No abstract available.
Acute Kidney Injury* ; Rhabdomyolysis*

This study was conducted to assess the effects of implementation of the patient referral system started July 1st, 1989. A comparison on the pattern of outpatient services of the Departments of Internal Medicine, General Surgery, and Pediatrics at the Yeungnam University Hospital was conducted for each one year period before and after implementation of the patient referral system. The pre-implementation period was from July 1. 1988 to June 30, 1989 and the post-implementation period was from July 1. 1989 to June 30, 1990. The information used for this study was obtained from official forms, prepared by the Yeungnam University Hospital, and submitted to the Korean Medical Insurance Cooperatives. After implementation of the patient referral system, the number of outpatient cases in the Department of Internal Medicine decreased 36.1% from 9,669 cases to 6,181 cases a year. Cases in the Department of General Surgery decreased 23.7% from 1,864 cases to 1,422 cases a year. The number of cases in the Department of General Surgery decreased 23.7% from 1,864 cases to 1,422 cases a year. The number of cases in the Department of Pediatrics decreased 36.9% from 3,372 cases to 2,128 cases a year. After implementation of the patient referral system, the average age of cases in the Departments of Internal Medicine and General Surgery was 52.5 and 49.7 years old, respcetively. This was a significant increase in comparison with the pre-implementation period. After implementation of patient referral system, the proportion of new outpatients in the Department of Internal Medicine decreased form 24.1% to 14.6%, the Department of General Surgery from 36.0% to 23.4%, and the Department of Pediatrics from 15.5% to 8.3%. The number of visits per case decreased significantly in the Department of Internal Medicine(from 1.74 to 1.61), but there was no significant change in the Department of General Surgery and Pediatrics. The length of treatment per case increased significantly in all three departments (form 16.1 days to 19.3 days in the Department of Internal Medicine, from 12.0 days to 15.2 days in the Department General Surgery, and 8.9 days to 11.2 days in the Department of Pediatrics). The number of clinical tests per case increased significantly in the Department of Internal Medicine (from 22. to 2.5), in the Department of Pediatrics(from 0.8 to 1.1) and increased in the Department of General Surgery(from 6.4 to 6.6). The average medical cost per case decreased form 43,900 Won to 42,500 Won in the Department of Internal Medicine, while the cost increased from 75,900 Won to 78,500 Won in the Department of General Surgery and from 12,700 Won to 13,500 Won in the Department of Pediatrics. In case-mix, the chronic degenerative disease(i. e. hypertension, diabetes mellitus, angina pectoris, malignant neoplasm, and pulmonary tuberculosis) ranked higher and acute infectious diseases and simple cases(i. e. gastritis and duodenitis, haemorrhoids, anal fissure, carbuncle, acute URI, and bronchitis) ranked lower after implementation of the patient referral system compared to before implementation.
Angina Pectoris ; Carbuncle ; Communicable Diseases ; Diabetes Mellitus ; Duodenitis ; Fissure in Ano ; Gastritis ; Humans ; Hypertension ; Insurance ; Internal Medicine ; Outpatients* ; Pediatrics ; Referral and Consultation*

A 26-year-old man presented with a 7-month history of hyperkeratotic skin lesions on both elbows and heels. He also had marked subungal hyperkeratosis and splinter hemorrhage on the finger and toe nails. A biopsy specimen from the elbow revealed lichenoid re-actions with areas of epidermal atrophy with alternating acanthosis and foci of parakeratosis. We made a diagnosis of keratosis lichenoides chronica based on the characteristic clinicopathologic findings. We have treated the patient with etretinate, but only the skin lesions on the elbows and heels responded to treatment.
Acitretin ; Adult ; Atrophy ; Biopsy ; Diagnosis ; Elbow ; Etretinate ; Fingers ; Heel ; Hemorrhage ; Humans ; Keratosis* ; Nails, Malformed* ; Parakeratosis ; Skin ; Toes

The purpose of the study was to determine factors influencing compliance with anti-tuberculosis therapy. The study subjects were 104 tuberculosis patients who have received the initial treatment in 3 health centers of Kyongju-city, Dalseong-Gun in Teagu and Kumi-city. Data were collected between september and october 1995. The patients were classified into the improved group and the non-improved group according to outcomes of 3 month treatment with short-term therapeutic regimen. To find factors influencing compliance with anti-tuberculosis therapy, multiple logistic regression was made. There was no significant differences between the improved group and the non-improved group in sex, age, education level, occupation, family pattern, and habitual change regarding smoking and drinking. The level of knowledge about anti-tuberculosis therapy in the improved group was significantly higher than the non-improved group(p<0.01). Multiple logistic regression analysis revealed that family support for not forgetting medication(p<0.05) was a predictor of improvement and knowledge about anti-tuberculosis therapy (p=0.054), regularity of medication(p=0.062), and consultation to family, doctor and nurse(p=0.075)were marginal predictors of improvement. Treatment must be given to every patient confirmed as having tuberculosis and must be given free of charge to the patients. The requirements for adequate chemotherapy are prescribed in the correct dosage and taken regularly by the patient for a sufficient period to prevent relapse of the disease after cure. It is suggested that education to the patients should be reinforced and connectedness between patients and tuberculosis control workers and family should be solidated.
Compliance* ; Drinking ; Drug Therapy ; Education ; Humans ; Logistic Models ; Occupations ; Recurrence ; Smoke ; Smoking ; Tuberculosis

BACKGROUND: Administration of hepatitis B vaccine has played a major part in the management of public health in this country. There were many researches to assess the immunogenecity, safety, long term effectiveness, dose, and route of administration of hepatitis B vaccine. But there was lack of validation of the recommendation that hepatit.is B vaccine should be administered in adults with negative HBsAg and AntiHBs, in an endemic area with high prevalence of HBsAg. Authors tried to establish a proper candidate for hepatitis B vaccination evaluating viral markers of hepatitis B in adults vaccinated. METHODS: 172 hepatitis B vaccinated subjects(35.0%) were drawn from 491 adults who have visited at health care center, Asan Kangnung Hospital from April 1st to May 31th, 1997. They were asked designed questions about the beginning year, frequency of vaccination, and the presence of family members with HBsAg in a direct line. RESULTS: Of the subjects(172), 2.3% were HBsAg(+), 63.4% AntiHBs(+), 68.6% AntiHBc(+). Among the HBsAg(-) adults(149) who had been vaccinated more than three times, 70.4%(105) were AntiHBs(+), of whom 66.6%(70) were AntiHBc(+) and 29.6%(44) were AntiHBs(-), of whom 56.8%(25) were AntiHBc(+). In the subjects(20) with family history of HBsAg, 80% were AntiHBc(+), which is higher than 61.2% in the group(129) without family history. Among the HBsAg(-) and AntiHBc(-) adults(54) who had been vaccinated more than three times, AntiHBs(+) group was not significantly differnt from AntiHBs(-) group in comparison of age and years after initial vaccination. CONCLUSIONS: The two thirds(68.9%) of vaccinated subjects showed AntiHBc(+), which means reflection of previous exposure to Hepatitis B virus. Accordingly, vaccination is not thought to be required for these. Consequently, all individuals are thought to have to be pretested for the presence of AntiHBc as well as HBsAg and AntiHBs in Korea.
Adult* ; Biomarkers ; Chungcheongnam-do ; Delivery of Health Care ; Hepatitis B Surface Antigens* ; Hepatitis B Vaccines ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans ; Korea ; Prevalence ; Public Health ; Vaccination

No abstract available.
Pleasure*

Alkaline Phosphatase ; Animals ; Biological Assay ; Biological Factors ; Bone Matrix ; Bone Morphogenetic Proteins ; Calcium ; Cartilage ; Chromatography ; Collagen ; Collagen Type I ; Electrophoresis, Polyacrylamide Gel ; Foreign Bodies ; Guanidine ; Osteogenesis ; Rats ; Sodium ; Tail ; Transforming Growth Factors

STATEMENT OF PROBLEM: Recently the populations of patients receiving implant surgery are greatly increase for maintaining oral health. PURPOSE: This study was conducted for implanted patients to assess the chewing ability patient satisfaction level and changes in quality of life before and after the implant surgery. MATERIAL AND METHODS: The current study subjected 109 adult patients, older than 20 years of age, who received implant surgery from December, 2006 to October, 2007 at the 6 dental clinics located at Daegu and Ulsan metropolitan cities. Twice of surveys were conducted for the patients before and after receiving the dental implant surgery. RESULTS: As the motivation of receiving implant surgery, 45.9% of the patients selected the surgery for the chance of "chewing function recovery", and "failure of treatment and complications" was found to be the most worrisome at the time of surgery by recording 38.5%. The satisfaction level before the implant surgery scored 30.37, while the score was increased to 45.01 after the surgery by showing a significant difference before and after receiving the surgery (P < .001). Regard on the surgery, 91.8% of the patients responded as "Satisfy", and 89% of the study subjects responded that they have willingness to recommend the surgery to their families and friends. The chewing ability score measured by using the surveys on edible foods, the score before the surgery was 15.24, while the score was increased to 19.11 after the surgery by showing a significant difference before and after receiving the surgery (P < .001). The quality of life score was also found to be increased to 11.17 after the surgery from 9.99 before the surgery by showing a significant difference (P < .001). CONCLUSION: In a future, the studies on the numbers of implanted loss teeth and the location of tooth loss are necessary, more long-term follow study are needed, and it is thought to be necessary to enlarge the sample size of subjects in conducting the studies.
Adult ; Dental Clinics ; Dental Implantation ; Dental Implants ; Friends ; Humans ; Mastication ; Motivation ; Oral Health ; Patient Satisfaction ; Quality of Life ; Sample Size ; Tooth ; Tooth Loss

This study was carried out to assess medical care expenditure of residents in urban poor area. The study population included 377 family members of 85 households in the poor area of Daemyung 8-Dong, Nam-Gu, Taegu and 442 family members of 96 households in a control area. The data was collected through self-administered q'iestionnaires completed by housewives. The survey was conducted. from , March 1 to May 31; 1992. The mean age was 31. 1 years in the poor area and 37. 1 years in the control area. The average number of households per house was 4.5 in the poor area and 4.5 in the control area. The frequency of medical care utilization per household in a one month period was 4.6 in the poor area and 4.3 in the control area. The average number of days of utilization was 12.9 in the poor area and 12.5 in the control area. The averge monthly income of a househlod in the poor area was 848,600 Won compared to the control area's 1,752,300 Won. The average monthly consumption expenditure of a household in the poor area was 568,800 Won and that in the control area 1,238,400 Won. The average medical care monthly expenditure per household was 34,500 Won in the poor area and 58,400 Won in the control area. The proportion of the medical care expenditure to monthly income and to monthly consumption expenditure was 4.1% and 6.1% respectively in the poor area, and 3.3% and 4.7%, respectively in the control area. The premium of medical insurance was 1.5% in both areas. The proportion of cost for drug was 57.4%, for medical appliance was 1.2%, and for medical treatment was 41.1% in the poor area and in the control area 52.4%, 1.9%, 45.7%, respectively. The highest proportion of medical care expenditures in the poor area was herb clinic utilization (36.9%). while hospital and clinic (37.8%) was the highest proportion in the control area. Mean medical care expenditure per visit was 7,400 Won in the poor area and 12,600 Won in the control area. Mean medical care expinditure per day was 2,800 Won in the poor area and 6.300 Won in the control area.
Daegu ; Family Characteristics ; Health Expenditures* ; Humans ; Insurance

To determine the incidence rate of accidents and its associated factors, a prospective survey was carried out in a rural area of a total of 1,360 residents for 1 year from January 1 to December 31, 1988 in Shin-am Ri, Jungdong Myun, Sangju Kun, Kyeongpook Province. Data for accidents were collected by the community health practitioner who is working at Primary Health Post in Shin-am Ri. A total number of accident cases was 85 among 1,360 persons during one year study period, and annual incidence rate was 62.5 per 1,000 persons. The highest incidence rate of accident was observed in the age group of 30-39 was 179.8. The incidence rate of accident in male was 86.5 which was about 2 times that in female. In male, the highest incidence rate was seen in 30-39 age group and in female, 60-69 age group. The highest incidence rate of accident was observed in spring (29.4%) and summer (29.4%), and the lowest in fall (17.7%). The highest incidence rate of accident was observed in Friday (24.5%) by day of week, and between 9 a.m. to 12 a.m. by time zone. The most frequent use of medical facilities was Primary Health Post (51.8%) and the next was clinic (38.8%). Mean duration of treatment was 9.8 days. The accident occurred in the room and kitchen (23.5%), in the yard and barn (23.5%), on the road (22.4%), and in the rice field and dry field (20.0%). The causes of accident were motor vehicle accident (20.0%), piercing or cutting (20.0%), collision or fighting (12.9%), and poisoning (11.8%) in order of frequency. The most common type of injury was open wound which was 43.5%. The most common tool of accident was farm machine which was 23.5%. The most common injured part of body was extremity 55.3%.
Agriculture ; Extremities ; Female ; Gyeongsangbuk-do ; Humans ; Incidence ; Male ; Motor Vehicles ; Poisoning ; Prospective Studies ; Wounds and Injuries