• Journal of Environmental Health Sciences
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• v.35 no.5
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• pp.343-354
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• 2009

Since Barker found associations between low birth weight and several chronic diseases later in life, the hypothesis of fetal origins of adult disease (aka, Barker Hypothesis) and epigenetics have been emerging as a new paradigm for geneenvironment interaction of chronic disease. Epigenetics is the study of heritable changes in gene silencing that occur without any change in DNA sequence. Gene expression can be regulated by several epigenetic mechanisms, including DNA methylation and histone modifications, which may be associated with chronic conditions, such as cancers, cardiovascular disease, and type-2 diabetes. One carbon metabolism which involves the transfer of a methyl group catalyzed by DNA methyltransferase is an important mechanism by which DNA methylation occurs in promoter regions and/or repetitive elements of the genome. Environmental factors may induce epigenetic modification through production of reactive oxygen species, alteration of methyltransferase activity, and/or interference with methyl donors. In this review, we introduce recent studies of epigenetic modification and environmental factors, such as heavy metals, environmental hormones, air pollution, diet and psychosocial stress. We also discuss epigenetic perspectives of early life environmental exposure and late life disease occurrence.

• Journal of Preventive Medicine and Public Health
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• v.56 no.2
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• pp.111-127
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• 2023

Objectives: Pre-pregnancy diet has an important role in preparing for healthy generation. However, evidence on this issue has been scarce. A scoping review synthesising current evidence will support the demand to map 'what has been researched' on pre-pregnancy diet and maternal and child health. Methods: Systematic search was performed using PICOS (Population, Intervention, Comparison, Outcomes, and Study design) framework in electronic databases. Articles were screened for eligibility, summarized, and the quality was assessed using the National Institute of Health assessment tool. The review structure complies with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guide. Results: Forty-two articles were included after full-text screening. Twenty-five studies were in high-income countries (HICs), six in each upper-middle income, five in lower-middle income countries (LMICs), and one in low-income countries (LIC). Based on the regions: North America (n=16), Europe (n=5), South America (n=4), Australia (n=4), Asia (n=5), Middle East (n=2), and sub-Saharan Africa (n=1). The two-most observed diet-related exposures were dietary pattern (n=17) and dietary quality (n=12). The most assessed outcome was gestational diabetes mellitus (n=28) and fetal and newborn anthropometry (n=7). The average quality score±standard deviation was 70±18%. Conclusions: Research related to pre-pregnancy diet is still concentrated in HICs. The context of diet may vary; therefore, future research is encouraged in LMICs and LICs context, and Mediterranean, South-East Asia, Pacific, and African regions. Some maternal and child nutrition-related morbidity, such as anemia and micronutrient deficiencies, have not been discussed. Research on these aspects will benefit to fill in the gaps related to pre-pregnancy diet and maternal and child health.

• Research in Community and Public Health Nursing
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• v.11 no.2
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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.

• Women's Health Nursing
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• v.21 no.3
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• pp.241-251
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• 2015

Purpose: The purpose of this study was to explore preserved belief system supporting Korean immigrant women's Taekyo practices and influencing factors while they observe the tradition within US sociocultural context. Methods: Leininger's exploratory focused ethnographic approach was used. Semi-structured in-depth interviews were conducted with purposive sample of sixteen Korean immigrant women who gave birth in the US within last 6 months. Researcher's observation and reflective field notes were also integrated into the interview data. Leininger and McFarland's four phases of ethnographic analysis guided data analysis process. Results: The perceived belief system supporting Taekyo practices included Taekyo as an enculturated Korean tradition, connecting parents with fetus, and positive impacts on fetal development. And Korean immigrant women's Taekyo practices were influenced by resources of information, woman's orientation toward Taekyo, pressure from local Korean community, and child order. Conclusion: The findings from this research would serve as an important knowledge base to expand US health care providers' understanding of Korean traditional Taekyo practices observed by Korean immigrant women's as important prenatal self-care practices. The findings could also aid in providing more patient-centered and culturally-tailored prenatal care plan to Korean immigrant by including Korean traditional belief system supporting Taekyo practices.

• Clinical and Experimental Reproductive Medicine
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• v.48 no.4
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• pp.303-310
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• 2021

Decorin (DCN) is a proteoglycan belonging to the small leucine-rich proteoglycan family. It is composed of a protein core containing leucine repeats with a glycosaminoglycan chain consisting of either chondroitin sulfate or dermatan sulfate. DCN is a structural component of connective tissues that can bind to type I collagen. It plays a role in the assembly of the extracellular matrix (ECM), and it is related to fibrillogenesis. It can interact with fibronectin, thrombospondin, complement component C1, transforming growth factor (TGF), and epidermal growth factor receptor. Normal DCN expression regulates a wide range of cellular processes, including proliferation, migration, apoptosis, and autophagy, through interactions with various molecules. However, its aberrant expression is associated with oocyte maturation, oocyte quality, and poor extravillous trophoblast invasion of the uterus, which underlies the occurrence of preeclampsia and intrauterine growth restriction. Spatiotemporal hormonal control of successful pregnancy should regulate the concentration and activity of specific proteins such as proteoglycan participating in the ECM remodeling of trophoblastic and uterine cells in fetal membranes and uterus. At the human feto-maternal interface, TGF-β and DCN play crucial roles in the regulation of trophoblast invasion of the uterus. This review summarizes the role of the proteoglycan DCN as an important and multifunctional molecule in the physiological regulation of oocyte maturation and trophoblast migration. This review also shows that recombinant DCN proteins might be useful for substantiating diverse functions in both animal and in vitro models of oogenesis and implantation.

• Nutrition Research and Practice
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• v.15 no.4
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• pp.492-503
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• 2021

BACKGROUND/OBJECTIVES: Recently, the recommended nutrient intakes (RNI) for vitamin D for Malaysian aged 1-70 yrs has been revised from 5 ㎍/day to 15 ㎍/day. This study is aimed to assess the adequacy of vitamin D intake based on revised RNI and to recommend several dietary strategies to increase total vitamin D intake. SUBJECTS/METHODS: Vitamin D intake from both food and supplement of 217 pregnant women was assessed using a validated food frequency questionnaire. Hypothetical effect of expanded supplementation and food fortifications strategies were modelled using the consumption data. RESULTS: The results revealed that more than half (67.7%) of pregnant women had inadequate vitamin D intake (RNI < 15 ㎍/day). The modelling results demonstrated the potential of universal provision of 10 ㎍/day of multivitamins supplements in increasing vitamin D intake. Moreover, mandatory fortification of both milk and malted drink at single level of 5 ㎍/serving would lead to increase in vitamin D intake of Malaysians, particularly pregnant women. CONCLUSIONS: The outcome of this study can be used as a reference for public health professionals to re-evaluate the existing Malaysian food fortification policies and supplementation recommendation for vitamin D for pregnant women.

• CELLMED
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• v.11 no.3
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• pp.12.1-12.5
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• 2021

Gestational diabetes mellitus (GDM) has become one of the major public health problems for both mothers and children globally. Internationally, the frequency of excess weight and obesity has risen dramatically in women of childbearing age. There seems to be a greater risk of having GDM in overweight or obese women, resulting in problems during pregnancy, birth and neonatal development. Hospital management is a problem for obese pregnant females with GDM and places extra burdens on the healthcare sector. GDM can result in possible risks to the wellbeing of the mother, fetus, and infant, as well as clinically significant negative effects on the mental health of the mother. For females and their developing babies, diabetes may cause problems during pregnancy. Unsatisfactory diabetes control enhances the risk of complications and other birth related issues during pregnancy. It may also cause a woman to suffer severe complications. Numerous maternal and fetal effects are associated with GDM and multiple detection and management methods are also pursued globally in order to reduce the burden of health. An overview of gestational diabetes treatment is given in this review.

• Journal of Nutrition and Health
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• v.50 no.2
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• pp.121-132
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• 2017

Purpose: This review was performed to establish a reference intake of water for Korean (KDRI-water) adults in 2015 by examining current knowledge of the relationship between water intake and health and the general status of water intake and loss. We expect that this study will be utilized for further refinement of KDRI-water. Methods: Documents were searched using RISS, NDSL, DBPIA, CINAHL, and Pubmed with the keywords 'water intake, water supply, water ingestion, hydration, dehydration, water balance, and fluid balance'. Results: Water balance is essential for the maintenance of health. Based on this assumption, numerous studies have been performed to investigate the association of water intake with several diseases such as urolithasis, obesity, diabetes, and cancer as well as other health problems, including constipation, cognition, and fetal weight. Effects of water intake for prevention or relief of these health problems vary. Water is supplied to the body by eating foods and drinking liquids such as plain water and beverages. Metabolic water is another source of water input. Water is lost through urine, skin, respiration, and feces. KDRI-water 2015 was set by adequate intake (AI) based on water intake volume, which was the sum of water intakes from foods and fluids reported by the Korea National Health and Nutrition Examination Survey, with extra milk intake of 200 mL. AIs in some age groups were modified considering their estimated energy requirements. Conclusion: Accurate data of water intake is critically important for the establishment of KDRI-water. Therefore, improvement of systems investigating water intake is required, and more studies on the status of water intake and loss in Korean people are needed for definite KDRI-water establishment.

• Journal of Preventive Medicine and Public Health
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• v.35 no.3
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• pp.255-262
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• 2002

Objectives : To investigate the fetal cholesterol levels and related factors in a rural adult population. Methods : 3,207 adults(1,272 men and 1,935 women) were examined in 1997 Their heights, weights, and fasting serum total cholesterol levels were measured, and their body mass indices were calculated. A questionnaire interviewing method was used to collect risk factor data. Results : The mean value of total cholesterol were 190.5 mg/dl, and 198.8 mg/dl, and the age-adjusted prevalence rates for hypercholesterolemia (above 240 mg/dl) were 13.7% and 10.2%, in men and women, respectively. From simple analyses, age, educational level, coffee intake, amount of meat and food intake, waist circumference, waist-hip circumference ratio(WHR), and body mass index(BMI) were significant risk factors in men (p<0.05) relating to serum total cholesterol levels. In women, age, educational level, hypertension history, diabetes history, herbal drug history, amount of feed intake, alcohol consumption, waist circumference, WHR, BMI, and menopausal status were significant risk factors (p<0.05). In multiple linear regression analyses, waist circumference (p<0.01), BMI (p<0.01), and coffee intake (p<0.05) proved to be significant risk factors in men. Whereas, menopausal status (p<0.01), BMI (p<0.01), herbal drug history (p<0.01), amount of food intake (p<0.05), waist circumference (p<0.05), and alcohol consumption (p<0.05) were significant risk factors in women. Conclusions : The significant risk factors, for both men and women, relating to the serum total cholesterol were waist circumference and BMI. Thus, for the reduction of serum total cholesterol level, it is recommended that health education for the control of obesity should be implemented.

• Women's Health Nursing
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• v.2 no.1
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• pp.88-105
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• 1996

The purpose of this study was to find out physical and emotional status, and nursing needs of the pregnant women who were hospitalized by premature labor. The research respondents were 96 from four university hospitals located in Seoul, from June 30, 1996 to September 15, 1995. The research instrument was consisted of 14 items of physical status(discomforts) (Cronbach's=0.86), 17 items of emotional status (Cronbach's=0.89), 33 items of nursing needs (Cronbach's=0.94), and they were measured by 5 level of Likert Scale. The data were analyzed by frequency, percentage, mean standard deviation, ANOVA, Pearson correlation coefficient as the statistical techniques in the program of SPSS/$PC^+$. The findings were as follows : 1. The perception of physical status was mainly about physicl discomforts during the hospital stay. It included four categories about 'absolute bed rest' 3.48, 'hospital foods' 3.38, 'health care teams' 2.93, 'hospital environment' 2.83 in order of mean of discomforts. The most discomfortable one was "malodor by not doing personal hygiene." The next one was "urination and defecation on the bed using bedpan." 2. The perception of the emotional status was about negative mood related to 'fetus', 'hospitalization' perse, 'personal situation.' The highest score of negative mood was "I am afraid that the baby's condition will be bad if I deliver it before full term." The next one was "I am anxious about whether my baby will be in incubator if I deliver it before full term." 3. The highest mean score among items of nursing needs was "Nurses observe whether the labor come or not with concerns." The next one was "Nurses observe the fetal movement and check up the fetal heart sound." The lowest one was "Nurses help me when I need bedpan." 4. Nursing needs were consisted of four categories : professional, educational, emotional, and physical. The mean score of them was high in professional, educational, emotional, and physical need in order. 5. The physical status was related to "Experience of treatment for maintenance of pregnancy" and "Experience of hospitalization by premature labor". The emotional status was related to "Type of delivery" and "Type of habitation." 6. In the correlation of physical and emotional status, it showed positive correlation between them. The higher score of physical discomfort, the higher score of negative mood(r=0.5113, p=0.0001).