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A Theoretical Review on the Natural Family Planning Method (자연적 가족계획 방법에 대한 이론적 고찰)

  • Park, Shin-Ae
    • Research in Community and Public Health Nursing
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    • v.7 no.2
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    • pp.410-419
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    • 1996
  • This study was reviewed from 1000 articles related to family planning from 1970 to 1990 and 20 articles associated with natural family planning from 1980 until the present. The purpose of natural family planning(NFP) is to identify the time ovulation of women themselves, to have intercourse with periodic abstinence, and to deliver a healthy child. The ultimate goal of NFP is to promote the family's health. The NFP method is described as periodic abstinence of intercourse to avoid pregnancy by identifying the ovulation time in the menstration cycle. Clinical symptoms and signs of reflection underlying changes in Estrogen and Progesterone are the change of basal body temperature, the change of cervical mucus and cervix, abdominal pain and breast tenderness. The types of NFP are the calender rthythm method, basal body temperature methods, cervical mucus method, symptothermal method, cyclo-thermal method and home based ovulation test kits. Recently the cyclo-thermal method involved. It is calendar rhythm method applied to B.B.T. For the cervical mucus method, when the estrogen level in the blood concentration is increased, the mucus begins to excrete, the amount of moist mucus increases while the mucus is clear, slippery, and smooth. For 3 days, this timing can be considered contraception. Fertility is at a maximum on the day mucus appears, abstinence for 3 days is a type of contraception. Sexual intercourse on a maximum day of mucus maximizes pregnancy potential. But, the contraception depends on the practice of a perfect rule. For basal body temperature methods, at ovulation time, the temperature increases $0.2^{\circ}C-0.5^{\circ}C$. Through the review of literature a high temperature above $0.2^{\circ}C$ for 3 days indicates that the previous 6 day period was ovulation and fertilization. The Symptothermal method is used to determine the prediction of ovulation through the observation of mucus excretion, high temperature, the change of cervical mucus, low abdominal pain, vaginal discharge, and breast change. Home based ovulation test kits are cervico-vaginal fluid aspiration, test a digital electric thermometer, body fluid(blood, saliva, urine) test kits, They are on the market. However, research on the contraception method is still in progress. For pregnancy it is still too early to use home based ovulation test kits because of deficit of reliability and simplicity more research on the technology is needed. It is suggested that NFP methods be included in nursing curriculum in order to educate NFP users how to effectively use NFP methods. Furthermore, this study has implications for the dissemination of NFP methods in terms of Korean policies of family planning and the support of community welfare agences.

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Reconstruction of Congenital Absence of Vagina using Vulvoperineal Fasciocutaneous Flap: A Case Report (외음회음 근막피부피판을 이용한 선천성 질결여증의 재건례)

  • Kim, Mi-Sun;Kim, Chul-Han;Lee, Yong-Sek;Kang, Sang-Gue;Tark, Min-Sung
    • Archives of Plastic Surgery
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    • v.37 no.6
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    • pp.831-834
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    • 2010
  • Purpose: Congenital absence of the vagina is a rare case. It occurs as a result of Mullerian duct aplasia or complete androgen insensitivity syndrome. The reconstructive modality includes skin graft, use of intestine and various methods of flap. We report a patient who underwent vulvoperineal fasciocutaneous flap to reconstruct congenital absence of the vagina, while the external genitalia and ovaries are normal. Methods: A 26-year-old woman presented with vaginal agenesis. Under general anesthesia, a U-shaped incision was made between the urethral meatus and the anus. The new vaginal pocket was created up to the level of the peritoneal reflection between the urinary structures and the rectum. Next, the vulvoperineal fasciocutaneous flaps were designed in a rectangular fashion. Flap elevation was begun at the lateral margin which the adductor longus fascia was incised and elevated, and the superficial perineal neurovascular pedicle was invested by the fascial layer. The medial border was then elevated. A subcutaneous tunnel was created beneath the inferior of the labia to rotate the flaps. The left vulvoperineal flap was rotated counterclockwise and the right was rotated clockwise. The neovaginal pouch was formed by approximating the medial and lateral borders. The tubed neovagina was then transposed into the cavity. Results: In 3 weeks, the vaginal canal remained supple After 6 weeks, the physical examination showed normalappearing labia majora and perineum with an adequate vaginal depth. A year after the operation, the patient had a 7 cm vagina of sufficient width with no evidence of contractures nor fibrous scar formation. The patient was sexually active without difficulty. Conclusion: Although many methods were described for reconstruction of vaginal absence, there is not a method yet to be approved as a perfect solution. We used the vulvoperineal fasciocutaneous flap to reconstruct a neovagina. This method had a following merits: a single-stage procedure, excellent flap reliability, the potential for normal function, minimal donor site morbidity and no need for subsequent dilatation, stents, or obturators. We thought that this operation has a good anatomic and functional results for reconstruction of the vagina.

Structured Assessment to Evaluate a Family Medicine Clerkship Program (가정의학 임상실습과정에 대한 구조화된 평가)

  • Park, Eun Ju;Lee, Sang Yeoup;Im, Sun Ju;Yune, So Jung;Kam, Beesung;Baek, Sun Yong;Kim, Yun-Jin;Woo, Jae Seok;Lee, Jeong-Gyu;Jeong, Dong-Wook;Cho, Young-Hye;Yi, Yu-Hyeon;Tak, Young Jin
    • Korean Medical Education Review
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    • v.19 no.1
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    • pp.47-55
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    • 2017
  • This study was conducted to analyze the strengths and weaknesses of a 3-week family medicine clerkship program based on the results of an online survey taken by the students (N=127) and a structured interview with a focus group (n=10), aimed to improve the quality of the clerkship program. The online survey contained questions pertaining to goals, schedule, contents, arrangement, atmosphere, environment, evaluation, and satisfaction regarding the clerkship. The focus group interview addressed the schedule and achievements of the program. Scores were reported on a 5-point Likert scale. Most students were highly satisfied with the overall quality of the clerkship. The structured interview results showed that 97.6% of the clerkship program was executed according to the schedule. The focus group reported a perfect score of 5 points on several measures including: accomplishment of the educational goals of the family medicine clerkship, providing many chances to obtain medical histories and perform physical examinations on real patients, experience with various symptoms and diseases, positive attitudes of faculty members when teaching, notification of the guidelines for evaluation beforehand, well-constructed and effective clerkship schedule, and reflection of student feedback. However, the focus group gave low scores on: support for health accidents of students, access to patient information, enough opportunities to practice clinical skills, appropriate rest facilities for students, and fairness of clerkship evaluation process. In conclusion, the structured evaluation performed after the 3-week clerkship program motivated students and helped them ensure an efficient clerkship. This structured evaluation also suggested basic data to make the professor who is subject of the assessment. This study shows that structured assessment is an effective method which can be used to improve the quality of clerkships.

Chimooite, a New Mineral from Dongnam Mine, Korea (동남광산에서 발견된 신종광물 Zn­란시아이트(치무석))

  • 최헌수;김수진
    • Journal of the Mineralogical Society of Korea
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    • v.16 no.4
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    • pp.333-339
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    • 2003
  • A new mineral, Zn analogue of rancieite (Chimooite), has been discovered at the Dongnam mine, Korea. It occurs as compact subparallel fine­grained flaky or acicular aggregates in the massive manganese oxide ores which were formed by supergene oxidation of rhodochrosite­sulfide ores in the hydrothermal veins trending NS­N25E and cutting the Pungchon limestone of the Cambrian age. The flakes of chimooite are 0.2 mm for the largest one, but usually less than 0.05 mm. The acicular crystals are elongated parallel to and flattened on (001). This mineral shows gradation to rancieite constituting its marginal part, thus both minerals are found in one and the same flake. Color is bluish black, with dull luster and brown streak in globular or massive aggregates. Cleavage is perfect in one direction. The hardness ranges from 2.5 to 4. Under reflected light it is anisotropic and bireflectant. It shows reddish brown internal reflection. Chemical analyses of different parts of both minerals suggest that rancieite and chimooite constitute a continuous solid solution series by cationic substitution. The empirical chemical formula for chimooite has been calculated following the general formula, $R_2_{x}$ M $n^{4+}$$_{9­x}$ $O_{18}$ $.$n$H_2O$ for the 7 $\AA$ phyllomanganate minerals, where x varies from 0.81 to 1.28 in so far studied samples, thus averaging to 1.0. Therefore, the formula of Zn­rancieite is close to the well­known strochiometric formula $_Mn_4^{4+}$ $O_{9}$ $.$4$H_2O$. The mineral has the formula (Z $n_{0.78}$N $a_{0.15}$C $a_{0.08}$M $g_{0.01}$ $K_{0.01}$)(M $n^{4+}$$_{3.98}$F $e^{3+}$$_{0.02}$)$_{4.00}$ $O_{9}$ $.$3.85$H_2O$, thus the ideal formula is (Zn,Ca)M $n^{4+}$$_4$ $O_{9}$ $.$3.85$H_2O$. The mineral has a hexagonal unit ceil with a=2.840 $\AA$ c=7.486 $\AA$ and a : c = 1 : 2.636. The DTA curve shows endothermic peaks at 65, 180, 690 and 102$0^{\circ}C$. The IR absorption spectrum shows absorption bands at 445, 500, 1630 and 3400 c $m^{1}$. The mineral name Chimooite has been named in honour of late Prof, Chi Moo Son of Seoul National University.ity.versity.ity.y.

Janggunite, a New Mineral from the Janggun Mine, Bonghwa, Korea (경북(慶北) 봉화군(奉化郡) 장군광산산(將軍鑛山産) 신종광물(新種鑛物) 장군석(將軍石)에 대(對)한 광물학적(鑛物學的) 연구(硏究))

  • Kim, Soo Jin
    • Economic and Environmental Geology
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    • v.8 no.3
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    • pp.117-124
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    • 1975
  • Wet chemical analysis (for $MnO_2$, MnO, and $H_2O$(+)) and electron microprobe analysis (for $Fe_2O_3$ and PbO) give $MnO_2$ 74.91, MnO 11.33, $Fe_2O_3$ (total Fe) 4.19, PbO 0.03, $H_2O$ (+) 9.46, sum 99.92%. 'Available oxygen determined by oxalate titration method is allotted to $MnO_2$ from total Mn, and the remaining Mn is calculated as MnO. Traces of Ba, Ca, Mg, K, Cu, Zn, and Al were found. Li and Na were not found. The existence of (OH) is verified from the infrared absorption spectra. The analysis corresponds to the formula $Mn^{4+}{_{4.85}}(Mn^{2+}{_{0.90}}Fe^{3+}{_{0.30}})_{1.20}O_{8.09}(OH)_{5.91}$, on the basis of O=14, 'or ideally $Mn^{4+}{_{5-x}}(Mn^{2+},Fe^{3+})_{1+x}O_{8}(OH)_{6}$ ($x{\approx}0.2$). X-ray single crystal study could not be made because of the distortion of single crystals. But the x-ray powder pattern is satisfactorily indexed by an orthorhombic cell with a 9.324, b 14.05, c $7.956{\AA}$., Z=4. The indexed powder diffraction lines are 9.34(s) (100), 7.09(s) (020), 4.62(m) (200, 121), 4.17(m) (130), 3.547(s) (112), 3.212(vw) (041), 3.101(s) (300), 2.597(w) (013), 2.469(m) (331), 2.214(vw)(420), 2.098(vw) (260), 2.014 (vw) (402), 1.863(w) (500), 1.664(w) (314), 1.554(vw) (600), 1.525(m) (601), 1.405(m) (0.10.0). DTA curve shows the endothermic peaks at $250-370^{\circ}C$ and $955^{\circ}C$. The former is due to the dehydration: and oxidation forming$(Mn,\;Fe)_2O_3$(cubic, a $9.417{\AA}$), and the latter is interpreted as the formation of a hausmannite-type oxide (tetragonal, a 5.76, c $9.51{\AA}$) from $(Mn,\;Fe)_2O_3$. Infrared absorption spectral curve shows Mn-O stretching vibrations at $515cm^{-1}$ and $545cm^{-1}$, O-H bending vibration at $1025cm^{-1}$ and O-H stretching vibration at $3225cm^{-1}$. Opaque. Reflectance 13-15%. Bireflectance distinct in air and strong in oil. Reflection pleochroism changes from whitish to light grey. Between crossed nicols, color changes from yellowish brown with bluish tint to grey in air and yellowish brown to grey through bluish brown in oil. No internal reflections. Etching reactions: HCl(conc.) and $H_2SO_4+H_2O_2$-grey tarnish; $SnCl_2$(sat.)-dark color; $HNO_3$(conc.)-grey color; $H_2O_2$-tarnish with effervescence. It is black in color. Luster dull. Cleavage one direction perfect. Streak brownish black to dark brown. H. (Mohs) 2-3, very fragile. Specific gravity 3.59(obs.), 3.57(calc.). It occurs as radiating groups of flakes, flower-like aggregates, colloform bands, dendritic or arborescent masses composed of fine grains in the cementation zone of the supergene manganese oxide deposits of the Janggun mine, Bonghwa-gun, southeastern Korea. Associated minerals are calcite, nsutite, todorokite, and some undetermined manganese dioxide minerals. The name is for the mine, the first locality. The mineral and name were approved before publication by the Commission on New Minerals and Mineral Names, I.M.A.

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