A household survey was conducted to compare the patterns of morbidity and medical care utilization between medical aid beneficiaries and medical insurance beneficiaries. The study population included 285 medical aid beneficiaries that were completely surveyed and 386 medical insurance beneficiaries selected by simple random sampling from a Dong (Township) in Taegu. Well-trained surveyors mainly interviewed housewives with a structured questionnaire. The morbidity rates of acute illness during the 15-day period, were 63 per 1,000 medical aid beneficiaries and 62 per 1,000 medical insurance beneficiaries. The rates for chronic illness were 123 per 1,000 medical beneficiaries and 73 per 1,000 medical insurance beneficiaries. The most common type of acute illness in medical aid and medical insurance beneficiaries was respiratory disease in medical aid beneficiaries, musculoskeletal disease was most common, but in medical insurance beneficiaries, gastrointestinal disease was most common. The mean duration of acute illness of medical aid beneficiaries was 3.8 days and that of medical insurance beneficiaries was 6.8 days. During the one year period, mean duration of medical aid beneficiaries chronic illnesses was 11.5 months which was almost twice as long compared to medical insurance beneficiaries. Pharmacy was most preferable facility among the acute illness patient in medical aid beneficiaries, but acute cases of medical insurance beneficiaries visited the clinic most commonly. Chronic cases of both groups visited the clinic most frequently. There were some findings suggesting that much unmet need existed among the medical aid beneficiaries. In acute cases, the average number of days of medical aid users utilized medical facilities was less than medical insurance users. On the other hand, the length of medical care utilization of chronic cases was reversed. Geographical accessibility was the most important factors in utilization of medical facilities. Almost half of the study population answered the questions about source of funds on medical security correctly. Most respondents considered that the objective of medical security was affordability. The chief complaint on hospital utilization was the complicated administrative procedures. These findings suggest that there were some problems in the medical aid system, especially in the referral system.
Chronic Disease ; Daegu ; Family Characteristics ; Financial Management ; Gastrointestinal Diseases ; Hand ; Humans ; Insurance Benefits ; Insurance* ; Musculoskeletal Diseases ; Pharmacy ; Referral and Consultation ; Surveys and Questionnaires

OBJECTIVE: To evaluate the perinatal prognosis of fetuses with a single umbilical artery. METHODS: From 1992 to 1998, nineteen cases with single umbilical artery(SUA) was observed in 8,704 deliveries at Chonnam University Hospital. RESULTS: Out of nineteen fetuses, thirteen fetuses with single umbilical artery were detected by antenatal ultrasonographic examination and six fetuses were detected after birth. The male to female ratio was 0.9: 1. Congenital malformations were observed in 8 babies(42.1%) and included leg deformity, esophageal atresia, imperforated anus, ventriculomegaly, meningocele, hydronephrosis, ventricular septal defect, joint contracture, cleft lip and palate, toe anomaly, imperforated anus, kyphosis, no urethra and testis, clubfoot, patent ductus arteriosus and rnild mitral regurgitation. Among 10 cases of karyotyping analysis three cases were diagnosed as trisomy 18. Fourteen fetuses(77.8%) showed growth restriction at delivery. Antenatal obstetric complications were hydramnios(n = 3), oligohydramnios(n =2), and severe preeclampsia(n = 3). CONCLUSION: Careful ultrasonographic evaluation for the identification of a SUA is necessary because of its frequent association with congenital anomaly, growth restriction and cytogenetic abnormality.
Anal Canal ; Chromosome Aberrations ; Cleft Lip ; Clubfoot ; Congenital Abnormalities ; Contracture ; Ductus Arteriosus, Patent ; Esophageal Atresia ; Female ; Fetus ; Heart Septal Defects, Ventricular ; Humans ; Hydronephrosis ; Jeollanam-do ; Joints ; Karyotyping ; Kyphosis ; Leg ; Male ; Meningocele ; Mitral Valve Insufficiency ; Palate ; Parturition ; Prognosis* ; Single Umbilical Artery* ; Testis ; Toes ; Trisomy ; Urethra

Microphthalmic globes vary in size from nearly normal to microscopic foci of tissue that may escape clinical dectection. Most of microphthalmic eyes may be associated with other structural anomalies. Pure microphthalmos or nanophthalmos is a rare condition in which the eye is reduced in size but absence of other structural malformations. It is thought to represent arrested development after closure of the embryonic fissure(7th weeks). Most nanophthalmic cases apparently occur sporadically although familial cases are occasionally seen. The eyes are usually deeply set in small orbits with narrow palpebral fissures. The microphthalmic eyes often associated with marked hypermetropia and occasionally with macular hypoplasia and angle closure glaucoma. In most oases the vision is subnormal and nystagmus and strabismus may occur. Glaucoma usually occur in the fourth and sixth decades of life. A 16 years old Korean girl was found to have bilateral microphthalmos with absence of other ocular or systemic abnormalites.
Adolescent ; Female ; Glaucoma ; Glaucoma, Angle-Closure ; Humans ; Hyperopia ; Microphthalmos ; Orbit ; Strabismus ; United Nations

The choice of equipment for the administration of anesthesia depends to a considerable extent upon personal preference. Underlying factors must guide this choice, however. Equipment is suited to the individual patient, with especial care to avoid resistance, dead space, fatigue, and trauma, since all of these insults are easily imposed upon small patients. As we have had good experience in pediatric anesthesia with the Ambu valve and the results were satisfactory, we report with discussion of references.
Anesthesia* ; Fatigue ; Humans

OBJECT: In order to estimate the frequency and risk factors for adenomyosis. METHOD: The clinical records of 1127 women undergoing hysterectomy were retrieved in the Department of Obstetrics and Gynecology, Incheon Christian Hospital, during 7 years, from Jan. 1st 1991 to Dec. 31st 1997. RESULT: The following results were obtained. 1. Adenomyosis was found in 206 of 1127 patients(18.3%). 2. The highest incidence was 41-50 years of age group, an incidence of 55% and mean age group was 46.9 years. 3. Adenomyosis was more frequently observed in parous woman than non-parous woman, such as 8.3% and 91.7%, respectively. 4. Grossly, the size of uterus was enlarged more than 10 weeks gestational size in adenomyosis, an incidence of 62.4%. 5. Pelvic pain, dysmenorrhea and metrorrhagia were common symptom of adenomyosis, an incidence of 26.7%, 25.2% and 19.4%, respectively. 6. Myoma was the most combined disease in adenomyosis, showing the incidence of 53.4%. 7. Combined pelvic endometriosis was not observed in this study. 8. Endometrial findings of adenomyosis showed proliferative phase of normal endometrial cycle in the highest incidence, giving 72.3% of all cases. 9. Preoperative diagnostic accurracy of adenomyosis was 8.2%. CONCLUSION: This results show that deeply understanding of the common symptom and epidemiology of adenomyosis improve the preoperative diagnostic accuracy.
Adenomyosis* ; Dysmenorrhea ; Endometriosis ; Epidemiology ; Female ; Gynecology ; Humans ; Hysterectomy* ; Incheon ; Incidence ; Menstrual Cycle ; Metrorrhagia ; Myoma ; Obstetrics ; Pelvic Pain ; Risk Factors ; Uterus

The occurrence of malignancies during pregnancy has increased over the last decades. Risks of cancer surgery during pregnancy include spontaneous abortion and preterm labor. Radiation therapy especially during the first trimester generally is not offered because it poses high risks : teratogenecity, induction of childhood malignancies and hematologocal disorders. All chemotherapeutic agents used in the treatment of breast cancer are pregnancy category D, meaning that teratogenic effects have occurred in humans. We report a baby of a 33-year-old pregnant woman with breast cancer. She was treated with modified radical mastectomy one month before the pregnancy and full-dose adriamycin, cyclophosphamide and taxol since the first trimester, and 5,400 cGy of radiation therapy in the second trimester. The infant was delivered at 33+6 weeks of gestation and showed no evidence of malformation or abnormalities and developed normally until 8 months of corrected age.
Abortion, Spontaneous ; Adult ; Breast Neoplasms* ; Breast* ; Cyclophosphamide ; Doxorubicin ; Drug Therapy* ; Female ; Humans ; Infant ; Mastectomy, Modified Radical ; Obstetric Labor, Premature ; Paclitaxel ; Pregnancy ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Pregnant Women*

Keratoconus (conical cornea) is a condition, beginning about puberty and developing mainly in females, in which the apex of the cornea thins gradually and usually bilaterally. The etiology is unknown. The presenting symptom is a reduction of the patient's vision owing to the development of a high degree of irregular myopic astigmatism. Early in the course of the disease the cornea does not look conical. The diagnosis of Keratoconus is confirmed by the distorted reflex observed with a Placido's disc and abnormal keratometer readings. In more advanced stages, signs include the obvious cone-shaped cornea and indentation of the lower lid by the cornea. By slit lamp biomicroscopy, vertical lines are noted in the deep layers of the stroma: the corneal nerve fibers are increasingly visible; and in about 50% of cases a yellow or green line is present around the base of the corn (Fleischer's ring). In advanced cases Bowman's membrane and Descemet's membrane rupture. Microscopically there is thinning of the tissue spaces between the corneal lamellae, fragmentation of the basement membrane of the comeal epithelium, fibrillation of Bowman's membrane, and folds or ruptures in Descemet's membrane. Acute hydrops may occur when Descemet's membrane ruptures. This is characterized by sudden cloudiness of vision due to imbibition of aqueous in the corneal stroma. However, as Descemet's membrane regenerates, the edema subsides. Permanent scarring may result if Bowman's membrane ruptures. Acute hydrops of the cornea was developed respectively in left eye on Oct, 1976 and in right eye on Dec, 1976 in a 13 year old Korean girl with Keratoconus O.U.
Adolescent ; Astigmatism ; Basement Membrane ; Bowman Membrane ; Cicatrix ; Cornea* ; Corneal Stroma ; Descemet Membrane ; Diagnosis ; Edema* ; Epithelium ; Female ; Humans ; Keratoconus* ; Nerve Fibers ; Puberty ; Reading ; Reflex ; Rupture ; Zea mays

BACKGROUND/AIMS: Entecavir is a synthetic nucleoside analogue, cyclopentyl guanine nucleoside, which has a potent antiviral effect and the least viral breakthrough in hepatitis B virus (HBV) replication. Entecavir has been available in Korea since 2007 but there are few reports on its effects. The aim of this study was to evaluate the virological response (VR) and biochemical response (BR) to entecavir in HBV patients at 3, 6 and 9 months after treatment with entecavir. MATERIALS AND METHODS: Thirty-three chronic hepatitis B patients who took entecavir for at least 9 months were enrolled. We investigated VR and BR by retrospectively reviewing medical records. Patients who satisfied the following criteria were chosen: 1) initial alanine aminotransferase (ALT) levels = 1.5upper limit of normal (ULN) and 2) initial HBV DNA levels = 5 log10 copies/ml. We measured ALT levels every 3 months until month 9. HBV DNA was measured every 2 or 3 months by polymerase chain reaction (PCR) method. RESULTS: Most patients taking entecavir showed good BR (ALT < 40 IU/L). The BR rates were 61%, 73% and 67% at months 3, 6 and 9, respectively. VR (HBV DNA < 5 log(10) copies/ml or 2 log lower than initial HBV DNA) rates were 82%, 91% and 91% at months 3, 6 and 9, respectively. Undetectable HBV DNA (HBV DNA < 4 log(10) copies/ml) rates were 49%, 73% and 85% at months 3, 6 and 9, respectively. Two patients presented with virological breakthrough without adverse effects until month 9. CONCLUSIONS: Entecavir showed good BR and VR from month 3 and these effects continued through the 9-month observation period. This suggests that entecavir is also a good choice for the first line treatment of chronic hepatitis B (CHB). Further studies are needed to determine the long-term efficacy and drug resistance of entecavir in Korean CHB patients.
Alanine Transaminase ; DNA ; Drug Resistance ; Guanine ; Hepatitis B virus ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Humans ; Korea ; Medical Records ; Polymerase Chain Reaction ; Retrospective Studies

Epithelial cyst formed from downgrowth of the epithelium into the submucous tissue in chronic inflammatory condition is the commest type of the conjunctival cysts. The cyst frequently occur in the upper lid and fornix coniunctiva, but they also have been noted in the lower fornix or in the bulbar conjunctiva. A 11 years old Korean boy was found to have small, soft, slightly bluish mass in the lower fornix (OD) which showed an epithelial cyst of the conjunctiva histopathologically.
Child ; Conjunctiva ; Epithelium ; Humans ; Male

Clinical trials were done to obtain ifnormation on the clinical efficacy, tolerance and side effects of a new antihistarnine, Mecloprodine(Tavegyl), in various skin disordetrs. A total of 48 patients suffered from various skin disorders as urticaria, eczema etc. v ere treated with 2mg. daily for 3 days to 15 days according to state of disorders. The results are as follows. 1. Improvement was noticed in 79.2% of total patients(38/48). 2. Tavegyl was efiective in all 8 cases of acute urticaria and most cases(7/8) of urticaria factitia. 3. Among 19 cases of chronic urticaria, improvement was noticed in 13 cases(68. 49). Improvement was alsa noticed in all 6 cases of eczema. 5. Drowsiness and weakness cccurred in 6.2% of cases(3/48).
Clemastine* ; Eczema ; Humans ; Skin ; Sleep Stages ; Urticaria