No abstract available.
Intestinal Fistula*

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.
Neurothekeoma*

No abstract available.
Voice*

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

OBJECTIVES: This study was performed to identify the socioeconomic factors, health behavior factors and dietary patterns that have an influence on the fasting blood glucose in adults. METHODS: This study used data collected from the 2007, 2008, 2009 Korea National Health and Nutrition Examination Survey. The final sample included 4163 subjects who were 30-59 years old and who had completed the necessary health examinations, the health behaviors survey and nutrition survey. RESULTS: Eleven dietary patterns emerged from the factor analysis with different factor loading. After controlling for potential confounders, multiple regression analysis of the dietary patterns showed that 'fruits', 'alcohols', and 'starchy foods' affected the fasting blood. Lower consumption of 'fruits' and higher consumption of 'alcohols' and 'starch foods' were significantly associated only with an increased risk of high blood glucose. CONCLUSIONS: In the light of the results of this study, it appears pretty likely that the risk of developing high blood glucose can be reduced by changing a person's dietary patterns.
Adult ; Age Factors ; Asian Continental Ancestry Group ; Blood Glucose/*analysis ; Body Mass Index ; *Diet ; *Fasting ; Female ; Health Behavior ; Humans ; Male ; Middle Aged ; Nutrition Surveys ; Republic of Korea ; Sex Factors

BACKGROUND: In the Far East, it is well known that hepatic resection is a best form of treatment for complicated intrahepatic stones (IHS). However, many investigators have reported that the associated intrahepatic biliary stricture is the main cause of treatment failure, requiring additional management because of recurrent cholangitis. PURPOSE: A retrospective comparative study was undertaken to clarify the long term efficacy of hepatic resection in IHS and to investigate the clinical significance of intrahepatic biliary stricture affected on treatment failure after hepatic resection. Patient and METHOD: The clinical records of 44 among 51 consecutive patients with symptomatic IHS who underwent hepatic segmentectomy or lobectomy between July 1986 and October 1996 were reviewed. We excluded 7 patients from study group because of postoperative death or incomplete follow- up. Patients were divided into two study groups: group A with intrahepatic biliary stricture (n=28) and group B without stricture (n=16). Residual or recurrent stones, recurrence of intrahepatic biliary stricture, late cholangitis, and final outcomes were analyzed and compared statistically between group A and B. Patients were followed up for a median duration of 65 months after hepatectomy. RESULTS: The overall incidence of residual or recurrent stones were 36% and 11%, respectively. The initial treatment failure rate was 50% in group A and 31% in group B. Intrahepatic biliary stricture was recurred in 46% of group A, but in none of group B (P=0.001). More than two thirds of restrictures were identified on the primary site. The incidence of late cholangitis was higher in group A (54%) than in group B (6%)(p=0.002). The late cholangitis was severe, recurrent and related to stones and strictures in 11 of the 15patients in group A. Twelve patients (ten in group A and two in group B) needed additional secondary multiple procedures at a median of 12 months after hepatectomy. These consisted of percutaneous fluoroscopic stone retrieval (n=6), postoperative cholangioscopy (POC) or percutaneous transhepatic cholangioscopy (PTCS) with electrohydraulic lithotripsy (EHL)(n=3), balloon dilatation (n=7)choledochotomy (n=3), S4 segmentectomy (n=1), Sphincteroplasty (n=1), drainage of the delayed subphrenic or liver abscess (n=2), and repair of prolonged biliary fistula (n=1). The final outcomes after hepatectomy with or without secondary management were good in 80%, fair in 16%, and poor in 4% of the cases. CONCLUSION: The majority of the recurrent cholangitis after hepatectomy in IHS were related to recurrent intrahepatic ductal strictures. Therefore, hepatic resection should be included the strictured duct. However, with hepatectomy alone, it is difficult to clean the IHS and relieve the ductal strictures completely, particularly in cases of bilateral IHS, so a perioperative team approaches, including both radiologic and cholangioscopic interventions, should be used for effective management of IHS.
Biliary Fistula ; Cholangitis ; Constriction, Pathologic* ; Dilatation ; Drainage ; Far East ; Hepatectomy ; Humans ; Incidence ; Lithotripsy ; Liver Abscess ; Mastectomy, Segmental ; Recurrence ; Research Personnel ; Retrospective Studies ; Treatment Failure

The prevalence of type 2 diabetes (T2DM) has increased dramatically during the last decade, especially in Asian population. The control of hyperglycemia is very important for diabetes patients. Prevention of T2DM should be a major public health goal because of its substantial effect on heath. Treatment of high-risk individuals with impaired fasting glucose and impaired glucose tolerance to prevent T2DM has important medical, economic, social, and human implications. Identifying risk factors affecting transition diabetes is thus very important. Having defined a patient population at high-risk for developing diabetes, the intensive intervention of diet, physical activity, lifestyle modification, and drug therapy (metformin) can substantially affect the delay and prevention of T2DM. Tight glucose control has the potential to reduce the incidence and prevalence of T2DM.
Asian Continental Ancestry Group ; Diet ; Fasting ; Glucose ; Humans ; Hyperglycemia ; Incidence ; Life Style ; Motor Activity ; Prevalence ; Public Health ; Risk Factors

We report a case of trichorrhexis nodosa in 16-year-old male. Multiple broken hair patches were seen on the both eyebrows. Scanning electron micrascopic findings revealed typical trichorrhexis nodosa; nodular swelling of hair shaft, loss of hair cuticle, longitudinal fissuring and fracture of hair cortex, and paintbrush effect on the side of fracture. Simple avoidance of trauma gave some regrowth of hair. Intralesinional administration of triamcinolone acetonide was not to be effective.
Adolescent ; Eyebrows* ; Hair ; Humans ; Male ; Triamcinolone Acetonide