• International Area Studies Review
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• v.22 no.1
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• pp.215-235
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• 2018

Policy concerns related to raising fertility rates are not only common interests among the OECD countries, but they are also issues of great concern to South Korea whose fertility rate is the lowest in the world. The fertility rate in South Korea continues to decline, even though most of the national budget has been spent on measures to address this and many studies have been conducted on the increase in the fertility rates. In this regard, this study aims to verify the effectiveness of the detailed factors affecting the fertility rate that have been discussed in the previous studies on fertility rates, and to investigate the overall trend toward enhancing the quality of life and increasing the fertility rate through macroscopic and structural studies under the recognition of problems related to the policy approaches through the case studies of the European countries. Toward this end, this study investigated if a high quality of life in advanced countries contributes to the increase in the fertility rate, which country serves as a state model that has a high quality of life and a high fertility rate, and what kind of social and policy environment does the country have with regard to childbirth. The analysis of the OECD Better Life Index (BLI) and CIA fertility rate data showed that the countries whose people enjoy a high quality of life do not necessarily have high fertility rates. In addition, under the recognition that a country with a high quality of life and a high birth rate serves as a state model that South Korea should aim for, the social characteristics of Iceland, Ireland, and New Zealand, which turned out to have both a high quality of life and a high fertility rate, were compared with those of Germany, which showed a high quality of life but a low fertility rate. According to the comparison results, the three countries that were mentioned showed higher awareness of gender equality; therefore, the gender wage gap was small. It was also confirmed that the governments of these countries support various policies that promote both parents sharing the care of their children. In Germany, on the other hand, the gender wage gap was large and the fertility rate was low. In a related move, however, the German government has made active efforts to a paradigm shift toward gender equality. The fertility rate increases when the synergy lies in the relationship between parents and children; therefore, awareness about gender equality should be firmly established both at home and in the labor market. For this reason, the government is required to provide support for the childbirth and rearing environment through appropriate family policies, and exert greater efforts to enhance the effectiveness of the relevant systems rather than simply promoting a system construction. Furthermore, it is necessary to help people in making their own childbearing decisions during the process of creating a better society by changing the national goal from 'raising the fertility rate' to 'creating a healthy society made of happy families'

• Clinical and Experimental Pediatrics
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• v.51 no.11
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• pp.1165-1171
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• 2008

Purpose : This study aimed to identify the true extent of non-responsiveness in full-term infants born from HBsAg-negative or HBsAg-positive mothers and vaccinated against hepatitis B virus (HBV) at 0, 1, and 6 months of age and to evaluate the effect of revaccination among non-responders. Methods : The study included 716 full-term infants born in 2004-2007. Of 716, 662 infants (A group) were born to HBsAg-negative mothers and 54 infants (B group: 50, except HBsAg-positive infants) were born to HBsAg-positive mothers. All infants were administered DNA recombinant vaccines at 0, 1, and 6 months of age. B group infants received hepatitis B immunoglobulin at birth. Anti-HBs titers were tested at 7-12 and 9-15 months in A and B groups, respectively. Three revaccination doses were administered to non-responders whose anti-HBs titers were under 10 mIU/ml; revaccinated infants were retested at 1-3 months after last vaccination. The association between HBeAg seropositivity of mother and the failure of HBV immunoprophylaxis was evaluated. Results : The seroconversion rates after primary hepatitis B vaccination were higher in A group (94.1%) than in B group (78%, P<0.001). The seroconversion rates were high in revaccinated infants (A group non-responders: 96.9%, B group non-responders: 87.5%). The failure of HBV immunoprophylaxis was significantly associated with maternal HBeAg seropositivity (P<0.001). Conclusion : The seroconversion rates after primary hepatitis B vaccination were low in B group infants. Revaccination of non-responders in B group was very effective. Therefore, anti-HBs testing and revaccination of B group is very important. Revaccination of non-responders in A group was also very effective. Thus, testing the immune status of infants born to HBsAg-negative mothers even after primary hepatitis B vaccination should be considered. However, to realize this, further studies on the cost-effectiveness of anti-HBs testing in healthy full-term infants are necessary.

• Journal of Preventive Medicine and Public Health
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• v.22 no.1 s.25
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• pp.146-152
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• 1989

To test the validity of referral of high risk pregnancy in the MCH Center, 6,017 pregnant women who visited MCH Center of South District Health Center for delivery between 1 April 1985 and 31 March 1987 were interviewed on arrival to obtain the data for demographic characteristics and obsteric history and traced to check the delivery outcome. Out of 5,820 women whose delivery outcomes were confrmed, 704 women(12.1%) were referred to other hospital or clinic for high risk factors. The proportion of poor delivery outcome(stillbirth, low birth weight and neonatal death) among referred cases was 4.4% while that of the women delivered at the MCH Center was 2.2% (p<0.01). Decision of the midwives for the referral of high risk pregnancy based on their clinical assessment was consistent with the delivery outcome (good or poor) in 86.5%. Major reasons for referral were premature rupture of membrane(46.5%) and cephalopelvic disproportion(20.0%) and the C-section rates for these cases were 10.1%, 17.6%, respectively. Discriminant analysis of the demographic characteristics and obstertric history for the discrimination of delivery outcome showed that gestational age had the highest discriminant function coefficient(0.88) and it was followed by parity(0.37) and maternal education(0.30). Referral of high risk pregnancy by the midwives based on their clinical assessment was considered to be reasonably valid. However, a risk scoring system for an MCH Center which can improve the validity may be developed if one applies the discriminant analysis for more comprehensive independent variable(including clinical assessment of midwife, demographic characteristics and obstetric history) and dependent variable (including medically indicated C-section, complication of pregnancy and delivery, stillbirth, low birth weight, neonatal death and maternal death).

• Advances in pediatric surgery
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• v.1 no.2
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• pp.140-148
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• 1995

To study the clinical profiles and outcome of surgery in infants with esophageal atresia, we reviewed 96 esophageal atresia cases who were treated from April, 1978 to June, 1995. There were 51 male and 45 female infants, a ratio of 1.1:1. The low birth weight(<2500g) patients were 32%. Clinical findings at the time of diagnosis included drooling in 57%, choking in 50%, cyanosis in 38%, respiratory distress in 27% and swallowing difficulty in 20%. Gross classification included 6 cases of type A esophageal atresia(6%), 79 cases of type C(82%), 3 cases of type E (3%) and 8 cases of type F(8%). Associated anomalies occurred in 34 infants(35%). Among them, cardiac anomalies were most common(60%). A primary repair of the defect was carried out in 76 patients with type A or C. A staged operation comprising a repair or gastric tube interposition after gastrostomy was performed in 8 patients. In all 3 infants with H-type, a division of fistula was performed. Esophageal resection and anastomosis was done in 8 infants with esophageal stenosis. In one infant, a gastrostomy was performed and he expired before staged operation. Anastomotic complications included leakage in 16 cases(17%), stricture in 37 cases(39%) and recurrent tracheoesopohageal fistula in 3 cases(3%). The mortality rate was 14% and the leading cause of death was pneumonia. The overall survival rate was 86%, and according to Waterston criteria, the survival rates were 93%, 85% and 58% in class A, Band C, respectively. 75 patients were followed up with median follow up 6.4 years. Among them, 93% were uneventful and 7% had frequent pneumonia.

• Clinical and Experimental Pediatrics
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• v.53 no.6
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• pp.694-700
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• 2010

Purpose: To assess the validity of individual and combined prognostic effects of severe bronchopulmonary dysplasia (BPD), brain injury, retinopathy of prematurity (ROP), and parenteral nutrition associated cholestasis(PNAC). Methods: We retrospectively analyzed the medical records of 80 extremely low birthweight (ELBW) infants admitted to the neonatal intensive care unit (NICU) of the Severance Children's Hospital, and who survived to a postmenstrual age of 36 weeks. We analyzed the relationship between 4 neonatal morbidities (severe BPD, severe brain injury, severe ROP, and severe PNAC) and poor outcome. Poor outcome indicated death after a postmenstrual age of 36 weeks or survival with neurosensory impairment (cerebral palsy, delayed development, hearing loss, or blindness) between 18 and 24 months of corrected age. Results: Each neonatal morbidity correlated with poor outcome on univariate analysis. Multiple logistic regression analysis revealed that the odds ratios (OR) were 4.9 (95% confidence interval [CI], 1.0-22.6; $P$=0.044) for severe BPD, 13.2 (3.0-57.3; $P$<.001) for severe brain injury, 5.3 (1.6-18.1; $P$=0.007) for severe ROP, and 3.4 (0.5-22.7; $P$=0.215) for severe PNAC. Severe BPD, brain injury, and ROP were significantly correlated with poor outcome, but not severe PNAC. By increasing the morbidity count, the rate of poor outcome was significantly increased (OR 5.2; 95% CI, 2.2-11.9; $P$<.001). In infants free of the above-mentioned morbidities, the rate of poor outcome was 9%, while the corresponding rates in infants with 1, 2, and more than 3 neonatal morbidities were 46%, 69%, and 100%, respectively. Conclusion: In ELBW infants 3 common neonatal mornidifies, severe BPD, brain injury and ROP, strongly predicts the risk of poor outcome.

• Asian-Australasian Journal of Animal Sciences
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• v.28 no.9
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• pp.1259-1265
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• 2015

The present study was performed to study the genetic relationship of productive life with production and type traits of Korean Holsteins at first three lactations. The data for the analysis from 56,054, 28,997, and 11,816 animals of first, second and third parity cows which were born from 2006 to 2011 were collected by Dairy Cattle Improvement Center, National Agricultural Co-operative Federation. Milk, protein and fat yields adjusted for 305 days and average somatic cell score considered as production traits and analyzed type traits were stature, strength, body depth, dairy form, rump angle, rump width, rear leg side view, foot angle, front attachment placement, rear attachment height, rear attachment width, udder cleft, udder depth, front teat placement and front teat length. A multi trait genetic analysis was performed using Wombat program with restricted maximum likelihood animal model composed of fixed effect of birth year, farm and the random effect of animal and random residual effect according to the traits. Heritability estimates of productive life were between 0.06 and 0.13. Genetic and phenotypic correlations between production and productive life traits ranged from 0.35 to 0.04 for milk, 0.16 to 0.05 for protein and 0.18 to 0.02 f 15-0034 (2nd) 150520 or fat. Somatic cells score showed a negative genetic and phenotypic correlation with productive life and also udder type traits, indicating that the selection for higher udder traits will likely to improve resistance to mastitis and persistence in the herd. Among all dairy form type traits, udder characters such as udder cleft showed a significant relationship with productive life. However, a specific change of heritabilities or correlations were not observed with the change of parity. Moreover, further studies are needed to further confirm the significance of the above traits and the effect of parity on above relationships in order to minimize both voluntary and involuntary culling rates while improving herd health and maintaining high yielding dairy cows.

• Asian-Australasian Journal of Animal Sciences
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• v.30 no.4
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• pp.585-592
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• 2017

Objective: The present study investigates pre- and post-implantation developmental competence of nuclear-transferred porcine embryos derived from male and female fetal fibroblasts. Methods: Male and female fetal fibroblasts were transferred to in vitro-matured enucleated oocytes and in vitro and in vivo developmental competence of reconstructed embryos was investigated. And, a total of 6,789 female fibroblast nuclear-transferred embryos were surgically transferred into 41 surrogate gilts and 4,746 male fibroblast nuclear-transferred embryos were surgically transferred into 25 surrogate gilts. Results: The competence to develop into blastocysts was not significantly different between the sexes. The mean cell number of female and male cloned blastocysts obtained by in vivo culture ($143.8{\pm}10.5$ to $159.2{\pm}14.8$) was higher than that of in vitro culture of somatic cell nuclear transfer (SCNT) groups ($31.4{\pm}8.3$ to $33.4{\pm}11.1$). After embryo transfer, 5 pregnant gilts from each treatment delivered 15 female and 22 male piglets. The average birth weight of the cloned piglets, gestation length, and the postnatal survival rates were not significantly different (p<0.05) between sexes. Conclusion: The present study found that the sex difference of the nuclear donor does not affect the developmental rate of porcine SCNT embryos. Furthermore, postnatal survivability of the cloned piglets was not affected by the sex of the donor cell.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.11
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• pp.5011-5017
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• 2016

Background: Cervical cancer is a major public health problem worldwide. There have been several studies indicating that risk is associated with geographic location and that the incidence of cervical cancer has changed over time. In Thailand, incidence rates have also been found to be different in each region. Methods: Participants were women living or having lived in upper Northern Thailand and subjected to cervical screening at Maharaj Nakorn Chiang Mai Hospital between January 2010 and December 2014. Generalized additive models with Loess smooth curve fitting were applied to estimate the risk of cervical cancer. For the spatial analysis, Google Maps were employed to find the geographical locations of the participants' addresses. The Quantum Geographic Information System was used to make a map of cervical cancer risk. Two univariate smooths: x equal to the residency duration was used in the temporal analysis of residency duration, and x equal to the calendar year that participants moved to upper Northern Thailand or birth year for participants already living there, were used in the temporal analysis of the earliest year. The spatial-temporal analysis was conducted in the same way as the spatial analysis except that the data were split into overlapping calendar years. Results: In the spatial analysis, the risk of cervical cancer was shown to be highest in the Eastern sector of upper Northern Thailand (p-value <0.001). In the temporal analysis of residency duration, the risk was shown to be steadily increasing (p-value =0.008), and in the temporal analysis of the earliest year, the risk was observed to be steadily decreasing (p-value=0.016). In the spatial-temporal analysis, the risk was stably higher in Chiang Rai and Nan provinces compared to Chiang Mai province. According to the display movement over time, the odds of developing cervical cancer declined in all provinces. Conclusions: The risk of cervical cancer has decreased over time but, in some areas, there is a higher risk than in the major province of Chiang Mai. Therefore, we should promote cervical cancer screening coverage in all areas, especially where access is difficult and/or to women of lower socioeconomic status.

• Journal of Nutrition and Health
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• v.24 no.4
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• pp.366-377
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• 1991

A retrospective cohort study of low- income households was carried out on 679 mother-infant pairs to see the effect of weaning practices on growth between March, 1987 and January, 1988 in one rural area, one small city, and one big city, by measuring weight and height of children and intervewing mothers. The sample children showed a linear growth retardation from around 7 or 8 month based on WAZ and HAZ using the Korea Growth Standard. After adjusting both for birth-weight/length and morbidity effect, the ANCOVA test showed that :1) infants who were given supplements were not greater than those of not given. 2) infants who were eating supplements more frequently did not show a larger WAZ or HAZ than those of not eating or sometimes eating them. 3) The caloric intake rates of those of higher food frequencies were not greater than those of lower food frequencies. The context of nutrition education about weaning practices has to be changed stressing not only the early introduction of supplements but also the adequate amount of food intake to secure the rapid growth at this critical age.

• Journal of Environmental Health Sciences
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• v.43 no.3
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• pp.167-175
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• 2017

Objectives: Children may be more exposed to certain environmental contaminants because they react with greater sensitivity and have different food intakes and breathing rate per unit of body weight compared to adults. The aim of this study was to determine general exposure factors such as skin surface area, period and frequency of exposure, and others among Korean children aged ${\leq}18$ years old. This study was carried out as the first of its kind in Korea. Methods: We developed 23 recommended exposure factors for Korean children aged 0 to 18 years by reclassifying raw data from the National Health and Nutrition Examination Survey and the National Statistical Information Service, as well as through investigation by experiments in the absence of related data. Results: Reflecting the activity patterns of about 9,000 children, the daily inhalation rates for long-term exposure ranged from $9.49m^3/day$ for children from birth to <2 years to $14.98m^3/day$ for children aged 16 to <18 years. The research found that Korean children spent an average of 22.21 hours indoors, 0.67 hours outdoors, and 1.12 hours in-transit every day. Young children (${\leq}2$ years old) spent approximately 34 more minutes outdoors on weekends than they did on weekdays. Conclusion: Various physiological variables in the human body reflect characteristics of children that can directly influence risk exposure. Therefore, the identification of general exposure factors based on Korean children is required for appropriate risk assessment.