Peripheral arterial disease(PAD) is a major health problem in the elderly population, so prevalence of PAD is investigated using Edinburgh claudication questionnaire. Subjects were over 65 years old in the kyeongsan county. The prevalence of PAD was 9.0% in total population(8.5% in men, 9.3% in women). definite claudication was 3.9%, atypical claudication was 5.l%. and, grade 1 was 4.4%, grade 2 was 4.6%. The prevalence of PAD was increased with age but not statistically significant. There was no difference of PAD by gender and smoking. PAD was significantly associated with systolic blood pressure positively. But, unexpectedly, PAD was significantly associated with BMl negatively. PAD are important elderly health problem in the our country. so the etiology and preventive methods of PAD will be researched on our country population.
Aged* ; Blood Pressure ; Humans ; Male ; Prevalence* ; Surveys and Questionnaires* ; Rural Population* ; Smoke ; Smoking

This study was conducted to compare the maternal characteristics, and birth weight of infants delivered at five different categories of medical facility in Taegu to examine the risk level of pregnant women and children by the medical facility for delivery. The study population included 1,410 pregnant women who delivered a baby at one of nine medical facilities (3 university hospitals, 2 general hospitals, 2 private clinics, 1 midwife clinic, 1 MCH center) in Taegu in April, 1987(April and May, 1987 for K university hospital). Pregnant women were interviewed to ask the age and educational level of woman, payment of medical fee, birth order, delivery method. Birth weight of infant was obtained from medical record. Mean ages of the women delivering at the university hospitals(27.5 years) and at general hospitals(26.7 years) were higher than those at midwife clinic(25.4 years) and at MCH center(26.1 years). Also, mean years of school education were higher in women of university hospitals(12.7 years) and general hospitals(12.2 years) than in women of midwife clinic(9.2 years) and MCH center (9.3 years). The percentages of women covered by the medical insurance were far greater in the university hospitals(78.1%) and general hospitals(82.9%) than in private clinics(44.3%), midwife clinic(29.1%) and MCH center (5.4%). Infants born at the MCH center were mostly the second birth (47.3%) while 56.0% to 61.7% of infants born at all the other medical facilities were the first birth more women delivering at the university hospitals had history of spontaneous abortion as well as still birth than the women delivering at the other medical facilities. The preterm birth rate (11.4%) and low birthweight incidence rates(5.8-13.0%) in university hospitals were significantly higher than those of other medical facilities. Accordingly, c-section rates showed a wide variation among the medical facilities. Study findings revealed that most of women delivering at the university hospitals and general hospitals are in the middle of or upper socio-economic class and obstetrically high risk group regardless of socioeconomic class while the women delivering at the midwife clinic and MCH center are low risk group of low socioeconomic class. Therefore, the data of a specific medical facility are highly limited in interpretation and can not be generalized.
Abortion, Spontaneous ; Birth Order ; Birth Weight* ; Child ; Daegu* ; Education ; Fees, Medical ; Female ; Hospitals, General ; Hospitals, University ; Humans ; Incidence ; Infant ; Insurance ; Medical Records ; Midwifery ; Parturition* ; Pregnancy ; Pregnant Women ; Premature Birth

No abstract available.
Hyperthyroidism*

To measure the fertility rate and pregnancy wastage of women in rural area, 3,780 married women under 50 years old who were not sterilized either woman or husband in Gunwee county were followed up for 2 years. Seventeen Myun health workers visited these women periodically to check the status of their family planning practice and menstruation. Pregnant women were interviewed for their past obstetric history and followed up to the time of delivery. Family planning was practiced in 51.6% of the 6,826 women-years observed during the period from April 1, 1985 to March 31, 1987. Pregnancy, abortion and delivery covered 7.6% of the observed women years and family planning was not practiced in 36.5% of the women-years. When sterilized women at the beginning of the study were included, the family planning practice rate was 72.1% which was slightly higher than the national family planning practice rate. However, 28% of the women of 30-39 years old had not practiced family planning although they had 2-3 children and they used more such less effective methods as safe-period method and condom than the women of 20-29 years old. Overall pregnancy rate was 14.3 per 100 woman-years. Women of 25-29 years old had the highest pregnancy rate of 27.4 per 100 woman-years. Pregnancy wastage including spontaneous and induced abortions and still births was 22.0% of all pregnancies and it increased with the age of women; 15.8% in women less than 30 years old and 43.7% in women of 30 years and over. Women who terminated the pregnancy with induced abortion had more pregnancies, more previous induced and spontaneous abortions and shorter pregnancy interval than those women who terminated with live birth. Pregnant women terminated with a live birth had received 4.2 prenatal cares on the average. Eighty-five percent of deliveries occurred at a medical facility and 15% at home which was substantially lower home delivery rate than the other rural area of Korea. This may be due to the effects of the demonstration project for the primary health care in 1970s in Gunwee county. These findings suggest that family planning service in rural area should be strengthened by promoting the use of more effective contraceptive method among women over 30 years of age.
Abortion, Induced ; Abortion, Spontaneous ; Adult ; Birth Intervals ; Birth Rate ; Child ; Condoms ; Contraception ; Family Planning Services ; Female ; Fertility* ; Follow-Up Studies* ; Humans ; Korea ; Live Birth ; Menstruation ; Middle Aged ; Parturition ; Pregnancy Rate ; Pregnancy* ; Pregnant Women ; Primary Health Care ; Spouses

BACKGROUND: Recently in Korea, the rate of addictive drug abuse is rapidly increasing in men on salary, housewives, and even in adolescents, who have been considered to be free from drugs, which presents a serious problem to the society. Especially, the habituation to gateway drug, such as cigarettes and alcohol, before 15 years old, would lead to the increased possibility of other drug abuse, including illicit drugs. Thereupon in this study, we intended toreview the effect of adolescents smoking an the drug abuse and deviated behaviors. METHODS: On September, 1997, randomly selected were 12 classes, an the basis of 2 classes per grade, from the two schools which was located each in Seoul and Buchean. And survey was dane on 610 students with non non-nominl, self-reported questionnaire. RESULTS: The rate of adolescent smoking was 28.1% in male students and had increasing tendency of "the higher the grades, the higher the smoking rate"(17.0% in the 1st gade, 31.5% in the 2nd grade, 35.9% in the 3rd grade). The smoking rate of female students was 12.3%. From the 2nd grade of middle school to the 2nd grade of high school was the critical period when the smoking habit was initiated in almost 90% of the students. The experiencing rates of drug abuse in studied subjects were as follows : drinking(79.0%), stimulants(4.8%), sedatives(4.1%), hypnotics(3.1%), glue sniffing(1.5%), butane gas(0.7%), marijuana/hemp(0.2%). They were higher in the smoking group than in the nansMoking group, showing statistical significances in most items except hypnotics and marijuana/hemp. Also simihr results were shown in deviated behaviors between the groups. CONCLUSIONS: With the concerted efforts of family, school, society and natian, we as family physicians should make efforts to delay and prevent adolescent's smoking, which is a gateway to drug abuse and deviated behaviors, and to increase people's recognition of health risks caused by smoking, and to provide proper program for adolescents to stop smoking.
Adhesives ; Adolescent ; Critical Period (Psychology) ; Female ; Humans ; Hypnotics and Sedatives ; Korea ; Male ; Physicians, Family ; Salaries and Fringe Benefits ; Seoul ; Smoke* ; Smoking* ; Street Drugs ; Substance-Related Disorders* ; Tobacco Products ; Surveys and Questionnaires

To test the validity of referral of high risk pregnancy in the MCH Center, 6,017 pregnant women who visited MCH Center of South District Health Center for delivery between 1 April 1985 and 31 March 1987 were interviewed on arrival to obtain the data for demographic characteristics and obstetric history and traced to check the delivery outcome. Out of 5,820 women whose delivery outcomes were confirmed, 704 women(12.1%) were referred to other hospital or clinic for high risk factors. The proportion of poor delivery outcome(stillbirth, low birth weight and neonatal death) among referred cases was 4.4% while that of the women delivered at the MCH Center was 2.2%(p<0.01). Decision of the midwives for the referral of high risk pregnancy based on their clinical assessment was consistent with the delivery outcome (good or poor) in 86.5%. Major reasons for referral were premature rupture of membrane(46.5%) and cephalopelvic disproportion(20.0%) and the C-section rates for these cases were 10.1%, 17.6%, respectively. Discriminant analysis of the demographic characteristics and obstetric history for the discrimination of delivery outcome showed that gestational age had the highest discriminant function coefficient(0.88) and it was followed by parity(0.37) and maternal education(0.30). Referral of high risk pregnancy by the midwives based on their clinical assessment was considered to be reasonably valid. However, a risk scoring system for an MCH Center which can improve the validity may be developed if one applies the discriminant analysis for more comprehensive independent variable(including clinical assessment of midwife, demographic characteristics and obstetric history) and dependent variable (including medically indicated C-section, complication of pregnancy and delivery, stillbirth, low birth weight, neonatal death and maternal death).
Discrimination (Psychology) ; Female ; Gestational Age ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Midwifery ; Pregnancy ; Pregnancy, High-Risk* ; Pregnant Women ; Referral and Consultation* ; Risk Factors ; Rupture ; Stillbirth

Background: The objective of our study was to analyze the postoperative direct medical expenses and hospital lengths of stay (LOS) of elderly patients who had undergone either hemiarthroplasty (HA) or total hip arthroplasty (THA) for femoral neck fractures and to determine the indication of THA by comparing those variables between the 2 groups by time. Methods: In this comparative large-sample cohort study, we analyzed data from the 2011 to 2018 Korean National Health Insurance Review and Assessment Service database. The included patients were defined as elderly individuals aged 60 years or older who underwent HA or THA for a femoral neck fracture. A 1:1 risk-set matching was performed on the propensity score, using a nearest-neighbor matching algorithm with a maximum caliper of 0.01 of the hazard components. In comparative interrupted time series analysis, time series were constructed using the time unit of one-quarter before and after 3 years from time zero. For the segmented regression analysis, we utilized a generalized linear model with a gamma distribution and logarithmic link function. Results: A total of 4,246 patients who received THA were matched and included with 4,246 control patients who underwent HA. Although there was no statistically significant difference in direct medical expense and hospital LOS for the first 6 months after surgery, direct medical expenses and hospital LOS in THA were relatively reduced compared to the HA up to 24 months after surgery (p < 0.05). In the subgroup analysis, the THA group’s hospital LOS decreased significantly compared to that of the HA group during the 7 to 36 months postoperative period in the 65 ≤ age < 80 age group (p < 0.05). Direct medical expenses of the THA group significantly decreased compared to those of the HA group during the period from 7 to 24 months after surgery in the men group (p < 0.05). Conclusions When performing THA in elderly patients with femoral neck fractures, the possibility of survival for at least 2 years should be considered from the perspective of medical expense and medical utilization. Additionally, in healthy and active male femoral neck fracture patients under the age of 80 years, THA may be more recommended than HA.

Purpose: The purpose of this study was to compare patients who had undergone spine surgery (SS) and hip arthroplasty surgery (HAS) and to analyze how medical policies drawn from “The Evaluation of the Appropriate Use of Prophylactic Antibiotics” have affected length of hospital stay (LOS), direct medical costs (DMC), and the duration of antibiotics use in Korea. Materials and Methods: This retrospective nationwide study identified subjects from the Korean National Health Insurance Review and Assessment Service database from January, 2011 to December, 2018. Evaluation of HAS (control group) was implemented in 2007, and that for SS (case group) was conducted for the first time in 2014 (intervention time). In our comparative interrupted time series analysis, we compared DMC, LOS, and use of antibiotics between both groups. Results: 177468 patients who underwent SS and 89372 patients who underwent HAS were included in the study. In 2016, DMC increased for HAS, compared to SS, by 1.03 times (p=0.041). However, cost changes during other observational periods for SS were not higher than those for HAS (p>0.05). SS incurred a reduced LOS of 3% in the first 2 years (p<0.05). Thereafter, LOS changes in SS were not smaller than those in HAS. A decrease in the usage of total antibiotics and broad spectrum antibiotics was observed for 5 years. Conclusion This medical policy was effective in terms of reducing usage and duration of antibiotics use, especially in the first 2 years after the implementation of the policy.

This study was conducted to investigate the factors related to the poor school performance of the elementary school children. Two schools in Taegu, one in the affluent area and the other in the poor area, were selected and a total of 175 children whose school performance was within low 10 percentile(poor performers) and 97 children whose school performance were within high 5 percentile(good performers) in each class of 2nd, 4th and 6th grades were tested for the physical health, behavioral problem and family background. Each child had gone through a battery of tests including visual and hearing acuity, anthropometry(body weight, height, head circumference), intelligence(Kodae Stanford-Binet test), test anxiety(TAI-K), neurologic examination by a developmental pediatrician and heavy metal content(Pb, Cd, Zn) in hair by atomic absorption spectrophotometry. A questionnaire was administered to the mothers for prenatal and perinatal courses of the child, family environment, child's developmental history, and child's behavioral and learning problems. Another questionnaire was administered to the teachers of the children for the child's family background, arithmatic and language abilities and behavioral problem. The poor school performance had a significant correlation with male gender, high birth order, broken home, low educational and occupational levels of parents, visual problem, high test anxiety score, attention deficit hyperactivity disorder(ADHD), poor physical growth(weight, height, head circumference) and low I.Q. score. The factors that had a significant correlation with the poor school performance in multiple logistic regression analysis were child's birth order(odds ratio=2.06), male gender(odds ratio=5.91), broken home(odds ratio=9.29), test anxiety score(odds ratio=1.07), ADHD(odds ratio=9.67), I.Q. score(odds ratio=0.85) and height less than Korean standard mean-1 S. D.(odds ratio=11.12). The heavy metal contents in hair did not show any significant correlation with poor school performance. However the lead and cadmium contents were high in males than in females. The lead content was negatively correlated with child's grade(p<0.05) and zinc was positively correlated with grade(p<0.05). Among the factors that showed a significant correlation with the poor school performance, high birth order, short stature and ADHD may be modified by a good family planning, good feeding practice for infant and child, and early detection and treatment of ADHD. Also, teacher and parents should restrain themselves from inducing excessive test anxiety by forcing the child to study and over-expecting beyond the child's intellectual capability.
Anxiety ; Birth Order ; Cadmium ; Child* ; Daegu ; Family Planning Services ; Female ; Hair ; Head ; Hearing ; Humans ; Infant ; Language ; Learning ; Logistic Models ; Male ; Mothers ; Neurologic Examination ; Parents ; Parturition ; Surveys and Questionnaires ; Spectrophotometry, Atomic ; Zinc

The optimal management of inflammatory aneurysm is still a matter of controversy, especially in surgical aspect. The disease is a infrequent entity and without surgical intervention, usually lead to uncontrolled sepsis or catastrophic hemorrhage. We report 12 cases of inflammatory aneurysms those admitted and were managed at Kangnam St. Mary's hospital during 6 years from April, 1991 through April, 1997. The medical records and dermographical datas of these patients were reviewed. Of these 12 patients, ten were male and three were female in age range from 37 through 80 years with a mean of 60 years. The diagnosis was mainly based on operative findings with aids of radiological and microbiological evidences. The number of location of involved arterial segments were 4 of thoracic aorta, 1 of suprarenal abdominal aorta, and 7 of infrarenal abdominal aorta including 2 of common iliac arteries. The main symptoms of these patients were abdominal or chest pain in 11 according to the location of the involved arterial segments, back pain in 6, fever and chillness in 8. The incidence of suspicious infected microorganisms of the patients, not of the credible direct cause of aneurysm itself, were 3 of Salmonellosis in Widal test, 2 of tuberculosis in AFB or sputum culture, 2 of G(-) bacilli in blood culture, and 1 of syphilis in FTA-ABS . 8 patients were operated by substituting the diseased arterial segments with artificial graft and 4 patients were medically managed. Of the 8 patients operated, one died within 48 hours after operation by sepsis. 7 patients were discharged by ambulation. In the 4 medically treated patients, one expired in hospital and three were discharged hopelessly. 7 patients those discharged after operation has been managed in out-patient department.
Aneurysm ; Aorta ; Aorta, Abdominal ; Aorta, Thoracic ; Back Pain ; Chest Pain ; Diagnosis ; Female ; Fever ; Hemorrhage ; Humans ; Iliac Artery ; Incidence ; Male ; Medical Records ; Outpatients ; Salmonella Infections ; Sepsis ; Sputum ; Syphilis ; Transplants ; Tuberculosis ; Walking