No abstract available.
Humans ; Inpatients*

The use of communication media suitable for the audience and message is important in conducting effective family planning IEC activities. This study 'intended to assess differential effects of various media used by the Korean program on rural women's family planning knowledge, attitude, and practice. Data for the study were collected originally for the study of family planning mothers' clubs by the School of Public Health, Seoul National University in 1973. The sample was drawn according to the principle usually employed in obtaining a small sample from a large area. Initially, a sample of 25 Gun's was selected from a total of 138 Gun's by systematic random sampling on the basis of the list of number of mother's clubs in each Gun. Secondly, from each of these primary units(Gun) selected, two second stage units(Myon) were drawn by a systematic random sampling method based on the list of the number of Li's -in each Myon. Finally, a sample of nine Li's was drawn by a simple random sampling method from each Myon selected in the second stage sampling. In this way, a total of 450 Li's, 18 Li's from each of 25 Gun's, were selected. In one of thess 18 Li's of each Gun, all the married women with a living husband, up to age 49, were interviewed. out of 1.052 women interviewed, 145 women were naturally sterile or beyond menopause, and were excluded from thib study. Thus, the analytical population consists of 90 fecundable wives, including those with tubal ligation. A series of analyses were made to examine the relationships between family planning status and selected socio-demographic and communication variables. The family planning status was measured by three indicators, one for each of family planning knowledge, attitude, and practice. The variable for family planning knowledge was created by classifying the respondents into two groups: 1) those who professed to know in detail at least one contraceptive method out of a total of five, including the loop, oral pill, vasectomy, condom, and rhythm, and 2) those who had no professed knowledge about any method. The variable for family planning attitude was dichotomized into those who had favorable attitude toward at least one method among the same list of five, and those who did not have a favorable attitude toward any method. Contraceptive status was classified into two categories of current users and non-users. The independent variables, applied to explain the family planning status, include four sociode-mographie variables and six communication variables. The socio-demographic variables are age, education, number of living children and sons, and ideal number of sons. Communication variables are frequency of exposure to family planning messages through each of the following channels: radio and/or TV, newspaper and/or magazine, 'Happy Home' and/or leaflet, public meeting and/or lecture, family planning worker, and neighbor. Major findings obtained from the analysis are summarized as follows: 1. It was observed that about 33% of the eligible women did not want to have additional children but were not practicing contraception(pong-eem). About half of these women were ever-users and the other half were never-users. They have at least perceived the need for family planning, and thus, should be a primary target population for family planning IEC activities. 2. Socio-demographic variables showed a'closer association with practice than with knowledge or attitude. 3. The communication variables affected family planning status over and above the effects of the socio-demographic variables. When the communication variables were added to the socio-demographic variables as independent variables in the multiple classification analysis, the explained variance was increased by 6.3% in knowledge, 8.7% in attitude, and 4.3% in practice. This also suggests that the communication variables exert larger effects on knowledge and attitude than on practice. Family planning adoption decisions may be influenced by many other factors as well as by family planning knowledge and attitude. 4. The Beta-coefficient was computed for each of the independent variables in multiple classification analysis. Among the media considered in this study, 1) neighborhood communication, radio and/or TV, and 'Happy Home' and/or leaflet had significant effect on family planning knowledge:2) public meetings and/or lecture, radio and/or TV, and neighborhood communication had significant effect on family planning attitude: and 3) radio and/or TV, Happy Home and/or leaflet, and home visit had significant effect on family planning practice. Although program media, neighborhood communication, and radio and/or TV appeared to be more effective than other media, no definite pattern emerged. In the interpretation of these data, however, it should be remembered tha t the frequency of contact varies with the media. 5. When women were exposed to family planning messages more frequently, they tended to have more detailed knowledge about, and more favorable attitudes toward family planning, and were more likely to he practicing family planning. 6. Media behavior differed with age and educational level. It was found that the younger the women and the higher their educational level, the more frequently they were exposed to family planning messages through radio, TV, or printed materials. On the other hand, the older the women and the lower their educational level, the more frequently they were exposed to family planning messages through meetings, home visits, and neighborhood communication. This implies that the audiences' characteristics, such as age and educational level, should be taken into account in the selection of appropriate media.
Child ; Condoms ; Contraception ; Surveys and Questionnaires ; Education ; Family Planning Services* ; Female ; Hand ; Health Services Needs and Demand ; House Calls ; Humans ; Menopause ; Mothers ; Newspapers ; Periodicals as Topic ; Public Health ; Residence Characteristics ; Seoul ; Spouses ; Statistics as Topic ; Sterilization, Tubal ; Vasectomy ; Periodicals

Loss of radial nerve function in the hand results in a significant disability and so cannot extend the wrist, thumb & fingers according to the injury levels. Therefore the patient has great difficulty in grasping objects, especially power grip. Tendon transfers to restore function of extension of wrist and fingers are among the the best − most predictable transfers in the upper extremity. We performed 13 cases of tendon transfers for radial nerve palsy and extensive extensor ruptures from 1987 to 1993. The results were evaluated according to Arbitrary Value Method. Among 13 cases 30% of excellent, 46% of good, 24% of fair and no poor result were obtained and the better results were obtatined in low radial nerve lesion.
Fingers ; Hand ; Hand Strength ; Humans ; Methods ; Paralysis ; Radial Nerve ; Radial Neuropathy ; Rupture ; Tendon Transfer ; Tendons ; Thumb ; Upper Extremity ; Wrist

OBJECTIVE: Our purpose was to assess the efficacy of routine ultrasonographic prediction of macrosomic fetal weight, to determine its influences on subsequent delivery type and to assess perinatal outcome by delivery type. METHODS: The hospital records of 177 patients delivered infants weighing > or =4000gm between January 1997 and December 1998 were reviewed. Statistical comparisons were made between patients in whom fetal macrosomia was predicted before delivery(n=71) and those in whom it was not(n=106) and between the perinatal outcomes for macrosomic fetuses delivered vaginally and by cesarean section. The statistical analysis was performed by student-t test, and Chi-square test and Fisher's exact test. RESULTS: The fetuses were consecutive singleton fetuses in vertex presentation delivered at a single institute. The sensitivity for identifying macrosomic fetus(birth weight >4000gm) with an estimated weight of > or =4000gm was 40%, Overall 60% of the infants had birth weights within 10% of the ultrasonographic estimates and 29% had birth weights within 5% of the ultrasonographic estimates. Cesarean sections were performed in 69% of the 'predicted' group and in 35% of the 'not predicted' group(69% vs 35%, p<0.0001, Fisher's exact test). Predicated group were more likely to be performed by elective cesarean section(48% vs 19%, p<0.0001, Fisher's exact test) and more like due to failed progress at<4cm cervical dilatation(27% vs 7%, p<0.05, Fisher's exact test). The proportion of patients delivered by cesarean section for failed progress at > or =4cm cervical dilatation was similar in the predicted and not predicted groups(19% vs 12%, NS). There was no significant difference in the incidences of the occurrence of birth trauma. CONCLUSION: There appears to be a limitation to obtain estimation of fetal weight by ultrasonography. The antenatal prediction of fetal macrosomia is associated with a marked increase in cesarean deliveries without a significant reduction in the incidence of fetal injury
Birth Weight ; Cesarean Section ; Female ; Fetal Macrosomia ; Fetal Weight* ; Fetus ; Hospital Records ; Humans ; Incidence ; Infant ; Labor Stage, First ; Parturition ; Pregnancy ; Ultrasonography*

OBJECTIVE: Our purpose was to evaluate the effect of epidural anesthesia on labor course. METHODS: Between January 1998 and December 1998, we evaluated pregnant women at term with singleton fetus in vertex presentation and with spontaneous onset of labor at our hospital. Comparison of 120 women (100 cases of primiparous women, 20 cases of multiparous women) who received epidural anesthesia in labor with 120 women (100 cases of primiparous women, 20 cases of multiparous women) who did not receive epidural anesthesia was performed. Adverse pregnancy outcomes were obtained from hospital delivery records and neonatal records. Statistical analysis were performed by Student's t-test and Chi square test. RESULTS: The results of this study were as followings; 1. There was no significant difference in mean age, body weight, height, and gestational age between epidural anesthesia group and control group (P>0.05). 2. The frequency of oxytocin augmentation was significantly greater in the primiparous epidural anesthetic group than in primiparous control group (p<0.05). 3. The effect of epidural anesthesia on the first stage of labor revealed no significant difference in both group. 4. Prolongation of second stage of labor was noticed in nullipara of epidural anesthesia group compared to control group (p<0.05). 5. The incidence of instrumental delivery was significantly increased in the primiparous epidural group than in the primiparous control group(p<0.05). 6. The meconium-stained amnionic fluid, Apgar score and birth weight were similar in both groups. 7. The maternal blood loss was similar in both groups. CONCLUSION: Epidural anesthesia, significantly prolongs second stage of labor in induced patients. While instrumental delivery was more prevalent in these parturients, C-section rate and intra-partum complications were not increased in these patients.
Amnion ; Anesthesia, Epidural* ; Apgar Score ; Birth Weight ; Body Weight ; Female ; Fetus ; Gestational Age ; Humans ; Incidence ; Oxytocin ; Pregnancy ; Pregnancy Outcome ; Pregnant Women

OBJECTIVE: The purposes of this study were 1) to determine whether preeclampsia itself affects failure of labor induction with prostaglandin E2 and oxytocin and 2) to investigate risk factors for failed induction in women with preeclampsia. METHOD: Fifty preeclamptic women and 175 nonpreeclamptic women requiring labor induction were studied prospectively. Intravaginal prostaglandin (PG) E2 tablet (Dinoprostone, The Upjohn company, 3 mg) followed by a second dose if the cervix assessed 6 hours later was 5 or less of Bishop score, and oxytocin were used for labor induction. Women with rupture of membrane, spontaneous contraction resulting in cervical change or an initial cervical examination showing more than 2 cm dilatation and 50% effacement were excluded. Statistics were analyzed with 2 test, Student t test, and multiple logistic regression. RESULTS: 1) The women with preeclampsia had a significantly higher rate of failed induction than did those without preeclampsia [24% (2/50) versus 9% (16/175); p <0.05]. However, the women with preeclampsia had a higher rate of the use of magnesium sulfate, and were more likely to decrease gestational age at induction and increase maternal weight than those without preeclamp sia (p <0.0001, respectively). There were no significant differences in prevalence of nulliparity and low initial Bishop score (< or =3) between the women with and without preeclampsia. 2) Multiple logistic regression showed that preeclampsia itself was not associated with failed induction after correction of known confounding variables (odds ratio 0.22, 95% confidence interval 0.03-2). 3) In women with preeclampsia, the use of magnesium sulfate only was associated with increased risk of failed induction analyzed by multiple logistic regression(odds ratio 38.5, 95% confidence interval 1.6-897). Maternal weight with 70 kg or more was associated with increased risk of failed induction, but it is not statistically significant (p=0.055). CONCLUSIONS: 1) The risk of failed induction is increased in women with preeclampsia, but not by preeclampsia itself but by the use of magnesium sulfate, prematurity, and increased maternal weight secondary to preeclampsia. 2) The use of magnesium sulfate is independent risk factor for failed induction in women with preeclampsia.
Cervix Uteri ; Confounding Factors (Epidemiology) ; Dilatation ; Dinoprostone* ; Female ; Gestational Age ; Humans ; Logistic Models ; Magnesium Sulfate ; Membranes ; Oxytocin* ; Parity ; Pre-Eclampsia* ; Prevalence ; Prospective Studies ; Risk Factors ; Rupture

BACKGROUND: Severe or massive postpartum hemorrhage (PPH) has remained a leading cause of maternal mortality for decades across the world and it results in critical obstetric complications. Recombinant activated factor VII (rFVIIa) has emerged as a gold standard adjunctive hemostatic agent for the treatment of life-threatening PPH refractory to conventional therapies although it remains off-licensed for use in PPH. We studied the effects of rFVIIa on coagulopathy, transfusion volume, prognosis, severity change in Korean PPH patients. METHODS: A retrospective review of medical records between December 2008 and March 2011 indicating use of rFVIIa in severe PPH was performed. We compared age, rFVIIa treatment, transfusion volume, and Sequential Organ Failure Assessment (SOFA) score at the time of arrival in the emergency department and after 24 hours for patients whose SOFA score was 8 points or higher. RESULTS: Fifteen women with SOFA score of 8 and above participated in this study and eight received rFVIIa administration whereas seven did not. Patients' mean age was 31.7 ± 7.5 years. There was no statistically significant difference in initial and post-24 hours SOFA scores between patients administered rFVIIa or not. The change in SOFA score between initial presentation and after 24 hours was significantly reduced after rFVIIa administration (P = 0.016). CONCLUSIONS: This analysis aimed to support that the administration of rFVIIa can reduce the severity of life-threatening PPH in patients. A rapid decision regarding the administration of rFVIIa is needed for a more favorable outcome in severe PPH patients for whom there is no effective standard treatment.
Emergency Service, Hospital ; Factor VIIa* ; Female ; Humans ; Maternal Death ; Maternal Mortality ; Medical Records ; Organ Dysfunction Scores ; Postpartum Hemorrhage* ; Postpartum Period* ; Prognosis ; Recombinant Proteins ; Retrospective Studies

Granuloma annulare is a common, benign, inflamatory, usually self-limited dermatosis. Disseminated perforating granuloma annulare is a rare variant of granuloma annulare. A 23-month-old female patient had asymptomatic, multiple umbilicated papules on the face, limbs including palms and soles, buttock and trunk for about 5 months. The new lesions have developed with mild fever or symptoms of upper respiratory infection. Histopathological examination revealed transepidermal elimination of mucinous degenerated collagen fibers and surrounding palisading lymphohistiocytic granuloma. After she was treated with prednisolone and antibiotics, the lesions slightly resolved, but thereafter, new lesions have developed frequently with mild fever. We herein reported a rare case of disseminated perforating granuloma annulare in the youngest patient yet reported.
Anti-Bacterial Agents ; Buttocks ; Child* ; Collagen ; Extremities ; Female ; Fever ; Granuloma Annulare* ; Granuloma* ; Humans ; Infant ; Mucins ; Prednisolone ; Skin Diseases

Predisposing factors for venous thrombosis can be identified in the majority of patients with established venous thromboembolism (VTE). However, an obvious precipitant may not be identified during the initial evaluation of such patients. In the present case, a 47-year-old female presented to the emergency department of our hospital after ingesting multiple drugs. She had no VTE-related risk factors or previous episodes, nor any family history of VTE. After admission to the intensive care unit sudden hypoxemia developed, and during the evaluation cerebral, renal, and splenic infarctions with pulmonary embolisms were diagnosed. However, the sources of the emboli could not be identified by transthoracic echocardiography or computed tomography angiography. Protein C deficiency was identified several days later. We recommend that hypercoagulable states be taken into consideration, especially when unexplained thromboembolic events develop in multiple or unusual venous sites.
Angiography ; Anoxia ; Causality ; Echocardiography ; Emergency Service, Hospital ; Female ; Humans ; Infarction* ; Intensive Care Units ; Middle Aged ; Protein C Deficiency ; Pulmonary Embolism ; Risk Factors ; Splenic Infarction ; Thrombophilia ; Venous Thromboembolism ; Venous Thrombosis

Colchicine poisoning is rare but can cause potentially life-threatening toxic complications such as hypovolemic shock, cardiovascular collapse and multiple organ failure. In this case report, we describe a case of a 20-year-old female who presented to the emergency department after suicidal ingestion of a toxic dose of colchicine. She developed thrombocytopenia, neutropenia and acute respiratory distress syndrome that required blood transfusion and administration of granulocyte colony stimulating factor for the prevention of infectious complications. With regard to the clinical manifestations of colchicine toxicity, we discussed suggested mechanisms.
Blood Transfusion ; Colchicine* ; Colony-Stimulating Factors* ; Eating ; Emergency Service, Hospital ; Female ; Granulocytes* ; Humans ; Multiple Organ Failure ; Neutropenia ; Poisoning* ; Respiratory Distress Syndrome, Adult ; Shock ; Thrombocytopenia ; Young Adult