• The Journal of Korean Medicine
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• v.38 no.1
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• pp.125-133
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• 2017

Objectives: The purpose of this study is to investigate the correlation between postpartium joint diseases and maternal season. So it can prevent postpartum joint diseases and provide fundamental data about postpartum health care. Methods: The subject of the present study was 219 women (142 women who completed vaginal delivery and 77 women who delivered by cesarean section) who completed labor between November 1, 2013 and November 31, 2016, at the clinic of OB&GYN. They have been taking good care of their health at postpartum clinic in Andong Woori Women Hospital. We investigated the various symptoms and situation which occurred from the moment of hospital to postnatal admission health care period and oriental doctor examined the patients. We classified the symptoms by the age of patients, the method of delivery, the term of pregnancy, the body weight of infant, the weight change of mother and the way of feeding. Through data analysis, we investigated the correlation between maternal season and postpartum joint diseases. Results: Postpartum joint diseases were the most common among all symptoms after childbirth. Postpartum joint diseases were classified into shoulder area pain and low back pain. In low back pain, there was no significant difference between maternal season and postpartum joint diseases. In shoulder, wrist and finger pain, pain was the most severe at winter delivery. It was the most painful in winter, followed by autumn, spring and summer. Conclusion: There was a close correlation between postpartum joint disease manifestations and maternal season.

• The Journal of Pediatrics of Korean Medicine
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• v.15 no.2
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• pp.31-41
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• 2001

We studied 100 neonates to enter a Dongguk University Oriental Hospital Postpartum Care Center, during 9 months from February 10. 2001 to November 4. 2001. The conclusion is following. 1. Newborn sex ratio was 1.70. 2. Delivery method : Normal vaginal delivery was 66 and cesarean section was 34. 3. Gestation age : Premature infants less than 37 weeks were 2 term infants from 37 to 41 weeks were 98 and post-term infants 42 or more weeks were zero. 4. Period between birth and admission : First to fifth day was 66 sixth to tenth day was 32 and eleventh or more day was 2. 5. Period of admission : 1 to 7 days were 8. 8 to 14 days were 65. 15 to 21 days were 23. and 22 to 28 days were 4. 6. Weight : Birth weight less than 2500g was 3. 2500 to 3999g was 92. and 4000g or more was 5. 7. Height : Zero week after birth the average height was 48.8cm, one week after birth was 50.0cm, two weeks after birth was 51.8cm, three weeks after birth was 53.2cm, four weeks after birth was 54.5cm. 8. Head circumference : Zero week after birth the average head circumference was 34.6cm, one week after birth was 35.3cm, two weeks after birth was 35.7cm, three weeks after birth was 36.3cm, four weeks after birth was 36.8cm. 9. Chest circumference : Zero week after birth the average chest circumference was 33.2cm, one week after birth was 33.5cm, two weeks after birth was 34.4cm, three weeks after birth was 35.1cm, four weeks after birth was 36.6cm. 10. Feeding : There was not breast feeding, artificial feeding was 8, and mixing feeding was 92. 11. Jaundice : Physiologic jaundice was 10, pathologic jaundice was 1.

• Advances in pediatric surgery
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• v.7 no.1
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• pp.54-58
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• 2001

Slide tracheoplasty. as a treatment for congenital tracheal stenosis, has been recently reported to have good results and quite a number of advantages as compared with conventional tracheoplasties. The aim of this study is to report a new surgical technique modified from the slide tracheoplasty. "the slide cricotracheoplasty" for the congenital cricotracheal stenosis. A girl was born by Cesarean section and the diagnosis of esophageal atresia (Gross type C) and cricotracheal stenosis (30 % of total length of trachea) was established. Esophageal atresia was successfully corrected at the 8th day of life. At the 31st day of life, corrective surgery for congenital cricotracheal stenosis. the slide cricotracheoplasty. was performed with success. Slide cricotracheoplasty is almost the same procedure as slide tracheoplasty except for two technical features. First the cricoid cartilage was split on its anterior surface. Second the split cricoid cartilage was fixed to pre vertebral fascia to maintain enough space to accommodate the sliding caudal segment of trachea because of the stiffness of the cricoid cartilage. We believe that the sliding cricotracheoplasty is a new surgical technique for congenital cricotracheal stenosis that has similar results and advantages as the sliding tracheoplasty.

• Asian-Australasian Journal of Animal Sciences
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• v.17 no.12
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• pp.1641-1646
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• 2004

The objective of this study was to generate transgenic mice expressing human resistin gene by using the tetraploidembryonic stem (ES) cell complementation method. Human resistin gene was amplified from human fetal liver cDNA library by PCR, cloned into $pCR^{(R)}$ 2.1 $TOPO^{(R)}$ vector and constructed in pCMV-Tag4C vector. Mammalian expression plasmid containing human resistin was transfected into D3-GL ES cells by Lipofectamine 2,000, and then after 10-12 days of transfection, the human resistin-expressing cells were selected with G418. In order to produce tetraploid embryos, blastomeres of diploid embryos at the two-cell stage were fused with two times of electric pulse using 60 V 30 $\mu$sec (fusion rate: 2,114/2,256, 93.5%) and cultured up to the blastocyst stage (development rate: 1,862/2,114, 94.6%). The selected 15-20 ES cells were injected into tetraploid blastocysts, and then transferred into the uteri of E 2.5 d pseudopregnant recipient mice. To investigate the gestation progress, two E 19.5 mused fetuses were recovered by Cesarean section of which one fetus was confirmed to contain human resistin gene by genomic DNA-PCR. Therefore, our findings demonstrate that tetraploid-ES mouse technology can be considered as a useful tool to produce transgenic mice for the rapid analysis of gene function in vivo.

• The Korean Nurse
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• v.33 no.3
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• pp.79-91
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• 1994

The purpose of this study was to identify the meaningful nursing diagnosis in maternity unit and to suggest formally the basal data to the nursing service with scientific approach. The subject for this paper were 64 patients who admitted to Chung Ang University Hospital, Located in Seoul, from Mar. 10, to July 21, 1993. The results were as follows: 1. The number of nursing diagnosis from 64 patients were 892 and average number of nursing diagnosis per patient was 13.9. 2. Applying the division of nursing diagnosis to Roy's Adaptation Model, determined nursing diagnosis from the 64 patients were 621 (69.6%) in physiological adaptation mode and (Comfort, altered r/t), (Injury, potential for r/t), (Infection, potential for r/t), (Bowel elimination, altered patterns r/t), (Breathing pattern, ineffective r/t), (Nutrition, altered r/t less than body requirement) in order, and 139 (15.6%) in role function mode, (Self care deficit r/t), (Knowledge deficit r/t), (Mobility, impaired physical r/t) in order, 122 (13.7%) in interdependence adaptation mode, (Anxiety r/t), (Family Process, altered r/t) in order, 10(1.1%) in self concept adaptation mode, (Powerlessness r/t), (Grieving, dysfunctional r/t) in order. 3. Nursing diagnosis in maternity unit by the medical diagnosis, the average hospital dates were 3.8 days in normal delivery and majority of used nursing diagnosis, (Comfort, altered r/t) 64.6%, (Self care deficit r/t) 13.6% in order, and the average hospital dates were 9.6 days in cesarean section delivery and majority of used nursing diagnosis, (Comfort, altered r/t) 51.6%, (Self care deficit r/t) 15.2%, (Infection, potential for r/t) 9.9%, (Injury, potential "for r/t) 8.1%, (Anxiety r/t) 5.0%, (Mobility, impaired physical r/t) 3.3% in order, and the average hospital dates were 15.8days in preterm labor and majority of used nursing diagnosis, (Comfort, altered r/ t), (Anxiety r/t), (Injury, potential for r/t) in order, and the average short-term hospital dates were 2.5days, long-term hospital dates were 11.5days in gynecologic diseases and majority of used nursing diagnosis, (Comfort, altered r/t). (Self care deficit r/t), (Injury, potential for r/t), (Infection, potential for r/t) in order.

• Archives of Plastic Surgery
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• v.40 no.1
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• pp.28-35
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• 2013

Background If a chronically infected abdominal wound develops, complications such as peritonitis and an abdominal wall defect could occur. This could prolong the patient's hospital stay and increase the possibility of re-operation or another infection as well. For this reason, a solution for infection control is necessary. In this study, surgery using a rectus abdominis muscle myofascial splitting flap was performed on an abdominal wall defect. Methods From 2009 to 2012, 5 patients who underwent surgery due to ovarian rupture, cesarean section, or uterine myoma were chosen. In each case, during the first week after operation, the wound showed signs of infection. Surgery was chosen because the wounds did not resolve with dressing. Debridement was performed along the previous operation wound and dissection of the skin was performed to separate the skin and subcutaneous tissue from the attenuated rectus muscle and Scarpa's fascial layers. Once the anterior rectus sheath and muscle were adequately mobilized, the fascia and muscle flap were advanced medially so that the skin defect could be covered for reconstruction. Results Upon 3-week follow-up after a rectus abdominis myofascial splitting flap operation, no major complication occurred. In addition, all of the patients showed satisfaction in terms of function and esthetics at 3 to 6 months post-surgery. Conclusions Using a rectus abdominis myofascial splitting flap has many esthetic and functional benefits over previous methods of abdominal defect treatment, and notably, it enabled infection control by reconstruction using muscle.

• Health Policy and Management
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• v.8 no.1
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• pp.1-14
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• 1998

Analysis of practice variations has been one of important issues in trying to contain costs as well as to manage quality in health care. This study was conducted to provide statistical model for analysing variations in inpatient costs by type of hospitals. Four K-DRGs including Cesarean section, appendectomy, cataract extraction, and pediatric pneumonia with CC class 0 were selected, and means and dispersions of inpatient procedure and operation costs were simultaneously compared between type of hospitals. The results indicated that joint modelling of means and dispersions by gamma distribution was a very useful analytic tool for identifying factors which might have relationship with variations in inpatient costs. This model can be expanded to test the significance of several independent variables in analysing cost variations. In surgical conditions, means and unit variations of procedure and operation costs showed consistent pattern which was tertiarty hospital, general hospital, and hospital in descending order. Different findings were identified in pediatric pneumonia, from which mean and unit variation of procedure and operation cost was the highest in general hospital. The practical implication of this difference could not be drawn from this study. It will be done by further sophisticated researches. In order to develop health policy for cost containment and quality management in Korea, it is essential to find out manageable factors affecting variations in practice patterns which include characteristics of population, providers, regions, and so on. The statistical model presented in this study will give health services researchers useful insights for future investigations in analysing cost variations.

• Journal of Preventive Medicine and Public Health
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• v.36 no.2
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• pp.147-152
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• 2003

Objectives : To develop a Diagnosis-Related Group (DRG) fraud candidate detection method, using data mining techniques, and to examine the efficiency of the developed method. Methods ; The Study included 79,790 DRGs and their related claims of 8 disease groups (Lens procedures, with or without, vitrectomy, tonsillectomy and/or adenoidectomy only, appendectomy, Cesarean section, vaginal delivery, anal and/or perianal procedures, inguinal and/or femoral hernia procedures, uterine and/or adnexa procedures for nonmalignancy), which were examined manually during a 32 months period. To construct an optimal prediction model, 38 variables were applied, and the correction rate and lift value of 3 models (decision tree, logistic regression, neural network) compared. The analyses were peformed separately by disease group. Results : The correction rates of the developed method, using data mining techniques, were 15.4 to 81.9%, according to disease groups, with an overall correction rate of 60.7%. The lift values were 1.9 to 7.3 according to disease groups, with an overall lift value of 4.1. Conclusions : The above findings suggested that the applying of data mining techniques is necessary to improve the efficiency of DRG fraud candidate detection.

• Archives of Plastic Surgery
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• v.41 no.5
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• pp.542-547
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• 2014

Background Abdominal wall free flaps are used most frequently in autologous breast reconstruction, and these flaps require intact and robust deep inferior epigastric perforator (DIEP) vessels. Pfannenstiel incisions are often present during preoperative visits for breast reconstruction and could potentially signal compromised blood supply to the lower abdominal wall. In this study, we compared the number of DIEP vessels between patients with and without Pfannenstiel incisions undergoing autologous breast reconstruction. Methods A retrospective review of medical records was performed for patients with (study) and without (control) Pfannelstiel incisions (n=34 for each group) between June 2010 and July 2013. In addition to patient demographics, number of caesarian sections, and outcomes of free flap reconstruction, abdominal wall vasculature was compared using the preoperative computed tomography angiographic data between the groups. For each patient, vessels measuring greater than 1 mm were counted and divided into four sections of the lower abdominal wall. Results The mean number of perforator vessels was 10.6 in the study group and 11.4 in the control group, which was not statistically different (P=0.575). Pfannenstiel incisions with history of repeat caesarian sections were not associated with decreased number of perforator vessels. Conclusions Pfannenstiel scars are associated with neither a change in the number of DIEP vessels nor decreased viability of a free transverse rectus abdominis myocutaneous and DIEP flap. Lower abdominal free flaps based on DIEP vessels appear safe even in patients who have had multiple caesarian sections through Pfannenstiel incisions.

• Clinical and Experimental Reproductive Medicine
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• v.8 no.1
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• pp.23-34
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• 1981

In order to study twin pregnancies, a retrospective survey was carried out in Yonsei University, Severance Hospital. Twin deliveries during 1967-1976 numbered altogether 264, and their relative frequency was 1.30%. Clinical palpation in addition to auscultation and roentgenologic technique had been used in the twin diagnosis. The diagnosis was made prior to delivery in 93.18% of the cases. The deliveries took place in the 37.26th (S.D. 3.95) gestational weeks on an average. The mean weights of the infants were-A (first baby) 2416.03g. (S.D. 802.61), and B (second baby) 2299.81g. (S.D. 190.31). The most common manner of twin delivery was spontaneous vaginal delivery. Cesarean section was done in 14.39%, of which the most common indication was hypotonic uterine dysfunction (34.21 %). Low one minute Apgar scores occured more often in B twins than among A twins. Breech delivery gave low one minute Apgar scores more often than did spontaneous vertex delivery in both twins. Full term twins and infants weighing more than 2500g. had fewer low one minute Apgar scores than the preterm infants and those with low birth weight. Perinatal mortality (PNM) in the total series was 14.77% (A 12.50% and B17.05%). The most common cause of perinatal mortality was prematurity in 44.87%. The worst outcome was recorded for the age groups 15-19 and ${\geqq}$40, in which perinatal mortality were 50.00%, respectively. The perinatal mortality of both A and B infants was lowest in the group diagnosed early during antenatal care before delivery. On the basis of our findings, we wish to emphasize particularly the importance of the early diagnosis of twins.