• 대한예방한의학회지
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• 제17권2호
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• pp.157-168
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• 2013

The objective of this study was to characterize the adverse effects of Ahnjon-Yichun-Tang during early pregnancy. Following successful mating, female Sprague-Dawley rats were given Ahnjon-Yichun-Tang(AYT) extract by oral administration daily with dose of 150mg (n=10), 300mg(n=10), 450mg(n=10) for 20 days of pregnancy. The rats in Control group(n=10) were orally administrated with Saline. All pregnant rats of Ahnjon-Yichun-Tang-treated and Control groups were sacrificed on day 20 of pregnancy. The pregnancy outcome was determined and the internal and reproductive organs of pregnant rat were observed. The fetuses were examined for the presence of various developmental toxic endpoints and stained with alcian blue and alizarin red S, and observed skeletal malformations. The results obtained in this study represent that there is no significant changes between Control and Ahnjon-Yichun-Tang-treated groups in body weight, organ weight, blood chemistry values, hematological values and pregnancy indexes of pregnant rat. The skeletal malformation of fetus was not observed as well. These results suggest that oral administration of Ahnjon-Yichun-Tang does not produce either maternal or developmental toxicity.

• Clinical and Experimental Pediatrics
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• 제55권2호
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• pp.35-41
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• 2012

Passive exposure to tobacco smoke significantly contributes to morbidity and mortality in children. Children, in particular, seem to be the most susceptible population to the harmful effects of environmental tobacco smoke (ETS). Paternal smoking inside the home leads to significant maternal and fetal exposure to ETS and may subsequently affect fetal health. ETS has been associated with adverse effects on pediatric health, including preterm birth, intrauterine growth retardation, perinatal mortality, respiratory illness, neurobehavioral problems, and decreased performance in school. A valid estimation of the risks associated with tobacco exposure depends on accurate measurement. Nicotine and its major metabolite, cotinine, are commonly used as smoking biomarkers, and their levels can be determined in various biological specimens such as blood, saliva, and urine. Recently, hair analysis was found to be a convenient, noninvasive technique for detecting the presence of nicotine exposure. Because nicotine/cotinine accumulates in hair during hair growth, it is a unique measure of longterm, cumulative exposure to tobacco smoke. Although smoking ban policies result in considerable reductions in ETS exposure, children are still exposed significantly to tobacco smoke not only in their homes but also in schools, restaurants, child-care settings, cars, buses, and other public places. Therefore, more effective strategies and public policies to protect preschool children from ETS should be consolidated.

• Journal of Chest Surgery
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• 제32권10호
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• pp.897-902
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• 1999

Use of the left internal thoracic artery(ITA) to bypass the left anterior descending(LAD) coronary artery has become the standard of care based on its superior graft patency, reduced cardiac events, and enhanced survival. But rarely we encountered with injury to the artery during harvesting which leads to loss of the merits of surgery. We reconstructed inadequate ITAa with other arterial conduits so proximal stump to be a blood source if possible. Maternal and method: Between January 1996 and March 1999, 12 patients received bypass with the reconstructed left internal thoracic artery grafts to left anterior descending artery because of an injury(n=8), short or small(n=4). Right or left ITA was used to LAD as a free graft(n=2). And the other 10 left ITAs were extended with radial artery(n=6), right ITA(n=3), saphenous vein(n=1). Composite "T" graft was made with other arterial conduits in these extended graft(n=5). Result: There was only one morbidity of minor would problem, and no mortality. The patency of extended graft to LAD was complete in 5 patients who received angiography during the period of 2wks to 2 years postoperative, but one of side branch of "T" graft occluded. All of these patients were well. Conclusion: Reconstructive extension with the use of other arterial conduit for the injured proximal ITA is warranted in any patients with acceptable results. acceptable results.

• 대한간호학회지
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• 제40권4호
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• pp.571-579
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• 2010

Purpose: The purpose of this study was to explore the effects of a taegyo program on parents-fetal attachment and parenthood in first pregnancy couples (mothers and spouses). Methods: The research design was a nonequivalent control group pretest-posttest experiment. Study participants were 52 first pregnancy couples visiting two medium-scale obstetrics and gynecology clinics located in Gwangju. A total of 52 couples were assigned to the experimental group (25 couples) and the control group (27 couples). The experimental couples were provided with a taegyo program for 4 weeks. Data were analyzed by chi square test, t-test, and ANCOVA using the SPSS program. Results: Post-treatment maternal- fetal attachment, paternal-fetal attachment and motherhood significantly increased in the experimental group as compared to the control group, but post-treatment fatherhood, anxiety, blood pressure and pulse of participants in the experimental group showed no significant difference from those in the control group. Conclusion: From these results, it is suggested that the taegyo program has beneficial effects in enhancing parent-fetal attachment and motherhood in first pregnancy couples. Therefore, a taegyo program can be recommended as a nursing intervention program for first pregnancy couples.

• 여성건강간호학회지
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• 제26권4호
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• pp.274-284
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• 2020

Purpose: The purpose of this study was to investigate the effects and characteristics of health care programs for pregnant women with gestational diabetes mellitus (GDM) in Korea. Methods: This study was conducted according to the Cochrane Collaboration's systematic literature review handbook and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline. We searched eight international and domestic electronic databases for relevant studies. Two reviewers independently selected the studies and extracted data. For each study, information on the research method, participants, characteristics of the program, and results were extracted using a previously established coding table. The National Evidence-based Healthcare Collaborating Agency's risk of bias assessment tool for non-randomized studies was used to assess the risk of bias of the included articles. A qualitative review of the selected studies was performed because the interventions differed considerably and the measured outcomes varied. Results: Out of 128 initially identified papers, seven were included in the final analysis. The risk of bias was evaluated as generally low. Health care programs for pregnant women with GDM showed positive effects on blood glucose control. Anxiety and depression were reduced, and self-management and self-care behavior, self-efficacy, and maternal identity improved. Conclusion: Our study provides clinical evidence for the effectiveness of health care programs for pregnant women with GDM, and its results can be used to support the development of health care programs for GDM. More well-designed research is needed on GDM, especially studies that deal with emotional stress and apply a family-oriented approach.

• 한국간호교육학회지
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• 제27권3호
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• pp.274-286
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• 2021

Purpose: This study aimed to explore the lived experiences of breastfeeding women with gestational diabetes and to understand the meaning of breastfeeding for them and its encompassing context. Methods: Qualitative data were collected by interviewing 15 mothers with gestational diabetes. The transcript data from 5 focus group interviews and 2 individual interviews were analyzed using thematic analysis. Results: A core theme and 10 sub-themes emerged. The core theme that emerged was "the maternal commitment enabled for a limited time a way to compensate for guilt." Because mothers had to control their blood sugar levels before childbirth, they were worried about whether it would harm the newborn baby and thus searched for dietary information. After the babies were born and separated from their mothers, they were free from gestational diabetes. Mothers then felt guilty about their unhealthy bodies when they were pregnant. This regret provides a motivational context for breastfeeding. However, the mothers realized that breastfeeding requires commitment and dedication and that they need breastfeeding support, such as being provided practical help. Conclusion: The results showed that the breastfeeding intention of women with gestational diabetes might originate from their feelings of guilt. Therefore, an integrated breastfeeding program that combines the empathetic support of women with similar experiences and that shares practical information from experts should be implemented in a structured and systematic way.

• 대한간호학회지
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• 제13권1호
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• pp.7-21
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• 1983

For the flexible and rational distribution of limited existing health resources based on measurements of individual risk, the socalled Risk Approach is being proposed by the World Health Organization as a managerial tool in maternal and child health care program. This approach, in principle, puts us under the necessity of developing a technique by which we will be able to measure the degree of risk or to discriminate the future outcomes of pregnancy on the basis of prior information obtainable at prenatal care delivery settings. Numerous recent studies have focussed on the identification of relevant risk factors as the Prior infer mation and on defining the adverse outcomes of pregnancy to be dicriminated, and also have tried on how to develope scoring system of risk factors for the quantitative assessment of the factors as the determinant of pregnancy outcomes. Once the scoring system is established the technique of classifying the patients into with normal and with adverse outcomes will be easily de veloped. The scoring system should be developed to meet the following four basic requirements. 1) Easy to construct 2) Easy to use 3) To be theoretically sound 4) To be valid In searching for a feasible methodology which will meet these requirements, the author has attempted to apply the“Likelihood Method”, one of the well known principles in statistical analysis, to develop such scoring system according to the process as follows. Step 1. Classify the patients into four groups: Group $A_1$: With adverse outcomes on fetal (neonatal) side only. Group $A_2$: With adverse outcomes on maternal side only. Group $A_3$: With adverse outcome on both maternal and fetal (neonatal) sides. Group B: With normal outcomes. Step 2. Construct the marginal tabulation on the distribution of risk factors for each group. Step 3. For the calculation of risk score, take logarithmic transformation of relative proport-ions of the distribution and round them off to integers. Step 4. Test the validity of the score chart. h total of 2, 282 maternity records registered during the period of January 1, 1982-December 31, 1982 at Ewha Womans University Hospital were used for this study and the“Questionnaire for Maternity Record for Prenatal and Intrapartum High Risk Screening”developed by the Korean Institute for Population and Health was used to rearrange the information on the records into an easy analytic form. The findings of the study are summarized as follows. 1) The risk score chart constructed on the basis of“Likelihood Method”ispresented in Table 4 in the main text. 2) From the analysis of the risk score chart it was observed that a total of 24 risk factors could be identified as having significant predicting power for the discrimination of pregnancy outcomes into four groups as defined above. They are: (1) age (2) marital status (3) age at first pregnancy (4) medical insurance (5) number of pregnancies (6) history of Cesarean sections (7). number of living child (8) history of premature infants (9) history of over weighted new born (10) history of congenital anomalies (11) history of multiple pregnancies (12) history of abnormal presentation (13) history of obstetric abnormalities (14) past illness (15) hemoglobin level (16) blood pressure (17) heart status (18) general appearance (19) edema status (20) result of abdominal examination (21) cervix status (22) pelvis status (23) chief complaints (24) Reasons for examination 3) The validity of the score chart turned out to be as follows: a) Sensitivity: Group $A_1$: 0.75 Group $A_2$: 0.78 Group $A_3$: 0.92 All combined : 0.85 b) Specificity : 0.68 4) The diagnosabilities of the“score chart”for a set of hypothetical prevalence of adverse outcomes were calculated as follows (the sensitivity“for all combined”was used). Hypothetidal Prevalence : 5％ 10％ 20％ 30％ 40％ 50％ 60％ Diagnosability : 12% 23% 40% 53% 64% 75% 80%.

• 미술이론과 현장
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• 제6호
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• pp.77-99
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• 2008

The purpose of this study is to show that the reason behind the ambivalent characteristic displayed in Niki de Saint Phalle's works is in her trauma and how such characteristic can be extracted from her works. During her creative years, Saint Phalle worked on various materials from different genres such as assemblages, shooting paintings, a series on Bride and Monster, 'Nana', 'Tarot Garden'and public sculptures. One commonality found among her various works is the ambivalent characteristic that contains contrasting elements simultaneously. Saint Phalle suffered a terrible psychological damage inflicted by her parents during her childhood. Specifically, she was sexually assaulted by her father and emotionally neglected by her mother, the trauma that affected her for the rest of her life. As a result, she came to develop extreme love- hate relationships with her parents and this became the main reason for the ambivalent characteristic displayed in her works. The love-hate relationship Saint Phalle developed can be identified through various researches done on the subject of the affect of sexual assault. It is common for incest victims to develop ambivalent feelings towards the perpetrator and Saint Phalle was no exception. Dissociation disorder and a snake well explain the trauma from her father. It is a generally accepted belief in the field of psychology that dissociation disorder commonly occurs to children who experience incest. And dissociation disorder is similar to the characteristic of ambivalence in the sense that a single entity contains more than two contrasting elements at the same time. In addition, the amputated doll objects used in her assemblages coincide with the expression of body detachment of people with dissociation disorder. These facts clearly indicate that the trauma from her father is showing through in her works. A snake is a subject matter that reflects the ambivalent tendency of Saint Phalle that resulted from her trauma. She remembers her father's rape as an image of a snake which is related to a phallic symbol in mythology or art reflecting her trauma. Moreover, she displays a similar pattern of ambivalent emotion like love and hate or fear towards a snake and her father. This is also confirmed by her portrayal of a snake as a monster or reversely as a creature with fundamental vitality in her works. The lack of affection from her mother can be explained by her mother's maternal deprivation. It appears that Saint Phalle's mother possessed all the causes for maternal deprivation such as maternal separation, personality disorder and inappropriate attitude towards child rearing. Especially, a study that shows mother's negative attitude towards child breeding tends to increase dissociation experience of children is another important evidence that supports Saint Phalle's dissociation tendency. These traces of Saint Phalle's trauma are clearly revealed in her assemblages and shooting paintings. The violent objects in her assemblages such as a hammer, razor, nail represent the rage and defensiveness towards her father. The objects such as fragments of broken plates of feminine patterns, pots and mirrors that her mother used symbolize the affection towards her mother. On the other hand, the destructed objects can be interpreted as her hate and resentment towards her mother. Shooting paintings contain her extreme fury and hate. Things such as acts of shooting and the image associated with blood after shooting are blunt expressions of her bursts of emotions. I have tried to define and classify the ambivalent characteristics shown in her assemblages and shooting paintings as hate, rage, violence, calm, love and pleasure according to the frame of Thanatos and Eros. Out of the six, hate, rage, violence and clam are associated with Thanatos while love and pleasure are associated with Eros and they correspondingly form an ambivalent structure. These ambivalent characteristics can be found in her assemblages and shooting paintings. The objects in her assemblages such as a razor, saw, hammer imply hate, rage, violence and the silence felt throughout her works represent calmness. And, as mentioned, the feminine objects can be seen as symbolizing love. In shooting paintings, hate, rage, violence can be found in the use of force and in the traces of watercolor after shooting, and a sense of pleasure in her feelings of catharsis after her shooting. Moreover, a shielded calmness can be found on the plywood all covered with plaster before the shooting. This study looked into the ambivalent characteristic of Saint Phalle's works by examining her trauma to find its correlation, and a meaning of this study can be found from the fact that it refocused the origin of Saint Phalle who is generally known as a feminist artist. Additionally, a meaning of the study can be found also from the fact that it examined the ambivalent characteristics of her works through a frame of Thanatos and Eros.

• The Korean Journal of Physiology
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• 제24권1호
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• pp.27-37
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• 1990

The extrafetal transfer of $Li^{+}$ in amniotic fluid was studied in 45 pregnant rabbits. LiCl solution was administered either intravenously to mother or directly into the amniotic sac and monitored the appearance and disappearance of $Li^{+}$ in the amniotic fluid, then calculated the transfer rate of $Li^{+}$ of extrafetal origin. To study the transplacental $Li^{+}$ transfer, a solution of 150 mM LiCl was infused continuously via maternal vein (initial dose: 0.7 mmol/kg, maintaining dose: 0.03 mmol/kg/min) and the $Li^{+}$ concentration was measured in maternal blood and amniotic fluid after 60 and 120 minutes of infusion. Change in the volume of aminotic fluid was determined by Congo red dilution method at the same time. Effects of duration of gestation was not considered in this study. Extrafetal transport of $Li^{+}$ into the amniotic fluid was estimated by comparing the $Li^{+}$ concentration and volume of amniotic fluid determined before and after ligating the placental vessels. Extrafetal $Li^{+}$ transport from the amniotic fluid was determined by observing the time dependent disappearance of $Li^{+}$ and Congo red in amniotic fluid after injecting 0.5 ml solution of 15 mM or 90 mM LiCl and 50 mg/ml Congo red. Following are the results obtained: 1) During infusion of LiCl through maternal vein the ratio of the aminotic $Li^{+}$/maternal plasma $Li^{+}$ increased significantly along with the increment of fetal weight. 2) The volume of amniotic fluid of larger fetuses than 20.5 gm increased significantly during administration of LiCl while that of smaller fetuses did not change. 3) After umbilical cord ligation the $Li^{+}$ concentration of amniotic fluid of larger fetuses than 20.5 gm was decreased to $59.9{\pm}10.3%$ and $56.9{\pm}42.9%$ $(mean{\pm}S.D.)$ of those of control group after 60 and 120 minutes of LiCl infusion respectively. In amniotic fluid of smaller fetuses than 20.5 gm, there was no significant difference between control and ligation groups. 4) The disappearance rate of Congo red in the amniotic fluid was $45.2{\pm}8.2%/hr$. 5) The disappearance rate of $Li^{+}$ after intraamniotic injection of LiCl depended on the amount injected. On injecting $7.5\;{\mu}mol$ LiCl, $Li^{+}$ disappeared rapidly from the amniotic fluid and the rates after 60 min and 90 min were $97.0{\pm}2.8,\;98.5{\pm}2.0%$ respectively. On injecting $45\;{\mu}mol$ LiCl, the rates were $56.0{\pm}15.4,\;78.9{\pm}14.5%$ at 60 and 90 min. 6) From the above results it was concluded: a) $Li^{+}$ transfer into the amniotic fluid increased along with the fetal growth and one half of $Li^{+}$ influx is through the extrafetal route even after the maturation of fetal kidney. b) One half of the $Li^{+}$ transfer from the amniotic fluid was through swallowing of fetus, while the remaining half was transfered rapidly through amniotic membrane, which was concentration limited.

• Childhood Kidney Diseases
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• 제9권1호
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• pp.8-14
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• 2005

목 적 : 정상 만삭아의 혈압을 측정하여 우리나라 신생아의 평균혈압을 알고 기존의 참고치로 사용되고 있는 외국 자료와 비교하고 신생아 고혈압 선별에 도움이 되고자 이 연구를 시행하였다. 방 법 : 2003년 5월부터 2004년 1월까지 포천 중문의과대학교 분당차병원에서 출생한 건강한 신생아 중 남아(194명), 여아(189명) 총 383명을 대상으로 진동식 자동 혈압계로 1-3회 측정하여 총 773회를 혈압치를 수집하였다. 전체 대상아의 평균 혈압과 성별 간, 분만 방법 간, 이상 병력의 유무(산모 질환, 주산기 과거력이나 단일제대 동맥 중 하나라도 있는 경우)에 따른 혈압의 차이를 구하고 출생체중과 재태기간에 따른 수축기 혈압의 변화를 알아보았다. 결 과 : 전체 대상아 383명의 수축기 혈압은 70.8$\pm$10.9 mmHg, 이완기 혈압은 43.4$\pm$8.0mmHg 이었다. 성별 간 비교에서는 남아의 수축기 혈압은 71.1$\pm$11.4 mmHg, 이완기 혈압은 43.6$\pm$8.2 mmHg, 여아의 수축기 혈압은 70.5$\pm$10.3 mmHg, 이완기 혈압은 43.2$\pm$7.7 mmHg로 성별 간 혈압의 통계학적 유의한 차이는 없었다.(p>0.05). 분만 방법의 차이에 따른 혈압의 비교에서는 혈압 측정한 날을 수정하여 비교한 결과 제왕절개를 한 군과 질식분만을 한 군 간의 혈압은 통계학적으로 유의한 차이가 없었다(P>0.05).이상 병력의 유무에 따른 혈압의 비교로는 이상 병력이 있는 군은 72명으로 수축기 혈압이 71.5$\pm$12.3 mmHg, 이완기 혈압이 43.4$\pm$8.5 mmHg이었으며, 이상 병력이 없는 311명의 신생아는 수축기 혈압이 70.6$\pm$10.5 mmHg, 이완기 혈압이 43.4$\pm$7.9 mmHg로 두 군 간 통계학적 유의한 차이는 없었다(P>0.05). 또한 출생체중과 재태기간이 증가할수록 수축기 혈압은 상승하였다.(r=0.1420, 0.0360)결 론 : 본 연구에서 건강한 신생아 383명을 대상으로 혈압을 측정한 결과 기존의 외국 데이터와 유사하였고, 이를 토대로 신생아 고혈압의 조기선별하고 치료를 시작하여 그 주요 원인이 되는 신질환 합병증의 예방과 신기능의 유지에도움이 되고자 한다.