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Prediction of Continuous Positive Airway Pressure Level for Treatment of Obstructive Sleep Apnea (폐쇄성 무호흡의 치료시 지속적 기도 양압치의 예측)

  • Lee, Kwan Ho;Chung, Jin Hong;Lee, Hyun Woo
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.755-762
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    • 1996
  • Background : Continuous positive airway pressure(CPAP) is doubtlessly using as a medical treatment of choice for patients with obstructive sleep apnea (OSA) syndrome. CPAP is effective in OSA patients as a physical "pneumatic pressure splint" mechanism. We have done this study for two purposes, first to seek for the factors to determine the optimal CPAP titer, second to predict the minimal CPAP titer using the determined factors. Methods: We studied a 72 OSA patients who were treated with CPAP. All of them were studied by using a two nights polysomnographic rests in hospital. We compared the patients requiring CPAP over $10cmH_2O$ with those who required CPAP under 5cm $H_2O$ to determine the factors affecting the minimal CPAP titer. Results : The high CPAP group is characterized by a significantly higher body mass index(BMI), apnea index(AI) and apnea and hyponea index(AHI) and significantly lower lowest $SaO_2$. Regression analysis using the optimal four variables resulted in the following prediction equation for CPAP titer. CPAPtiter=8.382 + 0.064 ${\times}$ BMI + 0.077 ${\times}$ AI - 0.004 ${\times}$ AHI - 0.077 ${\times}$ lowest $SaO_2$ When this regression equation was applied to the 72 patients, the mean CPAP titer as predicted by the above equation was $7.80{\pm}2.96$ mmHg. Compared this value with actually determined CPAPtiter, $7.93{\pm}4.00$mmHg, there was no significant difference between the two values. Conclusion: Obesity, apnea severity and lowest Sa02 were strongly correlated with CPAP titer. Linear regression equation for CPAP titer using these indices predicted very closely the actually measured values in the sleep laboratory.

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Effect of PLA2 Inhibitor Rutin on Endotoxin-Induced Acute Lung Injury (내독소로 유도된 급성폐손상에서 PLA2의 억제제인 Rutin의 효과)

  • Kim, Seong-Eun;Lee, Young-Man;Park, Won-Hark
    • Applied Microscopy
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    • v.34 no.1
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    • pp.31-42
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    • 2004
  • Acute respiratory distress syndrome (ARDS) is a kind of acute lung injury characterized by inflammatory disruption of alveolar-capillary barrier and notorious for its high mortality. Neutrophils cause cell damage through the production of free radicals, inflammatory mediators, and proteases in ARDS. $PLA_2$ might serve a primary regulatory role in the activation of neutrophils. This present study was performed to elucidate the effect of rutin known as $PLA_2$ inhibitor on ARDS induced by endotoxin. Endotoxin had increased lung myeloperoxidase (MPO) activity, BAL (bronchoalveolar lavage) protein content, numbers of neutrophils in BALF (bronchoalveolar lavage fluid) compared with those of control rat (p<0.001). In addition, histological evidence of lung injury was correlated with neutrophil influx into alveolar space and cerrous perhydroxide granules were found in lining of endothelial cell, alveolar type I, II cells. In contrast, pretreated group of rutin had significantly decreased all of the parameters (p<0.001). These data suggest that inhibition of $PLA_2$ is one step approach that block the process of ARDS. Accordingly, we conclude that rutin can be used as the prophylactic agent for ARDS on the bases of these experimental results.

A Survey on Treatment of Breast Cancer Patients with Korean Medicine: Preliminary Research for Clinical Practice Guidelines (한의표준임상진료지침 개발을 위한 유방암 보완치료 실태조사)

  • Kim, Nam-Hoon;Kang, Na-Hoon;Yoo, Eun-Sil;Park, Nam-Chun;Lee, Jin-Wook;Park, Kyoung-Sun;Lee, Jin-Moo;Lee, Chang-Hoon;Jang, Jun-Bock;Jang, Bo-Hyoung;Hwang, Deok-Sang
    • The Journal of Korean Obstetrics and Gynecology
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    • v.31 no.4
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    • pp.165-178
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    • 2018
  • Objectives: To determine the current status of the treatment of breast cancer patients by Korean Medicine doctors (KMDs) and to examine the need for clinical practice guidelines (CPGs) for the supportive care of these patients. Methods: This cross-sectional study used a self-administered questionnaire. Participants were asked about their experience in treating breast cancer patients; the number of breast cancer patients they currently treat; the main complaints expressed by, diagnoses of, and treatments used for such patients; and their opinions about Korean Medicine (KM) as the basis for providing supportive care for breast cancer. Results: The data for this study were collected from 322 respondents. 84 of whom reported having ever treated patients with breast cancer. Most breast cancer patients who visited the KM clinic were classified as stage I or II, and their major complaints were fatigue, general weakness and musculoskeletal pain. The major diagnostic strategies were syndrome differentiation and pulse diagnosis. The major treatments administered were herbal medicine, acupuncture, and moxibustion. KMDs cited a need for medical information, such as CPGs, as their most important concern with regard to the treatment of breast cancer patients. Conclusions: This survey determined the prevalence of the use of KM for Korean breast cancer patients. Our results underscore the need for clinical practice guidelines for using of KM as the basis of supportive care for breast cancer and for informing clinicians and patients about this approach.

Surgical Treatment of Thoracoabdominal Aortic Aneurysm (흉복부 대동맥류의 외과적 치료)

  • Ahn, Hyuk;Kim, Jun-Seok
    • Journal of Chest Surgery
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    • v.29 no.2
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    • pp.177-184
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    • 1996
  • Between 1987 and 1994, 21 patients were treated surgically for aortic aneurysm involving the thoracoabdominal aorta. There were 11 males and 10 females, and their age ranged from 20 to 67 years old and mean age was 41.5 years. Many complained of back pain, chest pain or discomfort, and flank pain, but three patients were asymptomatic. 15 patients had chronic dissection (71.4%) and 6 had nondissecting fusiform or saccular aneurysm(28.5%), and of those 15 patients with chronic dissection, 6(28.5%) had atherosclerosis assniated with hypertension, 5 (23.8%) were Martian syndrome, and 2 (9.5%) were associated with pregnancy. The diameter of an aneurysm ranged from 6cm to 12cm, and their extent was classified as type I in 7(33.3%), type II in 8(38.1%), type III in 3(14.3%), and type IV in 3(14.3%) patients based on Crawford classification for TAA . Diseased aorta was replaced with artificial vascular graft in all but one patient. In whom the aortic tear site due to pseudoaneurysm was closed by primary suture. For the spinal cord protection during the operation, we used partial cardiopulmonary bypass (FV-FA or PA-FA bypass) in 12 patients (57.1%), Biopump (LA-FA bypass) in 4(19.0%), total circulartory arrest and CPB in 2 (9.5%), Gott's heparinized shunt in 1(4.7%), and simple aortic cross clamping in 2 (9.5%). The most common complication after the operation was hoarseness due to unilateral vocal cord palsy which onured in 5 patients (23.8%), and the next common complication was wound infection in 4 patients(19.0%), paraplegia in 2 patients (9.5%), chylothorax in 1 patient(4.7%). The hospital mortality rate was 9.5% (2deaths), and there was no late death. Our experience shows that the graft replacement of TAAA had reasonable rate of mortality, low rate of serious complication, and provided good post operative state of the pati nts, and since the thoracoabdominal aortic operation is not a high risky procedure anymore, we recommend a radical operation for the indicated patients.

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A Clinical Study on Treatments of Hwabyung with Oriental Medicine (홧병환자의 한의학적 치료에 대한 임상적 연구)

  • Kim, Jong-Woo;Whang, Wei-Wan
    • The Journal of Korean Medicine
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    • v.19 no.2
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    • pp.5-16
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    • 1998
  • Hwabyung is a common emotional disorder which has symptoms expressed like firt's explosion in middle-aged after long period of emotional suppression among Koreans. It is similar in its characteristics such as neurosis, anxiety, panic attacks in Western Medicine, though the treatment method was not effective. So we have done a clinical research on Oriental Medical Method, especially on Acupuncture Therapy, and obtained following results. 1. Patients with Hwabyung complained of pressure pain around the Chunjung(?中, CV-17) point distinctively. About 70% of those were located on the CV-17 point, 25% were 1cm upper than the CV-17 point and 5% of those were 1cm lower point than the CV-17 point. 2. Degrees of pressure pain were divided into 5 grades from ade 1(feeling pain with slight pressure) to grade 5(feeling no pain with severe pressure), respectively. 3. Patients with Hwabyung showed various symptoms compared to fire's explosion such as anger, chest discomfort, difficulty in breathing. tachycardia. and feeling of epigasfric mass etc., and the degrees were divided into 5 grades according to the severities from grade 1(can't keep their usual living) to grade 5(no complaints with heavy stresses), respectively. 4. For the treatment of Hwabyung in this study, we had given Acupuncture therapy on some points such as Chunjung:?中:CV-17, Jungwan:中脘:CV-12) and Chunchu:天樞:S-25, etc. for 15 minutes a time twice a week. And Bunshimkiumgmnihang(分心氣飮加味方) was administered 3 times a day. 5. About 40% of the patients took treatment for more than 2 months, 29% of those took 1 to 2 months and 31% of those took less than 1 month. In this study, we excluded those who stopped treatment within a month without any expected effects. 6. We evaluated the changes of severity of pain according to the following categories such as - for no change, + for 1 grade, ++ for 2 grades, +++ for 3 grades, and ++++ for 4 grades of improvements. Among the patients taken 1 to 2 months of treatment. 48% of the those showed +, 7% of those showed ++, 3% of those showed +++ and 41% of those showed no change. Among the patients taken less than 2 months of treatment, 20%of those showed +, 40% of those showed ++, 28% of those showed +++ and 13% of those showed no change. 7. We evaluate the changes of symptoms according to the following categories such as - for no change, + for 1 grade, ++ for 2 grades, +++ for 3 grades and +++ for 4 grades of improvements. Among the patients taken 1 to 2 months of treatment, 34% of those showed +, 14% of those showed ++ and 52% of those showed no change. Among the patients taken more than 2 months of treatment, 20% of those showed +, 43% of those showed 20% of those showed +++, 3% of those showed +++ and 15% of those showed no change. 8. When we compare the changes of pain and symptoms according to the periods of treatment, the changes in quantity of pain in 1 to 2 months group was $0.72{\pm}0.75$, in more than 2 months group was $1.83{\pm}0.98$, and the changes in quantity of symptoms in 1 to 2 months group was $0.62{\pm}0.73$, in more than 2 months group was $1.75{\pm}1.03$. According to the above results, we have concluded that more than 2 months of treatment is more beneficial than 1 to 2 months of treatment.

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A Study on etiological factors, symptoms of a disease, and treatments of obesity based on Dong-Yi Bo Gam (동의보감(東醫寶鑑)을 위주(爲主)로한 비만의 원인(原因), 증상(症狀), 치료법(治療法) 연구)

  • Kim, Seok;Jin, Seng-Hee;Kim, Tae-Hee
    • The Journal of Korean Medicine
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    • v.19 no.2
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    • pp.125-136
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    • 1998
  • This study is on the etiological factors of the obesity, symptoms of a disease caused by the etiological factors and the method of medical treatment resulted from symptoms of a disease, it is based on Dong-Yi Bo Gam. The conclusion of this study is as follows. 1. The final metabolic of fat is depend on the defensive energy. The shape of fatty layer is changed by the point where the defensive energy is replenish or not. So 'Goin(暠人)' 'Bein(肥人)' and 'Yuckin(肉人)' is made a discriminated and there is defferent between 'Besudaeso(肥瘦大小)' and 'Herlqidaso(血氣多少)'. 2. Etiological factors of obesity is ; essential substance from cereals overcome the primodial energy, spleen and stomach are strong at once, spleen and stomach are weak at once, spleen is disturbed by evil energy, retention of phlegm and fluid, muscle is weak, blood is excess but energy (qi)is weak, hua-sid(華食) eating the sweat food very often, a rich fatty diet. 3. To investigate each syndrome as etiological factons, essential substance from cereals overcome primodial energy is divided into two case: one is the food increase itself because of the weakness of stomach energy (qi), the other is not to digest the food because liver overact spleen by seven emotion. The obesity because of strengthen of the spleen and stomach at once do not feel hungry very well and spleen and stomach do not damaged easily by overacting. The obesity because of weakness of spleen and stomach at once, and disturbace in spleen cause by evil energy, gain the weight even if they eat food a little. Also it is hard to move four limbs. Weakness of muscle is weakness of spleen and stomach. Weakness of muscle is caused by weakness of spleen and stomach. That is the case of faining the weight because of eating food with an empty stomach. The obsity caused by retention of fluid has intestine rumbling and gain the weight suddenly. 4. The method of medical treatment fallowing to the etiological factors: The food is inclined to increase itself caused by weakness of stomach energy, In case of the obseity caused by this phenomenon. We can use Decoction for Reinforcing Middle wanner and Replenishing Qi(補中益氣湯), five tastes il-going-san(左味異功散) and so on. The method of medical treatment on obsity caused by strengthen of spleen and stomach is not referred yet. But we must investigate about using peptic powder(平胃散), ji-chul-huan(枳朮丸) for strengthen of stomach qi (胃氣). If the obesity appear caused by weakness of spleen and stomach and disturbance in spleen as to evil energy, and in the same time stomach qi is weak, we can use li-gong san(異功散). If not only obesity but also indigestion, we can use Decoction for naurishing the stomach and promotion eating(養胃進食湯). If not only obesity but also weakness of spleen and stomach, we can use Decoction for Reinforcing Middle warmer and replenishing Qi(補中益氣湯). The energy being weak, we can use Decoction for six noble drugs(六君子湯). If the obesity appear because of retention of fluid, we can use sin-chul-huan(神朮丸). On the obesit, caused by excess of blood and weakness of qi(血管氣虛), there is not method of mectical treatment yet, but the method of medical treatment that we count of first important maybe to invigorate the spleen and the lung qi and to disperse and recitify the depressed liver energy(疏肝利氣). The method of medical treament about the obesity caused by a rich fatty diet is not mentioned yet, but it is important to improve the lifestyle of food and we think that invigorate the spleen, and the lung-qi(補疏肝氣) and disperse and recitify the depressed liver-energy (??肝利機) amy count of first important. 5.There is useful medicine for weight down for example Herb tea(茶), red bean, wax gourd, etc. 6.The etiological factors of the obesity that revive frequently is weakness of qi(氣虛), from 形成氣衰, deficiency of yang, hasty of qi, damp and so on. The symptoms and sign of a disease that revive frequently to the obesity is appoplexia(中風), leucorrhea, reddish and whitish turbid, feeling of fullness in the upper abdomen, diabetes and so on.

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The current child and adolescent health screening system: an assessment and proposal for an early and periodic check-up program (현행 영유아 및 소아청소년 건강검진제도의 평가 및 대안)

  • Eun, Baik-Lin;Moon, Jin Soo;Eun, So-Hee;Lee, Hea Kyoung;Shin, Son Moon;Seong, In Kyung;Chung, Hee Jung
    • Clinical and Experimental Pediatrics
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    • v.53 no.3
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    • pp.300-306
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    • 2010
  • Purpose : Recent changes in the population structure of Korea, such as rapid decline in birth rate and exponential increase in old-aged people, prompted us to prepare a new health improvement program in children and adolescents. Methods : We reviewed current health screenings applied for children and adolescents in Korea and other developed countries. We collected and reviewed population-based data focused on mortality and morbidity, and other health-related statistical data. We generated problem lists in current systems and developed new principles. Results : Current health screening programs for children and adolescents were usually based on laboratory tests, such as blood tests, urinalysis, and radiologic tests. Almost all of these programs lacked evidence based on population data or controlled studies. In most developed countries, laboratory tests are used only very selectively, and they usually focus on primary prevention of diseases and health improvement using anticipatory guidance. In Korea, statistics on mortality and morbidity reveal that diseases related to lifestyle, such as obesity and metabolic syndrome, are increasing in all generations. Conclusion : We recommend a periodic health screening program with anticipatory guidance, which is focused on growth and developmental surveillance in infants and children. We no longer recommend old programs that are based on laboratory and radiologic examinations. School health screening programs should also be changed to meet current health issues, such as developing a healthier lifestyle to minimize risk behaviors—or example, good mental health, balanced nutrition, and more exercise.

A Study on the Actual Condition of the Adult-smoking in a Region (일 지역 성인의 흡연실태)

  • Chong Young-sook
    • Journal of Korean Public Health Nursing
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    • v.13 no.1
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    • pp.97-113
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    • 1999
  • To investigate the actual condition of the adult-smoking in Chinan County. I used self-reporting questionnaires among 923 residents living in nine districts selected at random among the sites of eleven eup-myons from December 28. 1998 to January 6. 1999. collected data and analyized using SPSS. The smoking rate of adults in Chinan County was $36.9\%$. There was a significant difference in smoking rate according to the age. gender, education and job among general characteristics. The smoking rate in group of above 40s was about $40\%$ and that of the male took $55.5\%$ which was higher than that of female and the smoking rate of the people having high-school education was the highest$(46.2\%)$. With regard to the career. the smoking rate of the farmers ranked first$(46.1\%)$. Therefore anti-smoking business for smokers should be focused on above 40 years old, males. people having high school education and farmers. As the result of the survey of smoking habits of 340 people who smoke currently, the average smoking begining age was 21.8 and $81.5\%$ among them was between 16-25 years old. $4.4\%$ was under 15. during around the elementary school. Most motives to smoke were as followed; curiosity or taste$(33.6\%)$, relief of stress $(31.2\%)$, peer presure$(26.5\%)$ And considering the amount of the cigarette which is smoked per day, the case which is less than a pack of cigarettes was highest as $75.5\%$ and the people who smoke over one pack of cigarettes took $24.5\%$. As for the kind of tobacco which is smoked, how to smoke and the desire for the smoking, most case was toxin was moderate$(47.8\%)$ or mild$(46.9\%)$. shallowly$(49.0\%)$ or deeply$(46.3\%)$ and under stress$(33.4\%)$. after meals$(27.8\%)$, during drink$(15.7\%)$ and so on. The highest point marked among the factors of smoking motives was 'the reduce of negative emotion' $(3.27\pm1.00)$. followed by 'uncomfortable habits' $(2.87\pm1.02)$, 'addiction' $(2.84\pm1.06)$. 'habit' $(2.74\pm1.12)$. 'pleasure' $(2.70\pm1.04)$. 'stimulus' $(2.59\pm.90)$, 'sensation-exercise satisfaction' $(2.42\pm.97)$. Smokers smoke to reduce the negative emotions when angry in most common case. depressed. anxious. uncomfortable. lone. ashamed or embarrased. and intend to solve the certain problem. etc. Other motives are uncomfortable habit. addiction. habit. pleasure and the pursuit of stimulus. The level of nicotine dependence of adults m Chinan County was 10.57 which amount to 'high' wholly. As the resulf of the level of nicotine dependence score. the people who are low in the level of nicotine was $33.5\%$. the people who are high was $48.2\%$. very high was $18.4\%$. The approach for anti-smoking for smokers should be conducted differently according to the level of the nicotine. For the people who are in low level of nicotin dependence the prohibition of the smoking should be guided through the approach to foster strong will. for those who are in 'high' by acquiring proper method for the prohibition of smoking. and for those who are 'very high' the anti-smoking should be induced by providing proper program because of the possibility of the suffer from abstinence syndrome. The difference of the level of nicotine with the general characteristics of the objects had not statistically significant difference. The difference of the level of nicotine dependence accompanied by smoking habit had statistically significant difference according to the amount of smoke, the kind of tobacos. smoke inhale habit. In other words, the group of heavy smokers had higher level of the nicotine dependence than that of the light smokers relatively and the group which smoke strong taboaco has higher level of nicotine than that of which smoke mild or moderate. And the group of smokers who smoke deeply has higher level of nicotine than that who smoke shallowly or nonswallow. Aa a result of the analysis of the correlation between smoking motive factors and the level of nicotine, there was the indication that people who smoke for the decrease of the negative emotion. habit, pleasure. stimulus. sensation-exercise satisfaction had high level of the nicotine dependence. As the result of the anti-smoking will of smokers. $65.0\%$ of them had prohibition of smoking will. $29.3\%$ had no will to quit smoke. The most important reason for anti-smoking was health. $67.9\%$ had experience to try to quit smoke and the biggest reason to fail to quit smoking was the lack of the will power to keep anti-smoking. $52.8\%$ of them were advised to stop smoking from their spouses or children. only $2.8\%$ were by medical. The people who have the opinion to need anti-smoking education were $69.6\%$. Therefore when the business for the hygine of the mouth for adult is set. it should be centered on the people who have intention of prohibition of the smoking and help to quit smoking by way of other affirmative counter-program not smoking under stress.

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Genotypic and Phenotypic Characteristics of Staphylococcus aureus Isolates from Lettuces and Raw Milk (상추와 원유에서 분리한 황색 포도상구균의 유전형 및 표현형 특징)

  • Jung, Hye-Jin;Cho, Joon-Il;Park, Sung-Hee;Ha, Sang-Do;Lee, Kyu-Ho;Kim, Cheol-Ho;Song, Eun-Seop;Chung, Duck-Hwa;Kim, Min-Gon;Kim, Kwang-Yup;Kim, Keun-Sung
    • Korean Journal of Food Science and Technology
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    • v.37 no.1
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    • pp.134-141
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    • 2005
  • To characterize genotypic and phenotypic traits of Staphylococcus aureus isolates (n = 86) from lettuces and raw milk, major virulence-associated genes and antibiotic susceptibility were detected using PCR-based methods and disk diffusion method, respectively. All isolates possessed coagulase gene and showed five polymorphism types [500 bp (2.4%), 580 bp (17.4%), 660 bp (61.6%), 740 bp (17.4%), and 820 bp (1.2%)] due to variable numbers of tandem repeats present within the gene. Two or three different loci of hemolysin gene family were dominant in isolates, 47 of which (55%) possessed combination of hla/hld/hlg-2 genes as the most prevalent types. Among enterotoxin-encoding genes, sea was detected from 32 isolates (37%), sed from 1 isolate (1%), and sea and sed genes were co-detected from 4 isolates (5%), whereas seb, sec, and tsst-1 genes were not detected. All isolates were susceptible to ciprofloxacin, trimethoprim/sulfamethoxazole, oxacillin, and vancomycin, 85 isolates (99%) to penicillin G, 54 isolates (63%) to chloramphenicol, 51 isolates (59%) to erythromycin, and 7 isolates (8%) to clindamycin. Among resistant isolates, seven displayed multiantibiotic-resistance against two different antibiotics.

A Study on the physical Status of New Born Babies in Nursery at a Hospital in Seoul. - For Relationship between Neonatal Diseases and risk factors. - (종합병원 분만아의 신생아실 재원기간중 건강상태에 관한 연구 - 질환발생과 제요인과의 관계를 중심으로 -)

  • Park Ae Kyung
    • Journal of Korean Public Health Nursing
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    • v.2 no.2
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    • pp.81-98
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    • 1988
  • The purpose of this study was to fine out the general physical status of the neonates, and to identify the risk factors of the mothers and the neonates which were significantly related to the neonatal diseases during hospitalization. The data were obtained from clinical records of 1098 neonates born in Seoul Red cross Hospital between January 1st of 1984 and December 31th of 1986. The results of this study were summarized as follows: 1. General characteristics of the maternal group. 1) The average of maternal age was 26.6 years, the $91.7\%$ of the mothers de liveried at the age of 20-34 years old. 2) The distribution of the types of delivey were as follows : spontaneous delivery $39.9\%$, cesarean section $32.4\%$, vaccum extraction $25.7\%$, and breech delivery$2.0\%$. 3) The $40.3\%$ of the total de liveried mother had experienced abortion. 4) The $42.3\%$ of the total deliveried mother had one or more obstetric risk factors. 2. General characteristics of the neonatal group. 1) In the distribution of sex, male was $49.4\%$, female $50.6\%$. 2) The average of birth weights was 3,020gm. The distribution of birth weight were as follows; nomal weight $85.5\%$, low birth weight $12.7\%$ and high birth weight $2.5\%$. 3) The average of gestational age was 39.2 weeks. The distribution of gestational age were as follows; full term $77.4\%$, preterm $13.7\%$, and postterm $8.9\%$. 4) The average of Apgar Score was 9.0 at one minute and 9.6 at five minutes. 5) The $5.7\%$ of the neonates had one or more neonatal risk symptoms and signs at birth. 3. Apgar Score by the maternal and neonatal factors. In Apgar Score at one minute, normal group was higher than that of abnormal group. Apgar Score at five minutes was slightly higher than that at one minute. 4. The distribution of the maternal risk factors and the neonatal risk factors. 1) The total numbers of the maternal risk factors were 1376. The distribution of the maternal risk factors were as follows: obstetric factor $33.7\%$, abortion $32.2\%$, breech and cesarean section delivery $27.5\%$ and maternal age under 19 years and over 35 years $6.6\%$. 2) The total numbers of the neonatal risk factors were 517. The distribution of the neonatal risk factors were as follows: gestational age under 37 weeks and over 42 weeks $48.0\%$, birth weight under 2500gm and over 4000gm $12.2\%$, Apgar score under 4 at one munute $6.4\%$ and Apgar score at five munutes $2.7\%$. 3) The total numbers of the obstetric risk factors were 661. The types of the obstetric risk factors were meconium stained amniotic fluid $22.0\%$, premature rupture of membrane $17.5\%$. absence prenatal care $14.1\%$, unmarried pregnancy $10.3\%$, placenta problem $9.0\%$, toxemia $8.0\%$. 4) The total numbers of the neonatal risk symptoms and signs at birth were 83. The types of the neonatal risk symptoms and signs were respiratory distress $65.1\%$, neonatal apnea $14.4\%$, convulsion $13.3%$, meconium aspiration syndrome $4.8\%$, cyanosis $2.4\%$. 5. The relationship between the maternal risk factors and the neonatal risk factors. 1) Maternal age under 19 years or over 35 years was significantly related to Apgar Score under 4 at 5 minutes. 2) Breech delivery or cesarean section was significantly related to neonatal risk factor at birth such as birth weight, gestational age, Apgar Score at one minute and at five minutes. and neonatal risk symptoms and signs. 3) Obstetric risk factors were significantly related to the neonatal risk factors at birth. 4) Abortion was not related to the neonatal risk factors. 6. The relationship between neonatal diseases during hosptalization and the maternal or the neonatal risk factors. 1) The total numbers of neonatal diseases during hospitalization were 281. The distribution of neonatal diseases were as follows: birth trauma $38.1\%$, infectious disease $31.3\%$, hematologic disease $21.4\%$, respiratory disease $6.0\%$, neurologic disease $2.5\%$. cardiovascular disease $0.7\%$. 3) Most maternal risk factors except abortion were significantly related to neonatal diseases. 4) Most neonatal risk factors at birth were significantly related to neonatal diseases.

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