Unfortunately, we have poor knowledge of medical technology in North Korea. This study has thus attempted to identify the level and status of medical technology development through analyzing the contents of medical textbooks currently in use. This study has assumed that three factors are influencing the level and status of medical technology in a society ; the level of socio-economic development in general, the level of scientific technology revolution and health policy. Forty textbooks are collected for this purpose. The main findings are summarized as follows: 1) North Korea has strengths in that (1) its herb drugs, which are in a broad use, are cheaper, more safe and more attainable than bio-equivalent chemical ones, and (2) the development of its medical technology was carried out with emphasis on the practical and basic health needs. 2) North Korea has weaknesses in that (1) its medical diagnostic method largely depends on manual procedures, (2) the R & D investment in the development of chemical drugs, especially antibiotics, is very small, (3) the amount of medical equipments is in a absolute shortage, and (4) the medical technology is destitute of specialty, caused mainly by the overemphasis on Juche-Uihak or herb medicine. 3) Medical technology has two faces, positive and negative so that it cannot be successfully evaluated by one. It eventually acts a positive function for public health through developments of drug, equipment and new medical treatment method. But it is also true that it has negative effects such as the dehumanization of high cost medical technology, cost hike due to over-investments in expensive equipments, and the absence of wholistic care from overspecialization. 4) We have to consider economic status and the social needs of medical care in order to evaluate the medical technology of a society. It is also the ease with North Korea. A whole picture of the North Korean medical technology could be understood only if further comprehensive studies of medical technology are to be carried out for North Korea.
Anti-Bacterial Agents ; Dehumanization ; Democratic People's Republic of Korea* ; Health Policy ; Herbal Medicine ; Investments ; Public Health

The purpose of this paper is to identify factors affecting the optimum mix of required inputs and other relevant factors which account for the variation in physician's productivity in general hospitals, and to find out their implications for the efficient health planning and management. An extended version of Cobb-Douglas production function and cross sectional data of one day patient census from all general hospitals in Korea in 1988 were used in the analysis. Main results of the analysis and their implications could be summarized as follows ; (1) The production function for physician's inpatient service shows the evidence of economies of scale, but the production function for physician's outpatient and adjusted-patient service, which combines both out- and inpatient service, shows that of dis-economies of scale. (2) The physician's role for production for all service is smaller than auxiliary personnel's, which imply that more intensive utilization of nurses, nursing aides and other auxiliary personnel is desirable for improving general hospital productivity. (3) In case of physician's inpatient and adjusted-patient service, nurses is recommended for the efficient operation of general hospitals. (4) The factor of hospital beds plays the leading role among required inputs in the production for physician's in- and adjusted-patient service. (5) The physician's productivity of general hospitals in rural area is lower than that in urban area. And the productivity of teaching hospitals is lower than that of the other hospitals. Further analysis was made in physician production function based upon the size of hospitals, namely those hospitals below 250 beds and those above. Explained variances by the factor of hospital beds was significantly increased in the case of those hospitals above 250. A more detailed and thorough investigation is needed for verifying factors influencing physician's productivity in general hospitals in Korea.
Censuses ; Efficiency* ; Health Planning ; Hospitals, General* ; Hospitals, Teaching ; Humans ; Inpatients ; Korea ; Nursing ; Outpatients ; Physician's Role

No abstract available.
Calcium* ; Lidocaine* ; Neuroglia* ; Reperfusion*

The objectives of this study are two-fold : to identify geographic variations in the rate of tonsillectomy and adenoidectomy(T and A) and appendectomy and analyze the socioeconomic variables and health resources which affect geographic variation in the rate. The nationwide three month's cases of the two surgical procedures in 1991 are obtained from the record of the National Federation of Medical Insurance. The analysis shows two to ten-fold variations in the regional rates for the performance of two common procedures such as T and A and appendectomy. T and A shows a bigger regional variations than appendectomy. As a result of multiple regression, the factor of bed supply has been found significant for the dependent variable of the rate of T and A. The findings of large variations in the rate of surgical procedures throughout the country would have important implications for allocating scarce resources and managing quality of care. Further analysis is needed for the elaboration of the above implications.
Appendectomy* ; Health Resources ; Insurance ; Korea* ; Tonsillectomy*

Background: Dizziness/vertigo is one of the most common symptoms for which people seek healthcare. However, the healthcare expenditure attributable to dizziness/vertigo in South Korea remains poorly understood. We investigated the healthcare costs due to six major disorders causing dizziness/vertigo using claims data. Methods: The healthcare costs were evaluated using all the claims data submitted to the Health Insurance Review and Assessment Service from January 1 to December 31, 2022. The six major vestibular disorders included for analysis were benign paroxysmal positional vertigo (BPPV), psychogenic/persistent postural perceptual dizziness (PPPD), vascular vertigo/dizziness (VVD), vestibular migraine (VM), Meniere’s disease (MD), and vestibular neuritis (VN). Results: During the 1-year study period, 4.1% of adults aged 20 or older visited hospitals due to dizziness/vertigo in South Korea. Compared to the general population, the patients with dizziness/vertigo were more often elderly, female, and residents of small towns. The total healthcare cost for the six major vestibular disorders was ₩547.8 billion (approximately $406.5 million). BPPV incurred the highest annual healthcare cost (₩183.5 billion, 33.5%), followed by VVD (₩158.8 billion, 29.0%), MD (₩82.2 billion, 15.0%), psychogenic/PPPD (₩60.3 billion, 11.0%), VN (₩32.9 billion, 6.0%), and VM (₩30.1 billion, 5.5%). The mean healthcare cost per hospital visit due to dizziness/vertigo was ₩96,524 (95% confidence interval, ₩96,194–₩96,855), 30% higher than the average (₩73,948) of the overall healthcare cost per hospital visit over the same period. Conclusion Owing to higher healthcare costs for dizziness/vertigo and increased prevalence of dizziness/vertigo in the aged population, healthcare costs due to dizziness/vertigo will increase rapidly in South Korea. Thus, a guideline for cost-effective management of dizziness/ vertigo should be established to reduce the healthcare costs due to these common symptoms.

Few studies have investigated the long-term effects of gonadotropin-releasing hormone (GnRH) agonist treatment on the reproductive function of central precocious puberty (CPP) girls. In this cross-sectional study, we assessed the ovarian function by analyzing the serum anti-Müllerian hormone (AMH) levels of CPP girls. Our study included 505 CPP girls subdivided into 5 groups according to the GnRH agonist treatment stage: group A (before treatment, n = 98), group B (3 months after initiation, n = 103), group C (12 months after initiation, n = 101), group D (24 months after initiation, n = 101), and group E (6 months after discontinuation, n = 102). We compared the serum AMH levels of the CPP girls with those of 100 bone age-matched controls (before treatment: n = 55; after discontinuation: n = 45). At baseline, the mean AMH level of the CPP girls was 5.9 ± 3.6 ng/mL. The mean AMH level after 3 months of the GnRH agonist treatment was lower (4.7 ± 3.2 ng/mL, P = 0.047) than that at baseline and recovered after 12 months of treatment. Six months after discontinuation, the AMH levels were similar to those at pre-treatment. Before and after the GnRH agonist treatment, the AMH levels were similar to those of the bone age-matched controls. In the precocious puberty girls, the AMH levels based on the GnRH agonist treatment stage were all within the normal reference range. The results of this study suggest that GnRH agonist treatment has no adverse effects on the reproductive function.
Cross-Sectional Studies ; Female* ; Gonadotropin-Releasing Hormone* ; Humans ; Ovarian Reserve ; Puberty, Precocious* ; Reference Values

The timing of puberty onset varies greatly among individuals, and much of this variation is modulated by genetic factors. This study aimed to identify the kisspeptin receptor (KISS1R) gene variations and to investigate the associations between these variations and central precocious puberty (CPP). Korean girls with CPP (n = 194) and their healthy controls (n = 99) were included in this study. The entire coding region and the exon-intron boundaries (exon 1 through 5) of the KISS1R gene were directly sequenced. Seven polymorphisms were identified in the KISS1R gene. A missense change c.1091T>A, and an intron variant c.738+64G>T showed significantly higher allele frequencies in CPP patients than in controls (c.1091T>A: 30.7% vs. 22.2%, P = 0.031; c.738+64G>T: 45.6% vs. 35.9%, P = 0.023). The missense variant (c.1091T>A) was a nonsynonymous polymorphism that induces amino acid substitution of p.Leu364His. The haplotype CAGTGTC was detected more frequently in the CPP group (P = 0.042). The sequence variants of the KISS1R gene can be inducible factors in the development of CPP. The association between sequence variants and CPP should be validated by further evidence obtained from larger samples of children with CPP.
Adolescent ; Amino Acid Substitution ; Child ; Clinical Coding ; Female* ; Gene Frequency ; Genetic Variation* ; Haplotypes ; Humans ; Introns ; Puberty ; Puberty, Precocious*

PURPOSE: This study investigated the influence of obesity on the clinical course and effect of gonadotropin-releasing hormone analog (GnRHa) treatment in girls with central precocious puberty (CPP). METHODS: Medical records of 182 girls with CPP treated with GnRHa were reviewed. They were divided into 2 groups: normal weight (n=108) and overweight/obesity (n=74). Chronological age (CA), bone age (BA), difference between BA and CA (BA–CA), standard deviation score (SDS) of height, body mass index (BMI), predicted adult height (PAH), and laboratory findings were compared at baseline, after 1 year, and at the end of GnRHa treatment in both groups. RESULTS: Mean BMI SDS at baseline was 0.08±0.60 in the normal weight group and 1.55±0.36 in the overweight/obesity group. Initial CA, BA, midparental height, and PAH were similar between the 2 groups. BA–CA after treatment was significantly decreased compared to baseline in both groups (P < 0.001). Between the 2 groups, a decrease in BA–CA during treatment showed no significant difference. PAH at the end of treatment was significantly increased compared to baseline in both groups (P < 0.001). PAH at the end of treatment in the overweight/obesity group (159.88±3.41 cm) was similar to that of the normal weight group (159.19±3.25 cm). Comparing the 2 groups according to change in BMI after treatment, there were no differences in ΔPAH, ΔBA–CA, and Δheight SDS for BA. CONCLUSIONS: GnRHa treatment in obese girls with CPP improved the height outcome and had similar results in normal weight CPP girls. Obesity might not affect the efficacy of GnRHa in girls with CPP.
Adult ; Body Height ; Female* ; Gonadotropin-Releasing Hormone* ; Humans ; Medical Records ; Obesity ; Overweight ; Puberty, Precocious*

BACKGROUND: Steroid therapy has been considered as co-analgesic for palliative treatment of metastatic bone pain in terminal cancer. We designed prospective study to observe analgesic efficacy of dexamethasone, to evaluate different analgesic assessment methods and its correlation to actual improvement of quality of life. METHODS: Thirty seven men with symptomatic bone pain of prostate cancer were treated with dexamethasone infusions (10mg twice a day) for 2 weeks. Response to treatment was assessed by daily analgesic intake, by the McGill-Melzack pain questionnaire (MPQ), and by a series of 17 linear analog self-assessment scales (LASA) relating to pain and to various aspects of quality of life. Biochemical and radiological markers were measured. RESULTS: Fourteen patients (38%) had improvement in indices used to assess pain at 2 weeks after starting dexamethasone. Reduction in pain indices was associated with improvement in other dimensions of quality of life and in the scale for overall well-being. Even though radiological and biochemical markers showed no correlation, symptomatic relief of pain was associated with a decrease in serum concentration of adrenal androgens. CONCLUSION:g We conclude that 1) dexamethasone treatment may cause useful relief of pain in some of patients with bone pain of prostate cancer; 2) this relief of pain is associated with suppression of adrenal androgens; 3) measures of pain and quality of life can be used to assess benefits of systemic therapy with dexamethasone; and 4) this effects of dexamethasone should be further investigated in bone pain of other metastatic cancer.
Androgens ; Biomarkers ; Dexamethasone* ; Humans ; Male ; Palliative Care ; Prospective Studies ; Prostate* ; Prostatic Neoplasms* ; Quality of Life* ; Self-Assessment ; Weights and Measures

Objective: To evaluate the baseline colon transit time and rectoanal manometry and the effects of the electrical stimulation to the sacral dermatomes for the neurogenic bowel according to the level of spinal cord injury. METHOD: To determine the baseline differences, thirty three patients were classified into two groups: cord injured level above T9 and from T9 to L2. And thirteen patients were included in follow-up study to evaluate the effects of 4 weeks electrical stimulation. RESULTS: There was no significant difference in the baseline colon transit time on two groups. After electrical stimulation, the left and rectosigmoid transit time was more improved in lower level injured group comparing with upper level injured group. In the rectoanal manometry the mean resting anal pressure, mean squeezing pressure, high pressure zone, and threshold of rectoanal inhibitory reflex were increased after the electrical stimulation on two groups. And the mean squeezing pressure on T9-L2 injured patients was significantly increased (p<0.05). CONCLUSION: The elecrical stimulation to the sacral dermatomes increased the mean squeezing pressure of rectoanal manometry more significantly on the T9-L2 injured patients than the group of spinal cord injured level above T9. However, there was no statistically significant difference in the colon transit time before and after the electrical stimulation between two groups
Colon ; Electric Stimulation Therapy ; Electric Stimulation* ; Follow-Up Studies ; Humans ; Manometry ; Neurogenic Bowel* ; Reflex ; Spinal Cord Injuries* ; Spinal Cord*