The purpose of this study is to estimate the minimum optimal scale(MOS) of the self-employed health insurance associations. Considering the high proportion of operating expenses, the author have selected 254 regional health insurance associations from the 1990 Finance Report of the self-employed health insurance programs. both a quadratic function and a hyperbolic function were chosen for the analysis. The dependent variables are the average maintenance cost per insured person and per household, and the independent variables are the number of insured members and of household. The minimum optimal scale was obtained from the differentiation of the quadratic function. Major findings are summarized as follows: 1. The M.O.S. was calculated as 166,174 members (27,442 households) for the rural self-employed health insurance associations and 258,462 members (75,446 households) for the urban. Providing that both the rural and urban health insurance associations would e integrated, the M.O.S. be found to become 231,687 members (68,101 households) 2. Compared with the optimal minimum scale, the magnitude of the current health insurance association found to be much smaller, less than half of the optimal scale. 3. In order to reduce the operating cost, it is necessary to enlarge the operational scale of self-employed health insurance associations.
Family Characteristics ; Humans ; Insurance ; Insurance, Health* ; Korea* ; Urban Health

PURPOSE: This study was designed to examine the effects of horticultural therapy program on state-anxiety, fatigue and quality of life (QoL) of among women cancer survivors. METHODS: Quasi-experimental study was used with a nonequivalent control group pretest-posttest design. Data were collected from February to June, 2009. Participants consisted of 40 women cancer survivors in community. The experimental group participated in horticultural therapy program once a week for 18 weeks. Data were analyzed with SPSS/WIN 18.0 program using chi2-test and t-test. RESULTS: There were significant differences between the two groups in state-anxiety and QoL. CONCLUSION: The results of this study support that horticultural therapy program was effective in decreasing state-anxiety and improving QoL among women cancer survivors.
Anxiety ; Fatigue ; Female ; Horticultural Therapy ; Humans ; Quality of Life ; Survivors

OBJECTIVES: The aim of this study was to identify the health and environmental risk factors of air contaminants that influence environmental and respiratory diseases in Gyeongju, Pohang and Ulsan in South Korea, with a focus on volatile organic compounds (VOCs). METHODS: Samples were collected by instantaneous negative pressure by opening the injection valve in the canister at a fixed height of 1 to 1.5 m. The sample that was condensed in -150degrees C was heated to 180degrees C in sample pre-concentration trap using a 6-port switching valve and it was injected to a gas chromatography column. The injection quantity of samples was precisely controlled using an electronic flow controller equipped in the gas chromatography-mass spectrometer. RESULTS: The quantity of the VOC emissions in the industrial area was 1.5 to 2 times higher than that in the non-industrial area. With regards to the aromatic hydrocarbons, toluene was detected at the highest level of 22.01 ppb in Ulsan, and chloroform was the halogenated hydrocarbons with the highest level of 10.19 ppb in Pohang. The emission of toluene was shown to be very important, as it accounted for more than 30% of the total aromatic hydrocarbon concentration. CONCLUSIONS: It was considered that benzene in terms of the cancer-causing grade standard, toluene in terms of the emission quantity, and chloroform and styrene in terms of their grades and emission quantities should be selected for priority measurement substances.
Benzene ; Chloroform ; Chromatography, Gas ; Electronics ; Electrons ; Hot Temperature ; Hydrocarbons, Aromatic ; Hydrocarbons, Halogenated ; Republic of Korea ; Risk Factors ; Styrene ; Toluene ; Volatile Organic Compounds

BACKGROUND/AIMS: Two percent glutaradehyde has been the reference disinfectant for high-level disinfection, but often requires long period of exposure up to 45 minutes. The aims of this study were to evaluate the effectiveness of a new endoscope disinfectant that uses 0.2% peracetic acid, and to compare the culture-positive rate in each different endoscopes and washers used. MEHTODS: Three endoscopes and two washers that differed in purchase year were used. They were cleansed manually and disinfected with peracetic acid for 10 minutes. A total of 86 gastroduodenal endoscopic sessions were included in the study. RESULTS: Overall culture-positive rate was 37.2%, majority of which came from washings of biopsy channel. There was a significant difference in culture-positive rate according to the machine used. Culture positive rate was 11.4% in recently purchased endoscope and washer used. Of the 28 Helicobactor pylori positive cases, there was one Helicobactor pylori DNA PCR positive case, but no Helicobactor pylori was found. CONCLUSIONS: When new endoscope and washer is used, peracetic acid is effective as a disinfectant. Significant difference in culture rate according to the different machine used might come from the aging effect and difference of cleansing power of the washer.
Aging ; Biopsy ; Disinfection* ; DNA ; Endoscopes* ; Peracetic Acid* ; Polymerase Chain Reaction

Subcutaneous emphysema often occurs as a result of surgery, trauma of the aerodigestive tract, and increased alveolar pressure. Generally, spontaneous emphysema is rare, because "spontaneous" is only used to describe emphysema that has no obvious etiology. We reviewed six cases of non-traumatic subcutaneous emphysema occurring in the head and neck. Among them, four cases were associated with pneumomediastinum. Two occurred without obvious etiology, another two were due to heavy lifting events, one due to severe vomiting, and the last one due to severe blowing. Most cases occurred in young males. Clinical symptoms, commonly involved sites, treatments and results of these cases of spontaneous emphysema were analysed.
Emphysema ; Head* ; Humans ; Lifting ; Male ; Mediastinal Emphysema ; Neck* ; Subcutaneous Emphysema* ; Vomiting

A primary duodenal carcinoid tumor causing carcinoid syndrome is rare. In case of accompanying carcinoid syndrome in a primary duodenal carcinoid tumor, it mostly suggests massive liver metastasis. In rare case, venous drainage of carcinoid tumor and systemic venous drainage are directly connected without passing through the portal system. Therefore, it is rare and interesting case which a primary duodenal carcinoid tumor accompanies carcinoid syndrome without liver metastasis. We experienced an occasion of a primary carcinoid tumor located in duodenal bulb in a 56 year-old woman. This patient came to our hospital because of intermittent diarrhea, epigastric pain and facial flushing. And it was surely diagnosed as carcinoid tumor by gastrointestinal endoscopic biopsy. She was hospitalized for surgery and we were able to confirm that carcinoid syndrome was accompanied through biochemical test. However, metastatic lesion was not found at liver, small and large intestine. We report this case with reference to documents due to rarity.
Biopsy ; Carcinoid Tumor* ; Diarrhea ; Drainage ; Female ; Flushing ; Humans ; Intestine, Large ; Liver* ; Middle Aged ; Neoplasm Metastasis* ; Portal System