In order to reduce the health inequalities within a society changes need to be made in broad health determinants and their distribution in the population. It has been expected that the Health impact assessment(HIA) and Healthy Cities can provide opportunities and useful means for changing social policy and environment related with the broad health determinants in developed countries. HIA is any combination of procedures or methods by which a proposed 4P(policy, plan, program, project) may be judged as to the effects it may have on the health of a population. Healthy city is one that is continually creating and improving those physical and social environments and expanding those community resources which enable people to mutually support each other in performing all the functions of life and in developing to their maximum potential. In Korea, social and academic interest regarding the HIA and Healthy Cities has been growing recently but the need of HIA and Healthy Cities in the perspective of reducing health inequality was not introduced adequately. So we reviewed the basic concepts and methods of the HIA and Healthy Cities, and its possible contribution to reducing health inequalities. We concluded that though the concepts and methods of the HIA and Healthy Cities are relatively new and still in need of improvement, they will be useful in approaching the issue of health inequality in Korea.
Health Planning/*methods ; Health Services Accessibility ; *Health Status Disparities ; Humans ; Korea ; *Urban Health ; Urban Population

BACKGROUND: Mixed venous oxygen saturation (SO2) monitoring turned out to be invaluable in following up systemic cardiovascular status. But balloon-tipped flow-directed thermodilution catheter (Swan-Ganz catheter) insertion carries additional inherent risks other than those of central venous catheterization, and it costs much more expense than simple venous catheter. There has been a lot of papers which argue that central venous catheterization may substitute for the Swan-Ganz catheterization. In addition, it may be very difficult or impossible to insert the Swan-Ganz catheter in pediatric patients. This study was performed to determine whether Swan-Ganz catheterization might be replaced by the central venous catheterization in regards to SO2. METHODS: In 17 pediatric open heart surgery (OHS) patients, from the central venous catheter, the tip of which had been located in the center of right atrium (RA) and pulmonary artery, blood samples were drawn for gas analysis simultaneously, which was done immediately after emergence from cardiopulmonary bypass. RESULTS: There were no significant differences between RA blood and mixed venous blood gas analyses except oxygen saturation. The oxygen saturations of both were linearly correlated with each other. The relation was SO2=17 0.8 SRAO2 (R=0.77, p<0.05) CONCLUSIONS: It may be concluded that RA blood may be used for blood gas analysis in place of mixed venous blood immediately after pediatric open heart surgery.
Blood Gas Analysis ; Cardiopulmonary Bypass* ; Catheterization, Central Venous ; Catheterization, Swan-Ganz ; Catheters ; Central Venous Catheters ; Heart Atria ; Heart* ; Humans ; Oxygen* ; Pulmonary Artery ; Thermodilution ; Thoracic Surgery*

From 1986 to 1993, we analyzed experiences in clean intermittent catheterization(CIC) of 62 patients with neurogenic bladder who were closely follow up for averaging 25months. Initial urodynamic study revealed hyperreflexic bladder in 21patients: 11 with detrusor sphincter dyssynergia. Areflexic bladder was found in 41patients: l5 with low compliance. Although positive urine culture were relatively frequent(61%), febrile urinary tract infections were rare(3%) and upper urinary tract function was stable. Other complications of CIC(29%) were burning sensation, resist on urethral catheter, epididymitis, scrotal abscess, bladder stone, etc. Although minor complications are not rare, we can conclude that preservation of renal function and improvement of urinary incontinence can achieved with intermittent catheterization and that patient must be well motivated and cooperative and be able to use their hands for continuation of CIC.
Abscess ; Ataxia ; Burns ; Catheterization ; Catheters ; Compliance ; Epididymitis ; Follow-Up Studies* ; Hand ; Humans ; Intermittent Urethral Catheterization* ; Male ; Sensation ; Urinary Bladder ; Urinary Bladder Calculi ; Urinary Bladder, Neurogenic* ; Urinary Catheters ; Urinary Incontinence ; Urinary Tract ; Urinary Tract Infections ; Urodynamics

Treatment of rotator cuff tears by open subacromial decompression has known successful in decreasing pain and restoring function in patients who have failed nonoperative treatment. But, open rotator cuff repair may result in significant deficits in strength and active motion by deltoid separation from the acromion. Deltoid detachment may be avoided by repair using mini-open technique. Arthroscopic subacromial decompression and the rotator cuff repair revel satisfactory results. Subacromial decompression involves decompression of the coracoacromial arch including routine release or resection of the coracoacromial ligament. Recent ligament-cutting studies have confirmed the role of the coracoacromial ligament as a static restraint to superior humeral head displacement. Complete resection of the coracoacromial ligament may be avoided through minimized arthroscopic acromioplasty. We evaluated all 11 patients with rotator cuff tears who underwent arthroscopic minimized subacromial decompression and rotator cuff repairs using mini-open technique. Their average age was 53 years (26 to 64 years); and the average follow-up was 13 months. Preoperatively, all patients complained pain and weakness. Follow-up using modified Hospital for Special Surgery shoulder score showed good to excellent results in 10 cases and poor results in 1 case an average 13 months postoperatively. We found that arthroscopic minimized subacromial decompression and repair using mini-open technique are safe, effective procedure for addressing cuff tears of a wide range of sizes.
Acromion ; Decompression ; Follow-Up Studies ; Humans ; Humeral Head ; Ligaments ; Rotator Cuff* ; Shoulder

No abstract available.
Cryopreservation* ; Humans* ; Oocytes*

To evaluate the efficacy and immediate complications of Q-switched Nd:YAG laser iridotomy in the treatment of angle closure glaucoma, Q-switched Nd:YAG laser iridotomy using coherent model 7900(U.S.A.)was performed on 50 eyes, 43 patients with angle closure glaucoma between Feb. 1987 and Mar. 1988. Forty-six eyes of Thirty-nine Patients had been followed up {or more than 2 months. Four eyes were lost to follow-up. Among 50 treated eyes, 46 required a single laser session for patency and four eyes required two sessions. Intraocular pressure was significantly decreased after Q-switched Nd: YAG laser iridotomy and the continuous use of previous glaucoma medications as necessary(p<0.01). Immediate postoperative intraocular pressure elevation was seen in two Nd:YAG-treated eyes. Thirty-five eyes treated with the Nd:YAG laser had minimal bleeding from the iridotomy site. Forty-four Nd:YAG-treated eyes had transient iritis.
Glaucoma* ; Glaucoma, Angle-Closure ; Hemorrhage ; Humans ; Intraocular Pressure ; Iritis ; Lasers, Solid-State ; Lost to Follow-Up

Ischemic colitis is an uncommon disease in Korea, but nowadays, the incidence of this disease is increasing in Korea. The reason is that the number of old patients is increasing and colonoscopic diagnosis is performed more frequently. It is especially important to differentiate it from other inflammatory bowel disease, such as infectious colitis, ulcerative colitis, Crohn's disease, and drug-induced colitis, because ischemic colitis is similar to other inflammatory bowel disease in symptoms and colonoscopic findings. However, the authors were able to differentiate ischemic colitis from other inflammatory bowel disease by close examination of a patient's history, microscopic examination and culture studies of the bacteria in the stool, and close observation of the changes in the colonoscopic findings with time. We experienced six cases of ischemic colitis and report them along with a brief review of the literature.
Bacteria ; Colitis ; Colitis, Ischemic* ; Colitis, Ulcerative ; Crohn Disease ; Diagnosis ; Humans ; Incidence ; Inflammatory Bowel Diseases ; Korea

No abstract available.
DNA* ; Herpesvirus 4, Human* ; Nasopharyngeal Neoplasms* ; Polymerase Chain Reaction*

Behcet's disease is a recurrent and multisystemic disorder which usually persists over many years and is classified under vasculitic syndrome. A classic triad in this disorder is composed of a recurrent oral ulcer, genital ulceration and uveitis. While intestinal Behcet's disease most commonly affects the ileoecal region, dysphagia associated with esophageal ulceration is very uncommon. A 34-year-old-female patient visited our hospital because of dysphagia, epigastric pain and fever. The patient had ulcers on the oral mucosa, soft palate and extemal genitalia. Multiple irregularly marginated ulcers surrounded with hyperemic edematous mucosa were found on the middle and distal esophagus and lesser curvature of the stomach by an esophagogastroduodenoscopic examination. The pathologic findings were non-specific ulcers with necrotizing vasculitis in the vulva and with suspicious vasculitis in the esophagus. So she was diagnosed to have a Behcets disease and was treated with steroid and sulfasalazine. In this study we report a case of esophageal involvement of Behcet's disease with a review of the literature.
Deglutition Disorders ; Esophagus ; Fever ; Genitalia ; Humans ; Mouth Mucosa ; Mucous Membrane ; Oral Ulcer ; Palate, Soft ; Stomach ; Sulfasalazine ; Ulcer ; Uveitis ; Vasculitis ; Vulva

BACKGROUND AND OBJECTIVES: Cilostazol is an anti-platelet and arterial vasodilating drug that inhibits phosphodiesterase type III, an enzyme that breaks down cyclic AMP in platelets, vascular smooth muscle cells, cardiac myocytes and adipocytes. Several animal and human studies have shown that cilostazol has the potential to reduce restenosis after coronary angioplasty, but the precise mechanism by which the inhibition of vascular smooth muscle cell growth occurs from an increase in cyclic AMP is not yet clear. MATERIALS AND METHODS: We investigated the effects of cilostazol on cell proliferation and expression of iNOS and p21 by western blotting with the cultured aortic vascular smooth muscle cells stimulated with platelet-derived growth factor BB. RESULTS: In comparison to the control, treatment with cilostazol significantly inhibited (p<0.05) the increase in cell number. Inducible nitric oxide synthase (iNOS) and p21 expression increased with cilostazol treatment, and these effects of cilostazol were eliminated by simultaneous incubation with the NOS inhibitor, L-NAME. These results indicate that cilostazol increases p21 expression at least partially through an iNOS-dependent pathway in cultured vascular smooth muscle cells stimulated with PDGF-BB. CONCLUSION: These findings suggest that cilostazol has a direct inhibitory effect on abnormal proliferation of vascular smooth muscle cells accompanied by the induction of iNOS-dependent p21 expression, and cilostazol may have potential to prevent restenosis after percutaneous coronary intervention by this mechanism.
Adipocytes ; Angioplasty ; Animals ; Blotting, Western ; Cell Count ; Cell Proliferation ; Cyclic AMP ; Humans ; Muscle, Smooth, Vascular* ; Myocytes, Cardiac ; NG-Nitroarginine Methyl Ester ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type II ; Percutaneous Coronary Intervention ; Platelet-Derived Growth Factor