This study aims to find factors that affect variations in cesarean section frequency rates among OBGY clinics in Metropolitan areas. The factors include patient, medical supplier characteristics and economic factors. This study is a cross-sectional analysis using health insurance delivery claims from July to December 2000 and files of the NHIC(national health insurance corporation). Multiple regression was used to analyze the dependent variable of cesarean section frequency rate at each clinic. The results are as follows : Cesarean section frequency rate is increasing in proportion to the number of the following patients : repeated caesarean section, disproportion, obstructed labour, fetal distress, emergency caesarean section and self-employed patients. There are geographic variations as well. Cesarean section frequency rates are higher in Inchon and Gyonggi province than in Seoul. The higher number of total delivery the clinic has, the lower rate of cesarean section it has. Clinics with high frequency rates in 1999 showed higher rates the next year. Further research is required to develop evidence based delivery modes and change strategies for increasing normal delivery and activating midwife clinics.
Cesarean Section* ; Cross-Sectional Studies ; Emergencies ; Female ; Fetal Distress ; Humans ; Incheon ; Insurance, Health ; Midwifery ; Pregnancy ; Seoul ; Small-Area Analysis

No abstract available.
Dinoprostone* ; Suppositories*

The goal of cleft lip surgery is to reconstruct normal shape of the lip. To acomplish this goal, various operative method were contrived and concept of the method decided the shape of reconstructed lips. According to the operative result, some operative methods were disappeared or have been developed with a little modifiation. Traditional Millard's rotation-advancement method for unilateral cleft lip patients is largely accepted and developed as proper method for acquiring these functional and anatomic purposes. As a trial for this development, Mulliken add some modifications. He uses exaggerated high rotation incision and it lengthens into midcolumella without backcut. Also he dosen't steal from alar base or lateral lip for vertical height. C-flap is used to lengthen the affected columella and upper lip. The isolated orbicularis oris muscle is coaptated each other for more functional result. With supraperichondral dissection of alar cartilage and transpositioning of caudal septum, he performs synchronous repair of cleft lips, nose and sometimes alveolus. It is still debated when is most suitable age for surgical correction of nasal deformity of cleft lip patients. Done at the time of primary lip repair, there are both some apprehension and inducement. The former are based on technical difficulties due to shortage and fragility of neonatal tissue and possibility of progressive deformities with growing because of iatrogenic injuries to the alar cartilages. But te latter is rationalized because early reposition of deformed nasal cartilage in proper position would induce more natural growth of nasal structures. Some long-term follow up reports reveal the early operation innocent of any growth deterioration. Mulliken treats his cleft lip patient for separated lip and nasal deformities with single operation, and does gingiovoperiosteal alveoloplasty at the same time if necessary. He uses Latham appliance from 4 to 6 week after birth in case of severly collapsed lateral alveolar segment or wide alvolar gap, and perform the definitive opertation at the age of 4 to 6 months. I use lip adhension method to correct more than 10 mm alveolar gap without severe collapse of lateral alveolar segment, but if lateral segment was severely collapsed and away from alvolar arch, I apply the Latham appliance somewhat modificate from original type, which has a metal ring fastened at the front limb of appliance for rubber banding to coaptate easily. I have experienced repair of cleft lip by Mulliken's concept with some modification of my own to 44 cases of unilateral cleft lip patients and conclude that it was very flexible method. Doing with synchonous repair of cleft lip nose, we could get harmonious lip and nose with symmetric nostril sill, cupid's bow and red line. Columella was lengthened primarily. Normal growth of nose was anticipated by anatomic repositioning of alar septal cartilage.
Alveoloplasty ; Cartilage ; Cleft Lip* ; Congenital Abnormalities ; Extremities ; Follow-Up Studies ; Humans ; Lip ; Nasal Cartilages ; Nose ; Parturition ; Rubber

Colorectal cancer consists of 8.2 percent of all malignancy in korea, and shows more increaing tendency. Despite the advances in the detection of calorectal cancer no single screening technique has achieved both high degree of diagnostic accuracy and minimal patient morbidity. We studied 24 patients, who underwent colonoscopy, with clinical suspicious colon cancer at Presbyterian Medical Center between Jan and Sep.1995, and evaluated the diagnostic feasibility of colon lavage cytology using oral cleansing solution.(continue...)
Colon* ; Colonic Neoplasms* ; Colonoscopy ; Colorectal Neoplasms ; Diagnosis* ; Humans ; Korea ; Mass Screening ; Protestantism ; Therapeutic Irrigation

Colorectal cancer consists of 8.2 percent of all malignancy in korea, and shows more increaing tendency. Despite the advances in the detection of calorectal cancer no single screening technique has achieved both high degree of diagnostic accuracy and minimal patient morbidity. We studied 24 patients, who underwent colonoscopy, with clinical suspicious colon cancer at Presbyterian Medical Center between Jan and Sep.1995, and evaluated the diagnostic feasibility of colon lavage cytology using oral cleansing solution.(continue...)
Colon* ; Colonic Neoplasms* ; Colonoscopy ; Colorectal Neoplasms ; Diagnosis* ; Humans ; Korea ; Mass Screening ; Protestantism ; Therapeutic Irrigation

Anthocyanidins, the aglycones of anthocyanins, are natural colorants belonging to the flavonoid family. Cyanidin is one of the anthocyanidins, used for their antioxidant properties. Furthermore, previous studies have shown anthocyanidin-rich material extracts or aglycone form inhibit growth and induce apoptosis of cancer cells. But, Tumor metastasis is the most important cause of cancer death, and various treatment strategies have targeted on preventing the occurrence of metastasis. This study investigated the effects of cyanidin on metastasis processes, including motility, invasion and activity of MMP-2 and MMP-9 in MDA-MB-231 human breast cancer cell lines. We cultured MDA-MB-231 cells in presence of various concentrations 0, 5, 10 and 20 micrometer of cyanidin. The cell motility was significantly decreased dosedependently in cells treated with cyanidin (p < 0.05) and cyanidin treatment caused the significant suppression of the invasion (p < 0.05). MMP-2 and MMP-9 activities, and MMP-9 mRNA express were not affected by anthocyanin treatment. In conclusion, cyanidin inhibits cell motility, invasion in MDA-MB-231 human breast cancer cell lines.
Anthocyanins ; Apoptosis ; Breast ; Breast Neoplasms ; Cell Line ; Cell Movement ; Humans ; Neoplasm Metastasis ; RNA, Messenger

Morphometry of nuclei of the benign and malignant prostatic lesions was performed to study the relationship between nuclear size and shape and the prognosis of prostatic adenocarcinoma. Fifty one cases of prostatic adenocarcinoma and 13 cases of benign prostatic hyperplasia were included to evaluate area, perimeter, Dmax, Dmin, and 5 form factors of the nuclei by image analyzer (Zeiss Ibas 2000) using hematoxylin-eosin stained slides. All analytic factors of nuclear size and shape were significantly different between benign lesions and adenocarcinomas. Increased nuclear size was associated with nu- clear irregularity, presence of metastasis, advanced clinical stage, and high Gleason's grade and score of prostatic adenocarcinoma. On Kaplan-Meier method, survival was decreased with older age, no hormonal treatment, stage D, high Gleason's grade and stage as well as with larger size and irregular shape of the nuclei. In conclusion, morphometry of nuclei of the prostate can be a helpful tool to differentiate between benign and malignant lesions. Nuclear morphology is thought to be associated with prognosis of prostatic adenocarcinoma.
Adenocarcinoma ; Breast ; Fibroadenoma ; Hepatitis B e Antigens* ; Hepatitis B Surface Antigens* ; Hepatitis B* ; Hepatitis* ; Neoplasm Metastasis ; Prognosis ; Prostate ; Prostatic Hyperplasia

Purpose: The study was conducted to explore the experiences of job retention among working people with mental illness. Methods: The participants were members with mental illness at the S Community Mental Health Center in Gyeonggi Province and who had been working for more than six months. The data were collected through in-depth interviews with 11 participants between June 27 and August 20, 2018. The data were analyzed through Corbin and Strauss’s grounded theory method. Results: The core category was struggling to take root in the community as a productive member. The core phenomenon was the desire to be a productive person, and the causal condition was the willingness to change for a purposeful life. The action and interaction strategies included maintaining regular living patterns, maintaining medication, developing one’s tips for self-management, and self-approval. The intervening conditions were difficulties in forming social relationships, presence of symptoms, social resources, and acceptance of one’s mental illness. The consequences were restoration of family relationships, healthy pleasure through work, social inclusion, development of self-worth, and transition to an independent person. Conclusion Working people with mental illness are struggling to take root in the community as a productive member. This study suggests that a holistic understanding of the job retention experience among people with mental illness is required. The findings will provide the basis for developing interventions that can improve job retention among working people with mental illness.

Purpose: The study was conducted to explore the experiences of job retention among working people with mental illness. Methods: The participants were members with mental illness at the S Community Mental Health Center in Gyeonggi Province and who had been working for more than six months. The data were collected through in-depth interviews with 11 participants between June 27 and August 20, 2018. The data were analyzed through Corbin and Strauss’s grounded theory method. Results: The core category was struggling to take root in the community as a productive member. The core phenomenon was the desire to be a productive person, and the causal condition was the willingness to change for a purposeful life. The action and interaction strategies included maintaining regular living patterns, maintaining medication, developing one’s tips for self-management, and self-approval. The intervening conditions were difficulties in forming social relationships, presence of symptoms, social resources, and acceptance of one’s mental illness. The consequences were restoration of family relationships, healthy pleasure through work, social inclusion, development of self-worth, and transition to an independent person. Conclusion Working people with mental illness are struggling to take root in the community as a productive member. This study suggests that a holistic understanding of the job retention experience among people with mental illness is required. The findings will provide the basis for developing interventions that can improve job retention among working people with mental illness.

Purpose: This study discovered a substantive theory of the experience and process of peer support work among people with mental illness. Methods: The participants were members of community-based mental health facilities and had been working as peer supporters for more than six months. The data were collected through in-depth interviews with twelve participants and analyzed using Corbin and Strauss’s grounded theory approach. Results: The core category was “becoming a healer going with patients in the journey of recovery,” and the core phenomenon was “identity confusion as a peer supporter.” The causal conditions were “starting peer support work without certainty” and “standing at the boundary between the therapist and patient.” The intervening conditions were “willingness to become a successful peer supporter,” “feeling a sense of homogeneity with the patient,” “accepting the mental illness,” and “support from people around.” The action and interaction strategies were “letting go of greed,” “being open about oneself,” “developing professional skills,” “maintaining wellness in the body and mind,” and “being with the patient.” The consequences were “becoming a useful person,” “changing attitude toward life,” “expansion of the sense of self-existence,” “recovering from mental illness,” and “discovering a role as peer supporter.” Finally, the substantive theory of “becoming a healer going with patients in the journey of recovery” was derived. Conclusion This study provides a holistic understanding of peer support work and the implications of interventions to help people with mental illness in a person-centered recovery process.