PURPOSE:The incidence of congenital adrenal hyperplasia(CAH) is 1/5,000- 1/20,000 births and thus the importance of the neonatal screening test is being emphasized. However, the reference value for the term and preterm infants has not yet been established and false positive values are frequent due the immature hypothalamic-adrenal axis of the preterm infants or the stress-induced adrenal dysfunction. Therefore, we analyzed the 17-hydroxyprogesterone(17-OHP) concentration in terms of gestational age, birth weight, and postnatal state to establish the reference range for the Korean term and preterm infants. METHODS:We analyzed the results of the CAH screening test retrospectively, which was performed on 737 neonates(624 fullterm neonates, 113 premature neonates) born between January 1998 through July 1998 in Inje University College of Medicine Sanggye Paik Hospital. Mean gestational age and birth weight of infants were 38.2+/-2.6 weeks and 3,116+/-674kg respectively. 17-OHP screening test was performed on 4.9+/-3.8days after birth by obtaining blood samples from the heelstick of neonates. 17-OHP concentration was measured by the ELISA kit(ICN Co.) and repeated the procedure if the result was higher than 35ng/ml. RESULTS: 1) 17-OHP concentration of the preterm infants was significantly higher than that of the fullterm infants(19.1+/-12.3ng/ml vs 11.7+/-7.8ng/ml, P=0.001). 17-OHP concentration was inversely proportional to gestational age. 2)17-OHP concentration was inversely proportional to birth weight(r=0.22, P>0.01). 17-OHP concentration according to birth weight was as follows.:below 1,500g was 26.7+/-11.7ng/ml, 1,500 to 2,000g was 18.0+/-13.9ng/ml, 2,001 to 2,500g was 17.9+/-10.5ng/ml, 2,501 to 3,000g was 12.1+/-7.9ng/ml, 3,001 to 3,500g was 11.5+/-8.1ng/ml, above 3,500g was 11.4+/-7.5ng/ml. There was a significant decline in the 17-OHP concentration as the birth weight increased. 3) 17-OHP concentration was gradually decreased as sampling date increased. 4) The gender of the infants did not influence the 17-OHP concentration(male 13.0+/-9.1 vs female 12.7+/-9.0). 5)17-OHP concentration were significantly higher in sick preterm infants than healthy preterm infants. 6)Six cases, whose 17-OHP concentration were greater than 35ng/ml, were all preterm and low birth weight infants. Reexamination after one week showed the value within normal range. No CAH cases were diagnosed in the study. CONCLUSION: 17-OHP concentration was inversely proportional to gestational age and birth weight. Therefore, reference ranges of 17-OHP concentration should be subdivided according to gestational age and birth weight. Further research about perinatal risk factors affecting the 17-OHP concentration will be required.
17-alpha-Hydroxyprogesterone* ; Axis, Cervical Vertebra ; Birth Weight ; Enzyme-Linked Immunosorbent Assay ; Female ; Gestational Age ; Humans ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature* ; Mass Screening ; Neonatal Screening ; Parturition ; Reference Values ; Retrospective Studies ; Risk Factors

The UGI studies had been performed to 238 patients below the age of 15 years during the period from Jan. 1979to Jul. 1983 in SCH hospital. The results are as follows; 1. Among 238 cases, 48 cases revealed peptic ulcers ofstomach or duodenum (20.2%). The ulcer was in 31/37 cases of male patients(22.6%), and in 17/101 cases of female(16.8). Below the age of 5 years, ulcer was noted in 9 cases among 61 cases (14.8%), whereas above 5 years, in 39cases among 177 patients (22.0%). 2. In the age group below 5 years, mostly the objective symptoms were discovered(8/9), but above 5 years, complained of subjective symtoms (30/39). 3. The predominant site of peptic ulcer wasgastric antrum in the age group below 5 years (7/9), whereas duodenal bulb above 5 years(33/43). 4. Gastric antrumor duodenal bulb deformity was revealed in 13 cases and most of them were in the age group above 5 years. 5. Alllesion so peptic ulcers in this study were benign in nature. 6. In follow up study after 1 or 2 months, ulcer wasdecreased in size strikingly(9/11).
Congenital Abnormalities ; Duodenum ; Follow-Up Studies ; Humans ; Male ; Peptic Ulcer ; Ulcer

Korea has undergone rapid transformation, achieving significant advancements in both economic development and social security. Notably, the country achieved universal health coverage within a remarkably short period, representing a significant institutional milestone in healthcare. However, the healthcare system faces substantial challenges due to limited resources, a reliance on private healthcare providers, and a rapidly aging population which threatens its sustainability. Various efforts have been made to strengthen Korea’s primary care environment. This study aims to examine the multifaceted healthcare landscape surrounding primary care in Korea, analyze associated systems to identify institutional limitations, and propose strategies to enhance primary care in the future. Additionally, it seeks to raise awareness of the current state of primary care in Korea and serves as an example for other countries striving to improve their primary care systems. Furthermore, this review provides a comprehensive overview of key data sources relevant to primary care research in Korea, such as the National Health Insurance Service claims data and the Korea Health Panel Survey. It also outlines practical research methodologies—from epidemiological studies to policy analyses—serving as a valuable reference for both domestic and international scholars seeking to enhance primary care systems.

Korea has undergone rapid transformation, achieving significant advancements in both economic development and social security. Notably, the country achieved universal health coverage within a remarkably short period, representing a significant institutional milestone in healthcare. However, the healthcare system faces substantial challenges due to limited resources, a reliance on private healthcare providers, and a rapidly aging population which threatens its sustainability. Various efforts have been made to strengthen Korea’s primary care environment. This study aims to examine the multifaceted healthcare landscape surrounding primary care in Korea, analyze associated systems to identify institutional limitations, and propose strategies to enhance primary care in the future. Additionally, it seeks to raise awareness of the current state of primary care in Korea and serves as an example for other countries striving to improve their primary care systems. Furthermore, this review provides a comprehensive overview of key data sources relevant to primary care research in Korea, such as the National Health Insurance Service claims data and the Korea Health Panel Survey. It also outlines practical research methodologies—from epidemiological studies to policy analyses—serving as a valuable reference for both domestic and international scholars seeking to enhance primary care systems.

Korea has undergone rapid transformation, achieving significant advancements in both economic development and social security. Notably, the country achieved universal health coverage within a remarkably short period, representing a significant institutional milestone in healthcare. However, the healthcare system faces substantial challenges due to limited resources, a reliance on private healthcare providers, and a rapidly aging population which threatens its sustainability. Various efforts have been made to strengthen Korea’s primary care environment. This study aims to examine the multifaceted healthcare landscape surrounding primary care in Korea, analyze associated systems to identify institutional limitations, and propose strategies to enhance primary care in the future. Additionally, it seeks to raise awareness of the current state of primary care in Korea and serves as an example for other countries striving to improve their primary care systems. Furthermore, this review provides a comprehensive overview of key data sources relevant to primary care research in Korea, such as the National Health Insurance Service claims data and the Korea Health Panel Survey. It also outlines practical research methodologies—from epidemiological studies to policy analyses—serving as a valuable reference for both domestic and international scholars seeking to enhance primary care systems.

Korea has undergone rapid transformation, achieving significant advancements in both economic development and social security. Notably, the country achieved universal health coverage within a remarkably short period, representing a significant institutional milestone in healthcare. However, the healthcare system faces substantial challenges due to limited resources, a reliance on private healthcare providers, and a rapidly aging population which threatens its sustainability. Various efforts have been made to strengthen Korea’s primary care environment. This study aims to examine the multifaceted healthcare landscape surrounding primary care in Korea, analyze associated systems to identify institutional limitations, and propose strategies to enhance primary care in the future. Additionally, it seeks to raise awareness of the current state of primary care in Korea and serves as an example for other countries striving to improve their primary care systems. Furthermore, this review provides a comprehensive overview of key data sources relevant to primary care research in Korea, such as the National Health Insurance Service claims data and the Korea Health Panel Survey. It also outlines practical research methodologies—from epidemiological studies to policy analyses—serving as a valuable reference for both domestic and international scholars seeking to enhance primary care systems.

Gastritis cystica polyposa(GCP) is a polypoid cystic lesion showing all the histological features of the hyperplastic polyps and the cysts penetrating through the mucularis mucosae. Most reported GCP lesions were developed at gastraenterostomy stomas. It is rare that GCP develops without history of previous gastroenterostomy. In 1990, however, Kim et al reported a GCP presenting as a submucosal tume-like lesion in a 69-year-old man. Recently, we had experienced two consecutive cases of GCP diagnosed by endoscopic polypectomy. The first case was 49-year-old housewife without history of previous gastric surgery. Esophagogastroduodenoscopy(EGD) showed a 2.0x1.5x1.5cm sized lobulated polypoid lesion with a broad stalk on the anterior wall of the distal antrum. The second case was 45-year-old woman without history of previous gastric surgery. EGD revealed a 1.0 x 1.0 x l.0 cm sized polypoid lesion with a pedicle on the greater curvature aspect of the upper body and two duodenal ulcers with pseudodiverticulum formation. These lesions were endoscopically polypectomized and diagnosed as GCP by the histologic examination.
Aged ; Duodenal Ulcer ; Female ; Gastritis* ; Gastroenterostomy ; Humans ; Middle Aged ; Mucous Membrane ; Polyps

Klippel-Feil syndrome is characterized by congenital fusion of cervical vertebrae with a wide range of associated anomaly. The authors present a 50-year-old Klippel-Feil syndrome patient with a minor trauma followed progressive quadriparesis. He had typical radiologic findings of type II Klippel-Feil syndrome and presented progressive myelopathy due to cord compression at foramen magnum level with cervical instability. The patient underwent craniocervical decompression and fusion. The authors reviewed the pertinent literatures and discussed this rare syndrome.
Cervical Vertebrae ; Decompression ; Female ; Foramen Magnum ; Humans ; Klippel-Feil Syndrome* ; Middle Aged ; Quadriplegia* ; Spinal Cord Diseases

Bone scan using 99m Tc-MDP is the most accurate and reliable method for the early detection of fracture, andgive the most accurate in formation about the healing process of fractured bone. Recent days, the medicolegalproblem about the injured time is frequently provoked in vertebral fracture patient by trauma. The authorsanalyzed the bone scan of vertebral fracture patients from March to Dec. 1983. The authors obtained results asfollows: 1. The minimum time for a fracture to return to normal on a bone scan was 4 month in cervical spine. 2.It was 12 month in thoracic spine. 3. It was 6 month in lumbar spine. 4. Surrounding soft tissue injury was healedwithin 10 days after trauma in our cases. 5. Focal hot uptake is persisted in case of callus deposition on plainfilm, although very small in amount. 6. Healing time is delayed in case of severely compressed vertebral body,belowed the half than normal height. 7. With bone scan it is possible to differentiate the fresh fracture from oldhealed, impossible by plain film. 8. Healing time is delayed in old age.
Bony Callus ; Humans ; Methods ; Soft Tissue Injuries ; Spine

PURPOSE: The purpose of the study was to evaluate serum magnesium(Mg) concentration in very low birth weight(VLBW) infants during the first three weeks of life and to assess its relation to diseases of prematurity. METHODS: We measured serum Mg level at 0, 1, 2, and 3weeks of life in VLBW infants and analyzed its correlations with diseases of prematurity. Ninety-five VLBW infants(mean gestational age 30.4wks, birth wt 1304gm) who survived 30days were selected. Seven infants who had been treated with magnesium sulfate prenatally were excluded. RESULTS: Serum Mg level decreased linearly during the first three weeks of life(P=0.03). Serum Mg level at birth had no significant relation to gestational age, birth weight and serum calcium concentration. Serum Mg level at birth were higher within normal range in infants with respiratory distress syndrome(n=20, 2.6mg/dl vs. n=68, 2.2mg/dl, P=0.036), patent ductus arteriosus (n= 19, 2.5mg/dl vs. n=69, 2.2mg/dl, P=0.035) and bronchopulmonary dysplasia(BPD)(n=15, 2.6mg/dl. vs. n=73, 2.2mg/dl, P=0.01) than in infants without them. Serum Mg level at first week of life were similar(2.3mg/dl. vs. 2.2mg/dl, P=0.51) and serum Mg level at second and third weeks of life were significantly lower in infants with BPD than in control(1.9mg/dl vs. 2.2mg/dl, P=0.002 and 1.6mg/dl vs. 2.2mg/dl, P=0.001, respectively). CONCLUSION: Serum Mg level during the first three weeks of life decreased linearly. Serum Mg level of infants with BPD at birth was higher within normal variation than in infants without BPD. And serum Mg level of infants with BPD at second and third weeks of life were lower than control. Thus, we suggest that Mg deficiency during the first three weeks of life might play a role in the pathogenesis of BPD.
Birth Weight ; Bronchopulmonary Dysplasia ; Calcium ; Ductus Arteriosus, Patent ; Gestational Age ; Humans ; Infant* ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Magnesium Sulfate ; Magnesium* ; Parturition ; Reference Values