The purpose of this study is to analyze degree of geographic maldistribution of physicians and changes in the distributional pattern in Korea over the years 1980-1985. In assessing the degree of distribution and in identifying changes in the distribution pattern, the Gini index of concentration was used. The geographical units selected for computation of the Gini index in this analysis are districts (Gu), cities (Si), and counties (Gun). Locational data for 1980 and 1985 were obtained from the population census data in the Economic Planning Board and regular reports of physicians in the Korean Medical Association. The rates of physician located countries to whole physicians were 10.4% in 1980 and 9.6% in 1985. In term of the ratio of physicians per 100,000 population, rural area had 9.18 physicians in 1980 and 12.95 in 1985, 7.13 general practitioner in 1980 and 7.29 in 1985, and 2.05 specialists in 1980 and 5.66 in 1985. Only specialists of general surgery and preventive medicine were distributed over 10% in county and distribution of every specialists except chest surgery in county increased in 1985, comparing with that rates of 1980. The Gini index computed to measure inequality of physician distribution in 1985 indicate as follows; physicians 0.3466, general practitioners 0.5479, and specialists 0.5092. But the Gini index for physicians and specialists fell -15.40% and -10.42% from 1980 to 1985, indication more even distribution. The changes in the Gini index over the period for specialists from 0.3639 to 0.4542 for districts, from 0.2510 to 0.1949 for cities, and 0.5303 for countries indicate distributional change of 24.81%, -22.35%, and 10.65% respectively. The Gini indices for specialists of neuro-surgery, chest surgery, plastic surgery, ophthalmology, tuberculosis, preventive medicine, and anatomical pathology in 1985 were higher than Gini indices in 1980.
Censuses ; General Practitioners ; Humans ; Korea ; Ophthalmology ; Pathology ; Preventive Medicine ; Rural Population ; Socioeconomic Factors ; Specialization ; Surgery, Plastic ; Thorax ; Tuberculosis

Bartter's syndrome is a rare tubular disorder characterized by hypokalemic, hypochloremic metabolic alkalosis, hyperreninemic, hyperaldosteronism, hyporesponsiveness to pressor agents and juxtaglomerular apparatus heperplasia. We report a case of Bartter's syndrome of a 5 month-old male infant with subdural hematoma who was confirmed by characteristic clinical, laboratory findings and kidney biopsy.
Alkalosis ; Bartter Syndrome* ; Biopsy ; Epilepsy* ; Hematoma, Subdural* ; Humans ; Hyperaldosteronism ; Infant ; Juxtaglomerular Apparatus ; Kidney ; Male ; Seizures*

No abstract available.
Carrier Proteins* ; Vitamin A*

No abstract available.
Tibia*

The elbow joint is the most commonly dislocated-joint in the body except for the shoulder, and in children less then 10 years old, it is the most frequently dislocated articulation. The injury and the treatment are well described in most standard textbooks, but the characteristic findings and follow-up evaluations are not generally recognized. Authors have clinically analyzed 45 cases of traumatic fracture and dislocation of the elbow joint which are treated between January, 1975 and June, 1985 at the Department of Orthopedic Surgery, Wonju Medical College of Yonsei University. The results were as follows; 1. The age incidences were in even distribution except in the old ages where the incidence was low and the male to female ratio was 7: 3. 2. The major cause of the injury of the elbow was fall down (60%). 3. Posterior and posterolateral dislocations were about 60% of all cases. 4. Associated fractures were 35.6% of all the elbow dislocations, of which medial epicondyle fracture had the highest incidence. 5. Complications including ulnar nerve injury (3 cases), median nerve injury(1 case), radial nerve mjury(1 case), rupture of brachial artery(2 cases), recurrent dislocation(1 case) and calcification of ligament(2 cases) were observed. 6. Pure elbow dislocation occurred in 13 cases (28.9%). 7. The average immobilization period for patient with non-operative treatment (45%) and operative treatment(55%) were 7 days and 3 weeks, respectively, and much better results were seen in patients with non-operative treatment than in operative treatment and in shortened immobilization period.
Child ; Clinical Study ; Dislocations ; Elbow Joint ; Elbow ; Female ; Follow-Up Studies ; Gangwon-do ; Humans ; Immobilization ; Incidence ; Male ; Median Nerve ; Orthopedics ; Radial Nerve ; Rupture ; Shoulder ; Ulnar Nerve

Shortening and angular deformities in children are one of important orthopedic management problem. Conceptually, lengthening of the short side in treatment of limb length inequality is, in most instance, the most attractive approach to this problem. Throughout the evolution of lengthening procedures, the method that has remained most consistently acceptable is osteotomy followed by gradual distraction. However, the idea of increasing the length of or modifying the axis of s bone during growth by means of distraction of the grwoth plate is relatively new. Recently, Monticelli and Spinelli have had experience with a new and novel method of lower limb lengthening by physeal distraction. We have studied the results of effect of distraction epiphysiolysis and the use of nonsteroidal anti-inflammatory agents to impede bone bridge as well as premature epiphyseal closure. There are some reports in which indomethacin could prevent reformation of a bone bridge between the epiphysis and metaphysis without inhibiting normal growth and bone remodeling. For this study, a total of 30 rabbits with an initial weight of about 600 gram was used. At operation two K-wires(l.lmm in diameter) were drilled percutaneously on parallel trscks through the epipaysis and diaphysis of proximal tibia. Epiphyseal distraction of Turnbuckle type designed at our school was applied on each side of K-wire insertion at the tibia. The correct position of pin was confirmed by radiography and the rate of distraction is 0.5–1mm per day. Distrsction was continued for 3–6 weeks and radiographs was taken every 2 weeks. Some rabbits was sacrified sfter removal of distractor. Through these examination, following results were obtained. 1. Seperation of the epiphysis from the metaphysis occurred after average 3 days, and it always occurred in the zone of provisional calcification. 2. Short term results of growth plate distraction looked promising and longer limbs were seen, but long term results were unsstisfactory with premature epiphyseal closure and bone bridge formation occuring in many cases. 3. The role of indomethacine to impede bone bridge formation across the seperated growth plate could be observed, and was found that shortening could be possibly decreased. 4. Distraction epiphysiolysis would be one of valuable leg lengthening procedure at an age when the subjects bone growth is nearly complete, and also the administration of indomethacin with growth plate distraction might be effective to diminish the significant Change of shortening or angulation in high-risk juvenile fractures.
Anti-Inflammatory Agents, Non-Steroidal ; Bone Development ; Bone Remodeling ; Child ; Congenital Abnormalities ; Diaphyses ; Epiphyses ; Epiphyses, Slipped ; Extremities ; Growth Plate ; Humans ; Indomethacin ; Leg ; Lower Extremity ; Methods ; Orthopedics ; Osteotomy ; Rabbits ; Radiography ; Socioeconomic Factors ; Tibia

Accurate staging as well as diagnosis of cervix carcinoma is of paramount importance in planning treatment. Cervical smear cytologic studies have increased the detection rate of cervix carcinoma, but current radiologictechniques are limited in staging cervix carcinoma and precise visualization of lymphnodal metastasis. The CT scancan display the precise transaxial anatomical structures, permitting us not only to know the tumor size, shape andits extent but also lymphnodal enlargement in the pelvic cavity and around the abdominal aorta and secondarychanges of the kidney. The authors have tested the usefulness of CT in staging cervix carcinoma and detectinglymphatic involvement by analysis of 24 cases diagnosed by CT and confirmed histologically at St. Mary's hospitalduring the period from Oct. 1982 to May 1984. The conclusions are as follows; 1. The accuracy of CT instaging ofcervix carcinoma was 79%. 2. The accuracy of CT diagnosis of lymphatic involvement was 87.5%, sesitivity was85.7%, and speicificity was 88.2%.
Aorta, Abdominal ; Cervix Uteri ; Diagnosis ; Female ; Kidney ; Neoplasm Metastasis ; Vaginal Smears

No abstract available.
Female ; Obstetric Labor, Premature* ; Pregnancy ; Ritodrine*

Lumbar ligimentum flava obtained from 21 patients of spinal stenosis and 10 patients who underwent surgery for vertebral fracture(control group) were studied with hematoxylin-eosin stain, Verhoff s elastic stain, and immunohistochemical stains for S-100 protein ad fibronectin. The chondroid metaplasia of ligamentum flavum found more frequently and widely in the group of spinal stenosis compared with control group. The elastic fibers were decreased in number and irregu- larly arranged at the bone attached area in the group of spinal stenosis. There was tendency to increase the amount of fibronectin in the stroma of the ligamentum flavum in the group of spinal stenosis. Above findings suggest that chondroid metaplasia and changes of the elastic fiber in the peripheral area of the ligamentum flavum are able to contribute the pathogenesis of spinal stenosis.
Coloring Agents ; Elastic Tissue ; Fibronectins ; Humans ; Ligamentum Flavum ; Metaplasia ; S100 Proteins ; Spinal Stenosis

The majority of cystic lesions of the pancreas are psudocysts and a small fraction neoplastic. Failure to recognize the true nature of neoplastic cyst will lead to an incorrct treatment strategy. Ultrasonography, computerized tomography and angiography were used to distingish these lesions, but diagnostic value of ERCP is in controversy. To evaluate the diagnostic value of ERCP in cystic lesions of the pancreas, we analysed 33 cases of pancreatic cystic lesions (pseudocyst 18 cases, retention cyst 3 cases and cystic, neoplasm l2 cases) between Apr. 1985 and June 1993. In 18 cases of pseudocysts, ERP findings were communication with cyst in 8 cases (44.4%), chronic pancreatitis in 8 cases (44.4%), obstruction in 4 cases (22.2%) and displscement of pancreatic duct in 2 cases (11.1%), and ERC findings, which were perfomed in 8 cases, showed cholangitis in 3 cases (37.5%), CBD stone in 2 cases (25%), mass effect in 1 case (12.5%) and normal in 2 cases (25%). There was no communication with the cyst and pancreatic duct, except two mucinous ductal ectasia, in 12 cases of cystic neoplasms, and the other findings were displacement of pancreatic duct in 4 cases (33.3%), obstruction in 2 cases (16.7%) and normal in 4 cases (33.3%). ERC findings of cystic neoplasm were almost normal (85.7%) except 1 case of cholangitis. In conclusion, ERCP findings of pseudocysts were communication with pancreatic duct, chronic pancreatitis and biliary tract abnormality. In contrast, ERCP findings of cystic neoplasms were displacement or obstruction of pancreatic duct without communication and chronic pancreatitis, and biliary tract abnormality were rare.
Angiography ; Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde* ; Cholangitis ; Dilatation, Pathologic ; Mucins ; Pancreas ; Pancreatic Cyst* ; Pancreatic Ducts ; Pancreatitis, Chronic ; Ultrasonography