PURPOSE:Craniopharyngioma is one of the most common causes of organic growth hormone deficiency leading to pituitary hormonal insufficiency. However, some growth hormone(GH)-deficient children with craniopharyngioma may grow normally or even show accelerated growth. This study was designed to evaluate several factors associated with growth of patients with craniopharyngioma. METHODS:Forty children operated on for craniopharyngioma were evaluated for their pituitary function, serum insulin like growth factor-I(IGF-I), serum insulin like growth factor binding protein-3(IGFBP-3) and serum prolactin levels. We also observed their growth status and corresponding changes with or without GH treatment. RESULTS:Among 40 patients, one had normal pituitary hormonal status and one had isolated GHD(GH deficiency). The other patients showed multiple pituitary hormone deficiency including GH(98%), LH, FSH(75%), TSH(65%), ACTH(62%), and ADH(38%) deficiencies. Patients with GHD were categorized into 2 groups. Group 1 consisted of children who showed normal growth, thus had not received GH treatment(n=14) and Group 2, those who showed subnormal growth(n=25). Patients in Group 2 were subdivided into Group 2A, when the patients had not received GH treatment in spite of subnormal growth(n=9) and Group 2B, when GH treatment had been added later on(n=16). There were no differences in the age at diagnosis of GHD, initial height standard deviation score(Ht SDS), body mass index(BMI), peak GH concentration between Group 1 and Group 2. Height velocities in Group 1, 2A, and 2B were 8.1+/-.2 cm/yr, 2.4+/-.2 cm/yr, 2.7+/-.2 cm/yr during the first year of endocrinologic follow-up, 7.1+/-.8 cm/yr, 1.2+/-.1 cm/yr, 7.6+/-.7 cm/yr during the second year, 5.9+/-.0 cm/yr, 2.8+/-.9 cm/yr, 7.3+/-.7 cm/yr during the third year, respectively. BMI changes during the first year of endocrinologic follow-up and postoperative prolactin levels were not significantly different between Group 1 and Group 2A. Postoperative IGF-I and IGFBP-3 levels in Group 1 were significantly higher than those in Group 2A(P<0.05). Both IGFBP-3 and prolactin levels correlated significantly with height velocity in Group 1 and 2A(P=0.004 r=0.64 and P= 0.035 r=0.74 , respectively). CONCLUSION: In this study, growth in children with craniopharyngioma was likely to be associated with IGF-I, IGFBP-3 and prolactin levels. Further studies are needed to unravel other growth promoting factors related to GH independent growth.
Child* ; Craniopharyngioma* ; Diagnosis ; Follow-Up Studies ; Growth Hormone ; Humans ; Insulin ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Prolactin

Promoting women's health lifestyles are important due to their connection to family health. The purpose of this study was to analyse women's health lifestyles(HLP) and their effects on women's life-cycle, so in order to develop a program in a women's health care center. The subjects included were 1080 women over 18 years old living in Wonju city, and were selected by stratified and purposive sampling. The data were collected through a questionnaire and interview. The Cronbach alpha, %, mean, ANOVA, Pearson's correlation, and regression in SPSS PC Win. package was used to analyze the data. The sample was sepernted into three groups premarital group 20.2%(premarital women between 18 and 40 years old), delivery and children rearing group 49.9%(marital women between 18 and 40 years old), over middle agedelderly group 29.9%(women over 41 years old). Significant difference were found in the HPL according to group. Also, relating variables, such as self-efficacy, family functions, health locus of control and gender role perception that were considered relating variables to HPL significantly differed among the tree groups. HLP significantly correlated with self-efficacy, family functions, HLOC and gender role perception in all participants and at all groups. The regression analysis of HPL was interpreted 40.6% with relating variables, self-efficacy, health attention, family functions, and internal locus of control, health perception, power other locus of control and chance locus of control in all participant. Self-efficacy, family functions, health attention were considered important variables in premarital group, self-efficacy, family functions, internal locus of control, health attention, health perception and power of control were important in delivery-rearing group. Self-efficacy, health attention, internal locus of control, family functions and health perception were important in middle aged-elderly group. As a result, we found the differences HPL scores and relating variables according to life-cycle groups. Therefore, we should prepare health promoting education programs for women according to women's life cycles. Also we suggest that women's health care centers based on communities was needed for proper management of women's health.
Adolescent ; Child ; Education ; Family Health ; Female ; Gangwon-do ; Gender Identity ; Humans ; Internal-External Control ; Life Cycle Stages ; Life Style* ; Surveys and Questionnaires ; Women's Health

PURPOSE: There have been global initiatives and efforts over the last decade to manage patient safety. Thus aims of this study were to examine university hospital nurses' perceptions of patient safety culture and levels of safety control, and to identify factors that affect patient safety management activities. METHODS: Participants were 222 nurses who had worked as nurses for more than one year and who conducted patient safety management activities at a university hospital. Data were collected using structured questionnaires and were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson correlation coefficient, and multiple regression analysis with SPSS/WIN 20.0 computer program. RESULTS: General factors which positively impacted nurses' patient safety management were total length of work in nursing, total length of work in present hospital, and experience of a patient safety accident along with safety factors of perception of communication about accident related events and frequency of reporting accident events. These variables explained 45% of the variance in patient safety management activities. CONCLUSION: The findings from this study suggest solutions to promote patient safety management activities in hospitals and provide basic background for nursing education intervention strategies to promote safety control and patient safety management activities intended for nurses.
Education, Nursing ; Humans ; Nursing ; Patient Safety* ; Safety Management

Neonatal alloimmune thrombocytopenia(NAIT) is a rare disease caused by maternal alloimmunization against fetal platelet surface antigen, which is mainly platelet specific alloantigen or human leukocyte antigen(HLA). During routine hemotology, we accidentally discovered thrombocytopenia in a female fullterm newborn admitted due to jaundice. We excluded NAIT due to human platelet alloantigen(HPA), because the HPA of the mother and baby were the same on PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism). Mother's serum was tested for lyrnphocytotoxity against 36 donor lymphocytes, and anti-HLA A2, A24 and B58 were found. HLA typing of the father and baby revealed A2 antigen which was not present on the mothers lymphocytes. The patient received concentrated platelet and intravenous globulin. Her platelet count increased to 222,000/mm from 3,000/mm on the 11th day of life. We described a case of NAIT due to anti-HLA A2 antibody with a detailed clinical feature. (J Korean Pediatr Soc 1999;43:861-865)
Antigens, Surface ; Blood Platelets ; Fathers ; Female ; Histocompatibility Testing ; Humans ; Infant, Newborn ; Isoantigens ; Jaundice ; Leukocytes ; Lymphocytes ; Mothers ; Platelet Count ; Rare Diseases ; Thrombocytopenia ; Thrombocytopenia, Neonatal Alloimmune* ; Tissue Donors

The purposes of this study are to define the scope of occupational health management and to classify occupational management by review of related journals from 1945 to 1994 in Korea. The steps of this study were as follows: (l)Search of secondary reference; (2) Collection and review of primary reference; (3) Survey; and (4) Analysis and discussion. The results were as follows; 1. Most of the respondents majored in occupational health(71.6%), and were working in university (68.3%), males and over the age 40. Seventy percent of the respondents agreed with the idea that classification of occupational health management is necessary, and 10% disagreed. 2. After integration of the idea of respondents, we reclassified the scope of occupational health management. It was defined 3parts, that is, occupational health system, occupational health service and others (such as assessment, epidemiology, cost-effectiveness analysis and so on). 3. The number of journals on occupational health management was 510. It was slightly increased from 1986 and abruptly increased after 1991. The kinds of journals related to occupational health management were The Korean Journal of occupational Medicine(18.2%), several kinds of Medical College Journal(17.0%), The Korean Journal occupational Health(15.l%), The Korean Journal of preventive Medicine(15.l%) and others(34.6%). As for the contents, the number of journals on occupational health management systems was 33(6.5%) and occupational health services 477(93.5%). Of the journals on occupational health management systems, the number of journals on the occupational health resource system was 15(45.5%), occupational finance system 8(24.2%), occupational health management system 6(l8.2%), occupational organization 3(9.1%) and occupational health delivery system l(3.0%). of the journals on occupational health services, the number of journals on disease management was 269(57.2%), health management 116(24.7%), working environmental management 85(18.1%). As for the subjects, the number of journals on general workers was l85(71.l%), followed by women worker, white color workers and so on. 4. Respondents made occupational health service(such as health management, working environmental management and health education) the first priority of occupational health management. Tied for the second are quality analysis(such as education, training and job contents of occupational health manager) and occupational health systems(such as the recommendation of systems of occupational and general disease and occupational health organization). 5. Thirty seven respondents suggested 48 ideas about the future research of occupational health management. The results were as follows: (l) study of occupational health service 40.5%; (2) Study of organization system 27.1%; (3) Study of occupational health system (e.g. information network) 8.3%; (4) Study of working condition 6.2%; and (5) Study of occupational health service analysis 4.2%.
Classification* ; Surveys and Questionnaires ; Disease Management ; Education ; Epidemiology ; Female ; Humans ; Korea* ; Male ; Occupational Health Services ; Occupational Health*

No abstract available.

PURPOSE: The purpose of this study was to evaluate the effects of theophylline in preterm infants with apnea on glucose homeostasis and insulin values. METHOD: In this prospective study, level of glucose and insulin were measured from peripheral blood of 8 neonates(1,450+/-114gm, 31+/-2.1week), who were admitted from April 1, 1997 to July 30, 1997 in Neonatal Intensive Care Unit of Wonkwang University Hospital, for apnea of prematurity(> 20 sec with bradycardia and/or cyanosis) were given aminophylline intravenously. Blood samples were collected at pretreatment, posttreatment 2hours, 1-2days, 3-4days, 5-7days and posttreatment 48hours, and compare to those of the 8 control neonates(1,711+/-232gm, 32+/-1.7week). RESULTS: The results were as follows: 1) Plasma glucose values were significantly higher in the treatment group than those of the control group at 1-2days(104.67+/-20.39mg/dL vs 83.43+/-15.86mg/dL) and 3-4days(111.0+/-32.39mg/dL vs 79.25+/-14.03mg/dL)(p<0.05). 2) Plasma glucose values which were increased at 1-2days(104.67+/-20.39mg/dL)and 3-4days(111.0+-32.39mg/dL), were significantly higher than pretreatment values(66.33+/-31.19mg/ dL)(p<0.02), but were not increased to the level of hyperglycemia(> 125mg/dL). 3) The mean posttreatment glucose levels drawn at 48hours after discontinuation of theophylline was significantly decreased to the values of pretreatment values compared to those of the 1-2days and 3-4days(p<0.01). 4) Insulin concentrations were also increased insignificantly when blood glucose were increased in the treatment group compared with control group. CONCLUSION: In conclusion, intravenous administration of theophylline produces hyperglycemia significantly, including an increase in a serum insulin. But, clinically significant hyperglycemia(> 125mg/dL) was not noted. So, plasma glucose may not need to be monitored in preterm apneic infants receiving theophylline. But, further studies are need to elucidate the effect of theophylline considering the serum toxic level of theophylline.
Administration, Intravenous ; Aminophylline ; Apnea* ; Blood Glucose* ; Bradycardia ; Glucose ; Homeostasis ; Humans ; Hyperglycemia ; Infant ; Infant, Newborn ; Infant, Premature* ; Insulin* ; Intensive Care, Neonatal ; Plasma* ; Prospective Studies ; Theophylline

PURPOSE: In this study a system dynamics methodology was used to identify correlation and nonlinear feedback structure among factors affecting unplanned extubation (UE) of ICU patients and to construct and verify a simulation model. METHODS: Factors affecting UE were identified through a theoretical background established by reviewing literature and preceding studies and referencing various statistical data. Related variables were decided through verification of content validity by an expert group. A causal loop diagram (CLD) was made based on the variables. Stock & Flow modeling using Vensim PLE Plus Version 6.0b was performed to establish a model for UE. RESULTS: Based on the literature review and expert verification, 18 variables associated with UE were identified and CLD was prepared. From the prepared CLD, a model was developed by converting to the Stock & Flow Diagram. Results of the simulation showed that patient stress, patient in an agitated state, restraint application, patient movability, and individual intensive nursing were variables giving the greatest effect to UE probability. To verify agreement of the UE model with real situations, simulation with 5 cases was performed. Equation check and sensitivity analysis on TIME STEP were executed to validate model integrity. CONCLUSION: Results show that identification of a proper model enables prediction of UE probability. This prediction allows for adjustment of related factors, and provides basic data do develop nursing interventions to decrease UE.
Adult ; Airway Extubation/*psychology ; Female ; Humans ; Intensive Care Units ; Intubation, Intratracheal ; Male ; Middle Aged ; *Models, Theoretical ; Nonlinear Dynamics ; Risk Factors

A meta-analysis of 14 quasi-experimental studies was conducted to compare the effect of size on various relaxation therapies applied to patients and health volunteer students. These studies were selected from theses, dissertations and papers that have been done between 1982 to 1993. Also They have a randomized or nonequivalent control group in a pre test-post test design. The studies were evaluated in different ways; 1) types of relaxation therapy, 2) total amount of time of relaxation therapy, and 3) types of outcome variables. For a group of homogenious studies, the weighted mean effect size and standard error were estimated. Some findings are summarized as follows : 1. Jacobson relaxation therapy had a larger effect on systolic and diastolic blood pressures than on state anxiety. 2. For the total time of relaxation therapy, (longer than 60 minutes) had a much larger effect in decreasing systolic and diastolic blood pressures than in the case of a time period shorter than 60 minutes. 3. Relaxation therapy applied to surgery patients also had a larger effect in decreasing state anxiety than when applied to other patients.
Anxiety* ; Blood Pressure* ; Humans ; Relaxation Therapy* ; Relaxation* ; Volunteers

A meta-analysis of 14 quasi-experimental studies was conducted to compare the effect of size on various relaxation therapies applied to patients and health volunteer students. These studies were selected from theses, dissertations and papers that have been done between 1982 to 1993. Also They have a randomized or nonequivalent control group in a pre test-post test design. The studies were evaluated in different ways; 1) types of relaxation therapy, 2) total amount of time of relaxation therapy, and 3) types of outcome variables. For a group of homogenious studies, the weighted mean effect size and standard error were estimated. Some findings are summarized as follows : 1. Jacobson relaxation therapy had a larger effect on systolic and diastolic blood pressures than on state anxiety. 2. For the total time of relaxation therapy, (longer than 60 minutes) had a much larger effect in decreasing systolic and diastolic blood pressures than in the case of a time period shorter than 60 minutes. 3. Relaxation therapy applied to surgery patients also had a larger effect in decreasing state anxiety than when applied to other patients.
Anxiety* ; Blood Pressure* ; Humans ; Relaxation Therapy* ; Relaxation* ; Volunteers