INTRODECTION: In order to improve medical education through the introduction of a concept of comprehensive health care of a community, an area surrounding the University Campus was chosen for the Community Health Service Project. It has been on operation for last 4 years with its major emphasis on family planning services, and maternal and child health care. The major objectives of this survey at the area are to obtain: 1) The demographic data, 2) The health need and trend of medical care. 3) The attitude and practice in maternity care to be used for further improvement of the planning and the services of the project. Population and Survey Method: Out of three Dongs of the Community Health Service Area, only two Dongs namely Changchun and Yonhee were selected for the survey. Total number of households and population in the area studied was 3.683 and 21,857 respectively. An interview was performed with questionnaire schedule which was recorded by interviewers. This includes the degree of utilization of health services provided by the Community Health Service Program such as family planning, prenatal care during their last pregnancy, delivery history and complications of the delivery as well as the incidence of illnesses in general. Prior to the interview, all interviewers were trained for interviewing technique for two days. The survey was carried out during the period from October December 1967. RESUTLS: 1) Demographic Data : 41.3% of the population studied were children under age 15 and only 3.5% were over 60 years of age. Crude birth rate and crude death rate of this area studied during the period of November 1966-October 1967 were 20.5 and 7.7 respectively. Infant mortality rate during the same period was 35.9. 50.4% of the 2,832 households fell into the category of middle class, 39.8% to the lower class and 9.5% to the upper class in economic condition. 19.8% of 2,832 householders had no formal education, 22.7% primary school, and 57.5% middle or higher school education. 2) Health Status and Utilization of the Community Health Service: Those who suffered from many illnesses during the month of October, 1967 were 690(4.6% of 14,891 persons). Classification of these patients into the type of disease shown respiratory diseases 27.4%, gastrointestinal diseases 18.1%, tuberculosis 10.9%, skin and genitourethral diseases 4.5% and gynecologic patients 4.5%. Only 55.9% of the patients received medical care at hospital or doctor's clinic. But among TB and gynecologic patients, 70.7% and 72.4% were treated at medical facilities. 10.6% of 2,832 householders interviewed has ever utilized the Community Health Service Program provided by the Yonsei Medical School. Classifying these clients into the type of service, 35.9% utilized the wellbaby clinic, 31.0% the family planning clinic, 14.7% the home delivery care, and the rest utilized other services such as the premarital guidance clinic and the sanitary inspection service. 3) Maternity Care: 23.6% of 2,151 deliveries were done at medical facilities such as hospital, private clinic, while 76.4% were done at home. Acceptance rate of prenatal care was 32.6% as whole, but 49.6 of 774 women who had the prenatal care service had their deliveries at medical facility. 45.1% of total deliveries were attended by medical and or paramedical personnel. 75.8% of the deliveries of those received prenatal care were attended by medical and or paramedical personnel while only 27.8% of the deliveries of those who did not have prenatal care attended by medical and or paramedical personnel. 49.8% of deliveries of the upper class, 29.8% of the middle class and 9.9% of the lower class were attended by medical and or paramedical personnel. 6.2, 3.3% and 24.8% of mothers reported about their experience of edema, coma and fever during the period of trimester of pregnancy and puerperium. 4) Family Planning: The rate of practice of family planning was 27.9%. 31.7% of them were by IUD, 20.9% by oral pill, 15.2% by sterilization and the rest by traditional methods. Those women who had 3 to 4 children had highest(30.2%). Practice rate among the various methods of family planning, oral pill was the most popular method to whom had 2 or less children. In relation between the practicing rate of family planning and living standard, the upper, middle and lower class practiced 37.5, 29.4 and 19.9% respectively.
Allied Health Personnel ; Appointments and Schedules ; Birth Rate ; Child ; Child Health ; Classification ; Coma ; Community Health Services* ; Comprehensive Health Care ; Surveys and Questionnaires ; Edema ; Education ; Education, Medical ; Family Characteristics ; Family Planning Services ; Female ; Fever ; Gastrointestinal Diseases ; Health Services ; Health Surveys* ; Hospitals, Private ; Humans ; Incidence ; Infant ; Infant Mortality ; Mortality ; Mothers ; Postpartum Period ; Pregnancy ; Prenatal Care ; Surveys and Questionnaires ; Schools, Medical ; Seoul* ; Skin ; Socioeconomic Factors ; Sterilization ; Tuberculosis

It is currently necessary to manage chronic ischemic foot gangrene because the rate of hospitalization and operations is increasing as a result of diet change and the growth of an aging population. Chronic ischemic foot gangrene is caused by Buerger`s disease, atherosclerosis and particularly, diabetes. In this study, we used the Wagner ischemic index with Doppler flowmeter and Wagner classification on 62 patients over 8 years from 1991 to 1998 as an index for treatment and prognosis. We measured the systolic pressure to determine the ischemic index, and according to Wagner the blood flow was inadequate in cases of diabetic foot gangrene and nondiabetic foot gangrene when it was below 0.45 and 0.35, respectively. According to the observation of clinical symptoms, we divided the cases by Wagner classification. Based on the above data, we performed conservative treatment, skin graft, local flap, superficial sural arterial island flap and amputation. We then followed up the patients and observed the treatment results. We concluded that the Wagner ischemic index with Doppler flowmeter and Wagner classification was useful in determining, selecting, and predicting the rate of survival or death as a result of amputation and graft when a surgical operation is performed.
Aging ; Amputation ; Atherosclerosis ; Blood Pressure ; Classification* ; Diabetic Foot ; Diet ; Flowmeters* ; Foot Ulcer* ; Foot* ; Gangrene ; Hospitalization ; Humans ; Prognosis ; Skin ; Transplants

BACKGROUND: The effects of a muscle relaxant may differ in elderly compared with young adult patients for a variety of the pharmacokinetic and pharmacodynamic reasons. Atracurium is eliminated by nonorgan dependent pathway, Hofmann elimination and ester hydrolysis. So there are some arguments for age-related differences. The purpose of this study was to compare the differences of the onset and duration of atracurium in young and elderly. METHODS: Eighteen young adults (21-54 yr) and 18 elderly (>65 yr) patients anesthetized with nitrous oxide and enflurane. Atracurium (0.5 mg/kg) was given and then intubation was performed after T1 response was blocked more than 80%. Neuromuscular relaxation was measured by the first twitch of train-of-four (T1) response at the adductor pollicis after supramaximal stimulation of ulnar nerve at 2Hz every 12 sec. The onset (disappearance of T1) and duration of 5, 25, 50, 75% recovery time of T1 and recovery index (time for 25-75% recovery of T1) were recorded. RESULTS: Onset of block was not significantly different between the young and elderly. Recovery time of 5, 25, 50, 75% and recovery index were not prolonged in elderly compared with young adults. CONCLUSIONS: There were no significant differences between young and elderly adults in onest time, recovery time of 5, 25, 50, 75% and recovery index when atracurium is used in a single bolus dose. The results suggest that atracurium in elderly patients has similar onset and action duration compared with younger patients.
Adult ; Aged* ; Atracurium* ; Enflurane ; Humans ; Hydrolysis ; Intubation ; Nitrous Oxide ; Relaxation ; Ulnar Nerve ; Young Adult

No abstract available.
Intercellular Adhesion Molecule-1* ; Interleukin-6* ; Keratinocytes*

461 cases of renal biopsy specimens were summerized correlated with their light microscopic and immunofluorescence findings, which obtained from Jan. 1981 to Jul. 1986 at Department of Pathology, Kyung Hee School of Medicine, The results were as follws: 1) The incidence of IgM nephropathy was about 5.8% of the primary glomerulopathy. 2) Sex distribution showed male preponderance with male: female ratio of 1.7:1. 3) Age distribution were 0-9 years 7.4%, 10-19 years 29.6%, 20-29 years 37.0%, 30-39 years 7.4%, 40-49 years 7.4% and 50-59 years 11.1%. 4) The clinical symptoms were gross hematuria 7.4%, microscopic hematuria 59.2%, proteinuria (nonnephrotic) 37.0%, nephrotic syndrome 55.5%, hypertension 7.8% and edema 59.2%. 5) 9 cases (33.3%) had past histories of upper respiratory infections. 6) The distributions of the light microscopic deagnosis were minimal histologic change 11 cases (40.7%), focal glomerulonephritis 7 cases (25.9%), measangial proliferative glomerulonephritis 5 cases (18.5%), focal and segmental glomerulosclerosis 1 case (3.7%) and poststreptococla glomerulonephritis 1 case (3.7%). 7) Immunofluorescence study showed significant diffuse mesangial granular deposits of IgM and C3 in all of the 27 cases. 8) It was demonstrated that in the patients with nephrotic syndrome, the prognosis for the patients with IgM deposition were less favorable than those without IgM deposition.
Female ; Male ; Humans ; Incidence ; Biopsy

No abstract available.
Adult* ; Fetus* ; Humans ; Humerus* ; Radius* ; Ulna*

No abstract available.
Aged* ; Femur Neck* ; Fractures, Spontaneous* ; Humans

A case of malignant synovioma of the right knee joint is presented. Microscopically it showed sarcomatous growth of spindle cells and irregular slit spaces which were lined by tumor cells. A–K amputation has carried out on 10th hospital day and discharged on 30th hospital day without any complications.
Amputation ; Knee Joint ; Sarcoma, Synovial

A case of eosinophilic granuloma in 38-year-old male was reported. The patient was admitted with chief complaints of pain on the left thigh, tenderness and limping associated with localized swelling on upper 1/3 of left thigh. The diagnosis was confirmed by radiological evidence and biopsy findings. This case was healed completely by curettage. The review of literature was made briefly.
Adult ; Biopsy ; Curettage ; Diagnosis ; Eosinophilic Granuloma ; Eosinophils ; Humans ; Male ; Thigh

BACKGROUND: NO (nitric oxide), derived from L-arginine through the action of nitric oxide synthase (NOS), is a short-lived free radical transmitting cellular signals for vasodilation, neurotransmission, and cytotoxicity. Recently, this molecule has been reported to be involved in the various glandular secretion. Although the relationship between NO and the pancreatic endocrine secretion has been widely investigated, the role of NO on insulin secretion has not been elucidated. Therefore, the present study was designed to reveal the precise action of NO on the secretion and synthesis of insulin following administration of NAME (L-NG -nitroarginine methyl ester) or L-arginine using immunocytochemistry and in situ hybridization techniques. METHODS: NAME or L-arginine was administered into jugular vein of the male Sprague-Dawley rat (180~200 g, b,w.) exhibiting normoglycemia (80~120mg/dL). Blood glucose concentrations were measured at intervals of 30 minutes for 2 hours after drug treatment. The pancreatic tissues were taken out at 30 and 90 minutes following drugs administration for insulin immunocytochemistry and in situ hybridization. RESULTS: Both NAME and L-arginine treatments diminished blood glucose levels. The decrease of blood glucose level was more prominent in NAME-treated rats than that of L-arginine. Insulin immunoreactivity in drugs-treated rat pancreas decreased compared to that in normal control, while the expression of insulin mRNA was significantly increased. CONCLUSION: On the basis of present study, it is concluded that the transient changes of NO con-centration, regardless of increase or decrease, in Langerhans islet might act as a potent stimulant in insulin secretion and its synthesis.
Animals ; Arginine ; Blood Glucose ; Humans ; Immunohistochemistry ; In Situ Hybridization ; Insulin* ; Jugular Veins ; Male ; Nitric Oxide Synthase ; Nitric Oxide* ; Pancreas* ; Rats* ; Rats, Sprague-Dawley ; RNA, Messenger ; Synaptic Transmission ; Vasodilation