OBJECTIVE: Currently, preparation for childbirth is becoming an increasingly popular addition to patient education. Because of this interest, it seems advisable to review the evidence on the effect of prepared childbirth. The objective of this study is to evaluate the effectiveness of Lamaze preparation on labor and delivery. METHODS: To investigate whether prepared-childbirth courses offer measurable physical advantages, we compared the labor and delivery characteristics of 80 primiparas who had taken Lamaze-training classes with 76 control patients who had not. We reviewed retrospectively obstetrical records of 156 pregnant women delivered in Ewha Womans University MokDong Hospital from January to December, 1997. RESULT: The length of the first stage of labor in the group that attended childbirth preparation classes was 5.70 hours and 6.93 hours in the comparison group. This difference was statistically significant (P= .040). The mean duration of the second stage of labor in attenders was 42.43 minutes and 41.16 minutes in the nonattenders(P= .719). Average duration of labor in attenders was 1.07 hours shorter than in nonattenders (P= .075). The cesarean section rate in attenders was 25% compared with 36.8% in nonattenders (P= .10920). CONCLUSION: No statistical significance was found in this study. However we need to be aware that the length of first stage of labor was shorter and the rate of cesarean section was lower in prepared group. Childbirth education should be integrated into prenatal health care to be readily available for all women.
Cesarean Section ; Delivery of Health Care ; Female ; Humans ; Parturition ; Patient Education as Topic ; Pregnancy ; Pregnant Women ; Prenatal Education ; Retrospective Studies

No abstract available.
Growth Hormone* ; Testosterone*

No abstract available.
Pregnancy*

No abstract available.
Endometrium* ; Female ; Humans

No abstract available.
Diagnosis*

PURPOSE: Aggressive chemotherapy and bone marrow transplantation have a large demand for platelet concentrate and packed RBC transfusion. Febrile nonhemolytic transfusion reactions are an immunologically mediated reaction involving plasma in the recipient and the white blood cells in the donor. This study was performed to understand the role of cytokines and factors associated with febrile nonhemolytic transfusion reaction to transfused blood. METHODS: Samples were obtained from 42 transfused blood(36 packed RBC, 6 platelet concentrates). Initial WBC count, pH, LDH, irradiation, use of filter and storage time were checked. The serum levels of Interleukin-1beta(IL-1beta), Tumor necrosis factor alpha(TNFalpha) and Interleukin-6(IL-6) were measured by ELISA method using commercial kit for each cytokines. Transfusion reactions, including fever, were recorded in all cases. RESULTS: With the storage time of blood products longer in duration, the serum levels of IL-1beta, TNFalpha and IL-6 were significantly higher(P<0.05). The serum levels of IL-1beta, TNFalpha and IL-6 increased significantly as these blood products were more contaminated with WBC>3000/mm3(P< 0.05). There was no relationship between cytokines and LDH, pH respectively. Febrile reaction was noted in 2.3%(1/42). CONCLUSION: Transfusion reactions are not always the result of an antigen-antibody reaction, but could be caused by the administration of large amounts of cytokines in the plasma. The longer storage times of blood products was associated with frequency of febrile transfusion reactions. We recommend fresh blood transfusion and reduction of WBC before storage because it abrogates cytokine accumulation and dramatically lowers the rate of febrile transfusion reaction.
Antigen-Antibody Reactions ; Blood Group Incompatibility ; Blood Platelets ; Blood Transfusion ; Bone Marrow Transplantation ; Cytokines ; Drug Therapy ; Enzyme-Linked Immunosorbent Assay ; Fever ; Humans ; Hydrogen-Ion Concentration ; Interleukin-6* ; Leukocytes ; Plasma ; Tissue Donors ; Tumor Necrosis Factor-alpha*

PURPOSE: Aggressive chemotherapy and bone marrow transplantation have a large demand for platelet concentrate and packed RBC transfusion. Febrile nonhemolytic transfusion reactions are an immunologically mediated reaction involving plasma in the recipient and the white blood cells in the donor. This study was performed to understand the role of cytokines and factors associated with febrile nonhemolytic transfusion reaction to transfused blood. METHODS: Samples were obtained from 42 transfused blood(36 packed RBC, 6 platelet concentrates). Initial WBC count, pH, LDH, irradiation, use of filter and storage time were checked. The serum levels of Interleukin-1beta(IL-1beta), Tumor necrosis factor alpha(TNFalpha) and Interleukin-6(IL-6) were measured by ELISA method using commercial kit for each cytokines. Transfusion reactions, including fever, were recorded in all cases. RESULTS: With the storage time of blood products longer in duration, the serum levels of IL-1beta, TNFalpha and IL-6 were significantly higher(P<0.05). The serum levels of IL-1beta, TNFalpha and IL-6 increased significantly as these blood products were more contaminated with WBC>3000/mm3(P< 0.05). There was no relationship between cytokines and LDH, pH respectively. Febrile reaction was noted in 2.3%(1/42). CONCLUSION: Transfusion reactions are not always the result of an antigen-antibody reaction, but could be caused by the administration of large amounts of cytokines in the plasma. The longer storage times of blood products was associated with frequency of febrile transfusion reactions. We recommend fresh blood transfusion and reduction of WBC before storage because it abrogates cytokine accumulation and dramatically lowers the rate of febrile transfusion reaction.
Antigen-Antibody Reactions ; Blood Group Incompatibility ; Blood Platelets ; Blood Transfusion ; Bone Marrow Transplantation ; Cytokines ; Drug Therapy ; Enzyme-Linked Immunosorbent Assay ; Fever ; Humans ; Hydrogen-Ion Concentration ; Interleukin-6* ; Leukocytes ; Plasma ; Tissue Donors ; Tumor Necrosis Factor-alpha*

BACKGROUND AND PURPOSE: Evaluating instrumental activities of daily living (IADL) is an important part of procedure to diagnose dementia. The Korean-Instrumental Activities of Daily Living (K-IADL) has been used extensively in Korea. However, its cut-off score has not been reformulated since 2002. The purpose of this study was to yield a new optimal cut-off score for the K-IADL and confirm the validity of this new cut-off score with various dementia groups. METHODS: We retrospectively collected a total of 2,347 patients' K-IADL data from 6 general hospitals in Korea. These patients had mild cognitive impairment (MCI) or dementia with various etiologies for cognitive impairment. We also recruited a normal control group (n=254) from the community. Korean-Mini Mental State Examination, Short version of the Geriatric Depression Scale, Clinical Dementia Rating, and Global Deterioration Scale were administered to all participants. Caregivers completed K-IADL and Barthel Index. RESULTS: K-IADL scores were significantly different among dementia subgroups, but not significantly different among MCI subgroups. Based on internal consistency, correlations with other scales, and factor analysis, K-IADL showed excellent reliability and validity. The new optimal cut-off score to diagnose dementia was 0.40, which gave a sensitivity of 0.901 and a specificity of 0.916. Positive predictive value for dementia using the new cut-off score was 94.2% for Alzheimer's disease, 100% for vascular dementia, and 84% for Parkinson's disease. CONCLUSIONS: Our results illustrate that the new K-IADL cut-off score of 0.40 is reliable and valid for screening impairments of daily functioning resulting from various etiologies.
Activities of Daily Living* ; Alzheimer Disease ; Caregivers ; Cognition Disorders ; Dementia ; Dementia, Vascular ; Depression ; Hospitals, General ; Humans ; Korea ; Mass Screening ; Mild Cognitive Impairment ; Parkinson Disease ; Reproducibility of Results ; Retrospective Studies ; Sensitivity and Specificity ; Weights and Measures

OBJECTIVE: To determine the correlation between total anti-oxidant capacity (TAOC)and lipid peroxidase (LPO)levels in serum and disease activity in systemic lupus erythematosus (SLE). METHODS: The study population consisted of 99 patients with SLE according to the 1982 revised ACR criteria and 83 healthy controls.The serum TAOC levels in 99 patients with SLE and 83 healthy controls by the ABTS(R) inhibition method (Randox Ltd,Antrim,UK)and serum malondialdehyde (MDA)levels in 37 out of 99 patients with SLE were measured.Anti-dsDNA antibody (anti-dsDNA),albumin,AST,ALT,cholesterol,uric acid and creatinine were mea-sured to determine the association with the serum TAOC levels.The correlation between the serum TAOC levels and nephritis in 27 cases with nephritis out of 99 SLE patients was also investigated.The SLE disease activity was determined by the SLE disease activity index (SLEDAI)at the time of sample collection. RESULTS: Compared to the controls (1.37 +/- 0.127mmol/L),serum TAOC levels were significantly decreased (1.29 +/- 0.124mmol/L)in SLE patients (p=0.001). And there was a negative correlation between serum TAOC levels and SLEDAI total scores in the SLE patients (r=-0.388,p=0.0001),but no significant correlation between TAOC levels and C3 and anti-dsDNA.Further,a significant difference (p<0.04)in TAOC levels was found in SLE patients with and without nephritis.In comparison with other parameters such as AST,ALT,and cholesterol which might change anti-oxidant level,there was no correlation between the serum TAOC levels and them,except for serum uric acid (r=0.387, p=0.0001),creatinine,and albumin (r=0.507,p=0.0001).Additionally,we couldn't find significant correlation between the serum TAOC levels and MDA. CONCLUSIONS: The serum TAOC levels correlate significantly with SLE disease activity and are associated with nephritis.Also,this study showed a significant correlation with serum albumin levels in these patients.Conclusively,the measurement of the serum TAOC levels in patients with SLE will provide useful information on SLE disease activity.
Cholesterol ; Creatinine ; Humans ; Lupus Erythematosus, Systemic* ; Malondialdehyde ; Nephritis ; Peroxidase ; Serum Albumin ; Uric Acid