• Journal of Yeungnam Medical Science
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• v.38 no.1
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• pp.34-38
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• 2021

Background: We aimed to determine whether routine second trimester complete blood cell (CBC) count parameters, including neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), and platelet-lymphocyte ratio (PLR), could predict obstetric outcomes. Methods: We included singleton pregnancies for which the 50-g oral glucose tolerance test and CBC were routinely performed between 24 and 28 weeks of gestation in our outpatient clinic from January 2015 to December 2017. The subjects were divided into three groups according to their pregnancy outcomes as follows: group 1, spontaneous preterm births, including preterm labor and preterm premature rupture of membranes; group 2, indicated preterm birth due to maternal, fetal, or placental causes (hypertensive disorder, fetal growth restriction, or placental abruption); and group 3, term deliveries, regardless of the indication of delivery. We compared the CBC parameters using a bivariate correlation test. Results: The study included 356 pregnancies. Twenty-eight subjects were in group 1, 20 in group 2, and 308 in group 3. There were no significant differences between the three groups in neutrophil, monocyte, lymphocyte, and platelet counts. Although there was no significant difference in NLR, LMR, and PLR between the three groups, LMR showed a negative correlation with gestational age at delivery (r =-0.126, p =0.016). Conclusion: We found that a higher LMR in the second trimester was associated with decreased gestational age at delivery. CBC parameters in the second trimester of pregnancy could be used to predict adverse obstetric outcomes.

• Clinical and Experimental Pediatrics
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• v.65 no.4
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• pp.172-181
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• 2022

Pubertal onset is known to result from reactivation of the hypothalamic-pituitary-gonadal (HPG) axis, which is controlled by complex interactions of genetic and nongenetic factors. Most cases of precocious puberty (PP) are diagnosed as central PP (CPP), defined as premature activation of the HPG axis. The cause of CPP in most girls is not identifiable and, thus, referred to as idiopathic CPP (ICPP), whereas boys are more likely to have an organic lesion in the brain. ICPP has a genetic background, as supported by studies showing that maternal age at menarche is associated with pubertal timing in their offspring. A gain of expression in the kisspeptin gene (KISS1), gain-of-function mutation in the kisspeptin receptor gene (KISS1R), loss-of-function mutation in makorin ring finger protein 3 (MKRN3), and loss-of-function mutations in the delta-like homolog 1 gene (DLK1) have been associated with ICPP. Other genes, such as gamma-aminobutyric acid receptor subunit alpha-1 (GABRA1), lin-28 homolog B (LIN28B), neuropeptide Y (NPYR), tachykinin 3 (TAC3), and tachykinin receptor 3 (TACR3), have been implicated in the progression of ICPP, although their relationships require elucidation. Environmental and socioeconomic factors may also be correlated with ICPP. In the progression of CPP, epigenetic factors such as DNA methylation, histone posttranslational modifications, and non-coding ribonucleic acids may mediate the relationship between genetic and environmental factors. CPP is correlated with short- and long-term adverse health outcomes, which forms the rationale for research focusing on understanding its genetic and nongenetic factors.

• Clinical and Experimental Pediatrics
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• v.65 no.4
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• pp.201-208
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• 2022

Background: According to the National Family Health Survey-4, in India, 78.9% of deliveries occur in institutions, although only 42.6% of new mothers initiate breastfeeding within 1 hour of delivery. Purpose: To estimate the proportion of early initiation of breastfeeding (EIBF) among new mothers at discharge from a tertiary care hospital and identify the determinants of delayed initiation of breastfeeding among them. Methods: This was a hospital-based analytical cross-sectional study of 108 new mothers. After obtaining Institutional Review Board approval and informed consent, we interviewed the new mothers on the day of discharge. Multivariate logistic regression was performed using IBM SPSS Statistics ver. 24. Results: The median breastfeeding initiation time was 90 minutes (interquartile range, 30-180 minutes). Overall, 43.5% of the mothers practiced EIBF, 77.4% practiced exclusive breastfeeding, and 43.5% were rooming in at discharge. Reasons for breastfeeding delays included extended recovery time from spinal anesthesia, maternal lassitude, and uncomfortable breastfeeding position due to post-cesarean pain. In the multivariate analysis, a birth weight less than 2,500 g (adjusted odds ratio [aOR], 4.33; 95% confidence interval [CI], 1.12-16.82; P=0.03), cesarean section delivery (aOR, 4.68; 95% CI, 1.57-13.92; P=0.005), and mother's poor knowledge of breastfeeding (aOR, 4.61; 95% CI, 1.44-14.72; P=0.010) were more likely to delay the initiation of breastfeeding. Conclusion: EIBF was practiced by less than half of the new mothers as determined by the cesarean section, baby's birth weight, and mothers' awareness of breastfeeding. Thus, it is vital to improve breastfeeding and nutritional counseling among mothers during the antenatal period and improve healthcare professionals' training to facilitate EIBF, even in circumstances such as cesarean section.

• Journal of Yeungnam Medical Science
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• v.40 no.3
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• pp.268-275
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• 2023

Background: With the establishment of international guidelines and changes in insurance policies in Korea, the role of targeted ultrasonography has increased. This study aimed to identify the rates and clinical course of anomalies detected using prenatal targeted ultrasonography. Methods: This study was a retrospective analysis of all pregnancies with targeted ultrasonography performed in a single secondary medical center over 5 years. Results: Fetal anomalies were detected by targeted ultrasonography in 137 of the 8,147 cases (1.7%). The rates of anomalies were significantly higher in female fetuses (2.0% vs. 1.3%). In cases of female fetuses, the rate of anomalies was significantly higher in the advanced maternal age group (2.4% vs. 1.2%). In cases of male fetuses, the rate of anomalies was significantly higher in nulliparous (2.4% vs. 1.5%) and twin (5.7% vs. 1.9%) pregnancies. Pulmonary anomalies were significantly more common in the multiparity group (17.6% vs. 5.8%). Among the 137 cases, 17.5% terminated the pregnancy, 16.8% were diagnosed as normal after birth, and 42.3% were diagnosed with anomalies after birth or required follow-up. Conclusion: Through the first study on the rates and clinical course of anomalies detected by targeted ultrasonography at a single secondary center in Korea, we found that artificial abortions were performed at a high rate, even for relatively mild anomalies or anomalies with good prognosis. We suggest the necessity of a nationwide study to establish clinical guidelines based on actual incidences or prognoses.

• Journal of dental hygiene science
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• v.23 no.4
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• pp.312-319
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• 2023

Background: Parental attention is crucial for preventing childhood oral diseases. Mothers play a significant role in maintaining their families' oral health, and their educational level influences their children's oral health behaviors. This study investigates the impact of mothers' educational levels on adult oral health behaviors using data from a national survey. Methods: This study employed a cross-sectional analysis of secondary data. The data used were obtained from the 8th Korea National Health and Nutrition Examination Survey. Descriptive statistics were calculated to identify participant characteristics. Next, t-tests and one-way analysis of variance were conducted to examine the effects of the explanatory variables on the distribution of the dependent variable. Finally, logistic regression analysis was used to investigate the influence of the explanatory variable on the dependent variable, using "no education" as the reference value, and calculate the odds ratios. Results: Children of mothers with a college education or higher had a 1.13 times higher likelihood of receiving oral examinations than those whose mothers had no education. Children whose mothers graduated from college or higher had a 2.23 times higher probability of receiving preventative dental treatment than those whose mothers had no education. Children whose mothers graduated from college or higher had a 1.92 times higher probability of receiving scaling than those whose mothers had no education. Children whose mothers graduated from high school had a 1.35 times higher probability of receiving scaling than those whose mothers had no education. Conclusion: Developing oral health programs is important for low-educated and low-income parents to change theirs and their children's oral health behaviors/attitudes. This will help reduce oral health disparities among adults raised by parents of higher and lower socioeconomic statuses. Therefore, a comprehensive approach is essential for adults to maintain good oral health, regardless of variations in their parental educational levels during childhood.

• Health Policy and Management
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• v.33 no.4
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• pp.421-431
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• 2023

Background: The coronavirus disease 2019 (COVID-19) pandemic has led to socio-economic issues, highlighting the importance of strengthening health systems for future infectious diseases. This study aims to analyze the relationship between health system preparedness, response levels, and COVID-19 fatality rates across 194 countries. Methods: This study examined various indicators of national health system preparedness and response, including health service delivery, health workforce, health information systems, essential medicines and health products, health financing, and leadership and governance. Results: A correlation was found between the health system and the COVID-19 case fatality rate (CFR). Further examination of specific indicators within health service delivery, health workforce, health information systems, health financing, and leadership/governance showed significant correlations with the CFR. Multiple regression analysis, considering aging and urbanization rates, identified reproductive/maternal/newborn and child health, infectious diseases, nursing and midwifery personnel density, birth registration coverage, and out-of-pocket health expenditure as significant factors affecting the CFR. Conclusion: Countries with strong health system indicators experience lower case fatality rate from COVID-19. Strengthening access to essential health services, increasing healthcare personnel and resources, ensuring reliable health information, and bolstering overall health systems are crucial for preparedness against future infectious diseases.

• Journal of Veterinary Science
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• v.24 no.5
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• pp.49.1-49.15
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• 2023

Background: Hystricomorpha rodents display a similar placentation model to humans. The present study was carried out considering the scarcity of information concerning the placental development in agouti. Objective: Describe the microscopy of the placenta, subplacenta and yolk sac of agoutis in early pregnancy and report on the inversion of the yolk sac. Methods: Fifteen females between the 14^th-32^nd day of gestation were used following euthanasia. Gestational buttons were collected, fixed, processed, stained to optical microscopy or immunohistochemistry. Results: Chorioallantoic placenta (CP) ranged from conical to a half-sphere, as follows: from the 14^th to 17^th day, the CP displays an inverted "V" shape, predominantly formed by cytotrophoblasts; from 20 to 22 days, formed almost entirely by cytotrophoblasts; at 28 days, a half sphere, with distinct lobes and interlobular area, numerous maternal gaps delimited by syncytiotrophoblasts and trophoblast giant cells; at 32 days, globose and undergoing the maturation process. Subplacenta, located between decidua and CP, initially presents septa consisting of simple columnar epithelium and after 17 days, comprising stratified epithelium. Visceral yolk sac (VYS) is attached to two CP projections between 14 and 17 days, formed by a simple cubic epithelium and inverted. Between 20 and 22 days, the epithelium displays apical villous projections with cytoplasmic vacuoles and a vascularized mesoderm. After the 24^th day, the VYS near the placenta is pleated, very vascularized and villous, with decreased villi sizes further away from the placenta. Conclusion: The agouti CP displays similar characteristics to other hystricomorpha, including placenta lobulation, a subplacenta and an inverted vitelline placenta.

• Journal of Yeungnam Medical Science
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• v.40 no.4
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• pp.394-401
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• 2023

Background: Pregnancy is associated with a number of physical, emotional, and biological changes that can exacerbate maternal psychological disturbances, such as body image concerns and depression. Sleep disturbances during pregnancy can also have adverse impacts. This study aimed to determine the prevalence of depression, sleep disturbances, and body image concerns among pregnant women. The study also examined the relationship between these factors and pregnancy-related variables, such as bad obstetric history and whether the pregnancies were unplanned. Methods: A cross-sectional study of 146 pregnant patients was conducted at a tertiary care center over 15 months. The patients were administered the Beck Depression Inventory, Pittsburgh Sleep Quality Index, and Body Image Concern Inventory questionnaires. Contingency tables, Fisher exact test, and Spearman correlation were used to identify underlying relationships. Results: The prevalence of depression was 22.6%. Although body image disturbance was noted in only 2.7% of patients, 46.6% had poor sleep quality. Poor sleep was associated with primigravida status. Bad obstetric history and unplanned pregnancy were associated with depression. Depression was found to be significantly correlated with body image disturbances and poor sleep quality. Conclusion: Psychiatric disorders were prevalent during pregnancy. This study highlights the importance of screening for depression in pregnant patients. Counselling and caregiver education can be useful for mitigating psychological disturbances. Management of pregnancies by multidisciplinary teams that include psychiatrists could be immensely useful in improving the pregnancy experiences of patients.

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

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

• Pediatric Infection and Vaccine
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• v.6 no.2
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• pp.194-202
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• 1999

Background : Group B ${\beta}$-hemolytic Streptococcus(GBS) has been the major pathogen of neonatal sepsis in western country. In contrast, GBS has played little role in neonatal sepsis in Korea. But recently, neonatal GBS infections are encountered more frequently. It is important to characterize the clinical and epidemiological features of GBS infection in Korean children. Methods: We reviewed retrospectively the medical records of twenty-seven infants and children with GBS infection experienced at the Seoul National University Children's Hospital during 14 year-period from June, 1985 to June, 1999. Fourteen strains isolated from blood and cerebrospinal fluid were serotyped. Minimum inhibitory concentrations of 10 strains were determined by agar dilution method for penicillin, ampicillin, ampicillin with sulbactam, cefarolin, cefuroxime, and cefuiaxone. Results: The numbers of cases with GBS infection increased in 1990s. Among twenty seven cases, twenty-five cases were under three months of age and both of two cases with underlying disease occurred at three years of age. All neonatal infections were late-onset type and meningitis predominated. Serotypes were III(6 strain), Ib(4), Ia(l) and V(2). All of the strain were susceptible to all of the antibiotics tested. Conclusion: GBS infections in infants were increasingly recognized. GBS should be considered as an etiological agent of neonatal sepsis or meningitis in Korea. Maternal screening and prophylactic antibiotic therapy may be considered.