The purpose of this study is to analyze degree of geographic maldistribution of physicians and changes in the distributional pattern in Korea over the years 1980-1985. In assessing the degree of distribution and in identifying changes in the distribution pattern, the Gini index of concentration was used. The geographical units selected for computation of the Gini index in this analysis are districts (Gu), cities (Si), and counties (Gun). Locational data for 1980 and 1985 were obtained from the population census data in the Economic Planning Board and regular reports of physicians in the Korean Medical Association. The rates of physician located countries to whole physicians were 10.4% in 1980 and 9.6% in 1985. In term of the ratio of physicians per 100,000 population, rural area had 9.18 physicians in 1980 and 12.95 in 1985, 7.13 general practitioner in 1980 and 7.29 in 1985, and 2.05 specialists in 1980 and 5.66 in 1985. Only specialists of general surgery and preventive medicine were distributed over 10% in county and distribution of every specialists except chest surgery in county increased in 1985, comparing with that rates of 1980. The Gini index computed to measure inequality of physician distribution in 1985 indicate as follows; physicians 0.3466, general practitioners 0.5479, and specialists 0.5092. But the Gini index for physicians and specialists fell -15.40% and -10.42% from 1980 to 1985, indication more even distribution. The changes in the Gini index over the period for specialists from 0.3639 to 0.4542 for districts, from 0.2510 to 0.1949 for cities, and 0.5303 for countries indicate distributional change of 24.81%, -22.35%, and 10.65% respectively. The Gini indices for specialists of neuro-surgery, chest surgery, plastic surgery, ophthalmology, tuberculosis, preventive medicine, and anatomical pathology in 1985 were higher than Gini indices in 1980.
Censuses ; General Practitioners ; Humans ; Korea ; Ophthalmology ; Pathology ; Preventive Medicine ; Rural Population ; Socioeconomic Factors ; Specialization ; Surgery, Plastic ; Thorax ; Tuberculosis

No abstract available.
Scoliosis*

Cervical intraepithelial neoplasia in human consist of dysplasia of various developmental stages and squamous cell carcinoma in situ of various types. These lesions can be diagnosed cytologically on cervico-vaginal smears, although the diagnostic reproducibility is limited. To obtain the objects morphologic distinction between normal squamous epithelial cell in different maturation, different stages of dysplastic cells and varieties of in situ carcinoma cells, Kontron IBAS-1 imaging analyzer was applied for the measurement of nuclear and cytoplasmic areas of each categorised cells. The followings are results obtained: 1) Nuclear and cytoplasmic areas of superfical (36.9 micrometer2, 2319.9 micrometer2) intermedicate (45.7 micrometer2, 2989.7 micrometer2) and parabasal cells (50.8 micrometer2, 432.7 micrometer2) of normal squamous epithelium origin are mostly distinctive between cell types. However, cytoplasmic areas of both superficial and intermediate cells and nuclear areas of both intermediate and parabasal cells are not significantly different. 2) Normal squamous cells and various dysplastic cells show obvious difference in their nuclear and cytoplasmic areas, while difference between cytoplasmic areas of both parabasal (432.7 micrometer2) and severe dysplastic cells (409.7 micrometer2) are not statistically significant. 3) No statistical difference is observed in between nuclear areas of both moderate dysplastic (112.3 micrometer2) and severe dysplastic cell (117.6 micrometer2). 4) Varieties of carcinoma in situ cells and severe dysplastic cells are in difference in their nuclear and cytoplastic areas, whereas nuclear areas from both in situ carcinoma cells (95.3 micrometer2) of large cell type and severe dysplasia (117.6 micrometer2) are not distinctive. The results lead the author to consider that the morphometric analysis for various parameters of cell constituents are of value in making objective distinction between cells from cervical intraepithelial neoplasia in human.
Humans

At first, we review a sample size estimation method for log-rank test in survival analysis. Although it is widely used these days, it has a weakness for practical use. We propose a modification method to avoid the weakness.
Sample Size*

Tamoxifen is a nonsteroidal triphenylethylene delivative that has been widely used in the treatment of breast cancer. tamoxifen is indicated for the adjuvant treatment of breast cancer in women following total mastectomy or segmental mastectomy, breast irradiation and chemotherapy. tamoxifen has been shown to have significant benificial effect in the treatment of breast cancer patient as hormonal therapy. However ,there is mounting evidence that tamoxifen may affect other hormon sensitive organs, including the uterus and ovaries. An increased risk of endometrial polyps, endometrial hyperplasia and adenocarcinoma has been reported in tamoxifen treated women. We have met cases of endometrial polyp and endocervical polyp which were associated with tamoxifen use, after modified radical mastectomy for infilterating ductal carcinoma of breast . So we report these cases with the brief review of literatures.
Adenocarcinoma ; Breast ; Breast Neoplasms ; Carcinoma, Ductal ; Drug Therapy ; Endometrial Hyperplasia ; Female ; Humans ; Mastectomy, Modified Radical ; Mastectomy, Segmental ; Mastectomy, Simple ; Ovary ; Polyps* ; Tamoxifen* ; Uterus

Purpose: To analyze the causes and to prevent dislocations of the hip joint that occur in patients who underwent revisions of total hip arthroplasties by changing only the polyethylene liners and femoral heads, subsequent to primary total hip arthroplasties. Materials and Methods: We evaluated 28 patients who underwent acetabular component revisions of total hip arthroplasties subsequent to primary total hip arthroplasties. The average age of the patients was 55 years old and all 28 patients had operations through the posterolateral approach. In 17 of the cases, the acetabular cups, polyethylene liners, and femoral heads were changed; in 10 cases, just the polyethylene liners and femoral heads were changed; and in 1 case, only the polyethylene liner was changed. Results: We observed 7 cases of hip dislocations that occurred among a total of 28 cases after revisions of total hip arthroplasties. In all 7 cases, the polyethylene liners and femoral heads were changed, but not the acetabular cups. In additional, in all 7 cases of dislocation, the patients were non-compliant and started weight-bearing prematurely after revisions of the total hip arthroplasties Conclusion: We observed new dislocations in the 7 cases in which the polyethylene liners and femoral heads were changed. The main reasons were inadequate soft tissue tension and hip joint laxity. Therefore, it is necessary to increase the neck length, use elevated rim polyethylene liners, readjust the acetabular cups to their optimal positions, and apply hip abduction braces to patients early after revision of total hip arthroplasties in order to lessen the danger of dislocations.
Acetabulum* ; Arthroplasty ; Braces ; Dislocations* ; Head ; Hip ; Hip Dislocation ; Hip Joint ; Humans ; Neck ; Polyethylene ; Risk Factors* ; Weight-Bearing

A total of 72 cases of internal biliary drainage procedure has been done percutaneously at Departement ofRadilogy, Seoul Natinal Universtiy Hospital for recent 4 and half years since August 1981. Five different types ofinternal drainage including endoprosthesis were applied to various conditions with different obstruction levels.The different method of procedure in each type of internal drainage was described and the results were analysed.1. Among the clinical diagnosis in 72 cases, carcinoma of bile duct was in 37 cases as the most frequent one. Thenext was pancreas head carcinoma in 16 cases, followed by metastatic carcinoma and other disease. 2. Type Iinternal drainage, classical internal and external type with distal end in duodenum, was applied in 43 cases asthe most comon one. Type II, modification of type I with distal end in CBD, was applied in 17 cases. Type III,endoprosthesis distal end into duodenum, was applied in 7 cases. Type IV, endoprosthesis just across theobstruction in bile duct, was applied in 2 cases, Type V, combined type of any internal drainage with externaldrainage, was applied in 3 cases. 3. According to various obstruction level, prefered type could be selected. Forproximal obstruction type II and IV were preferred and for distal obstruction type III was chosen. However, type Icould be applied in any situation. 4. Early complication occurred in 9 cases(12.5%). Clinical imporvement withdecrease in bilirubin level was observed 17 of 21 cases in which follow-up data was available over 2 months. 5.Though the experience with those 72 cases it is recommended that appropriate type of internal biliary drainageshould be selected according to prognosis, obstruction level and clinical findings of each patient.
Bile Ducts ; Bilirubin ; Diagnosis ; Drainage ; Duodenum ; Follow-Up Studies ; Head ; Humans ; Methods ; Pancreas ; Prognosis ; Seoul

No abstract available.
Apoptosis* ; Caspase 3* ; Endothelial Cells* ; Perforin* ; Vibrio vulnificus* ; Vibrio*

No abstract available.

No abstract available.
Leg* ; Skin*