• Tuberculosis and Respiratory Diseases
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• v.48 no.2
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• pp.180-190
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• 2000

Background: Genomic instability, which is manifested by the replication error(RER) phenotype, has been proposed for the promotion of genetic alterations necessary for carcinogenesis. Merlo et al. reported frequent microsatellite instability in primary small cell lung cancers. However, Kim et al. found that instability occurred in only 1% of the loci tested and did not resemble the replication error-positive phenotype. The significance of microsatellite instability in the tumorigenesis of small cell lung cancer as well as the relationship between microsatellite instability and its clinical prognosis was investigated in our study. Methods: Fifteen primary small cell lung cancers were chosen for this study. The DNAs extracted from paraffin-embedded tissue blocks with primary tumor and corresponding control tissue were investigated. Forty microsatellite markers on chromosome 1p, 2p, 3p, 5q, 6p, 6q, 9p, 9q, 13q, and 17p were used in the microsatellite analysis. Results: Thirteen(86.7%) of 15 tumors exhibited LOH in at least one of the tested microsatellite markers. Three of 13 tumors exhibiting LOH lost a larger area in chromosome 9p. LOH was shown in 72.7% on chromosome 2p, 40% on 3p, 50% on 5q, 46.7% on 9p, 69.2% on 13q, and 66.7% on 17p(Table 1). Nine(60%) of 15 tumors exhibited shifted bands in at least one of the tested microsatellite markers. Nine cases exhibiting shifted bands showed altered loci ranging 2.5~52.5%(mean $9.4%\pm16.19$)(Table 2). Shifted bands occurred in 5.7% (34 of 600) of the loci tested(Table 2). Nine cases with shifted bands exhibited LOH ranging between 0~83.3%, and the median survival duration of those cases was 35 weeks. Six cases without shifted bands exhibited LOH ranging between 0~83.3%, and the median survival duration of those cases was 73 weeks. There was no significant difference between median survival durations of the two groups(p=0.4712). Conclusion: Microsatellite instability as well as the inactivation of several tumor suppressor genes may play important roles in the development and progression process of tumors. However, the relationship between microsatellite instability and its clinical prognosis in primary small cell lung cancer could not be established.

• Journal of the Korean Society of Food Science and Nutrition
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• v.37 no.12
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• pp.1589-1598
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• 2008

The objective of this study was to investigate the effect of obesity on health by analyzing the factors which are related to obesity through the questionnaires on the dietary pattern, nutrient intake and physical measurements. The subjects, 419 college women aged 20 to 24 year-old, were randomly selected from Seoul and data were collected during March to May, 2008 and classified as under underweight, normal weight, and obesity groups according to BMI. However, weight, skeletal muscle mass, body fat mass, fat free mass, percentage of body fat, and waist to hip ratio showed significant differences among all the groups (p<0.05). In the obese group, 77.8% ate fat-rich foods such as galbi and samgyopsal more than two times per week, 66.7% ate vegetables other than kimchi (p<0.05) as compared to the underweight and normal groups by mini dietary assessment (p<0.05). The cholesterol intakes of the underweight, normal weight, and obese groups were $164.67{\pm}114.52mg/dL$, $143.31{\pm}99.58mg/dL$, and $121.92{\pm}54.91mg/dL$, respectively, and the obese group had a significantly lower intake than the other groups (p<0.05). The serum total cholesterol levels of the underweight, normal, and obese groups were $177.04{\pm}26.36mg/dL$, $189.46{\pm}29.05mg/dL$, and $170.00{\pm}12.75mg/dL$, respectively, and the obese group showed lower total cholesterol level than the other groups (p<0.05). The triacylglycerol level of the obese group ($132.00{\pm}64.60mg/dL$) was significantly higher than the other two groups (p<0.05). The HDL-cholesterol levels of the underweight, normal weight, and obese groups were $51.92{\pm}9.39mg/dL$, $59.20{\pm}13.53mg/dL$, and $43.00{\pm}8.98mg/dL$, respectively, showing that the obese subjects had significantly lower HDL-cholesterol levels as compared to the subjects in the other groups (p<0.05). The HDL-C/LDL-C ratios of the underweight ($0.52{\pm}0.45$) and normal weight ($0.59{\pm}0.23$) groups were higher than the ratio of the obese group ($0.41{\pm}0.06$). Total cholesterol were positively correlated with LDL-cholesterol (r=0.768, p<0.01), but triacylglycerol were adversely correlated with HDL-cholesterol. In conclusion, our results show that college-aged women in Seoul should be encouraged to amend their overall dietary habits, make a dietary plan that fits their individual needs, and maintain an effective exercise schedule.

• Economic and Environmental Geology
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• v.40 no.6
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• pp.713-726
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• 2007

The Daebong deposit consists of gold-silver-bearing mesothermal massive quartz veins which fill fractures along fault zones($N10{\sim}20^{\circ}W,\;40{\sim}60^{\circ}SW$) within banded gneiss or granitic gneiss of Precambrian Gyeonggi massif. Ore mineralization of the deposit is composed of massive white quartz vein(stage I) which was formed in the same stage by multiple episodes of fracturing and healing and transparent quartz vein(stage II) which is separated by a major faulting event. The hydrothermal alteration of stage I is sericitization, chloritization, carbonitization, pyritization, silicification and argillization. Sericitic zone occurs near and at quartz vein and includes mainly sericite, quartz, and minor illite, carbonates and epidote. Chloritic zone occurs far from quartz vein and is composed of mainly chlorite, quartz and minor sericite, carbonates and epidote. Fe/(Fe+Mg) ratios of sericite and chlorite range 0.36 to 0.59($0.51{\pm}0.10$) and 0.66 to 0.73($0.70{\pm}0.02$), and belong to muscovite-petzite series and brunsvigite, respectively. Calculated $Al_{IV}-Fe/(Fe+Mg)$ diagrams of sericite and chlorite suggest that this can be a reliable indicator of alteration temperature in Au-Ag deposits. Calculated activities of chlorite end member are $a3(Fe_5Al_2Si_3O_{10}(OH){_6}=0.00964{\sim}0.0291,\;a2(Mg_5Al_2Si_3O_{10}(OH){_6}= 9.99E-07{\sim}1.87E-05,\;a1(Mg_6Si_4O_{10}(OH){_6}=5.61E-07{\sim}1.79E-05$. It suggest that chlorite from the Daebong deposit is iron-rich chlorite formed due to decreasing temperature from $T>450^{\circ}C$. Calculated $log\;{\alpha}K^+/{\alpha}H^+,\;log\;{\alpha}Na^+/{\alpha}H^+,\;log\;{\alpha}Ca^{2+}/{\alpha}^2H^+$ and pH values during wall-rock alteration are $4.6(400^{\circ}C),\;4.1(350^{\circ}C),\;4.0(400^{\circ}C),\;4.2(350^{\circ}C),\;1.8(400^{\circ}C),\;4.5(350^{\circ}C),\;5.4{\sim}6.5(400^{\circ}C)\;and\;5.1{\sim}5.5(350^{\circ}C)$, respectively. Gain elements (enrichment elements) during wallrock alteration are $K_2O,\;P_2O_5,\;Na2O$, Ba, Sr, Cr, Sc, V, Pb, Zn, Be, Ag, As, Ta and Sb. Elements(Sr, V, Pb, Zn, As, Sb) represent a potentially tools for exploration in mesothermal and epithermal gold-silver deposits.

• Journal of Food Hygiene and Safety
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• v.26 no.3
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• pp.260-265
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• 2011

Plantago asiatica L. (P. asiatica) has been used as one of the popular folk medicines in Asia for human health care practices. Various activities of P. asiatica have been reported, such as anti-oxidant, anti-glycation, anti-inflammatory and hepatoprotective activity. Therefore, the potential of P. asiatica to reduce oxidative stress has been studied in several ways for over 20 years, especially at liver and kidney. However no investigation has been reported revealing its protective effect on prostate. Method: Treatment of P. asiatica leaf ethanolic extract (PLE) (1 g/kg body weight (b.w.), 2 g/kg b.w., or 4 g/kg b.w.) were given separately to animals for pretreatment once per day for 7 days, and on the seventh day ferric nitrilotriacetate (Fe-NTA; 0.24 mmol Fe/kg b.w.), which is known as an oxidative stress-inducer at prostate, was administrated by i.p to negative control group. At the end of the study period, dissection was carried out for detecting the prostate protective effect of PLE. Result: Fe-NTA-treated animals produced reactive oxygen species (ROS) resulting in depletion of antioxidant biomaker, such as glutathione (GSH), glutathione reductase (GR), and glutathione s-transferase (GST) and increase of lipid peroxidation in prostate. However, PLE pretreatment resulted in an increase in the GSH, GST and GR levels concentration dependent manner and in an significant decrease in the levels of lipid peroxidation. Conclusion: Our data suggest that PLE may be effective in protecting oxidative stress-induced damage of prostate, and PLE may be an chemopreventive agent against Fe-NTA-mediated prostate oxidative damage.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.1
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• pp.102-107
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• 2012

Purpose : Because of the rapid physical decay of the short half-lived radionuclide, counting of event for image is very limited. In this reason, long scan duration is applied for more accurate quantitative analysis in the relatively low sensitive examination. The aim of this study was to evaluate the difference according to scan duration and investigate the resonable scan duration using the radionuclide of 11C and 18F in PET scan. Materials and Methods : 1994-NEMA Phantom was filled with 11C of $30.08{\pm}4.22MBq$ and 18F of $40.08{\pm}8.29MBq$ diluted with distilled water. Dynamic images were acquired 20frames/1minute and static image was acquired for 20minutes with 11C. And dynamic images were acquired 20frames/2.5minutes and static image was acquired for 50minutes with 18F. All of data were applied with same reconstruction method and time decay correction. Region of interest (ROI) was set on the image, maximum radioactivity concentration (maxRC, kBq/mL) was compared. We compared maxRC with acquired dynamic image which was summed one bye one to increase the total scan duration. Results : maxRC over time of 11C was $3.85{\pm}0.45{\sim}5.15{\pm}0.50kBq/mL$ in dynamic image, and static image was $2.15{\pm}0.26kBq/mL$. In case of 18F, the maxRC was $9.09{\pm}0.42{\sim}9.48{\pm}0.31kBq/mL$ in dynamic image and $7.24{\pm}0.14kBq/mL$ in static. In summed image of 11C, as total scan duration was increased to 5, 10, 15, 20minutes, the maxRC were $2.47{\pm}0.4$, $2.22{\pm}0.37$, $2.08{\pm}0.42$, $1.95{\pm}0.55kBq/mL$ respectively. In case of 18F, the total scan duration was increased to 12.5, 25, 37.5, and 50minutes, the maxRC were $7.89{\pm}0.27$, $7.61{\pm}0.23$, $7.36{\pm}0.21$, $7.31{\pm}0.23kBq/mL$. Conclusion : As elapsed time was increased after completion of injection, the maxRC was increased by 33% and 4% in dynamic study of 11C and 18F respectively. Also the total scan duration was increased, the maxRC was reduced by 50% and 20% in summed image of 11C and 18F respectively. The percentage difference of each result is more larger in study using relatively shorter half-lived radionuclide. It appears that the accuracy of decay correction declined not only increment of scan duration but also increment of elapsed time from a starting point of acquisition. In study using 18F, there was no big difference so it's not necessary to consider error of quantitative evaluation according to elapsed time. It's recommended to apply additional decay correction method considering decay correction the error concerning elapsed time or to set the scan duration of static image less than 5minutes corresponding 25% of half life in study using shorter half-lived radionuclide as 11C.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.9-16
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• 2010

Purpose: With increasing medical use of radiation and radioactive isotopes, there is a need to better manage the risk of radiation exposure. This study aims to grasp and analyze the individual radiation exposure situations of radiation-related workers in a medical facility by specific job, in order to instill awareness of radiation danger and to assist in safety and radiation exposure management for such workers. Materials and Methods: 1 January 2007 to 31 December 2009 to work in medical institutions are classified as radiation workers Nuclear personal radiation dosimeter regularly, continuously administered survey of 40 workers in three years of occupation to target, Imaging Unit beautifully, age, dose sector, job function-related tasks to identify the average annual dose for a deep dose, respectively, were analyzed. The frequency analysis and ANOVA analysis was performed. Results: Imaging Unit beautifully three years the annual dose PET and PET/CT in the work room 11.06~12.62 mSv dose showed the highest, gamma camera injection room 11.72 mSv with a higher average annual dose of occupation by the clinical technicians 8.92 mSv the highest, radiological 7.50 mSv, a nurse 2.61 mSv, the researchers 0.69 mSv, received 0.48 mSv, 0.35 mSv doctors orderly, and detail work employed the average annual dose of the PET and PET/CT work is 12.09 mSv showed the highest radiation dose, gamma camera injection work the 11.72 mSv, gamma camera imaging work 4.92 mSv, treatment and safety management and 2.98 mSv, a nurse working 2.96 mSv, management of 1.72 mSv, work image analysis 0.92 mSv, reading task 0.54 mSv, with receiving 0.51 mSv, 0.29 mSv research work, respectively. Dose sector average annual dose of the study subjects, 15 people (37.5%) than the 1 mSv dose distribution and 5 people (12.5%) and 1.01~5.0 mSv with the dose distribution was less than, 5.01~10.0 mSv in the 14 people (35.0%), 10.01~20.0 mSv in the 6 people (15.0%) of the distribution were analyzed. The average annual dose according to age in occupations that radiological workers 25~34 years old have the highest average of 8.69 mSv dose showed the average annual dose of tenure of 5~9 years in jobs radiation workers in the 9.5 mSv The average was the highest dose. Conclusion: These results suggest that medical radiation workers working in Nuclear Medicine radiation safety management of the majority of the current were carried out in the effectiveness, depending on job characteristics has been found that many differences. However, this requires efforts to minimize radiation exposure, and systematic training for them and for reasonable radiation exposure management system is needed.

• The Korean Journal of Mycology
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• v.21 no.3
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• pp.200-211
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• 1993

Somatic hybrids of Pleurotus florida ASI 2016 and Pleurotus ostreatus ASI 2018 were obtained by protoplast fusion. The 40 fusants($P1{\sim}P40$) was examined for the yield on fermented and pasteurized rice straw in a tray. The carpophore yield of them were showed as the range of $27.0{\sim}155.2$, based on parental values of 100(ASI 2018), The pilei of fusants between orange white colored P. florida and dark grey colored P. ostreatus had mixed colors in the young stage. Other breeding programmes were performed to improve new varieties with high yield and good quality. A new oyster mushroom variety, Wonhyeongneutaribeosus(P72), was developed at the Agricultural Sciences Institute, Rural Development Administration in 1990. This P.florida-ostreatus-ostreatus hybrid P72 was selected from 38 protoplast fusion products($P41{\sim}P78$) between P.florida-ostreatus recombinant P5-M 43-arg rib and P. ostreatus ASI 2-13-0 2001-19-pro orn. The yield indexes of 38 hybrids ranged $40.5{\sim}152.7$ compared with the parental values of 100(ASI 2001). Hybrid P72 was characterized by the large fruiting bundle of semispherical shape with long stipe and by the small and circular pileus, resulting in lower harvesting cost. A significant increase in carpophore production was observed in somatic hybrids of protoplasts due to heterosis. A comparision of hybrid with parents P72 was made using isozyme analysis. The esterase banding patterns could be characterized by new bands in the hybrids. Seven fusion products of four crosses between P.florida ASI 2016 and P. ostreatus ASI 2018 were analysed with respect to the distribution of progenies and segregation of gene markers by random basidiospore analysis. Segregation of alleles should yield progeny of four genotypes in a Mendelian ratio of 1 : 1 : 1 : 1 for prototrophs, auxotrophs of one parental type, auxotrophs of the other parental type, and auxotrophic recombinants, respectively. However, five fusants of them did not detect one parental, P.ostreatus, type. Basidiospores could yield progeny of 16 genotypes in the cross of one of the recombinant P5-M43-arg $rib{\times}P. ostreatus$ ASI 2-13-pro orn but the segregants of three fusants were not detected clearly. The allele ratio of loci could be expected 1 : 1 : 1 : 1 for arg, rib, pro and orn. The ratio, however, would be changed to 4 : 1 : 1 : 1 with increasing proportion of argo In almost all the fusants, prototrophic recombinants were recovered in large numbers against auxotrophic markers. Parental genotypes were recovered with the recombinant progeny amounting to $38.68{\sim}99.56%$. The analysis provides proof of heterokaryosis and strong evidence for haploidy of vegetative nuclei, a sexual cycle consisting of nuclear fusion and meiosis.

• Journal of Chest Surgery
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• v.30 no.5
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• pp.471-478
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• 1997

Introduction: The use of rabbits as a cardiopulmonary bypass(CPB) animal model is extremely dif%cult mainly due to technical problems. On the other hand, deep hypothermic circulatory arrest(CA) is used to facilitate surgical repair in a variety of cardiac diseases. Although steroids are generally known to be effective in the treatment of cerebral edema, the protective effects of steroids on the brain during CA are not conclusively established. Objectives of this study are twofold: the establishment of CPB technique in rabbits and the evaluation of preventive effect of steroid on the development of brain edema during CA. Material '||'&'||' Methods: Fifteen New Zealan white rabbits(average body weight 3.5kg) were divided into three experimental groups; control CA group(n=5), CA with Trendelenberg position group(n=5), and CA with Trendelenberg position + steroid(methylprednisolone 30 mglkg) administration group(n=5). After anesthetic induction and tracheostomy, a median sternotomy was performed. An aortic cannula(3.3mm) and a venous ncannula(14 Fr) were inserted, respectively in the ascending aorta and the right atrium. The CPB circuit consisted of a roller pump and a bubble oxygenator. Priming volume of the circuit was approximately 450m1 with 120" 150ml of blood. CPB was initiated at a flow rate of 80~85ml/kg/min, Ten min after the start of CPB, CA was established with duration of 40min at $20^{\circ}C$ of rectal temperature. After CA, CPB was restarted with 20min period of rewarming. Ten min after weaning, the animal was sacrif;cod. One-to-2g portions of the following tissues were rapidly d:ssected and water contents were examined and compared among gr ups: brain, cervical spinal cord, kidney, duodenum, lung, heart, liver, spleen, pancreas. stomach. Statistical significances were analyzed by Kruskal-Wallis nonparametric test. Results: CPB with CA was successfully performed in all cases. Flow rate of 60-100 mlfkgfmin was able to be maintained throughout CPB. During CPB, no significant metabolic acidosis was detected and aortic pressure ranged between 35-55 mmHg. After weaning from CPB, all hearts resumed normal beating spontaneously. There were no statistically significant differences in the water contents of tissues including brain among the three experimental groups. Conclusion: These results indicate (1) CPB can be reliably administered in rabbits if proper technique is used, (2) the effect of steroid on the protection of brain edema related to Trendelenburg position during CA is not established within the scope of this experiment.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.34 no.5
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• pp.536-544
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• 2001

Three harmful algal bloom species with similar morphology, Cochlodinium polykrikoides, Gyodinium impudicum and Gymodinium catenatum have damaged to aquatic animals or human health by either making massive blooms or intoxication of shellfishes in a food chain. Eco-physiological and hydrodynamic studies on the harmful algae offer useful informations in the understanding their bloom mechanism by giving promising data for the prediction and modelling of harmful algal blooms event. Thus, we studied the abundance of these species in the coastal area of South Sea of Korea and their effects of temperature, salinity, irradiance and nutrient on the growth for the isolates. The timing for initial appearance of the three species around the coastal area of Namhaedo, Narodo and Wando was between Bate July and late August in 1999 when water temperature ranged from $22.8^{\circ}C\;to\;26.5^{\circ}C$ Vegetative cells of C. polykrikoides and G. impudicum were abundant until late September when water temperature had been dropped to less than $23^{\circ}C$. By contrast, vegetative cell of G. catenatum disappeared before early September, showing shorter period of abundance than the other two species in the South Sea. Both G. impudicum and G. catenatum revealed comparatively low density with a maximal cell density of 3,460 cells/L and 440 cells/L, respectively without making any bloom, while C. polykrikoides made massive blooms with a maximal cell density more than $40\times10^6$cells/L, The three species showed a better growth at the relatively higher water temperature ranging from 22 to $28^{\circ}C$ with their maximal growth rate at $25^{\circ}C$ in culture, which almost corresponded with the water temperature during the outbreak of C. polykrikoides in the coastal area of South Sea. Also, they all showed a relatively higher growth at the salinity from 30 to $35\%$. Specially, G. impudicum showed the euryhalic characteristics among the species, On the other hand, growth rate of G. catenatum decreased sharply with the increase of water temperature at the experimental ranges more than $35\%$. The higher of light intensities showed the better growth rates for the three species, Moreover, C. polykrikoides and G. impudirum continued their exponential growth even at 7,500 lux, the highest level of light intensity in the experiment, Therefore, It is assumed that C. polykrikoides has a physiological capability to adapt and utilize higher irradiance resulting in the higher growth rate without any photo inhibition response at the sea surface where there is usually strong irradiance during its blooming season. Although C. poiykikoides and G. impudicum continued their linear growth with the increase of nitrate ($NO_3^-$) and ammonium ($NH_4^-$) concentrations at less than the $40{\mu}M$, they didn't show any significant differences in growth rates with the increase of nitrate and ammonium concentrations at more than $40{\mu}M$, signifying that the nitrogen critical point for the growth of the two species stands between 13.5 and $40{\mu}M$. Also, even though both of the two species continued their linear growth with the increase of phosphate ($PO_4^{2-}$) concentrations at less than the $4.05{\mu}M$, there were no any significant differences in growth rates with the increase of phosphate concentrations at more than $4.05{\mu}M$, signifying that the phosphate critical point for the growth of the two species stands between 1.35 and $4.05{\mu}M$. On the other hand, C. polykrikoides has made blooms at the oligotrophic environment near Narodo and Namhaedo where the concentration of DIN and DIP are less than 1.2 and $0.3{\mu}M$, respectively. We attributed this phenomenon to its own ecological characteristics of diel vertical migration through which C. polykrikoides could uptake enough nutrients from the deep sea water near bottom during the night time irrespective of the lower nutrient pools in the surface water.

• Journal of Preventive Medicine and Public Health
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• v.31 no.4 s.63
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• pp.751-769
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• 1998

This study was conducted to assess the attitude of pregnant women toward delivery method, understanding of the reason for determining her own delivery method, participation in decision-making process and satisfaction with delivery method after labor. Study subjects were 693 pregnant women who had visited obstetric clinic for prenatal care in the last month of pregnancy in one general hospital and one obstetrics-gynecology specialty hospital in Taegu city from February 1 to March 31 in 1998. A questionnaire was administered before and after labor and a telephone interview was done one month after labor. Proportion of women who had health education and/or counselling about delivery method during prenatal care was 24.0% and this proportion was higher for women who had previous c-section(35.5%) than others. Women thought vaginal delivery is better than c-section for both maternal and baby's health regardless of previous delivery method. About 90% of primipara and multiparous women who had previous vaginal delivery wanted vaginal delivery for the index birth, while 85.6% of multiparous women who had previous c-section wanted repeat c-section. Reasons for choosing c-section in pregnant women who preferred vaginal delivery before labor were recommendation of doctors(81.9%), recommendation of husband (0.8%), agreement between doctor and pregnant woman(4.7%), and mother's demand (12.6%). Reasons for choosing vaginal delivery were mother's demand(30.6%) and no indication for c-section(67.2%). Reasons for choosing c-section in pregnant women who preferred c-section before labor were recommendation of doctors(76.2%), mother's demand(20.0%), recommendation of husband(1.3%), and agreement between doctor and pregnant woman(2.5%). Of the pregnant women who had c-section, by doctor's recommendation, the proportion of women who had heard detailed explanation about reason for c-section by doctor was 55.1%. Mother's statement about the reason for c-section was consistent with the medical record in 75.9% . However, over 5% points disparities were shown between mother's statement and medical record in cases of the repeat c-section and mother's demand. In primipara and multiparous women who had previous vaginal delivery, the delivery method for index birth had statistically significant association with the preference of delivery method before labor(p<0.05). All of the women who had previous c-section had delivered the index baby by c-section. Among mothers who had delivered the index baby vaginally, 84.9% of them were satisfied with their delivery method immediately after labor and 85.1% at 1 month after labor. However, mothers who had c-section stated that they are satisfied with c-section in 44.6% immediately after labor and 42.0% at 1 month after labor. Preferred delivery method for the next birth had statistically significant association with delivery method for the index birth both immediately after labor and in 1 month after labor. The proportion of mothers who prefer vaginal delivery for the next birth increased with the degree of satisfaction with the vaginal delivery for the index birth but the proportion of mothers who prefer c-section for the next birth was high and they did not change significantly with the degree of satisfaction with the c-section for the index birth. These results suggest that the current high technology-based, physician-centered prenatal and partritional cares need to be reoriented to the basic preventive and promotive technology-based, and mother-fetus-centered care. It is also suggested that active involvement of pregnant woman in decision-making process for the delivery method will increase the rate of vaginal birth after c-section and decrease c-section rate and improve the degree of maternal satisfaction after delivery.