This study investigated the German experience in the transition to a unified health care system and suggests the following implications for Korea. First, Germany could have made use of the unification process better if there had been a good road map. Therefore Korea must develop a well prepared road map that considers all possible situations. Second, Germany saw an opportunity for the improvement of the health care system in the early stage of unification but could not take advantage of it because the situation changed dramatically and they had not sufficiently prepared for it. Korea should take into account the opportunity for improvement of the present health care system, such as the roles of public health and traditional medicine. Thirdly, the conditions f North Korea seem to be far worse than those of former East Germany and also worse than even those of other transition countries. Therefore Korea should design a long-term road map taking as many variables into account as possible, including the different rigid way of thinking and the interrelationship among the social sectors. Fourthly, during the German reunification unexpected factors changed the direction of the events. Korea should have a separate plan for the unexpected factors.
Ambulatory Care ; Delivery of Health Care/methods/*organization & administration/standards ; Germany ; Germany, East ; Humans ; Medicine, Traditional ; Public Health ; Republic of Korea

This article was initially published in the Journal of Preventive Medicine and Public Health 2013;46(3):127-133, with a misspelled word in the Abstract.

No abstract available.

No abstract available.
Fractures, Compression* ; Vertebroplasty*

We tried to determine the significance of invasion to the muscularis mucosae on the progression and recurrence of the superficial bladder cancer. Muscularis mucosae was composed of the smooth muscle bundles around relatively large vessels and found in the lamina propria approximately midway between the surface mucosa and the true muscular layer, lying parallel to the mucosa. Between January 1984 and December 1993, 81 patients with diagnosed superficial bladder cancer showing lamina propria invasion (pTl) were treated by transurethral resection (TUR) at our hospital. The mean age was 59.4 years ( range, 31-86 years), the mean follow-up period was 35.3 months ( range, 13-120 months) and the male : female ratio was 69 : 12. We subclassified superficial bladder cancer showing lamina propria invasion into two groups with ( pT1b) or without ( pT1a) cancer invasion to the muscularis mucosae. The muscularis mucosae was identified in 58 (71.6%) of 81 cases. In the other cases ( 28.4% ), relatively large vessels were used as the landmark instead of the muscularis mucosae. Of 81 bladder cancers, 52 (64.2%) were diagnosed as pT1a and 29 (35.8%) as pTlb. The progression rate of pT1b cancer (41.4% ) was significantly higher than that of pT1a cancer (3.8% ) (p= 0.001). And the recurrence rate of pT1b cancer (55.2% ) was significantly higher than that of pT1a cancer ( 26.9 %)(p= 0.024). In conclusion, superficial bladder cancer invading to the muscularis mucosae has a high risk for disease progression after TUR. Careful follow-up examination and aggressive therapy should be recommended in patients with these tumors.
Deception ; Disease Progression ; Female ; Follow-Up Studies ; Humans ; Male ; Mucous Membrane* ; Muscle, Smooth ; Recurrence ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Tubal leiomyoma during pregnancy is rare. Fewer than 100 cases of leiomyoma of the fallopian tube have been described in the literature. Most of them are asymptomatic. The diagnosis is incidentally if there is a primary tubal lesion such as ectopic pregnancy or during the general gynecologic operation. The tube must be entirely sectioned and completely examined whether there is primary tubal adenocarcinoma, if rare. We experienced a case of tubal leiomyoma in woman at 38+5 weeks gestation with previous primary cesarean section diagnosed after repeat cesarean delivery and bilateral tubal ligation with a brief review of literature.
Adenocarcinoma ; Cesarean Section ; Diagnosis ; Fallopian Tubes ; Female ; Humans ; Leiomyoma* ; Pregnancy* ; Pregnancy, Ectopic ; Sterilization, Tubal

No abstract available.
Blastocyst ; Coculture Techniques ; Fertilization ; Oocytes* ; Sperm Injections, Intracytoplasmic ; Sperm Retrieval* ; Spermatozoa*

Epithelial gastric polyps can be categorized as hyperplastic or adenomatous polyps. Hyperplastic polyps are predominant, comprising 75 to 90% of gastric polyps. It has been generally accepted that adenomatous gastric polyps exhibit malignant change. However, potential of malignant transformation of hyperplastic gastric polyps was originally denied and have been rarely reported, the incidence varying from 1.5 to 2.1%. The size and the associated dysplasia of polyps seem to be important in transformation to gastric carcinoma. Most of the reported cases of hyperplastic gastric polyps with transformation to adenocarcinoma were histopathologically well differentiated. We report a rare case of moderately differentiated adenocarcinoma arising in a hyperplastic polyp on the greater curvature of the midbody in the stomach with a brief review of the literatures.
Adenocarcinoma* ; Adenomatous Polyps ; Incidence ; Polyps* ; Stomach*

Gastrointestinal fistula is a disease of varying etiologies. It may occur spontaneously or as a result of an iatrogenic cause. Spontaneous fistula occurs as a result of an inflammatory process, malignancy or radiotherapy. The majority of fistula are caused by iatrogenic causes, most frequently as a complication of surgical intervention. Treatment of gastrointestinal fistulae usually consists of surgery and conservative management such as nutritional support and control of inflammation. Recently, it has been reported that gastrointestinal fistulae can be treated endoscopically using tissue adhesive agents such as Histoacryl and fibrin glue. We report two cases of gastrointestinal fistulae that were successfully treated by endoscopic local injection therapy with a review of literature.
Enbucrilate ; Fibrin Tissue Adhesive ; Fistula* ; Inflammation ; Nutritional Support ; Radiotherapy ; Tissue Adhesives

Granular cell tumor is a rare disease, and it is even rarer in the male breast. Although it is typically a benign tumor, due to its features and image findings, it can be easily misdiagnosed and managed as a malignant tumor. Therefore, the extent of the surgery can inappropriately be expanded. To avoid misdiagnosis and overtreatment, surgeons must perform a careful evaluation. We describe a case of a granular cell tumor of the male breast treated with mastectomy.