The purpose of this paper is to identify factors affecting the optimum mix of required inputs and other relevant factors which account for the variation in physician's productivity in general hospitals, and to find out their implications for the efficient health planning and management. An extended version of Cobb-Douglas production function and cross sectional data of one day patient census from all general hospitals in Korea in 1988 were used in the analysis. Main results of the analysis and their implications could be summarized as follows ; (1) The production function for physician's inpatient service shows the evidence of economies of scale, but the production function for physician's outpatient and adjusted-patient service, which combines both out- and inpatient service, shows that of dis-economies of scale. (2) The physician's role for production for all service is smaller than auxiliary personnel's, which imply that more intensive utilization of nurses, nursing aides and other auxiliary personnel is desirable for improving general hospital productivity. (3) In case of physician's inpatient and adjusted-patient service, nurses is recommended for the efficient operation of general hospitals. (4) The factor of hospital beds plays the leading role among required inputs in the production for physician's in- and adjusted-patient service. (5) The physician's productivity of general hospitals in rural area is lower than that in urban area. And the productivity of teaching hospitals is lower than that of the other hospitals. Further analysis was made in physician production function based upon the size of hospitals, namely those hospitals below 250 beds and those above. Explained variances by the factor of hospital beds was significantly increased in the case of those hospitals above 250. A more detailed and thorough investigation is needed for verifying factors influencing physician's productivity in general hospitals in Korea.
Censuses ; Efficiency* ; Health Planning ; Hospitals, General* ; Hospitals, Teaching ; Humans ; Inpatients ; Korea ; Nursing ; Outpatients ; Physician's Role

Meningiomas, one of the most common neoplasms of the central nervous system, may be encountered incidentally during autopsy. Most of these tumors, however, are benign and hence, are not considered as the chief cause of death. Further, sudden unexpected death caused by meningioma is very unusual. Moreover, the diagnosis of an incidental meningioma as the cause of sudden death may sometimes be difficult. In the present report, we describe an autopsy case of a sudden, unexpected death due to a large olfactory groove meningioma accompanied by severe cerebral edema and tonsillar herniation.
Autopsy ; Brain Edema ; Brain Neoplasms ; Cause of Death ; Central Nervous System ; Death, Sudden ; Diagnosis ; Encephalocele ; Meningioma*

Unfortunately, we have poor knowledge of medical technology in North Korea. This study has thus attempted to identify the level and status of medical technology development through analyzing the contents of medical textbooks currently in use. This study has assumed that three factors are influencing the level and status of medical technology in a society ; the level of socio-economic development in general, the level of scientific technology revolution and health policy. Forty textbooks are collected for this purpose. The main findings are summarized as follows: 1) North Korea has strengths in that (1) its herb drugs, which are in a broad use, are cheaper, more safe and more attainable than bio-equivalent chemical ones, and (2) the development of its medical technology was carried out with emphasis on the practical and basic health needs. 2) North Korea has weaknesses in that (1) its medical diagnostic method largely depends on manual procedures, (2) the R & D investment in the development of chemical drugs, especially antibiotics, is very small, (3) the amount of medical equipments is in a absolute shortage, and (4) the medical technology is destitute of specialty, caused mainly by the overemphasis on Juche-Uihak or herb medicine. 3) Medical technology has two faces, positive and negative so that it cannot be successfully evaluated by one. It eventually acts a positive function for public health through developments of drug, equipment and new medical treatment method. But it is also true that it has negative effects such as the dehumanization of high cost medical technology, cost hike due to over-investments in expensive equipments, and the absence of wholistic care from overspecialization. 4) We have to consider economic status and the social needs of medical care in order to evaluate the medical technology of a society. It is also the ease with North Korea. A whole picture of the North Korean medical technology could be understood only if further comprehensive studies of medical technology are to be carried out for North Korea.
Anti-Bacterial Agents ; Dehumanization ; Democratic People's Republic of Korea* ; Health Policy ; Herbal Medicine ; Investments ; Public Health

Hypotony and choroidal detachment have been found to be the most common complication after trabeculectomy, with a mean onset time of 5.6 days. We experienced five eyes of four patients with glaucoma, which developed a flat anterior chamber, hypotony, and choroidal detachment two to nine days after technically uncomplicated trabeculectomy. After treatment with topical and systemic corticosteroids and mydriatic-cycloplegic eyedrops, four of five eyes showed clinical improvement within six days. The one remaining eye eventually improved after surgical drainage of the choroidal detachment and reformation of the anterior chamber performed on the seventh postoperative day.
Adrenal Cortex Hormones ; Anterior Chamber ; Choroid* ; Drainage ; Glaucoma ; Humans ; Ophthalmic Solutions ; Trabeculectomy*

No abstract available.
Calcium* ; Lidocaine* ; Neuroglia* ; Reperfusion*

Most of the medical schools are confronted with various changes to medical curricula in Korea. Some of them already established a steering group to plan a new curriculum. The study's target is the graduates who had undertaken their 6 year-medical course of Medical School at K University. The purpose of the study is to ascertain how well the medical course they had undertaken had equipped them for practice. The questionnaire explored the level of factual content, the adequacy of their skills training, and the development of attitudes and personal attributes during the course. A total of 204 graduates replied, a response rate of 67.5%. The results can be summarized as follows. The graduates' views on the preclinical course they had undertaken at school of medicine show that they felt there were 'too much' anatomy, biochemistry, and pathology. Their views on the clinical course were shown relatively to be adequate level of factual content in comparison with preclinical course. The graduates' views were also sought concerning the help they had received in acquiring certain skills during their education. Only in the area of 'History-taking' and 'Physical examination' did most feel that the skills had been 'well covered' or 'partially covered'. A part of the survey focused on the attitudes and personal attributes that it was hoped medical students would have acquired by the time they qualified. In most cases the respondents did feel that they had acquired the 15 items' attributes listed, at least partially, by the time they had qualified.
Biochemistry ; Curriculum ; Surveys and Questionnaires ; Education* ; Hope ; Humans ; Korea ; Pathology ; Schools, Medical ; Students, Medical

The purpose of this study is to estimate the minimum optimal scale(MOS) of the self-employed health insurance associations. Considering the high proportion of operating expenses, the author have selected 254 regional health insurance associations from the 1990 Finance Report of the self-employed health insurance programs. both a quadratic function and a hyperbolic function were chosen for the analysis. The dependent variables are the average maintenance cost per insured person and per household, and the independent variables are the number of insured members and of household. The minimum optimal scale was obtained from the differentiation of the quadratic function. Major findings are summarized as follows: 1. The M.O.S. was calculated as 166,174 members (27,442 households) for the rural self-employed health insurance associations and 258,462 members (75,446 households) for the urban. Providing that both the rural and urban health insurance associations would e integrated, the M.O.S. be found to become 231,687 members (68,101 households) 2. Compared with the optimal minimum scale, the magnitude of the current health insurance association found to be much smaller, less than half of the optimal scale. 3. In order to reduce the operating cost, it is necessary to enlarge the operational scale of self-employed health insurance associations.
Family Characteristics ; Humans ; Insurance ; Insurance, Health* ; Korea* ; Urban Health

This study was carried out for three years from 1968 to 1970. Three coastal villages and four remote islets of Che Ju Island were surveyed and 90% of all inhabitants were blood smeared. These study areas were grouped into five according to its characteristic for evaluation of mass treatment with diethylcarbamazine citrate (Hetrazan U.S.P.) and insecticide spray in control of human filariasis. To set baseline up for control group, placebo was administered. Followings are the results obtained: 81.1% of all mf positives accepted and completed the mass chemotherapy; main reason for refusal was side reactions told by neighboring villagers who experienced them. 6 mg of hetrazan/kg B.W. x 12 doses given every day turned mf postives to mf negative in 92.1%. The patients who had high mf density remained mf positive in 16.5% whereas only 2.1% for low mf density. 73.8% of mf positives after the treatment showed marked decrease in mf density. Most of them to less than 15n mg/20 mm(3) of blood that can not infect mosquito effectively. Mosquito infection rates were also dropped markedly in areas where mf positive were mass treated. Side reaction induced by diethylcarbamazine was frequent(64%-90%) and various. The most frequent symptom was headache and fever. DDT spray did not influence human mf rate and mosquito infection rate.
parasitology-helminth-nematoda ; chemotherapy-diethylcarbamazine citrate ; epidemiology ; Brugia malayi ; filariasis ; diethylcarbamazine citrate

PURPOSE: The present study was carried out to determine day-to-day differences in cortisol levels and the molar cortisol-to-dehydroepiandrosterone (DHEA) ratio (molar C/D ratio) in working subjects. MATERIALS AND METHODS: The cortisol and DHEA levels were measured from saliva samples collected 30 minutes after awakening for 7 consecutive days in full-time working subjects that worked Monday through Saturday. To determine the day-to-day differences within subjects, the collected data was analyzed using variance (ANOVA) for a randomized complete block design (RCBD). RESULTS: The cortisol levels from samples collected 30 minutes after awakening on workdays were similar to each other, but were significantly different from the cortisol levels on Sunday. The DHEA levels were not significantly different between the days of week. The DHEA levels on Monday and Tuesday were relatively lower than the levels on the other weekdays. The DHEA levels on Thursday and Friday were relatively higher than the other days. The molar C/D ratios on Sunday were significantly lower than those on workdays. The molar C/D ratios on Monday and Tuesday were significantly higher than those on Wednesday or other workdays. CONCLUSION: The cortisol levels and the molar C/D ratios demonstrate differences in adrenocortical activities between workdays and non-workdays, but the molar C/D ratio additionally represents differences in adrenocortical status between the first two workdays and other workdays. Thus, it is possible that the day-to-day differences in the cortisol levels and the molar C/D ratio represent the adrenal response to upcoming work-related stress.
Adult ; Analysis of Variance ; Dehydroepiandrosterone/*metabolism ; Female ; Humans ; Hydrocortisone/*metabolism ; Male ; Middle Aged ; Saliva/chemistry ; Work/*physiology

No abstract available.
Hydronephrosis* ; Turner Syndrome*