maturing. Conclusion: Chinchilla shows high kit survivability and British spot has highest milk yield among the four breeds of rabbit.

• 보건행정학회지
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• 제25권4호
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• pp.277-284
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• 2015

Background: This study investigates the relationship of socioeconomic status with adverse birth outcomes (low birth weight, preterm birth) and the relationship of socioeconomic status with infant mortality, using the birth cohort in Korea, 1995-2010. Methods: 8,648,035 births from National Statistics Offics, 1995-2010 were studied with respect to social variation in adverse birth outcomes and infant mortality in Korea. The effect of social inequality was examined against adverse birth outcomes and infant mortality using multivariate logistic regression after controlling for other covariates. Results: Social inequality were observed in adverse birth outcomes: low birth weight (LBW, 1,500-2,499 g), very LBW (1,000-1,499 g), and extremely LBW (500-999 g) as well as moderately preterm birth (PTB, 33-36 weeks), very PTB (28-32 weeks), extremely PTB (22-27 weeks), and infant mortality. The effect of social inequality was higher among moderately LBW (1,500-2,499 g) and PTB (33-36 weeks) than very or extremely LBW and PTB. Conclusion: The social inequality in adverse birth outcomes (low birth weight and preterm) and infant mortality existed and increased in Korea from 1995 to 2010. The effect of maternal education on adverse birth outcomes as well as infant mortality was apparent in the study results. Especially, social inequailiy in infant mortality was greater among the sub-normal births (low birth weight [1,500-2,499 g] or preterm birth [33-36 weeks]), which suggests, social interventions should aim at more among the subnormal births. This study suggest that tackling inequality in births as well as infant mortality should be focused on the social inequality itself.

• Asian Pacific Journal of Cancer Prevention
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• 제15권16호
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• pp.6929-6934
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• 2014

Background: To analyze the mortality distribution of esophageal cancer in China from 1991 to 2012, to forecast the mortality in the future five years, and to provide evidence for prevention and treatment of esophageal cancer. Materials and Methods: Mortality data for esophageal cancer in China from 1991 to 2012 were used to describe its epidemiological characteristics, such as the change of the standardized mortality rate, urban-rural differences, sex and age differences. Trend-surface analysis was used to study the geographical distribution of the mortality. Curve estimation, time series, gray modeling, and joinpoint regression were used to predict the mortality for the next five years in the future. Results: In China, the incidence rate of esophageal cancer from 2007 and the mortality rate of esophageal cancer from 2008 increased yearly, with males at $8.72/10^5$ being higher than females, and the countryside at $15.5/10^5$ being higher than in the city. The mortality rate increased from age 45. Geographical analysis showed the mortality rate increased from southern to eastern China, and from northeast to central China. Conclusions: The incidence rate and the standardized mortality rate of esophageal cancer are rising. The regional disease control for esophageal cancer should be focused on eastern, central and northern regions China, and the key targets for prevention and treatment are rural men more than 45 years old. The mortality of esophageal cancer will rise in the next five years.