Finances of health insurance can be explained by factors determining benefit expense and premium collection. This study was conducted to analyze factors contributing to the financial status of rural health insurance. Nationwide 134 health insurance associations except the six pilot project counties were analyzed and obtained the followings. 1. In univariate analysis, statistically significant variables that explain 1) outpatient benefit expenditures include public health center utilization, proportion of pregnant women, premium and collection rate of premium 2) inpatient benefit expenditures include public health center utilization, proportion of old age, proportion of pregnant women, premium and collection rate of premium 3) profits include public health center utilization, proportion of old age, proportion of pregnant women and collection rate of premium. 2. In multiple regression analysis, statistically significant determinants in 1) outpatient benefit include premium and public health utilization 2) inpatient benefit include premium 3) profit include public health center utilization, premium and collection rate of premium.
Female ; Health Expenditures ; Humans ; Inpatients ; Insurance ; Insurance, Health* ; Outpatients ; Pilot Projects ; Pregnant Women ; Public Health ; Regression Analysis ; Rural Health

No abstract available.
Pregnancy*

Metastatic cancer of the esophagus is unusual, Toreson discovered 19 in 599 autopsies on carcinoma patients, an incidence of 3.2%, Most of the patients had primary tumors of the lung, stomach, larynx or breast. Contiguous spread of tumor into the esophagus may produce an ulcerative lesioin resembling primary cancer of the esophagus, as examplified by the direct extension of tumor from the gastric cardia. These tumors may produce esophageal symptoms, notable dysphagia, and present no particular problem to the endoscopist because the ulcerative tumor in the lumen of the eaophagus makes diagnosis easy. Unusuually these tumor will extend into the esophagus submucosally producing submucosal nodules or cicatricial stricture of the esophagus without ulceration inito the lumen. This increases the diagnostic problems because of the difficulty of obtaining a endoscopic biopsy. We experienced a case of multiple nodular metastatic esophageal carcinoma, which was submucosally extended from the stomach cancer, confirmed by endoscopic biopsy. So we report this case with brief review of the previous litera- tures.
Autopsy ; Biopsy ; Breast ; Cardia ; Constriction, Pathologic ; Deglutition Disorders ; Diagnosis ; Esophageal Neoplasms ; Esophagus ; Humans ; Incidence ; Larynx ; Lung ; Stomach Neoplasms* ; Stomach* ; Ulcer

OBJECTIVES: This study was conducted to provide accurate exposure evaluation of workers in a biologicallymonitored state who were simultaneously exposed to benzene and toluene. For the purpose of this study, an animal experiment was conducted. METHODS: The following concentrations of solvents were administered orally to Sprague-Dawley rats : benzene at 2.26 mg/kg body weight (equivalent concentration to the 2.5 ppm, Threshold Limit Value-ShortTerm Exposure Limit, in the USA) and 9.02 mg/kg body weight (equivalent concentration to the 10 ppm, Threshold Limit Value-TimeWeighted Average in Korea), simultaneously with toluene at 106.42 mg/kg body weight (equivalent concentration to the 100 ppm, Threshold Limit Value-TimeWeighted RESULTS: The following results were obtained from the analysis of reading taken at 3hour intervals of S-phenylmercapturic acid (SPMA) and phenol concentration in urine metabolites of benzene after oral administration for 30 hours. 1. The concentrations of phenol and SPMA in urine were markedly decreased in the initial phase of the mixed group (both benzene and toluene administered group) as compared with the benzeneonly administered group, and the concentrations were slightly elevated. 2. The total excreted amounts of phenol and SPMA in urine decreased in the mixed group compared with the benzene-only group, and these decreases were more remarkable at the benzene administration concentration of 9.02 mg/kg than at 2.26 mg/kg. 3. The urinary excretions of phenol and SPMA were delayed in the case of the mixed group, and the extent of the delay was dependent on the amount of benzene administrat CONCLUSIONS: Benzene metabolism was suppressed by toluene, and hence the excretion of phenol and SPMA as urinary metabolites of benzene was delayed. This result will have applications in the interpretation of results from future biological monitoring of workers exposed to mixed solvents. We should not underestimate the importance of carefully interpreting the results of biological monitoring data when workers are exposed to mixed solvents. We should not underestimate the importance of carefully interpreting the results of biological monitoring data when workers are exposed to mixed benzene and toluene.
Administration, Oral ; Animal Experimentation ; Animals ; Benzene* ; Body Weight ; Environmental Monitoring ; Metabolism ; Phenol* ; Rats* ; Rats, Sprague-Dawley ; Solvents ; Toluene*

Panax ginseng (PG) has been used as an important analeptic in traditional medicine. This study was purposed to investigate the effect of PG on immune responses induced by glucocorticoid in mice. PG solution was injected into CV6 and BL23, which are the classical acupuncture points, for 7 days after injection with glucocorticoid. And then B and T cell proliferation and cytolytic activity of natural killer (NK) cells were measured. B cell proliferation by 'H-thymidine incorporation was decreased by about 25% in control group as compared with normal group. However, B cell proliferation was significantly increased 1.8-fold in CV6 group and 2.5-fold in BL23 group as compared with normal group. T cell proliferation by H- thymidine incorporation was decreased by about 15% in control group as compared with normal group. On the other hand, T cell proliferation was significantly increased 1.9-fold in CV6 group and 2.3-fold in BL23 group as cornpared with normal group. Furthermore in purified T cell, the proliferation was furtherly increased rather than in non-purified T cell. The activity of NK cell was remarkably decreased in control group as compared with normal group. However, the activities of NK cells in CV6 and BL23 groups were recovered to the above levels of normal group. On the other hand, the activity of NK cell in the blank locus group was slightly increased compared with control group. However this increasement was not reached the levels of CV6 and BL23 groups. And in the case of purified NK cell, the cytolytic activity of NK cell was respectively increased 1.6-fold in normal group, 1.4-fold in control group, 2.0-fold in blank locus group and 2.0-fold in CV6 group and 1.4-fold in BL23 group as compared to the non-purifed NK cell. These results suggest that PG aqua-acupuncture at CV6 and BL23 may proliferate B and T cells that is suppressed by glucocorticoid, and activate NK cell activity.
Acupuncture Points ; Acupuncture* ; Animals ; Cell Proliferation ; Hand ; Killer Cells, Natural ; Lymphocytes* ; Medicine, Traditional ; Mice* ; Panax* ; T-Lymphocytes ; Thymidine

PURPOSE: To evaluate the pattern of colonic diverticulosis according to age and sex, and recent trend. MATERIALS AND METHODS: The authors retrospectively reviewed 120 cases of colonic diverticulosis in 1,020 patients who had undergone a double contrast barium enema examination between January 1st, 1993, and December 31st, 1995, and analyzed the frequency, size, multiplicity and anatomical site, according to age and sex. Diverticulum size was classified into one of three groups : less than 5mm, 5-10mm, over 10mm in diameter. RESULTS: The overall incidence of colonic diverticulosis was 120 cases among 1,020 patients(11.8%) with an incidence 5.3 times higher in males than in females. Peak incidence was in the fifth decade, with 19 cases (15.8%) among males, and after the sixth decade, with four cases(3.3%) among females. Mean age was 57.7 years. Diverticulum size of 5-10mm in diameter was predominant 2% of cases) ; average diameter was 5-6mm. The incidence of colonic diverticulosis was 5.1 times more frequent in the right colon(101 cases) than in the left (20 cases). CONCLUSION: The overal overall incidence of colonic diverticulosis has continually increased; in addition it has also recently increased slightly in left-sided colon. This is thought to be due to various factors, both congenital and acquired, including longer life with good health care, constipation, irritable bowel syndrome, stress and the tendency of eating patterns to more closely resemble those of the west.
Barium* ; Colon* ; Constipation ; Delivery of Health Care ; Diverticulosis, Colonic* ; Diverticulum ; Eating ; Enema* ; Female ; Humans ; Incidence ; Irritable Bowel Syndrome ; Male ; Retrospective Studies

The prevalence of right-sided infective endocarditis is increasing with a growing number of intravenous drug abusers. A case of right-sided endocarditis is reported in a 18-year-old female heroin addict. Tricuspid valve vegetation, septic pulmonary emboli and staphyloccus aureus in blood cultures are noted. During antimicrobial therapy, she developed remittent fever and skin rash due to vancomycin. After a change of the antibiotic to teicoplanin, she was freed from fever and discharged in an improved condition.
Adolescent ; Drug Users ; Endocarditis* ; Exanthema ; Female ; Fever ; Heroin ; Humans ; Malaria ; Prevalence ; Pulmonary Embolism* ; Teicoplanin ; Tricuspid Valve* ; Vancomycin

OBJECTIVE: Several surgical procedures have been reported for the treatment of chronic subdural hematoma (CSDH). We compared the results of treatments for CSDH obtained from one burr-hole craniostomy with closed system drainage with or without irrigation, two burr-hole craniostomy with closed system drainage with irrigation, and small craniotomy with irrigation and closed-system drainage. METHODS: Eighty-seven patients with CSDH underwent surgery at our institution from January 2004 to December 2008. Our patients were classified into three groups according to the operative procedure; group I, one burr-hole craniostomy with closed system drainage with or without irrigation (n = 25), group II, two burr-hole craniostomy with closed system drainage with irrigation (n = 32), and group III, small craniotomy with irrigation and closed-system drainage (n = 30). RESULTS: Age distribution, male and female ratio, Markwalder's grade on admission and at the time of discharge, size of hematoma before and after surgery, duration of operation, Hounsfield unit of hematoma before and after surgery, duration of hospital treatment, complication rate, and revision rate were categories that we compared between groups. Duration of operation and hospitalization were only two categories which were different. But, when comparing burr hole craniostomy group (group I and group II) with small craniotomy group (group III), duration of post-operative hospital treatment, complication and recurrence rate were statistically lower in small craniotomy group, even though operation time was longer. CONCLUSION: Such results indicate that small craniotomy with irrigation and closed-system drainage can be considered as one of the treatment options in patients with CSDH.
Age Distribution ; Craniotomy ; Drainage ; Female ; Hematoma ; Hematoma, Subdural, Chronic ; Hospitalization ; Humans ; Male ; Recurrence ; Surgical Procedures, Operative

This paper summarizes our experience of five cases of sick-sinus syndrome, hospitalized at Presbyterian Medical Center in Jeonju from January, 1980 to January, 1983. Diagnosis was made depending on clinical symptoms, physical examination, EKG and provocative test with atropine sulfate. The etiologies of 4 cases were as follows: coronary disease, hypertension, myocarditis, coronary disease with hypertension; but, the etiology of one case was not clear. Symptoms, including syncope, dizziness, and palpitation subsided after implanting the temporary pacemaker. A permanent pacemaker was implanted in all but one case, who had myocarditis.
Atropine ; Coronary Disease ; Diagnosis ; Dizziness ; Electrocardiography ; Hypertension ; Jeollabuk-do ; Myocarditis ; Physical Examination ; Protestantism ; Syncope

Renal osteodystrophy is well recognized complication of end stage renal disease(ESRD) and is associated with a marked morbidity. To evaluate bone loss in renal osteodystrophy, we measured bone mineral density(BMD) in distal radius by quantitative computed tomography in 43 ESRD patients on starting hemodialysis(HD) and in 84 healthy controls matched for age and sex. We also measured intact parathyroid hormone(iPTH), serum total alkaline phosphatase(T-ALP), osteocalcin(OC) and urine deoxypyridinoline(U-DPD) as bone turn-over markers. 1) The mean age of ESRD patients and control groups were 49.8 and 49.7 years. M:F ratio were 1:1.1 and 1:1.3 on each groups. There was no significant differences on each groups. 2) Serum T-ALP and OC were 263.9+/-264.5U/L, 43.5+/-27.6ng/mL in ESRD patients and 167.4+/-46.6U/ L, 8.8+/-3.9ng/mL in control groups. These were significantly higher in ESRD patients(P<0.001, P< 0.001), while U-DPD were not significant difference on each groups(5.3+/-4.1 vs 5.4+/-1.9nM/mM. Cr.). 3) Serum iPTH and aluminum were 296.8+/-263.4pg/mL, 10.1+/-11.6ng/mL in ESRD patients. 4) Total density, trabecular density and cortical density were 340.4+/-83.6, 172.9+/-48.4, 477.2+/-123.5mg/ cm3 in ESRD patients and 393.2+/-49.1, 210.6+/-32.9, 541.3+/-76.2mg/cm3 in control groups. BMD was statistically significantly reduced in ESRD patients (P<0.001, P<0.001, P<0.001, respectively). Z score of total density and trabecular density were -0.62+/-1.12, -0.91+/-0.95 in ESRD patients and 0.19+/-0.68, 0.06+/-0.59 in control groups. It was significantly reduced in ESRD patients(P<0.001, P<0.001, P<0.001, respectively). 5) In ESRD patients, serum T-ALP, iPTH, OC, U-DPD were not correlated with BMD and Z score. But in control groups, serum OC was correlated inversly with BMD, and U-DPD was only correlated inversely with trabecular density. 6) In ESRD patients(n=22) who were having iPTH above 300pg/mL, serum OC and U-DPD were significantly higher than in ESRD patients(n=21) who were having iPTH below 300pg/mL(52.6+/-28.8ng/ mL, 6.8+/-5.1nM/mM.Cr. vs. 33.9+/-23.3ng/mL, 3.7+/-1.9 nM/mM.Cr. P<0.05, P<0.05 repectively). But serum aluminum, and T-ALP were not significant difference on each groups. BMD and Z score were also not difference on each groups. 7) In ESRD patients who were having iPTH above 300pg/mL, iPTH and serum OC were inversely correlated with BMD but U-DPD were only inversely correlated with trabecular density. In ESRD patients who were having iPTH below 300pg/mL, bone turn-over markers were not correlated with BMD. In ESRD patients on starting HD, BMD were significantly reduced, but serum T-ALP, OC, iPTH and U-DPD were not correlated with BMD. In ESRD patients who were having iPTH above 300 pg/mL, BMD were significantly inversely correlated with serum OC, iPTH.
Aluminum ; Bone Density* ; Humans ; Kidney Failure, Chronic* ; Radius ; Renal Dialysis* ; Renal Osteodystrophy