• Clinical and Experimental Reproductive Medicine
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• v.29 no.4
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• pp.269-278
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• 2002

Objective s: Chromosome aneuploidy is associated with recurrent abortion and congenital anomaly and genetic diseases occur repeatedly in the specific families. Preimplantation genetic diagnosis (PGD) can prevent aneuploidy or genetic disease by selecting normal embryos before implantation and is an alternative to prenatal diagnosis. The aim of this study is to assess the outcome of PGD cycles by using FISH or PCR, and to determine the clinical usefulness and values in patients with risk of chromosomal aneuploidy or genetic disease. Materials and Methods: From 1995 to Apr. 2001, a total of 108 PGD cycles in 65 patients with poor reproductive outcome were analyzed. The indications of PGD were translocation (n=49), inversion (n=2), aneuploidy screening (n=7), Duchenne muscular dystrophy (n=5) and spinal muscular atrophy (n=2). PGD was applied due to the history of recurrent abortion, previous birth of affected child or risk of aneuploidy related to sex chromosome aneuploidy or old age. Blastomere biopsy was performed in 6$\sim$10 cell stage embryo after IVF with ICSI. In the single blastomere, chromosome aneuploidy was diagnosed by using FISH and PCR was performed for the diagnosis of exon deletion in DMD or SMA. Results: The FISH or PCR amplification was successful in 94.3% of biopsied blastomeres. The rate of transferable balanced emb ryos was 24.0% in the chromosome translocation and inversion, 57.1% for the DMD and SMA, and 28.8% for the aneuploidy screening. Overall hCG positive rate per transfer was 17.8% (18/101) and clinical pregnancy rate was 13.9% (14/101) (11 term pregnancy, 3 abortion, and 4 biochemical pregnancy). The clinical pregnancy rate of translocation and inversion was 12.9% (11/85) and abortion rate was 27.3% (3/11). In the DMD and SMA, the clinical pregnancy rate was 33.3% (3/9) and all delivered at term. The PGD results were confirmed by amniocentesis and were correct. When the embryos developed to compaction or morula, the pregnancy rate was higher (32%) than that of the cases without compaction (7.2%, p<0.01). Conclusions: PGD by using FISH or PCR is useful to get n ormal pregnancy by reducing spontaneous abortion associated with chromosome aneuploidy in the patients with structural chromosome aberration or risk of aneuploidy and can prevent genetic disease prior to implantation.

• Clinical and Experimental Reproductive Medicine
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• v.37 no.4
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• pp.349-359
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• 2010

Objective: This study was performed to compare the clinical outcome of elective single embryo transfer (eSET) performed at the cleavage stage to that of elective double embryo transfer (eDET). Methods: Of the women less than 36 years old who visited Daegu Maria from January 2008 to April 2009, the only women (n=330) with more than 8 mm of endometrial thickness and at least one good quality embryo, who were treated with GnRH agonist long protocol, were included in this study. After information about complications that can arise by multiple embryo transfer, either eSET or eDET was conducted by their request (167 and 163, respectively).Results: The implantation rate of eSET group was significantly higher than that of eDET group (53.9% vs. 40.2%, p<0.01). The twin pregnancy rate of eSET group was significantly lower than that of eDET group (1.1% vs. 32.3%, p<0.001). However, there were no significant differences between two groups in the clinical pregnancy (53.3% vs. 60.7%, p=0.172), ongoing pregnancy (47.3% vs. 54.6%, p=0.185) and live birth rates (44.9% vs. 50.9%, p=0.275). The number of the surplus embryos which developed to the blastocyst stage and cryopreserved at that stage was significantly higher in eSET group than that of eDET group ($3.2{\pm}2.6$ vs. $2.1{\pm}2.4$, p<0.001). Conclusion: These results suggest that eSET should reduce significantly the multiple baby pregnancy without decreasing the whole pregnancy rate in women with less than 36 years old.

• Korea journal of population studies
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• v.21 no.2
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• pp.182-227
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• 1998

Korean government decided to adopt an explicit population control policy in 1961 and from the following year the establishment and operation of the national family planning programme was included in each of the Five-Year Economic Development Plans that began in 1962. This policy was pursued in the understanding that without proper population control measures korea could not be able to achieve economic development. Korean national family planning programme is characterized by contraceptive target system through public health network with distribution of free contraceptives by family planning field workers and clinical contraceptive services such as IUD, vasectomy and tubaligation at designated clinics by the government. In addition, IE&C activities by the Planned Parenthood Federation of Korea and programme evaluation and research by the Korea Institute for Health and Social Affairs contributed to the development of the government programme. Between 1960 and mid 1980s the nation's total fertility rate was reduced from 6.0 to population replacement level of 2.1 and thereafter it has been maintained at 1.6 to 1.7 of below replacement level. With a short period of less than three decades fertility transition was completed in Korea. It is estimated that if the current level of below replacement fertility continues, the population in Korea stabilize at around 52.78 million people by the year 2028, and it will begin to decrease thereafter. Under this circumstances, the government adopted new directions and strategies of the population policy in June 1996, focused primarily on population quality and social welfare than on demographic arenas. In spite of over 80 percent of high contraceptive prevalence among married women, high incidence of induced abortions is maintained. Moreover, the prevalence of sex selective induced abortions using procedures to determine the sex of the fetus has resulted in an imbalance in the sex ratio at birth. In order to overcome those problems associated with reproductive health new policy for population quality control and health promotion programme should be highly strengthened in the future.

• Journal of Korean Medical classics
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• v.13 no.1
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• pp.269-303
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• 2000

The xin(心) has various meanings in ${\ll}$Huangdineijing(黃帝內經)${\gg}$ but they sometimes contradict each other. This thesis divided the xin into the meaning and the Zang-xiang(藏象), and then analyzed the xin's notion in detail. The concept of the xin in ${\ll}$Huangdineijing(黃帝內經)${\gg}$ is sorted out into : the notion of space, yin-yang five elements(陰陽五行) and shen(神) The xin is the upper part of body and it possesses the character of yang(陽). So the concept of the breast has originated from this character and it rightly belonged to the top. The xin is assigned to fire among five elements, 'chang(長)', which has the energy of moving forward, noon at a day when yang-qi(陽氣) is properous and shows 'gu(鉤)' & 'keo(矩)' in pulse condition. The xin possesses the character, 'Taiyang of the yang(陽中之太陽)' along with the notion of space combined with five elements. That is, the notion of upper space means 'of the yang(陽中)', and, fire in five elements means 'yang'. This is similar to '=(Taiyang)' of Sasang(四象) at ${\ll}$the Book of Changes(周易)${\gg}$ Since the xin puts shen(神) in order, actions of spirit have effect on the xin. And it depends whether the sense of vitality is broad or narrow. The xin related with broad sense of spirit is 'monarch of the organs(君主之官)'. Therefore it has control over the human body. As it also directly effects the life or death, Pericardium(心句) substitutes the xin and protects the external invasion. In Shi-er-won(十二原) and Bonsu(本輸), instead of the Xin Channel the Pericardium Channel was used in healing patients. The xin can be interpretable as the mind, because the xin includes spirit. The mind can be distinguished into 'desire' and 'state of profound reason'. In ${\ll}$Huangdineijing(黃帝內徑)${\gg}$, the disease of the xin caused by emotion was mentioned many times. This emotion is 'desire' which resorted to the sentiment. The reason one mind has both character is; man preserves given principle (reason) and emotion reveals via the reason exercised. The above is about the xin related with the broad sense of vitality. Concerning the narrow sense of vitality, one of the five vitalities is stored with the others away in the five solid organs. Then it takes part in the operation of five body constituents and it is linked with the personified description of five solid organs. The xin, spleen, stomach and kidney are 'the ground of life'. Spleen and stomach are the origin of making qi and blood, which 'means the ground after birth'. Kidney keeps the essence of life, and manages the growing and generative function of human body. The xin keeps 'Shin-myung(神明)', in other words, it has control over and supervise whole activity of body. Therefore xin's role is needed for the appropriate working of spleen, stomach and kidney. And 'Shin-myung' is its motive power. In ${\ll}$Huangdineijing(黃帝內經)${\gg}$, the reason why xin was assigned to September and October is that yang-qi of the human body goes to the inner part, with xin at the same time. This explains that yang-qi of the human body is adapted to change of season and goes into xin-fire(心火) in order to get away from the cold. In this case, heart means more inner part than liver, spleen and lung. Mengzi(孟子), philosopher of the China's turbulent ages emphasized the thinking function of xin. Sunzi(荀子) asserted that xin is 'heaven monarch(天君)' and the other organs are 'heaven rninisters(天官)'. This conception is similar to 'monarch of the organs' of ${\ll}$Huangdineijing(黃帝內經)${\gg}$. After the Ming Dynasty, commentators of Huangdineijing(黃帝內經) explained the heart, as 'monarch of the organs', or 'the master of body(一身之主)'. This was due to the influence of Sung Confucianism.

• Korea journal of population studies
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• v.16 no.2
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• pp.84-110
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• 1993

This study aims at identifying the recent change in marriage behaviors in Korea. The data used here is the vital statistics compiled from the vital registration system of which registration form is put on one from together with the civil registration form. According to the results of this analysis, since 1970 the number of marriages has steadily increased from about 300, 000 in the former of 1970s to about 400, 000 in the latter of 1980s, appproximately coincided with the change in population size at the marriageable age span. The few exceptions that can be seen in the 1970s seem to result from the impact of social upheavals during 1950s; since the birth cohorts affected by the low fertility during the Korean war and the post-war baby-boom generations chracterized by the high fertility entered the marriage market in the 1970s. However, the marriage rate shows a little increase from around 7 in the former of 1970s to around 9 in the latter of 1980s, indicating that the marriage prevalence has been more or less inconsiderably changed during this period. It is also found that the proportion of remarriage to the total marriages has increased to around 10 per cent in 1989, while decreasing that of first marriage. This fact can be attributable to the higher prevalence of divorces and the collapsing of the Confucianism ethic which contributed to expediting the remarriage of widows. Although this proportion is insignificant compared with that of the of more developed countries, it is not difficult to say that the proportion of remarriages will continue to increase in future. The age first at first marriage(AFM) which directly affects the span exposed to the risks pregnancy has increased to the age about 28 for male and about 25 for female in recent years. However, big difference in AFM between urban and rural areas has narrowed, resultant from the increasing involuntary postponement of marriage of rural young population who have met difficulties in seeking their bride or bridegroom in rural areas characterized by the heavy out-migration of young, particularly female, population. The present study shows the reverse relationship between AFM and educational attainment; i.e, the higher the educational attainment the lower the AFM. The conditions which are taken into considerations were the class and the family in the past time but which are, educational attainment, job and personal characteristics. With regard to the age condition, in recent years the male prefers the female younger than himself on the average by 3 years and vice versa, which is reduced form 4-5 years in beginning of 1970s. The age difference bride and bridegroom tends to decrease with the educational attainment increase. This may be attributable to the fact that the persons with the higher educational attainment prefer the love marriage and hence are more likely to choose their counterparts in the about same age. The education condition is characterized by the bridegroom having the higher educational level than bride. It is also significant to note that the proportion of love marriage has increased, whereas that of traditional arranged marriage has decreased. This is true in the urban areas than the rural areas, indicating that rights as well as responsibilities for marriage have been handed over the young population from their parents. In conclusion, the change in the marriage behaviors in Korea are characterized by increasing tendency for the postponement of first marriage, higher prevalences of divorces and a result remarriages, increase of love marriages, narrowing age difference between bride and bridegroom, etc. which are the main results of rapid industrization, increase in educational and economic activity opportunities and change in the ideals of marriages during the past decades. These phenomena prevailing in Korean society would affect not only the family structure that will become less proliferiated but the population size and structure. The most important is that the changes in marriage behaviors of Koreans and their impact on the society with respect to norms, values, morals, of individual and family in the social aspect, change in population size and structure in the demograpic aspects, and economic development in the economic aspects should be integrated into the plannings towards to the future.

• Korea journal of population studies
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• v.21 no.1
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• pp.184-228
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• 1998

This study reviews the relationship between son preference and fertility behavior, and infant and chlid mortality in the context of fertility and mortality decline. In Korea the situation reveals that fertility can decline to a very low level even in the presence of strong son preference, but son preference has certain effects on fertility and childhood mortality. The effect of son preference on fertility increased as the level of fertility declined. Our findings show that son preference causes excess female childhood mortality both directly and indirectly through fertility. Also, in Korea, the analysis reveals that female children suffer excessively high level of mortality and part of the excess mortality is due to parents' behavior on family building related to the effort to secure the birth of a son.

• Korea journal of population studies
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• v.26 no.2
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• pp.1-32
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• 2003

An analysis on cause-specific mortality at the provincial level provides essential information for policy formulation and makes it possible to draw hypotheses regarding various diseases and causes of death. Although the mortality level and causes of death at the provincial level are determined by the multiple effects of socioeconomic, cultural, medical and ecological factors, this study primarily intends to examine similarities and differences of cause-specific mortality at the provincial level. Utilizing the registered death and the registered population as of 1998, the delayed death registration and unreported infant deaths were supplemented at the provincial level and age-standardized death rates and life tables were calculated. Regarding the mortality level due to all causes, major findings were as follow: (1) For both sexes as a whole, Seoul showed the lowest mortality level, and Jeonnam showed the highest mortality level; and (2) The differences of the mortality level among provinces were greater for males than females and for those less than 65 years than those 65 years and over. Regarding the cause-specific mortality level revealed in all indicators (cause-specific age-standardized mortality rates and the probability of dying at birth due to a specific cause for males, females, and both sexes combined respectively), the major findings were as follow: (1) The mortality level due to heart diseases was the highest in Busan and the lowest in Gangweon; (2) The mortality level due to liver diseases was the highest in Chonnam; and (3) The mortality level due to traffic accidents was the highest in Chungnam and the lowest in Inchon. As the mortality differentials at the provincial level are related to various factors, exploratory statistical analysis is attempted for the 25 explanatory variables including socioeconomic variables and 90 mortality variables. Mortality due to all causes are related to socioeconomic variables. Among cause-specific mortality, mortality due to liver diseases and traffic accidents is related to socioeconomic variables. Finally, the need to improve the quality of death certificate is discussed.

• Clinical and Experimental Pediatrics
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• v.45 no.10
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• pp.1213-1218
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• 2002

Purpose : Hydronephrosis constitutes a great portion of fetal anomalies screened by prenatal sonogram. The present authors made an attempt to access its natural courses through follow up neonatal hydronephrosis diagnosed by prenatal sonogram. Methods : The study was composed of 23 neonates(36 renal units) who were diagnosed with hydronephrosis through prenatal sonogram screening and confirmed 3-7 days after birth with sonographic evaluation at Kyung Hee University Hospital. The neonates were closely monitored for 12-24 months with renal sonogram, diuretic renogram, intravenous pyelography(IVP) and voiding cystoureterography(VCUG). Results : The underlying diseases were composed of 16 cases(44%) of functional abnormalities, 14 cases(39%) of ureteropelvic junction(UPJ) obstruction, three cases(8%) of vesicoureteral reflux (VUR) and on case each of multicystic dysplastic kidney, UPJ obstruction with ureteral stenosis and ureterovesical junction(UVJ) obstruction with VUR. The degree of hydronephrosis was divided into three classes according to its severity. In 30 renal units with UPJ obstruction and functional abnormalities, 26(87%) showed mild hydronephrosis, while four(13%) were moderate. During the follow up period, six cases(20%) showed natural resolution of hydronephrosis, 15 cases(50%) showed improvement while two cases(7%) were aggravated with improvement only after surgery of the underlying disease. The cases which showed natural resolution were all mild hydronephrosis at diagnosis and the cases which underwent surgery due to continuous aggravation were mild one case and moderate one case. Conclusion : Those with cases of mild hydronephrosis show rapid natural improvement. On the other hand, in some cases, follow up monitoring reveal aggravation of the situation, emphasizing the necessity for thorough follow up for a long period of time.

• Clinical and Experimental Pediatrics
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• v.53 no.3
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• pp.300-306
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• 2010

Purpose : Recent changes in the population structure of Korea, such as rapid decline in birth rate and exponential increase in old-aged people, prompted us to prepare a new health improvement program in children and adolescents. Methods : We reviewed current health screenings applied for children and adolescents in Korea and other developed countries. We collected and reviewed population-based data focused on mortality and morbidity, and other health-related statistical data. We generated problem lists in current systems and developed new principles. Results : Current health screening programs for children and adolescents were usually based on laboratory tests, such as blood tests, urinalysis, and radiologic tests. Almost all of these programs lacked evidence based on population data or controlled studies. In most developed countries, laboratory tests are used only very selectively, and they usually focus on primary prevention of diseases and health improvement using anticipatory guidance. In Korea, statistics on mortality and morbidity reveal that diseases related to lifestyle, such as obesity and metabolic syndrome, are increasing in all generations. Conclusion : We recommend a periodic health screening program with anticipatory guidance, which is focused on growth and developmental surveillance in infants and children. We no longer recommend old programs that are based on laboratory and radiologic examinations. School health screening programs should also be changed to meet current health issues, such as developing a healthier lifestyle to minimize risk behaviors—or example, good mental health, balanced nutrition, and more exercise.

• Clinical and Experimental Pediatrics
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• v.50 no.8
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• pp.746-752
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• 2007

Purpose : Total hydroperoxide (TH), free radical-mediated oxidation product can be used as a measure of free radical injury. The aim of the present study was to see if preterm newborns are at increased risk for oxidative stress compared with term newborns, and to determine whether oxidative stress during postnatal first 1 week is associated with clinical outcomes in preterm infants. Methods : Serum TH levels of preterm infants (n=39) were compared with those of term infants (n=24) on the postnatal day 1. Among the preterm infants, serum TH levels of uncomplicated group (n=23) were also compared with those of complicated group (n=16) who developed oxygen radical related diseases on the postnatal day 1 and 7. Retrospective analysis was performed to find out risk factors for oxygen radical injuries based on birth history, laboratory data, neuroimaging findings and clinical progress in two preterm groups. Results : Serum TH levels on postnatal day 1 were higher in the preterm infant group than the term infant group. Serum TH levels on postnatal day 1 in the complicated preterm infant group were significantly higher compared with uncomplicated group, but there was no significant difference in serum TH levels on postnatal day 7. Also, there was no significant difference in serum TH levels between uncomplicated preterm infants and term infants. Serum TH level on postnatal day 1 was independently associated with higher morbidity after adjusting for gestational age, Apgar score (5 min), arterial blood gas analysis. Conclusion : Complicated preterm newborns are at increased risk for oxidative stress compared with uncomplicated newborns and term newborns. Oxidative injury during the prenatal or postnatal day 1 is associated with adverse outcomes in preterm infants. Elevated TH levels on postnatal day 1 may have a value to predict clinical outcomes in preterm infants.