The purpose of this study was to find educational needs of toddler's mother in child-caring experience. The subject of the study was toddler's mother who visited one health care center in J city for immunization and had a child or children between twelve and thirty six months old. The subjects were 37 mothers. The instrument used for this study was a semi-structured questionnaire developed by researcher and based on Objective Content Test of Garretson(1967). The Collected data were analized by two researchers using the method of content Analysis. The results of this study are summarized as follows ; 1) Of the large categories, the need of the highest frequency was 'prevention and management of disease and injury', that of the lowest 'growth and development'. 2) In 'physical care' category, 'care of sleeping' was the highest. In 'nutrition and eating-habitual management' category, 'weaning management' was the highest. In 'prevention and management of disease and injury' category, 'disease management' was the highest. In 'discipline and teaching' category, 'discipline' was the highest. 3) In comparison with preceding references, the educational needs of child-caring which had not been shown in preceding references but had been shown in this study were hair-caring, kind of weaning diet, method of cure and nursing, management of deformity, and so on. In conclusion, educational needs of toddler's mother in child-caring experience were matter-of-fact and inclusive. Needs in management of special situation such as disease were higher than usual parenting procedure or method. In addition, there were higher needs in questions happened through child-caring experience or confirmation of procedures practicing now. Then, it is suggested that parent education program should be developed on the basis of educational needs found in this study to be more effective in preparing mothers's child-caring.
Child ; Congenital Abnormalities ; Delivery of Health Care ; Diet ; Education ; Humans ; Immunization ; Mothers* ; Nursing ; Parenting ; Parents ; Weaning ; Child Health ; Surveys and Questionnaires

[Background] Over the last thirty years, majority of researches on clinical effectiveness of acupuncture have been explanatory (or experimental) randomized controlled trial. The benefits of acupuncture in clinical trials are stillcontroversial and most studies concluded that further control studies were required. Standardized combinations of acupuncture points for all the experimental subjects in various past studies have been criticized because such treatments do not reflect current routine clinical treatment.
[Objective] This paper aims to review pragmatic clinical trials on the effect of acupuncture treatment and to develop the ideal clinical research methodology of acupuncture study.
[Method] Clinical studies of acupuncture relevant with pragmatic or individualized trials were searched mainly in Pubmed and Science direct databases. All articles were fully reviewed by researchers, and data were evaluated by usage of a standardized form.
[Results & Suggestion] Pragmatic acupuncture researches were tried for various symptoms (eg. low back pain, hypertension, depression during pregnancy, sleep quality in HIV disease, chronic poststroke leg spasticity, headache, etc). Individualized acupuncture treatments based on oriental disease pattern diagnosis reflexes practical treatments which is more effective than unified and fixed acupuncture treatments without any theoretical basis of oriental medical philosophy.
[Conclusion] To overcome the controversies and limitations of past explanatory acupuncture trials, more individualized and tailored acupuncture trials with the theoretical basis of oriental medical diagnosis is highly recommended. Also clear definition and categorization of pattern identification should be established for further active clinical researches and applications of acupuncture.

The common errors in preoperative treatment plan for the orthognathic surgery can be occurred during cast impression, cast mounting procedure with face-bow transfer, surgical stent fabrication, and so on. One of the most common errors exists during mounting process of the model on the articulator. Accurate mounting of dental casts to articulator should be achieved by transferring the 3- dimensional spatial relationship of the maxillary arch to an articulator. A face-bow is used for transfer this relationship to articulator, usually by relating the face-bow to a plane of reference of maxillary cast. The purpose of this study is evaluation of the accuracy of face-bow transferring of maxillary model to the articulator. The maxillary casts of thirty patients for orthognathic surgery were mounted on articulator with an face-bow instrument. The relationship of occlusal plane angle to Frankfort horizontal plane relations were compared the cephalogram with the cast-mounted articulator. As a result of this study, the significant difference between the maxillary occlusal planes angle in the cephalogram and articulator were found . The results were followed,1. The mean occlusal plane angle in cast-mounted articulator was 13.5.(SD+/-5.4).2. The mean occlusal plane angle in cephalogram was 10.4.(SD+/-4.3).3. The mean difference of occlusal plane angle between cast-mounted articulator and cephalogram was 3.3.(SD+/-4.6).According to the result, we should suggest that the occlusal plane angle to Frankfort plane in cast-mounted articulator is more steeper than that of cephalogram.And then, maxillofacial surgeon should try to get a more predictable result by suggesting the proper correction method and mounting the cast accurately.
Dental Articulators ; Dental Occlusion* ; Humans ; Orthognathic Surgery ; Stents

OBJECTIVE: Adult onset Still s disease is an acute systemic inflammatory disorder. There are no pathognomonic symptoms or specific laboratory abnormalities. In recent reports, serum ferritin concentration is increased in active disease phase and decreased after defervescence. Our purpose was to determine the clinical significance of serum ferritin as an indicator for disease activity. METHODS: Seven patients who were diagnosed as adult onset Still s disease at Samsung Medical Center between October 1994 and March 1997, were reviewed. In these patients we checked leukocyte count, ESR, CRP and serum ferritin concentrations at the time of diagnosis and during follow-up periods and recorded febrile events during follow-up periods. RESULTS: At the time of diagnosis and during febrile periods, the concentrations of ferritin were extremely high(927ng/ml to 96,650ng/ml normal 10-290.8 ng/ml). The values were unrelated to other manifestations of the disease or laboratory findings. The ferritin concentrations decreased rapidly after adequate treatment. Eleven febrile reattacks happened in 7 patients. Serum ferritin concentrations were increased in 8 febrile attacks, while leukocyte count, ESR, and CRP were increased in 5, 5, 6 febrile attacks respectively, There were 10 events of increased serum ferritin concentrations in 7 patients during follow-up periods and 8 events were related with fever. The increases of other laboratory tests were similar. CONCLUSIONS: In all patients, serum ferritin concentrations were increased at the time of diagnosis and closely related to fever. During follow-up periods, serum ferritin concentrations are helpful in monitoring disease activity and guiding decisions about treatment.
Adult* ; Diagnosis ; Ferritins* ; Fever ; Follow-Up Studies ; Humans ; Leukocyte Count ; Still's Disease, Adult-Onset*

BACKGROUND: Residual pleural thickening is frequently seen following treatment for tuberculous pleurisy, and pleural decortication is performend occasionally in patients with severe residual pleural thickening. However, predictive factors for the development of residual pleural thickening are uncertain at the initial diagnosis of the tuberculous pleurisy. Therefore, the purpose of this study was to identify the associated factors for residual pleural thickening at initial diagnosis. METHODS: We separated 63 patients diagnosed as tuberculous pleurisy into two groups; group 1 consisted of patients without residual pleural thickening and group 2 comprised patients with residual pleural thickening at the end of tuberculous pleurisy treatment. We analyzed the clinical characteristics, radiological findings, pleural biopsy and characteristics of pleural fluid between group 1 and group 2. RESULTS: The study population and clinical symptoms of the two groups were not significantly different and the duration of symptoms before treatment and the peripheral WBC were similar between the two groups. The presence of pulmonary tuberculosis, pleural fluid loculation or the amount of pleural effusion sid not differ significantly between the thwo groups. The incidence of positive AFB staining(group 1 : 8%, group 2 : 38%) and granuloma(group 1 : 30%, group 2 : 62%) on pleural biopsy specimens was significantly higher in group 2 than in group 1. Pleural fluid WBC and differential count, adenosine deaminase level, pH, preotein level or glucose level did not differ between the two groups. However, group 2 had higher LDH levels (1370±208mg/dl) than group 1 (860±71mg/dl, p<0.05). CONCLUSION: In tuberculous pleurisy, patients with residual pleural thickening following treatment demonstrated a higher incidence of posivive AFB staining and granuloma on the pleural biopsy specimens or higher LDH level in the pleural fluid than patients wihtout residual pleural thickening From these results, we speculate that the amonut of tuberculous bacilli and granuloma are probably correlated with residual pleural thickening in the tuberculous pleurisy.
Adenosine Deaminase ; Biopsy ; Diagnosis ; Drug Therapy* ; Glucose ; Granuloma ; Humans ; Hydrogen-Ion Concentration ; Incidence ; Pleural Effusion ; Pleurisy* ; Sudden Infant Death ; Tuberculosis, Pleural ; Tuberculosis, Pulmonary

Liver function tests before treatment showed abnormalities of liver function tests during treatment, while 15(68. 2%) of 22 patients who had abnormal liver function tests before treatment showed abnormalities during treatment. In 12 of the 25 patients who showed abnormalities of liver function tests during treatment with allopurinol, allopurinol was stopped and all patients showed improvement of liver function tests. In remaining 13 patients, 10 patients were improved and other 2 patients showed only mild abnormalities of liver function tests despite of continuing allopurinol and 1 patient was lost during follow-up. CONCLUSION: Abnormalities of liver function tests were common during treatment with allopurinol. Most patiensts who had mild abnormalities of liver functions tests during treatment with allopurinol were improved regardless of continuing allopurinol.
Allopurinol* ; Follow-Up Studies ; Gout* ; Humans ; Liver Function Tests* ; Liver*

OBJETIVE: To investigate the efficacy of high infusion frequency of liquid nitrogen on pregnancy in human embryo after freezing and thawing. MATERIALS AND METHODS:: 150 infertile patients underwent 162 consecutive thawing-ET cycles. In the high infusion frequency group (Group A), 47 patients (50 cycles) underwent cryopreservation with high infusion frequency of liquid nitrogen. In the low infusion frequency group (Group B), 103 patients (112 cycles) underwent cryopreservation with low infusion frequency of liquid nitrogen. We analyzed the clinical characteristics, fertilization rates, development of embryo, good quality embryo ratio, implantation rates, and pregnancy rates between these two groups. RESULTS: There was no difference between the groups with regard to clinical characteristics (mean age, infertility duration, infertility factors, hormone profile), mean number of oocyte retrieval, fertilization rates, and mean embryo number of transfers. The survival rates in group A was 64.9% (228 of 350 embryos), and among the 228 embryos 190 embryos (83.3%) which progressed to the two- to eight-cell stage. After thawing, the embryo numbers were 65 (34.2%), 29 (15.3%), 35 (18.4%), and 37 (19.5%) of grades 1, 2, 3, and above 4, respectively. The survival rates in group B was 63.8% (482 of 755 embryos), and among the 482 embryos 465 embryos (96.5%) which progressed to the two- to eight-cell stage. After thawing, the embryo numbers were 106 (22.8%), 94 (20.2%), 89 (19.1%), and 112 (24.1%) of grades 1, 2, 3, and above 4, respectively. There was no difference in embryo quality change after the freezing-thawing procedure between the groups. Implantation rates (31.1% vs. 34.3%) were not significant. However hCG positive rates in group A (40%) were higher than group B, but not statistically significant. Clinical pregnancy rate (26% vs. 25.9%), on going pregnancy rates (>20 weeks) were not significant (26% vs. 25%). CONCLUSION: We compared embryo quality change, survival rates, and pregnancy rates between high infusion frequency group and low infusion frequency group and the results were similar between the two groups. Therefore, high infusion frequency of liquid nitrogen for cryopreservation is a worthy method to preserve in human embryos.
Cryopreservation ; Embryonic Development* ; Embryonic Structures* ; Female ; Fertilization ; Freezing* ; Humans* ; Infertility ; Nitrogen* ; Oocyte Retrieval ; Pregnancy ; Pregnancy Rate* ; Pregnancy* ; Survival Rate

OBJECTIVE: To compare maternal characteristics and pregnancy outcomes in a group of women with gestational diabetes mellitus(GDM) diagnosed in our hospital with those of women without this disorder. MATERIALS AND METHOD: This is a retrospective study of 402 gestational diabetic women with singleton cephalic presenting pregnancies delivered at Ilsin Christian Hospital during the period January 1, 1997, through December 31, 1999. National Diabetes Data Group thresholds were used to diagnose gestational diabetes. Women in this group were compared with a nondiabetic control group(n=430) randomly selected and effects of confounding variables were analyzed using stratified analysis. RESULTS: Prevalence of GDM was 2.36%. Women with gestational diabetes were significantly older, heavier, of greater parity and more often had the following risk factors for GDM. Hypertension, cesarean delivery, macrosomia, and large for gestational age(LGA) rate were significantly increased. The adequate treatment group diagnosed before 32wks and received glucose control was compared with a inadequate treatment group. And there was no significant difference in maternal characteristics and pregnancy outcomes between the two groups. Within the adequate treatment group, three groups were subdivided by birth weight as SGA(small for gestational age), AGA(appropriate for gestational age) and LGA. The group with LGA had no difference in age, parity, pregnancy-induced hypertension, 2hr mean postprandial glucose level except body mass index and insulin treatment rate. After adjusting these two factors with stratified analysis, there was no general association between birth weight and glucose level(p=0.342). CONCLUSIONS: Maternal characteristics of gestational diabetes were significantly different compared with those of nondiabetic women. Pregnancy outcomes of gestational diabetic women were not improved by our conventional management and more intensified but acceptable and compliable treatment should be tried.
Birth Weight ; Body Mass Index ; Confounding Factors (Epidemiology) ; Diabetes, Gestational* ; Female ; Glucose ; Humans ; Hypertension ; Hypertension, Pregnancy-Induced ; Insulin ; Parity ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Prevalence ; Retrospective Studies ; Risk Factors

Objectives: Although the side effects of radiation therapy vary from mucositis to osteomyelitis depending on the dose of radiation therapy, to date, an experimental animal model has not yet been proposed. The aim of this study was to develop an animal model for assessing complications of irradiated bone, especially to quantify the dose of radiation needed to develop a rat model. Materials and Methods: Sixteen Sprague-Dawley rats aged seven weeks with a mean weight of 267.59 g were used. Atraumatic extraction of a right mandibular first molar was performed. At one week after the extraction, the rats were randomized into four groups and received a single dose of external radiation administered to the right lower jaw at a level of 14, 16, 18, or 20 Gy, respectively. Clinical alopecia with body weight changes were compared and bony volumetric analysis with micro-computed tomography (CT), histologic analysis with H&E were performed. Results: The progression of the skin alopecia was different depending on the irradiation dose. Micro-CT parameters including bone volume, bone volume/tissue volume, bone mineral density, and trabecular spaces, showed no significant differences. The progression of osteoradionecrosis (ORN) along with that of inflammation, fibrosis, and bone resorption, was found with increased osteoclast or fibrosis in the radiated group. As the radiation dose increases, osteoclast numbers begin to decrease and osteoclast tends to increase. Osteoclasts respond more sensitively to the radiation dose, and osteoblasts are degraded at doses above 18 Gy. Conclusion A standardized animal model clinically comparable to ORN of the jaw is a valuable tool that can be used to examine the pathophysiology of the disease and trial any potential treatment modalities. We present a methodology for the use of an experimental rat model that incorporates a guideline regarding radiation dose.

This research investigated on the medical recorder manpower relation by before / after medical record computerization for the object of 51 hospitals in 1998 year. Judging from the situation before / after computerization shown on this investigation, the number of personnels was more increased since computer work than manual work, and the medical recorder present conditions by years show that they have been gradually increasing. This is considered why affairs diversely change according to computerization, the auxiliary recorder present conditions shows the reduction of 98 year in comparison with 94 year. This is regarded that personnels were reduced by facilities like existing transporting pipes. Accordingly, vast data are produced and utilized in the medical record department(room) too, therefore information will be quickly / correctly dealt for this. The times invested for simple affairs will be easily diminished by making existing simple affairs be computerized, and so personnels will have to be invested to earnestly / diversely utilize vast information not to reduce personnels in proportion to diminished times.
Humans ; Medical Record Administrators* ; Medical Records*