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

PURPOSE: Malignant disease of the anus is rare. Abdominoperineal resection was formerly considered to be the treatment of choice. But, in recent, less ablative and more effective combined therapeutic modalities have been developed. METHODS: we analyzed 33 patients who were diagnosed and treated as anal cancers at the Department of Surgery, Gospel Hospital, Kosin Medical Collage, from July 1, 1988 to Nov. 30, 1997. RESULTS: The ratio of male to female was 1.4:1 and mean age was 56.7 years old. Twenty-two (84.8%) of these cancers were located in the anal canal and 5 (15.2%) in the anal margin. Three main histologic types of the anal cancers were identified: squamous cell carcinoma was the most common lesion, accounted for 17 cases (51.1%), adenocarcinoma accounted for 8 cases (24.2%), malignant melanoma accounted for 8 cases (24.2%). The overall 3-year survival rate and 5-year survival rate of anal cancer were 54.1%, 41.7%. Eleven patients with squamous cell carcinoma were treated curatively: 6 patients were treated with chemoradiotherapy, 3 patients with abdominoperineal resection, one patient with chemoradiotherapy and abdominoperineal resection, one patient with local excision. CONCLUSION: In survival rate, there were no significant differences between chemoradiotherapy group and surgical treatment group. In squamous cell carcinomas, chemoradiotherapy had anal sparing benefit without loss of survival. On univariate analysis, T, N, type of treatment, histologic type had no statistical significances on survival. On multivariate analysis, location of lesion and distant metastasis had statistical significances.
Adenocarcinoma ; Anal Canal ; Anus Neoplasms* ; Carcinoma, Squamous Cell ; Chemoradiotherapy ; Female ; Humans ; Male ; Melanoma ; Multivariate Analysis ; Neoplasm Metastasis ; Survival Rate

No abstract available.
Flail Chest*

No abstract available.
Peripheral Nerves* ; Regeneration*

No abstract available.
Disseminated Intravascular Coagulation* ; Heparin*

Angiographic procedures and their applications maybe divided into following roups: I) procedures used to increased blood folw, as the angioplasty, II) procedures used to decreased blood flow, as the embolization and local infusion of vasoconstrictors and III) miscellaneous procedures. Transcatheter vessel occlusion was first performed in 1930 by Brook to occlude the carotid cavernous fistula by embolization of the surgically exposed carotid artery with muscle marked with a sliver clip injected directly into the internal carotid artery. Autologous clot, first used by Doppman(1968) to occlude a spinal arteriovenous malformation was quickly adopted use in traumatic hemorrhage with pelvic fracture, nonoperable aneurysm, gastrointerstinal hemorrhage and diagnosis and treatment of the tumors. In Kores, there have been several reports of transcatheter vessel occlusion after Han(1978) made a first report in the radiology part. In orthopedics part of Korea, Kim(1981) and Yoo(1982) reported the cases of surgical treatments of arteriovenous malformation without embolization. Also, in Korea, there has been no report of transcather embolizations of vascular diseases of the extremities, such as huge arterial aneurysm and dilated varicose vein. We reported the 4 cases who were treated at the Chonbuk National University Hospital between January 1987 and April 1988. Transcatheter vessel occlusion have such advantages : 1. The vascular status of the mass can be recognized prior to operation, such as biopsy. 2. Since the bleeding can be reduce, the operation can be performed easily. 3. Nonoperable huge arterial aneurysm could sometimes be treated only with transcatheter vessel occlusion adequately. 4. It can make a differential diagnosis with other vascular anomaly easy.
Aneurysm ; Angioplasty ; Arteriovenous Malformations ; Biopsy ; Carotid Arteries ; Carotid Artery, Internal ; Diagnosis ; Diagnosis, Differential ; Extremities ; Fistula ; Hemorrhage ; Jeollabuk-do ; Korea ; Orthopedics ; Varicose Veins ; Vascular Diseases ; Vasoconstrictor Agents

Mirizzi syndrom is a rare disorder characterized by obstruction of common hepatic duct due to impacted gallbladder neck or dystic duct stone and is an uncommon cause of obstructive jaundice. Authors experienced one case of Mirizzi syndrome mimicked lobulated intraductal tumor.
Gallbladder ; Hepatic Duct, Common ; Jaundice, Obstructive ; Mirizzi Syndrome ; Neck

Many procedures of quadricepsplasty were reported by Thompson (1944), Judet (1959), van Nes (1962), Nicoll (1963) and Hesketh (1963) in confining the indication of them for the strictly extra-articular origin of their causes. During the period of January 1979 to August 1979, 5 cases of stiff knee joints were surgically treated by means of arthrolysis and quadriceps release. The result were gratifying. The average gain of flexion was 119 degrees, and extension lag was absent except a case which had compression fracture of femoral condyle.
Fractures, Compression ; Knee Joint ; Knee

The management of supracondylar fractures of the femur remains controversial. Most studies over the past twenty years have attempted to compare the results of non-surgical with those of surgical methods. Until a few years ago, conservative treatment was considered superior to internal fixation of supracondylar fractures of the femur. However, the development of new fixation devices and techniques have, according to several investigations, improved the results of the treatment of these fractures. The following clinical results were shown by analysis of 96 cases of supracondylar fractures of the femur treated in the Department of Orthopedic Surgery, Yonsei University, College of Medicine during the past 10 years from Jan. 1971 to Dec. 1980. 1. The prevalent age distribution was between 21 and 50 years of age (79.1%), and the ratio between males and females was 3.4:1. The most common cause of injury was car accidents (51.0%). 2. A classification of supracondylar fractures was unicondylar, simple supracondylar and intercondylar. Intercondylar which was subdivided into Type I, II-A, II-B, III according to Neer's classification. 3. Fifty nine patients (61.4%) were associated with injuries of other parts and the most frequent associated fracture was tibial fracture and the most common associated soft tissue injury was cerebral concussion or contusion. 4. The methods of treatment: conservative management by using skeletal traction for 34 cases, surgical treatment by open reduction and internal fixation for 58 cases and A-K amputation for 4 cases due to populiteral artery injury. 5. Fifty nine cases were suitable for result analysis. The satisfactory result of surgical treatment was 63.4% and conservative treatment was 50.0% respectively. The factors affecting the final results were Type of fracture, severity of injury, and rigid internal fixation. 6. The main complications of the supracondylar fractures of the femur were delayed union (10.2%), infection (10.2%), and traumatic arthritis (13.3%). 7. Finally, the results of treatment depend largely on anatomical reduction, rigid fixation, early joint motion.
Age Distribution ; Amputation ; Arteries ; Arthritis ; Brain Concussion ; Classification ; Clinical Study ; Contusions ; Female ; Femur ; Humans ; Joints ; Male ; Orthopedics ; Soft Tissue Injuries ; Tibial Fractures ; Traction

No abstract available in English.
Osteosarcoma