The status of health administration and medicare insurance program of 58 universities and colleges of 4-year course was studied in 1971 and the following results were obtained; 1. The average number of students of 20 universities was 4,800+/-2,600 and that of 36 colleges was 780+/-620. 2. The types of health service facilities for the students varied widely according to the institutions, from an elaborate one, university health center, to a poor one first aid room. 3. Thirty-six out of 58 institutions had some sort of health service facilities, either health center or health service room. And 14 out of 36 institutions had elaborate health service facilities such as university health center or student health center. 4. The number of full time staff of the health center and that of the health service room were 2 to more than 10 and 0 to 3 respectively. 5. The range of student health service fee varied widely according to the institutions from won50 to won550 per student, per semester. The average cost of student health service fee at the institutions with health centers was won300+/-150 and that with health service rooms was won200+/-150 per student, per semester. 6. Utility rate of the student health service facilities at the institutions with health centers and with health service rooms were 1,200 to 1,400 and 3,900 to 4,100 per 1,000 students per year. 7. There was an obvious increasing tendency of tuberculosis prevalence rate in the students. 8. The institutions which had appointed hospitals for student medicare were 24 ; where the reduction rate of medical expenses for students varied from 10 to 50 percent. 9. Students medicare insurance program was adopted by six universities which accommodated more than 2,000 students. 10. The range of student medicare insurance fee varied widely according to the institutions from won140 to won800 per student per year. Each of the six universities which had adopted the insurance program had each own's special regulations to apply for pay claims.
Fees and Charges ; First Aid ; Health Services ; Humans ; Insurance* ; Korea* ; Medicare* ; Prevalence ; Social Control, Formal ; Student Health Services ; Tuberculosis

The status of health administration and medicare insurance program of 58 universities and colleges of 4-year course was studied in 1971 and the following results were obtained; 1. The average number of students of 20 universities was 4,800+/-2,600 and that of 36 colleges was 780+/-620. 2. The types of health service facilities for the students varied widely according to the institutions, from an elaborate one, university health center, to a poor one first aid room. 3. Thirty-six out of 58 institutions had some sort of health service facilities, either health center or health service room. And 14 out of 36 institutions had elaborate health service facilities such as university health center or student health center. 4. The number of full time staff of the health center and that of the health service room were 2 to more than 10 and 0 to 3 respectively. 5. The range of student health service fee varied widely according to the institutions from won50 to won550 per student, per semester. The average cost of student health service fee at the institutions with health centers was won300+/-150 and that with health service rooms was won200+/-150 per student, per semester. 6. Utility rate of the student health service facilities at the institutions with health centers and with health service rooms were 1,200 to 1,400 and 3,900 to 4,100 per 1,000 students per year. 7. There was an obvious increasing tendency of tuberculosis prevalence rate in the students. 8. The institutions which had appointed hospitals for student medicare were 24 ; where the reduction rate of medical expenses for students varied from 10 to 50 percent. 9. Students medicare insurance program was adopted by six universities which accommodated more than 2,000 students. 10. The range of student medicare insurance fee varied widely according to the institutions from won140 to won800 per student per year. Each of the six universities which had adopted the insurance program had each own's special regulations to apply for pay claims.
Fees and Charges ; First Aid ; Health Services ; Humans ; Insurance* ; Korea* ; Medicare* ; Prevalence ; Social Control, Formal ; Student Health Services ; Tuberculosis

PURPOSE: The aim of this study was to investigate treatment results, toxicity and efficacy of hyperfractionated radiation therapy combined with paclitaxel for paraaortic node recurrence in cervix cancer. MATERIALS AND METHODS: Between September 1997 to March 1999, 12 patients with paraaortic node recurrence in cervix cancer who previously received radical or postoperative radiotherapy were treated with hyperfractionated radiation therapy combined with paclitaxel. Of these, 2 patients who irradiated less than 30 Gy were excluded, 10 patients were eligible for this study. Median age was 5 1 years. Initial FlGO stage was 1 stage IB1, 2 stage IIA, 7 stage IIB. For initial treatment, 7 patients received radical radiotherapy and 3 received postoperative radiotherapy. The paraaortic field encompassed the gross recur rent disease with superior margin at T 12, and inferior margin was between L5 and S 1 with gap for previously pelvic radiation field. The radiation field was initially anterior and posterior opposed field followed by both lateral field. The daily dose was 1.2 Gy, twice daily fractions, and total radiotherapy dose was between 50.4 and 60 Gy(median, 58.8 Gy). Concurrent chemotherapy was done with paclitaxel as a radiosensitizer. Dose range was from 20 mg/m to 30 mg/m (median, 25 mg/m'), and cycle of chemotherapy was from 3 to 6 (median, 4.5 cycle). Follow-up period ranged from 3 to 21 months. RESULTS: Interval between initial diagnosis and paraaortic node recurrence was range from 2 to 63 months (median, 8 months). The 1 year overall survival rate and median survival were 75% and 9.5 months, respectively. The 1 year disease free survival rate and median disease free survival were 30% and 3 7 months, respectively. At 1 month after treatment, 4 (40%) achieved a complete response and 6 (63%) experienced a partial response and all patients showed response above the partial response. There was distant metastasis in 6 patients and pelvic node recurrence in 2 patients after paraaortic node irradialion. There was 2 patients with grade 3 to 4 leukopenia and 8 patients with grade 1 to 2 nausea/ vom ting which was usually tolerable with antiemetic drug. There was no chronic complication in abdomen and pelvis during follow up period. CONCLUSION: Hyperfractionated radiation therapy combined with paclitaxel as a radiosensitizer showed high response rate and few complication rate in paraaortic node recurrence in cervix cancer. Therefore, present results suggest that hyperfractionated radiation therapy combined with paclitaxel chemotherapy can be used as optimal treatment modality in this patients.
Abdomen ; Cervix Uteri* ; Diagnosis ; Disease-Free Survival ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Leukopenia ; Neoplasm Metastasis ; Paclitaxel* ; Pelvis ; Radiotherapy ; Recurrence* ; Survival Rate ; Tolnaftate ; Uterine Cervical Neoplasms*

Intracranial pial arteriovenous fistulas (AVFs) are uncommon, high-flow connection between an artery and a vein without an intervening nidus, vascular lesions treated using endovascular approach with a variety of embolic materials. To our knowledge, hyperperfusion syndrome as a result of embolization of pial AVFs has not been reported before. We report our experience in the treatment of high-flow pial AVF using detachable coils and hyperperfusion syndrome after coil embolization.
Arteries ; Arteriovenous Fistula* ; Embolization, Therapeutic* ; Veins

The incidence of spine trauma has been increasing. To investigate the incidence, characteristics, and difficulty in management of the acute spine-injuried patients in suburban area we analyzed 50 cases treated conservatively or by operative fusion over a recent one-year period. This study comprised of 26 females and 24 males, between 23 and 83 years old patients with injury of whole column of spine. The most frequent cause of injury was traffic accident. The most common lesion was the compression fracture of the first lumbar spine. Most patients complained neck or back pain on admission. In 3 cases, neurological deficits were noted. For six patients, surgical treatment were performed and 44 patients has been conservatively managed with halo brace, neck collars, and thoracolumbar orthoses. The average period of admi-ssion and immobilzation for the conservatively treated patients was 6 weeks. During which time a few complications such as progressive kyphosis, hypoalbuminemia, thrombophlebitis, urinary tract infection, paralytic ileus, bed sore, and alcohol withdrawal syndrome were aroused. In most cases, good outcomes were achieved. Most of geriatric patients, concomitant systemic diseases with cardiovascular and pulmonary dysfunction were usually present and absence of the insight on spine injury made difficulties in managment. On the basis of these results we concluded that most elderly patients with spine fracture coulde be effectively treated by conservative methods, and also careful and systemic management with adequate education for patients and their families were required.
Accidents, Traffic ; Aged ; Aged, 80 and over ; Back Pain ; Braces ; Education ; Female ; Fractures, Compression ; Humans ; Hypoalbuminemia ; Incidence ; Intestinal Pseudo-Obstruction ; Kyphosis ; Male ; Neck ; Orthotic Devices ; Pressure Ulcer ; Spine ; Thrombophlebitis ; Urinary Tract Infections

PURPOSE: Composite tissue allotransplantation is a new therapeutic modality to reconstruct major tissue defects of the head and neck region and extremities. However, there is a serious ethical debate about whether the risks posed by the life-long immunosuppression that a recipient would have to take justify the benefits of receiving this non-life saving procedure. The purpose of this study is to examine differences between expert and non-expert groups in risk acceptance and expectations regarding hand and foot allotransplantations. METHODS: The author conducted a survey of 345 subjects in total (lay public n=110; medical students, n=120; doctors, n=115), using a questionnaire-based instrument, the Louisville Instrument for Transplantation (translated to Korean). RESULTS: Of the three groups studied, risk acceptance was found to be lowest in the doctor group and highest in the non-expert group, and the difference was significant (p < 0.05). The expectations of aesthetic and functional improvement from the procedure, however, were found to be highest in the non-expert group and lowest in the doctor group, and the differences were also significant (p < 0.05). CONCLUSION: The results of this study shows that the three populations have noticeable differences in risk acceptance and expectations regarding hand and foot allotransplantations. Therefore, accurate and sufficient information on these procedures should be provided to patients from both medical and ethical perspectives.
Extremities ; Foot ; Hand ; Head ; Humans ; Immunosuppression ; Neck ; Students, Medical ; Transplants

PURPOSE: Facial allotransplantation (FA) could provide an excellent alternative to current treatments for facial disfigurement. However, despite being technically feasible, there continues to be various ethical and psychosocial issues associated with the risks and benefits of performing FA. The purpose of this study is to investigate risk acceptance and expectations in FA. METHODS: In a quantitative assessment of risk versus benefit with respect to FA, from 2004 to 2008, Barker et al. developed and published a questionnaire-based instrument (Louisville Instrument for Transplantation [LIFT]), which contained 237 standardized questions. In the current study, the authors assessed risk versus benefits and expectations of FA using a Korean version of the LIFT. Respondents in three study groups (lay public, n=140; medical students, n=120; doctors, n=34) were questioned about risk acceptance as related to immunosuppression and tissue rejection, and expectations as related to quality of life improvement, and functional and aesthetic outcomes. A summary of the data has been provided and statistical analyses were performed. RESULTS: Among the three study groups, results indicated that doctors accept the least amount of risk for a facial allotransplant, followed by medical students, and finally lay public. There was a significant statistical difference in three of the four questions regarding risk acceptance between the groups (p < 0.05). In general, lay public exhibited higher expectations for facial allotransplantation than the other groups. Additionally, there was a significant statistical difference in the importance of aesthetic outcome between the groups (p < 0.05). CONCLUSION: The authors' data indicate the three populations have vastly different levels of risk acceptance and expectations with regard to FA. Therefore, it is very important that surgeons establish clear, open, and thorough communication with patients in their consultations regarding FA. This is particularly important with respect to whether or not a patient's level of risk acceptance and expectations are progmatic.
Surveys and Questionnaires ; Humans ; Immunosuppression ; Quality of Life ; Referral and Consultation ; Rejection (Psychology) ; Risk Assessment ; Students, Medical ; Transplants

PURPOSE: To correct breast ptosis, reduction mammoplasty and mastopexy have been developed in a way that minimizes complications. Recently, as the mean age of breast cancer occurrence is decreasing, the need for breast reconstruction in patients with breast cancer is rising. If mastopexy is performed with breast reconstruction at the same time, the size of the normal breast and the new one is not quite different. We decided to apply Z-plasty, which is a widely-used technique in plastic surgery to lengthen or change the direction of tension of the tissue. METHODS: From March 2008 to December 2009, we performed breast reconstruction in 6 patients with breast cancer and scar contracture. After breast reconstruction, mastopexy with Z-plasty was applied to correct the asymmetry. The new nipple-areolar complex is placed on the line connecting the midclavicle and the current nipple. The inferior border of the new areola corresponds with the inferior border of the original areola, and the superior border about 2 cm upward the original superior border. We drew two oblique lines connecting the medial end of the incision line lower to the nipple-areola complex and the lateral end of the inframammary fold for Z-plasty. The excess tissue between these two lines was removed and the new triangular flaps were put together. RESULTS: The average age of patients was 42.6 years, aged from 36.1 to 48.1 The weight of removed tissue was between 54g and 95 g, with the mean of 74 g. The average distance from the midclavicle to the nipple was 24 cm before surgery, and 21 cm after the surgery. The average operation time per patient (1 mastopexy) was 45 minutes, and the patients were satisfied with the size and shape. CONCLUSION: Applying Z-plasty for the mastopexy on the normal breast ptosis is a relatively simple way to achieve symmetry in patients who need breast reconstruction.
Aged ; Breast ; Breast Neoplasms ; Cicatrix ; Contracture ; Female ; Humans ; Mammaplasty ; Nipples ; Surgery, Plastic

We present a case of a patient who had undergone human allograft cardiac transplantation 5 months before ascending aorta replacement. A pseudoaneurysm at the anastomotic site of ascending aorta with periaortic hematoma compressing the superior vena cava (SVC) had been revealed by chest CT, and after the median sternotomy, paraaortic abscess was revealed as the cause of this patient's SVC syndrome. The ascending aorta replacement was performed under deep hypothermic circulatory arrest. The anesthetic management of this patient included the use of a sterile technique, slow cautious induction, and the maintenance of adequate intravascular volume.
Abscess ; Allografts ; Aneurysm, False ; Aorta* ; Circulatory Arrest, Deep Hypothermia Induced* ; Heart Transplantation ; Heart* ; Hematoma ; Humans ; Sternotomy ; Tomography, X-Ray Computed ; Vena Cava, Superior

BACKGROUND AND OBJECTIVES: Nasolabial cysts are relatively rare and are sometimes confused with tumors due to progressive enlargement. Treatment of a nasolabial cyst consists of sublabial excision or endonasal endoscopic marsupialization (EEM). The purpose of this study was to investigate the clinical features of nasolabial cysts in order to provide a basis for correct diagnosis and treatment. MATERIALS AND METHODS: Sixty-four patients with a nasolabial cyst were surgically treated between December, 1989 and January, 2010 at the Department of Otolaryngology, Asan Medical Center. Their clinical features, radiologic and histopathologic findings, and treatment and outcomes were retrospectively analyzed. RESULTS: The patients comprised 51 (80%) women and 13 men (20%), with ages ranging from 16 to 69 years with a mean of 43 years. Swelling of the nasolabial fold was the most frequently experienced symptom. There was no right or left side preponderance. Sublabial excision was applied in 57 cases (89%), while seven cases (11%) were treated via the endonasal approach. There was no case of recurrence. CONCLUSION: Nasolabial cysts should be suspected in patients with swelling of the nasolabial area and nasal obstruction. Enhanced CT may be needed to differentiate from tumors, odontogenic cysts, or other inflammatory lesions. Nasolabial cysts can be successfully treated via sublabial or endonasal approaches. Postoperative complications or recurrence is very rare.
Female ; Humans ; Male ; Nasal Cavity ; Nasal Obstruction ; Nasolabial Fold ; Nose ; Odontogenic Tumors ; Otolaryngology ; Postoperative Complications ; Recurrence ; Retrospective Studies