During 2 months from December 1979 to January 1980, Medical practitioners in chonnam province were grouped into Si (city), Eup(town) and Myun (rural area) groups according to the locations of their clinic. 40 practitioners were randomly selected in each group and were asked their opinions about rural medical care in general. Total of 88 practitioners replied to the question as 73.3 percent of response rate in average. The most frequently mentioned advantages of rural practice were ease of clinic opening in Si-and Myun-group respondents and good social relationship in Eup-group respondents. The most frequently mentioned disadvantages were medical isolation in Si-group respondents and resident's ignorance in medicine in Eup-and Myun-group respondents. In all groups, most respondents though that rural medicine care should be delivered by and controled by physician. Suggestions made by Eup-and Myun-group respondents for improving rural medical care by structural change focused on the regional medical insurance system, while Si-group respondents noted district hospital or hospital linkage as most preferable system.
Surveys and Questionnaires ; Hospitals, District ; Insurance ; Jeollanam-do

We compared the clinical and radiographic outcomes between femoral varus osteotomy (23 hips) and Salter innominate osteotomy (18 hips) for treatment of Catteral is groups III and IV Perthes disease after 3-12 years follow-up. There were no statistically significant differences in the clinical outcomes using the lowa hip rating score and leg length discrepancy and in the final radiographic outcomes using the femoral head sphericity and Stulberg type between the two groups. However, neckshaft angle and center-edge angle were closer to normal value in the Salter innominate osteotomy group compared with the femoral varus osteotomy group. When the patients underwent femoral varus osteotomy at the older age (7 years), articulotrochanteric distance ratio and neck-shaft angle were significantly less than those of other patients. Salter innominate osteotomy may be better indi- cated as compared to femoral varus osteotomy, when physeal damage of proximal femur is obvious or highly suspicious particularly in the older children (7 years) with severe Perthes disease.
Child ; Femur ; Follow-Up Studies ; Head ; Hip ; Humans ; Leg ; Legg-Calve-Perthes Disease* ; Osteotomy* ; Reference Values

A study was made on 50 cases of epileptic children who had been observed at the pediatric department of Chungnam National University Hospital Taejeon Eul Ji Hospital during the period from July, 1986 to June, 1991. The result are as follows: 1) Epilepsy was most frequent in children from 1 year to 10 year of age (80%). Epilepsy was commoner in female children compare to male representing male to female ratio, 1:1.2. 2) Intractable cases with VPA were 40%, and male to female ratio was 1.2:1. Intractable cases were most common between 1 and 5 years (65%). 3) The most common epileptic type was generalized tonic clonic seizure (38%). 4) The clinical effect of valproic acid was the worst in severely abnormal EEG finding. 5) The mean plasma VPA level was significantly lower for the polytherapy (57.7microgram/ml) than for the monotherapy (69.5microgram/ml). The VPA dose of steady-state was significantly higher for polytherapy (27.9mg/kg/d) than for the monotherapy (20.9mg/kg/d). VPA level: dose ratio was reduced in the polytherapy (2.1) as compared to monotherapy (3.3). 6) The plasma VPA level increased according to dosage. In the same dose, plasma level of monotherapy was significantly higher than polytherapy. 7) The VPA dose of stead-state was highest under 1 year (monotherapy: 24.8mg/kg/day, polytherapy: 33.4mg/kg/day). The VPA dose decreased in accordance with an increase of the age. 8) There was no correlation between EEG change and plasma concentration of VPA. 9) There was linear correlation between clinical affect and plasma VPA level, and plasma concentration of VPA reached 51 to 100microgram/ml at that time. 10) The clinical effect was good in abscence seizure, simple partial seizure, myoclonic seizure, and generalized tonic clonic seizure in decreasing order. 11) The incidence of side effect were gastrointestinal disturbance, behavior disorder, laboratory abnormality, neurologic abnormality in order of frequency. The frequency of overall side effects observed was 40% but toxic effects were generally mild.
Child* ; Chungcheongnam-do ; Daejeon ; Electroencephalography ; Epilepsy ; Female ; Humans ; Incidence ; Male ; Plasma ; Seizures ; Valproic Acid*

No abstract available.
Denture, Partial, Fixed* ; Finite Element Analysis*

Purpose: This study analyzed the changes in the number of surgeries and surgical patterns due to the adoption and diffusion of new medical technology while focusing on radical prostatectomy. Materials and Methods: Medical equipment status report data and the National Health Insurance claims data from 2007 to 2019 were used. A total of 62798 radical prostatectomies from 135 medical facilities were analyzed. Radical prostatectomy was classified into open radical prostatectomy (ORP), laparoscopic radical prostatectomy (LRP), and robot-assisted laparoscopic radical prostatectomy (RARP) using the fee schedule codes. A linear mixed model was used to determine whether the adoption of a robotic surgical system had an effect on the number of surgeries and surgical patterns after adjusting for medical characteristics. Results: The number of radical prostatectomies performed in Korea increased from 1756 in 2007 to 8475 in 2019. During this period, the proportion of RARP in total surgery increased from 17.5% to 74.3%. The mean number of surgeries at medical facilities adopting the robotic surgical system was 128.3, which was higher compared to 18.5 cases in medical facilities that did not adopt it. The adoption of a robotic surgical system increased the number of radical prostatectomy surgeries by 12.1 cases and the RARP share by 47.2% in a linear mixed model.  Conclusion The adoption and diffusion of robotic surgical systems in Korea increased the number of surgeries as well as the share of robotic surgery. It is necessary to manage a technology that is widely used in a state where its clinical effectiveness is uncertain.

The Ilizarov technique for gradual distraction osteogenesis was developed in the 1950s. A correctly performed osteotomy is essential to the success of distraction osteogenesis and prepares for limb lengthening. Between Sept. of 1991 and 1994, thirty-four patients were treated by Ilizarov technique at St. Benedict Hosp. and Gang-Dong Hosp.. And then assigned to two separate groups : a corticotomy group (group A) and osteotomy group (group B; osteotomy with Gigli saw or osteotomy with multiple drill holes and osteotome). The regenerate segments were evaluated weekly for the first six weeks after operation. After the initial six-week evaluation period, observations of these segments were continued through a series of monthly radiographs. Distraction began on postoperative day seven in group A and on day eleven in group B; and continued at a rate of 1 mm/day and a frequency of 4 times/day. Group A displayed new bone formation earlier than group B: group A's mean was 16.5 ± 4.9 days, while B's mean was 25.3 ± 4.6 days. The first bridging callus occurred earlier in group A than it did in group B: A's mean was time of 36.7 ± 9.9 days, while B's mean was 44.0 ± 7.9 days. There was no significant difference between groups A & B in terms of first cortical formation : A's mean was 86.9 ± 24.0 days, and B's mean was 100.6 ± 25.2 days. There was no significant difference between groups A & B in terms of the bone healing index : A's mean was 41.6 ± 13.5 days and B's mean was 41.15 ± 8.10 days.
Bony Callus ; Extremities ; Humans ; Ilizarov Technique ; Methods ; Osteogenesis ; Osteogenesis, Distraction ; Osteotomy

No abstract available.

Pathological study was performed on the 135 cases (137 lesion) of early gastric cancer (EGC) diagnosed during the period from 1970 to 1988. The gastrectomy specimens were obtained from Pusan National University Hospital and Pusan Paik Hospital. The statistical analysis was applied on the point of pathological and epidemiological aspects. The results obtained were summarized as follows: 1) The proportion of patients with EGC of all gastric cancer diagnosed in Pusan area during the period of 1970 to 1974 was 1.3%, those during 1975 to 1979 was 1.7%, those during 1980 to 1984 was 7.8%, and those during 1985 to 1988 was 20.0% respectively. 2) The model age group was 6th decade in both sexes. The average age of patients with EGC was 50. 1-year-old in men and 47. 9-year-old in women respectively. The sex ratio (M/F) was 2 : 1 but it was lower for young people than for old people. 3) The proportion of sites involved by the EGC in the stomach was as follows : the antrum 61%, the body 39%, and the cardia and fundus 0.01%. The intestinal type cancer more frequently involved the lower portion than the upper portion of the stomach. 4) Regarding the distribution of the gross types of EGC, the elevated group (Type I, IIa) accounted for 14%, the flat type (Type IIb) accounted for 4%, and the depressed group (Type IIc, III) accounted for 82%. There was no correlation between the gross type and the depth of the lesion. The elevated group was more frequent in intestinal type than in diffuse type. 5) The size distribution of the EGC was as follows : 46% of the lesions were smaller than 2.0 cm in diameter, 47% were between 2.1 to 5.0 cm, and 7% were larger than 5.1 cm. There was no correlation between the size of the lesion and the gross type. 6) The intestinal type of EGC was 77 lesions (56.2%) and the diffuse type 60 lesions (43.8%). The ratio of both types (I/D) was 1.3 : 1, and it was lower for younger people than for old people. 7) Ten of 135 cases (7%) had lymph node metastases. The metastatic rate of EGC confined to submucosa was much higher than that of EGC confined to mucosa only, but the metastatic rate was not related with the size of the lesion.
Female ; Male ; Humans ; Neoplasm Metastasis ; Stomach Neoplasms

The exposures to carbamate pesticides (BPMC specifically) of agricultural workers were estimated by collecting pesticide in air by personal sampler and by analyzing with gas chromatography. Data revealed that the highest BPMC concentration in the aspirated air was 7.7 mg/m3. Concentrations were generally higher in the group whose spray conditions were controlled than the group uncontrolled. Actual concentrations were relatively lower than the values predicted theoretically. These findings suggest that personal sampler be useful in the estimation of pesticide exposure.
Farmers ; Chromatography, Gas* ; Humans ; Pesticides ; Pilot Projects* ; Rural Health

A new balloon dissector, a modification of a Foley catheter, was devised and it can be used either as a dissector or a tissue expander. Since most operating time was spent in balloon manipulation (inflation/deflation), the duct for saline injection was made to be wider than the Foley catheter. As a result, the balloon could be inflated faster than before. In order to reduce the scar at the donor site, harvest of the sural nerve using endoscopic technique is currently applied, but utilization of this method is technically difficult and requires a long operating time. For these reasons, new our method of using a balloon dissector was devised. The balloon dissector can also be used for immediate intraoperative tissue expansion for the reconstruction of small skin defects without distortion. We have found that the advantages of using the new balloon dissector include a reduction in operating time, preservation of the perforating vessels, and primary closure with less tension. In addition, this simple and inexpensive instrument is cost-beneficial to patients.
Catheters ; Cicatrix ; Humans ; Skin ; Sural Nerve ; Tissue Donors ; Tissue Expansion ; Tissue Expansion Devices