• 지역사회간호학회지
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• 제7권1호
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• pp.138-153
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• 1996

Intending to offer basic information for a prospective health services in Korea, this study is to investigate the complication caused by sterilization in goverment family planning program from 1962 to 1995. The results are as follows: 1. Total number of sterilization performed during the period from 1962 to 1995 were 1.367,772 cases of male sterilization and 2,889,635 cases of female sterilization. 2. Incidence of the complication caused by sterilization operation from 1980 to 1995 were 1,883(0.20%) out of 925,801 cases in vasectomies and 15,866(0.70%) out of 2,256,020 cases in tubal sterilizations. 3. Major complications in vasectomy were epididymities of 658 cases (34.9%), vas recanalization of 326 cases(17.3%), hematoma of 266 cases(14.1%), scrotal abscess of 184 cases(9.8%), sperm granuloma of 76 cases(4.0%),and other of 373 cases(19.8%). On the other hand, in tubal sterilization, ectopic pregnancy was the most significant complication of 15,078 cases (95.0%) among 15,866 total complications, followed by pelvic inflammatory diseases of 155 cases(0.9%), peritonities of 96 cases(0.6%), ovarian & tubal bleeding of 31 cases(0.2%), intestinal perforation of 16 cases (0.1%), uterine bleeding of 14 cases(0.1%), uterine cervix laceration of 1 case (0.1%), and other of 271 cases(1.7%), while 161 pregnancies(0.1%) were terminated and 43 cases(0.3%) with normal delivery. 4. The occurrence rate of the complication for each period showed that most of the complication cases by vasectomy occurred in a year after the operation -the cases were 1,256 (66.7%). 254 cases(13.5%) occurred between the next year and the 2nd year, 138 cases (7.3%) between the 2nd year and the 3rd year, 73 cases(3.9%) between the 3rd year and the 4th year, 52 cases(2.8%) between the 4th year and the 5th year, 31 cases(1.6%) between the 5th year and the 6th year, 79 cases(4.2%) over the 6th year. Tubal sterilization indicated that the occurred complication cases in a year were 2,175 cases(13.7%), 2,113 cases(13.3%) occurred between the next year and the 2nd year, 2,082 cases(13.1%) between the 2nd year and the 3rd year, 2,049 cases (12. 9%) between the 3rd year and the 4th year, 1,819 cases(11.5%) between the 4th year and the 5th year, 621 cases(10.2%) between the 5th year and the 6th year, 4,007 cases(25.3%) over the 6th year. 5. For the cost of complication treatment, total \7,928,229,000 were paid as medical expenditure in which \609,438,000 for vasectomy and \7,318,791,000 for tubal sterilization. Accordingly per capita expenses were \345,000 for vasectomy and \467,000 for tubal sterilization. As the proportion of government sterilization program was decreased after 1988, that of private sterilization program would be increased. So it is recommended to set a guideline for the private sterilization program and to continue government sterilization program for the lower class.

• Clinical and Experimental Reproductive Medicine
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• 제25권2호
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• pp.189-198
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• 1998

Since the male sterilization (vasectomy) has been performed on a large scale as an accepted family planning in Korea on 1980s and this, in turn, has been followed by an increase in the number of patients requesting vasovasostomy. We studies 1000 consecutive cases of vasovasostomy performed from January 1975 to July 1995 in Pusan National University Hospital. In this report, we are going to present serial studies of vasovasostomy through which we attempted to find out what factors are of impotence in influencing the successful outcome of vasovasostomy operation. We inquired the operative results data through the questionnaire and telephone interview with survey of medical records. A total of 259 cases was excluded due to the loss of follow-up. The overall patency and pregnancy rates of 741 cases were 86.9% and 51.1%, respectively. The age of man at the time of anastomosis ranged from 23 to 57 years old with an average of 34.9. The most frequent reason for requesting vasovasostomy was the desire to have more children (43.4%). The average obstructive interval was 60.6 months with range from 1 to 264 months. If the obstructive interval had been less than 5 years patency rate was 92.4% and pregnancy rate 64.8%, but 6 years or more 84.1% and 48.5% (p<0.01, p<0.01). Patency and pegnancy rates according to intraoperative vas fluid were 93.1% and 62.8% for presence and 83.7% and 53.1% for absence (p<0.01, p<0.05). Patency and pregnancy rates according to histologically proven sperm granuloma at vasectomy site were 87.7% and 49.2% for presence and 86.9% and 50.6% for absence (p>0.05, p<0.05). Patency and pregnancy rates were not significantly different between microscopic standard vasovasostomy (88.4%, 64.3%) and modified vasovasostomy (89.5%, 56.3%)(p>0.05, p>0.05). Both patency and pregnancy rates according to level of anastomosis were 89.8% and 59.8% in cases of straight vas and 91.5%, 60.1% in cases of convoluted vas (p>0.05, p>0.05). Patency and pregnancy rates according to the kind of suture materials were 91.5% and 56.2% for absorbable, 91.0% and 64.2% for non-absorbable and 93.3% and 53.3% for absorbable plus non-absorbable, respectively (p>0.05, p<0.05). Thus it is suggested that the important factor influencing the success rate of vasovasostomy is the interval of obstruction and vasal ooze with surgical skills.

• 대한생식의학회:학술대회논문집
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• 대한불임학회 2000년도 제39차 춘계 학술대회
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• pp.29-35
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• 2000

The imbalance between reactive oxygen species (ROS) production and total antioxidant capacity (TAC) in seminal fluid indicates oxidative stress and is correlated with male infertility. A composite ROS-TAC score may be more strongly correlated with infertility than ROS or TAC alone. We measured ROS, TAC, and ROS-TAC scores in semen from 127 patients and 24 healthy controls. Of the patients, 56 had varicocele, eight had varicocele with prostatitis, 35 had vasectomy reversals, and 28 had Idiopathic infertility. ROS levels were higher among infertile men, especially those with varicocele with prostatitis (mean ${\pm}$ SE, 3.25 ${\pm}$ 0.89) and vasectomy reversals (2.65 ${\pm}$ 1.01). All infertility groups had significantly lower ROS-TAC scores than control. ROS-TAC score identified 80% of patients and was significantly better than ROS at identifying varicocele and idiopathic infertility. The 13 patients whose partners later achieved pregnancies had a mean ROS-TAC score of 47.7 ${\pm}$ 13.2, similar to controls but significantly higher than the 39 patients who remained infertile (35.8 ${\pm}$ 15.0; P < 0.01). ROS-TAC score is a novel measure of oxidative stress and Is superior to ROS or TAC alone in discriminating between fertile and infertile men. Infertile men with male factor or idiopathic diagnoses had significantly lower ROS-TAC scores than controls, and men with male factor diagnoses that eventually were able to initiate a successful pregnancy had significantly higher ROS-TAC scores than those who failed.

• 대한간호학회지
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• 제8권2호
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• pp.63-77
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• 1978

Studies pertaining to influential factors on adoption and practice of family planning are very much needed to lower fertility, for family planning has regarded as only one social acceptable means to curb the accelerated population growth. One of the influential factors is known as rumors on family planning methods that hinder the actual practice of family planning. This study generally aimed at disclosing rumors on family planning methods prevalent in rural communities so that one could gain some in sights to cope with the ill effects of rumors to promote family planning Practice in rural communities in Korea. In order to accomplish the general aims this study formulated following four specific objectives; 1. Find out types and frequencies of rumors exposed of contraceptive methods. 2. Find out the relationship between the rumors exposed and socio-economic and demographic characteristics of new village leaders and health workers. 3. Examine the relationship between family planing rumors and family planning practices. The materials for this study were drawn from the two different sets of data gathered in July and Octorber 1977 respectivily by Center for Population ＆ family Planning, Yon sei University. One is current family planning practice among eligible women reaiding in 4 Myuns in Kwang Wha country and the other is Survey on Rumor on family planning method heard by new village leaders and health workers in the four myuns. The four Myuns were divided into 60 small areas. Current family planning practice rate in each small area and as a whole were calculated. The unit of analysis in this study was not the indviduel person but the 55 small areas. Percentage, average, F-Test t-test and a coefficient of correlation were used for statistical analysis. Results of this study could be summarized as follows: 1. Rumors by different method of contraception: Medical complications, gastro-intestinal disorders, and difficulty in usage one most prevalent rumors about oral pills. Around 49% -77% of the 55 areas were often heard and the most frequent rumor was related medical complications of oral pills. Rumors on medical complications and incomplete effect of intrauterines as contraceptive were heard 51-66% of the 55 small areas. Rumors that vasectomy resulted in family problems, for instance infiedelity of spouse were often heard to 44% of the 55 small areas. 2. Rumors by socio-economic and demographic characteristic of new village leader and health workers: Among the demographic characteristics such as sex, age and sex composition of children, sex and age differentials in frequency of rumors heard more observed, Female new village health workers have heard more frequently than male new village leader. (t = 7.137, p> 0.01, d.f. = 53, a coefficient of correlation 0.27, p>0.05) The Younger age group less than 40 years of age have heard rumors of than the group over 40 years old. (t = 7.18, p>0.01, d.f. = 53, a coefficient of correlation 0.27, p>0.05) However, it was not observable that a consistent sex and age differentials in frequency of rumors heard of each contraceptive mettled, But, more female new village health works heard of rumors about intrauterine device than male new village leaders. (t = 0.497, p> 0.01, d.f. = 53, a coefficient of correlatin 0.32, p>0.01) 3. It was found that there was no statistically significant relationship between the frequency of rumors heard and current family planning practices on the whole, However, frequency of rumors heard about vasectomy appeared to have a positive relationship with current practice of vasectomy. A rather consistent pattern of relationship between“requency of rumors heard”and current family practice rate was demonstrated of 10 graphes which showed the relation between the two variagles. The current family planning practice rate in the“never heard”group and “frequently heard”group was equally lower than that in“often heard”group. The relatively consistent ∩ pattern of relationship needs to be farther investigated, for this pattern is different from the relationship that has been assumed to exist between these two variables.

• Clinical and Experimental Reproductive Medicine
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• 제23권1호
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• pp.67-71
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• 1996

During a 2-year period microsurgical vasovasostomies using permanent silicone stent(c-shaped stent with 0.6mm slit, 5mm in length, 0.8mm in outer diameter, 0.5mm in inner diameter) were performed in 30 patients for vasectomy revesal. The stent-assisted vasovasostomy(SVV) was intended to decrease the technical demand, the time requirement and the occurrence of reobstruction due to postoperative stricture. The effectiveness of the permanent silicone stent for vasovasostomy was compared with that of microsurgical two-layered vasovasostomy(VV). Sperms were present in all the ejaculates of the 25 men on semen analysis 1-2 months after SVV. Pregnancy occurred in 10 of 22 couples(45.5%) during 2-24 months of follow-up and it took 4-10 months(average 7.2 months) to get pregnant. Average operation time for the VV was 150 minutes and that for the SVV 125 minutes. Among 12 men who had sperms in the ejaculates 1-2 months after SVV, 4 revealed azoospermia 3-17 months postoperatively. Among the 4 patients with postoperative azoospermia, 2 underwent reoperation. On histopathologic examination, previously anastomsed sites showed obliterated lumen of the stent and strictures of vas proximal and/or distal to the stents due to granulation tissues. In conclusion, the SVV was not more efficacious in terms of patency and pregnancy rate than the VV.

• Clinical and Experimental Reproductive Medicine
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• 제7권1_2호
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• pp.35-38
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• 1980

Korean family planning program has been adopted as a part of the Economic Development Plan with strong national government backup. After initiation of family planning program, the increase rate of total population declined from 2.6 percent during 1955-1960, to 2.1 percent in 1960-1975, and 1.6 percent in 1979. Of course, we do not ascribe this population increase rate decline to the national family planning program alone. Other contributing factors have been changes such as growing numbers of induced absortions, a rising marriage age and economic development. Currently, 2,600 family planning workers are assigned in all myun of the country. 21 percent of the works are registered nurse, 9 percent are midwife and aid nurses occupy 70 percent (Table 1). Authorized clinics are 2,329 which composed 1,765 IUD clinics, 1,070 vasectomy clinics and 1,150 Fimale sterilization clinics (Table 2). Cumulative contraceptive services provided by government program, 1962-1974 is illustrated in Table 3. After government program in family planning has been initiated (1962-1978), estimated number of births averted by each methods was measured (Table 4). From 1962 to 1978, tendency of contraceptive acceptors is illustrated in Table 5 showed that IUD, oral pill and condom program is decreasing and in other hand, sterilization program is increasing very much. Attitude change toward family size (1965-1978), contraceptive practice and son preference are showed in Table 7, 8, respectively. Auther concluded that future program in family planning should target to the point, that smaller family size norm for maternal health should be emphasized rather than smaller size family for national development.

• 한국보건간호학회지
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• 제3권2호
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• pp.143-156
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• 1989

This study was done in order to analyze the factors which influenced the performance level of urban family planning health personnels' task. Interview survey was done during the period May, 1989. Interviewee were 130 family planning health personnels among total of 140 family planning health personnels in Seoul metropolitan city area. The internal consistency reliability was tested by Cronbach’s Alpha and the construct validity of the survey tool was tested by Factor analysis. Multiple stepwise regression analysis was used to identify major factors influenced to perform family planning health personnels' task. The results of this study were summarized as follows: 1. The internal consistency reliability was high and very significant (Cronbach's Alphs=0.8445, p<0.0000). 2. The construct validity was high and very significant. This analysis was contained 5 factors; registering and keeping of eligible woman records, health educating for FP & MCH, referral for vasectomy and tubal ligation and loop, supplying contraceptive appliances, sending moved-out eligible woman records. 3. Among a total of 15 contents of their functions recording of daily report and monthly report (76.2%), classifying and keeping of records(66.2%), registering of eligible woman records(60.85ti), distribution of leaflets and pamplets(54.6%), counselling & supervision about family planning(53.8%) were actively performed. Sending moved-out eligible woman records(60.8%), health education for community people(49.2%), referring contraceptors' side-effects were poorly performed. 4. The factors which influenced the performance level of urban family planning health personnels' function were age, marital status, educational level, certification, number of residents, number of eligible women, job car-eer, work responsibility, job satisfaction knowledge, position, cooperation of community people, cooperation of Dong Office, cooperation of Health Center. These 14 variables were able to explain job function from 21.4% of follow-up care of contraceptor to 9.1% of classifying & keeping of eligible woman records.

• Clinical and Experimental Reproductive Medicine
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• 제24권1호
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• pp.67-81
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• 1997

To determine the concentration and the physiologic role of metal components in blood plasma and seminal plasma in relation to male infertility, the concentrations of twelve metal components in blood plasma and seminal plasma including Na, Mg, K, Ca, Cr, Mn, Fe, Cu, Zn, Se, Cd and Pb were measured by atomic absorbance spectrophotometery or ion selective electrode analysis. Semen and blood samples were obtained from a total of 110 men including 70 male infertility patients, 20 vasectomized persons and 20 fertility proven volunteers visited to the Male Infertility Clinic of Pusan National University Hospital. The concentrations of Ca, Zn, Mg, Cr and Cd in control group were higher in seminal plasma than in blood plasma, and additionally Pb were higher in infertility group. The concentrations of all metal components revealed no significant difference according to patients' age, resident, occupation, sperm density, motility and hormone level in blood plasma, but some metal components including Ca, Mg, Cu, Mn, Cd and Pb revealed a significant difference according to each these parameters except patient's age in seminal plasma. The concentrations of Mn, Cd and Pb in the vasectomy persons were higher than in the infertility group III including testicular and epididymal factors, but not in blood plasma. We conclude that the quantitative changes of metal components in the seminal plasma may have effects on not only spermatogenesis and sperm function, but also contribute to diagnostic parameter according to organ specificity of the metal in the male reproduction.

• 한국인구학
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• 제7권1호
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• pp.39-77
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• 1984

It has been well known that the family pjanning programme has a great deal with declining fertility in Korea. The present study was aimed to measure the impact of family planning program me on fertility level. The specific objectives are to overview the demographic changes ncluding fertility declining and to calculate actual number of birth averted during the last 20 years. The data used for the present study was collected from various sources such as service statistics of the government, survey and research reports, and other related papers. The tool used for calculation of birth prevention was "Standard Couple Years of Protection (SCYP) Method" developed by M Gorosh. The major findings are summarized as follows ; Total of family planning acceptors from 1962 to 1982 was 9,556,153. On the basis of this data, total of averted births was calculated for eachcontraceptive Method ; 1.Oral pills, total number of acceptors from 1968 to 1982 was 2.347,259. Estimated number of birth averted was 272 ,303 .70 and the Coefficient of births prevention per acceptor turned out to be 0.114 2.Condoms, total number of birth acceptors from 1962 to 1982 was 2,874,216. Estimated number of birth averted was 220,495.30 and the coefficient of births prevention per acceptor turned out to be 0.077. 3.IUD, total number of acceptors from 1962 to 1982 was 5,101 .650. Estimated number of birth averted was 1,377,584.76 and the coefficient of births prevention per acceptor turned out to be 0.270. 4.Vasectomy, total number of acceptors from 1962 to 1982 was 556,508. Estimated number of birth averted was 626 ,128 .80 and the coefficient of births prevention per acceptor turned out to be 1.125. 5.Tubaligation total number of birth acceptors from 1972 to 1982 was 1 210,775. Estimated number of birth averted was 1 ,117 679.00 and thecoefficient of birtlts prevention per acceptor turned nut to be 0.923. 6.Abortion, total number of acceptors from 1973 to 1982 was 465,525. Estimated number of birth averted was 355 ,283 .60 and the coefficient of births prevention per acceptor turned out to be 0.763.

• Clinical and Experimental Reproductive Medicine
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• 제27권1호
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• pp.99-105
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• 2000

Objective: The objective of this study was to compare results of the macroscopic one-layer vasovasostomy with those of microscopic one-layer vasovasostomy and to analyze the change of semen parameters according to the interval of vasal obstruction. Method and Materials: Between March 1987 and December 1997, we performed 121 vasovasostomies using modified one-layer technique with loupe magnification (macroscopic vasovasostomy) or microscope. Among the 68 could be followed post-operatively, 37 patients were treated by macroscopic technique with loupe, and 31 patients by microscopic technique. We compared rates of anatomical patency (sperm count above than $10{\times}10^{6}$/ml) and pregnancy of macroscopic vasovasotomy with those of microscopic vasovasostomy. Patency and pregnancy rates according to vasal obstructive interval were also examined. Results: The patency rates of macroscopic and microscopic technique were 86.5% and 87.1%, and pregnancy rates of macroscopic and microscopic technique were 64.9% and 67.7%. There was no statistical significance between these two methods (p>0.05). The pregnancy rates and sperm motility were decreased if more than 10 years had elapsed following vasectomy (p<0.05). Conclusion: We found little difference in success rates resulting from macroscopic and microscopic vasovasostomy and the former had the advantage of reduced cost and a lower operator skill level. In post-operative semen analysis, the sperm motility was the most probable factor associated with vasal obstructive interval.