PURPOSE: This study was conducted to discover the related factors of neonatal suckling in the initiation of breastfeeding in primiparous mothers and to provide basic data for promoting nursing intervention strategies to improve the practice of breastfeeding. METHOD: The subjects of this study were 71 primiparous mothers who had normal vaginal deliveries at one obstetric hospital in P metropolitan city and one delivery center in J city. The collected data was analyzed using the SPSS program. RESULT: The average IBFAT (Infant Breastfeeding Assessment Tool) score was 9.6+/-2.3. The general characteristics studied that had a significant influence on neonatal suckling in the initiation of breastfeeding were the place of delivery (ex: Hospital, Postnatal Unit), whether oxytocin was used, no usage of analgesic medication, amount of satisfaction after the first breastfeeding weight of the newborns and the Apgar score at one minute. CONCLUSIONS: A higher IBFAT score was related to primiparous mothers who had a hospital delivery, received oxytocin, received maternal labour analgesics, neonatal weight, Apgar score at one minute, and satisfaction after the first breastfeeding.
Analgesics ; Apgar Score ; Breast Feeding* ; Humans ; Infant, Newborn ; Mothers* ; Nursing ; Oxytocin

A 24-year-old woman was seen for evaluation of an skin lesion on thiright nipple. Examination revealed a solitary 1.5 x 1cm-sized, erythematous, oozing, eroded andruted, verrucous nodule on the right nipple. A small amount of serous discharge was found but there was no pain or tenderness. Histopathologic findings showed cystic invaginations extending down vard from the epidermis and papillary projections extending into the lumina of the invagination. Pupiae were lined by two rows of cells. In stroma, there were marked inflammatory infiltrates containing any plasma cells. The overlying dermis showed an adenomatous growth pattern with a prolifertion of round, oval or irregular shaped ducts and fibrotic stroma.
Adenoma* ; Cytochrome P-450 CYP1A1 ; Dermis ; Epidermis ; Female ; Humans ; Nipples* ; Plasma Cells ; Skin ; Young Adult

PURPOSE: The purpose of this study was to validate the Needs Assessment Tool for Case Management (NATCM) for use with Korean medical aid beneficiaries. METHODS: Psychometric testing was performed with a sample of 645 Korean medical aid beneficiaries, which included 41 beneficiaries who were selected using proportional sampling method, to examine intraclass correlation coefficients (ICC). Data were evaluated using item analyses, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), Cronbach's alpha, and ICC. RESULTS: Through psychometric testing the final version of NATCM was found to consist of two subscales: 1) Appropriateness of Health Care Utilization (5 items) and 2) Self Care Ability (6 items). The two subscale model was validated by CFA (RMSEA=.08, GFI=.97, and CFI=.93). Internal consistency measured by Cronbach's alpha was .82, and subscale reliability ranged from .79 to .84. The ICC of the NATCM between case managers was .73 and between case managers and health care professionals. .82. CONCLUSION: This study suggests that the final version of NATCM is a brief, reliable, and valid instrument to measure needs of Korean medical aid beneficiaries. Therefore, the NATCM can be effectively utilized as an important needs assessment as well as outcome evaluation tool for case management programs in Korea.
Activities of Daily Living ; Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Case Management ; Female ; Health Status ; Humans ; Male ; Middle Aged ; *Needs Assessment ; Pain Management ; Psychometrics ; Questionnaires ; Republic of Korea ; Social Support

To find the medical insurance utilization of workers when suffering from low back pain, an analysis was made toward the data of medical insurance benefits matched with the general characteristics of 10,183 workers, who were registered continuously from 1993 to 1995 at a medical insurance cooperation for industrial workers. The results were as follows; 1. The period prevalence of the medical insurance utilization for low back pain for 3 years from 1993 to 1995 was calculated as 17.1% for male workers and 19.4% for female workers. Most common cause of utilization was other dorsopathies including the herniation of lumbar discs. 2. The utilization rate increased significantly as the present age and the age joining the company got older(p<0.001). As the duration of employment got longer, the utilization rate of the male showed the tendency to increase and that of the female increased significantly(p<0.05). Among male workers employed at cement and concrete manufacturing companies showed higher utilization rate and among female laborers showed significantly higher utilization rate than clerical workers(p<0.01). 3. Annual utilization rate for low back pain didn't show any difference, but the portion of other dorsopathies among cause of utilization showed the tendency to increase from 1993 to 1995. 4. The mean number of claims for outpatient medical care for low back pain differed significantly by age, working duration, type of industries, income level(p<0.05), and the mean of total visiting days for care of low back pain differed siginificantly by working duration. In conclusion, considering the fact that the medical insurance utilization for low back pain increased annually and other dorsopathies including the herniation of dorsopathies were increasing, an effective preventive or management program for low back pain toward worker employed at industries were required.
Employment ; Female ; Humans ; Insurance Benefits ; Insurance* ; Low Back Pain* ; Male ; Outpatients ; Prevalence

BACKGROUND: Chronic idiopathic thrombocytopenic purpura is an autoimmune disorder caused by sequestration of antibody-sensitized platelets in the reticuloendothelial system. However, uncertainty as to the specificity, frequency and clinical significance of such antibodies still remains. So, we tried to further clarify the above uncertainty in childhood chronic idiopathic thrombocytopenic purpura. METHODS: We analyzed sera from 29 patients. Twenty six patients were chronic ITP who were admitted or followed up to the Department of Pediatrics, Severance Hospital, Yonsei University Medical College from August 1996 to March 1997 by employing a modified antigen-capture ELISA(MACE), flow cytometry and electrophoresis(SDS-PAGE) and immuno-blotting(IB) assays. Three patients with ITP less than 6 months after onset of ITP were included to know the possibility to differrentiate between acute ITP and chronic ITP in this study. RESULTS: 1) Glycoprotein(GP)-specific antibodies were found in 28% (8/29) of patients, with 2 patients having antibodies directed solely to Gp II b/III a, no patients holding antibodies specific only for GPI b/I X and 6 possessing antibodies against both anti-GP I b/I X and Gp II b/III a antigen. 2) The detection rate of GP-specific antibodies of flow cytometry was about 10%. The positivity of anti-GPI b/I X antibodies by MACE and immunoblotting was 14% (4/29), respectively, the positivity of anti-Gp II b/III a antibodies by MACE and immunoblotting was, 21 % (6/29) respectively. The concordance rate between two assays(MACE and IB) was 79% (23/29). None of the three methods was good enough to stand alone. 3) Serum antibodies were not more frequently detected in active(p=1.0) or non-splenectomized(p=.54) chronic ITP patients. 4) No association was found between antibody specificity(anti-GPI b/I X, anti-Gp II b/ III a) and platelet counts(p : .87). CONCLUSION: We conclude that in korean childhood chronic ITP, antibodies against both anti-GPI b/I X and Gp II b/III a antigen were predominant antibody. But, the longterm follow-up in more cases is needed to further clarify the clinical significance of antral-platelet antibody in chronic ITP should be assessed.
Antibodies* ; Blood Platelets* ; Flow Cytometry ; Follow-Up Studies ; Humans ; Immunoblotting ; Mononuclear Phagocyte System ; Pediatrics ; Purpura, Thrombocytopenic, Idiopathic* ; Sensitivity and Specificity ; Uncertainty

The sudden onset of respiratory acidosis or alkalosis due to inadequate ventilation during general inhalation anesthesia may influence the action of neuromuscular blocking agents. In virtro animal studies by Funk et al.(1980) suggested that the neuromuscular blocking action of Org NC 45(NC) was minimally depressed above pH 7.68 and significantly potentiated under acidotic conditions(pH 7.05). They proposed that this was the result of an increase in NC metabolism by alkaline hydrolysis in the alkalotic state and greater molecular stability during acidosis. This study was performed to determine the effects of the neuromuscular blocking action of NC during respiratory acidosis and alkalosis. The patients were divided in to 3 groups: 1, ll & lll and experienced normocarbia, hypocarbia and hypercarbia, respectively. Hypocarbia was induced by hyperventilation and hypercarbia by adjustment of a rebreathing valve in the CO2 absorber in the semiclosed system. Simultaneously, arterial blood samples were collected from radial arteries for arterial blood gas analysis including pH and pCO2. Following the administration of succinylcholine(SCC) and the recovery of a 75% twitch height, ED95 of NC was given to the patient and the results were recorded by an evoked electromyograph (NMT, Datex). The results are follows: 1) The number of patients in groups l, ll and lll were 22, 13 and 8, respectively. The patients in each group were evenly distributed with respect to age, body weight and anesthesia. 2) The end-tidal CO2 tension in group l, ll and lll group was 38.86+/-4.62, 20.23+/-2.42 and 52.00+/-4.86mmHg, and the arterial pCO2(pH) was 37.36+/-5.71(7.461+/-0.054), 23.00+/-1.51(7.649+/-0.032) and 53.29+3.35 mmHg(7.314+/-0.026), resptectively. The end-tidal CO2 tension, arterial CO2 tension and pH in group ll and lll were significantly different from those of group l(p<0.05). 3) The onset time of SCC in group ll and lll was shorter than that in group l (p<0.05), but within 1 min in all groups. The duration of SCC in group lll(19.56+/-6.15min) was longer than that in group l (14.74+/-4.56min) (p<0.05). 4) Although there was no significant difference among the groups with respect to onset time and duration, the recovery index in group ll(10.29+/-2.21min) was significantly different from group l and lll(14.76+/-5.26 and 13.50+/-13.67 min, respectively) (p<0.05). After administration of NC in 5 min intervals, twitch tension was measured and the results were inserted into a regression equation which emphasized the delayed recovery in group lll(r=0.87). In conclusion, the recovery index in alkalosis shortened and the initial twitch tension in acidosis following NC administration was delayed compared to that in normocapnis and alkalosis. Patients with alkalosis may require more frequent doses of NC and continuous monitoring following repeated or continuous infusion in acidosis.
Acid-Base Equilibrium ; Acidosis ; Acidosis, Respiratory ; Alkalosis ; Anesthesia ; Anesthesia, Inhalation ; Animals ; Arterial Pressure ; Blood Gas Analysis ; Body Weight ; Humans ; Hydrogen-Ion Concentration ; Hydrolysis ; Hyperventilation ; Metabolism ; Neuromuscular Blockade* ; Neuromuscular Blocking Agents ; Radial Artery ; Vecuronium Bromide* ; Ventilation

No abstract available.
Arthritis*

PURPOSE: This study was conducted to evaluate the effect of a one-session spouse-support enhancement childbirth education on childbirth self-efficacy and perception of childbirth experience. METHODS: The design of this study was a nonequivalent control group pretest-posttest experiment. The participants in the study were 31 couples in the experimental group and 30 in the control group. The experimental couples were provided with one session on spouse-support enhancement childbirth education the night before delivery. Data were collected at two hours after delivery using the Childbirth Self-Efficacy Inventory (CBSEI) and perception of childbirth experience scale. Data were analyzed using PASW statistics 18 program. Frequencies, percentage, mean, chi2 test, t-test were used for data analysis. RESULTS: Childbirth self-efficacy significantly increased in the experimental group as compared to the control group, but there was no significant difference in perception of childbirth experience in the experimental group compared to the control group. CONCLUSION: The results suggest that a one-session childbirth education has beneficial effects on enhancing childbirth self-efficacy in pregnant couples. A one-session spouse-support enhancement childbirth education is recommended as an effective nursing intervention to promote couple's childbirth self-efficacy and it is also recommended that modifications of program to promote women's childbirth experience should be considered.
Adaptation, Psychological ; Adult ; Female ; Humans ; Male ; Parturition/psychology ; Patient Education as Topic ; Pregnant Women/*psychology ; *Self Efficacy ; Spouses/*psychology

The severe form of chronic periodontitis(CP) has been reported to be strongly associated with the presence of allele 2 of composite IL-1B(+3954) and IL-1A(+4845) genetic polymor- phisms(genotype positive). However, other studies have reported conflicting findings. These might have resulted from differences in ethnic background and disease entities. The aim of this study was to determine the distribution of IL-1A(+4845), IL-1B(+3954), IL-1B(-511), and IL-1 RN(VNTR) genetic polymorphisms in children as a future Korean population. The study population consisted of 92 children from the Dept. of Pediatric Den- tistry, Chonnam National University Hospital. Genomic DNA was obtained from buccal swab. The IL-1A(+4845), IL-1B(+3954), and IL-1B(-511) genes were genotyped by amplifying the polymorphic region using multiplex polymerase chain reaction(PCR), followed by restriction enzyme digestion and gel electrophoresis. IL-1 RN(VNTR) polymorphism were then evaluat- ed by PCR amplification and fragment size analysis in agarose gel. The allele 2 frequency was 41.3%, 4.3%, 47.8%, and 9.9% for IL-1A(+4845), IL-1B(+3954), IL-1B(-511), and IL-1 RN respectively. The frequency of genotype with allele 2 carriage for IL-1A(+4845), IL-1B(+3954), IL-1B(-511), and IL-1 RN was 77.1%, 7.6%, 63.0%, and 15.2% respectively. The allele 2 frequency in IL-1B(+3954) was significantly higher in female than in male population(p<0.05). The negative association was shown between the presence of allele 2 in IL-1B(-511) and in IL-1B(+3954), and the carriage rate of IL-1B(+3954) allele 2 tended to lower in IL-1B(-511) allele 2(P=0.056). Only 7.3% of children carried the composite genotype of IL-1A(+4845) and IL-1B(+3954). These results suggest that the polymorphism of IL-1B(+3954) and the positive composite genotype was relatively rare in Korean population.
Alleles ; Child* ; Digestion ; DNA ; Electrophoresis ; Female ; Genotype ; Humans ; Interleukin-1* ; Jeollanam-do ; Male ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Sepharose

BACKGROUND: The nationwide tuberculosis registry system in Korea has been operated with the dual reporting system - public health center (PHC) and private medical services (PMS) - since 2000. While three-fifths of the registered cases in 2002 was reported by PMS, it was reported that the success rate of patients at PMS was lower than that at PHC. To identify the problems of the patients' management at the PMS as well as the PHC in a community is the aim of this paper. METHODS: The subject was selected from the registered cases of the pulmonary tuberculosis in Jejudo, 2002. The needed items for this study were gathered by the reviewing the medical charts directly. METHODS: Of the 262 patients included in the subject, 92 cases (35%) were treated initially at PMS. The sputum smear as an essentially diagnostic test was carried out with 69.2% at private clinics compared with 98.2% at PHC. The success rate of the treatment at PMS was 59.8% so that it had a statistically significant difference from that at PHC (80.0%; p<0.01). CONCLUSION: These results showed that there were several problems in diagnosis and treatment for the patient of pulmonary tuberculosis at PMS. To improve the success rate of the treatment at PMS, the nationwide clinical guideline for control of pulmonary tuberculosis should be systematically disseminated and strongly recommended at PMS by the government.
Diagnosis ; Diagnostic Tests, Routine ; Humans ; Jeju-do* ; Korea ; Private Practice ; Public Health ; Sputum ; Treatment Outcome ; Tuberculosis ; Tuberculosis, Pulmonary*