OBJECTIVES: The purpose of this study was to obtain basal information to establish a proper birth-encouraging policy in the future through the survey of the attitude towards childbirth and its related factors among female students in junior, senior high school, and university. METHODS: A survey was performed for 2 weeks in June, 2006, for a total of 688 female students which included 185 ones in a girls' junior high school and 242 ones in a girls' senior high school in Sacheon, and 261 ones in two universities in Jinju. The selfadministered questionnaires developed by the authors included the socio-demographic characteristics, the attitude towards childbirth, the preference of a son for their future child, the belief on relative importance of family or work after marriage, the seriousness perception of low birth rate in Korea, frequencies of education in school about low birth rate. The attitude was measured by an answer to the question of 'To what degree do you think you are going to have a child(or children)?' RESULTS: The proportion of positive attitude towards their future childbirth was 76.2% in junior high school, 63.9% in high school, and 82.8% in university students (p<0.01). In the logistic regression analysis, the significant factors related with positive attitude towards future childbirth were school grade, preference of a son for their future children, and belief on relative importance of family or work after marriage. CONCLUSIONS: It suggests that the related factors with positive attitude towards future childbirth need to be considered to make a proper birth policy.
Birth Rate ; Child ; Education ; Female* ; Gyeongsangnam-do ; Humans ; Korea ; Logistic Models ; Marriage ; Parturition* ; Surveys and Questionnaires

This study was conducted to compare the delivery management including laboratory tests, medication and surgical procedures for the delivery in various medical facilities. Two university hospitals, two general hospitals, three hospitals, two private obstetric clinics, and two midwifery clinics in a large city were selected as they permitted the investigators to abstract the required data from the medical and accounting records. The total number of deliveries occurred at these 11 facilities between 15 January and 15 February, 1989 was 789 among which 606(76.8%) were vaginal deliveries and 183(23.3%) were C-sections. For the normal vaginal deliveries, CBC, Hb/Hct level, blood typing, VDRL, hepatitis B antigen and antibody, and urinalysis were routinely done except the private clinics and midwifery clinics which did not test for hepatitis B and Hb/Hct level at all. In one university hospital ultrasonography was performed in 71.4% of the mothers and in one general hospital liver function test was done in 76.7% of the mothers. For the C-section, chest X-ray, bleeding / clotting time and liver function test were routinely done in addition to the routine tests for the normal vaginal deliveries. Episiotomy was performed in 97.2% of the vaginal deliveries. The type and duration of fluid infused and antibiotics administered showed a wide variation among the medical facilities. In one university hospital antibiotics was not administered after C-section at all while in the general hospitals and hospitals one or two antibiotics were administered for one week on the average. In one private clinic one pint of whole blood was transfused routinely. A wide variation was observed among the medical facilities in the use of vitamin, hemostatics, oxytocics, antipyreptics, analgesics, anti-inflammatory agents, sedatives, digestives, stool softeners, antihistamines, and diuretics. Mean hospital day for the norma vaginal deliveries of primipara was 2.6 days with little variation except one hospital with 3.5 days. Mean hospital day for the C-section of primipara was 7.5 days and that of multipara was 7.6 days and it ranged between 6.5 days and 9.4 days. Average hospital fee for a normal vaginal delivery without the medical insurance coverage was 182,100 Won for the primipara and 167,300 Won for the multipara. In case of the primipara covered by the medical insurance a mother paid 82,400 Won and a multiparous mother paid 75,600 Won. Average hospital fee for a C-section without the medical insurance was 946,500 Won for the primipara and 753,800 Won for the multipara. In case of the primipara covered by the medical insurance a mother paid 256,200 Won and a multiparous mother paid 253,700 Won. Average hospital fee for a normal vaginal delivery in the university hospitals showed a remarkable difference, 268,000 Won vs 350,000 Won, as well as for the C-section. A wide variation in the laboratory tests performed for a normal vaginal delivery and a C-section as well as in the medication and hospital days brought about a big difference in the hospital fee and some hospitals were practicing the case payment system. Thus, standardization of the medical care to a certain level is warranted for the provision of adequate medical care for delivery.
Anti-Bacterial Agents ; Anti-Inflammatory Agents, Non-Steroidal ; Blood Grouping and Crossmatching ; Diuretics ; Episiotomy ; Fees and Charges ; Female ; Hemorrhage ; Hemostatics ; Hepatitis B ; Histamine Antagonists ; Hospitals, General ; Hospitals, University ; Humans ; Hypnotics and Sedatives ; Insurance ; Insurance Coverage ; Liver Function Tests ; Midwifery ; Mothers ; Oxytocics ; Research Personnel ; Thorax ; Ultrasonography ; Urinalysis ; Vitamins

We have experienced 19 patients of the cerebral arteriovenous malformation with subarachnoid hemorrhage, who were admitted to the Presbyterian Hospital, Daegu from January 1966 to July 1968, and to the Catholic Medical Center, Seoul from August 1968 to August 1971. All of the patients, who have the cerebral arteriovenous malformation, were proved by cerebral angiography. Since the site of lesions were considered to have close relation to the neurologic deficit and the result of surgery, various analysis of the clinical manifestations and the cerebral angiographic findings were attempted. Of the 19 patients, surgery was performed on 12 patients and its results were analyzed correlating to various types of surgical procedure. Following are the results. 1. From January 1966 to August 1971, there were 100 cases of cerebral vascular anomalies which were proved by cerebral angiography. Among the 100 cases, there were 71 intracranial aneurysms, 19 cerebral arteriovenous malformations, one cavernous angioma, 2 telangiectasis, 5 cerebral rete mirabile, and s Sturge Weber-Dimitris disease. The ratio of arteriovenous malformatons to aneurysms was 1: 3.7. 2. Age distribution of the bleeding arteriovenous malformations was ranged from 8 to 54, and 42 per cent of them were in the third decade. 73 percent of the group had bleeding from the cerebral arteriovenous malformation before the age of 40. The ratio of male to female was 1.9:1. 3. The parietal region was most commonly involved by the malformations. There were 8 parietal lesion, 4 temoroparietal lesions, one temporal lesion, one occipital lesion, and one tela chorioidea lesion. Simultaneous involvement of the both hemispheres occurred in one case. In lesions involving the cerebral hemisphere, there was a predominance of the left side. 4. In the past history, convulsive seizure was recorded in two cases and recurrent hemorrhages were reported in two. One patient was recorded to have suffered fourth hemorrhage and the other have sufferd third hemorrhge. 5. Meningeal irritation signs were most frequently observed in bleeding arteriovenous malformations. The incidence of weakness of extremities was higher in lesions involving the parietal area. Unconsciousness was occurred in 6 patients at the onset of symptom, of which transient loss of consciousness was seen in 3 patients. Transient hypertension at the onset was observed in two patients. 6. The feeding arteries of the malformations were most frequently seen from the middle cerebral artery and the draining veins from the malformations were into the superior sagittal sinus and internal cerebral vein in many cases. It was evident that the carotid artery of the sites of arteriovenous malformations was markedly dilated in 5 patients. 7. Ligation of the vessels feeding the arteriovenous malformations was carried out in 8 patients. One patient had neurologic deficit after the operation. Evacuation of intracerebral hematoma, resection of the anomaly or carotid ligation were carried out in 4 patients. Of the 12 patients who underwent various types of surgery, there was one death after evacuation of a large intracereral hematoma. 8. In our opinion, the ligation of feeding artery a choice of procedure to reduce the incidence of rebleeding, if the resection of the lesion was considered to have operative risk by the location of malformations.
Age Distribution ; Aneurysm ; Arteries ; Arteriovenous Malformations ; Carotid Arteries ; Cerebral Angiography ; Cerebral Veins ; Cerebrum ; Daegu ; Extremities ; Female ; Hemangioma, Cavernous ; Hematoma ; Hemorrhage ; Humans ; Hypertension ; Incidence ; Intracranial Aneurysm ; Intracranial Arteriovenous Malformations ; Ligation ; Male ; Middle Cerebral Artery ; Neurologic Manifestations ; Protestantism ; Rabeprazole ; Seizures ; Seoul ; Subarachnoid Hemorrhage ; Superior Sagittal Sinus ; Telangiectasis ; Unconsciousness ; Veins

OBJECTIVE: This study was conducted in order to investigate predictors of smoking cessation in outpatients. METHOD: Subjects were 401 adult smoking patients who saw their doctors in the outpatient setting at a university hospital, regardless of their willingness of otherwise in smoking cessation. Physicians delivered a brief, stop smoking prompt to all patients who smoked one or more cigarettes a day. Then they referred to on-site counselors who provided a brief, nurse assisted intervention with a survey to a randomly assigned intervention group (200 smoking patients), whom the counselors telephoned later to prevent relapse or promote the motivation to quit, or gave only a survey to a control group (201 smoking patients). After at least 5 months, self-reported current smoking cessation was confirmed later using cut-off values of 7 ppm or less in expired alveolar air after breath holding portable CO analyzer. RESULTS: After 5 months, subjects in the intervention group were 1.56 times (95% C.I. 0.89-2.73) more likely to quit smoking than those in the non-intervention group (14.0% vs. 9.0%). Willingness to quit smoking in a month, scheduled admission in a month, self efficacy score and FTND (Fagerstrom Test for Nicotine Dependence) score were all significantly related with smoking cessation. In stepwise multiple logistic regression, previous attempts to quit smoking were significant instead of self efficacy score. In the intervention group who had willingness to quit smoking in a month (132 smoking patients), FTND score, whether quit date was today, and whether quit promise paper was submitting were all significantly related with smoking cessation. In stepwise multiple logistic regression, scheduled admission in a month and whether quit date was today were significant predictor variables. Smoking cessation treatment should be tailored to individual smoking patients considering these predictors.
Adult ; Breath Holding ; Counseling ; Humans ; Logistic Models ; Methods ; Motivation ; Nicotine ; Outpatients* ; Recurrence ; Self Efficacy ; Smoke* ; Smoking Cessation* ; Smoking* ; Tobacco Products

PURPOSE: This study examined the rate in which a diagnostic workup and treatment for osteoporosis are performed on patients with a hip fracture in Jeju Island, South Korea. MATERIALS AND METHODS: This study reviewed the medical records and radiographs of 174 patients (141 women and 33 men) older than 50 years and diagnosed with femoral neck or intertrochanteric fractures at 8 hospitals in Jeju Island during 2005. The mean age at the time of diagnosis was 78.3 years (range, 50-104 years). The number of patients examined with bone densitometry and treated for osteoporosis after the hip fracture was calculated. RESULTS: DXA was performed on 35 patients (20.1%) diagnosed with osteoporosis (T-score < -2.5). Of these 35 patients, 27 patients were treated for osteoporosis after a hip fracture. Among the 174 patients, only 27 patients (15.5%) had received medication for osteoporosis. CONCLUSION: The detection and treatment of osteoporosis are essential for reducing the incidence of another fracture after a hip fracture. However, a diagnostic study and the treatment for osteoporosis were performed only in a small portion of hip fracture patients.
Densitometry ; Diagnosis ; Female ; Femur Neck ; Hip Fractures* ; Hip* ; Humans ; Incidence ; Korea ; Medical Records ; Osteoporosis*

Cerebral cavernous hemangioma is very rare disease in the cerebral vascular malformations. We experienced a case of this vascular malformations at the left frontal lobe near the cortex which had symptoms and signs of abrupt generalized tonic-clonic seizure. This malformation is encountered more commonly in adult in the third to fifth decade, and is found most frequently in the white matter of the cerebral hemisphere. The value of computerized tomography(C-T) in the detection of such malformations is stressed. Good result was obtained by the microsurgical approach to these malformations.
Adult ; Cerebrum ; Frontal Lobe* ; Hemangioma, Cavernous* ; Hemangioma, Cavernous, Central Nervous System ; Humans ; Microsurgery ; Rare Diseases ; Seizures ; Vascular Malformations

Epidural injection of 2-4mg morphine for 7-14 days were given to 18 patients with severe chronic pain. All cases except 2 arachnoiditis had considerable amelioration of pain, which commenced within 2-3min, reached a peak in 10-20min, and was effective for 6-72 hours. Using sensory evoked potentials(SEP) examination for pre-and post-morphine epidural infusion in 18 pain patients, we found the morphine inhibited the action of spinal pain receptor system. It is suggested that morphine reached the subarachnoid space and produced its effect by direct action on the specific opiate receptors in the substantia gelatinosa of the posterior horn cell of the spinal cord.
Arachnoid ; Arachnoiditis ; Chronic Pain* ; Humans ; Injections, Epidural ; Morphine* ; Nociceptors ; Posterior Horn Cells ; Receptors, Opioid ; Spinal Cord ; Subarachnoid Space ; Substantia Gelatinosa

OBJECTIVES: The objectives of this study were to evaluate the effect of smoking on utilization of and expenses in ambulatory dental care. METHODS: The subjects of this study were 5,751 men aged over 20 years selected from the Korea Health Panel data collected during 2010-2012. Pack-years of smoking were calculated based on the survey data. Dental utilization was defined as dental outpatient clinic use least once in three years. The expenses in ambulatory dental care were summed to determine total dental health care spending for three years. To detect the effect of smoking, we used multiple logistic regression analysis for dental utilization and multiple linear regression for expenses in ambulatory dental care after changing log. RESULTS: The pack-years had a significant effect on dental utilization and expenses in participants aged 40-59 years. After controlling for income level, bedtime brushing, and the presence of chronic disease, dental care utilization rates in the over 10 to less than 25 pack-year and the over 25 pack-year groups were about 1.4 (OR=1.37, (P =0.007)) and 1.6 times (OR=1.59, (P =0.001)) those in the 0 pack-year group. In comparison with the 0 pack-year group, the over 10 to less than 25 pack-year group spent 50,000 won more over dental expenses, while the corresponding number for the over 25 pack-year group was about 100,000 won. Thus, the ambulatory dental care expenses increased with the packyears of smoking. CONCLUSIONS: Smoking significantly influenced the utilization and expense in ambulatory dental care in men aged 40-59 years.
Ambulatory Care Facilities ; Chronic Disease ; Delivery of Health Care ; Dental Care* ; Humans ; Korea ; Linear Models ; Logistic Models ; Male ; Smoke* ; Smoking*

A 29-year-old woman in her 8th week of pregnancy was referred to our hospital for swelling in the lower extremities, rapid onset of dyspnea (1 hr) and pre-syncope. Severe right ventricular dysfunction and moderate pulmonary hypertension were detected using 2-dimentional Doppler echocardiography. In addition, left calf vein and proximal thromboses were detected by venous compression ultrasound imaging. After successful thrombolytic treatment, the patient quickly recovered and was discharged from hospital on subcutaneous low-molecular-weight heparin. She delivered a normal, healthy infant at full-term (40 weeks).
Adult ; Dyspnea ; Echocardiography, Doppler ; Female ; Heparin, Low-Molecular-Weight ; Humans ; Hypertension, Pulmonary ; Infant ; Lower Extremity ; Pregnancy* ; Pulmonary Embolism* ; Thrombolytic Therapy ; Thrombosis ; Ultrasonography ; Veins ; Venous Thrombosis* ; Ventricular Dysfunction, Right

To evaluate the validity of serum pepsinogen levels as a screening tool for gastric cancer and adenoma, immunoradiometric assays of serum pepsinogen I level (PG I), II level (PG II) and esphagogastroduodenal endoscopies were done in 757 health examlnees. Serum PG I level was higher in subjects with active duodenal ulcer (n=45, 75.2+/-34.3 microgram/l(mean+/-standard deviation), p<0.01) and gastroduodenal ulcers (n=8,756+/-19.8 microgram/l, p<0.05), and was lower in those with gastric adenoma (n=4,37.7+/-37.2 microgram/l, p<0.2) than those with normal, mild gastritis findings or ulcer scars (n=378, 56.6+/-24.9 microgram/l). Serum PG II level las higher in subjects with active duodenal ulcer (17.2+/-13.8 microgram/l, p<0.2), active gastro-duodenal ulcers (l8.3+/-7.4 microgram/l, p<0.2) and gastric carcinoma (n=3, 23.8+/-10.9 microgram/l, p<0.05) than those with normal, mild gastritis findings or ulcer scars (14.5+/-7.9 microgram/l). Serum PG I/PG 11 ratio was higher in subjects with active duodenal ulcer (5.1+/-1.6, p<0.05) and was lower in those with chronic gastritis (n=107, 4.1+/-1.7, p<0.05), gastric polyp (n=19, 3.9+/-1.4, p<0.2), gastric adenoma (n=4, 2.1+/-1.9, p<0.01) and gastric carcinoma (n=3, 2.7+/-1.2, p<0.1) than those with normal, mild gastritis findings or ulcer scars (4.5+/-1.7). Serum PG 11 level increased with age until 6th decade, whereas serum PG I/PG II ratio decreased with age in 378 subjects with normal, mild gastritis findings or ulcer scars. The screening criteria of serum PG I<70 microgram/l and PG I/PG II ratio<3.0 for detecting gastric cancer and adenorna gave a positive rate of 15.7%, sensitivity of 57.1% and specificity of 84.7%.
Adenoma* ; Cicatrix ; Duodenal Ulcer ; Gastritis ; Immunoradiometric Assay ; Korea* ; Mass Screening* ; Pepsinogen A* ; Peptic Ulcer ; Polyps ; Sensitivity and Specificity ; Stomach Neoplasms* ; Ulcer