PURPOSE: The purpose of this study was to identify the relationship of job stress, depression and to identify factors influencing suicide ideation of women-workers. METHODS: The research was a cross-sectional, descriptive study. Data collection was done using self-report questionnaires with 348 women-workers who agreed to participate in the study. Data were analyzed using descriptive statistics, t-test, chi2-test, logistic regression analysis by using SPSS/WIN 18.0. RESULTS: The results showed, among the independent variables, drinking, job stress, depression are significant factors that influence women-workers' suicide ideation. Women-workers' depression is 3.05 times higher (p<.002), and job stress 1.03 times higher suicide ideation (p<.045), and drinking 2.15 times higher suicidal ideation (p<.006). CONCLUSION: The results indicate that suicide ideation is highly prevalent in women-workers, especially among people with depression and job stress. It is necessary to seek how to prevent and manage womenworkers' suicide ideation considering features.
Data Collection ; Depression* ; Drinking ; Logistic Models ; Surveys and Questionnaires ; Suicidal Ideation ; Suicide*

BACKGROUNDS : Extended spectrum beta-lactamases (ESBL) are plasmid-mediated enzymes that confer broad-spectrum resistance to aztreonam, most penicillins, and cephalosporins including ceftazidime, cefotaxime and ceftriaxone. But with most routine susceptibility tests, ESBL-producing strains may not appear to be resistant, which makes it difficult to predict the effectiveness of the beta-lactam agents. In this study, we performed several test procedures to detect ESBL in blood isolates of Klebsiella pneumoniae and examined the risk factors for bacteremia due to ESBL-producing K. pneumoniae. MATERIALS AND METHODS: Of 87 blood culture Isolates of K. pneumoniae during the first 7 month of 1996, 39 showed reduced susceptibilities to at least one of the 4 antibiotics, aztreonam, cefotaxime, ceftazidime and ceftriaxone. Twenty-three of the 39 isolates were assailable for screening for ESBL. Antibiotic resistance was tested by the agar dilution method and beta-lactamase assay using nitrocefin disks. Effect of beta-lactamase inhibition was examined by the doubledisk synergy test using aztreonam, cefotakime, ceftazldime, and ticarc illin/clavulanate disks and by ESBL Etest involving ceftazidime and cert tazidime/clavulanate. Ability to transfer the beta-lactam resistance was tested by conjugation. We also reviewed the medical records of the patients with K. pneumoniae. (21 with and 41 without ESBL) bacteremia to ananlyze their clinical characteristics. RESULTS: Of 23 strains tested, reduced susceptibilities to cefotaxime, aztreon am and ceftazidime were shown in 23, 18, and 18 strains, respectively. All strains were positive for beta-lactamase and its activity was trasfered to E. coli in all strains. Activities of beta-lactamases were shown to be inhibited by clavulanate in 21 strains by the double-disk method, but in only 15 strains by the ESBL Etest. Nineteen of 21 bacteremia were nosocomially acquired. ESBL-producing strains were associated with length of hospitalization, stay in intensive care unit, use of invasive procedures and administration of antibiotics Including penicillins and third-generation cephalosporins. CONCLUSIONS: Although an increasing incidence of and outbreaks by ESBL-producing strains are reported, detection of ESBLs has proved to be difficult. Using several testing methods such as double-disk synergy test, ESBL Etest and conjugation, we estimated that 40.9% of blood isolates of K. pneumoniae produce ESBL. We should pursue for more sensitive and reliable screening methods for the detection of ESBL.
Agar ; Anti-Bacterial Agents ; Aztreonam ; Bacteremia ; beta-Lactam Resistance ; beta-Lactamases* ; Cefotaxime ; Ceftazidime ; Ceftriaxone ; Cephalosporins ; Clavulanic Acid ; Disease Outbreaks ; Drug Resistance, Microbial ; Hospitalization ; Humans ; Incidence ; Intensive Care Units ; Klebsiella pneumoniae* ; Klebsiella* ; Mass Screening ; Medical Records ; Penicillins ; Pneumonia ; Risk Factors

OBJECTIVE: Our purpose was to evaluate the pregnancy outcome and the advantages of laparoscopic tubal reanastomosis. METHOD: During 16 months, January 1996 to April 1997, thirty-two patient had underwent laparoscopic tubal reanastomosis in Pudang CHA General Hospital. The mean age of the patients was 36.1+/-4.3 years(mean+/-SD; range 26 to 47 years). RESULT: The intrauterine pregnancy rate of laparoscopic tubal reanastomosis was 72.4%(21/29). Data comparing laparoscopic procedure retrospectively to tubal reversal by laparotomy was also evaluated. The mean interval from operation to pregnancy was similar in the two groups (p=0.9). The operation time was sigoificantly longer for laparoscopy (215.3+/-35.5 minutes) than for laparotomy(159.7+/-52.3 minutes). Nevertheless, the intensity of postoperative pain was lower (p<0.05) in patient who underwent laparoscopy than in patient who underwent laparotomy. Also, the mean hospital stay (3.6+/-2.3 days for laparoscopy, 6.1+/-0.5 days for laparotomy) was shortened(p<0.05) after laparoscopy compared with laparotomy. CONCLUSION: Laparoscopic tubal reanastomosis may offer the benefits of lower postoperative pain and shorten recovery time in comparison with laparotomy. Therefore, considering the high pregnancy rate in minimal follow up period of 6 month, laparoscopic tubal reanastomosis could be an alternative procedure to microsurgical laparotomy in patients requesting reversal of sterilization.
Female ; Fertility* ; Follow-Up Studies ; Hospitals, General ; Humans ; Laparoscopy ; Laparotomy ; Length of Stay ; Pain, Postoperative ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Retrospective Studies ; Sterilization ; Sterilization Reversal*

No abstract available.
Calcinosis* ; Heel* ; Humans ; Infant*

We report a case of a 13-year-old girl who was noted to have combined malformation of complete septate uterus, obstructed hemivagina and ipsilateral renal agenesis with complaints of dysmenorrhea. Hematometrocolpos was developed in the result of retained menstrual blood since menarche. This rare congenital anomaly is supposed to be derived from disorders of mesonephric and M llerian developement in embryogenesis of female genitouinary tract. An accurate preoperative diagnosis of this syndrome is critical because of the difference in therapeutic strategy and prognosis. Simple and definite treatment of the condition is excision of the obstructed vaginal septum with prompt exit of retained blood. We present here a interesting case of M llerian anomaly in attempt to alert gynecologist to the possible occurrence of such a malformation with a brief review of concerned literatures.
Adolescent ; Diagnosis ; Dysmenorrhea ; Embryonic Development ; Female ; Humans ; Menarche ; Pregnancy ; Prognosis ; Uterus*

Service diversification is recognized as an important strategy against turbulent environmental change. This study is designed to find out the trend of service diversification in Korean health care organizations and also to identify factors associated with the degree of service diversification. Data were collected from 69 hospitals out of 71 hospitals with over 300 beds. Important findings are summarized below. 1. Types of diversification are closely related to hospital size. Large hospitals have a tendency to provide sophisticated service requiring specialized skills and equipment, while small hospital have concentrated their efforts on health screening programs. 2. The more competitive and bigger hospitals are, the greater number of services that provide. Also, hospitals operating rational management information systems provide more services. Contrary to the expectation, hospitals with a low performance during last 3 years showed more service diversification. 3. A trend of more diversification was observed in hospitals whose chief executive officer used a prospector strategy. 4. A multiple regression analysis revealed that bed size, competitive environment, degree of rational management, and the growth pattern were significantly associated with teh service diversification.
Delivery of Health Care ; Health Facility Size ; Hospital Bed Capacity ; Management Information Systems ; Mass Screening

Aberrant left-sided pulmonary artery(pulmonary artery sling) is an uncommon anomaly, which may cause significant respiratory abnormality. We report a case of pulmonary artery sling which is combined with persistent left superior vena cava and dextrocardia. This case was identified by esophagogram and CT and confirmed by MRI and angiography. We consider that MRI is a valuable new method for the diagnosis of aberrant left-sided pulmonary artery.
Angiography ; Arteries ; Dextrocardia ; Diagnosis ; Magnetic Resonance Imaging ; Methods ; Pulmonary Artery* ; Vena Cava, Superior

There are increasing interest and need for information on health care consumer with the significance of hospital marketing and strategic planning being increasingly emphasized. This study was conducted to investigate the criteria for selection of medical facilities according to the characteristics of health care consumer by the types of medical services on a sample of 1,500 population aged 20 years and above. Major findings are as follows; 1. When considering the criteria for selection of medical facilities into two factors, namely, quality or convenience factors, convenience factor was the major contributor for outpatient and dental services whereas it was quality factor for inpatient services. 2. Females and those residing in large cities selected medical facilities based on convenience factor in the outpatient services. In the case of inpatient service, persons who considered their present health status to be good and whose ages were 50 years old and above choose medical facilities based on quality factor. 3. Persons who considered medical facilities to be profit-making tended to choose medical facilities based on convenience factor for outpatient services. There were no differences in the cases of inpatient and dental services. 4. There was no significant difference on the criteria for selection of medical facilities according to the decision maker for selection or trust on medical facilities. On the use of health service information, selection of medical facilities was based on qPality factor for those who made more use of the information in the cases of outpatient and dental services. 5. Analysis using the logistic regression model on the criteria for the selection of medical facilities with the characteristics of health care consumer as independent variables was performed. The selection of medical facilities was significantly related with residential area, sex, and use of information on medical facilities for outpatient services and with age, average monthly income, and perception of health status for inpatient services. For dental services significant association with residential area and use of information on medical facilities was seen. The results of this study, despite some limitations, can be used as baseline data for marketing and strategic planning of hospital management.
Delivery of Health Care ; Female ; Health Services ; Humans ; Inpatients ; Logistic Models ; Marketing ; Middle Aged ; Outpatients ; Patient Selection

PURPOSE: Cerebral palsy or hearing disability of hyperbilirubinemic complication was reduced by blood exchange transfusion(BET) and phototherapy(PT). But in spite of these treatment, abnormal Auditory Brainstem evoked Response(ABR) finding after BET or PT and neurodevelopmental defect due to chronic bilirubin encephalopathy were observed. So we have studied risk factors and outcome of chronic bilirubin encephalopathy after BET, and treatment of hyperbilirubinemia. METHODS: We have analyzed clinical characteristics, the finding and change of ABR after BET in 17 hyperbilirubinemic neonates, and in 8 hyperbilirubinemic neonates who were treated by phototherapy and 15 normal control neonates. RESULTS: 1) Mean bilirubin concentraion were 27.5+/-4.1mg/dL in BET group and 22.1+/-2.3 mg/dL in PT group. There were no difference of clinical findings between BET and PT group. 2) Change of ABR (1) Wave I loss resulted in 4 neonates, wave III loss in 3 neonates, and wave V loss in 2 neonates in BET group(P<0.05). (2) Wave I peak latency and hearing threshold in BET group were significantly increased more than normal control group(P<0.01). 3) In 10 neonates(58.8%) among 17 BET group, 4 neonates(50%) in 8 PT group were observed abnormal initial ABR finding after jaundice treatment. Age at treatment and duration of jaundice(interval between onset of jaundice and treatment) in abnormal ABR group were significant prolongation compared with normal ABR group(P<0.05). 4) Chronic bilirubin encephalopathy(CBE) was observed in 3 neonates(17.6%) among 17 BET group and showed higher of bilirubin level than normalized group after BET (31.1mg/dL vs 26.6mg/dL), other clinical findings showed no significant differences. CONCLUSION: Bilirubin level was significantly elevated in CBE more than in BET group and duration of jaundice, age at treatment were longer in abnormal ABR group than in normal ABR group. So not only bilirubin level but also duration of jaundice shoud be considered at jaundice treatment, and ABR has a potential utility in detection of acute brain toxicity of bilirubin and follow up evaluation of bilirubin encephalopathy.
Bilirubin ; Brain ; Brain Stem ; Cerebral Palsy ; Follow-Up Studies* ; Hearing ; Humans ; Hyperbilirubinemia ; Infant, Newborn* ; Jaundice ; Kernicterus ; Phototherapy* ; Risk Factors

Primary tumors of the adrenal cortex are comparatively rare. In the medical literature they are most frequently reported as single case. Because of their infrequent occurence some features of their clinical behavior and pathologic anatomy are not widely known. For this reason the recording of the 7 cases from the Department of Pathology, School of Medicine, Chungnam National University is thought to be worth while. Of the seven tumors, five were associated with primary aldosteronism, one Cushing's syndrome, and the remaing one virilizing syndrome. All were benign. Females were affected more frequently than males. Adrenocortical adenomas tend to be small, weighing less than 42 gm. The tumors associated with primary aldosteronism were composed of zona fasciculata-like cells and "hybrid" cells. The tumor with Cushing's syndrome consisted of zona reticularis-like cells. The tumor with virilizing syndrome consisted of zone reticularis-like cells.
Female ; Humans ; Adenoma