• Archives of Plastic Surgery
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• 제43권2호
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• pp.153-159
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• 2016

Background The prenatal ultrasound detection of cleft lip with or without cleft palate (CL/P) and its continuous management in the prenatal, perinatal, and postnatal periods using a multidisciplinary team approach can be beneficial for parents and their infants. In this report, we share our experiences with the prenatal detection of CL/P and the multidisciplinary management of this malformation in our institution's Congenital Disease Center. Methods The multidisciplinary team of the Congenital Disease Center for mothers of children with CL/P is composed of obstetricians, plastic and reconstructive surgeons, pediatricians, and psychiatrists. A total of 11 fetuses were diagnosed with CL/P from March 2009 to December 2013, and their mothers were referred to the Congenital Disease Center of our hospital. When CL/P is suspected in the prenatal ultrasound screening examination, the pregnant woman is referred to our center for further evaluation. Results The abortion rate was 28% (3/11). The concordance rate of the sonographic and final diagnoses was 100%. Ten women (91%) reported that they were satisfied with the multidisciplinary management in our center. Conclusions Although a child with a birth defect is unlikely to be received well, the women whose fetuses were diagnosed with CL/P on prenatal ultrasound screening and who underwent multidisciplinary team management were more likely to decide to continue their pregnancy.

• Neonatal Medicine
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• 제25권4호
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• pp.161-169
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• 2018

Purpose: We assessed the influence of antenatal corticosteroid (ACS) on the inhospital outcomes of intrauterine growth restriction (IUGR) infants. Methods: A retrospective study was conducted with singletons born at $23^{+0}$ to $33^{+6}weeks$ of gestation at Seoul National University Hospital from 2007 to 2014. We compared clinical outcomes between infants who received ACS 2 to 7 days before birth (complete ACS), at <2 or >7 days (incomplete ACS), and those who did not receive ACS in IUGR and AGA infants. Multivariate logistic regression using Firth's penalized likelihood was performed. Results: 304 neonates with 91 IUGR neonates were eligible. Among AGA neonates, mortality (adjusted odds ratio [aOR], 0.13; 95% confidence interval [CI], 0.02 to 0.78), hypotension within 7 postnatal days (aOR, 0.20; 95% CI, 0.06 to 0.64), and severe bronchopulmonary dysplasia (BPD) or death (aOR, 0.24; 95% CI, 0.07 to 0.77) were lower in complete ACS group after adjusting for pregnancy induced hypertension and uncontrolled preterm labor. Mortality (aOR, 0.18; 95% CI, 0.04 to 0.78), hypotension (aOR, 0.26; 95% CI, 0.09 to 0.70), and severe BPD or death (aOR, 0.33; 95% CI, 0.12 to 0.92) were also lower in the incomplete ACS group. Among IUGR infants, after adjusting for birth weight and 5-minute Apgar score, inhaled nitric oxide use within 14 postnatal days was lower in both complete ACS (aOR, 0.07; 95% CI, 0.01 to 0.67) and incomplete ACS (aOR, 0.04; 95% CI, 0.01 to 0.37) groups. Conclusion: ACS was not effective in reducing morbidities in IUGR preterm infants.

• Journal of mucopolysaccharidosis and rare diseases
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• 제2권1호
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• pp.5-7
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• 2016

Mucolipidoses II and III alpha/beta (ML II and ML III) are lysosomal disorders in which the essential mannose-6-phosphate recognition marker is not synthesized onto lysosomal hydrolases and other glycoproteins. The disorders are caused by mutations in GNPTAB, which encodes two of three subunits of the heterohexameric enzyme, N-acetylglucosamine-1-phosphotransferase ML II, recognizable at birth, often causes intrauterine growth impairment and sometimes the prenatal "Pacman" dysplasia. The main postnatal manifestations of ML II include gradual coarsening of neonatally evident craniofacial features, early cessation of statural growth and neuromotor development, dysostosis multiplex and major morbidity by hardening of soft connective tissue about the joints and in the cardiac valves. Fatal outcome occurs often before or in early childhood. ML III with clinical onset rarely detectable before three years of age, progresses slowly with gradual coarsening of the facial features, growth deficiency, dysostosis multiplex, restriction of movement in all joints before or from adolescence, painful gait impairment by prominent hip disease. Cognitive handicap remains minor or absent even in the adult, often wheelchair-bound patient with variable though significantly reduced life expectancy. As yet, there is no cure for individuals affected by these diseases. So, clinical manifestations and conservative treatment is important. This review aimed to highlight the extra-skeletal clinical problems in ML II and III.

• 대한간호학회지
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• 제34권5호
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• pp.722-728
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• 2004

Purpose: This study was designed to determine the predictors of postpartum depression. Method: One hundred-sixty one women within one year after delivery from one public health center located in the northern area of Seoul were used in this study. The instruments were a survey of general characteristics, the Edinburgh Postnatal Depression Scale, recent life events index, perceived social support from family, Quality of marriage index, parenting stress index, and Rosenberg's self-esteem inventory. Data was analysed using descriptive statistics, Pearson correlation coefficients, and logistic regression. Result: The average item score of the EPDS was 6.67. 12.4% of respondents, who scored above a threshold 12, were likely to be suffering from a depression of varying severity. The fitness of the model for explaining postpartum depression from six variables, plan for pregnancy, family support, quality of marital relation, perceived social support, life events, childcare stress, and self-esteem, was statistically significant and the predictive power of these variables was 90.9%. The significant predictors of postpartum depression were family support and child care stress. Conclusion: Further research is needed to identify the prevalence rate of postpartum depression using more reliable sampling methods from a large general population. Nursing interventions need to be developed for promoting family support and reducing childcare stress.

• Child Health Nursing Research
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• 제28권2호
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• pp.103-111
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• 2022

Purpose: This study investigated the physical and emotional health of South Korean mothers of preterm infants in the early postpartum period. Methods: In this descriptive correlational study, the participants included 91 mothers of preterm infants who were admitted to the neonatal intensive care unit of a tertiary hospital in South Korea. Physical health status was measured using a self-reported questionnaire, postpartum depression using the Edinburgh Postnatal Depression Scale, anxiety using the State-Trait Anxiety Inventory, and guilt using a 4-item scale. Results: Fatigue had the highest score among mothers' physical health problems, followed by shoulder pain, nipple pain, neck pain. The average postpartum depression score was 11.02 points, and 44% of women had postpartum depression with a score of 12 or above. Postpartum depression significantly was correlated with physical health (r=.35, p=.001), anxiety (r=.84, p<.001), and guilt (r=.75, p<.001) and was significantly higher for women with multiple births, and preterm infants who required ventilator and antibiotic treatment. Anxiety also showed a significant difference according to preterm infants' condition. Conclusion: The significant correlations between postpartum depression and physical health, anxiety, and guilt indicate a need for nursing interventions that provide integrated management of mothers' physical and emotional health.

• Journal of Preventive Medicine and Public Health
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• 제9권1호
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• pp.39-47
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• 1976

The organized community is the one of the best system for the effective public health administration, and a model area was selected for the study to see what would be achieved when a certain small community is placed under the special public health control based on the family unit. The 178 families involved total of 875 populations. The rate of vaccination with B.C.G. among 191 infants and children could be increased upto 100.0% from 72.5% of the time when the basic study was performed after 8 months period of this study; 99.0% from 47.1% with D.P.T.; 96,9% from 71.7% against smallpox; 83.2% from 69.1% against poliomyelitis; but only 25,7% from 21.5% against measles. The status of family planing was 36.8% among 155 women of possible conception at the time of the basic research. And, at the end of this study, the number of women utilizing one of the methods of contraception for family planning were increased upto 52.9% among the same number. The most frequently utilized method was 34.1% of oral pills followed by 30.5% of intrauterine device; but both of which had higher rate of interruption of use because of the complications, 14.3% and 16.0% respectively. The 10 pregnant women at the time of basic research experienced normal deliveries during the period of study and they had received pre and postnatal health care through this health center. The status of oral hygiene, pulmonary tuberculosis control, and parasitological examination were also reported as well as the cases with diseases seen among the population and vaccinations performed against other infectious diseases. The stress on discussion was placed upon the effectiveness of public health administration when it is undergone on the individual family unit to achieve the best results. However, the shortness of both personnel and material resources were considered to be the one of the major difficulties retarding the generalization of the idea obtained through this study based on family unit public health administration.

• 여성건강간호학회지
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• 제25권3호
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• pp.315-328
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• 2019

Purpose: The purpose of this study was to explore the components and nature of happiness in middle-aged women in Korea. Methods: Thirty middle-aged women living in metropolitan Seoul and Gyeonggi and Chungcheong provinces agreed to participate in this study. The data were collected through in-depth interviews with the participants in one-on-one settings. The data were analyzed qualitative using Colaizzi's method of phenomenology. Results: The three theme clusters were extracted from the raw data, along with 13 themes and 138 meaningful sentences and phrases. The three happiness theme clusters in middle-aged women were "live healthy for stability," "rule one's mind for harmony," and "activate hopes for self-esteem." The first theme cluster included healthy life, economic stability, physical youth, and positive thought. The second theme cluster included that harmonious family, ruling of mind, my position as invisible person in social relationships, and precious relationships to support. The last theme included the center of one's life is oneself, a sense of accomplishment, self-improvement, recognition of one's worth and rest for one self. The three theme clusters were associated with the existence, relatedness, and growth (ERG) of ERG areas, respectively. Conclusions: We conclude that the core components of happiness in middle-aged women are to live healthy and mind-ruled and activate hope. The nature of happiness is egocentric stability in middle-aged women. The results suggest that theme clusters might be used to develop a scale for measuring happiness in middle-aged women. This will be helpful to assess the psychosocial status of middle-aged women in Korea.

• Neonatal Medicine
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• 제16권2호
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• pp.182-189
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• 2009

목 적 : 최근 multiplex RT-PCR의 개발로 급성 호흡기 감염에서 바이러스의 검출이 용이해졌다. 지금까지 respiratory syncytial virus (RSV)에 대한 연구는 많았지만 이전에 건강했던 신생아나 미숙아로 출생한 어린 영아에 대한 연구는 많지 않고 더욱이 이들에서의 다른 호흡기 바이러스에 대한 연구는 거의 없다. 저자들은 신생아집중치료실에 입원한 급성 호흡기 감염 환아를 대상으로 바이러스를 검출하고 다른 바이러스와 비교한 RSV 감염의 특성을 알아보고자 하였다. 방 법 : 신생아집중치료실에 급성 호흡기 감염으로 입원하여 multiplex RT-PCR을 시행한 환아를 대상으로 전향적 관찰 연구를 시행하였다. 모든 환아를 RSV군과 RSV가 검출되지 않은 No RSV 군으로 나누어 인구학적 특징과 임상양상 및 혈액검사와 흉부X-선 검사결과를 비교하였다. 결 과 : RSV 군은 23명(50%)이었다. Rhinovirus는 15.2%로 두 번째로 많이 검출되었다. RSV는 1월과 2월에, rhinovirus는 4월에 중점적으로 발생하였다. 중복감염 된 환아는 세 명(6.5%)이었다. 미숙아 수와 형제가 있거나 흡연에 노출 된 경우는 두 군간 차이가 없었으나 RSV 군에서 조리원 감염이 유의하게 많았다(60.9% vs. 21.7%, P=.007). RSV 군에서 No RSV 군에 비해 호흡곤란(34.8% vs. 8.7%, P=.032)과 폐렴(73.9% vs. 43.5%, P=.036)으로 입원한 환아가 많았고 산소 투여(52.5% vs. 13.0%, P=.005)와 금식(43.5% vs. 13.0%, P=.022)이 필요한 경우가 많았다. 우측상엽의 침윤도 RSV 군에서 많았다(56.5% vs. 8.7%, P=.001). 결 론 : 신생아나 미숙아로 출생했던 어린 영아는 RSV 뿐만 아니라 다른 다양한 호흡기 바이러스 감염으로 입원하게 된다. RSV 감염은 다른 감염에 비해 중증도가 높으므로 건강한 신생아에 대해서도 주의를 요하며 특히 조리원 등 밀집도가 높은 곳에서는 철저한 감염예방 관리가 필요하다.

• 대한한방부인과학회지
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• 제23권2호
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• pp.106-115
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• 2010

Purpose: The purposes of this study were in understanding maternal and neonatal risk factors for postpartum depression using Edinburgh Postnatal Depression Scale(EPDS). Methods: Among 788 women, who had delivery include cesarean section in the department of obstetrics and gynecology at OO medical center from May 28th 2008 to October 6st 2009, 72 women filled out EPDS questionnaire sheets. Additional aspects included for the analysis are maternal factors including age, number of children, parity, delivery method, and hemoglobin; and neonatal factors such as weight, sex, gestational age, apgar score, and neonatal intensive care unit admission. Comparison was performed between the women with EPDS score equal or less than 8 and the women with EPDS score equal to or higher than 9 using statistical methods of student t-test for linear variables and chi-square test for non-linear variables. SPSS version 13.0 for windows was used for analysis. Results: Thirty women(41.7%) were included in the postpartum depression risk group (EPDS score ${\geqq}9$). Statistically significant difference(P<0.05) was found in gestational ages of the risk group($36.57{\pm}29.6$ weeks) and the non-risk group ($38.10{\pm}1.97$ weeks). Identified statistically significant risk factors(P<0.05) include cesarean section (OR=3.304 [1.121-9.744]), low birth weight infant(OR =6.500 [1.606-26.314]), preterm delivery(OR=2.857[1.071-7.621]), low apgar score (1minute) after delivery (OR=14.909 [1.750-127.025]). There was no statistically significant difference in maternal age, number of children, parity, hemoglobin, neonatal sex, apgar score (5minutes), NICU admission. Conclusions: Through the results showed, gestational age, delivery method, neonatal weight, apgar score(1minute) were identified as risk factors for postpartum depression. To prevent or minimize postpartum depression, oriental medical intervention is recommended for pregnant women through early detection.

• 대한예방한의학회지
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• 제10권2호
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• pp.81-93
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• 2006

This study was carried out to examine the actual condition of health promotion program through oriental medicine in the health center and to provide basic data to develop proper policy of oriental medical health promotion program for the community people. The data were collected from 26 health centers which have been implementing the oriental medical health promotion program, using selfadministered questionnaire for two weeks from 1 October to 15 October 2006. The results are as follows : Generally, the respondents have the positive views on the level of budget and facilities/equipments of the oriental medical health promotion program in health center. However, they have the negative views on the level of manpower and education/training of the program. And also more than 70% of the respondents have the negative opinion on capabilities of formulating and evaluating the oriental medical health promotion program. The respondents indicated that there was the lack of coordination between the oriental medical health promotion program and existing health promotion in health center, and that low rate of utilizing community resources. With regard to the method of selecting the target group for the program, there are differences according to the each program. Many programs tended to select the target group not through the criteria of life-course and illness group but through the efficiency of selecting group. And many programs such as stroke prevention program, constitutional medicine program, oriental medical prenatal program, oriental medical prenatal and postnatal program, oriental medical child care program are mainly composed of the development of educational program and lecture. Regarding the number of the present oriental medical health promotion programs, around 65% of respondents answered that the number of the programs was many and thus they needed to decrease to the proper level. And with regard to the priority of the need, effectiveness and the satisfaction for each programs, on the whole, Qui gong program, stroke prevention program, area-specialty program and oriental medical home visiting program have high score. In particular, oriental medical quit-smoking program has lowest score. From these results, it requires to develop and improve the oriental medical health promotion program in health center considering the need and characteristics of community.