This study was designed to analyse effects of Family Health Workers' activities on the performance of a child immunization program an part of the evaluative research in the community health demonstration project in Kang Wha. Frequent shortcomings of evaluative research are problems in setting evaluative indices, difficulties in interpreting influences of socioeconomic changes due to lack of control and failure of demonstrating association between activity input and program performance. Specific objectives of this study was to improve the frequent shortcoming of evaluative research by isolating the effects of Family Health Workers' activities on the performance of the program through controlling other variable which also influenced the program performance. The target population consisted of 1240 children who were born between Jan. 1971 and Dec. 1075 in Sunwon Myun, and Naega Myun in Kwahg Wha Gun, Kyonggi Province. The data were collected in part through 20 Family Health Workers who interviewed the mothers of these children in their villages during Nov. 1977. Part of the data were obtained by summarizing Family Health Workers daily activity records. All data were grouped for each birth cohort according to the 20 villages. Dependent variable of the model is the measle immunization rate of each village and the independent variables are characteristics of baby, mother, household, travel time to the health sub-center, to Kang Wha Town, and the mean member of visits to the household by Family Health Workers as well as their other related activities and the year of birth of children according to village. The model was analysed by stepwise multiple regression technique. The summarized results show that overall R2 were 39.3% and mean number of Family Health Worker household visits, mean age of mother and mean economic status were significant variables in explaining the immunization rate. Therefore Family Health Workers' activities are one of the significant variables in influencing the increased immunization rate of children in villages of the project area.
Child ; Cohort Studies ; Family Characteristics ; Family Health* ; Gyeonggi-do ; Health Services Needs and Demand ; Humans ; Immunization ; Immunization Programs ; Mothers ; Parturition

No abstract available.

No abstract available.
Herpes Zoster* ; Paralysis* ; Upper Extremity*

Since the male sterilization (vasectomy) has been performed on a large scale as an accepted family planning in Korea on 1980s and this, in turn, has been followed by an increase in the number of patients requesting vasovasostomy. We studies 1000 consecutive cases of vasovasostomy performed from January 1975 to July 1995 in Pusan National University Hospital. In this report, we are going to present serial studies of vasovasostomy through which we attempted to find out what factors are of impotence in influencing the successful outcome of vasovasostomy operation. We inquired the operative results data through the questionnaire and telephone interview with survey of medical records. A total of 259 cases was excluded due to the loss of follow-up. The overall patency and pregnancy rates of 741 cases were 86.9% and 51.1%, respectively. The age of man at the time of anastomosis ranged from 23 to 57 years old with an average of 34.9. The most frequent reason for requesting vasovasostomy was the desire to have more children (43.4%). The average obstructive interval was 60.6 months with range from 1 to 264 months. If the obstructive interval had been less than S years patency rate was 92.4% and pregnancy rate 64.8%, but 6 years or more 84.1% and 48.5% p<0.01, p<0.01). Patency and pregnancy rates according to intraoperative vas fluid were 93.1% and 62.8% for presence and 83.7% and 53.1% for absence p<0.01, p<0.05). Patency and pregnancy rates according to histologically proven sperm granuloma at vasectomy site were 87.7% and 49.2% for presence and 86.9% and 50.6% for absence (p>0.05, p<0.05). Patency and pregnancy rates were not significantly different between microscopic standard vasovasostomy (88.4%, 64.3%) and modified vasovasostomy (89.5%, 56.3%)(p>0.05, p>0.05). Both patency and pregnancy rates according to level of anastomosis were 89.8% and 59.8% in cases of straight vas and 91.5%, 60.1% in cases of convoluted vats (p>0.05, p>0.05). Patency and pregnancy rates according to the kind of suture materials were 91.5% and 56.2% for absorbable, 91.0% and 64.2% for non-absorbable and 93.3% and 53.3% for absorbable plus non-absorbable, respectively 0>0.05, p<0.05). Thus it is suggested that the important factor influencing the success rate of vasovasostomy is the interval of obstruction and nasal ooze with surgical skills.
Busan ; Child ; Erectile Dysfunction ; Family Planning Services ; Follow-Up Studies ; Granuloma ; Humans ; Interviews as Topic ; Korea ; Male ; Medical Records ; Middle Aged ; Pregnancy Rate ; Spermatozoa ; Sterilization, Reproductive ; Sutures ; Thoracic Surgery, Video-Assisted ; Vasectomy ; Vasovasostomy ; Surveys and Questionnaires

We studied prospectively on the grade of severity of reflux gastritis after Billroth- I (15 patients and B-II (66 patients) using gastrofiberscopy mostly 3~4 montsh after operations from December 1988 to February.The grade of severity af gastritis was arbitarily defined as follows; Grade 0-almost no reflux of bile and no redness on gastric mucosa. Grade 1-mild redness of the mucosa limited within an inch from anastomotic line. Giade 2-Edema and mucosal redness involves almost one half of remaining gastric mucosa. Grade 3-the above cbanges involves most of remnant gastric mucosa. Gtade 4-in addition to grade 3, friability of mucosa and/or, erosions is noted. Grade 5- ulceraitions of mucosa in addition to the above changes. Using the above defined criteria, we obtained the following results; 1) there was no rieflux gastritis in one patient in B- I group and remainders have varing grades of reflux gastritis, ie; 93% (14/15) (see Table 2). 2) In B- II reconstructed patients, grade 0 was 2 patients and remainder had reflux gastrits, ie; 96% (64/66) (see table 4). 3) Grade 5 patients have ulcerations in the esophagus and grade 2 changes in the stomach.
Bile ; Esophagus ; Gastrectomy* ; Gastric Mucosa ; Gastritis* ; Humans ; Mucous Membrane ; Prospective Studies ; Stomach ; Ulcer

We report our case of laparoscopy-assisted distal gastrectomy with D1 + beta lymph node dissection for a patient with early gastric cancer and laparoscopic cholecystectomy for gallstone with situs inversus totalis. A superficial elevated lesion was found on the lesser curvature of the antrum. The preoperative diagnosis was cStage IA (cT1, cN0, cH0, cP0, cM0). A 1 cm-sized gallstone was found in the fundus through upper abdominal ultrasound. A laparoscopy-assisted distal gastrectomy with standard D2 lymph node dissection for early gastric cancer and laparoscopic cholecystectomy was successfully performed by not shifting the monitor to the left and right and not changing operator's position without additional blood loss and time. The number of retrieved lymph nodes was 36. We have not found any abnormal course of blood vessels except for the right/left inversion. Billroth I reconstruction was performed through end-to-side anastomosis. Based on a histopathological examination, a 1.5 x 1.5 cm, submucosal (sm3), moderately differentiated adenocarcinoma (pT1, pN0, sH0, sP0, sM0, stage IA) was diagnosed. The postoperative course was favorable and the patient was discharged on postoperative day 7.
Adenocarcinoma ; Blood Vessels ; Cholecystectomy, Laparoscopic ; Gallstones ; Gastrectomy ; Gastroenterostomy ; Humans ; Lymph Node Excision ; Lymph Nodes ; Organothiophosphorus Compounds ; Situs Inversus ; Stomach Neoplasms

No abstract available.
Follow-Up Studies* ; Needles* ; Prostate* ; Prostatic Hyperplasia*

This sutdy was performed to find out a LD isoenzyme pattern in neoplastic tissue of gastric carcinoma and in gastric mucosa with intestinal metaplasia, which has been known as premalignant lesion. The specimens used in this study were 18 stomachs with caarcinoma and 8 stomachs with peptic ulcer as control, and wer obtained by subtotal or total gastrectomy at Pusan National University Hsopital from Oct. 1987 to Sept. 1988. Total LD activity and its isoenzymes in body and antral mucosae and neoplastic tissue of stomach were assayed, and analysed statistically from several points of view. The results obtained were summarized as follows: 1) There was no significant difference in total LD activity between univolved body and antral mucosae of stomach with carcinoma, and between mucosa of stomach with peptic ulcer and univolved mucosa of stomach with carcinoma. 2) Total LD activity in the neoplastic tissue of gastric carcinoma was significantly higher than those of univolved body and antral mucosae of stomach with carcinoam or that of stomach with peptic ulcer, but no significant difference was observed among histological types of gastric carcinoma. 3) The uninvolved body mucosa of stomach with carcinoma or peptic ulcer showed a pattern of LD1 predominance and increas of H to M ratio, while the antral mucosa of stomach with carcinoma or peptic ulcer showed a pattern of LD3 predominance and decrease of H to M ratio. 4) The LD4 and LD5 fractions in antral mucosa with moderate to severe intestinal metaplasia were slightly increased than those of antral mucosa with nil to mild intestinal metaplasia, but did not show statistically significant difference. 5) Marked increase of LD5 fraction was found in neoplastic tissue of gastric carcinoma, and thus ratio of H to M subunit in neoplastic tissue was significantly lower, as compared with body or antral univolved mucosa of stomach. In conclusion, the neoplastic tissue of gastric carcinoma and gastric mucosa with intestinal metaplasia show substantially predominant "M" subunit as well as increased total LD activity.

No abstract available.
Child* ; Hepatitis* ; Humans

It has been well known that infertile women experience not only emotional disturbance but also stress. But there is no concern about male infertility patients. So phychiat.ic symptoms were studied with SCL-90 (Symptom Check List-90) in 30 infertile men who was operated testicular sperm extraction (TESE) in Samsung Cheil Hospital and in age matched 31 fertile men from Jan. 1998 to Aug. 1998. In 5 symptom dimensions (Obcessive-Compulsive, Interpersonal Sensitivity, Depression, Phobic anxiety, Psychoticisim) scores. The Infertile group scored significantly higher than the control group. The result revealed that infertile men also experienced substantially more psychiatric symptoms than fertile men. Considering this results, psychiatric evaluation and tender care by infertility specialist are necessary for infertile men during and after evaluation and treatment.
Affective Symptoms ; Anxiety ; Depression ; Female ; Humans ; Infertility ; Infertility, Male* ; Male ; Male* ; Specialization ; Spermatozoa