PURPOSE: This study was done to investigate factors affecting perceived financial burden of medical expenditures. METHOD: The participants were 2,024 inpatients who were enrolled in a survey on the benefit coverage rate of the National Health Insurance in 2006. The collected data were analyzed using t-test, ANOVA-test, Mann-Whitney-test, Kruskal-Wallis-test, Chi-square test and logistic regression. RESULTS: The crucial factors for perceived financial burden were age, job, equivalence scale, ratio of annual family income vs medical expenditure, and private health insurance. Perceived financial burden was higher for people who were older, who were unemployed, whose medical expenditures were high compared to annual family income, whose index of family equalization was low and for those who had no private health insurance. CONCLUSION: The results of the study indicate a demand for system reform that will enable management of no-pay hospital bills in the National Health Insurance to decrease the medical expense of people in the low-income bracket.
Health Expenditures ; Humans ; Inpatients ; Insurance, Health ; National Health Programs

No abstract available.
Intracranial Arteriovenous Malformations* ; Radiosurgery*

Eosinophilic gastroenteritis is a rare disease characterized by prominent eosinophilic tissue infiltration of the gastrointestinal tract. Here, we report a case of eosinophilic gastroenteritis in an 18-year-old patient with prolonged nephrotic syndrome who presented with abdominal pain and peripheral hypereosinophilia. During the previous 2 years, he had visited local Emergency Department several times because of epigastric pain and nausea. He had been treated with steroid-dependent nephrotic syndrome since 3 years of age. Tests ruled out allergic and parasitic disease etiologies. Gastroduodenoscopy with biopsy revealed marked eosinophilic infiltration in the duodenum. Renal biopsy findings indicated minimal change disease spectrum without eosinophilic infiltration. The oral deflazacort dosage was increased, and the patient was discharged after abdominal pain resolved. To our knowledge, this is the first report of eosinophilic gastroenteritis in a patient with minimal change disease.
Abdominal Pain ; Adolescent* ; Biopsy ; Duodenum ; Emergency Service, Hospital ; Eosinophilia ; Eosinophils* ; Gastroenteritis* ; Gastrointestinal Tract ; Humans ; Male* ; Nausea ; Nephrosis, Lipoid ; Nephrotic Syndrome* ; Parasitic Diseases ; Rare Diseases

Background: Charcot-Marie-Tooth disease type 1A (CMT1A) is caused by duplication of the 17p12 region including PMP22 gene. In CMT1A patients, anticipation showing increased severity by generations has been reported in the CMT1A patients. It has also been reported that severity increases in the non-de novo cases than in the de novo cases. This study was performed to examine epigenetic differences between CMT1A cases and controls as well as between de novo cases and non-de novo cases. Methods: This study examined 40 Korean CMT1A patients and 11 controls. Methylation level was determined using the SureSelect XT Methyl-Seq reagent kit and bisulfite sequence mapping program. Results: Many differentially methylated CpG sites (DMCs) were identified in the comparisonbetween cases and controls and between de novo cases and non-de novo cases. Most DMCs were located within or nearby genes related to the nervous system, mental stress, and motor ability. Conclusions This study is the first epigenetic study to uncover the mechanism of clinical heterogeneity among CMT1A patients. We suggest that weak severity in the de novo cases than the non-de novo cases may be related to the epigenomic differences in the nerve and stress-related genes.

Interstitial irradiation using high-activity Iridium-192 sources was studied clinically to treat supratentorial malignant astrocytomas(including glioblastoma multifrome). As of 1988, in attempt to define the efficacy of this technique in patients with more extensive disease, we treated patients less rigid selection criteria. 15 eligible patients have been approached and ten have accepted randomization for follow-up study over two years. Pathology was anaplastic astrocytoma in 5 patients, glioblastoma multiforme in 5 patients. Mean survival of patients treated with this procedure was 18.4 months. Continued investigation will determine which patient may benefit from this techique.
Astrocytoma* ; Brachytherapy* ; Follow-Up Studies ; Glioblastoma ; Humans ; Pathology ; Patient Selection ; Random Allocation

BACKGROUND: Postpartum thyroiditis is an autoimmune thyroid dysfunction that occurs in the first year after a delivery. Although a postpartum thyroid dysfunction after a full-term pregnancy is well described, little is known about its association with an abortion. The purpose of this study was to investigate the clinical and laboratory findings in thyroid dysfunction that develops after abortion and to investigate the differences in the clinical course according to the types of abortion. METHODS: Thirty patients who were proven to have thyroid dysfunction after either spontaneous or an elective abortion were studied. We analyzed their past history, the type of abortion, their clinical features, the laboratory findings and the courses of the disease. RESULTS: Seventeen patients were hypothyroid and 13 were thyrotoxic at the time of the initial thyroid function evaluation. In the thyrotoxic group, the T3 and free T4 were significantly higher but the TSH was lower than in the hypothyroid group. The titers of antimicrosomal and antithyroglobulin antibody were not different between the two groups. In the thyrotoxic group, 3 cases showed normal values, 2 cases were hypothyroid and the remaining 8 cases were persistently thyrotoxic during the 2 months of observation. TSH receptor antibodies were absent in all of the transient thyrotoxic patients, but they were present in 83.3% of the persistent thyrotoxic patients. The clinical manifestations of the thyroid dysfunction were not different according to the type of abortion. CONCLUSION: Reproductive-age women who have an abnormal thyroid function require careful history taking with respect to their history of regarding parturition or abortion in order to evaluate the possibility of a transient thyroid dysfunction after the abortion.
Antibodies ; Female ; Humans ; Parturition ; Postpartum Period ; Postpartum Thyroiditis ; Pregnancy ; Receptors, Thyrotropin ; Reference Values ; Thyroid Gland*

BACKGROUND: It is important to know one's own exact blood type. While the primary purpose of blood donation is an adequate blood supply, it is also an excellent opportunity for donors to confirm their blood type. Over 5% of the total population in Korea donated bloods in 1997. This study was carried out to investigate the relationship between increased participation in blood drives and an increase in members of the public's knowledge of their own blood type. METHODS: 271,346 blood donors at Dung-Bu Red Cross Blood Center answered to a questionnaire. The discrepancy ratio between perceived and actual ABO blood type was obtained through answerey questionnaire. Another 3,058 answered a more detailed questionnaire to probe their general knowledge of ABO and Rh(D) blood types were analyzed. RESLUTS: The discrepancy ratio between real and perceived ABO blood types was 1% but only 90.7% were confident of their ABO blood type. Only 58.3% were correctly answered to their Rh(D) blood type, and 98.7% of the donors who knew his or her Rh(D) blood type as negative were proved to be Rh(D) positive. The ABO discrepancy ratio was lower in females and it has decreased as blood donations increased (p<0.01). The discrepancy ratio increases with the age of the donor, and respondents over 30 had a higher discrepancy than those under 30 (p<0.01). Knowledge of Rh(D) blood type in transfusion was not well known to the general public. CONCLUSION: The study shows that the discrepancy ratio between real and perceived ABO blood type has decreased as a national blood donation rate has increased. Nevertheless, to increase the public's knowledge of blood type in relation to transfusion, especially to increase awareness of Rh(D) blood type, it is needed to conduct test exactly and to educate the result and general knowledge of blood type and tranfusion to the public.
Blood Donors ; Surveys and Questionnaires ; Female ; Humans ; Korea ; Questionnaires ; Red Cross ; Tissue Donors* ; Volunteers*

BACKGROUND: Bone mineral density (BMD) is under strong genetic control. A recently reported case of severe estrogen resistance caused by a germ-line mutation at the estrogen receptor gene locus suggests the possibility that other variants of the estrogen receptor (ER) gene could be responsible for the heritable components of bone density. METHODS: Two restriction fragment length polymorphisms (RFLPs) at the ER gene locus, represented as PvuII and XbaI, and their relationship to bone mineral density (BMD) and bone turnover markers were examined in 95 healthy premenopausal women. Their mean age was 29 +-6.9 years (mean+-SD). RESULTS: The distribution of the PvuII and XbaI RFLPs was as follows: PP 20 (21.1%), Pp 40 (42.1%), pp 35 (36.8%), and XX 5 (5.3%), Xx 33 (34.7%), xx 57 (60.0%) (capital letters signify the absence of, and lower case letters signify the presence of the restriction site of each RFLP). There was no significant relation between ER genotypes and BMD measured at several sites such as lumbar spine (L2-4), distal forearm, and femoral neck. Also no significant genotypic differences were found in the several biochemical markers and sex hormone status. CONCLUSION: These data indicate that these polymorphisms are not predietive of bone turnover nor BMD in a sample of healthy Korean premenopausal women.
Biomarkers ; Bone Density* ; Estrogens* ; Female ; Femur Neck ; Forearm ; Genotype* ; Germ-Line Mutation ; Humans ; Osteoporosis ; Polymorphism, Restriction Fragment Length ; Spine

The Korea School Lunch Program mandates that school meals should safeguard the health and well-being of our children. School meals provide a nutritious diet that contains at least 1/3 of the daily Recommended Dietary Allowances of necessary nutrients at reasonable prices. This study was performed to assess the nutritional management of primary school meals, and to provide basic data for improvement of school meal nutritional guidelines. Three hundred and thirty six dietitians who worked at primary schools were recruited using a stratified sampling method. A survey was done by e-mail with a set of questionnaires about nutritional meal management. During school lunch planning, dietitians referred nutrition standards with priority, followed by students' food preferences and food hygiene. They considered energy as a most important nutrient during primary school lunch planning, followed by protein and calcium. Protein is usually over-served, whereas iron, vitamin A and calcium are usually under-served during primary school meal planning. For first and second grade primary students, grains, meat and vegetable side dishes seemed to be large compared to their eating capacity. Over 92% of school dietitians agreed the needs of food group standards for primary school lunch program. For making a checklist of the school lunch program, energy, protein and calcium were highly recommended, and meat.fish.egg group, vegetable.fruit group and dairy group were also highly recommended by school dietitians. Cooking method was also highly recommended. School dietitians proposed that remodeling of school kitchens and new cooking machine were the most important factors for improving school lunch system. These results suggest that food standards should be established for health-oriented nutritional management of primary school lunch programs. Nutritional checklists could include nutrient-rich foods and food groups, and items about cooking methods.
Calcium ; Edible Grain ; Checklist ; Child ; Cooking ; Diet ; Eating ; Electronic Mail ; Food Preferences ; Humans ; Hygiene ; Iron ; Korea ; Lunch* ; Meals ; Meat ; Nutritionists ; Surveys and Questionnaires ; Recommended Dietary Allowances ; Vegetables ; Vitamin A

The Korea School Lunch Program mandates that school meals should safeguard the health and well-being of our children. School meals provide a nutritious diet that contains at least 1/3 of the daily Recommended Dietary Allowances of necessary nutrients at reasonable prices. This study was performed to assess the nutritional management of primary school meals, and to provide basic data for improvement of school meal nutritional guidelines. Three hundred and thirty six dietitians who worked at primary schools were recruited using a stratified sampling method. A survey was done by e-mail with a set of questionnaires about nutritional meal management. During school lunch planning, dietitians referred nutrition standards with priority, followed by students' food preferences and food hygiene. They considered energy as a most important nutrient during primary school lunch planning, followed by protein and calcium. Protein is usually over-served, whereas iron, vitamin A and calcium are usually under-served during primary school meal planning. For first and second grade primary students, grains, meat and vegetable side dishes seemed to be large compared to their eating capacity. Over 92% of school dietitians agreed the needs of food group standards for primary school lunch program. For making a checklist of the school lunch program, energy, protein and calcium were highly recommended, and meat.fish.egg group, vegetable.fruit group and dairy group were also highly recommended by school dietitians. Cooking method was also highly recommended. School dietitians proposed that remodeling of school kitchens and new cooking machine were the most important factors for improving school lunch system. These results suggest that food standards should be established for health-oriented nutritional management of primary school lunch programs. Nutritional checklists could include nutrient-rich foods and food groups, and items about cooking methods.
Calcium ; Edible Grain ; Checklist ; Child ; Cooking ; Diet ; Eating ; Electronic Mail ; Food Preferences ; Humans ; Hygiene ; Iron ; Korea ; Lunch* ; Meals ; Meat ; Nutritionists ; Surveys and Questionnaires ; Recommended Dietary Allowances ; Vegetables ; Vitamin A