The purposes of this study were to investigate the perception of community nutrition programs and the conditions to carry them out, for 32 directors of health centers where public health nutritionists are not employed. The results of this study can be summarized as follows. Nutrition intervention programs were not carried out actively except those for infants but the health center directors strongly felt the necessity of carrying out various nutrition programs. The factors that affect the selecting and priotizing of nutrition programs were the need of community residents, the perception of the local congressmen, and the head of the local government. The most urgent and important problem to be solved in order to intervene nutrition programs was employing public health nutritionists on a tenure basis. Other were securing necessary revenue, precise guidance, political support, hardwares, etc. These results showed the importance of employing public health nutritionists for intervening appropriate nutrition programs and improving the perception of nutrition services for health center directors, local congressmen and personnels in charge of formulating nutrition policies.
Head ; Humans ; Infant ; Local Government ; Nutrition Policy ; Nutritionists* ; Public Health*

The purpose of this study is to estimate cesarean section rate in Korea and analyze the socioeconomic variables and health resources which affect regional variation in the rate. Samples were drawn from the record of vaginal and cesarean section deliveries based upon insurance claim bills which have been submitted to the National Federation of Medical Insurance for the first three months, January through March, 1991. The results are obtained as follows: It was found that, cesarean section rate was increasing rapidly up to 23.1% in 1991. Cesarean section per 10 thousand insured people was 4.8 and the number of cesarean section per 10 thousand insured eligible(15-49 years old) female was 7.6. The fee for normal delivery was 109,489 won and that for cesarean section was 390,024 won. The average days of hospitalization in normal delivery was 2.3 days, and those in cesarean section was 7.6 days. On the average cesarean section has a longer of stay as much as by 4.3 days and cost 3.6 times more than normal deliveries. Cesarean section rates vary among medical facilities: 19.8% at clinics 37.6% in small-scale hospitals, and 29.1% in general hospitals. The regional variation of cesarean section rates was also fairly prominent. The South Cheju Gun has the highest rate of cesarean section, 56.2%. Meanwhile no cesarean section cases has been reported in Sunchang Gun during the period of this study. The variation is noted among provinces. The rate for Cheju province has been 3.4 times higher than that for Chunnam. The number of cesarean section per 10 thousand insured people vary greatly among regions, too. This study has found that there exists significant regional variations among various geographic units in terms of average length of stay, average cost, number of obsretricians and number of beds. Multiple regression analysis was done to identify factors explaining the regional variance of various cesarean section rates: In the urban areas, no significant explaining variables were noted except the number of beds for the dependent variable of cesarean section cases per 10 thousand insured eligible females. The smaller the number of bed, the more cases of cesarean section was noted for an urban area. The is mostly because the rate of cesarean section is higher in medium-size hospitals than in large general hospitals. In the rural areas, the factor of education has been found significant for all three dependent variables. The higher the educational level, the rate of cesarean section is most likely to rise. An income variable measured by the amount of monthly insurance contribution has been identified a powerful predictor in explaining the variance of cesarean section rates. The same has been noted for the number of obstetricians. Similar findings are observed for the country as a whole. The income level has been found as the most powerful explaining factor in the regional variance of cesarean section rates. In general the rate is higher in the urban areas, and lower in the area with more small hospitals. As this is the initial attempt to identify the factors relevant to the regional difference in the rates of cesarean section, more elaborated study is urgently required.
Cesarean Section* ; Education ; Fees and Charges ; Female ; Health Resources ; Hospitalization ; Hospitals, General ; Humans ; Insurance ; Jeju-do ; Korea* ; Length of Stay ; Pregnancy

No abstract available.
Female ; Humans ; Hysterosalpingography*

No abstract available.
Hydronephrosis* ; Turner Syndrome*

Purpose: The purpose of this study was to examine the experiences of public officials working for the Coronavirus Disease-19 (COVID-19) response in community health centers in South Korea. Methods: A qualitative thematic analysis was conducted using data collected from three focus groups and two individual interviews. Results: The participants performed quarantine tasks in a poor working environment with several problems, such as significant workload, lack of manpower, and inappropriate compensation system. Participants experienced obstacles in performing quarantine works, which had the lack of the detailed quarantine guidelines, work support and cooperation system. Participants suffered from civil complaints. Participants endured sacrifices in their personal lives while partaking in COVID-19 response work without holidays, and subsequently experienced health problems. And also participants said that it was necessary to secure expertise and effective communication for infectious disease management. Conclusion The study results suggest that policies are required that are aimed to improve the working environment and the recruitment of experts in infectious diseases. In addition, the job stress related to the COVID-19 response by public officials in community health centers must be evaluated, and the relation of their job stress to physical and mental problems, as well as psychosocial stress, must be examined.

No abstract available.
Female ; Ovulation*

PURPOSE: To report a case of endogenous Nocardia endophthalmitis developed in an immunocompromized patient. METHODS: Case report. RESULTS: A 25 year-old man with terminal stage renal disease who was treated with renal transplantation and immunosuppressive medications, presented with reduced vision in his right eye. Ocular examination showed inflammation of anterior chamber, vitreous opacity and subretinal abscess. Prior to ocular symptom, he had been diagnosed to have Nocarida abscess in the lung, brain and soft tissue. He was treated with systemic antibiotics (Imipenam, TMP/SMX). Retinal lesion was improved to achieve 20/200 vision. CONCLUSIONS: We experienced a case of endogenous endophthalmitis due to systemic Nocardia infection in an immunocompromised patient. To our knowledge, this case was the first report of endogenous Nocardia endophthalmitis in Korea.
Abscess ; Adult ; Anterior Chamber ; Anti-Bacterial Agents ; Brain ; Endophthalmitis* ; Humans ; Immunocompromised Host ; Inflammation ; Kidney Transplantation ; Korea ; Lung ; Nocardia ; Nocardia Infections ; Retinaldehyde ; Transplantation* ; Vision, Low

It has been reported that ischernia causes changes in the concentration and tumover of monoamine neurotransmitters in brain. For the mechanism of cellular death in brain ischernia it is suggested that accumulation of intracellular calcium during ischemia is one of the main causes. Present study was undertaken to investigate the influence of ischemia on the contents and tumover of the biogenic anines in rat brain and further to investigate the effects of nimodipine, a calcium channel blocker, and cromakalim, a potassium channel opener, on them. Brain ischemia was induced by partial ligation of bilateral common carotid artery. Nimodipine (36 ,ug/kg, I.p.) or cromakalim (0.5mg/kg, I.p.) was administered 20 minutes before ligation. Nimodipine was administered every 4 hours in 24-hour ischemic group. Rats were sacrificed by decapitation 3 or 24 hours after induction of ischemia and whole brains were excised. The brain was divided into follow ing regions; cerebral cortex, corpus striatum, hippocampus, thalamus, hypothalamus, substantia nigra and cerebellum. The concentrations of biogenic amines and their metabolites were measured by high performance liquid chromatography-electrochemical detector (HPLC-ECD).
Animals ; Biogenic Amines* ; Brain Ischemia ; Brain* ; Calcium ; Calcium Channels ; Carotid Artery, Common ; Cerebellum ; Cerebral Cortex ; Corpus Striatum ; Cromakalim ; Decapitation ; Hippocampus ; Hypothalamus ; Ischemia ; Ligation ; Neurotransmitter Agents ; Nimodipine* ; Potassium Channels ; Rats* ; Substantia Nigra ; Thalamus

OBJECTIVE: To find out clinical features and long-term outcomes of idiopathic childhood nephrotic syndrome(NS) patients with late steroid resistance(LSR)/late steroid sensitiveness(LSS). PATIENTS AND METHODS: A retrospective chart review was performed on 480 patients diagnosed with idiopathic childhood NS at Asan Medical Center Children's Hospital from 1990 to 2013. Twenty-four patients whose responsiveness to steroids changed over a minimum 2 year follow-up period (2-17.5 years) were investigated. All patients had undergone a renal biopsy. RESULTS: Among 480 nephrotic children, 428 (89%) were sensitive to the first steroid course. Of those who initially responded, 11 (2.5%) developed resistance to steroid therapy after relapses. LSR mostly developed between 1 month and 1 year after the initial episode. Six patients showed a minimal change and five showed focal segmental glomerulosclerosis (FSGS). Nine (82%) responded to cyclosporine or methylprednisolone pulse therapy. Of these, two had no further relapse, whereas the other seven experienced several relapses that ranged in length from 1.1 to 13.9 years. Three of the nine who initially responded to immunosuppression went on to experience several changes in steroid responsiveness. Two (18%) with resistance to immunosuppressants, including steroids, eventually progressed to end stage renal disease. Among the 52 patients (11%) who were initially steroid resistant, 13 (23%) were converted to steroid sensitive at relapses. Among these, 9 showed minimal change and 4 showed FSGS. Two had no further relapse and the other 11 responded to steroids on subsequent relapses ranging in length from 1.3 to 9.4 years. All these patients have had no further changes in steroid responsiveness with normal renal function. CONCLUSIONS: In this study, 2.5% of initial steroid responders and 25% of initial steroid non-responders changed their responsiveness to steroids at subsequent relapses. Eighteen percent of LSR patients developed end stage renal disease. All of the LSS patients showed preserved normal renal function. Responsiveness to immunosuppressants seemed to be the most important factor determining longterm outcomes in LSR/LSS patients.
Biopsy ; Child ; Chungcheongnam-do ; Cyclosporine ; Follow-Up Studies ; Glomerulosclerosis, Focal Segmental ; Humans ; Immunosuppression ; Immunosuppressive Agents ; Kidney Failure, Chronic ; Methylprednisolone ; Nephrotic Syndrome* ; Recurrence ; Retrospective Studies ; Steroids

PURPOSE: To compare high-order aberrations in the pseudophakia with different types of intraocular lenses (IOLs), as well as with normal phakic eyes. METHODS: This single-center prospective study comprised 80 cataract patients who underwent cataract surgery and 20 phakic eyes. Twenty eyes received an AF-1(R) VA-60BB; 20 eyes, a Corneal(R) ACR6D SE; 20 eyes, a Sensar(R) AR40e; and 20 eyes, a ClariFlex(R). One month after cataract surgery, the eye aberration was measured using a Hartmann-Shack type aberrometer. The same test was performed for 20 normal phakic eyes. The individual Zernike polynomials, the root mean square (RMS) values of the third and fourth order aberration, and the total RMS among the groups were compared. RESULTS: The individual Zernike coefficient (Z3(-1), Z3(3), Z4(-4), Z4(0), Z4(4)) showed a significant difference in the IOL-implanted groups compared with the normal phakic eyes. There were statistically significant differences in the RMS values of the third and fourth order aberration, and total among each group. CONCLUSIONS: There was a statistically significant increase in aberration in patients with high refractive index IOL and a statistically significant decrease in patients with silicone IOL, compared to the normal phakic eyes.
Cataract ; Humans ; Lenses, Intraocular* ; Prospective Studies ; Pseudophakia* ; Refractometry ; Silicones