• 한국의학물리학회지:의학물리
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• 제11권2호
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• pp.109-116
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• 2000

자궁경부암 환자의 방사선 조사시 고려하여야 할 사항 중 한가지는 결정 장기인 방광 및 직장의 부작용이다. 강내 고선량률 근접 치료시 방광과 직장의 흡수선량을 열형광량계 선량측정법을 이용하여 간접적으로 측정하였다 방광 및 직장의 부작용을 줄일 수 있는 방법이 제안되었다. 방사선 치료 후 예후관찰 중인 200명의 자궁경부암 환자의 자기공명 영상에서 자궁경부의 중심축에서 방광 및 직장 그리고 자궁벽의 두께를 측정하였다. 밀봉시킨 열형광량계를 오보이드의 팩킹거즈 위에 놓고 씨물레이션 필름 상에서 오보이드의 중심에서부터의 거리를 측정한 후 실제의 방광과 직장의 흡수선량을 계산하였다. 발표된 연구결과들에서 방광 및 직장의 최대 견딤선량을 계산하였고 고선량률 근접치료 1회당의 허용선량을 토대로 양방향의 팩킹두께를 알아냈다 방광과 직장방향의 최소의 팩킹두께는 각각 0.43 과 0.92 cm 이었다. 이 결과를 마이스버거 다항식을 이용한 계산결과와 비교하였다. 본 연구에서 제시한 방법이 임상에서 고선량률 근접 치료시 방광과 직장 같은 결정장기의 흡수선량을 평가하는 방법으로 사용되기를 바란다.

• Neonatal Medicine
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• 제18권2호
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• pp.280-287
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• 2011

목적: 미숙아에서 위액 내 Ureaplasma urealyticum 의 검출이 미숙아의 특징과 임상적 예후에 어떤 영향을 주는지를 알아보고자 하였다. 방법: 미숙아를 대상으로 출생 후 30분 이내에 첫 위액은 채취하였고, 위액 내 U. urealyticum 이 검출되는지를 확인하기 위해 24시간 이내에 배양을 실시하였다. 그리고 U. urealyticum 이 검출된 군을 양성군으로, 검출되지 않은 군을 음성군으로 나누었다. 결과: 91명의 미숙아 중에서 17명(19%)에서 위액 내 U. urealyticum 이 검출되었다. U. urealyticum 양성군에서 음성군보다 통계학적으로 30주 미만의 미숙아 수가 더 많았고(P=0.02), 1분과 5분 아프가 점수가 더 높았으며(P=0.017과 P=0.048), 그리고 질식 분만이 더 많았다(P=0.000). 두 군간에 기관지폐이형성증의 발생률은 차이가 없었지만, 이전에 신생아호흡 곤란증 진단 없이 기관지폐이형성증의 발생한 빈도는 음성군(1%)보다 양성군 (11%)에서 의미 있게 높았다(P=0.03). 결론: 위액 내 U. urealyticum 검출은 임신 기간 30주 미만 미숙아에서 높게 관찰되고, 미숙아에서 선행되는 신생아호흡곤란증후군이 없이도 발생할 수 있는 기관지폐이형성증을 예측하는데 도움이 된다.

• Clinical and Experimental Pediatrics
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• 제52권8호
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• pp.888-892
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• 2009

목 적 : 신생아실에서 만삭아에 준한 경과 관찰 후 퇴원한 후기 조산아들의 재입원과 관련된 위험 요인과 재입원 원인을 알고자 연구를 계획하였다. 방 법 : 2003년 1월부터 2008년 12월까지 일신 기독 병원 신생아실에서 만삭아에 준한 경과 관찰 후 퇴원한 후기 조산아들 중 생후 28일 이내에 재입원하였던 135명의 신생아들의 의무 기록지를 후향적으로 조사하였다. 재입원의 위험 요인을 알고자 대조군과 비교 분석하였다. 결 과 : 재입원과 관련된 위험 요인 연구에서 재태주수, 출생 체중, 성별, 분만 방법, 산모의 나이, 교육 정도, 결혼 여부, 진통과 분만 과정상의 합병증은 관련이 없었고, 모유 수유(71.9% vs 44.4%), 짧은 신생아실 경과 관찰 기간($3.3{\pm}1.6$일 vs $4.1{\pm}2.0$일), 초산모(60.0% vs 45.3%)와 임신 합병증이 있었던 경우(31.9% vs 18.8%) 통계적으로 유의하게 재입원율이 높았다. 재입원 시점은 출생 후 평균 $6.2{\pm}3.6$일로, 출생 5-6일 사이에 재입원하는 경우가 40.7%로 가장 많았다. 재입원 시 83.7%가 황달을 주소로 입원하여 가장 흔한 원인이었고, 자연 분만(43.4% vs 1.8%), 산모의 나이가 적은 경우($29.8{\pm}3.4$세 vs $32.1{\pm}4.2$세), 임신과 관련된 합병증 동반이 적은 경우(28.3% vs 50%)가 황달로 인한 재입원과 관련 있었다. 결론 : 후기 조산아들의 재입원과 관련된 위험 요인은 모유 수유, 짧은 신생아실 경과 관찰 기간, 초산모와 임신 합병증이 있었던 경우였고, 재입원 시점은 평균 $6.2{\pm}3.6$일, 가장 흔한 재입원 원인은 황달이었다.

• Clinical and Experimental Pediatrics
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• 제52권2호
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• pp.242-246
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• 2009

13번 환염색체 증후군은 정신발달의 지체, 성장 장애, 안면부 기형, 중추신경계 기형, 심장기형, 손발의 기형, 골격계 기형 및 항문기형의 특징을 가진다. 많은 수의 13번 환염색체 증후군에 대한 보고가 있었지만 국내에서는 오직 6예의 임상증례 고가 있다. 이들 보고는 모두 순수한 13번 환염색체 증후군을 보고한 것으로 본 저자들은 13번 환염색체 모자이크 현상의 증례를 경험하였다. 산전진찰 상 자궁내 발육지연이 의심되었던 남아에서 안면부기형이 관찰되었으나 이 외에 이학적 검사상 심장 기형, 골격계 및 외부 생식기 기형은 특별히 관찰되지 않았다. 시행한 세포 유전학 검사상 13번 염색체의 ring/monosomy/dicentric 모자이크 현상이 나타났다. 이후에도 근력저하, 성장과 발달지연을 보이고 있다. 저자들은 안면부 기형, 소두증과 대칭성 자궁내 발육지연을 보인 남아에서 13번 환염색체의 모자이크 증후군을 경험하여 기존에 보고된 다른 증례들과 임상 양상을 비교하여 보고하는 바이다.

• 기본간호학회지
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• 제4권1호
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• pp.73-85
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• 1997

The purpose of this study was to find out the prevalence of the urinary incontinence and it's relating factors in women. The target population is 327 community dwelling women in the age of 30-70 years old at 6 cities in Korea. The data were collected from August, 1996 to December. 1996 with interview using structured questionaire composing of items of general characteristics, obstetric characteristics, disease characteristics, situation of experiencing urinary incontinence, discomfort due to urinary incontinence, and depression. The data were analysed with $SPSS/PC^+$ program, T-test, $x^2$ test, and ANOVA test. The results obtained from this study were as follows : 1) The prevalence of urinary incontinence in women is 37.7%(130/327). 2) The mean duration of experiencing the urinary incontinence was 75.9 months and the 60% of the respondents experienced a few frequency of urinary incontinence and the most common amount of urinary incontinence(91.5%) was somewhat small expressed as 'wetting their clothes'. 3) The common factors related to the urinary incontinence were coughing, sneezing, laughing aloudly, and the activities of need for hurry. 4) The most common situations of discomforts associated with urinary incontinence were having long journey, exercise, playing, and social meeting. 5) The incidence of urinary incontinence was significantly higher in woman who had more children, older age of last delivery, more vaginal delivaries, and less c-section. 6) The incidence of urinary incontinence was not affected with the disease characteristics of the respondents, however it was higher when the women had the physical problems of constipation, abdominal laparatomy and episode of urinary catheterization than who had not. 7) The most common symptom of urinary incontinence was the frequent urine(43.1%), and the next was the urgent urine(12.3), delayed urine(9.2%). 8) 90.7% of the epsodic urinary incontinence were not treated at al, however, they wanted to try the herb medicine(41.5%), Kegel exercise(27.7%), and biofeedback(10.0%). 9) The level of Depression in the group of urinary incontinence was higher than that of non incontinence group significantly. In conclusion, as urinary incontinence in women proved severe health problem, health care providers need to develop and provide nursing intervention of urinary incontinence such as pelvic muscle exercise with bio-feedback and psychological care.

• 대한간호학회지
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• 제5권1호
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• pp.133-143
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• 1975

Most of mothers place their babies in either supine or prone position without change of position. Studies comparing supine and prone position of the newborn infants -have already been performed with the result that the prone position is relatively better than the supine position. However, one kind of position recommended to the mothers is not sufficient for the good rearing practice of children, because the same position placed for period long of time may bring out physical, mental tension and fatigue, and deformities of the skull and the thorax. For this reason nurses have to find out other position which has identical or more advantages than prone position so as to perform the position change for the babies. Main purpose of this study is to identify the differences of vital signs, the number of urination, defecation, diaper rash, crying and amount of feeding of the newborn infants with prone position or lateral position during the first three days of life. Sixty two newborn infants who were delivered at Seoul National University Hospital during the period from July 1 to September 5, 1974 were chosen as subjects for this study. The criteria for the choice of subjects were the babies born with vaginal delivery; body weight 2.5kg or over at birth; Apgar score Seven or over; and gestation period between thirty-eight months ana forty- two months. Of these subjects, by random sampling, thirty-one newborn infants were placed in the prone position and the other thirty-one in the lateral position. The results of this study reviewed in a statistical analysis of the t-test to obtain the following findings : 1. The heart rates of babies in the prone position were the mean heart rates of 135.03 and those in the lateral position 135.98 without any statistically significant difference. 2. There was no significant difference of respiration rate between two groups : a group in the prone position showed the mean respiration rates of 45,57 and the other in the lateral position 46.49. 3. There was no significant difference of body temperature between two groups: the mean body temperature of a group placed in the prone position was 98$^{\circ}$18'F(36$^{\circ}$77'C) and that of the other group 98$^{\circ}$20'F(36$^{\circ}$78'C). 4. One baby showed diaper rash only in a group of infants in the prone position. 5. The number of crying of the babies in the prone position were 23.70 and those in the lateral position 30.00 with a statistical difference at 5 percent level. 6, There was no difference of frequency of urination between two groups: the mean frequency of a group placed in tile prone position was 5.44 and that of the other group 5.06, 7. There was no significant difference of frequency of defecation between two groups : the mean frequency of a group placed in the prone position was 4.20 and that of tile other group 4.21, 8. There was no significant difference of feeding amount between two groups : the average amount of a group in the prone position showed 325.03 and that of the other group in the lateral position 291.51. All the above results mean that we may substitute tile lateral position for the Prone position or utilize both position for tile rearing practice of the babies.

• Child Health Nursing Research
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• 제6권2호
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• pp.158-166
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• 2000

The purpose of this study was to confirm the efficient umbilical cord care of healthy newborns in nursery. In order to determine the efficient care, the time of umbilical cord separation and the skin condition of periumbilical area were evaluated. The data were collected in sample of 529 normal, healthy newborns of C hospital in Seoul, from September 1st, 1999 to January 16th, 2000. The babies were randomly selected and allocated into four groups-alcohol swab/tub bath, alcohol swab/partial bath, natural dry/tub bath, natural dry/partial bath- by the methods of care. The mothers of babies were also surveyed by questionnaire about general characteristics. The data were analyzed by SAS program. The results of this study were as follows : 1. The average gestation period of newborns was 39+3 weeks. The average birth weight was 3.27Kg. In gender of babies, boys were 51.7% and girls were 48.3%. The 65% of newborns were born normal vaginal delivery, 35% were C-section. The feeding methods were 55.3% of the babies fed by mixed type, 22.9% by breast, and 21.8% by bottle. There was no significance among four groups by general characteristics. 2. The average time of umbilical cord separation was 8.27 days(SD=2.3). The time was no difference significantly among four groups(F=1.68, P=0.17). 3. The prevalence of the umbilical care complication did not show differences among four groups( 2=3.93, P=0.27). In conclusion, Nurses have preferred the traditional alcohol swab/partial bath method in care of newborns. But there was no difference among the ways to take care of umbilicus according to this study. The way to naturally is more efficient due to reduce the time and expense in umbilical care for normal babies of nursery. This also matched the change in approach to healthy population from intervention to nonintervention way. This could be suggested in education for normal and healthy babies care at home and nursery as a useful way. Endly, the further study about bacterial colony nda infection rate at umbilicus by ways of care is needed.

• Journal of Preventive Medicine and Public Health
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• 제25권4호
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• pp.413-428
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• 1992

The aim of this study was to evaluate the appropriateness of some kinds of surgery and admission, such as cesarean section (C/S), cholecystectomy, and pediatric pneumonia. For appropriateness evaluation, we ourselves developed some criteria, which were included in the category of explicit and linear criteria, with the assistance of specialists of relevant clinical field. The evaluation of appropriateness was performed by two family physicians. The major findings were as follows: 1. For cesarean section, 77.6% of deliveries were determined to be 'appropriate', but the level of appropriateness was not significantly different among hospitals and between hospital groups by size. The most freqeunt indication of C/S was repeated operation, followed by cephalopelvic disproportion (CPD). The labor trials for vaginal delivery among repeated C/S and CPD cases were performed in 24.5% of pertinent deliveries. 2. About 73.8% of cholecystectomy cases was appropriate to one of the surgical indications, without significant differences among hospitals. Of surgical indications, 'sufficiently frequent and intense symptom recurrence' was the most frequent, and 'confirmed acute cholecystitis' was the second. 3. Of children admitted due to pneumonia, only 57.4% of cases satisfied admission criteria, and the level of appropriateness of admission was different among hospitals. The common reasons fur admission were 'failure to initial treatment', 'suspected bacterial pneumonia', 'young infant', etc. We could find that there were differences of quality among hospitals in some procedures, especially in the pediatric pneumonia and labor trial before C/S, which suggested that the implementation of quality assurance activiteis would be necessary in this country. In this study, we used some simple and primitive research tools and the numbers of subjects and tracer procedures were limited. So advanced studios with plentiful subjects and more representative diseases or procedures should be tried.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제12권2호
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• pp.179-191
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• 2001

연구목적：신생아의 행동 특성과 DAT1, DRD2, DRD3 및 DRD4 유전자 다형성 사이에 연관이 있는지 평가하였다. 방 법：2000년 4월 17일부터 2000년 6월 17일까지 출생한 정상 신생아 114명을 대상으로 하였다. 신생아 행동 평가는 Neonatal Behavioral Assessment Scale(NBAS)을 이용하여 생후 약 18시간에 평가하였으며, 출산시 제대혈액을 채취하여 DAT1, DRD2, DRD3 및 DRD4 유전자 다형성을 검사하였다. DAT1, DRD2, DRD3 및 DRD4 유전자의 유전자형에 따라서 집단 사이에 NBAS 7개 항목 점수를 비교하였다. 결 과：DAT1 유전자는 10/10 유전자형 집단과 비교해서 기타 유전자형 집단이 사회성-상호작용, 상태 조직력 및 상태 조절 능력 항목에서 유의하게 점수가 높았다. DRD2 유전자 Ser311/Cys311 유전자형은 Ser/Ser 유전자형 집단과 기타 유전자형 집단 사이에 NBAS 항목 점수에 유의한 차이가 없었다. DRD2 유전자는 TaqI A 및 TaqI B 유전자형에 의한 집단 사이에 NBAS 항목 점수에 유의한 차이가 없었다. DRD3 유전자는 유전자형에 의한 집단 사이에 NBAS 항목 점수에 유의한 차이가 없었다. DRD4 유전자 promoter 유전자형에 의한 집단 사이에 NBAS 항목 점수에 유의한 차이가 없었다. DRD4 유전자 반복배열이 긴 유전자형 집단은 짧은 유전자형 집단보다 습관화 항목 점수가 유의하게 높았다. 결 론：이러한 성적은 DAT1 및 DRD4 유전자 반복배열 다형성이 신생아 행동 특성에 영향을 미치는 유전적 기전일 가능성을 시사한다.

• Child Health Nursing Research
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• 제3권2호
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• pp.228-240
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• 1997

It is important to asess the risk factors of parenting and provide early intervention for promotion of the maternal caretaking ability. The purpose of the study was to identify the maternal burden of caretaking, the supporting and the educational need for the caretaking activities of the mother of infant. Sixty three mothers of infants who visited the wellbaby clinic of S university hospital and one health center during the period of November 1st, to 30th in 1996 comprised the subjects of this study, Data were gathered through the instruments that were developed by researcher. Statistical analysis of this study was used ANOVA and Pearson correlation. The results were as follows : 1) The mean score of the maternal burden of caretaking was 22.06. The maternal burden of caretaking was significantly high in the mothers who had vaginal delivery compare with the mothers who had caeserean section and in the muthers who gave artificial feeding compare with the group of breast or mixed feeding. 2) The mean score of the support need for the caretaking activities was 30.69. The support need for the caretaking activities was significantly high in the mothers who had the second child, compare with the mothers who had first or third child. And the support need for the caretaking activities was significantly high in the mothers who had caretaking help compare with the mothers who had no caretaking help. The specific subjects of 'mother-infant interaction', 'immunization' and 'prevention of accident' on the support need for the caretaking activities were relatively high. 3) The mean score of the educational need of caretaking activities was 29.3. The educational need of caretaking activities was significantly high in the mother who had the second child compare with the mothers who had first or third child. And the educational need of caretaking activities was significantly high in the mothers who had caretaking help compare with the mothers who had no caretaking help. The specific subjects of 'mother-infant interaction', 'emergency care' and 'prevention of accident' on educational need of caretaking were relatively high. 4) The maternal burden of caretaking was not correlated with the support need or the educational need of caretaking activities. But the support need of caretaking activities was significantly correlated with the educational need of caretaking activities. 5) The support and educational need of caretaking activities were significantly high in the mothers who wanted home care for caretaking their infants. Through the study, it was found that there is considerable maternal burden of caretaking as well as the support and educational need on the caretaking activities in the mothers whose child is young. Therefore developing the systematic and effective program is needed to meet the mother's need. The results of this study will be useful resources to develop the program. On the other hand, it can be recommanded that home health care will be one of the approach to support the mothers caretaking activities.