Health centers provided intensive health care services for local residents according to changes in the times and environment. Public health centers were given various roles such as medical treatment, administration, and service, and the demand for functional reorganization has emerged. We analyzed the literature on the functional restructuring of public health care institutions. In addition, the current status of medical services, which is the main function of institutions, will be analyzed through health insurance statistical data, and detailed contents will be analyzed according to regional types and income levels. As a result of the analysis of medical services at institutions, the total number of patients was 2,238,000, and the number of visits was 11,806 times. Total medical expenses were 169.6 billion won, of which 132 billion won was found to be benefit. When analyzing the number of patients per institution, public health centers had the largest number of 4,326, and the share of benefit was also the highest at public health centers. It should focus on the function of providing local health and medical services related to health promotion and disease prevention in the community. This functional reorganization of public health centers can contribute to forming cooperative relationships with private medical institutions in the local community. For this, first, to establish the role, essential functions for public health centers for preventive health management are established. Secondly, regular manpower expansion and flexible manpower management are required in the human resources sector. Finally, in the organizational sector, it is necessary to establish a step-by-step organizational system according to environmental changes.

The involvement of health-care professionals in tobacco-control activities is essential to prevent smoking-related morbidity and mortality. The purposes of this predictive correlational study were to examine tobacco-control activities and to identify the predictors of such activities of community health practitioners (CHPs). Of the 1,813 members of the Korean Association of CHP, 1,247 participated in this study. A mailed survey was conducted to collect data. The majority of CHPs supported tobacco-control policies and recognized tobacco-control activities as an important role for them. Only 44.3% of CHPs were confident in their knowledge and skills regarding tobacco-control activities, and only 30.8% had received professional tobacco-control education. While the majority of the CHPs "asked, advised, and assessed"their clients, only a small number "assisted or arranged". The tobacco-control activities of CHPs were predicted by their attitude toward it, age, experience of tobacco-control education, educational level, and general perception of the risk of smoking; these variables accounted 13.5% of variance in the tobacco-control activities of CHPs. These findings provide the basis for developing a continuing education program for CHPs. CHPs should be encouraged to integrate tobacco-control activities into their routine practice, and CHP education programs should be adjusted to increase the time spent on the tobacco-control intervention techniques.
Adult ; Aged ; Analysis of Variance ; *Attitude of Health Personnel ; Clinical Competence/standards ; Community Health Nursing/education/*organization & administration ; Cross-Sectional Studies ; Education, Nursing, Continuing/standards ; Educational Status ; Health Knowledge, Attitudes, Practice ; Humans ; Korea ; Middle Aged ; Needs Assessment ; *Nurse's Role ; Nursing Methodology Research ; Nursing Staff/education/organization & administration/*psychology ; Predictive Value of Tests ; Questionnaires ; Regression Analysis ; Risk Factors ; Self Efficacy ; Smoking/*prevention & control ; Smoking Cessation

PURPOSE: Neuroendocrine (NE) cells of the prostate are considered to be involved in the pathogenesis of benign prostate hyperplasia (BPH). By a comparative analysis of NE cell density in BPH tissue of men who were either exposed to or not exposed to 5alpha-reductase inhibitor, we investigated the relationship between NE cells and BPH, and the effect of androgen deprivation on NE cells. MATERIALS AND METHODS: Prostate tissue specimens, obtained from 30 men by transurethral resection of the prostate or radical cystoprostatectomy, were used. Of the 30 patients, 10 had a prostate smaller than 25 ml (normal control), the other 20 had a prostate larger than 40ml, 10 of who had taken 5alpha-reductase inhibitor (finasteride) for 3 months before surgery (androgen blockade group), and 10 who had not (BPH group). The distribution of NE cells in the prostate was examined using the anti-chromogranin A (CgA) antibody, and the density of the CgA-positive cells was compared by an optical dissector method. Immunoblotting was performed using the neuron specific enolase (NSE) antibody. A Mann-Whitney U test was used in a statistical analysis. RESULTS: Most of the CgA-positive NE cells were localized between the acinar epithelial cells. The mean numbers of CgA-positive NE cells per acinus in the normal controls and the BPH groups were 1.67+/-0.78 and 4.45+/-2.54, respectively, and the difference was statistically significant (p<0.05). However, the mean number of CgA-positive NE cells in the androgen blockade group, was 4.93+/-2.17, which was similar to the BPH group. In a NSE immunoblotting study, a distinct band was observed in the BPH and androgen blockade groups, but the density of the band was higher in the androgen blockade group. CONCLUSIONS: Our results suggest that NE cells may be involved in the hyperplastic process of BPH. Inhibition of dihydrotestosterone, caused by the oral administration of the 5alpha-reductase inhibitor, failed to induce any significant change in the NE cells, probably due to the incomplete androgen blockade.
Administration, Oral ; Cell Count ; Dihydrotestosterone* ; Epithelial Cells ; Humans ; Hyperplasia ; Immunoblotting ; Male ; Neuroendocrine Cells* ; Phosphopyruvate Hydratase ; Prostate ; Prostatic Hyperplasia*

OBJECTIVE: The cordocentesis is regarded as an useful procedure for the prenatal evaluation of fetal disease, but it's complications are fetal loss, umbilical cord bleeding, umbilical cord hematoma, fetal bradycardia, fetomaternal hemorrhage, abruptio placentae, and chorioamnionitis due to it's invasiveness. The fetal bradycardia following cordocentesis is transient and self-limited in most cases, and the prevalence rate of fetal bradycardia following cordocentesis was reported to be between 1.5 and 13 per cent. The purpose of this study was to evaluate the association of fetal heart rate pattern following cordocentesis with adverse pregnancy outcome. METHODS: We investigated retrospectively the fetal heart rate following cordocentesis, the Apgar score of neonate, the birth weight of neonate, gestational age at delivery, preterm delivery, intrauterine growth retardation, stillbirth, and chromosome analysis in 64 codocenteses between 1 February 2000 and 28 February 2001. Normal fetal heart rate was defined as 100 up to 170 bpm, fetal bradycardia as less than 100 bpm lasting one more minute, and fetal tachycardia as more than 170 bpm lasting one more minute. RESULTS: 1. Fetal heart rate pattern following the cordocentesis was normal in 53 cases (82.8%), bradycardia in 6 cases (9.4%) and tachycardia in 5 cases (7.8%). 2. The pregnancy outcome was well-being fetus at birth in 51 cases, terminated pregnancy in 5 cases, intrauterine growth restricted fetus in 5 cases, preterm birth in 1 case and intrauterine death in 2 cases. 3. Mean Apgar-1minute/-5minute scores in neonates were 8.4 +/- 0.2/9.3 +/- 0.2 in the normal fetal heart rate group, 6.8 +/- 1.7/7.6 +/- 1.9 in fetal bradycardia group and 8.4 +/- 0.2/9.4 +/- 0.2 in fetal tachycardia group, that showed no statistically significant difference between groups. 4. The gestational weeks at birth/birth weight were 38.9 +/- 0.4 weeks/3193 +/- 90 g in normal fetal heart rate group, 36.8 +/- 3.2 weeks/2733 +/- 340 g in bradycardia group and 40.0 +/- 0.2/3465 +/- 21 g in tachycardia group, that showed no statistically significant difference between groups. 5. The number of puncture at the same time of cordocentesis was one in 45 cases, two in 15 cases and three in 4 cases. 6. There was no difference in fetal heart rate pattern following cordocentesis between 60 cases of normal and 4 cases of abnormal cardiovascular findings sonographycally. 7. The karyotyping was normal in 60 cases and abnormal in 4 cases, each of which was 46,XY,inv(9),46,X,i(Xq)/45,X,47,XY,+mar, and 46,XX,t(7;15)(q10;q10) respectively. CONCLUSION: Fetal bradycardia or tachycardia following cordocentesis was not associated with adverse pregnancy outcomes.
Abruptio Placentae ; Apgar Score ; Birth Weight ; Bradycardia ; Chorioamnionitis ; Cordocentesis* ; Female ; Fetal Diseases ; Fetal Growth Retardation ; Fetal Heart* ; Fetomaternal Transfusion ; Fetus ; Gestational Age ; Heart Rate, Fetal* ; Hematoma ; Hemorrhage ; Humans ; Infant, Newborn ; Karyotyping ; Parturition ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Premature Birth ; Prevalence ; Punctures ; Retrospective Studies ; Stillbirth ; Tachycardia ; Umbilical Cord

For 16 years after the finding of HIV as an agent of AIDS in 1981, HIV therapeutic drugs of reverse transcriptase inhibitors (AZT, ddI, ddC, d4T) and protease inhibitors have been developed. Recent studies also were focused on a combination therapy by using HIV therapeutic drugs or natural compounds. Korean red ginseng (KRG) of natural compounds has been well known as a good reinforcement agent in Asia. The percentage of CD3+CD4+ T cell in nine HIV-infected patients without KRG treatment averaged 17.8% on baseline and decreased 15.8% after 6 months, whereas the percentage of the cell in fifteen HIV-infected patients with KRG treatment averaged 15.3% on baseline and increased up to 18.9% after the same period. The average percentage of CD3+CD8+ T cell of KRG-nontreated and KRG-treated HIV patients increased after 6 months 47.8% to 50.7% and 44.7% to 51.4%, respectively; and the average percentage of B and NK cell in the KRG-nontreated and KRG-treated HIV patients decreased 9.4% to 7.9% and 13.0% to 9.7%, 8.9% to 8.5% and 16.2% to 11.6%, respectively, KRG, therefore, didn't have any effects on the CD3+CD8+ T cell, B cell, and NK cell. However, it seems that KRG has a potential activity for stimulating the
Asia ; HIV ; Humans ; Killer Cells, Natural ; Lymphocyte Subsets* ; Lymphocytes* ; Panax* ; Protease Inhibitors ; Reverse Transcriptase Inhibitors

PURPOSE: Neck ultrasonography (NUS) is one of the most commonly used methods for evaluating thyroid nodules and preoperative higher TSH levels are known to be associated with differentiated thyroid cancers. This study was conducted to assess whether serum TSH levels and neck ultrasonography are of value in predicting malignancy in patients with atypia of undetermined significance/follicular lesions of undetermined significance (AUS). METHODS: A total of 62 patients (7 men, 55 women; mean age 48.4±11.9 years) who had indeterminate cytologic results indicating AUS underwent thyroidectomy. Preoperative clinical data including serum TSH and the findings of NUS were analyzed retrospectively between malignant and non-malignant groups. RESULTS: The final pathologic results of malignancy were reported in 53 of 62 (85.5%) patients with AUS. There was no significant difference in the mean value of preoperative serum TSH between malignant and non-malignant groups (1.5±1.3 vs. 1.9±1.2, P=NS). In NUS, the patients diagnosed with malignancy in histology showed a higher proportion of calcification, taller-than-wide shape, hypoechoic texture and irregular margin (58.5% vs. 22.2%, P=0.044; 34% vs. 0%, P=0.038; 98.1% vs. 44.4%, P<0.01; 47.2% vs. 0%, P=0.008). CONCLUSION: Serum TSH was not related to malignancy in thyroid nodules showing AUS. However, ultrasonographic features including calcifications, taller-than-wide shape, hypoechoic pattern and irregular margin could be used to predict malignancy. Ultrasonography should be the first useful methods when making decisions regarding management of thyroid nodules showing indeterminate cytologic results as AUS.
Female ; Humans ; Male ; Neck* ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroid Nodule ; Thyroidectomy ; Ultrasonography*

PURPOSE: The purposes of this study were to describe a viable communication skills course for medical students and to discuss how to improve it for better teaching. METHODS: The subjects were a communication skills course and one hundred thirty three third-year medical students who participated in the course in 2006. Program evaluation by students was conducted using questionnaire at the end of each session and the entire course. RESULTS: The communication course was named as "Medical Communication Skills". Basic communication skills and interview skills for specific clinical situations were taught. We used experiential leaning methods such as standardized patient (SP) interviews with feedback. Students rated the course highly especially for SP-based practice sessions and student group projects. The course evaluation indicated that the students considered communication skills to be significantly more important as a clinical competency after the completion of the course. CONCLUSION: We confirmed that the communication skills course was well perceived by medical students and they preferred experiential learning methods more than didactic methods.
Humans ; Problem-Based Learning ; Program Evaluation ; Students, Medical* ; Surveys and Questionnaires

BACKGROUND: Telomerase activity in precancerous conditions of lung adenocarcinomas has not been well studied. This study is designed to investigate the role of telomerase in premalignant lesions of urethane-induced mouse lung adenocarcinoma. METHODS: We harvested A/J mouse lung tissues at 3, 6, 9, 12, 28, 41, and 48 weeks after intraperitoneal urethane treatment, and classified each lesion in terms of histologic findings. We examined telomerase activity using a modified version of the telomeric repeat amplification protocol assay using both gel-based and enzyme linked immunosorbent assay methods. An immunohistochemical analysis of proliferating cell nuclear antigen (PCNA) was performed. RESULTS: In urethane-induced mouse lung tissues, it was sequentially developed from hyperplasia, adenoma, and eventually to adenocarcinoma. Telomerase activity began to show a positive level in tissues with no histologically visible nodule after urethane administration. It revealed a statistically significant increase in hyperplasia compared to the "control" lung tissue (p<0.05), which was proportionally elevated relative to adenoma and adenocarcinoma. There was a direct correlation between telomerase activity and the PCNA labeling index (p<0.05). CONCLUSIONS: The elevation of telomerase activity in normal-appearing lung lesions is thought to be a possible marker of early detection of pulmonary adenocarcinoma.
Adenocarcinoma ; Adenoma ; Animals ; Cell Transformation, Neoplastic ; Enzyme-Linked Immunosorbent Assay ; Hyperplasia ; Lung ; Mice ; Precancerous Conditions ; Proliferating Cell Nuclear Antigen ; Telomerase ; Urethane

No abstract available.
Animals ; Embryonic Structures* ; Mice* ; Quality Control*

BACKGROUND: The properties of hypobaric spinal anesthesia are excellent in sensory and motor block with low concentration solutions, increased venous return, and hemodynamic stability. Much volume is needed with hypobaric spinal anesthesia because low concentration solutions are used. The purpose of this study was to examine the effects of the injected volume on the level of anesthesia in hypobaric spinal anesthesia during a total hip replacement. METHODS: Twenty-seven adult patients scheduled for a total hip replacement were assigned randomly to two groups, one with 0.1% (n = 14), and the other with 0.2% (n = 13) hypobaric tetracaine spinal anesthesia. 8 mg of tetracaine was used for male patients and 7 mg for female patients. Hence the injected volumes were 8 ml for male and 7 ml for female patients in 0.1% solution and 4 ml for male and 3.5 ml for female patients in 0.2% solution, respectively. Epinephrine was mixed to either solution in concentrations of 1:200,000. The speed of injection was fixed at the rate of 0.2 ml/sec. RESULTS: The height of sensory block with the 0.1% was one dermatome higher (T5.7) than with the 0.2% tetracaine solution (T6.7). The time for sensory block (11.4 min vs 12.3 min) and the time for motor block (10.0 min vs 15.0 min) with 0.1% was shorter than that with the 0.2% tetracaine solution. The duration of sensory block and the duration of motor block were not significantly different in either groups. Complete motor block was achieved in all patients. CONCLUSIONS: Both 0.1% and 0.2% hypobaric tetracaine spinal anesthesia are suitable for a total hip replacement. However we got better results with 0.1% than with 0.2% tetracaine such as rapid and high sensory block with rapid motor block.
Adult ; Anesthesia ; Anesthesia, Spinal* ; Anesthetics ; Arthroplasty, Replacement, Hip ; Epinephrine ; Female ; Hemodynamics ; Humans ; Male ; Tetracaine*