The level of copayment increased in order to stabilize the financial condition of the health insurance on 1986. An important question regarding the policy was whether the increase in the level of copayments reduced the utilization of medical services in the poor selectively. In spite of the importance of the research question, no study has been reported. This study was designed to find out changes in nuniU rs of physician visits, to explain charac teristics influencing the difference of utilization before and after the program. Finally the interaction effect between the program and the level of income was examined for the abover question. A total of 10,421 persons from eight institutions was selected as the study sample. Research findings are as follows. 1. The number of physician visits decreased by ten percent as a result of increasing the level of copayment. 2. The decrease was remarkable in some groups such as children, rural area and large family. 3. The most important factor which explained the difference was the number of physician visits before the introduction of the new program.. The more numbers of physian visits during the last year were, the more numbers of physian visits decreased after the program. 4. The interaction term between the program and the level of income was statistically significant in the multiple regression model which explained physician visits and its coefficient was negative. It means that an increase in copayment did not reduced the number of physician visits in the poor, selectively. 5. It can be concluded that imposing adequate copayment reduces the use of medical services as well as medical costs without serious damage in access especially for the poor pule.
Child ; Humans ; Insurance, Health

No abstract available.
Intestinal Fistula*

No abstract available.
Voice*

No abstract available.
Neurothekeoma*

Autogenous bone-patellar tendon-bone is popular ligament substitute used in anterior cruciate liga- ment(ACL) reconstructions. Fracture of the patella is a rare but serious complication unique to this type of reconstruction. We report 4 cases of patellar fracture after autogenous bone-patellar tendon-bone ACL reconstruction.
Autografts* ; Ligaments ; Patella

PURPOSE: The Purposes of this study are to identify the circulating etiologic viruses of acute lower respiratory tract infection in children and to understand the relation with clinical diagnosis. METHODS: We obtained a total of 418 nasopharyngeal aspirates from children admitted for their acute lower respiratory tract infections at three tertiary hospitals in Seoul from September 2008 to March 2009. We performed multiplex RT-PCR to identify 14 etiologic viruses and analyzed their emerging patterns and clinical features. RESULTS: Average age of patients was 16.4 months old and the ratio of male to female was 1.36. Viruses were detected in 56.2% of a total of 418 samples. Respiratory syncytial virus (35%) was the most frequently detected and followed by human rhinovirus (22%), human bocavirus, adenovirus, human metapneumovirus, parainfluenza virus, influenza virus and human coronavirus. Co-infection reached 21.9% of positive patients. CONCLUSION: When we manage the patients with acute lower respiratory infectious diseases, we should remind the role of various viral pathogens, which might be circulating by seasons and by local areas.
Adenoviruses, Human ; Child ; Coinfection ; Communicable Diseases ; Coronavirus ; Female ; Human bocavirus ; Humans ; Male ; Metapneumovirus ; Orthomyxoviridae ; Paramyxoviridae Infections ; Respiratory Syncytial Viruses ; Respiratory System ; Respiratory Tract Infections ; Rhinovirus ; Seasons ; Tertiary Care Centers ; Viruses

PURPOSE: This research compares the predictive value of the abdominal obesity indicator, waist circumference (WC), and the overall obesity indicator, body mass index (BMI), among men and women with regard to type 2 diabetes. MATERIALS AND METHODS: This study used data collected from 4,400 households selected by a stratified multistage probability sampling method during the 2001 Korea National Health and Nutrition Examination Survey (KNHANES). The final study sample included 4,684 subjects over 30 years of age who had completed the health examination required for the analysis of the health interview and health behavior surveys. RESULTS: Both men and women showed significant differences in fasting blood glucose (FBG) or HbA1c levels based on abdominal obesity irrespective of BMI. However, the presence of overall obesity among men with abdominal obesity was not significantly correlated with FBG or HbA1c levels, while the presence of overall obesity among women with abdominal obesity was significantly different in regard to FBG or HbA1c levels. CONCLUSION: Both WC and BMI emerged as a measures of risk factors for type 2 diabetes among women while only WC emerged as a risk factor for diabetes among men.
Adult ; Blood Glucose/*analysis ; Body Mass Index ; Diabetes Mellitus, Type 2/*drug therapy ; Female ; Health Behavior ; Hemoglobin A, Glycosylated/metabolism ; Humans ; Insulin/*administration & dosage/*therapeutic use ; Male ; Middle Aged ; Nutrition Surveys ; Obesity/blood/*complications ; Obesity, Abdominal/blood/*complications ; ROC Curve ; Republic of Korea

To evaluate whether mast cells are involved in developing pathologic feature of psoriasis, 60 biopsy specimens of patients with psoriasis were analyzed. They had not been treated for at least 1 week before skin biopsy. Histological findings in early and fully developed lesions and numbers of mast cells in their dermal papillae were investigated. The results were as follows: 1. In epidermal changes of psoriatic lesions, parakeratosis and acanthosis revealed different findings between early lesions and fully developed lesions. While early lesions revealed mounds of parakeratosis and mild to moderate acanthosis, fully developed lesions revealed confluent parakeratosis and moderate to severe acanthosis. In dermal changes of psoriatic lesions, papillomatosis revealed different findings between early developed lesions and fully developed lesions. While early lesions revealed normal to moderate papillomatosis, fully developed lesions revealed moderate to severe papillomatosis. 2. Degree of acanthosis is related to the degree of papillomatosis. The more increase in the degree of acanthosis, papillomatosis, and parakeratosis, mast cell numbers in dermal papillae were more increased. 3. Mast cell numbers in dermal papillae were more increased in fully developed lesions than early lesions. 4. These findings suggest that mast cell may play an active role in developing pathologic finding of psoriasis.
Biopsy ; Humans ; Mast Cells* ; Papilloma ; Parakeratosis ; Psoriasis* ; Skin

This research analyzes the prevalence of metabolic syndrome (MS) in Korea and examines how the presence of a familial history of diseases related to MS, such as hypertension/stroke, cardiovascular disease, and diabetes, affect the development of MS in Koreans. The prevalence of MS and its components, as defined by the Nation-al Cholesterol Education Program Adult Treatment Panel guidelines, were evalu-ated in nationally representative samples of non-institutionalized civilian Koreans. This analysis is based on the 2001 Korea National Health and Nutrition Examina-tion Survey, which used a stratified multistage probability sampling design. The final study included 5, 742 adults who had completed the necessary health examinations and met the diagnosis of MS. The prevalence of MS was 25.5% in men and 28.7% in women. Odds ratio for MS among men with a familial history of hypertension/stroke was higher than that among men who did not have this history. The OR for MS among women with a familial history of hypertension/stroke or diabetes was higher than that among women who had no familial history of these diseases. These results show that familial history of hypertension/stroke and diabetes was significantly related to the presence of MS in both young men and women.
Sex Factors ; Prevalence ; Odds Ratio ; Middle Aged ; Metabolic Syndrome X/epidemiology/*genetics ; Male ; Korea/epidemiology ; Hypertension/*genetics ; Humans ; Genetic Predisposition to Disease/*genetics ; Female ; Family Health ; Diabetes Mellitus/*genetics ; Cerebrovascular Accident/*genetics ; Cardiovascular Diseases/*genetics ; Aged ; Age Factors ; Age Distribution ; Adult

PURPOSE: This study focused on local communities and the factors influencing injuries requiring hospital admission that affect the quality of life for Koreans. MATERIALS AND METHODS: This study used data collected from 4,400 households during the 2001 Korea National Health and Nutrition Examination Survey (KNHANES). A stratified multistage probability sampling method was applied and the final sample included 7,924 subjects over 20 years old who had completed the questionnaire regarding factors influencing injuries requiring hospital admission. Multiple logistic regression analysis was used to estimate the risk factors influencing injuries. RESULTS: The incidence of injuries requiring hospital admission in Koreans was higher in men than in women at 2.3% (95% CI: 1.8-2.8) and 1.7% (95% CI: 1.3-2.1), respectively. Statistically significant factors affecting the occurrence of injuries requiring hospital admission were marital status (OR: 2.60, 95% CI: 2.22- 5.56), state of health (OR: 0.63, 95% CI: 0.43-0.92), frequency of heavy drinking (OR: 1.96, 95% CI: 1.01-3.79), normal physical activities (OR: 1.68, 95% CI: 1.07-2.65), and sleep (OR: 1.54, 95% CI: 1.01-2.35). CONCLUSION: The results of this study can be used to develop measures to prevent fatal injuries and be used as basic data for community health programs.