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A study on analyzing effectiveness of childbirth education (임부교실 운영효과 분석을 위한 일 연구)

  • Kim, Hea Sook;Choi, Yun Soon;Chang, Soon Bok;Jung, Jae Won
    • The Korean Nurse
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    • v.34 no.3
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    • pp.85-98
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    • 1995
  • The purpose of this study is to provide basic data regarding effective learning opportunities in childbirth education classes. Also analysis of the data indicates the optimum conditions for the welfare and improvements in the promotion of health in childbearing mothers. The results of this study are as follows; 1) The average age of the subjects in this study was 30.6 years and the total number of subjects was 58 pregnant women. The average number of children was one and 84.5% of the subjects were unemployed even though 63.8% of them held over bachelor's degrees. It was found that 22.4% of the subjects were living in an extended family. Also 61.5% of them were living with parents-in-law. The number of pregnancies were calssified as one, two, or three to nine times with the percentages of 58.7%, 22.4% and 18.9%, respectively. Further, 72.4% of the subjects had no abortion experience and 15.5% had one aborion experience. While 89.7% of the subjects planned to feed their babies with breastmilk, mixed feeding were used by only 22.4% of the sample. These data were collected at about 6 months after delivery. Thus one can see that a low rate of breastfeeding was common. 2) The length of one period of childbirth education is four weeks. It was found that 36.2% of the subjects participated in childbirth education only once, where as 13.8% participated four times and 19% of the subjects participated in this class more than four times. pregnant at least once. Further, 75.9% of the participants were participated in this education through their own will. Their motivation for participation developed through information, advertisement and posters which contained information on childbirth education. Those with unplanned pregnancies 92.9% participated after a suggestion by the nurses. The number of participants in terms of percentage according to the childbirth education contents can be classified as following. The most active participation was shown in preparation of delivery(77.6%), postpartrm management(56.9%) fetal development(37.6%) and physiology of pregnancy(17.2%). It was found that 75.9% of the subjects were willing to participate again if they were given a chance. The reason can be summarized as following: The content of the education is very helpful(47.7%). Scientific knowledge can be obtained through this program(20.5%). Participation helps in achieving psychological stability(9.1%). Participation enables one to establish a friendly relationship with other participants(6.8%) of the sample. 24.1% of the participants did not want to participate again. The reasons can be as following: They do not want another baby(42.9%). The first paricipation in childbirth education gave enough knowledge about childbirth(21.4%). Another reason for not want to participate again was because they had a cesarean birth(14.3%). Only 7.1% of them responded with a negative view. A response that they do not need childbirth education after their operation can be traced back to the general belief that childbirth education is the place where one prepares for natural birth through the Lamaze breathing technique. Of the subjects, 91.4% suggested that this program could be recommended to other childbearing mothers, because this program gave educational content along with psychological stability for childbearing women. Of the subjects 41.4% did not see any efforts towards the welfare of the baby, where as 88.2% did. Among the subjects 58.6% made some effort to eliminate the discomfort of labor by breathing and imagination and breathing and walking. Further 41.7% of the 24 subjects did not do anything toward the welfare of the baby, because they did have a cesarean section so that they didn't have a chance even though they had been educated about childbirth. Also 33.3% of the subjects did not do anything toward the welfare of the baby, because they lacked a willingness. After leaving the hospital, only 75.9% of the subjects did some exercises. The subjects who tried participate this program with their husband accounted for 20.7% of the sample. Interviewing with the subjects solved some of the uneasiness and. fear of delivery, increased self-confidence in parenting and active coping in the delivery process.

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Clinical Experiences of Open Heart Surgery (개심술(開心術) 2,000례의 임상적 고찰)

  • 김하늘루;박경택;곽기오;한일용;소영환;최강주;이양행;조광현
    • Journal of Chest Surgery
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    • v.31 no.12
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    • pp.1183-1194
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    • 1998
  • Background: From Sept. 1985 to Sept. 1997, 2,000 cases of open heart surgery(OHS) were performed in the Department of Thoracic & Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University. Material and Method: Among the total of 2,000 cases of OHS, 1532 cases were congenital heart disease(CHD) and 468 cases were acquired heart disease(AHD). The age distribution was 9 days(4.0kg) to 68 years in CHD and 11 to 66 years in AHD. In 1532 cases of CHD, there were 1403 acyanotic cases and 129 cyanotic cases. Result: The CHD cases consisted of 940 ventricular septal defects(61.4%), 324 atrial septal defects(21.1%), 112 tetralogy of Fallot(7.3%), 46 pulmonary stenosis(3%), 38 endocardial cushion defects(2.5%), 15 valsalva sinus ruptures(1%), 4 transposition of great arteries (0.3%), 4 double outlet right ventricles(0.3%), and etc. Corrective operations were applied for congenital heart disease with a result of 3.1% hospital mortality. Of 468 AHD, 381 cases were valvular heart diseases, 48 ischemic heart diseases, 12 cardiac tumors, 8 annuloaortic ectasias, 16 dissecting aortic aneurysms and etc. In the 381 valvular heart diseases, there were 226 single valve replacements(36 aortic valve replacements(AVR), 188 mitral valve replacements(MVR), and 2 tricuspid valve replacements(TVR), among these were 71 cases of double valve replacements(AVR & MVR), 54 cases of MVR with tricuspid valve annuloplasty(TVA), and 18 cases of AVR, MVR with TVA. The total implanted prosthetic valves were 466. In MVR, 123 St. Jude Medical valves, 90 Carpentier-Edwards valves, 65 CarboMedics valves, 42 Sorin valves and 16 other valves were used. In AVR, 68 St. Jude Medical valves, 36 CarboMedics valves, 14 Carpentier-Edwards valves and 9 other valves were used. Coronary Artery Bypass Surgery(CABG) were performed in 48 cases. The patterns of bypass graft were 14 patients of single vessel graft, 21 patients of two vessels graft, 10 patients of three vessels graft and 3 patients of four vessels graft. Conclusion: The hospital operation mortality rate of congenital acyanotic, cyanotic and acquired heart diseases were 2.0%, 15.5%, and 5.1% respectively. The overall mortality rate was 3.6%(72/2,000).

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Analysis of Long-Term Variation in Marine Traffic Volume and Characteristics of Ship Traffic Routes in Yeosu Gwangyang Port (여수광양항 해상교통량의 장기변동 및 통항 특성)

  • Kim, Dae-Jin;Shin, Hyeong-Ho;Jang, Duck-Jong
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.26 no.1
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    • pp.31-38
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    • 2020
  • The characteristics of ship traffic routes and the long term fluctuation in marine traf ic volume of the incoming and outgoing routes of the Yeosu Gwangyang Port were analyzed using vessel traffic data from the past 22 years and a real-time vessel traffic volume survey performed for 72 hours per year, for three years, between 2015 and 2017. As of 2017, the number of vessels passing through Yeosu Gwangyang Port was about 66,000 and the total tonnage of these ships was about 804,564 thousand tons, which is a 400 % increase from the 189,906 thousand tons shipped in 1996. Specifically, the dangerous cargo volume was 140,000 thousand tons, which is a 250 % increase compared to 1996. According to the real-time vessel traffic volume survey, the average daily number of vessels was 357, and traf ic route utilization rates were 28.1 % in the Nakpo sea area, 43.8 % in the specified sea area, and the coastal area traf ic route, Dolsan coastal area, and Kumhodo sea area showed the same rate of 6.8 %. Many routes meet in the Nakpo sea area and, parallel and cross passing were frequent. Many small work vessels entered the specific sea area from the neighboring coastal area traffic route and frequently intersected the path of larger vessels. The anchorage waiting rate for cargo ships was about 24 %, and the nightly passing rate for dangerous cargo ships such as chemical vessels and tankers was about 20 %. Although the vessel traffic volume of Yeosu Gwangyang Port increases every year, the vessel traffic routes remain the same. Therefore, the risk of accidents is constantly increasing. The route conditions must be improved by dredging and expanding the available routes to reduce the high risk of ship accidents due to overlapping routes, by removing reefs, and by reinforcing navigational aids. In addition, the entry and exit time for dangerous cargo ships at high-risk ports must be strictly regulated. Advancements in the VTS system can help to actively manage the traffic of small vessels using the coastal area traffic route.

Clinical Analysis of the Results following Meniscal Suture (반월상 연골 파열환자에서 봉합술 후 결과 분석)

  • Bae, Dae-Kyung;Yoon, Kyoung-Ho;Jeong, Ki-Woong;Kwon, Chang-Hyeok;Shin, Neung-Choel
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.1
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    • pp.19-24
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    • 2000
  • Purpose : To clinically analyze 62 patients who had meniscal repair and compare the results according to methods of repair. Materials and Methods : Between May 1997 and June 1998, we repaired 68 torn menisci in 68 patients. There were 52 male and 10 female with an average age of 26.9 years(ranging from 6 to 51 years). We used Linvatec suture in 46 knees(group A)and meniscal arrow in 16 knees(B group). In six knees we used Linvatec and meniscal arrow both. These 6 knees were excluded and 62 of 68 repaired meniscus were analyzed in this study. Average follow-up period was 18.5 months(ranging 12 to 26 months). We evaluated clinical results by Tapper and Hoover's grading system and subjective symptoms of the patients. Results : There were excellent in 47 cases$(76\%)$, good in 12$(19\%)$ and fair in 3$(5\%)$. In group A, there were excellent in 35 cases$(76\%)$, good in 9$(20\%)$ and fair in 2$(4\%)$. In group B, there were excellent in 12 cases$(75\%)$, good in 3$(19\%)$ and fair in 1$(6\%)$. There was no significant differences in clinical results between two groups. But mean operative time taken for meniscus repair was 40 minutes in group A and 25 minutes in group B. Conclusion : We can obtain good clinical results with short operation time in meniscal repair by proper selection of methods of repair according to the type, location, and size of meniscal tear and associated lesions.

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Evaluation on the Implementation of Girl Friendly Science Activity (여학생 친화적 과학활동 프로그램의 운영 평가)

  • Jhun, Young-Seok;Shin, Young-Joon
    • Journal of The Korean Association For Science Education
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    • v.24 no.3
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    • pp.442-458
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    • 2004
  • This study was conducted to develop a plan for a large-scale implementation of the Girl Friendly Science Program based on the results of analysis and investigation of its current pilot implementation, Girl Friendly Science Program materials, which was first developed in 1999 with the support from Ministry of Gender Equality, consist of 1) five theme-based units that are specifically targeted individual students' unique ability, aptitude, and career choice, and 2) differentiated learning materials for 7th through 10th grade female students. All the materials are available at the homepage (http://tes.or.kr/gfsp.cgi) of 'Teachers for Exciting Science(the organization of science teachers in Seoul area)'. Since the materials are well organized by topic and grade level and presented in both Korean word process document and html format, anyone can easily access to the materials for their own instructional use. Ever since its launch the number of visitors to the homepage has been constantly increasing. The evaluation results of the current pilot implementation of the materials that targeted individual students' ability and aptitude showed that it scored high in terms of its alignment to the original purpose, content, level, and effectiveness to implement in classrooms. However, its evaluation scores were low in terms of the convenience for teachers to guide the materials, and its organization and operation. The results also showed a significant change in students' perception of science, and students' positive experiences of science through various interdisciplinary activities. On the other hand, the evaluation of students' experiences with the materials showed that students' assessment about an activity was largely depending on a success or failure of their experiences. Overall, students' evaluation of activities scores were low for simple activities such as cutting off or pasting papers. According to students' achievement test results, differences between pre and post test scores in the Affective Domain was statistically significant (p<0.05), but not in Inquiry Domain. Based on teachers observations, numerous schools where have run this program reported that students' abilities to cooperate, discuss, observe and reason with evidences were improved. In order to implement this program in a larger scale, it is critical to have a strong support of teachers and induce them to change their teaching strategy through building a community of teachers and developing ongoing teacher professional development programs. Finally, there still remain strong needs to develop more programs, and actively discover and train more domestic woman scientists and engineers and collaborate with them to develop more educational materials for girls in all ages.

Clinical Features and Management of Multidrug-Resistant Tuberculosis (다제 내성 폐결핵 환자의 임상상 및 치료에 대한 고찰)

  • Lee, Jae-Cheol;Lee, Seung-Jun;Kim, Gye-Soo;Yoo, Chul-Gyu;Cheong, Hee-Soon;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.1
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    • pp.14-21
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    • 1996
  • Objectives: Although outbreak of MDR Tb has been a recent problem in western countries, it has been a longstanding problem in Korea. The poor outcome of MDR Tb is mainly due to poor compliance, high rate of side reaction of secondary drugs, and limitation in number of available drugs. Thus, to improve the outcome of MDR Tb, it is crucial to make individualized adequate prescription based on the knowledge of the patterns of resistance to each drugs in the community as well as the natural history. The purpose of present study is to evaluate the clinical features of Korean MDR Tb patients including patterns of drug resistance and success rate of treatment which was prescribed according to the sensitivity tests. Methods: Retroscpective analysis of 71 Korean patients with MDR Tb was made. All strains isolated from patients showed resistence to at least two first line drugs. Patients profile, previous treatment history, patterns of drug resistance, outcome of treatment was analysed. Initial treatment regimen was selected according to the previous treatment history and was modified according to the sensitivity reports. The regimen was composed to include at least 4 sensitive drugs when possible. Results: The patients showed resistance to 4.1 drugs on average. 90% of them were resistant to INH and RFP. Among 71 patients, 35 patients(49%) had cavitary lesions in CXR. Treatment outcome was analysed in 55 patients. 35 patients(67%) were improved after treatment and 18 patients(33%) showed treatment failure. 5 patients showed primary resistance. Treatment outcome could be evaluated in 4 of them and all showed improvement after treatment. 14 patients(20%) had to change their regimens due to drug side effects. The most frequent side effect was elevation of liver enzymes(6 patients). Others included dizziness, hyperuricemia, tinnitus, skin rash, GI troubles. More than 50% of side effects developed within 3 months. In repeated drug sensitivity test, the concordance rate of resistance to INH was 100% and RFP 98%. EMB, PZA showed 80% concordance rate. But in the other drugs, the concordances were less than 50%. Operation was done in 5 patient - 1 patients as a adjunctive means of chemotherapy -. In that case, negative conversion of sputum AFB was done. Conclusion: 2/3 patients of multidrug-resistant tuberculosis were improved by appropriate prescription and regular medication suggesting that more aggressive management and monitoring is indicated in multidrug-resistant tuberculosis.

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Clinicopathological Analysis of a Superficial Spreading Type of Early Gastric Cancer (표층팽창형 조기위암의 임상병리학적 분석)

  • Yu Myoung;Kim Byung-sik;Oh Sung-tae;Yook Jeung-hwan;Lee Chang-hwan
    • Journal of Gastric Cancer
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    • v.4 no.4
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    • pp.213-218
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    • 2004
  • Purpose: The superficial spreading type of early gastric cancer has different clinicopathologic features from other types of early gastric cancer in terms of its invasiveness and lymph-node metastases. Therefore, we attempted to elucidate the pathological features, surgical procedures and patients prognoses. Materials and Methods: Clinical information was reviewed for patients who had undergone a gastrectomy for gastric cancer during an 8-year period ($1995\~2002$) at Dankook University Hospital and Ulsan University, with an average follow-up of 48 months. Three hundred (300) superficial spreading lesions were analyzed with respect to macroscopic type, lymph-node (LN) metastasis, recurrent pattern, survival rate and method of surgical operation. In addition, the clinicopathological features of the superficial spreading type were compared with those of 739 other patients with small-sized cancer. Results: In both groups, the IIc-type macroscopic lesion, the elevated subtype to be more specific, occurred most frequently. There was no significant difference in the method of surgery between the groups. The submucosal invasion was $39.8\%$ in small-sized cancer, and $61.7\%$ in superficial spreading cancer (P=0.005). The incidence of LN metastasis was $11.3\%$ in early gastric cancer, $7.8\%$ in small-sized cancer and $20.0\%$ in superficial spreading cancer (P=0.005). The incidence of lymphatic invasion was $4.6\%$ in small-sized cancer and $13.0\%$ in superficial spreading cancer (P=0.009). The incidence of recurrence was $1.4\%$ in small-sized cancer and $3.6\%$ in superficial spreading cancer. The overall 5-year survival rate was $84.8\%$ in superficial spreading cancer and $93.0\%$ in small-sized cancer (P=0.052). The 5-year diseasefree survival rate was $94.7\%$ in superficial spreading cancer and $87.5\%$ in small-sized cancer (P=0.053). Conclusion: The superficial spreading type of early gastric cancer tends to be more invasive and to show a higher incidence of lymph-node metastasis than small-sized early gastric cancer. A wide resection with extensive lymph-node dissection seems to be an appropriate treatment for a superficial spreading type of early gastric cancer.

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Learning Curve of a Laparoscopy Assisted Distal Gastrectomy for a Surgeon Expert in Performing a Conventional Open Gastrectomy (개복 위절제술에 경험이 풍부한 술자에 의한 복강경 보조하 원위부 위절제술의 Learning Curve)

  • Kim, Ji-Hoon;Jung, Young-Soo;Jung, Oh;Lim, Jeong-Taek;Yook, Jeong-Hwan;Oh, Sung-Tae;Park, Kun-Choon;Kim, Byung-Sik
    • Journal of Gastric Cancer
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    • v.6 no.3
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    • pp.167-172
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    • 2006
  • Purpose: The laparoscopy assisted gastrectomy has been increasingly reported as the treatment of choice for early gastric cancer. However, expert surgeons, who have performed a conventional open gastrectomy for a long time, tend to have a negative attitude toward laparoscopic procedures. The aim of this study was to determine the learning curve of a laparoscopy assisted distal gastrectomy (LADG) for a surgeon expert in performing an open gastrectomy and to analyze the factors that have an effect on a LADG. Materials and Methods: Between April 2005 and March 2006, 62 patients underwent a LADG with D1+beta lymph-node dissection. The 62 patients were divided into 10 sequential groups with 6 cases in each group (the last group was 8 cases), and the time required to reach the plateau of the learning curve was determined by examining the average operative times of these 10 groups. Other factors, such as sex, BMI, complications, transfusion requirements, the number of retrieved lymph nodes, and change of postoperative hemoglobin level, were also analyzed. Results: With the $5^{th}$ group (after 30 cases), the operative time reached a plateau (average: 170 min/operation). The differences between before the $30^{th}$ case and after the $31^{st}$ case with respect to changes in the postoperative hemoglobin level, the number of retrieved lymph nodes, the transfusion requirements, and the complications rate were not significant. Conclusion: According to an analysis of the operative time, experience with 30 LADGs in patients with early gastric cancer is the point at which the plateau of the learning curve (7 months) is reached. Abundant experience with a conventional open gastrectomy and a well-organized laparoscopic surgery team are important factors in overcoming the learning curie earlier.

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Korea's Optimal Basket Exchange Rate : Thoughts on the Proper Operation of the Market Average Rate Regime (우리나라의 적정(適正)바스켓환율(換率) : 시장평균환율제도(市場平均換率制度)의 운용기준(運用基準) 모색(模索))

  • Oum, Bong-sung
    • KDI Journal of Economic Policy
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    • v.12 no.1
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    • pp.111-125
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    • 1990
  • For the last several years, considerable criticism has been leveled against Korea's exchange rate management. While Korea was designated a currency manipulator by the U.S., domestically it is often complained that the won/dollar rate did not adequately reflect changes in Korea's export competitiveness and fluctuations in the exchange rates of major currencies. In view of this situation, Korea changed its exchange regime at the beginning of March this year from the dual currency basket system to a more flexible one, called a "market average rate regime". Under this new regime, the won rate is determined in the exchange market based upon the supply of and demand for foreign exchange and is allowed to freely fluctuate each day within a + 0.4 % range. This paper, first, seeks to evaluate Korea's exchange rate management under the dual basket regime of the 1980s, and then to construct an optimal currency basket for the won which could provide a proper indicator for exchange market intervention under the new market average rate regime. The analysis of fluctuations in the real effective exchange rate (REER) of the won indicates that the won rates in the 1980s failed not only to offset changes in relative prices between home and trading partner countries, but also to properly respond to variations in major exchange rates as further evidenced by sizable fluctuations in the nominal effective rates of the won. In other words, the currency basket regime which was adopted in 1980 for the stabilization of the REER of the won has not been operated properly, mainly because authorities often resorted to policy considerations in determining the won's rate. In the second part of the paper, an optimal currency basket for Korea is constructed, designed to minimize the fluctuations in the REER of the won without including policy considerations as a factor. It is recognized, however, that both domestic and foreign price data are not available immediately for the calculation of the REER. For this problem, the approach suggested by Lipschitz (1980) is followed, in which optimal weights for currencies in the basket are determined based upon the past correlation between price and exchange rates. When the optimal basket is applied to Korea since the mid-80s, it is found that the REER of the won could have been much more stable than it actually was. We also argue for the use of variable weights rather than fixed ones, which would be determined by the changing relationship between exchange rates and relative prices. The optimal basket, and the optimal basket exchange rate based on that basket, could provide an important medium- or long-term reference for proper exchange market intervention under the market average rate regime, together with other factors, such as developments in the current account balance and changes in productivity.

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CLINICAL ANALYSIS OF GONIAL ANGLE CHANGE AFTER ORTHOGNATHIC SUGERY IN PATIENTS WITH THE MANDIBULAR PROGNATHISM (하악전돌증환자의 악교정수술후 하악각변화에 관한 임상적 분석)

  • Kwon, Yeong-Ho;Jang, Hyun-Jung;Lee, Sang-Han
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.22 no.2
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    • pp.206-216
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    • 2000
  • Predictional study for lateral change between pre- and post-orthognathic surgery has been emphasized mainly on anterior area of lateral profile; upper lip, lower lip and chin et al. So interest for lateral profile change has been less in posterior area of lateral profile and literature analyzing gonial angle change is rare. The purpose of this study is to make prediction for gonial angle change possible and to offer somewhat treatment guidance for gonial angle to be improved by investigating overall gonial angle change between pre- and post-orthognathic surgery and inquiring into factors influencing on pattern of genial angle change. For this study 35 patients were selected retrospectively. Lateral cephalometric radiographs were taken in just pre-op time, pod 1 day, pod 1 year. They were analyzed and genial angles were measured. The results were as follows : 1. Gonial angle at pod 1 day was decreased about $9.3^{\circ}$ than pre-op and gonial angle at pod 1 year was increased about $4.0^{\circ}$ than pod 1 day. So genial angle at pod 1 year was decreased about $5.3^{\circ}$ than pre-op genial angle(p<0.01). 2. Mean pre-op gonial angle was $129.4^{\circ}$, showing significantly high value than normal and mean gonial angle at pod 1 year was $124.1^{\circ}$, showing value near to normal. 3. Mean gonial angle change between pre-op and pod 1 year was decreased about $5.4^{\circ}$ in female and $5.3^{\circ}$ in male. There was no statistically significant difference between male and female(p>0.05). 4. Principal factor influencing on decreased gonial angle in gonial angle change between pre-op and pod 1 year was amount of mandibular setback. 5. Principal factor influencing on increased gonial angle in gonial angle change between pod 1 day and pod 1 year was % horizontal relapse, and it was thought that resorption and bone remodelling on posterior area in mandibular distal segment also were related to increased gonial angle. 6. It is thought that sagittal split ramus osteotomy in mandibular prognathic patients with high value of gonial angle is effective to improvement of gonial angle, and In patients who have normal range of gonial angle and are required with excessive mandibular setback, short lingual cut method, additional resection of posterior margin of distal segment, Obwegeser II method will be considerd. 7. More prudent operation and careful post-op management will be responsible for maintenance of postoperative stable gonial angle.

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