• Neonatal Medicine
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• v.16 no.2
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• pp.154-162
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• 2009

Purpose: Death is an important problem for physicians and parents in neonatal intensive care unit. This study was intended to evaluate the mortality rate, causes of death, and the change of mortality rate by year for infants admitted to the neonatal intensive care unit. Methods: We retrospectively surveyed the medical records of the infants who were admitted to the neonatal intensive care unit at Asan Medical Center and who died before discharge between 1998 and 2007. Gestational age, birth weight, gender, time to death and the underlying diseases related to the causes of infant deaths and obtained from the medical records and analyzed according to year. Results: A total of 6,289 infants were admitted and 264 infants died during the study period. The overall mortality rate was 4.2%. For very low and extremely low birth weight infants, the mortality rate was 10.6% and 21.4%, respectively. There was no significant change in the mortality rate during the study period. Prematurity related complications and congenital anomalies were the conditions most frequently associated with death in the neonatal intensive care unit. of the infant deaths 37.1% occurred within the first week of life. Conclusion: Even though a remarkable improvement in neonatal intensive care has been achieved in recent years, the overall mortality rate has not changed. To reduce the mortality rate, it is important to control sepsis and prevent premature births. The first postnatal week is a critical period for deaths in the neonatal intensive care unit.

• Clinical and Experimental Pediatrics
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• v.60 no.1
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• pp.10-16
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• 2017

Purpose: Although procalcitonin (PCT) level is useful for the diagnosis of neonatal sepsis, PCT reliability is inconsistent because of the varied conditions encountered in neonatal intensive care units. This study aimed to investigate PCT levels and factors influencing increased PCT levelin newborns without bacterial infection during the first week of life. Methods: In newborns hospitalized between March 2013 and October 2015, PCT levels were measured on the first, third, and seventh days after birth. Newborns with proven bacterial (blood culture positive for bacteria) or suspicious infection (presence of C-reactive protein expression or leukocytosis/leukopenia) were excluded. Various neonatal conditions were analyzed to identify the factors influencing increased PCT level. Results: Among 292 newborns with a gestational age of $35.2{\pm}3.0$ weeks and a birth weight of $2,428{\pm}643g$, preterm newborns (n=212) had higher PCT levels than term newborns (n=80). Of the newborns, 7.9% had increased PCT level (23 of 292) on the firstday; 28.3% (81 of 286), on the third day; and 3.3% (7 of 121), on the seventh day after birth. The increased PCT level was significantly associated with prenatal disuse of antibiotics (P=0.004) and surfactant administration (P<0.001) on the first day after birth, postnatal use of antibiotics (P=0.001) and ventilator application (P=0.001) on the third day after birth, and very low birth weight (P=0.042) on the seventh day after birth. Conclusion: In newborns without bacterial infection, increased PCT level was significantly associated with lower gestational age and respiratory difficulty during the first week of life. Further studies are needed for clinical applications.

• Archives of Plastic Surgery
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• v.43 no.2
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• pp.153-159
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• 2016

Background The prenatal ultrasound detection of cleft lip with or without cleft palate (CL/P) and its continuous management in the prenatal, perinatal, and postnatal periods using a multidisciplinary team approach can be beneficial for parents and their infants. In this report, we share our experiences with the prenatal detection of CL/P and the multidisciplinary management of this malformation in our institution's Congenital Disease Center. Methods The multidisciplinary team of the Congenital Disease Center for mothers of children with CL/P is composed of obstetricians, plastic and reconstructive surgeons, pediatricians, and psychiatrists. A total of 11 fetuses were diagnosed with CL/P from March 2009 to December 2013, and their mothers were referred to the Congenital Disease Center of our hospital. When CL/P is suspected in the prenatal ultrasound screening examination, the pregnant woman is referred to our center for further evaluation. Results The abortion rate was 28% (3/11). The concordance rate of the sonographic and final diagnoses was 100%. Ten women (91%) reported that they were satisfied with the multidisciplinary management in our center. Conclusions Although a child with a birth defect is unlikely to be received well, the women whose fetuses were diagnosed with CL/P on prenatal ultrasound screening and who underwent multidisciplinary team management were more likely to decide to continue their pregnancy.

• The Journal of Korean Obstetrics and Gynecology
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• v.33 no.2
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• pp.63-76
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• 2020

Objectives: The purpose of this study is to compare postpartum symptoms of 528 women by age groups and delivery method through health questionnaires of postpartum care center. Methods: From January 2018 to December 2018, we statistically compared the 528 women's postpartal symptoms who divided into 4 age groups using SPSS Statistics 21.0 program. Results: There were no differences in weight changes, gestational age and degree of subjective discomfort by age (p>.05). On the other hand, parity, fetal weight and delivery method were statistically associated with age (p<.05). Especially the rate of cesarean delivery was increased with age. Degree of feeling dyspepsia and edema was higher in cesarean section delivery group (p<.05). Also, as the weight increased by 1 kg during pregnancy, the degree of feeling postnatal edema increased by 0.204 (β=0.204, t=4.204, p<.05). Conclusion: This study showed that age itself will not affect postpartum symptoms alone. Instead it is necessary to consider post-cesarean delivery symptoms for advanced maternal age.

• Women's Health Nursing
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• v.6 no.2
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• pp.291-304
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• 2000

Being a mother is motherhood which means maternal role attainment and has to meet maternal identity and role confidence of caring infant. This study was designed to examine maternal identity as a motherhood and role confidence in the immediate postpartum period, and then explain the correlations of them. Data were collected for 2 months by questionnaires from 64 mothers in the hospital. The scales were to measure motherhood questionnaire which consisted of 11 items and role confidence questionnaire which consisted of 13 items. The analysis of data was done with SPSSWIN program for descriptive statistics and t-test, chi-square, ANOVA, Multiple Regression Analysis. The results were as follows: 1. Mean score of maternal identity of primipara was 55.41 and multipara was 53.81. In this outcome primipara's score was higher than multipara's. 2. Mean score of role confidence of primipara was 44.0 and multipara was 46.81. Multipara's score was higher than primipara's. 3. Correlation between maternal identity and role confidence was r=0.29(P=0.03). This was a interesting result. Because many studies reported that primipara had a lower score of maternal identity and role confidence than multipara's. But this study showed that primipara's score of maternal identity was higher than multipara's. So nurse has to support primipara's identity as a mother, taking advantage of nursing intervention from prenatal to postnatal periods. Also nurse has to offer many opportunities to experience premiparas and multiparas how to care their infants.

• Clinical and Experimental Pediatrics
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• v.57 no.3
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• pp.117-124
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• 2014

Purpose: Administration of antiretroviral drugs to mothers and infants significantly decreases mother-to-child human immunodeficiency virus (HIV) transmission; cesarean sections and discouraging breastfeeding further decreases this risk. The present study confirmed the HIV status of babies born to mothers infected with HIV and describes the characteristics of babies and mothers who received preventive treatment. Methods: This study retrospectively analyzed medical records of nine infants and their mothers positive for HIV who gave birth at Korea University Ansan Hospital, between June 1, 2003, and May 31, 2013. Maternal parameters, including HIV diagnosis date, CD4+ count, and HIV ribonucleic acid (RNA) copy number, were analyzed. Infant growth and development, HIV RNA copy number, and HIV antigen/antibody test results were analyzed. Results: Eight HIV-positive mothers delivered nine babies; all the infants received antiretroviral therapy. Three (37.5%) and five mothers (62.5%) were administered single- and multidrug therapy, respectively. Intravenous zidovudine was administered to four infants (50%) at birth. Breastfeeding was discouraged for all the infants. All the infants were negative for HIV, although two were lost to follow-up. Third trimester maternal viral copy numbers were less than 1,000 copies/mL with a median CD4+ count of $325{\mu}L$ ($92-729{\mu}L$). Among the nine infants, two were preterm (22.2%) and three had low birth weights (33.3%). Conclusion: This study concludes that prophylactic antiretroviral therapy, scheduled cesarean section, and prohibition of breastfeeding considerably decrease mother-to-child HIV transmission. Because the number of infants infected via mother-to-child transmission may be increasing, studies in additional regions using more variables are necessary.

• Journal of Society of Preventive Korean Medicine
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• v.10 no.1
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• pp.33-51
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• 2006

With the reduction of contagious diseases throughout the world and prolonged life expectancy has lead into increase of habitual related diseases. Industrial development and better economic situation made people more concerned about their health. As primary illnesses are subdued in the past years, health care system and the public value prevention and well-being more than the treatment itself. Based on this trend, this study focused on the view of life from the perspective of Oriental medicine as it's peculiarities, regimen methods, and the definition of healthy life are evaluated. Following results were obtained: - View of life in Oriental medicine focused on two basic principles of interrelationship between the organs internally, inter-dependency with the natural environment and social surrounding externally as recognition and respect between the medium were valued. - Sustaining and maintaining good health in Oriental medicine are closely related to prenatally healthy pregnancy and fetation, as well as prenatal training. Postnatal maintenance includes accommodation to seasonal changes, adequate food intake, mind control, various regimen methods and avoidance of wrong doings. - Defining health includes body's internal condition and external influences, principles of essence, qi, spirit, and yin and yang, harmony and balance, and individuality. - To conclude, good health in Oriental medicine is defined as 'external adaptation to society and natural environment, and internal balancing of individual difference with accumulation of essence, nurturing and circulating qi, and every material around the body in harmony and balance."

• Korean Journal of Acupuncture
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• v.25 no.4
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• pp.187-204
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• 2008

Objectives : To investigate how Korean Medicine Doctors (KMDs) and pregnant women understand acupuncture treatment during pregnancy with a focus on safety. Methods : A survey was conducted in 163 KMDs and 157 women who were hospitalised in postnatal care clinics after childbirth. KMDs were asked regarding experience in acupuncture treatment for pregnant women and condition/disease for acupuncture treatment, intention to give acupuncture treatment to pregnant women and reason for yes/no, and consideration for acupuncture treatment for pregnant women. Patients were asked regarding their experience in acupuncture treatment before and during pregnancy and willingness to receive acupuncture treatment if necessary during future pregnancy. Results : 78% of KMDs have given acupuncture treatment to pregnant women if necessary, and it was mainly for pain. 63% of KMDs were willing to give acupuncture treatment for pregnant women with consideration of patient’s condition, specific acupuncture points, and stimulation methods. Pregnant women, however, were reluctant to receive acupuncture treatment during pregnancy (58%) in fear of miscarriage or needling itself. KMDs’ clinical experience, patients’ income level and level of education were not associated with greater use of acupuncture treatment during pregnancy (P>0.05). Conclusion : While many KMDs are willing to give acupuncture treatment to pregnant women if necessary, little evidence on its safety and effectiveness prevents patients from seeking acupuncture treatment during pregnancy. Further research on this issue is urgently needed.

• Journal of Preventive Medicine and Public Health
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• v.9 no.1
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• pp.39-47
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• 1976

The organized community is the one of the best system for the effective public health administration, and a model area was selected for the study to see what would be achieved when a certain small community is placed under the special public health control based on the family unit. The 178 families involved total of 875 populations. The rate of vaccination with B.C.G. among 191 infants and children could be increased upto 100.0% from 72.5% of the time when the basic study was performed after 8 months period of this study; 99.0% from 47.1% with D.P.T.; 96,9% from 71.7% against smallpox; 83.2% from 69.1% against poliomyelitis; but only 25,7% from 21.5% against measles. The status of family planing was 36.8% among 155 women of possible conception at the time of the basic research. And, at the end of this study, the number of women utilizing one of the methods of contraception for family planning were increased upto 52.9% among the same number. The most frequently utilized method was 34.1% of oral pills followed by 30.5% of intrauterine device; but both of which had higher rate of interruption of use because of the complications, 14.3% and 16.0% respectively. The 10 pregnant women at the time of basic research experienced normal deliveries during the period of study and they had received pre and postnatal health care through this health center. The status of oral hygiene, pulmonary tuberculosis control, and parasitological examination were also reported as well as the cases with diseases seen among the population and vaccinations performed against other infectious diseases. The stress on discussion was placed upon the effectiveness of public health administration when it is undergone on the individual family unit to achieve the best results. However, the shortness of both personnel and material resources were considered to be the one of the major difficulties retarding the generalization of the idea obtained through this study based on family unit public health administration.

• Women's Health Nursing
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• v.25 no.3
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• pp.315-328
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• 2019

Purpose: The purpose of this study was to explore the components and nature of happiness in middle-aged women in Korea. Methods: Thirty middle-aged women living in metropolitan Seoul and Gyeonggi and Chungcheong provinces agreed to participate in this study. The data were collected through in-depth interviews with the participants in one-on-one settings. The data were analyzed qualitative using Colaizzi's method of phenomenology. Results: The three theme clusters were extracted from the raw data, along with 13 themes and 138 meaningful sentences and phrases. The three happiness theme clusters in middle-aged women were "live healthy for stability," "rule one's mind for harmony," and "activate hopes for self-esteem." The first theme cluster included healthy life, economic stability, physical youth, and positive thought. The second theme cluster included that harmonious family, ruling of mind, my position as invisible person in social relationships, and precious relationships to support. The last theme included the center of one's life is oneself, a sense of accomplishment, self-improvement, recognition of one's worth and rest for one self. The three theme clusters were associated with the existence, relatedness, and growth (ERG) of ERG areas, respectively. Conclusions: We conclude that the core components of happiness in middle-aged women are to live healthy and mind-ruled and activate hope. The nature of happiness is egocentric stability in middle-aged women. The results suggest that theme clusters might be used to develop a scale for measuring happiness in middle-aged women. This will be helpful to assess the psychosocial status of middle-aged women in Korea.