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

Restoration of functional and anatomic changes of kidney in UPJ stricture is one of most important subjects in urology. A clinical observation was made on the 28 cases (29 kidneys) of pyeloplasties for UPJ stricture from Jan. 1976 to Dec. 1981. Of them 20 cases (21 kidneys) were followed up for more than 6 months postoperatively. The following results were obtained; 1. The patients in this series were 22 males and 6 females, and 11 children and 17 adults. The left side was 3 times more frequently affected than the right. They symptoms on admission were mostly flank pain, palpable mass, and etc. 2. Preoperative status of UPJ was; UPJ stricture alone in 20, UPJ stricture with aberrant vessel in 4, UPJ stricture with stone in 3, and UPJ stricture with vesicoureteral reflux in 1 case. 3. Preoperative grade of hydronephrosis was closely related to each other in the functional and anatomic aspects of kidney. In general, children showed relatively more advanced hydronephrosis than adults and the degree of improvement of hydronephrosis postoperatively was similar to each other. 4. Anderson Hynes' method of pyeloplasty in most cases (20 kidneys) and simple pyeloureterostomy in 9 kidneys were performed, and results between both operations showed no difference. But Anderson Hynes' method was more effective in marked hydronephrosis such as giant hydronephrosis and simple pyeloureterostomy in mild hydronephrosis. 5. In cases in which UTI was present preoperatively, postoperative UTI tended more to persist than in those not complicated with preoperative UTI, and in both sides postoperative UTI mostly persisted for 2 months and disappeared within 6 months. 6. The period of nephrostomy and ureteral stent was not directly related to postoperative results, but nephrostomy without ureteral stent relatively showed good results. 7. Postoperative complication was UTI in 2, re-do pyeloplasty in 1 and secondary nephrectomy in 1 case. 8. Improvement Of hydronephrosis continued for about a year after operation. It is recommended that more careful attention should be paid for the first year and be continued to watch for consecutive 2 years.
Adult ; Child ; Constriction, Pathologic* ; Female ; Flank Pain ; Humans ; Hydronephrosis ; Kidney ; Male ; Nephrectomy ; Postoperative Complications ; Prognosis* ; Stents ; Ureter ; Urology ; Vesico-Ureteral Reflux

No abstract available.
Pleasure*

The authors attempted to examine the distribution of S-100 protein in the human fetal skin. Immunohistochemical staining(ABC rnethod) using anti-S-100 antibodies was carried out on skin specimens taken from 11 human fetuses ranging from 9 weeks to 27 weeks of estimated gestational age. At 9 weeks of estimated gestational age, the embryonic epidermis consisted of three cell layers,' the basal layer, intermediate layer and periderm, all of them being stained for S-100 protein. But after 18 weeks, the basal layer changed to be negative. Granular and cornified layer's, beginning their development at 22 weeks, were not stained for S-100 protein. Hair germ of 12 week-fetuses was recognized unstained as a bulge of basal cells. In fully differentiated structural components of the hair follicle after 18 weeks, the outer root sheath only was stained for S-100 protein whereas the inner root sheath, hair matrix cells and sebaceous glands were unstained. Eccrine gland germs developed at 12 weeks of embryonic life as undulation of the basal layer and were not, stained. And at 22 weeks, the secretory portion of the eccrine glands were formed in the dermis and stained for S-100 protein. Our present study suggests that the expression of S-100 protein can undergo considerable changes during ernbryonic differentiation in the epidermis and epidermal appendages.
Antibodies ; Dermis ; Eccrine Glands ; Epidermis ; Fetus ; Gestational Age ; Hair ; Hair Follicle ; Humans* ; S100 Proteins ; Sebaceous Glands ; Skin*

BACKGROUND: The clinical and histopathological classification of erythema multiforme(EM) and Stevens-Johnson syndrome (SJS) are difficult due to a lack of clear-cut criteria. In recent studies, some authors suggested that erythema multiforme and Stevens-Johnson syndrome were clinically and histopathologically different disorders. OBJECTIVE: The purpose of this study was to review the clinicopathological characteristics of the EM and SJS and to suggest specific findings for differentiating between the two diseases. METHODS: Fifty four patients with EM and SJS diagnosed in the Department of Dermatology of Dong-San Hcepita1 from January 1987 through to December 1996 were studied retrospectively. RESULTS: The results were summarized as follows. l. In view of causal factors, 54 cases were classified as drug-induced (n=22, 41%), herpes-induced (n=16, 30%), tuberculosis (n= 2, 3%), pneumonia (n=l, 2%), unknown (n=13, 24%). 2. Fifty four cases were clinically classified as SJS (n= 29, 54%), EM minor (n=-15, 2S%) and EM major (n = 10, 18%). 3. Erythema multiforme was found to be more related to herpes (13 of 25 cases) than to drugs (3 of 25 cases), while SJS was more related to drugs (19 of 29 cases) than to herpes (3 of 29 cases). 4. Varying degrees of necroti changes of keratinocytes were found in all the cases. The severity of degree or extent of necrosis was higher in patients with SJS than EM. 5. In demial changes, EM showed differences from SJS by having a denser and deeper lymphocytic infiltrate, and increased amount of extravasated erythrocytes. CONCLUSION: Taken together, although our findings could not provide a defmite clue to determine whether EM and SJS are different distinet entities or not, this study may be useful to differentiate and to understand the pathogenesis of EM and SJS. A prospective large scaled study should be conducted to definitively characterize these entities.
Classification ; Dermatology ; Erythema Multiforme* ; Erythema* ; Erythrocytes ; Humans ; Keratinocytes ; Necrosis ; Pneumonia ; Retrospective Studies ; Stevens-Johnson Syndrome ; Tuberculosis

No abstract available.
Abdominal Cavity* ; Abscess* ; Atrial Natriuretic Factor* ; Drainage*

BACKGROUND: Androgenetic alopecia is considered to be a genetically determined disorder influenced by age and androgen. The proportion of patients with androgenetic alopecia among the total number of patients with alopecia seems to be gradually increasing. OBJECTIVES: The purpose of this study is to evaluate the family history,clinical and endocrine status of the patients with androgenetic alopecia. METHODS: 1113 patients with androgenetic alopecia who had visited the Department of Dermatology, Yongsan Hospital, College of Medicine,Chung-Ang University during the 3 years (1995.1-1998. 12) have been examined. RESULTS: The results are summarized as follows 1) The incidence of androgenetic alopecia among the total number of alopecia patients was 64.5%, showing recent increment. 2) There were 855 male and 258 female patients being most prevalent in the third decade in both sexes and the patients younger than 30 years old with premature androgenetic alopecia,made up 70.3% of the male patients and 48.8% of the female patients with androgenetic alopecia. 3) While Norwood's type Iia was the most common and following type II, III vertex,and IV in the male AGA, Ludwig's type II was the most common in female AGA 4) There was a family history of baldness in 53.5% of first degree relatives in male patients and 51.6%in female patients. 5)Associated diseases were observed in 565(66.8%) of the male patients and 219 (84.8%) of the female patients:diseases associated with androgen such as seborrheic dermatitis and acne vulgaris occupied 39.1%. CONCLUSION: Based on our findings, those who want to treat androgenetic alopecia at the earlier ages are gradually increasing and it seems to be reasonable to believe that the age, genetic factors, localized effects of androgens on the scalp and the density and/or functional activity of androgen receptors may influence the pathogenesis of androgenetic alopecia.
Acne Vulgaris ; Alopecia* ; Androgens ; Clinical Study* ; Dermatitis, Seborrheic ; Dermatology ; Female ; Humans ; Incidence ; Male ; Receptors, Androgen ; Scalp ; Testosterone

We herein report a case of therapy-resistant dermatomyositis treated with oral prednisolone and chlorambucil combination therapy. Concurrently, she showed cervical carcinoma in situ(CIS). Initially, we started to treat her with combination oral prednisolone, intramuscular methotrexate, hydroxychloroquin, and removal of cervical CIS. However, our patient failed to respond to these regimens. Thus, we had have another combination treatment of oral prednisolone and chlorambucil. After the treatment of this combination regimen, her recalcitrant dermatomyositis improved dramatically without recurrence. There were no significant adverse side effects with chlorambucil therapy.
Chlorambucil* ; Dermatomyositis* ; Humans ; Methotrexate ; Prednisolone ; Recurrence

No abstract available.
Colon* ; Rectum*

BACKGROUND: Exogenously administered epinephrine under enflurane anesthesia was known to have mild myocardial sensitizing effect. And N2O activates the sympathetic nervous system mildly. We planed this study to confirm cadiovascular effects of clinically administered epinephrine for hemostasis under the enflurane-N2O anesthesia during tonsillectomy. METHODS: Eighty children scheduled to have tonsillectomy were selected randomly and divided into 2 groups as follows; Group E: 1:100,000 epinephrine 2ug/kg and Group EL: 1:100,000 epinephrine containing 1% lidocaine 2 g/kg. Blood pressure, heart rate, and the occurrence of arrhythmia were evaluated before injection, at injection, 1 min, 2 min, 3 min, 5 min and 10 min after injection and 1 min after operation start. RESULTS: In both groups, systolic and diastolic blood pressure and heart rate are increased. But there are no significant statistical differences in each group and between groups. One min after operation, there are significant increases in systolic and diastolic blood pressure and heart rate in both groups (p<0.05), but there is no significant difference between groups. CONCLUSION: Under the enflurane-N2O anesthesia of children, 1:100,000 epinephrine 2ug/kg used for hemostasis could be used comparatively safe without any significant hemodynamic changes. But because there is always the possibility of myocardial sensitization, careful observation is necessary during epinephrine injection under the enflurane-N2O anesthesia.
Anesthesia* ; Arrhythmias, Cardiac ; Blood Pressure ; Child ; Enflurane ; Epinephrine* ; Heart Rate ; Hemodynamics ; Hemostasis* ; Humans ; Lidocaine ; Sympathetic Nervous System ; Tonsillectomy*