Accessibility to medical facilities and personnels has been known as one of important determinants of medical care utilization. This study attempted to identify the effects of medical accessibility in terms of geographical distance and occupational opportunity to the medical utilizations. Two-year-experiences of Yonsei University Health Insurance Cooperatives were used as the sources of data. Out patient utilization patterns of 713 members sampled from 4,352 members of Health Insurance Cooperatives were analyzed in order to identify the effects of medical accessibilities. Findings: 1. Average clinic visit rate of Yonsei Health Insurance is 1.66 per person per year. 2. The utilization rates of geographically more accessible group were 33% higher than that of less accessible group. 3. No marked difference in clinic visit rate were observed between medical and non-medical personnel and their family members. 4. Clinic visit rates among occupationally accessible group were slightly higher than those of less accessible. The utilization rate was more sensitively changed by the insurance policy changes in occupationally accessible group.
Ambulatory Care ; Humans ; Insurance ; Insurance, Health* ; Occupations

Intramedullary spinal cord metastases (ISCM) account for only 3.4% of symptomatic metastases to the spinal cord. The survival of patients with ISCM is characteristically short, often no longer than 2 months, due to a rapid neurologic deterioration and the presence of widespread metastases, including metastases to the brain. We report two cases of ISCM arising from primary sphenoid sinus carcinoma and primary lung cancer along with a review of the literature. The case of ISCM from the primary sphenoid sinus is the third case of secondary syringomyelia due to ISCM in the world literature, and ISCM from the primary lung cancer is the first case reported in Korea. One case showed a slow progression of symptoms and a longer survival (26 months after the radiotherapy to the spine), and the other showed a rapid deterioration of symptoms with a shorter survival. More effective palliation can be achieved if the disease is diagnosed at an early stage when the neurologic deficits are still reversible.
Brain ; Humans ; Korea ; Lung Neoplasms ; Neoplasm Metastasis* ; Neurologic Manifestations ; Radiotherapy ; Sphenoid Sinus ; Spinal Cord* ; Syringomyelia

Multiple factors including gastroesophageal reflux disease (GERD) were evaluated for a case-control study in Chonnam area to investigate the causative entity of COPD. Data on the multiple causative factors from hospital records and interview survey were analyzed in three groups of COPD(64 cases as case group), normal lung (83 cases as control group 1) and non-COPD lung disease (45 cases as control group 2). Smoking status, history of adulthood pulmonary infection and frequent history of URI, socioeconomic status, and GERD were significantly different between COPD group and control group 1. Drinking status, physical height of the subjects and GERD were significantly different between COPD group and control group 2. If control group 1 was used, odds ratio of GERD and COPD was 5.68(95%confidence interval, 95% CI:2.59-12.45) and 4.81 (95% CI:1.89-10.53) when adjusted by age and smoking status. If control group 2 was used. Odds ratio of GERD and COPD was 4.22 (95% CI:1.69-10.56) and 4.59 (95% CI:1.64-12.86) when adjusted by alcohol and adulthood respiratory infection status. In summary, there results suggested that GERD might play a causative role in the development of COPD.
Case-Control Studies ; Drinking ; Gastroesophageal Reflux* ; Hospital Records ; Jeollanam-do ; Lung ; Lung Diseases ; Odds Ratio ; Pulmonary Disease, Chronic Obstructive* ; Smoke ; Smoking ; Social Class

It is known that the painful sensation of diabetic peripheral neuropathy (DPN) results in sleep problems in type 2 diabetes mellitus (T2DM). However, it is not known that the painless DPN also is associated with poor sleep quality in T2DM. The purpose of the current study was to investigate the association between painless DPN and poor sleep quality in T2DM.

It is known that the painful sensation of diabetic peripheral neuropathy (DPN) results in sleep problems in type 2 diabetes mellitus (T2DM). However, it is not known that the painless DPN also is associated with poor sleep quality in T2DM. The purpose of the current study was to investigate the association between painless DPN and poor sleep quality in T2DM.

No abstract available.
Cognition*

No abstract available.
Ileum*

No abstract available.
Polyarteritis Nodosa*

We investigated the 1,004 workers who worked in a automobile factory to study the epidemiologic characterist of dermatoses due to cutting oils. Among the workers, 667(66.4%) answered the questionnaire. They are belong to 5 departments of the factory-the Engine-Work(86), Power train Assembly(17). We measured the oil mist concentration in air of the departments and examined the workers who had dermatologic symptoms. The results were follows; 1) Oil mist concentration; Of all measured points(52), 9 points(17.2%) exceeded 5mg/m3-the time-weighed PEL- and one department had a upper confidence limit(95%) higher than 5mg/m3. 2) Dermatologists examined 213 workers. 172 of them complained any skin symptoms at that time-itching(32.5%), papule(21.6%), scale(15.7%), vesicle(12.5%) in order. The abnormal skin site found by dermatologist were palm(29.3%), finger & nail(24.6%), forearm(16.2%), back of hand(8.4%) in order. 3) As the result of physical examination, we found that 160 workers had skin diseases. Contact dermatitis was the most common; 69 workers had contact dermatitis alone(43.1%), 11 had contact dermatitis with acne(6.9%), 10 had contact dermatitis with folliculitis(6.3%), 1 had contact dermatitis with acne & folliculitis, and 1 had contact dermatitis with abnormal pigmentation. Others were folliculitis(9 workers, 5.6%), acne(8, 5.0%), folliculitis & acne(2, 1.2%), keratosis(1, 0.6%), abnormal pigmentation(1, 0.6%), and non-specific hand eczema(47, 29.3%). 4) The prevalence of any skin diseases was 34.0 per 100 in cutting oil users, and 13.3 per 100 in non-users. Especially, the prevalence of contact dermatitis was 23.0 per 100 in cutting oil users and 4.3 per 100 in non-users. 5) We tried patch test(standard series, oil series, organic solvents) on 49 patients to differentiate allergic contact dermatitis from irritant contact dermatitis and found 20 were positive. 6) In a multivariate analysis(independent=age, tenure, kinds of cutting oil), the risk of skin diseases was higher in the water-based cutting oil user and both oil user than non-user or neat oil user(odds ratio were 2.16 and 2.78, respectively). And the risk of contact dermatitis was much higher at the same groups(odds ratio were 5.16 and 6.82, respectively).
Acne Vulgaris ; Automobiles ; Dermatitis, Allergic Contact ; Dermatitis, Contact ; Fingers ; Folliculitis ; Hand ; Humans ; Oils ; Physical Examination ; Pigmentation ; Prevalence ; Surveys and Questionnaires ; Skin ; Skin Diseases

Injury to major retroperitoneal vessels is a recognized life-threatening complication of lumbar diskectomy. CT can depict vessel tearing and consequent retroperitoneal hemorrhage. We report a case of retroperitoneal hemorrhage due to right common iliac vein injury during lumbar diskectomy with a brief review of the literature.
Diskectomy* ; Hemorrhage* ; Iliac Vein* ; Tears*