OBJECTIVES: The purpose of this investigation was to determine whether women with unexplained elevations of maternal serum human chorionic gonadotropin(hCG) at 14-20weeks gestation are at incresed risk for poor pregnancy outcomes. METHODS: 661 pregnant women undergoing second trimester triple marker screening test for Down syndrome and neural tube defect and delivered at our hospital were reviewed. Of 656 pregnancies that did not have maternal serum alpha feto-protein> or =2.5 multiples of the median(MoM), risk for poor pregnancy outcomes include to preeclampsia, preterm delivery, preterm rupture of membrane(PROM), small for gestational age(SGA) and fetal distress was evaluated in women with elevated hCG(> or =2.0 MoM) compared with women without elevated hCG(<2.0 MoM). RESULTS: Pregnancies with elevated hCG levels were at increased risk for preeclampsia (risk ratio 3.4, 95% confidence interval 1.5-7.6) but elevated hCG levels were not significantly associated with preterm delivery, PROM, and SGA and fetal ditress independent with preeclampsia. CONCLUSION: Pregnancies with elevated second-trimester hCG appear to be at higher risk of subsequent preeclampsia and this finding supports the theory that placental vascular changes that ultimately lead to preeclampsia begin at least by the second trimester. But further studies must be to determine how such information can be used to improve pregnany outcome.
Chorion ; Chorionic Gonadotropin* ; Down Syndrome ; Female ; Fetal Distress ; Humans* ; Mass Screening ; Neural Tube Defects ; Pre-Eclampsia* ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, Second ; Pregnant Women ; Rupture

No abstract available.
Humans ; Biomarkers, Tumor*

No abstract available.
Sertoli-Leydig Cell Tumor*

No abstract available.
Ascites* ; Pancreatitis, Chronic* ; Pleural Effusion*

PURPOSE: The purpose of this study was to develop an instrument to measure nursing professional values. METHOD: Forty preliminary items were selected by classifying 223 basic items extracted via a literature study and in-depth interviews of subjects and testing the relevance of their contents. In order to verify the reliability and relevance of the preliminary instrument, data was collected from 504 nurses in 3 general hospitals. RESULT: As a result of the item analysis, 29 items were selected from a total of 40 items. Five factors were extracted by factor analysis, and the total variance was 51.5%. For the explanation of variances by factors, the 1st factor, 'self-concept of the profession' accounted for 14.8%, the 2nd factor, 'social awareness' 12.1%, the 3rd factor, 'professionalism of nursing' 9.8%, the 4th factor, 'the roles of nursing service' 9.1%, and the 5th factor, 'originality of nursing', 5.6%. Cronbach's Alpha of those 29 items was .9168, which was high. CONCLUSION: This paper is meaningful in a way that it developed a tool capable of measuring nursing professional values, which reflects the characteristics of our country. In order to re-verify the relevance and stability of this tool, it is necessary that comparative studies should be conducted.
*Social Values ; Psychometrics ; Nursing ; *Nurse's Role ; Humans ; Female ; *Attitude of Health Personnel ; Adult

BACKGROUND: Epidural adhesion can cause pain from compression and irritation of nerves. But a simple injection into the lumbar epidural space usually goes into the area of least resistance and cannot deliver the medication to the target area. Thus, the adhesiolysis of the affected area is sometimes mandatory. We performed an adhesiolysis, irrigating with normal saline, and targeted an injection of a local anesthetic and steroid mixture to the epidural space, using a flexible catheter-secured epiduroscopic unit in 15 patients with low back pain, and assessed the pain score changes. METHODS: With the patient in the prone position, the epidural space was entered with a 17-gauge Tuohy needle. A guide-wire was inserted through the needle and advanced under fluoroscopic guidance to the level of the suspected pathology. A catheter was then advanced over the guide-wire. After the removal of the guide-wire, an adapter was then attached to the proximal end of the catheter, and its side arm was connected to a syringe containing normal saline flush. The 0.9 mm diameter fiberoptic scope was introduced into the catheter via the adaptor, and a video camera was then attached. Gentle irrigation of normal saline less than 50 ml distended the epidural space. The catheter and fiberoptic scope were advanced to the adhesion area and adhesiolysis was done by moving the tip of the steering catheter. Assuming that original NRS (Numeric Rating Scale) before the procedure was 10, we asked the NRS at 1, 4, 8, 12, 16 weeks after the epiduroscope. RESULTS: NRS at 1, 4, 8, 12, 16 weeks after the epiduroscope showed significant decrease of both low back pain and radiating pain, compared with the original pain (P<0.05). CONCLUSIONS: The flexible catheter-secured epiduroscopic unit proved to be painless, safe, and more simple, than an operation, it is, thus, a practical method for pain relief using adhesiolysis and irrigation of epidural space under the direct visualization of the epidural space in patients with low back and lower extremity pain.
Arm ; Catheters ; Epidural Space ; Humans ; Low Back Pain ; Lower Extremity* ; Needles ; Pathology ; Prone Position ; Syringes

No abstract available.
Stevens-Johnson Syndrome*

PURPOSE: Our purpose was to deterrnine the efficacy of maternal corticosteroid therapy on the morbidity of premature infants between 26 and 31 weeks' gestation. METHOD: A total of 62 premature infants between 26 and 31 weeks gestation admitted to pediatric department of National Medical Center from Nov, 1990 to June 1996 were analyzed to evaluate the efficacy of prenatal corticosteroid therapy on the morbidity such as hyaline membrane disease, intreventricular hernorrhage, necrotizing enterocolitis, sepsis, neonatal death, days on ventilation and hospital days. RESULT: Among 62 women who delivered premature infants between 26 and 31 weeks, 22 received betamethasone before delivery and 40 did not. 1) The rate of hyaline membrane disease was less in the betamethasone group (41% vs. 70%, P<0.05). 2) The rate of intracranial hemorrhage was less in the betamethasone group (0 vs. 20%, P<0.05). 3) The days of ventilator care was less in the betamethasone group among survival cases (27+/-3.2 vs. 5.2+/-4.6, P<05). 4) Arnong 14 women who delivered at 26 to 28 weeks, 4 received betamethasone before delivery and 10 did not. The rate of neonatal death was less in the betamethasone group (o% vs. 80%, P<0.05). 5) Among 48 women who delivered at 29 to 31 weeks, 18 received betamethasone before delivery and 30 did not. The rate of hyaline membrane disease was less in the betamethasone group (39% vs. 73%, P<0.05). CONCLUSION: Betamethasone appears to reduce hyaline membrane disease, intraven- tricular hemorrhage, neonatal death and the morbidity significantly in premature infants between 26 and 31 weeks' gestation.
Betamethasone ; Enterocolitis, Necrotizing ; Female ; Hemorrhage ; Humans ; Hyaline Membrane Disease ; Infant, Newborn ; Infant, Premature* ; Intracranial Hemorrhages ; Pregnancy ; Sepsis ; Ventilation ; Ventilators, Mechanical

This study was purosed to investigate maternal and fetal clinical parameters effecting on maternal serum alpha-fetoprotein(MSAFP) levels at late normal singleton pregnancies. The subjects of this study were 171 pregnant women with gestational age of 36 to 42 weeks, and didn`t have any medical or gynecologic diseases. They delivered fetuses within three days after blood test of MSAFP. MSAFP levels were measured by enzyme-immunoassay. The analysed clinical parameters included fetal sex, fetal weight, gestatioal age, maternal age, gravidity, parity, maternal weight and maternal total weight gain during pregnancy. The results were as follows: At uncomplicated late pregnancies, 1. Male fetus bearers had higher MSAFP(mean: 191.8 ng/ml, SD: 80.8 ng/ml, n=79) than female-fetus bearers(mean 153.6 ng/ml, SD 73.0 ng/ml, n=92)(p=0.0014). 2. Multiparas had higher MSAFP(mean: 192.7 ng/ml, SD: 77.9 ng/ml, n=80) than nulliparas(mean: 152.3 ng/ml, SD 75.1 ng/ml, n=91)(p=0.0007). 3. MSAFP did not have correlation with maternal age, maternal weight, maternal total wight gain during pregnancy, gestational age, fetal weight. According to the above results, fetal sex and parity are the factors that influences MSAFP levels at uncomplicated late pregnancies. So MSAFP values should be interpreted with cautions.
Female ; Fetal Weight ; Fetus ; Genital Diseases, Female ; Gestational Age ; Gravidity ; Hematologic Tests ; Humans ; Male ; Maternal Age ; Parity ; Pregnancy* ; Pregnant Women ; Weight Gain

PURPOSE: This study was undertaken to assess the change of the serum cholesterol level according to the duration of fever in children. METHODS: A retrospective study presents data on fasting serum cholesterol assessed 346 children aged from 3 to 14 years, admitted to National Medical Center from Jan. 1992 to Jun. 1994 due to febrile disease. These patients were divided into three groups according to the duration of fever at the time of cholesterol measurement. Group 1 comprised children in whom cholesterol was evaluated on the first 2day of fever, group 2 children in whom cholesterol was assessed on day 3 to 5 and group 3 subjects evaluated 6 to 20 days after the onset of fever. 200 healthy children without fever were also enrolled in this study. The fasting serum cholesterol levels were also measured in both febrile period and afebrile convalescent period in 34 children with febrile diseases during the 7months period of Apr. to Oct. 1994. RESULTS: As the retrospective study, the fasting serum cholesterol levels of group 1, 2 and 3 were lower than those of the controls. And the difference of the serum cholesterol levels between group 1 and group 3 was significant. The prospective study was significantly associated with a decrease of serum cholesterol in the febrile period compared with that in the convalescent period. CONCLUSIONS: Timing of blood collection for screening test and diagnostic measurement of serum cholesterol level should be carefully defined taking into account that febrile illnesses are biologic variables that may significantly affect serum cholesterol.
Child* ; Cholesterol* ; Fasting ; Fever* ; Humans ; Mass Screening ; Prospective Studies ; Retrospective Studies