• 대한유전성대사질환학회지
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• 제19권1호
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• pp.1-11
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• 2019

목적: 선천성 갑상선기능저하증(Congenital hypothyroidism, CH)은 전세계적으로 출생아 3,000-4,000명 당 1명의 빈도로 발생하는 신생아기에 가장 흔한 내분비질환이다. 본 연구는 1991년부터 2004년까지 남한의 선천성 갑상선기능저하증 발생률의 빈도 및 현재까지 적용되어온 광범위한 신생아 선별검사의 검사방법과 결과를 재평가하기 위해 수행되었다. 방법: 서울 지역에 위치하지만 전국적인 지사를 운영하고 있는 검사기관 서울의과학 연구소(SCL)에서는 서울 외 6개 광역시(부산, 인천, 대구, 대전, 광주, 울산)와 9개도(경기, 강원, 충북, 충남, 전북, 전남, 경북, 경남, 제주)로 한국을 15개 지역으로 분류하였다. 15개 지역으로부터 신생아의 채혈지를 수집하여 서울본원에서 수집하여, TSH 및 유리 T4를 ELISA 검사법으로 신생아선별검사를 수행하였다. SCL 데이터 및 복지부에 보고된 전국적인 양성자수를 검토하였다. 선천성갑상선기능저하증에 대한 신생아선별 검사법의 cut-off 치는 신생아 갑상선자극호르몬(TSH) 측정을 위해서는 20 mIU/L를 유리 T4의 검사를 위해서는 0.8 ng/dL 이하를 사용하였다. TSH 및 유리 T4 ELISA 분석에 기초한 선천성 갑상선기능저하증에 대해 1차 선별검사에서 선천성 갑상선기능저하증 양성은 신생아 671,805명 중 신생아 159명에서 발견되었으며, 이의 발병빈도는 4,225명 중 1명으로 추정되었다 결과: TSH 분석에서 cut-off 20 mIU/ L를 사용했을 때 민감도, 특이도 및 양성 측도(PPV)는 각각 100.0%, 99.7% 및 10.8%였다. 유리 T4 분석을 위해 0.8 ng/dL cut-off를 사용했을 때 민감도, 특이도 및 양성 예측도는 각각 100.0%, 98.5% 및 3.9%였다. 결론: NBS를 통해 얻은 CH의 발병빈도는 2004년 이전에 해외의 여러 국가에서 보고 된 발병빈도와 비교할 만큼 유사하였다.

• 대한유전성대사질환학회지
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• 제19권1호
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• pp.12-19
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• 2019

목적: 코발라민(Cobalamin)과 동반되지 않은 독립형 메틸말론산혈증(methylmalonic acidemia)은 프로피오네이트 대사 질환으로 상염색체 열성으로 유전된다. Methylmalonyl-CoA mutase (MCM)효소발현에 관련된 유전자인 MMUT에는 유전자 결함에는 두 가지 아형이 있다. $Mut^0$은 효소 활성도가 완전히 없는 것이고 Mut-형은 효소활성도가 저하되어 있지만 hydroxocobalamin (OHCbl) 보충으로 잔여효소의 활성도가 증가될 수 있는 형이다. 본 연구의 목적은 한국인 MMA 환아에서 코발라민의 반응성과 돌연변이를 조사하는 것이다. 방법: 최적의 치료를 위해 MCM 활성도와 비타민 $B_{12}$ 반응성을 측정하기 위하여 섬유 아세포의 체세포 보완 분석을 사용하여 10명의 MMA 환자를 평가했다. MMUT 유전자는 MMA 돌연변이의 염기서열을 확인하였다. 결과: $^{14}C-propionate$의 첨가는 OHCbl에 반응이 없는 모든 환자에서 낮게 나타났다. $^{14}C-methyltetrahydrofolate$와 $^{57}Co-cyanocobalamin$의 투여 후 모두 정상범위 내에 있었다. 아데노 실 코발라민의 합성은 낮지 만 메틸 코발라민의 합성은 적절하였다. 보완 분석 결과 모든 환자들은 $mut^0$ 유형이었다. DNA 염기서열분석결과에서 2개의 새로운 돌연변이, p.Gln267Ter 및 p.Ile697Phe를 포함하여 12개의 상이한 MMUT 돌연변이를 확인하였다. 신생아에서 증상이 나타나며 $mut^0$ 형인 MMA 환자 10례 모두에서 코발라민 반응을 보이지 않았다. 결론: 본 연구에서는 모든 한국 MMA 환자에서 코발라민 반응을 시험한 결과 음성이었다.

• 한국미생물·생명공학회지
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• 제49권4호
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• pp.519-527
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• 2021

본 연구에서는 국내 건강한 산모의 모유에서 분리한 E. faecalis BMSE-HMP 4주의 용혈여부와 다제내성 균에 대한 항용혈 효능 및 항균 효과를 확인하였다. 분리 균주의 효소 활성을 측정 결과, E. faecalis BMSE-HMP 4주는 지질에 대한 가수분해 효소인 esterase 및 esterase lipase에 대한 활성이 우수하였다. 용혈여부를 확인한 결과, 분리균 모두 용혈반응이 나타나지 않았다. 또한 용혈을 일으키는 다제내성 균주에 대한 항용혈 효능을 검토한 결과, S. aureus CCARM 3855에 대한 항용혈 효능은 BMSE-HMP002가 75.71 ± 10.00%로 가장 높았으며, E. coli DC 2 CCARM 0238과 P. aeruginosa CCARM 0223에 대한 항용혈 효능은 BMSE-HMP001이 각각 76.92 ± 2.99%와 87.93 ± 1.93%로 가장 높게 나타났다. 다제내성균 Staphylococcus spp., Escherichia spp., Pseudomonas spp., Salmonella spp., Klebsiella spp. 및 Enterobacter spp.에 대한 항균활성을 검토한 결과, E. faecalis BMSE-HMP 4주는 그람 양성균주와 그람 음성균주에서 모두 항균력을 보였으며, 분리균 4주 중에서는 BMSE-HMP001과 BMSE-HMP002가 가장 우수한 결과를 보였다. 본 연구에서는 모유유래 유산균 E. faecalis BMSE-HMP 4주의 안전성과 다제내성 균에 의한 용혈 및 항균 효과를 검토하여 유용 유산균으로써 가능성을 확인하였으며, Enterococcus 균주는 항생제 내성 유전자 및 독성 유전자가 없는 경우에 한하여 사용이 가능한 것으로 고시된 바와 같이 본 연구에서 분리한 모유유래 유산균 E. faecalis BMSE-HMP 4주의 항생제 내성 및 독성에 대한 추가적인 연구를 통해 안전성에 대한 입증이 필요할 것으로 생각된다.

• Pediatric Infection and Vaccine
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• 제30권2호
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• pp.84-90
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• 2023

목적: 발열이 있는 생후 90일 이하의 영아에게는 심각한 감염의 위험이 높다. 본 연구는 코로나바이러스감염증-19 감염증(코로나19)이 발생한 90일 미만의 영아의 임상적 특징을 분석하기 위해 진행되었다. 방법: 2020년 3월 1일부터 2022년 5월 1일까지 코로나19로 진단받고 입원한 생후 90일 이하 영아의 의무기록을 후향적 연구로 검토하였다. 결과: 총 105명의 영아가 포함되었으며, 이 중 27명(25.7%)은 생후 28일 미만 신생아, 48명(45.7%) 및 30명(28.6%)는 각각 생후 28-59일과 60-90일 사이의 영아였다. 이 중 5명(4.7%)은 무증상이었고, 68명(62.8%)은 발열이 있었으며, 평균 발열 기간은 2일이었다. 가장 흔한 증상은 기침(66.6%), 코 막힘(51.4%), 콧물(40.9%)등 호흡기 증상으로 확인되었다. 총 10명의 영아에서 혈액배양검사가 시행되었으나 균은 동정되지 않았다. 8명의 영아에서 채뇨백을 이용하여 소변 검사를 시행하였고 2명에게서 농뇨는 없었으나 세균이 배양되었다. 9명(8.6%)의 영아가 경험적 항생제를 투약 받았으며, 투약 기간의 중간값은 2.3일(범위, 1-7일)이었다. 모든 105명의 영아들은 합병증 없이 증상이 호전되었으며, 사망 사례 또한 없었다. 결론: 본 연구에서 코로나19로 진단된 90일 이하의 영아들 대부분이 경미한 증상을 보였으며, 배양 검사가 시행된 환자들에게서 세균 동시감염은 없었다. 이러한 결과는 임상의들이 코로나19 유행기 동안 코로나바이러스 감염이 있는 어린영아들에게 적절한 검사를 시행하고 치료하는 데에 도움이 될 수 있을 것이다.

• 대한유전성대사질환학회지
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• 제24권1호
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• pp.26-36
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• 2024

Lesch-Nyhan syndrome (LNS)은 X-염색체 열성 장애로 퓨린 재활용 효소인 hypoxanthine-guanine phosphoribosyltransferase (HPRT)의 결핍으로 인해 발생하는 선천성 대사질환이다. 임상 증상은 잔여 효소 활성도 및 유전적 돌연변이에 따라 다양하다. 국내에서는 27례의 LNS 사례가 보고되어 있다. 분홍색 기저귀로 방문했던 2례의 환아중에서 잔여 효소가 전혀 없는 LNS로 사망한 1례와 잔여 효소가 부분적으로 존재하는 1례의 11년간 비교 추적 관찰한 결과를 보고한다. 증례 1: 핑크색 기저귀로 병원에 내원하여 반복적인 구내염으로 치료를 받다가 2개월에 경련발작으로 시작하여 심한 단백질 식품 거부, 발달지연, 퇴행이 있어 뇌성마비로 재활치료를 받던 중 만 6세에 LNS로 진단되어 요산치료로 요산은 정상화 되었으나 심한 불면증과 변비가 관찰되었다. 자해 행동과 척추 측만증, 간질 대발작, 심한 경직을 동반하며 몸통 근육긴장 저하, 무도무정위 운동과 운동실조가 진행성으로 심해졌다. 체중이 줄고 심한 영양실조 상태와 콩팥 모양의 요로 결석, 반복적 재발성 폐렴으로 병원 치료를 받다가 11세에 갑자기 사망하였다. 유전자 검사 결과 반접합성 HPRT1 변종(c.151C>T(p.Arg51Ter))이 밝혀졌다. 요산 수치는 10.5 mg/dl(정상 범위: ~3.5-7.9), HPRT 활성도는 0.02 nmol/hr/spot (10-23.8 nmol/hr/spot)이었다. 증례 2: 핑크색 기저귀로 병원에 방문하여 요산이 높아진 것을 알게 되었고 단백질을 거부하는 식사 습관이 있으며 저체중 상태로 성장하였다. 초등학교에 다니는 정상적인 지능을 가지고 있었고 자해 증상은 전혀 관찰되지 않았으며 정기적인 신장 초음파 검사에서 전혀 요로결석 없이 추적관찰 되었다. 유전자 검사상 반접합성 HPRT1 변이체(c.35A>C(p.Asp12Ala))를 가지고 있었으며 요산 수치와 HPRT 활성도는 11 mg/dL, 0.56 nmol/hr/spot이었다. 신생아 시기 이후까지 핑크색 기저귀가 보이며 심한 단백질 거부, 신경학적인 문제, 및 신장 결석을 동반한 경우 LNS에 대한 감별이 필요하다. 의심이 될 경우 혈청 요산 수치, HPRT 효소 활성도, 그리고 분자 생물학적인 검사가 LNS의 예후를 예측하는데 도움이 될 수 있다.

• 농촌의학ㆍ지역보건
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• 제1권1호
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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.

• Child Health Nursing Research
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• 제4권1호
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• pp.60-75
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• 1998

The parents have much expectation upon the pregnancy and child birth, and in most cases, they expect the healthy parturient child. However, we can be placed on the high-risk conditions which have the physical, social and immature infant, due to the unexpected results, among the new-born. Accordingly, these high-risk newborn and premature infants will be mostly in NICU, which the concentrated medical treatment can be given, upon their conditions. After their birth and during these periods, they will be divided from the parents, and the nurse will accomplish the bringing-up activities which they can take care of the infant, expected by the parents after their birth. The hospitalization of high-risk newborn including these premature infants is the shocking experience to the parents of family, and thus they can feel the fear and uneasiness, and these reactions of parents are troubled in the behavior at the usual days, and cause the disorder and spiritless status, and these results break the supporting ability of parents, and cause the obstruction. Also, the unavoidable division between the parents and the children as like hospitalization of children can make the parents to feel the alienation emotionally, and this causes the results which the pride on the bringing-up ability of baby gets to be lost. These problems can cause the difficulties on the bonding or the parenting in the further days, and can be related to the neglect and abuse of children. Also, it is gradually increased to study and report which the emotional division by the physical division between the mother and the baby obstructs the normal affection course between the parent and the infant. The stress caused by the birth and the hospitalization of high-risk newborn, as like this, is important in the points which it can uncertainly affect the potential energy for the relationship of parent-child who are finally healthy. Accordingly, the significance and purpose of this study are to understand the contents and degree of stress which the parents of high-risk newborn including the immature child can be experienced from the hospitalization of ICU for their new borns, and thus to offer the basic program to the nursing intervention program for these. The subject of this study is the mother of newborn in NICU of 10 General Hospitals located at the 3one of Pusan, Korea from September 1997 to October 1997, and thus makes the subject of 95 person of parents who agreed to take part in the study and it is descriptive study related to the stress of mother having the newborn in NICU. The method is based on the preceding study related to the stress of mother having the experience of child hospitalization and chronic disease child, and then acquires the advice of specialists group as like 5 nursing professors, and then is amended and supplemented. Total number of questions is 43 items and consists of 5 factors as like medical treatment &nursing procedures, disease status & prognosis, role of parents, communication & inter-personal relationships, hospital environment, and is 5 point Likert Scale. The reliability of this study method is very highly shown to be Cronbach α=0.95. The collected data is analysed as Average, Frequency, Standard Deviation, T-test, ANOVA, Pearson Correlation Coefficient, Duncan multifulrange test by use of SPSS /PC (V7.5). The results of this study is summarized as under. 1. Every characteristics of subject is which the party of mother is 28.70age(±7.48) in the average ages, 51% in the high-school graduate, 38.5% in the christianity, total monthly income is 212.55 thousand won(±1.971), 74.5% in the housewife, 72.9% in the parents and children together living and the number of children to be 1.48person(± 0.6) in average, the recognition on the prognosis of baby is 74.0% in 'Don't know', the relationship with the husband after the hospitalization of babyis 37.3% in 'More Intimate', the relationship with the family of husband to be 48% in 'No-change', and the degree which is consulted with the husband about the baby is 55% in 'very frequently' and the visiting number per week is 4.59(±1.63) in average and the accompanying person in the time of visiting is which the number of husband is 56.3% and thus is the highest. The characteristics of baby is which the age is 21.88days(±16.47) after the birth in average, the sex to be 50 person in the female 52.1% and the order of birth to be 54.2% in the first chid, and the weight in the birth to be 2770gm(±610) and the height in the birth to be 46.26cm(±7.62) in aver age. The medical diagnosis is 37.5% in the premature infant, the career of hospitalization is 96.9% in 'None', and the operation plan is 90.6% in 'None' and the execution of operation is 88% in 'None' and the nursing of incubator is 55.2% in 'Yes', and the method of feeding is 50.5% in 'Oral' and the contents of feeding is 46.9% in the 'Milk'. 2. The total stress degree of subject is almost highly shown to be as 3.36(±0.86). If it is compared upon each cause, 'stress on disease status & prognosis' is highest 3.79(±1.28), and it is in the order of 'stress on medical treatment & nursing procedures' 3.70(±0.93), 'stress on hospital environment' 3.14(±0.86), 'stress on role of parents' 3.18(±0.92) and 'stress on communication & inter personal relationship' 2.62(± 0.77) 3. As the results of checking the notworthiness of stress degree upon each variable of subject, the variable showing the noted difference was the birth weight(γ=-0.16, P=0.04), birth height(γ=-0.23, P=0.03), nursing in the incubator(F=8.93, P=0.04), feed method(F=2.94, P=0.04). That is to say, it is shown which the smaller the birth weight is, the higher the stress degree of mother is noteworthily. Also, the smaller the birth height baby is, the higher the stress of mother is. In the incubator, it os shown which the mother whose baby is nursing in the incubator is higher in the stress degree than other mothers. Upon the feeding method of baby, that is to say, TPNis the highest, and it is shown in the order of NPO, Tube feeding, and P.O. feeding. When we review the above-mentioned results, as the status is serious, it is thought which we include the supporting nursing for coping with the stress of parents in the setting-up od nursing plan for the baby in the NICU.

• 한국가금학회지
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• 제33권3호
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• pp.171-179
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• 2006

이 연구는 한국 재래 닭에서 부화 후 고환 발달 과정을 명확하게 이해가기 위하여 부화 후 1, 2, 4, 6, 8, 10, 12, 14, 16, 18, 21, 28, 32, 44, 52 및 64주령(n=13마리/일령)의 한국 재래닭을 이용하여 수행하였다. 한국 재래 닭의 고환은 2.5 % glutaraldehyde를 이용하여 전신 관류 고정하고 조직 처리 과정을 거쳐 Epon-araldite에 포매하였다. 초박절편기를 사용하여 $1{\mu}m$로 절편한 다음 methylene blue로 염색하여 일반적인 조직의 변화상과 형태 계측을 일반적인 방법에 따라서 정자 생성을 측정하여 다음과 같은 결과를 얻었다. 부화 후 1주령의 고환의 평균 무게는 0.015 g이었고 점진적으로 증가하여 21주령에는 3.93 g이고 21주령부터 64주령까지는 변화가 없었다. 곱슬정세관의 용적 치밀도는 1주령에 32.6%이었으나 점차적으로 증가하여 64주령에서는 92.89이었다. 1주령의 한국 재래 닭 고환 간질 조직은 고환 실질의 67.4%를 나타내었고 이러한 비율은 성장하는 동안에 점차적으로 감소하여 64주령에 7.11%를 나타내었다. 고환내 총 정자 생성은 18주령부터 28주령까지는 유의성있게 증가하였고 고환 1g당 정자 생성은 $18\sim28$주령까지는 유의성있게 증가하였고 $28\sim52$주령까지는 변화가 없었으나 64주령에 유의성 있게 감소하였다. 곱슬정세관의 평균 직경은 $1\sim21$주령까지 주령에 따라 점진적으로 증가하였고 곱슬정세관의 길이는 1주령에 0.34 m이었고 성장하면서 유의성 있게 증가하여 64주령에서는 72.2 m이었다. 곱슬정세관내 생식세포의 발달 단계는 다음과 같이 분류할 수 있다. 1) 정조세포($1\sim8$주령), 2) 정조세포, 정모세포($10\sim12$주령), 3) 정조세포, 정모세포, 원형의 정자세포($14\sim16$주령), 4) 정조세포, 정모세포, 정자세포 및 정자($18\sim64$주령). 이러한 결과를 종합하여 보면 한국 재래 닭에서 부화 후부터 성숙시기까지 고환 발달의 양상은 신생시기-성 성숙 이전기($1\sim12$주령), 성 성숙시기($14\sim18$주령) 및 성숙시기$(21\sim64)$로 나뉜다.

• Child Health Nursing Research
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• 제5권1호
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• pp.70-83
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• 1999

The birth of a premature infant is distressing for its parents. The parents of a premature infant experience stress according to the infant's physical appearance and behavior, the environment of the neonatal intensive care unit (NICU) , and the alteration in the parental role. Especially, a mother of a premature infant feels distressed even after the discharge of the infant : therefore, she has difficulties in maternal role performance. The main purpose of this study is to identify the effects of the planned infant care information program in order to lower the stress level for mothers of premature infants caused by the birth and hospitalization in NICU of premature infants, to reduce the maternal role strain, and to promote the maternal role performance after the infants' discharge. This study employed two methods of research at the same time : quasi -experimental non-equivalent pre and post test to compare : non-equivalent post test to compare. The total number of subjects was 19 who were assigned to the research program : 12 mothers of premature infants at the NICU at the Ch university hospital and 7 at the NICU at the Y general hospital located in Chounju city. The data were collected for 79 days from August 18 to November 5, 1998. The questionnaire method was applied for the data collection, and the measures used in this study were Parental Stressor Scale : NICU(Miles, 1993), the Maternal Role Strain Measures ( Hobbs, 1968 ; Steffensmeier, 1982) , and Self Confidence Scale (Pharis, 1978). Research procedure is as follows : after preliminary examination, the experimental subjects, the mothers of premature infants at the Nl CU at Ch university hospital were provided with slide films and information developed by the researcher based on existing documents and data. It took two 60-minute sessions a week for two weeks, and the mothers' stress level was measured using the same instrument twice one week and two week after the infants' hospitalization. The stress level of the contrast subjects, the mothers at Y general hospital was measured during the same period. The experimental subjects were provided with booklets on matters that require attention after the infants' discharge and on developmental project, and they were educated to play the maternal role in person for 2-3 hours a week : breast-feeding, burping a baby, and changing diapers. One week after the infants' discharge, the maternal role strain and the maternal role performance were examined in two groups of the subjects. The analysis of collected data was done using descriptive statistics including real numbers, percentages, averages, and standard deviations. Mann-Whitney test ; x² test ; Repeated Measures Analysis of Variance ; ANCOVA Spearman's rho correlation coefficients. The results on this study were as follows. (1) The examination of the same quality showed that there were no differences in the general and obstetrical characters between the two groups. However, in terms of the characters of premature infants. just right after their birth, the infants at the contrast group weighed more than those at the experimental group(U=16.5, p=.02), and the former was in mother's womb longer than the latter(U=15.5, p=.02). (2) The stress level of the mothers provided with the plannned nursing intervention program became lower as time passed compared to the others'(F=16.61, p=.00) Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the mothers' stress levels made a statistical difference 2 weeks after the infants' hospitalization depending on treatment (F=8.00, p=.01) (3) The maternal role strain of the mothers provided with the planned nursing intervention program was lower than the others'(U=2.0, p=.00). Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the maternal role strain levels made a statistical difference 2 weeks after the infants' hospitalization, depending on treatment(F=14.72, p=.00). (4) The maternal role performance level of the mothers provided with the planned nursing program was higher than the others'(U=.0, p=.00). Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the mothers' stress levels made a statistical difference 2 weeks after the infants' hospitalization, depending on treatment(F=8.00, p=.01). (5) The correlation between a mother's stress level 2 weeks after her infant's hospitalization, the maternal role strain and the maternal role performance were compared : the stress and the maternal role strain were statistically irrelevant to each other(r=.33, p=.12) : the stress was found to be in inverse proportion to the maternal role performance(r=-.53, p=.02). The maternal role strain was in inverse proportion to the maternal role performance as well(r=-.50, p=.00). In conclusion, for the mothers provided with the planned nursing intervention program, their stress level was getting lower as time passed during the infants' hospitalization, their maternal role strain reduced when they took care of their infants after their discharge, and their maternal role performance level was high compared to the other mothers. Besides, the lower the stress level of mothers of premature infants was during the infants' hospitalization, the higher the maternal role performance after their discharge was. The lower maternal role strain was, the higher the maternal role performance was as well. These results of the study suggested that the nursing intervention program for the mothers of premature infants developed by the researcher would be effectively applied to nursing practice, and it would be a foundation for the development of this kind of program.

• Clinical and Experimental Pediatrics
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• 제45권5호
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• pp.596-602
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• 2002

목 적 : 체순환에서 중성구수의 감소는 과립구에 의해 발생하는 폐손상에서 공통적으로 발견되는 소견으로, 특히 말초 혈액에서 중성구 감소와 폐실질로의 중성구의 이동은 다양한 정도의 호흡 장애와 관련된 것으로 알려져 있다. 저자들은 조산아에서 생후 2시간내에 시행한 말초 혈액 검사에서 중성구수의 감소와 호흡 부전증과의 연관성을 알아보고자 본 연구를 시행하였다. 방 법 : 출생체중 500 gm에서 1,350 gm 사이의 조산아로 1993년 1월에서 1999년 12월까지 방지거병원에서 출생한 97례 중, 중성구수에 영향을 미칠 수 있는 경우를 제외한 44례를 대상으로 생후 2시간 이내 중성구수가 $1.0{\times}10^9/L$ 미만인 경우를 중성구 감소군 (17례), $1.0{\times}10^9/L$ 이상인 경우를 중성구 비감소군(27례)으로 나누고 후향적인 임상적 고찰을 통해 연구를 시행하였다. 재태연령, 출생체중, 분만방식, 1분 및 5분 Apgar점수를 조사하여 기록하였고, 환아의 입원기간, 기계적 환기요법 기간, 산소 보충요법 기간, 최고 흡기압력, 최고 인공환기 횟수, 최고 흡기농도 등의 호흡지표와 동맥관 개존증의 유무, 폐렴, 기흉, 신생아 호흡부전증, 기관지폐 이형성증, 뇌실내출혈, 미숙아 망막증의 유무를 연구하였다. 결 과 : 중성구 감소군의 출생체중은 $1,046.50{\pm}180.76gm$, 1분 Apgar점수는 $3.41{\pm}1.18$, 5분 Apgar 점수는 $5.41{\pm}0.87$이었고, 중성구 비감소군에서는 출생체중 $1,156.70{\pm}124.99g$, 1분 Apgar점수는 $4.30{\pm}1.46$, 5분 Apgar점수는 $6.15{\pm}0.95$로 출생체중(P=0.021)과 1분 및 5분 Apgar점수(P=0.049, P=0.024)에서 통계적 유의성을 나타냈다. 또한, 신생아 호흡부전증의 발생은 두 군간에 차이가 없었고, 기관지폐 이 형성증은 중성구 감소군에서 12례로 중성구 비감소군의 7례보다 유의하게 많이 발생하였다(P=0.0036). 그리고 재원기간에서 각각 $55{\pm}25$일, $29{\pm}15$일로 나타 났으며 기계적 환기요법기간에서는 각각 $41{\pm}20$일, $29{\pm}16$일, 그리고 산소 보충요법 기간에서는 각각 $35{\pm}18$일, $23{\pm}13$일로 유의한 차이를 보였다(P=0.014). 그리고 동맥관 개존증, 뇌실내 출혈, 미숙아 망막증, 폐렴, 기흉, 사망률은 두 군간 다소 차이는 있었으나 통계적 유의성은 발견할 수 없었다. 또한, 두 군간 주요 독립적인 변수은 출생체중(Odds ratio=5.457, 95% CI=1.551-27.525, P=0.0172), 초기 백혈구수(Odds ratio= 8.308, 95% CI=2.054-52.699, P=0.0087), 기관지폐 이형성증(Odds ratio=0.099, 95% CI=0.017-0.397, P=0.0034) 등으로 나타났다. 결 론 : 본 연구에서는 초기 2시간내에 시행한 혈액 검사상 중성구 감소증을 보이는 군에서 기관지폐 이 형성증의 발병이 증가하면서 폐손상이 심해진다는 것을 확인하였다.