This study was designed to investigate factors relating to fiscal deficit for regional health insurance. The financial statements for the fiscal year 1990 of nationwide 254 regional medical insurance societies were analyzed. Important findings are summarized below: 1. There were differences in the main reason for the financial deficit among regions when deficit and surplus societies were compared by regions. The total revenue per enrollee, especially revenue from the premium contribution of a deficit society was significantly smaller than that of a surplus society in large cities and counties. On the other hand, the total expenditure per enrollee of a deficit society was larger than that of a surplus society in small cities. 2. Both low premium irate at the beginning of health insurance program and less effort to increase the premium rate were main factors for the smaller revenue from the contribution of a deficit society in large cities and counties. 3. Larger expenditures per covered person of a deficit society in small cities were explained with larger medical expenditures especially for out-patients services rather than larger administrative expenses. 4. A regression analysis showed that utilization rates in out-patient services were significantly associated with income and numbers of total medical care institution per capita within a region where a health insurance society located. Also expenses paid by insurer per visit were associated with the proportion of utilization for tertiary care hospitals as well as the proportion of utilization of public health centers.
Hand ; Health Expenditures ; Humans ; Insurance ; Insurance Carriers ; Insurance, Health* ; Korea* ; Outpatients ; Public Health ; Tertiary Healthcare

Aging of the population in industrialized countries, as a result of increased life expectancy, is known to be associated with an increased risk of dementia, especially Alzheimer's disease. Estrogen use by postmentopausal women has been reported to have favorable effects on health, cognitive function, and prevention of Alzheimer's disease in old age, which now represents a revitalized area of clinical research. And may investigator reported that estrogen promotes the growth and survival of cholinergic neurons and could decrease cerebral amyloid deposition, both of which may delay the onset or prevent Alzheimer's disease. But more propective studies are needed to establish the dose and duration of estrogen required to provide these benefits and to assess its safety in elderly postmentopausal women.
Aged ; Aging ; Alzheimer Disease* ; Cholinergic Neurons ; Dementia ; Developed Countries ; Estrogens* ; Female ; Humans ; Life Expectancy ; Plaque, Amyloid ; Research Personnel

Heat stroke, a medical emergency, occurs when the body's thermal regulation is upset and unable to dissipate adequate amounts of heat with a rise in body temperature. It is characterized by hyperyrexia, with a core temperature of 40degrees C or more, hot dry skin, and central nervous system disturbance and usually results in rhabdomyolysis and multiorgan failure. Our case, a 43-year-old healthy male, was caused by a marathon, half course, on a sunny day in late summer. He suddenly fell down on the road and was delivered to a nearby hospital, where a seizure developed. He was transfered to our hospital and then displayed Central Nervous System disturbance, hot dry skin, acute liver failure, rhabdomyolysis, anuric acute renal failure, and disseminated intravasculular coagulopathy. He was treated with general supportive care and hemofiltration. Despite the aggressive management, he died of shock on the fifth day after admission.
Acute Kidney Injury ; Adult ; Body Temperature ; Central Nervous System ; Emergencies ; Heat Stroke* ; Hemofiltration ; Hot Temperature* ; Humans ; Liver Failure, Acute ; Male ; Rhabdomyolysis ; Seizures ; Shock ; Skin

No abstract available.
Rhinomanometry*

No abstract available.
Tongue Neoplasms* ; Tongue*

Actin and some actin binding proteins such as tropomyosin, -actinin and troponin T were localized by simultaneous double immunogold labeling in several developmental stages of Cryptosporidium parvum. All of the observed developmental stages have many particles of tropomyosin and actin around pellicle and cytoplasm. Tropomyosin was labeled much more than the actin when these two proteins were labeled simultaneously. And alpha-actinin was labeled mostly in the pellicle, but troponin T labeling was very rarely observed. From this study, it was suggested that tropomyosin seems to be one of the major proteins of C. parvum, so it must be playing important roles in C. parvum.
parasitology-protozoa ; actin ; tropomyosin ; alpha-actinin ; troponin T ; Cryptosporidium parvum

No abstract available.
Cartilage* ; Rabbits* ; Ribs*

No abstract available.
Animals ; Congenital Abnormalities* ; Rats*

Topical epinephrine can cause severe hypertension, ventricular tachycardia, myocardial ischemia, cardiac arrest or pulmonary edema. The increased blood pressure and left ventricular afterload, as well as decreased left ventricular compliance caused by epinephrine may also decrease the cardiac output. If a beta blocker is used in these situations, the resulting decreased contractility and inability to increase the heart rate may further compromise the cardiopulmonary function. A 26 year-old man developed tachycardia and hypertension following the local infiltration of epinephrine 2 ml (1:10,000) around the nasal mucosa and an intramucosal injection of epinephrine 7.2 ml (1:100,000). He was treated with intravenous esmolol 10 mg. He showed a decreasing heart rate and blood pressure, depressed ST segments and inverted T waves. At the same time, the pulsation of the femoral arteries was not palpable. Cardiac massage was started. He was treated with intravenous atropine 0.5 mg and epinephrine 5microgram. He recovered from circulatory failure after this treatment and his ECG showed a normal sinus rhythm.
Adult ; Atropine ; Blood Pressure ; Cardiac Output ; Compliance ; Electrocardiography ; Epinephrine* ; Femoral Artery ; Heart Arrest ; Heart Failure* ; Heart Massage ; Heart Rate ; Heart* ; Humans ; Hypertension ; Myocardial Ischemia ; Nasal Mucosa ; Pulmonary Edema ; Shock ; Tachycardia ; Tachycardia, Ventricular

Formation of cerebral de novo aneurysms (CDNA) is rare, and the pathogenesis remains obscure. In this study, we investigated the factors that contribute to the formation of CDNA and suggest guidelines for following patients treated for cerebral aneurysms. We retrospectively reviewed 2,887 patients treated for intracranial aneurysm at our institute from January of 1976 to December of 2005. Of those patients, 12 were readmitted due to recurrent rupture of CDNA, which was demonstrated by cerebral angiography. We assessed clinical characteristics, such as gender, size and site of rupture, past history, and the time to CDNA rupture. Of the 12 patients, 11 were female and 1 was male, with a mean age at rupture of the first aneurysm of 44.7 years (range: 30-69 years). The mean time between the first episode of subarachnoid hemorrhage (SAH) and the second was 8.9 years (range: 1.0-16.7 years). The most common site of ruptured CDNA was the internal carotid artery (5 patients, 41.7%), followed by basilar artery bifurcation (3 patients, 25.0%). In the remaining 4 patients, rupture occurred in the anterior communicating, middle cerebral, anterior cerebral (A1), or posterior cerebral (P1) arteries. In 5 cases (41.7%), the CDNA occurred contralateral to the initial aneurysm. Eleven patients (91.7%) had a past history of arterial hypertension. There was no history of habitual smoking or alcohol abuse in any of the patients. Eight patients underwent clipping for CDNA and three patients were treated with coiling. One patient who had multiple aneurysms was treated with clipping following intra-aneurysmal coiling. Assessment according to the Glasgow Outcome Scale (GOS) of the patients after the treatment was good in 10 cases (83.3%) and fair in 2 cases (16.7%). Although formation of CDNA after successful treatment of initial aneurysm is rare, several factors may contribute to recurrence. In our study, female patients with a history of arterial hypertension were at higher risk for ruptured CDNA. We recommend follow-up imaging studies every five years after treatment of the initial aneurysm, especially in women and those with a history of arterial hypertension.