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Reproducibility of Adenosine Tc-99m sestaMIBI SPECT for the Diagnosis of Coronary Artery Disease (관동맥질환의 진단을 위한 아데노신 Tc-99m sestaMIBI SPECT의 재현성)

  • Lee, Duk-Young;Bae, Jin-Ho;Lee, Sang-Woo;Chun, Kyung-Ah;Yoo, Jeong-Soo;Ahn, Byeong-Cheol;Ha, Jeoung-Hee;Chae, Shung-Chull;Lee, Kyu-Bo;Lee, Jae-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.6
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    • pp.473-480
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    • 2005
  • Purpose: Adenosine myocardial perfusion SPECT has proven to be useful in the detection of coronary artery disease, in the follow up the success of various therapeutic regimens and in assessing the prognosis of coronary artery disease. The purpose of this study is to define the reproducibility of myocardial perfusion SPECT using adenosine stress testing between two consecutive Tc-99m sestaMIBI (MIBI) SPECT studies in the same subjects. Methods: Thirty patients suspected of coronary artery disease in stable condition underwent sequential Tc-99m MIBI SPECT studies using intravenous adenosine. Gamma camera, acquisition and processing protocols used for the two tests were identical and no invasive procedures were performed between two tests. Mean interval between two tests were 4.1 days (range: 2-11 days). The left ventricular wall was divided into na segments and the degree of myocardial tracer uptake was graded with four-point scoring system by visual analysis. Images were interpretated by two independent nuclear medicine physicians and consensus was taken for final decision, if segmental score was not agreeable. Results: Hemodynamic responses to adenosine were not different between two consecutive studies. There were no serious side effects to stop infusion of adenosine and side effects profile was not different. When myocardial uptake was divided into normal and abnormal uptake, 481 of 540 segments were concordant (agreement rate 89%, Kappa index 0.74). With four-grade storing system, exact agreement was 81.3% (439 of 540 segments, tau b=0.73). One and two-grade differences were observed in 97 segments (18%) and 4 segments (0.7%) respectively, but three-grade difference was not observed in any segment. Extent and severity scores were not different between two studios. The extent and severity scores of the perfusion defect revealed excellent positive correlation between two test (r value for percentage extent and severity score is 0.982 and 0.965, p<0.001) Conclusion: Hemodynamic responses and side effects profile were not different between two consecutive adenosine stress tests in the same subjects. Adenosine Tc-99m sestaMIBI SPECT is highly reproducible, and could be used to assess temporal changes in myocardial perfusion in individual patients.

The Role of Initial Relative Renal Function in Unilateral Hydronephrosis (일측 폐색성 및 역류성 수신증에서 술전 상대적 신기능의 의미)

  • Han Sang-Won;Kang Seon-Jung;Kwon Min-Jung;Kim Dae-Joong;Choi Seung-Kang;Lee Tack
    • Childhood Kidney Diseases
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    • v.3 no.2
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    • pp.203-208
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    • 1999
  • Purpose: The information on the change of the relative renal function after operation is essential to set the initial treatment plan in unilateral hydronephrosis. So we analyzed the preoperative and postoperative relative renal function, and observed the functional changes by operation and reliability of the various factors in those changes. Materials and Methods: A retrospective trial was done of 81 patients, 35 ureteropelvic junction(UPJ) obstruction and 46 vesicoureteral reflux(VUR), among 393 patients undergoing operations at our institution from March. 1992 to February. 1997. The patients who had infravesical abnormalities, abnormal contralateral kidney and insufficient research data were excluded. We determined the relative renal functions using DTPA and MAG3 scan in UPJ obstruction and DMSA scan in VUR. The mean observation period after operation was 2.01(0.25-4) years. Results: A. UPJ Obstruction 1. The relative renal function was improved significantly after operation(P=0.0007). 2. The kidneys which have preoperative functions between 20% and 40% improved significantly in relative renal function comparing to the kidneys of the other functions(P=0.0046). B. VUR 1. The renal functions didn't improve significantly after operation(P>0.05). 2. There was no significant factor affecting the prognosis in renal functions. Conclusions: 1. The kidneys with UPJ Obstruction show the difference in functional improvement after operation according to the degree of the preoperative renal function, but more investigations about the exact value are needed. 2. In VUR there was no difference between preoperative and postoperative functions, the theoretical basis on objectives of the operation could be the symptoms or factors except the operation.

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Clinical Significance of the Nutritional Support Team for Preterm Infants in a Neonatal Intensive Care Unit (신생아중환자실에 입원한 미숙아에서 영양지원팀 활동의 임상적 의의)

  • Yang, Hye-Ran;Choi, Chang-Won;Kim, Beyong-Il;Seo, Jeong-Kee;Choi, Su-Ahn;Kim, So-Yeon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.1
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    • pp.39-45
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    • 2009
  • Purpose: Preterm infants are very susceptible to malnutrition because of a lack of storage of nutrients, immature digestion and metabolism, and accompanying diseases associated with prematurity. The purpose of this study was to evaluate the effects of nutritional support by the pediatric nutritional support team (pNST) on the clinical course of preterm infants in the neonatal intensive care unit (NICU). Methods: Between July 2003 and July 2006, 48 preterm infants who were admitted to the NICU at Seoul National University Bundang Hospital were included. The subjects were divided into the following two subgroups according to the presence of NST activity; pre-NST group (n=23) and NST group (n=25). Hospital records were reviewed retrospectively. Results: Forty-eight preterm babies were included (M:F=27:21; gestational age, 25~33 weeks). A dietician, pharmacists, or the pNST participated in the prescription of total parenteral nutrition (TPN) more rapidly in the NST group (p=0.000). The fasting periods and TPN administration periods were significantly decreased in the NST group compared to the pre-NST group (p=0.017 & p=0.001, respectively). The doses of calories, protein, and lipids administered via TPN were significantly increased in the NST group compared to the pre-NST group (p=0.016, p=0.000, and p=0.000, respectively). The total period on antibiotic therapy was significantly decreased in the NST group compared to the pre-NST group (p=0.007). Conclusion: Because nutritional support by the pNST is of benefit to the clinical course of preterm infants in the NICU, the pNST should recommend to improve the nutritional status and clinical outcome of preterm infants.

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Integrated Management Data Warehouse Development Process of Research Expenses in Enterprise Environment (엔터프라이즈 환경의 연구비 통합관리 데이터 웨어하우스 개발 프로세스)

  • Choi, Seong-Man;Yoo, Cheol-Jung;Chang, Ok-Bae
    • The KIPS Transactions:PartD
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    • v.11D no.1
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    • pp.183-194
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    • 2004
  • The existing management job of research expenses has been divided into three parts: budget planning, budget draw-up, and exact settlement of budget. However, it caused some problems. Under this current circumstance it is required to obtain research expenses steadily, to operate efficiently and to use them clearly to solve such problems. As a result of a study on data warehouse development process of existing system integration company (Inmon, IBM) to reflect current trend described above, data warehouse development process of Inmon uses systematic and gradual access as a classical development cycle method. It causes overlap and feedback to the previous step in the process of each step Is requested. And another problem that it is difficult to toil what function refers and corrects data because functions and data are separated during performing development process at data warehouse development process of IBM is caused. Integrated management data warehouse development process of research expenses in the enterprise environment which applies UML at planning and analysis step, design step and implement and test step is suggested in this paper. Information retrieval agent uses existing budget plan DB, budget draw-up DB and budget settlement DB to find out information that a user wants to know. Information retrieval agent collects and saves information at integration database and information integration agent extracts, transports, transforms and loads the data. Information integration agent reduces a user's efforts to access to a number of information sources and check each of them. It also screens out data that a user may not need. As a result, integrated management data warehouse development process of research expenses in the enterprise environment reflects a user's requirements as much as possible and provides various types of information to make a decision which is needed to establish the policy of research expense management. It helps an end user approach his/her desired analysis information quickly and get various data from the comprehensive viewpoint rather than the fragmentary viewpoint. Furthermore, as it integrated three systems into one, it is possible to share data, to integrate the system, to reduce operating expenses and to simplify supporting environment for the decision making.

Application of Antibiotic Resistance Test for the Recognition of Korean Native Rhizobium japonicum Strain (한국(韓國) 토착대두(土着大豆) 근류균(根瘤菌)의 균주(菌株) 인식(認識)을 위한 항생제(抗生劑) 내성(耐性) 검정법(檢定法)의 응용(應用))

  • Lim, Sun-Uk;Kim, Min-Kyun
    • Korean Journal of Soil Science and Fertilizer
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    • v.22 no.3
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    • pp.239-244
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    • 1989
  • This work was for the elucidation of heterogeneity in a natural population of Rhizobium japonicum existing in Seoul National University's Experiment Field and of sensitivities of R. japonicum isolates for several antibiotics by using a method based on intrinsic antibiotic resistance (IAR). In addition, the suitability of IAR method for the recognition of R. japonicum strain was elucidated. Twenty seven isolates from various soybean cultivars cultivated at SNU's Experiment Field were tested to 4 antibiotics (streptomycin sulphate, kanamycin sulphate, ampicillin, oxytetracycline);There were 21 different IAR patterns among 27 isolates. It demonstrated diverse distribution of R. japonicum strains in SNU's Experiment Field. Their growth was inhibited at from a low concentration of about $1{\mu}g/ml$ to a high concentration of $400{\mu}g/ml$ for streptomycin sulphate, ampicillin, and oxytetracyclin. For kanamycin sulphate, on the contrary, all 27 isolates showed their growth inhibitances at below the concentration of $12.5{\mu}g/ml$. Two isolates identified as different strains from each other by the previous seroimmunological tests showed the same sensitivities for 4 antibiotics, and it seemed that IAR method was not perfect for the exact recognition of R. japonicum strain.

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Statistical Study on Respiratory Stability Through RPM Signal Analysis according to Patient Position Under Radiation Therapy and Device (방사선 치료 환자의 자세 및 Device에 따른 RPM 신호 분석을 통한 호흡 안정성의 통계적 고찰)

  • Park, Myung-Hwan;Seo, Jeong-Min;Choi, Byeong-Gi;Shin, Eun-Hyeok;Song, Gi-Won
    • The Journal of Korean Society for Radiation Therapy
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    • v.23 no.2
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    • pp.83-90
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    • 2011
  • Purpose: This study statistically analyzed the difference of the stability of maintaining a respiratory period shown according to position and use of a device to search the tendency and usefulness of a device. Materials and Methods: The study obtained respiratory signals which maintained a respiratory period for 20 minutes each supine and prone position for 11 subjects. The study obtained respiratory signals in a state of using a belly board for 7 patients in a bad condition of a respiratory period in a prone position to analyze a change in respiration and the stability before and after the use of a device. Results: The supine part showed 54.5%, better than the prone part of 36.4% in a case that the stability for maintaining a respiratory period was in a good condition as a fixed respiratory period was well maintained according to the position. 6 patients (85%) showed a maintenance pattern of a respiratory period significantly different before the use and 4 patients showed a significantly good change in the stability for maintaining a respiratory period as a result that belly boards were used for 7 patients that the maintenance of a respiratory period was not in a good condition on a prone position. Conclusion: It seemed that this study could contribute to the maintenance of respiratory period and of respiratory stability as the optimal position for maintenance of respiration and the use of a device such as a belly board were decided through statistic analysis of respiratory signals and its application even if patient position and use of device were decided by the beam arrangement a treatment part of a patient, location of a target, and an expected plan.

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A Study for Reappearance Acording to the Scan Type, the CT Scanning by a Moving Phantom (팬톰을 이용한 전산화 단층촬영방법에 따른 재현성에 대한 고찰)

  • Choi, Jae-Hyock;Jeong, Do-Hyeong;Suk, Choi-Gye;Jang, Yo-Jong;Kim, Jae-Weon;Lee, Hui-Seok
    • The Journal of Korean Society for Radiation Therapy
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    • v.19 no.2
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    • pp.123-129
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    • 2007
  • Purpose: CT scan shows that significant tumor movement occurs in lesions located in the proximity of the heart, diaphragm, and lung hilus. There are differences concerning three kinds of type to get images following the Scan type called Axial, Helical, Cine (4D-CT) mode, when the scanning by CT. To know how each protocol describe accurately, this paper is going to give you reappearance using the moving phantom. Materials and Methods: To reconstruct the movement of superior-inferior and anterior-posterior, the manufactured moving phantom and the motor following breathing were used. To distinguish movement from captured images by CT scanning, a localizer adhered to the marker on the motor. The moving phantom fixed the movement of superior-inferior upon 1.3 cm /1 min. The motor following breathing fixed the movement of anterior-posterior upon 0.2 cm /1 min. After fixing each movement, CT scanning was taken by following the CT protocols. The movement of A localizer and volume-reappearance analyzed by RTP machine. Results: Total volume of a marker was 88.2 $cm^3$ considering movement of superior-inferior. Total volume was 184.3 $cm^3$. Total volume according to each CT scan protocol were 135 $cm^3$ by axial mode, 164.9 $cm^3$ by helical mode, 181.7 $cm^3$ by cine (4D-CT) mode. The most closely describable protocol about moving reappearance was cine mode, the marker attached localizer as well. Conclusion: CT scan should reappear concerning a exact organ-description and target, when the moving organ is being scanned by three kinds of CT protocols. The cine (4D-CT) mode has the advantage of the most highly reconstructible ability of the three protocols in reappearance of the marker using a moving phantom. The marker on the phantom has always regular motion but breathing patients don't move like a phantom. Breathing education and devices setting patients were needed so that images reconstruct breathing as exactly as possible. Users should also consider that an amount of radiation to patients is being bombed.

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A Study on Geology of Clay Mineral Deposits of Pohang-Ulsan Area and their Physico-Chemical Properties (포항-울산간의 점토자원의 지질과 그 물리화학적 특성에 관한 연구)

  • Kim, Ok Joon;Lee, Ha Young;Kim, Suh Woon;Kim, Soo Jin
    • Economic and Environmental Geology
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    • v.4 no.4
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    • pp.167-215
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    • 1971
  • I. Purpose and Importance of the Study The purpose of the present study is to clarify to geological, mineralogical, and physico-chemical properties of the clay minerals deposits imbedded in the Tertiary sediments in the areas between. Pohang and Ulsan along southeastern coastal region of Korea. These clays are being mined and utilized for filter and insecticide after activation or simple pulverizing, nontheless activated clays are short coming as chemical industry in Korea has been rapidly grown in recent years. In spite of such increase in clay demand, no goological investigation on clay deposits nor physico-chemical properties of the clays have been carried out up to date. Consequently activated clays produced in Korea is not only of low grade but also of shortage in supply, so that Korea has to import activated clays of better grade. The importance of the present study lies, therefore, on that guiding principle could be laid down by knowing stratigraphical horizons, of clay deposits and fundamental data of improving grade of activated clays might be derived from the results of physico-chemical examinations. II. Contents and Scope of the study The contents of the study are pinpointed down in the following two subjects: 1) General geological investigation of Tertiary formations distributed in the areas between Pohang and UIsan, and detail geological study of the bentonitic clay deposits imbedded in them. 2) To clarifty physico-chemical characteristics of the clays by means of chemical analysis, X-ray diffraction and electron microscope. The scope of the study involves the following there points: i) Regional geological investigation-This investigation has been carried out in order to find out the distribution of Tertiary sediments and exact location of clay mineral deposits in the areas between Pohang and UIsan. ii) Detail geological investigation-This has been concentrated in and around the clay deposits which. had been found out by the regional investigation. iii) Laboratory researchs include i) age determination and correlation of Tertiary sediments by paleontological study, and ii) Chemical analysis, X-ray diffraction, and electron microscopic studies on clays, samples taken from various clay deposits. III. Research Results and Suggestions 1) The geology of the area investigated is composed mainly of Janggi and Beomgokri groups of Miocene age in ascending order rested on the upper Silla system, Balkuksa granite and volcanic rocks of upper Cretaceous age as base. 2) Janggi group is composed in ascending order of Janggi conglomerate, Nultaeri rhyolitic tuff, Keumkwangdong shale, two beds of lignite-bearing formations which consist of alternation of conglomerate, sandstone and mudstone, and andesitic, rhyolitic, and basaltic tuff beds. 3) Beomgokri group is mainly composed of andesitic to rhyolitic tuff interlayered by conglomerate and tuffaceous sandstone. In the areas around boundary between North-and South Kyeongsang-do is distributed Haseori farmation which is composed of conglomerate, sandstone, mudstone and andesitic to rhyolitic tuff, and which is correlated to Eoilri formation of Janggi group. 4) Clay deposits of the area are interbedded in Eoilri, Haseori, Nultaeri tuff, Keumkwangdong shale, upper and lower horizon of the lower lignite-bearing seam, and Keumori rhyolitic tuff formations of Janggi group; and are genetically classi.fied into four categories, that is, i) those derived from volcanic ash beds(Haseori and Daeanri deposits), ii) those of secondary residual type from rhyolitic tuff beds(Seokupri deposits), iii) Clay beds above and beneath the lignite seams, (Janggi and Keumkwangdong deposits), and iv) those derived from rhyolitic tuff beds(Sangjeong and Tonghae deposits). 5) Mineral constituents of clay deposits are, according to X-ray diffraction, montmorillonite accompanied in different degree by cristobalite, plagioclase, quartz, stilbite, and halloysite in rare occasion. The clays are grouped according to mineral composition into four types; i) those consist mostly of montmorillonite, ii) those composed of montmorillonite and cristobalite, iii) those composed of montmorillonite and plagioclase, and iv) those composed of montmorillonite, plagioclase and quartz. 6) Clays interbedded in Haseori formation and vicinity of lignite seams belong to the first type, are of good quality and derived either from volcanic ash bed, or primary clay beds near lignite seams. Clays belonged to other types are derived from weathering of rhyolitic tuff formations and their quality varies depending upon original composition and degree of weathering. Few clays in secondary residual type contain small amount of halloysite. 7) Judging from analytical data, content of silica($SiO_2$) varies proportionally with content of cristobalite, and alumina($Al_2O_3$) content does not vary with that of plagioclase, but increases in the sedimentary bedded type of deposits. 8) It is unknown whether or not these days could be upgraded by beneficiation since no grain size of these impurities nor beneficiation test had been studied. 9) Clay beds derived from valcanic ash layers or sedimentary layers at the vicinity of lignite seams are thin in thickness and of small, discontinueous lenticular shape, although they are of good quality; and those derived from rhyolitic tuff formations or residual type from tuff are irregular in both occurrence and quality. It is, therefore, not only very difficult but also meaningless to calculate its reserve, and reserve estimation, even if done, will greatly be deviated from practically minable one. Consequently, way of discovery and exploitation of clay deposits in the area under consideration is to check the geologically favorable areas whenever needed.

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The current status and control measures of BSE in the worldwide (국내, 외 광우병의 발생 현황과 대응 방안)

  • Yoo, Han-Sang
    • 한국환경농학회:학술대회논문집
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    • 2009.07a
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    • pp.273-282
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    • 2009
  • The transmissible spongiform encephalopathies (TSEs) disease group are fatal neurodegenerative disorders affecting a wide range of hosts. The group includes kuru and Creutzfeldt-Jakob disease (CJD) in humans, scrapie in sheep and goats and Bovine spongiform encephalopathy (BSE) in cattle. The exact nature of the infectious agent involved in the transmission of these diseases remains controversial. However, a central event in their pathogenesis is the accumulation in infected tissues of an abnormal form of a host-encoded protein, the prion protein (PrP). Whereas the normal cellular protein is fully sensitive to protease ($PrP^{sen}$), the disease-associated prion protein ($PrP^d$) is only partly degraded ($PrP^{res}$), its amino-terminal end being removed. BSE was first reported in the mid-80s in the UK. Ten years later, a new form of human prion disease, variant CJD (vCJD) developed in the wake of the BSE epidemic, and there is now strong scientific evidence that vCJD was initiated by the exposure of humans to BSE-infected tissues, thus indicating a zoonotic disease. However, the ban on the feeding of animal-derived proteins to ruminants, and the apparent lack of vertical transmission of BSE, have led to a decline in the incidence of the disease within cattle herd and therefore, an assumed decreased risk for human contacting vCJD. The origin of the original case(s) of BSE still remains an enigma even though three hypotheses have been raised. Hypotheses are i) sheep- or goat-derived scrapie-infected tissues included in meat and bone meal fed to cattle, ii) a previously undetected sporadic or genetic bovine TSE contaminating cattle feed or iii) originating from a human TSE through animal feed contaminated with human remains. A host cellular membrane protein ($PrP^C$), which is abundant in central nervous system tissue, appear to be conformationally altered in the diseased host into a prion protein ($PrP^{Sc}$). This $PrP^{Sc}$ is detergent insoluble and partially protease-resistant ($PrP^{res}$). The term $PrP^{res}$ is normally used to describe the protein detected after protease treatment, in techniques such as Western immunoblotting, and enzyme-linked immunosorbant assay using fresh/frozen tissue. Immunohistochemistry may performed with formalin-fixed tissues. Also, clinical signs of the BSE are one of the major diagnostic indicators. Recently, atypical forms (known as H- and L-type) of BSE have appeared in several European countries, Japan, Canada and the United States. An unusual case was also reported in a miniature zebu. The atypical BSE fall into two groups based on the relative molecular mass (Mm) of the unglycosylated $PrP^{res}$ band relative to that of classical BSE, one of the higher Mm (H-type) and the other lower (L-type). Both types have been detected worldwide as rare cases in older animals, at a low prevalence consistent with the possibility of sporadic forms of prion diseases in cattle. This raises the unwelcome possibility that vCJD could increase in the human population. Now, active surveillance program against BSE is going on in Korea. In regional veterinary service lab, ELISA is applied to screen the BSE in slaughter and confirmatory tests by Western immunoblotting and immunohistochemisty are carried out if there are positive or suspect in the screening test. Also, the ruminant feed ban is rigorously enforced. Removal of specified risk materials such as brain and spinal cord from cattle is mandatory process at slaughter to prevent the infected material from entering the human food chain.

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A Study on Needs of the Families of Head Injury Patients (두부 손상환자 가족의 간호요구에 대한 연구)

  • Cho Gyoo-Yeong;Park Hyoung-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.6 no.3
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    • pp.414-433
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    • 1999
  • The purpose of this study is to identify the needs which are perceived by one of the familiy members who have head injury parients by traffic accidents in the intensive care units. Subjects were 70 families members of head injury patients admitted to 2 general hospitals NICU located Pusan city, 1 general hospital NICU located Ulsan city from December 1. 1998 to February 28. 1999. For this study, 70 family members were interviewed with aid of a Likert scale which was developed by researcher for this study. For development of the survey instrument, literature review and open questionnaire technique with family members and the nurses working in NICU. The 50needs-items were classified into 7 groups according to the homogeneity of the items with the support of literature review. For the content validity, the instrument was reviewed by 1 nursing professor and the internal reliability of this instrument was Cronbach alpha=0.94 which is highly accepted. Data was analyzed by a SPSS computer program. Data analysis included frequency. percentage, mean, standard variance and t-test or ANOVA. The results were as followings : 1. The general characteristics of head injury patients shows that the male was 74.3%, the female was 25.7% and age distribution shows that the fifty-fifty nine years was 30%, the highest. Of religion the buddhism was the most, The diagnosis distribution shows that epidural hematoma was 32.9% and subdural hematoma was 24.3%. The mentalility distribution shows that semicoma was 31.4% and stupor was 31.4%. Hemiplegia was 42.9% 2. The general charaterisrics of the family needs of head injury patients shows that thirty-thirty nine years was 31.4%, the highest. sex distribution shows that the male was 20%, the female was 80%. Of religion the buddism was the most. 3. The family needs of head injury patients was $3.03{\pm}0.42$, needs for the information of a patient's condition was $3.65{\pm}0.48$, the highest. And needs for the information of care and treatment was $3.48{\pm}0.48$, needs to be supplied with comfortable facilities for family was $3.04{\pm}0.66$, needs to be participate in a patient's care was $2.90{\pm}0.55$, needs to be informed about the available resources was $2.83{\pm}0.59$, needs to be supported emotionally for family was $2.79{\pm}0.55$, needs for religious assistance was $2.51{\pm}0.85$. 4. Examining the family needs of head injury patients according to patient's characteristics, mentality, plegia degree and operation were shown be variables to make an effect on the needs for the head injury patients family. At all, according to severity of head. injury, the family needs of head injury patients was high. 5. Examining the family needs of head injury patients according to their general characteristics, we could know that religion, job. income were shown to be variables to make an effect on the family needs. Through the examination it can be seen that the characteristics of head injury patients and the family needs of head injury patients. In conclusion, the family needs of head injury patients was almost same the family needs of ICU patients. Therefore we must involve the family's care of head injury patients and we must provide exact and repeated explanation, education and support the family of head injury patients. As this study was resulted in selecting the families admitted to NICU of some general hospital, we couldn't stretch the result in our favor. Therefore, continuous studies are suggested.

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