Finances of health insurance can be explained by factors determining benefit expense and premium collection. This study was conducted to analyze factors contributing to the financial status of rural health insurance. Nationwide 134 health insurance associations except the six pilot project counties were analyzed and obtained the followings. 1. In univariate analysis, statistically significant variables that explain 1) outpatient benefit expenditures include public health center utilization, proportion of pregnant women, premium and collection rate of premium 2) inpatient benefit expenditures include public health center utilization, proportion of old age, proportion of pregnant women, premium and collection rate of premium 3) profits include public health center utilization, proportion of old age, proportion of pregnant women and collection rate of premium. 2. In multiple regression analysis, statistically significant determinants in 1) outpatient benefit include premium and public health utilization 2) inpatient benefit include premium 3) profit include public health center utilization, premium and collection rate of premium.
Female ; Health Expenditures ; Humans ; Inpatients ; Insurance ; Insurance, Health* ; Outpatients ; Pilot Projects ; Pregnant Women ; Public Health ; Regression Analysis ; Rural Health

No abstract available.
Pregnancy*

No abstract available.
Colon* ; Polyps*

No abstract available.
Dexamethasone* ; Humans ; Infant, Newborn* ; Meningitis, Bacterial*

Objective: We evaluated the protective effect of dexamethasone (DX) administration on brain damage produced in a perinatal model of cerebral hypoxia-ischemia in the rat. Since hyperglycemia has been shown to reduce hypoxic-ischemic brain injury (HI) in immature tar, we investigated the role of glucocorticoid-induced hyperglycemia in the neuroprotective mechanism of DX. Methods: Hypoxic-ischemic brain injury in 7-day-old rats was induced by right common carotid artery occlusion and 2 hours of 8% oxygen. Pups received 3 doses of DX (0.5mg/kg/d intraperitoneally) 48 hours, 24 hours and immediately before HI (Dx1)(n=12), a single dose of DX 24 hours(DX2)(n=16), 3 hours (DX3)(N=10)or immediately before HI (DX4)(n=14), a single dose of DX immediately after HI (DX5) (n=9), 3 doses of DX immediately, 24 hours and 48 hours after HI (DX6) (n=14) and a single dose of DX 24 hours before HI with insulin (0.5U/kg, subcutaneously, 1.5 hours before HI)(IN)(n=8). Control pups (n=15) received a single dose of normal saline 24 hours before HI. Blood glucose was estimated before hypoxia, 1 hour and 2 hours after hypoxia using glucometer in DX 1~4. IN and control rats. Pups were killed at 14 days of age for determination of mortality during HI, gross cerebral infarction and right cerebral hemisphere atrophy. We measured the diameter of each cerebral hemisphere and cortical thickness from a coronal section at the dorsal hippocampus level, and expressed the % atrophy from the change in the right vs left hemisphere diameter. Results: The mortality that occurred during and after HI was similar in all groups. The incidence of gross cerebral infarction was 0.0%, 0.0%, 75.0%, 83.3%, 87.5%, and 90.0% in DX 1~6, respectively, 0.0%in IN, and 100.0% in control group. There was a significant difference (p<0.001)in the incidence of gross cerebral infarction of DX1, DX2, IN vs control group. The mean % atrophy was 5.4 +/- 2.2, 4.9 +/- 1.8, 21.7 +/- 8.1, 29.7 +/- 5.0, 37.4 +/- 5.5, 33.4 +/- 9.3 in DX 1~6, respectively, 1.5 +/- 1.1 in IN, and 29.1 +/- 3.4 (mean+/-SEM) in control group. There was a significant difference in % atrophy of DX1, DX2, IN vs control group. Before hypoxia, there was no significant difference in blood glucose between saline, all DX, and DX with insulin treated groups. But after hypoxia, pups in DX1 and Dx2 were more hyperglycemic compared to DX 3~4, IN, or saline treated groups. Conclusions: Dexamethasone administration in the neonatal period protects the brain during the subsequent periods of hypoxia-ischemia in rats and glucocorticoid-induced hyperglycemia does not explain the neuroprotective effects dexamethasone.
Animals ; Anoxia ; Atrophy ; Blood Glucose ; Brain Injuries ; Brain* ; Carotid Artery, Common ; Cerebral Infarction ; Cerebrum ; Dexamethasone* ; Hippocampus ; Hyperglycemia* ; Hypoxia-Ischemia, Brain ; Incidence ; Insulin ; Mortality ; Neuroprotective Agents ; Oxygen ; Rats*

In addition to many of the widely accepted risk factors of bronchopulmonary dysplasia (BPD), such as prematurity, oxygen toxicity, barotrauma, and infection, the amount of fluid intake during the early phase of life has recently been reported to be an important factor, especially the amount of colloid. Forty-one premature infants who were admitted to the NICU of Severance Hospital, Yonsei University College of Medicine between Jan. 1990 and Jun. 1992 and treated for respiratory difficulty with mechanical ventilation and restrictive fluid therapy were included in the study. fourteen were diagnosed as BPD and the rest were grouped as Non-BPD. We confirmed prematurity, low birth weight, high oxygen concentration, high ventilator pressures and rates, perinatal asphyxia, acidosis, and low blood pressures as risk factors. However, with restrictive fluid therapy that we have used, there was no difference in the amount of total fluid, of crystalloid, or of colloid between BPD and Non-BPD groups, as were the urine output, serum electrolyte concentrations, and percent body weight change. The amount of colloid when used for the maintenance of adequate blood pressures and for the prevention and treatment of hypovolemia, oliguria, anemia of sepsis under the scheme of restrictive fluid therapy would not influence adversely in the development of BPD. Instead, the amount of colloid used may imply the severity of illness of the patient; that is, the more severe the condition of the patient the more the amount of colloid used.
Acidosis ; Anemia ; Asphyxia ; Barotrauma ; Body Weight Changes ; Bronchopulmonary Dysplasia* ; Colloids ; Fluid Therapy* ; Humans ; Hypovolemia ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature* ; Oliguria ; Oxygen ; Respiration, Artificial* ; Risk Factors* ; Sepsis ; Ventilators, Mechanical

PURPOSE: To investigate the effect of 21-aminosteroid U74389G (U) on the extent of brain damage and edema formation in the newborn rats with hypoxic ischemic (HI) brain injury. METHODS: This is a randomized, placebo-controlled, experimental study. The subjects were 113 seven-days-old rats with HI injury. Pups were treated with 3, 10, or 20 mg/ kg of U intraperitoneally 30 minutes before hypoxia (Group 1, 2, 3: n=10, 13, 11), 10 mg/kg of U immediately after hypoxia (n=11) (Group 4), 10 mg/kg of U 30 minutes before and after hypoxia (n=n=13) (Group 5), or vehicle (n=12) (Group C). We expressed the degree of brain infarction and brain edema in % atrophy (Left hemisphere-Right hemisphere/Left hemispherex100) and water content % (wet weight-dry weight/wet weightx100) RESULTS: There were significant reductions in the diameters of right hemisphere compared with those of left hemisphere in vehicle and U treated animals (P<0.05). As to the cortical thickness, group 2, 3 and 5 pups showed no significant reductions in the right side compared with the left side implicating that U treatment in these groups was of benefit in attenuating HI cortical injury, while there was significant difference between the right and left side in group 1, 4 and C animals (P<0.001). There was a significant difference (P< 0.01) in % atrophy of group 2, 3, 5 versus group C, but the mean % atrophy was similar in groups 1, 4 and C. There was a significant (P<0.05) increase of water content in right hemisphere compared with left hemisphere both in U and vehicle treated groups. CONCLUSION: Pre-treatment and prepost-treatment at moderate doses (10 or more mg/kg) of 21-aminosteroid U74389G reduced the extent of perinatal hypoxic-ischemic brain damages, especially in the cortex, but do not affect the extent of brain edema.
Animals ; Anoxia ; Atrophy ; Brain Edema ; Brain Infarction ; Brain Injuries ; Brain* ; Edema* ; Humans ; Infant, Newborn* ; Lipid Peroxidation ; Rats*

No abstract available.
Abscess* ; Nocardia*

PURPOSE: The increasing prominence of pneumococcal infections and of antimicrobial resistance has emphasized the need for a effective vaccine to reduce the risk of pneumococcal disease in childhood. To study the antibody response of pneumococcal vaccine, we compared the concentration and opsonophagocytic capacity of antibodies to the capsular polysaccharide of S. pneumoniae serotype 19F in sera from healthy adults after immunization with 23-valent pneumococcal polysaccharide(PS) vaccine. METHODS: Thirty healthy adults were immunized with pneumococcal 23-valent PS vaccine. One month after vaccination, the amounts of total, IgG, IgG1, and IgG2 antibody were determined by enzyme-linked immunosorbent assay(ELISA). To investigate the function of anti-19F antibodies, the opsonization titer was determined by opsonophagocytic assay. RESULTS: The mean antibody levels of total immunoglobulin and IgG specific to 19F serotype were 21.9mg/mL and 16.2mg/mL, respectively. Most of the IgG anti-PS antibodies were IgG2 isotype. The mean value of opsonization titer was 229.1. The opsonization titer against the 19F serotype was strongly correlated with total immunoglobulin and IgG anti-19F antibody concentration. And IgG2 concentration was correlated more with opsonization titer than with IgG1. CONCLUSION: Antibody level may be of general use in predicting vaccine-induced protection among adults for 19F pneumococcus. This study should be extended to other serotypes and to assess the antibody response to new protein conjugate pneumococcal vaccine in young children.
Adult ; Antibodies ; Antibody Formation ; Child ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunization ; Immunoglobulin G ; Immunoglobulins ; Pneumococcal Infections ; Pneumonia* ; Streptococcus pneumoniae ; Vaccination

OBJECTIVE: To verify the pattern of p53 and TGF-beta protein expression in benign and malignant epithelial ovarian tumors. METHODS: An immunohistochemical technique was applied to formalin-fixed paraffin-embedded samples of 22 benign and 9 malignant epithelial ovarian tumors using p53 monoclonal antibody and TGF-beta polyclonal antibody. Expressions of p53 and TGF-beta protein in two histological types were compared, and correlated with clinico-pathologic findings of the respective cases. RESULTS: p53 immunoreactivity of high or intermediate degree was detected in 2 out of 22 benign (9%) and 5 out of 9 malignant (55%) cases. On the other hand, intermediate to high TGF-beta expression was found in 17 out of 22 benign (77%), and 3 out of 9 malignant (33%) cases. The prevalence differences of p53 and TGF-beta expression between benign and malignant groups were statistically significant (p<0.05). In addition, the prevalence of immunoreactivities of p53 and TGF-beta in malignant tumor didn't show any association with age, tumor size, histologic types and stage. CONCLUSION: Our results suggest that p53 expression and loss of TGF-beta expression may play an important role in the malignant transformation of ovarian epithelial cells. However further studies seem to be necessary to know the exact relationship between their roles.
Epithelial Cells ; Hand ; Prevalence ; Transforming Growth Factor beta*