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Usefulness Evaluation of Open Mouth View when PET/CT scan In Tongue Cancer Patients (Tongue Cancer 환자에서 PET/CT 검사 시 Open Mouth 촬영법의 유용성 평가)

  • Kim, Jae Hwan;Yun, Jong Jun;Jung, Ji Wook;Kim, Jung Wook;Hwang, Ju Won;Ji, Hye In
    • The Korean Journal of Nuclear Medicine Technology
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    • v.20 no.2
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    • pp.14-20
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    • 2016
  • Purpose Tongue cancer is 1.8% of all cancer tumors occur in the tongue, it is known that the high incidence enough to account for 75% of oral cancer conducted a PET / CT examination for early diagnosis, metastasis, staging, etc. and. Tongue when PET / CT scan of a cancer patient and a Torso taken to close mouth lesions if the condition was caused due to the overlapping or corresponding artifacts are not clearly observed. The purpose of this study is to evaluate the changes that occur during PET / CT scan with open mouth and its usefulness under. Materials and Methods From June 2015 to March 2016 complained of herein by May 21 had received a diagnosis of tongue cancer underwent PET / CT scan patients were treated with a target (16 males, 5 female). The first was taken to close mouth Torso state, it was taken to add 1 bed open mouth condition. Tumor (T), measuring the Normal Tongue (NT), Lymph Node (LN) standard intake coefficient by setting a region of interest in the (standardized uptake value, SUV) SUVmean, the average value was measured SUVmax, drawn to each region of interest 3 times and Background (Carotid artery) was out of the SUV. In Chapter 3 of the slice to the tumor clearly visible by setting the region of interest to measure the change Tumor size was calculated average value. Gross Image resolution assessment were analyzed statistically through were divided into 1-5 points by the Radiation 7 people in 2, more than five years worked in specialized nuclear medicine compare to proceed with the blind test nonparametric test (wilcoxon signed rank test). (SPSS ver.18) Results $SUV_{mean}$ T's were in close mouth $5.01{\pm}2.70$ with open mouth $5.48{\pm}2.88$ (P<0.05), $SUV_{max}$ were respectively $8.78{\pm}5.55$ and $9.70{\pm}5.99$ (P<0.05). $SUV_{mean}$ in the NT were respectively $0.43{\pm}0.30$ and $0.34{\pm}0.24$ (P=0.20), $SUV_{max}$ was $0.56{\pm}0.34$ and $0.45{\pm}0.25$ (P=0.204). LN $SUV_{mean}$ were respectively $1.62{\pm}1.43$ and $1.69{\pm}1.49$ (P=0.161), $SUV_{mean}$ was $2.09{\pm}1.88$ and $1.99{\pm}1.74$ (P=0.131). Tumor size change is close mouth $4.96{\pm}4.66cm^2$ $5.33{\pm}4.64cm^2$ with 7.45% increase was (P<0.05), gross image resolution evaluation is $2.87{\pm}0.73$, $3.77{\pm}0.68$ with open mouth examinations 30.5% increase was (P<0.05). Conclusion Tumor SUV on the changes that had an increase in open mouth during inspection, the normal tongue and lymph node, but there was no significant difference in the change slightly. It is also one open mouth PET / CT scan will provide improved image to all patients with tongue cancer, but it could be confirmed that similar overall through the blind test, or tumor size changes and showing a high resolution image. It can be the perfect alternative method for problems that occur when the close mouth Open mouth PET / CT scan, but is believed to be through the open mouth to observe the boundary of overlapping or tumor of the oral cavity other structures a little more clearly. Tongue cancer patients how to recommend that the shooting further open mouth PET / CT.

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Current Status of Children Born from Renal Transplanted Mother (신이식을 받은 산모로부터 출생한 소아의 성장상태)

  • Ki Mina;Yook Jinwon;Kim Ji Hong;Kim Pyung-Kil;Moon Jang Il;Kim Soon Il;Kim Yu Seun;Park Kiil;Park Young Won
    • Childhood Kidney Diseases
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    • v.4 no.1
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    • pp.77-83
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    • 2000
  • Purpose: Pregnancy in transplanted mother is considered as a high-risk pregnancy, and significant incidences of prematurity and low-birthweight(LBW) infants have been reported. The objective of this study is to examine the outcome of pregnancy in transplanted mothers and to evaluate the current growth status in their children. Patients and Methods: We retrospectively reviewed 54 pregnancies in 40 kidney recipients until June 1999. Outcomes of pregnancy were reviewed and assessment of the current growth status in children was performed. Results: 54 pregnancies in 40 recipients were identified; 22 ended in termination of pregnancy because of unwanted pregnancy or therapeutic purposes. And of the other 32, 29 livebirths resulted in 28 recipients. The mean age of conception was $30.3{\pm}3.8$ years, with a mean interval from transplantation to conception of $35.9{\pm}23.2$ months. All patients were maintained on immunosuppressive regimens. Incidence of drug-treated hypertension(HTN) prior to pregancy was $52\%$, HTN during pregnancy, $48\%$; preeclampsia, $41\%$; urinary tract infection, $48\%$; oligohydramnios $4\%$; and no rejection during pregnancy and up to 3month post delivery. Of the 29 liveborn infants, prematurity(<37wk) occurred in $52\%$, LBW(<2500g) in $62\%$, VLBW(<1500g) in $7\%$ and $48\%$ born intrauterine growth retardation(IUGR). Mean gestational age was $36.3{\pm}3.0\;wk$; a mean birthweight, $2.23{\pm}0.6\;kg$; a mean birth-height, $45.1{\pm}3.6cm$. Current mean height standard deviation score (height SDS) was $0.29{\pm}0.91$ and mean weight SDS was $0.62{\pm}1.34$. Only one child($4\%$) under 1 year of age was below 10 percentile in height. Most of children had no medical problems except for 4 children; cleft palate(1), tuberous sclerosis(1), essential hematuria(1), and one child expired due to sepsis. Conclusion: This study showed similar incidence of premaure birth($57\%$) and low birth weight infants($62\%$), but lower incidence of spontaneous abortion($5.6\%$) was observed and compared to other studies. Postnatal growth in majority of children($96\%$) achieved catch-up growth before 1 year. Present study supports a more optimistic view of pregnancy in renal transplant mother and normal growth in their children.

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A Study of Influence of Filgrastim on PET/CT In Diffuse Large B cell Lymphoma (미만성 거대 B 세포 림프종 환자에서 Filgrastim 사용이 PET/CT 영상에 미치는 영향에 대한 고찰)

  • NamKoong, Hyuk;Park, Hoon-Hee;Ban, Yung-Gak;Kang, Sin-Chang;Kim, Sang-Kyoo;Lim, Han-Sang;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.17-23
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    • 2009
  • Purpose: It has been known that PET/CT is very valuable in follow-up study of diffuse large B cell lymphoma (DLBCL). Generally, in DLBCL, radiotherapy and chemotherapy has been progressed, because the lesion hasn‘t been limited to one site. And, it has lead to the decrease of leukocyte like neutropenia, due to myelosuppression of chemotherapy. So, in that case, administration of Filgrastim (Granulocyte colony-stimulating factor; G-CSF) is universal. However, in short time after administration, PET/CT has limitation to offer accurate images, through the uptake of $^{18}F$-FDG is increased in the region that is activated bone marrow by hematopoietic growth. Therefore, the aim of this study is that PET/CT in a certain period of time after administration of Filgrastim is able to show normal degree of $^{18}F$-FDG uptake. Materials and Methods: 10 patients under follow-up study of diffuse large B cell lymphoma were examined in this study from January, 2007 to January, 2009 (Male: 4 persons; Female: 6 persons; The mean age: 53.8 years old; The mean weight: 57.3 Kg). Using PET/CT (Discovery STe; GE Healthcare, Milwaukee, WI, USA), whole body images were acquired in 1 hour after $^{18}F$-FDG injection. For image analysis, each ROI ($120\;mm^2$) was drawn on $C^6$ (the sixth C-spine), $L_4$ (the forth L-spine), liver, spleen, and lung, then SUV (Standard Uptake Value)s were measured. We compared with each uptake between in 1-day and 5~7 days after administration of Filgrastim at same patient, so confirmed significance about these by SPSS version 12. Results: In case of $C_6$, $L_4$, spleen, every SUV of 1 day later was remarkably higher than that of 5~7 days later, but liver and lung were similar. Also, the images acquired after 5~7 days distinct remarkably and show normal degree of $^{18}F$-FDG uptake, because uptake of bone was almost disappeared. Conclusions: In this study, each SUV was prominent difference as a period of time after Filgrastim’s administration. And Filgrastim makes concentrate uptake of $^{18}F$-FDG in bone, but, after 5~7 days, bone‘s uptake was greatly decreased. Therefore, we are able to infer a certain period of time that shows normal degree of uptake, by numerical value proven. Also, we consider that this study contribute to advanced study about the other agent like Pegfilgrastim, Lenograstim besides Filgrastim, afterwards.

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Second allogeneic hematopoietic stem cell transplantation in children to overcome graft failure or relapse after initial transplant (조혈모세포이식 후 생착 실패나 재발한 소아환자에서 2차 이식의 의의)

  • Kim, Dong-Yeon;Kim, Do Kyun;Kim, Soo Young;Kim, Seok Joo;Han, Dong Gyun;Baek, Hee Jo;Kook, Hoon;Hwang, Tai-Ju
    • Clinical and Experimental Pediatrics
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    • v.49 no.12
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    • pp.1329-1339
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    • 2006
  • Purpose : Failure of hematopoietic stem cell transplantation(HSCT) may be encountered in practice because of either relapse of the malignancy or dysfunction of the graft. Second HSCT may be the only option for some patients whose initial HSCT failed. Methods : From May, 1991 to December, 2004, 115 HSCTs were performed at the Pediatric Blood & Marrow Transplantation Center, Chonnam National University. This study was a retrospective analysis of the medical records of 15 patients who received the second HSCT after initial graft. Results : Among eight patients with nonmalignant diseases, two patients underwent the second HSCT because of primary graft failure and five because of late graft rejection. The remaining Fanconi anemia patient was re-transplanted due to development of AML. Two patients died and one experienced primary graft failure, but is still alive. The Kaplan-Meier 5-year overall survival rate was 75 percent and the disease free survival rate was 62.5 percent in nonmalignant diseases. All malignant patients underwent second transplants because of relapses. Four died of relapse and one of treatment-related complications. The Kaplan-Meier 2-year overall and event free survival rate was 28.6 percent each in malignant diseases. Conclusion : Second HSCT for graft dysfunction of nonmalignant disease seems to be feasible and should be considered as a standard practice. The relapse of malignant diseases remains a big obstacle even after the second HSCT, although a small portion of patients might be salvaged. Further investigation of novel therapeutic strategies, as well an the understanding of the biology should be explored.

[ $Gd(DTPA)^{2-}$ ]-enhanced, and Quantitative MR Imaging in Articular Cartilage (관절연골의 $Gd(DTPA)^{2-}$-조영증강 및 정량적 자기공명영상에 대한 실험적 연구)

  • Eun Choong-Ki;Lee Yeong-Joon;Park Auh-Whan;Park Yeong-Mi;Bae Jae-Ik;Ryu Ji Hwa;Baik Dae-Il;Jung Soo-Jin;Lee Seon-Joo
    • Investigative Magnetic Resonance Imaging
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    • v.8 no.2
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    • pp.100-108
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    • 2004
  • Purpose : Early degeneration of articular cartilage is accompanied by a loss of glycosaminoglycan (GAG) and the consequent change of the integrity. The purpose of this study was to biochemically quantify the loss of GAG, and to evaluate the $Gd(DTPA)^{2-}$-enhanced, and T1, T2, rho relaxation map for detection of the early degeneration of cartilage. Materials and Methods : A cartilage-bone block in size of $8mm\;\times\;10mm$ was acquired from the patella in each of three pigs. Quantitative analysis of GAG of cartilage was performed at spectrophotometry by use of dimethylmethylene blue. Each of cartilage blocks was cultured in one of three different media: two different culture media (0.2 mg/ml trypsin solution, 1mM Gd $(DTPA)^{2-}$ mixed trypsin solution) and the control media (phosphate buffered saline (PBS)). The cartilage blocks were cultured for 5 hrs, during which MR images of the blocks were obtained at one hour interval (0 hr, 1 hr, 2 hr, 3 hr, 4 hr, 5 hr). And then, additional culture was done for 24 hrs and 48 hrs. Both T1-weighted image (TR/TE, 450/22 ms), and mixed-echo sequence (TR/TE, 760/21-168ms; 8 echoes) were obtained at all times using field of view 50 mm, slice thickness 2 mm, and matrix $256\times512$. The MRI data were analyzed with pixel-by-pixel comparisons. The cultured cartilage-bone blocks were microscopically observed using hematoxylin & eosin, toluidine blue, alcian blue, and trichrome stains. Results : At quantitation analysis, GAG concentration in the culture solutions was proportional to the culture durations. The T1-signal of the cartilage-bone block cultured in the $Gd(DTPA)^{2-}$ mixed solution was significantly higher ($42\%$ in average, p<0.05) than that of the cartilage-bone block cultured in the trypsin solution alone. The T1, T2, rho relaxation times of cultured tissue were not significantly correlated with culture duration (p>0.05). However the focal increase in T1 relaxation time at superficial and transitional layers of cartilage was seen in $Gd(DTPA)^{2-}$ mixed culture. Toluidine blue and alcian blue stains revealed multiple defects in whole thickness of the cartilage cultured in trypsin media. Conclusion : The quantitative analysis showed gradual loss of GAG proportional to the culture duration. Microimagings of cartilage with $Gd(DTPA)^{2-}$-enhancement, relaxation maps were available by pixel size of $97.9\times195\;{\mu}m$. Loss of GAG over time better demonstrated with $Gd(DTPA)^{2-}$-enhanced images than with T1, T2, rho relaxation maps. Therefore $Gd(DTPA)^{2-}$-enhanced T1-weighted image is superior for detection of early degeneration of cartilage.

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Imaging of Lung Metastasis Tumor Mouse Model using $[^{18}F]FDG$ Small Animal PET and CT ($[^{18}F]FDG$ 소동물 PET과 CT를 이용한 폐 전이 종양 마우스 모델의 영상화)

  • Kim, June-Youp;Woo, Sang-Keun;Lee, Tae-Sup;Kim, Kyeong-Min;Kang, Joo-Hyun;Woo, Kwang-Sun;Chung, Wee-Sup;Jung, Jae-Ho;Cheon, Gi-Jeong;Choi, Chang-Woon;Lim, Sang-Moo
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.1
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    • pp.42-48
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    • 2007
  • Purpose: The purpose of this study is to image metastaic lung melanoma model with optimal pre-conditions for animal handling by using $[^{18}F]FDG$ small animal PET and clinical CT. Materials and Methods: The pre-conditions for lung region tumor imaging were 16-22 h fasting and warming temperature at $30^{\circ}C$. Small animal PET image was obtained at 60 min postinjection of 7.4 MBq $[^{18}F]FDG$ and compared pattern of $[^{18}F]FDG$ uptake and glucose standard uptake value (SUVG) of lung region between Ketamine/Xylazine (Ke/Xy) and Isoflurane (Iso) anesthetized group in normal mice. Metastasis tumor mouse model to lung was established by intravenous injection of B16-F10 cells in C57BL/6 mice. In lung metastasis tumor model, $[^{18}F]FDG$ image was obtained and fused with anatomical clinical CT image. Results: Average blood glucose concentration in normal mice were $128.0{\pm}23.87$ and $86.0{\pm}21.65\;mg/dL$ in Ke/Xy group and Iso group, respectively. Ke/Xy group showed 1.5 fold higher blood glucose concentration than Iso group. Lung to Background ratio (L/B) in SUVG image was $8.6{\pm}0.48$ and $12.1{\pm}0.63$ in Ke/Xy group and Iso group, respectively. In tumor detection in lung region, $[^{18}F]FDG$ image of Iso group was better than that of Ke/Xy group, because of high L/B ratio. Metastatic tumor location in $[^{18}F]FDG$ small animal PET image was confirmed by fusion image using clinical CT. Conclusion: Tumor imaging in small animal lung region with $[^{18}F]FDG$ small animal PET should be considered pre-conditions which fasting, warming and an anesthesia during $[^{18}F]FDG$ uptake. Fused imaging with small animal PET and CT image could be useful for the detection of metastatic tumor in lung region.

Effect of Dose Rate Variation on Dose Distribution in IMRT with a Dynamic Multileaf Collimator (동적다엽콜리메이터를 이용한 세기변조방사선 치료 시 선량분포상의 선량률 변화에 따른 효과)

  • Lim, Kyoung-Dal;Jae, Young-Wan;Yoon, Il-Kyu;Lee, Jae-Hee;Yoo, Suk-Hyun
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.1
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    • pp.1-10
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    • 2012
  • Purpose: To evaluate dose distribution differences when the dose rates are randomly changed in intensity-modulated radiation therapy using a dynamic multileafcollimator. Materials and Methods: Two IMRT treatment plans including small-field and large-field plans were made using a commercial treatment planning system (Eclipse, Varian, Palo Alto, CA). Each plan had three sub-plans according to various dose rates of 100, 400, and 600 MU/min. A chamber array (2D-Array Seven729, PTW-Freiburg) was positioned between solid water phantom slabs to give measurement depth of 5 cm and backscattering depth of 5 cm. Beam deliveries were performed on the array detector using a 6 MV beam of a linear accelerator (Clinac 21EX, Varian, Palo Alto, CA) equipped with 120-leaf MLC (Millenium 120, Varian). At first, the beam was delivered with same dose rates as planned to obtain reference values. After the standard measurements, dose rates were then changed as follows: 1) for plans with 100 MU/min, dose rate was varied to 200, 300, 400, 500 and 600 MU/min, 2) for plans with 400 MU/min, dose rate was varied to 100, 200, 300, 500 and 600 MU/min, 3) for plans with 600 MU/min, dose rate was varied to 100, 200, 300, 400 and 500 MU/min. Finally, using an analysis software (Verisoft 3.1, PTW-Freiburg), the dose difference and distribution between the reference and dose-rate-varied measurements was evaluated. Results: For the small field plan, the local dose differences were -0.8, -1.1, -1.3, -1.5, and -1.6% for the dose rate of 200, 300, 400, 500, 600 MU/min, respectively (for 100 MU/min reference), +0.9, +0.3, +0.1, -0.2, and -0.2% for the dose rate of 100, 200, 300, 500, 600 MU/min, respectively (for 400 MU/min reference) and +1.4, +0.8, +0.5, +0.3, and +0.2% for the dose rate of 100, 200, 300, 400, 500 MU/min, respectively (for 600 MU/min reference). On the other hand, for the large field plan, the pass-rate differences were -1.3, -1.6, -1.8, -2.0, and -2.4% for the dose rate of 200, 300, 400, 500, 600 MU/min, respectively (for 100 MU/min reference), +2.0, +1.8, +0.5, -1.2, and -1.6% for the dose rate of 100, 200, 300, 500, 600 MU/min, respectively (for 400 MU/min reference) and +1.5, +1.9, +1.7, +1.9, and +1.2% for the dose rate of 100, 200, 300, 400, 500 MU/min, respectively (for 600 MU/min reference). In short, the dose difference of dose-rate variation was measured to the -2.4~+2.0%. Conclusion: Using the Varian linear accelerator with 120 MLC, the IMRT dose distribution is differed a little <(${\pm}3%$) even though the dose-rate is changed.

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The Effect of Deep Breathing Methods on Pulmonary Ventilatory Function of Patients Who experiened Upper-abdominal surgery (심호흡 방법에 따른 상복부 수술환자의 폐 환기능에 미치는 효과)

  • Hwang Jin-Hee;Park Hyung-Suk
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.1 no.2
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    • pp.129-147
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    • 1994
  • The purpose of this study was to examine the effect of deep breathing exercise with Incentive Spirometer on the pulmonary ventilatory function of postoperative patients. This experiment was operated by quasi-experimental design which was compared pre-experimental measures with post-experimental ones. The subject of this study was 46 inpatients who were scheduled for elective upper abdominal surgery under the general anesthesia in P National University Hospital in Pusan and classified into the experimental group(23 patients) and control group(23 patients) by using Incentive Spirometer or unusing one. The data were collected from November, 1, 1993, to December, 31, 1993. The effects of the deep breathing exercise on the pulmonary ventilatory function were compared between experimental group who were recieved deep breathing exercise with Incentive Spirometer and control group who were recieved same method without Incentive Spirometer. The Forced Vital Capacity (FVC) and the First Second Forced Expiratory Volume ($FEV_1$) were represented as index of the pulmonary ventilatory function and those were measured by Vitalograph Compact. The collected data were analysed by SPSS/PC+ (percentage, average, standard deviation, chi-square test, t-test, and ANOVA). The results were as follow : (1) The $FVC_s$ of the experimental group were significantly increased in course of time, 24, 48, 72 hours after surgery(F=3.530, P=0.035). (2) The $FVC_s$ and $FEV_{1S}$ of the control group were significantly increased in course of time, 24, 48, 72 hours after surgery ($FVC_s$ : F=3.480, P=0.037, $FEV_{1S}$ : F=6. 153, P=0.004). (3) The FVC which was measured at 72 hours after surgery was significantly higher in the experimental group than in the control group(t=2.620, P=0.013). (4) The $FEV_{1s}$ which were measured at 24 and 72 hours after surgery were significantly higher in the experimental group than in the control group(24hr. : t=2.530, P=0.017, 72hr. : t=2.540, P=0.016). (5) Among general characteristics, sex was significant variable which influenced to effect of pulmonary ventilatory function. In conclusion, this study showed that the deep breathing exercise with Incentive Spirometer was more effective to recover the pulmonary ventilatory function after surgery than the deep breathing exercise without Incentive Spirometer.

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Dosimetric Evaluation of a Small Intraoral X-ray Tube for Dental Imaging (치과용 초소형 X-선 튜브의 선량평가)

  • Ji, Yunseo;Kim, YeonWoo;Lee, Rena
    • Progress in Medical Physics
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    • v.26 no.3
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    • pp.160-167
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    • 2015
  • Radiation exposure from medical diagnostic imaging procedures to patients is one of the most significant interests in diagnostic x-ray system. A miniature x-ray intraoral tube was developed for the first time in the world which can be inserted into the mouth for imaging. Dose evaluation should be carried out in order to utilize such an imaging device for clinical use. In this study, dose evaluation of the new x-ray unit was performed by 1) using a custom made in vivo Pig phantom, 2) determining exposure condition for the clinical use, and 3) measuring patient dose of the new system. On the basis of DRLs (Diagnostic Reference Level) recommended by KDFA (Korea Food & Drug Administration), the ESD (Entrance Skin Dose) and DAP (Dose Area Product) measurements for the new x-ray imaging device were designed and measured. The maximum voltage and current of the x-ray tubes used in this study were 55 kVp, and 300 mA. The active area of the detector was $72{\times}72mm$ with pixel size of $48{\mu}m$. To obtain the operating condition of the new system, pig jaw phantom images showing major tooth-associated tissues, such as clown, pulp cavity were acquired at 1 frame/sec. Changing the beam currents 20 to $80{\mu}A$, x-ray images of 50 frames were obtained for one beam current with optimum x-ray exposure setting. Pig jaw phantom images were acquired from two commercial x-ray imaging units and compared to the new x-ray device: CS 2100, Carestream Dental LLC and EXARO, HIOSSEN, Inc. Their exposure conditions were 60 kV, 7 mA, and 60 kV, 2 mA, respectively. Comparing the new x-ray device and conventional x-ray imaging units, images of the new x-ray device around teeth and their neighboring tissues turn out to be better in spite of its small x-ray field size. ESD of the new x-ray device was measured 1.369 mGy on the beam condition for the best image quality, 0.051 mAs, which is much less than DRLs recommended by IAEA (International Atomic Energy Agency) and KDFA, both. Its dose distribution in the x-ray field size was observed to be uniform with standard deviation of 5~10 %. DAP of the new x-ray device was $82.4mGy*cm^2$ less than DRL established by KDFA even though its x-ray field size was small. This study shows that the new x-ray imaging device offers better in image quality and lower radiation dose compared to the conventional intraoral units. In additions, methods and know-how for studies in x-ray features could be accumulated from this work.

Effect of Planned Nursing Intervention on the Stress, the Maternal Role Strain, and the Maternal Role Performance of Mothers of Premature Infants (계획된 간호 중재가 미숙아 어머니의 스트레스, 모성 역할 긴장과 역할 수행에 미치는 영향)

  • Joung Kyoun -Hwa
    • Child Health Nursing Research
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    • v.5 no.1
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    • pp.70-83
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    • 1999
  • The birth of a premature infant is distressing for its parents. The parents of a premature infant experience stress according to the infant's physical appearance and behavior, the environment of the neonatal intensive care unit (NICU) , and the alteration in the parental role. Especially, a mother of a premature infant feels distressed even after the discharge of the infant : therefore, she has difficulties in maternal role performance. The main purpose of this study is to identify the effects of the planned infant care information program in order to lower the stress level for mothers of premature infants caused by the birth and hospitalization in NICU of premature infants, to reduce the maternal role strain, and to promote the maternal role performance after the infants' discharge. This study employed two methods of research at the same time : quasi -experimental non-equivalent pre and post test to compare : non-equivalent post test to compare. The total number of subjects was 19 who were assigned to the research program : 12 mothers of premature infants at the NICU at the Ch university hospital and 7 at the NICU at the Y general hospital located in Chounju city. The data were collected for 79 days from August 18 to November 5, 1998. The questionnaire method was applied for the data collection, and the measures used in this study were Parental Stressor Scale : NICU(Miles, 1993), the Maternal Role Strain Measures ( Hobbs, 1968 ; Steffensmeier, 1982) , and Self Confidence Scale (Pharis, 1978). Research procedure is as follows : after preliminary examination, the experimental subjects, the mothers of premature infants at the Nl CU at Ch university hospital were provided with slide films and information developed by the researcher based on existing documents and data. It took two 60-minute sessions a week for two weeks, and the mothers' stress level was measured using the same instrument twice one week and two week after the infants' hospitalization. The stress level of the contrast subjects, the mothers at Y general hospital was measured during the same period. The experimental subjects were provided with booklets on matters that require attention after the infants' discharge and on developmental project, and they were educated to play the maternal role in person for 2-3 hours a week : breast-feeding, burping a baby, and changing diapers. One week after the infants' discharge, the maternal role strain and the maternal role performance were examined in two groups of the subjects. The analysis of collected data was done using descriptive statistics including real numbers, percentages, averages, and standard deviations. Mann-Whitney test ; x² test ; Repeated Measures Analysis of Variance ; ANCOVA Spearman's rho correlation coefficients. The results on this study were as follows. (1) The examination of the same quality showed that there were no differences in the general and obstetrical characters between the two groups. However, in terms of the characters of premature infants. just right after their birth, the infants at the contrast group weighed more than those at the experimental group(U=16.5, p=.02), and the former was in mother's womb longer than the latter(U=15.5, p=.02). (2) The stress level of the mothers provided with the plannned nursing intervention program became lower as time passed compared to the others'(F=16.61, p=.00) Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the mothers' stress levels made a statistical difference 2 weeks after the infants' hospitalization depending on treatment (F=8.00, p=.01) (3) The maternal role strain of the mothers provided with the planned nursing intervention program was lower than the others'(U=2.0, p=.00). Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the maternal role strain levels made a statistical difference 2 weeks after the infants' hospitalization, depending on treatment(F=14.72, p=.00). (4) The maternal role performance level of the mothers provided with the planned nursing program was higher than the others'(U=.0, p=.00). Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the mothers' stress levels made a statistical difference 2 weeks after the infants' hospitalization, depending on treatment(F=8.00, p=.01). (5) The correlation between a mother's stress level 2 weeks after her infant's hospitalization, the maternal role strain and the maternal role performance were compared : the stress and the maternal role strain were statistically irrelevant to each other(r=.33, p=.12) : the stress was found to be in inverse proportion to the maternal role performance(r=-.53, p=.02). The maternal role strain was in inverse proportion to the maternal role performance as well(r=-.50, p=.00). In conclusion, for the mothers provided with the planned nursing intervention program, their stress level was getting lower as time passed during the infants' hospitalization, their maternal role strain reduced when they took care of their infants after their discharge, and their maternal role performance level was high compared to the other mothers. Besides, the lower the stress level of mothers of premature infants was during the infants' hospitalization, the higher the maternal role performance after their discharge was. The lower maternal role strain was, the higher the maternal role performance was as well. These results of the study suggested that the nursing intervention program for the mothers of premature infants developed by the researcher would be effectively applied to nursing practice, and it would be a foundation for the development of this kind of program.

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