• 제목/요약/키워드: e-medicine

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붉은싸리버섯 추출물의 항산화 및 Human Neutrophil Elastase 저해활성 (Study on the Antioxidant and Human Neutrophil Elastase Inhibitory Activities of Mushroom Ramaria formosa Extracts)

  • 김관철;권용범;장해동;김재화;정재철;이익수;하병조;유익동
    • 대한화장품학회지
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    • 제42권3호
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    • pp.269-278
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    • 2016
  • 천연자원으로부터 항노화 화장품 신소재를 탐색하던 중, 국내 자생버섯의 일종인 붉은싸리버섯 자실체 추출물이 항산화 활성과 인체 호중구 엘라스타제 저해활성이 우수함을 확인하고 일련의 연구를 수행하였다. 붉은싸리버섯 추출물의 DPPH 라디칼 소거활성은 붉은싸리버섯 추출물 $500{\mu}g/mL$ 처리시 $117.0{\mu}g/mL$ (ascorbic acid 환산값)의 매우 우수한 소거활성을 나타냈다. Peroxy 라디칼 소거활성을 oxygen radical absorbance capacity (ORAC) assay 를 통하여 측정한 결과 붉은싸리버섯 추출물 1, 10, $20{\mu}g/mL$ 처리 시, 각각 0.8, 5.2, 7.8 $ORAC_{Roo}$ (trolox equivalents, $1{\mu}M$)로 농도 의존적으로 높은 소거활성을 나타냈다. 뿐만아니라 cellular antioxidant capacity를 DCF fluorescence intensity (% of control)로 조사한 결과에서도 붉은싸리버섯 추출물 $20{\mu}g/mL$ 처리시 약 30% 이상 높은 항산화 활성을 나타냈다. Human neutrophil elastase 저해활성은 농도 의존적으로 저해활성을 나타냈으며 특히 에탄올 추출분획에서 $ED_{50}$ 값은 $42.9{\mu}g/mL$이었다. 붉은싸리버섯 추출물은 Bacillus subtilis (B. subtilis), Escherichia coli (E. coli), Candida albicans (C. albicans), Aspergillus oryzae (A. oryzae) 균주 모두에서 항균활성은 나타나지 않았다. 또한 염증성 cytokine인 interleukin-10 및 interferon-${\gamma}$ (IFN-${\gamma}$)의 생산 또는 분비 조절에는 영향을 미치지 않았다. 이상의 결과로 붉은싸리버섯 추출물은 항산화활성과 elastase 저해활성을 우수하여 피부에 자극이 없는 항노화 화장품 조성물로 유용하게 사용될 수 있음을 확인하였다.

단태아와 쌍태아 모체의 임신 분기별 지방산 섭취와 혈청 인지질 지방산 조성 비교 (Comparison of Maternal Fatty Acid Intake and Fatty Acid Composition of Serum Phospholipids Between Singleton and Twin Pregnancies)

  • 권슬기;임수정;신중식;장성희;안홍석
    • 대한지역사회영양학회지
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    • 제13권4호
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    • pp.555-564
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    • 2008
  • Essential fatty acids are important essential nutrients during pregnancy. The objective of this study was to compare fatty acid composition of serum phospholipids and essential fatty acid intakes between Korean pregnant women with a single baby and Korean pregnant women with twins. A total of 116 pregnant women who had maintained their health without any symptoms of pregnancy complications participated in the study. The subjects consisted of 57 women of singleton pregnancy and 58 women of twin pregnancy at the 1st, 2nd, or 3rd trimester of pregnancy. A 24-hour dietary recall was administered to each subject to obtain dietary information. The mean ages of the singleton pregnancy group and the twin pregnancy group were 31.44 years and 32.27 years, respectively, and the mean height values were 161.86 cm and 160.64 cm, respectively. The mean daily energy intakes in the singleton pregnancy group were 1639.95 kcal, 1904.71 kcal, and 1882.82 kcal for the 1st, 2nd, and 3rd trimester group, respectively. The mean daily energy intakes in the twin pregnancy group were 1745.99 kcal, 2203.46 kcal, and 2092.26 kcal for the 1st, 2nd, and 3rd trimester group, respectively. There were no significant differences in the mean fatty acid intakes by the type of pregnancy (i.e., singleton vs. twins) and the stage of pregnancy (i.e., 1st vs. 2nd vs. 3rd trimester). However, the mean total fatty acid intake of those at the 1st trimester among the singleton pregnancy group tended to be higher than that of those at the 1st trimester among the twin pregnancy group. Such a trend seemed to be retro-versed. That is, the mean total fatty acid intakes of the twin pregnancy group were higher compared to the singleton pregnancy group for the 2nd and 3rd trimester group. The LA and total n6 concentrations of serum phospholipids of the singleton pregnancy group were significantly higher as the gestational age increased(p<0.05). The $\alpha-LNA$(p<0.05), EPA(p<0.05), and total n3(p<0.001) concentrations of serum phospholipids of the twin pregnancy group were significantly lower as the gestational age increased. The $\alpha-LNA$ concentrations of serum phospholipids in the singleton pregnancy group at the 3rd trimester were significantly higher than that in the twin pregnancy group at the same trimester(p<0.05). The serum phospholipids levels of AA and DHA of the twin pregnancy group were generally higher compared to those of the singleton pregnancy group. Particularly the differences reached at the level of statistical significance for those at the 1st trimester(p<0.01). It is concluded that the study findings imply that fatty acid metabolism may meaningfully differ by the type and stage of pregnancy. Future research needs to be conducted to more elucidate grounding etiology and possible roles of dietary fatty acid intake levels in relation to the study findings.

남부지역에서 주요 콩 품종의 파종기에 따른 생태적특성 및 수량 변이 (Ecological Characteristics and Yield of Major Soybean Cultivars at Different Sowing Times in Southern Korea)

  • 김동관;최진경;박흥규;신해룡;윤성탁;이경동;임요섭
    • 한국작물학회지
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    • 제58권1호
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    • pp.57-66
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    • 2013
  • 본 연구는 남부지역에서 주요 콩 품종의 파종기 이동이 생태반응과 생육 및 수량성 등에 미치는 영향을 구명하고자 전남 나주(위도 $35^{\circ}$ 04'N, 경도 $126^{\circ}$ 54'E)에서 2008년부터 2010년까지 3개년간 수행되었다. 여름형콩 품종인 새올콩과 다원콩, 가을형콩 품종인 태광콩, 풍산나물콩 및 청자3호를 이용하여 5월 15일, 5월 30일, 6월 15일, 6월 30일, 7월 15일에 파종하였다. 1. 여름형콩 품종 중에서 새올콩은 다원콩에 비해 파종기 지연에 따른 개화일수와 등숙일수 및 생육일수의 짧아지는 정도가 적었다. 2. 가을형콩 품종 중에서 태광콩의 생식생장기 일장반응은 풍산나물콩이나 청자3호보다 낮은 편이었다. 반면에 풍산나물콩과 청자3호의 영양생장기와 생식생장기 일장반응은 기타 시험품종보다 높았고, 그 경향은 풍산나물콩이 더 컷다. 3. 경장, 주경절수 및 주경두께는 대부분 시험품종에서 늦게 파종할수록 감소하는 경향이었으나, 새올콩의 경장과 주경절수는 유의차가 없었다. 4. 여름형콩 품종인 새올콩과 다원콩의 제1착협절위와 모든 시험품종의 절간장은 파종기를 달리하여도 유의차가 없었다. 5. 개체당 협수는 새올콩을 제외한 모든 시험품종에서 파종기가 지연됨에 따라 감소하는 경향이었는데, 소립종인 다원콩과 풍산나물콩에서 변이가 크고, 특히 가을형콩 품종인 풍산나물콩이 더 컷다. 6. 수량은 다원콩과 태광콩 및 풍산나물콩 5월 30일 파종, 청자3호 5월 30일과 6월 15일 파종에서 가장 많았다. 새올콩의 수량은 5월 30일부터 7월 15일 파종기간 유의차가 없고 5월 15일 파종에서 가장 낮았다.

미백보조광 조사가 치아미백의 효과에 미치는 영향 (EFFECT OF THE BLEACHING LIGHT ON WHITENING EFFICACY)

  • 박종현;신혜진;박덕영;박세희;김진우;조경모
    • Restorative Dentistry and Endodontics
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    • 제34권2호
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    • pp.95-102
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    • 2009
  • 이 연구의 목적은 미백제의 치아미백효과에 미백보조광의 빛에너지의 영향을 평가하는 것이다. 발거된 하악 대구치 치관의 설면을 실험에 사용하였고, 하나의 대구치에서 근심과 원심으로 구분되는 2개의 치아절편을 얻었다. 모든 시편을 24시간동안 적포도주에 보관하여 착색을 유도하고, 인공타액에 보관하였다. 시편들은 미백광조사기와 미백 powder의 종류에 따라 4개의 실험군으로 나뉘었으며, 실험군은 다음과 같다. Group 1 : LumaCool로 광조사를 시행, LumaWhite를 사용 Group 2: LumaCool로 광조사를 시행, Polaoffice를 사용 Group 3: FlipoWhite 2로 광조사를 시행 LumaWhite를 사용 Group 4: FlipoWhite 2로 광조사를 시행, Polaoffce를 사용 미백처치는 10분간 매 24시간마다 총 6회 시행하였고, 미백처치시 동일한 치아에서 얻어진 두 개의 시편 중 원심시편에는 미백광조사를 시행한 반면, 근심시편에는 미백광조사를 시행하지 않았다. 색조의 평가는 spectrophotometer를 사용하여 매 미백처지 전과 후에 시행하였고, 근심측과 원심측에서 얻어진 색조 변화 차이를 paired-sample T test를 이용하여 95%의 신뢰수준으로 비교하였다. 미백처치 후 모든 실험군에서 $L^*$ value와 ${\Delta}E$의 증가와 $a^*$ value와 $b^*$ value의 감소가 관찰되었다. Group 2원심 절편의 $a^*$ value와 group 3원심절편의 $b^*$ value에서의 더 큰 변화와 group 4의 원심절편에서의 $a^*$ value가 좀 더 적은 변화를 제외하고, 모든 실험군에서 근심절편과 원심절편사이에서 색조변화의 차이는 통계적 유의성을 보이지 않았다. 이상의 연구 결과에서 미백보조광의 빛에너지는 미백제의 치아미백 효과를 증가시키는 것에 명백한 영향을 주지 않는 것으로 평가되었다.

과산화수소의 산화적 스트레스로 유도된 Apoptosis에 대한 생약복합조성물(HemoHIM)의 방호효과 평가 (Protective Effects of a Herbal Composition (HemoHIM) Against Apoptosis Induced by Oxidative Stress of Hydrogen Peroxide)

  • 신성해;김도순;김미정;김성호;조성기;변명우;이성태
    • 한국식품영양과학회지
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    • 제35권9호
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    • pp.1127-1132
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    • 2006
  • 본 연구팀에서는 방사선으로부터 위장관과 면역조혈계를 방호하기 위하여 당귀, 천궁, 백작약으로 새로운 생약복합물 HIM-I을 개발하였고, HIM-I을 에탄올 침전하여 에탄올 분획(HIM-I-E)과 조다당 분획(HIM-I-P)을 얻은 후, HIM-I에 조다당 분획을 첨가하여 HemoHIM을 제조하여 실험하였으며, 과산화수소를 이용하여 산화적 스트레스를 유발한 후 HemoHIM의 apoptosis 억제 효과를 측정하였다. 과산화수소를 세포주에 처리한 결과 세포독성 증가, 세포막 파괴, subG1기 세포 증가, DNA 절단 현상 등이 관찰되었다. 이때 HIM-I, HIM-I-P, HemoHIM을 첨가하여 전처리 배양한 다음에 과산화수소로 apoptosis를 유도하였다. 그 결과 과산화수소에 의한 세포독성, 세포막 파괴, subG1기 세포, DNA 절단현상 등이 현저하게 감소하는 것으로 나타났다. 전반적으로 HemoHIM의 방호 효과는 HIM-I-P와 비슷하였으며 HIM-I보다 높은 것으로 나타났다. 이상의 결과로 HemoHIM은 면역기능 방호 회복 물질로서 뿐만 아니라 산화적 스트레스에 대한 항산화제로서 유용하게 활용될 수 있을 것으로 생각된다.

홍삼추출액은 lipoteichoic acid로 자극된 소교세포에서 Akt 및 MAPK 의존적으로 heme oxygenase-1 발현을 유도함으로써 NO 생성을 억제함 (A Formulated Korean Red Ginseng Extract Inhibited Nitric Oxide Production through Akt- and Mitogen Activated Protein Kinase-dependent Heme Oxygenase-1 Upregulation in Lipoteichoic Acid-stimulated Microglial Cells)

  • 신지은;이경민;김지희;이스칸더 마디;김영희
    • 생명과학회지
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    • 제29권4호
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    • pp.402-409
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    • 2019
  • 생삼을 쪄서 건조시킨 홍삼은 전통적으로 사용되고 있는 약재로서 면역, 내분비 및 중추신경계 작용을 증진시키며 염증을 억제하는 효과가 있는 것으로 알려져 있다. 본 연구에서는 그람 양성균의 세포벽 성분인 lipoteichoic acid (LTA)에 의한 염증반응에 홍삼추출액(RGE)이 항염증 효과를 가지는지 관찰하고 그 작용 기전을 연구하였다. BV-2 소교세포에서 RGE는 세포에 독성을 유도하지 않으면서 LTA로 인한 nitric oxide (NO)의 생성과 inducible nitric oxide synthase (iNOS) 발현을 억제하였으며, NF-kB p65의 핵으로의 이동과 IkB-a의 분해 또한 억제하였다. 한편, RGE는 농도의존적으로 heme oxygenase-1 (HO-1)의 발현을 유도하였으며, HO-1 siRNA를 처리했을 때는 RGE가 iNOS의 발현을 억제하지 못하였다. RGE는 HO-1의 발현에 관여하는 전사인자인 nuclear factor E2-related factor 2 (Nrf2)를 핵으로 이동을 촉진시켰다. 또한 RGE에 의한 HO-1의 발현은 phosphatidylinositol-3-kinase(PI-3K) 및 MAPK 억제제에 의해 감소되었으며, RGE가 Akt와 ERK, p38, JNK의 인산화를 유도하였다. 이상의 결과를 종합해보면, RGE는 PI-3K/Akt 및 ERK, p38, JNK 신호전달과정을 통해 HO-1의 발현을 유도함으로써 NO와 같은 염증매개물질의 생성을 억제한다는 것을 알 수 있다. 그러므로 홍삼추출액은 그람 양성균에 의한 신경염증과 염증관련 신경계 질환의 치료제로서 사용될 수 있을 것이라 사료된다.

합천(陜川) 해인사(海印寺) 희랑대사상(希朗大師像)의 특징과 제작 의미 (Characteristics and Significance of the Huirang Daesa Sculpture at Haeinsa Temple in Hapcheon)

  • 정은우
    • 미술자료
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    • 제98권
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    • pp.54-77
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    • 2020
  • 희랑대사상은 고려시대에 제작된 상으로 높이 82.4cm, 무릎폭 66.6cm, 앞뒤 최대폭 44cm에 이르는 등신상에 가까운 크기이다. 제작 기법은 승상의 앞면과 뒷면을 건칠과 나무를 접합하여 만든 것으로 동아시아의 유일한 사례로 주목된다. 유사한 기술이 나말여초의 작품으로 추정되는 봉화 청량사 건칠약사여래좌상에 이미 적용된 바 있어 이 시기의 특징으로 이해된다. 희랑대사상에 대해서는 18세기에 쓰여진 가야산을 여행하면서 쓴 기행문에 구체적으로 기술되어 있다. 즉 승상의 가슴에 있는 구멍과 힘줄과 뼈가 울퉁불퉁하다는 등의 독특한 특징은 현재의 희랑대사상과 정확하게 부합된다. 가슴에 있는 구멍은 신통력의 상징으로 3~4세기에 활동한 서역의 승려 불도징(佛圖澄)의 가슴에도 있었다고 한다. 또한 당시에는 흑칠 상태였으며, 19세기에 현재와 같이 채색되었음도 알 수 있다. 봉안 전각은 해인사의 해행당(解行堂)과 진상전(眞常殿)이었으며, 이후 조사전과 보장전을 거치면서 현재에 이른다. 우리나라에서 승상의 제작과 봉안은 삼국시대부터 있었던 것으로 문헌 기록에 등장하지만 현존하는 작품은 매우 드문 편이다. 현재 우리나라에 남아있는 승상의 초상조각은 고려시대의 희랑대사상을 비롯하여 조선시대에 제작된 나옹과 의상대사상 등 모두 네 구뿐이다. 이 가운데 희랑대사상은 고려 초기 10세기경에 제작된 상으로서 최고의 제작 기술과 사실적인 재현 그리고 내면의 인품까지 표현한 점에서 예술적 가치가 뛰어난 작품이다. 승상을 제작하여 숭배하고 신성시하는 전통은 한국만이 아니라 중국, 일본 등 동아시아에서 크게 유행하였다. 다만 재료와 제작 기술에 대해서는 나라마다 차이와 특이성을 보이며 발전하였다. 중국은 육신불(肉身佛)이 많은 편이며 일본은 건칠, 나무, 흙 등 시대마다 다양한 재료를 이용하여 많은 승상을 제작하였다. 저마다 다른 재료와 기법을 사용했지만 동아시아 각국의 승상 제작은 승려의 참모습과 정신성의 성공적 표현을 추구하였다는 점에서는 다르지 않다.

국내 뇌졸중 환자를 대상으로 한 일상생활활동 중재 연구 분석: 단일대상연구 설계를 중심으로 (Analysis of Intervention in Activities of Daily Living for Stroke Patients in Korea: Focusing on Single-Subject Research Design)

  • 성지영;최유임
    • 재활치료과학
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    • 제13권1호
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    • pp.9-21
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    • 2024
  • 목적 : 본 연구의 목적은 뇌졸중 환자에게 일상생활활동 향상을 위해 중재를 시행한 국내 단일대상연구문헌의 특성과 질적 수준을 확인하는 것이다. 연구방법 : 학술연구정보서비스(Research Information Sharing Service), 누리미디어(DBpia), 학술교육원(e-article)의 원문제공 서비스를 통해 2009년부터 2023년까지 최근 15년간 발간된 논문 중 '뇌졸중', '일상생활활동', '단일대상연구'를 주요 키워드로 검색하였다. 총 9편의 논문을 대상으로 분석 대상 논문의 특징과 질적 수준을 알아보았다. 결과 : 9편의 분석 대상 논문 중 작업치료 분야 학회지에 실린 논문이 6편이었고, 분석 논문에서 적용한 연구 설계는 ABA 설계가 3편으로 가장 많았다. 대상자들의 성별은 남성과 여성이 각각 10명씩이었고, 대상자 수가 3명인 논문이 5편으로 가장 많았다. 연구 대상자들의 연령은 60대가 6명으로 가장 많았다. 일상생활활동 향상을 위해 적용한 독립변인은 강제유도운동치료, 상상연습, 시각되먹임을 차단한 자세 수직훈련, 양측성 상지운동, 가상현실을 이용한 과제훈련, 신경인지재활치료와 전통적인 작업치료, 체간 안정화 훈련, 완곡추적 안구운동과 경부신전근 진동자극법, 작업기반 지역사회 재활 각각 1편씩으로 다양한 중재들을 적용하고 있는 것으로 나타났다. 종속변인을 측정한 평가도구는 Assessment of Motor and Process Skills이 4편으로 가장 많았고, Modified Barthel Index와 Canadian Occupational Performace Measure가 각각 2편이었다. 분석 논문의 질적 수준을 평가한 결과 총 9편 중 높은 수준의 연구가 7편이었고, 중간 수준의 연구는 2편이었으며, 낮은 수준의 연구는 단 1편도 없었다. 결론 : 뇌졸중 환자의 일상생활활동 향상을 위한 중재법으로 여러 유형의 재활치료가 활발히 적용되고 있으며, 일상생활활동 중재를 적용한 단일대상연구들의 질적 수준은 신뢰할 수준인 것을 확인할 수 있었다.

가족계획과 모자보건 통합을 위한 조산원의 투입효과 분석 -서산지역의 개입연구 평가보고- (An Intervention Study on Integration of Family Planning and Maternal/Infant Care Services in Rural Korea)

  • 방숙;한성현;이정자;안문영;이인숙;김은실;김종호
    • Journal of Preventive Medicine and Public Health
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    • 제20권1호
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    • pp.165-203
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    • 1987
  • This project was a service-cum-research effort with a quasi-experimental study design to examine the health benefits of an integrated Family Planning (FP)/Maternal & Child health (MCH) Service approach that provides crucial factors missing in the present on-going programs. The specific objectives were: 1) To test the effectiveness of trained nurse/midwives (MW) assigned as change agents in the Health Sub-Center (HSC) to bring about the changes in the eight FP/MCH indicators, namely; (i)FP/MCH contacts between field workers and their clients (ii) the use of effective FP methods, (iii) the inter-birth interval and/or open interval, (iv) prenatal care by medically qualified personnel, (v) medically supervised deliveries, (vi) the rate of induced abortion, (vii) maternal and infant morbidity, and (viii) preinatal & infant mortality. 2) To measure the integrative linkage (contacts) between MW & HSC workers and between HSC and clients. 3) To examine the organizational or administrative factors influencing integrative linkage between health workers. Study design; The above objectives called for quasi-experimental design setting up a study and control area with and without a midwife. An active intervention program (FP/MCH minimum 'package' program) was conducted for a 2 year period from June 1982-July 1984 in Seosan County and 'before and after' surveys were conducted to measure the change. Service input; This study was undertaken by the Soonchunhyang University in collaboration with WHO. After a baseline survery in 1981, trained nurses/midwives were introduced into two health sub-centers in a rural setting (Seosan county) for a 2 year period from 1982 to 1984. A major service input was the establishment of midwifery services in the existing health delivery system with emphasis on nurse/midwife's role as the link between health workers (nurse aids) and village health workers, and the referral of risk patients to the private physician (OBGY specialist). An evaluation survey was made in August 1984 to assess the effectiveness of this alternative integrated approach in the study areas in comparison with the control area which had normal government services. Method of evaluation; a. In this study, the primary objective was first to examine to what extent the FP/MCH package program brought about changes in the pre-determined eight indicators (outcome and impact measures) and the following relationship was first analyzed; b. Nevertheless, this project did not automatically accept the assumption that if two or more activities were integrated, the results would automatically be better than a non-integrated or categorical program. There is a need to assess the 'integration process' itself within the package program. The process of integration was measured in terms of interactive linkages, or the quantity & quality of contacts between workers & clients and among workers. Intergrative linkages were hypothesized to be influenced by organizational factors at the HSC clinic level including HSC goals, sltrurture, authority, leadership style, resources, and personal characteristics of HSC staff. The extent or degree of integration, as measured by the intensity of integrative linkages, was in turn presumed to influence programme performance. Thus as indicated diagrammatically below, organizational factors constituted the independent variables, integration as the intervening variable and programme performance with respect to family planning and health services as the dependent variable: Concerning organizational factors, however, due to the limited number of HSCs (2 in the study area and 3 in the control area), they were studied by participatory observation of an anthropologist who was independent of the project. In this observation, we examined whether the assumed integration process actually occurred or not. If not, what were the constraints in producing an effective integration process. Summary of Findings; A) Program effects and impact 1. Effects on FP use: During this 2 year action period, FP acceptance increased from 58% in 1981 to 78% in 1984 in both the study and control areas. This increase in both areas was mainly due to the new family planning campaign driven by the Government for the same study period. Therefore, there was no increment of FP acceptance rate due to additional input of MW to the on-going FP program. But in the study area, quality aspects of FP were somewhat improved, having a better continuation rate of IUDs & pills and more use of effective Contraceptive methods in comparison with the control area. 2. Effects of use of MCH services: Between the study and control areas, however, there was a significant difference in maternal and child health care. For example, the coverage of prenatal care was increased from 53% for 1981 birth cohort to 75% for 1984 birth cohort in the study area. In the control area, the same increased from 41% (1981) to 65% (1984). It is noteworthy that almost two thirds of the recent birth cohort received prenatal care even in the control area, indicating that there is a growing demand of MCH care as the size of family norm becomes smaller 3. There has been a substantive increase in delivery care by medical professions in the study area, with an annual increase rate of 10% due to midwives input in the study areas. The project had about two times greater effect on postnatal care (68% vs. 33%) at delivery care(45.2% vs. 26.1%). 4. The study area had better reproductive efficiency (wanted pregancies with FP practice & healthy live births survived by one year old) than the control area, especially among women under 30 (14.1% vs. 9.6%). The proportion of women who preferred the 1st trimester for their first prenatal care rose significantly in the study area as compared to the control area (24% vs 13%). B) Effects on Interactive Linkage 1. This project made a contribution in making several useful steps in the direction of service integration, namely; i) The health workers have become familiar with procedures on how to work together with each other (especially with a midwife) in carrying out their work in FP/MCH and, ii) The health workers have gotten a feeling of the usefulness of family health records (statistical integration) in identifying targets in their own work and their usefulness in caring for family health. 2. On the other hand, because of a lack of required organizational factors, complete linkage was not obtained as the project intended. i) In regards to the government health worker's activities in terms of home visiting there was not much difference between the study & control areas though the MW did more home visiting than Government health workers. ii) In assessing the service performance of MW & health workers, the midwives balanced their workload between 40% FP, 40% MCH & 20% other activities (mainly immunization). However, $85{\sim}90%$ of the services provided by the health workers were other than FP/MCH, mainly for immunizations such as the encephalitis campaign. In the control area, a similar pattern was observed. Over 75% of their service was other than FP/MCH. Therefore, the pattern shows the health workers are a long way from becoming multipurpose workers even though the government is pushing in this direction. 3. Villagers were much more likely to visit the health sub-center clinic in the study area than in the control area (58% vs.31%) and for more combined care (45% vs.23%). C) Organization factors (admistrative integrative issues) 1. When MW (new workers with higher qualification) were introduced to HSC, it was noted that there were conflicts between the existing HSC workers (Nurse aids with less qualification than MW) and the MW for the beginning period of the project. The cause of the conflict was studied by an anthropologist and it was pointed out that these functional integration problems stemmed from the structural inadequacies of the health subcenter organization as indicated below; i) There is still no general consensus about the objectives and goals of the project between the project staff and the existing health workers. ii) There is no formal linkage between the responsibility of each member's job in the health sub-center. iii) There is still little chance for midwives to play a catalytic role or to establish communicative networks between workers in order to link various knowledge and skills to provide better FP/MCH services in the health sub-center. 2. Based on the above findings the project recommended to the County Chief (who has power to control the administrative staff and the technical staff in his county) the following ; i) In order to solve the conflicts between the individual roles and functions in performing health care activities, there must be goals agreed upon by both. ii) The health sub·center must function as an autonomous organization to undertake the integration health project. In order to do that, it is necessary to support administrative considerations, and to establish a communication system for supervision and to control of the health sub-centers. iii) The administrative organization, tentatively, must be organized to bind the health worker's midwive's and director's jobs by an organic relationship in order to achieve the integrative system under the leadership of health sub-center director. After submitting this observation report, there has been better understanding from frequent meetings & communication between HW/MW in FP/MCH work as the program developed. Lessons learned from the Seosan Project (on issues of FP/MCH integration in Korea); 1) A majority or about 80% of the couples are now practicing FP. As indicated by the study, there is a growing demand from clients for the health system to provide more MCH services than FP in order to maintain the achieved small size of family through FP practice. It is fortunate to see that the government is now formulating a MCH policy for the year 2,000 and revising MCH laws and regulations to emphasize more MCH care for achieving a small size family through family planning practice. 2) Goal consensus in FP/MCH shouBd be made among the health workers It administrators, especially to emphasize the need of care of 'wanted' child. But there is a long way to go to realize the 'real' integration of FP into MCH in Korea, unless there is a structural integration FP/MCH because a categorical FP is still first priority to reduce the rate of population growth for economic reasons but not yet for health/welfare reasons in practice. 3) There should be more financial allocation: (i) a midwife should be made available to help to promote the MCH program and coordinate services, (in) there should be a health sub·center director who can provide leadership training for managing the integrated program. There is a need for 'organizational support', if the decision of integration is made to obtain benefit from both FP & MCH. In other words, costs should be paid equally to both FP/MCH. The integration slogan itself, without the commitment of paying such costs, is powerless to advocate it. 4) Need of management training for middle level health personnel is more acute as the Government has already constructed 90 MCH centers attached to the County Health Center but without adequate manpower, facilities, and guidelines for integrating the work of both FP and MCH. 5) The local government still considers these MCH centers only as delivery centers to take care only of those visiting maternity cases. The MCH center should be a center for the managment of all pregnancies occurring in the community and the promotion of FP with a systematic and effective linkage of resources available in the county such as i.e. Village Health Worker, Community Health Practitioner, Health Sub-center Physicians & Health workers, Doctors and Midwives in MCH center, OBGY Specialists in clinics & hospitals as practiced by the Seosan project at primary health care level.

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농촌영유아의 영양상태(營養狀態)에 관(關)한 조사연구(調査硏究) (A Study on Nutritional Status of Young Children in Rural Korea)

  • 김경식;김방지;남상옥;최정신
    • Journal of Preventive Medicine and Public Health
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    • 제7권1호
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    • pp.1-28
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    • 1974
  • The writers have conducted the investigation to assess the nutritional status of young rural Korean children aged from 0 to 4 years old in August 1971. The survey areas were Kaejong-myon. Daeya-myon, Okku-gun, Jeonra-bukdo, Korea. These survey areas were typical agricultural plain areas. The total numbers of children examined were 2,706 comprising 1,394 male and 1,312 female. The weight, height, and chest circumference of children were measured and means and standard deviations. were calculated for each measurement. In addition, the nutritional status of each child was classified by the four levels of malnutrition and the Gomez classification, The examination of red blood cell count, haematocrit value, and intestinal parasite infection were carried out at the same time. In general, recent work tend to suggest that environmental influences, especially nutrition, are of great importance than genetic background or other biological factors for physical growth and development. Certainly the physical dimensions of the body are much influenced by nutrition, particularly in the rapidly growing period of early childhood. Selected body measurements can therefore give valuable information concerning protein-calory malnutrition. Growth can also be affected by bacterial, viral, and parasitic infection. For the field workers in a developing country, therefore, nutritional anthropometry appears to be of greatest value in the assessment of growth failure and undernutrition, principally from lack of protein and calories. In order to compare and evaluate the data obtained, the optimal data of growth from the off-spring of the true well-fed, medically and socially protected are needed. So-called 'Standards' that have been compiled for preschool children in Korea, however, are based on measurement of children from middle or lower socio-economic groups, who are, in fact, usually undernourished from six months of age onwards and continuously exposed to a succession of infective and parasitic diseases. So that, the Harvard Standards which is one of the international reference standards was used as the reference standards in this study. Findings of the survey were as follows: A. Anthropometric data: 1) Comparing the mean values for body weight obtained with the Korean standard weight of the same age, the rural Korean children were slightly haevier than the Korean standard values in both sexes. Comparing with the Japanese children values, the rural Korean children were slightly haevier in male and in the infant period of female but lighter in female of the period of 1 to 4 years old than Japanese children. 2) Comparing the mean values for height obtained with the Korean standard height of the same age, the rural Korean children were taller than the Korean standard values except the second half of infatn period in both sexes. Comparing with the Japanese children, the rural Korean children were slightly smaller than Japanese children except the first half of infant peroid in both sexes. 3) Mear values of chest circumference of rural Korean children obtained were less than the Korean standard values of the same ages in both sexes. B. Prevalence of Protein-Calory Malnutrition: Children examined were devided into two groups, i. e., infant(up to the first birthday) and toddler (1 to 4 fears old). 1) Percentages of four levels of malnutrition: a) When the nutrtional status of each child was classified (1) by body weight value, the percentages for male and female of children attained standard growth were 52.8%(infant 83.3%, toddler 44.4%) and 39.7% (infant 74.5%. toddler 30.5%), the first level of malnutrition were 31.9%(infant 13.7%, toddler 36.9%) and 31.7%(infant 15.3%, toddler 36,0%), the second level of malnutrition were 12.3%(infant 1.7%, toddler 15.3%) and 23.3% (infant 7.7%, fodder 27.5%), the third level of malnutrition were 2.7%(infant 0.7%, toddler 3.2%) and 4.6%(infant 1.8%, toddler 5.3%) the fourth level of malnutrition were 0.3% (infant 0.7%, toddler 0.2%) and 0.7% (0.7% for infant and toddler) respectively. (2) by height value, the percentages for male and female of children attained standard growth were 80.3% (infant 97.3%, toddler 75.6%) and 75.1% (infant 96.4%, toddler 69.5), the first level of malnutrition were 17.9% (infant 2.0%, toddler 22.3%) and 23.6% (infants 3.6%, toddler 28.8%), the second level of malnutrition were 1.2% (infant 0.3%, toddler 1.5%) and 1.1% (infant 0%, toddler 1.4%), the third level of malnutrition were 0.4%(infant 0.3%, toddler 0.5%) and 0.2%(infant 0%, toddler 0.3%), the fourth level of malnutrition were 0.1%(infant 0%, toddler 0.1%) and 0% respectively. (3) by body weight in relation to height, the percentages for male and female of children attained standard growth were 87.9% (infant 77.6%, toddler 87.9%) and 78.2% (infant 77.4%, toddler 78.2%), the first level of malnutrition were 12.2% (infant 18.4%, toddler 10.6%) and 18.2% (infant 17.9%, toddler 18.3%), the second level of malnutrition were 1.9%(infant 3.3%, toddler 1.5%) and 3.0%(infant 3.3%, toddler 2.9%), the third level of malnutrition were 0.1%(infant 0%. toddler 0.1%) and 0.5% (infant 0%, toddler 0.6%), the fourth level of malnutrition were 0.1%(infant 0.7%, toddler 0%) and 0.3% (infant 1.5%, toddler 0%) respectively. b) When the nutritional status of each child according to the mother's age at perturition, i. e., young aged mother (up to 30 years old), middle aged mother (31 to 40 years old) and old aged mother (41 years or above) was classified (1) by body weight, among infants and toddlers, at each year of age, with increasing the mother's age, there was an increase in percentage of subjects underweight. This tendency of increasing percentage of underweight was more significant in the infant period than the toddler period. (2) by height value, no significant differences between each mother's age group were found. c) When the nutritional status of each child according to the birth rank, i. e., lower birth rank (first to third) and higher birth rank (fourth or above) was classified (1) by weight value, children of higher birth rank were slightly more often underweight than those of lower birth rank, but not significant. (2) by height value, no differences were found between children of lower and higher birth rank. 2) Gomez Classification: When the nutritional status of each child was classified a) by body weight value, the percentages for male and female of children. attained standard growth were 53.1% (infant 82.6%, toddler 44.9%) and 39.2% (infant 73.4%, toddler 30.1%), the first degree of malnutrition were 39.4% (infant 14.7%, toddler 46.2%) and 47.1% (infant 21.9%, toddler 53.8%), the second degree of malnutrition were 7.3%(infant 2.3%, toddler 8.6%) and 12.9% (infant 4.0%, toddler 15.2%). and the third degree of malnutrition were 0.2%. (infant 0.3%, toddler 0.2%) and 0.8% (infant 0.7%, toddler 0.9%) respectively. b) by height value, the percentages for male and female of children attained standard growth were 80.8% (infant 97.0%, toddler 76.3%) and 73.8%(infant 95.6%, toddler 68.0%), the first degree of malnutrition were 18.5% (infant 2.7%, toddler 22.9%) and 24.6% (infant 4.4%, toddler 30.0%), the second degree of malnutrition were 0.6%(infant 0.3%, toddler 0.7%) and 0.5% (infant 0.1%, toddler 0.7%), and the third degree of malnutrition were 0.1%(infant 0%, toddler 0.1%) and 1.1% (infant 0%, toddler 1.3%) respectively. C. Results of clinical laboratory examination: 1) Red blood cells: The ranges of mean red blood cell counts for male and female were $3,538,000/mm^3\;to\;4,403,000/mm^3\;and\;3,576,000/mm^3\;to\;4,483,000/mm^3$ respectively. The lowest red cell counts were seen at the age of 0-3 months for male and 1-2 months for female. 2) Haematocrit value : The ranges of haematocrit value of male and female were 35.1% to 38.8% and 34.7% to 38.8% respectively. The lowest haematocrit values were seen at the age of 2-3 months for male and 1-2, months for female. 3) The prevalence rates of intestinal parasites for male and female children with Ascaris lumbricoides were 34.1% (infant 18.8%, toddler 38.1%) and 36.0%(infant 18.4%, toddler 40.7%), with Trichocephalus trichiuris were 6.8% (infant 2.9%, toddler 7.9%) and 9.0% (infant 3.0%, toddler 10.6%), with Hookworm were 0.3% (infant 0.5%, toddler 0.2%) and 0.3% (infant 0.5%, toddler 0.3%), with Clonorchis sinensis were 0.4%(infant 0%, toddler 0.5%) and 0.1%(infant 0%, toddler 0.1%) respectively.

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