A household survey was conducted to determine the utilization rate of medical facilities and to identify the factors related with the utilization in the South District of Taegu from July 3 to July 15, 1988. Study population included 1,723 family members of 431 households which were selected by one-stage simple cluster random sampling. Well trained medical college students interviewed mainly housewives with a structurized questionnaire. Morbidity rate of acute illness during the 2-week period was 101 per 1,000 persons and it was highest in the age group of 9 years below. The rate for chronic illness was 77 per 1,000 persons, increasing with age, low income and medicaid benefit. During the 2-week period, 689 of 1,000 persons utilized the medical facilities, Of the facilities, most number, 294, used hospital and clinic, and the order ran as pharmacy, health center, and herb medical clinic. The utilization rate was higher in the female, 70-year and older group, medicaid group, the lowest income class and self-employed group than other groups. The average number of visits among users of medical facilities during the 2-week period was 3.25. those who visited medical facilities most frequently were females, the 70-year and older group, the lowest income class and blue collar worker group. During one-year period, admission rate of 1,000 persons was 27.6 and that of female was 38.9, higher than that of male. the eldest group had the highest admission rate. Admission rate of medical insurance beneficiaries was twice or higher than non-beneficiaries. The higher the family monthly income, the more frequently they admitted. During one-year period, average admission days of the persons hospitalized were 22.5 days and males were hospitalized longer than females. The groups which were hospitalized longest were those between the ages of 40 and 49, medical insurance beneficiaries, the lowest income group and unemployed group. During one-year period, average admission days of 1,000 persons were 560 days and those of female were 661 days, more than those of male. The guoups which had the longest admission days were those above 70 years of age, the lowest income and unemployed groups. The medical insurance beneficiaries were three times or longer than non-beneficiaries. In logistic regression analysis of utilization of physician, significant independent variables were the 9-year and younger group(+), the 70-year and older group(+), acute illness episode(+), chronic illness episode(+), medical insurance beneficiary(+) and white collar workers(-). Acute and chronic illness episode(+), and medical insurance for government employees and private school teacher(-) were significant variables in analysis of utilization of pharmacy. In multiple regression analysis of the number of physician visits, siginificant variables were acute illnes episode(+), chronic illness episode(+), industrial, occupational and regional medical insurance beneficiary(+), white collar workers(-). Acute and chronic illness episode(+), and medical insurance beneficiary() were significant variables in analysis of the number of pharmacy visits. In logistic regression analysis of admission event, significant independent variables were the 9-year and younger group(+), the 70-year and older group(+), chronic illness episode(+), and medical insurance beneficiary(+).
Chronic Disease ; Daegu* ; Family Characteristics ; Female ; Humans ; Insurance ; Logistic Models ; Male ; Medicaid ; Pharmacy ; Surveys and Questionnaires

OBJECTIVE: The purpose of this study is to investigate the prognostic factors and appropriate treatment in patients with intracerebral hemorrhage secondary to ruptured middle cerebral artery(MCA) aneurysms. METHODS: Among 120 cases with ruptured MCA aneurysms during last 9 years from 1993 to 2002, 85 cases was analyzed according to hematoma distribution. All cases were included in one of three groups Group A(15 cases) having an intraparenchymal hematoma(IPH) larger than 5cc with or without subarachnoid hemorrhage(SAH). Group B(25 cases) having an intrasylvian hematoma(ISH) with or without SAH. Group C(45 cases) having a diffuse SAH without localized hematoma. Prognosis was evaluated postoperatively by applying Glasgow Outcome Scale(GOS) at discharge. RESULTS: In Group A, hypertension and Hunt-Hess(H-H) grade on admission, hematoma volume larger than 15cc and postoperative edema were corrleated with poor outcome. In Group B, old age, postoperative edema and delayed ischemic neurologic deficit(DIND) were related to poor outcome. Group C revealed better consciousness on admission and favourable outcome than Group A and B. CONCLUSION: We suggest that therapeutic consideration in Group A is focused on postoperative edema after early surgical intervention and in Group B is focused on postoperative edema with DIND after removal of residual clot in sylvian fisssure as much as possible by irrigation and suction.
Aneurysm ; Cerebral Hemorrhage* ; Consciousness ; Edema ; Hematoma ; Hemorrhage* ; Humans ; Hypertension ; Intracranial Aneurysm* ; Middle Cerebral Artery* ; Prognosis ; Suction

PURPOSE: To establish the basis for a non-invasive and non-destructive assessment of the mechanical properties during natural fracture healing by analyzing the vibrational property of the fracture healing and comparing the vibrational property, the bone healing status (as determined by X-ray) and the mechanical strength parameters. MATERIALS AND METHODS: The tibial shafts of rabbits were broken under general anesthesia. The rabbits were sacrificed at 2, 4, 6 weeks after the fracture, then X-rays of the fractured tibias were sequentially taken to detect the fracture healing. The vibration mode and the biomechanical strength were measured. RESULTS: According to the results of a multiple regression analysis, the standardized coefficients of callus, apposition, lateral angulation, DAMP1, FREQ1 in the fractured tibias, were -0.80, -0.23, -0.21, -0.25, -0.25. In normal contralateral tibias, the standardized coefficients of the area, FREQ1, DAMP1, FREQ2, DAMP3 were -0.73, 0.28, 0.41, 0.39, -0.25. CONCLUSION: A monitoring of the fracture healing process that utilizes the frequency response function is thought to be useful in detecting the early phase of healing within 4 weeks. Additional studies on the vibrational characteristics of the healing bones after a clinical union or after simillar pathologies should be pursued so that future diagnostic applications ca be made.
Anesthesia, General ; Bony Callus ; Fracture Healing ; Fractures, Bone* ; Pathology ; Rabbits ; Tibia ; Vibration

Hyperplastic gastric polyps (HPPs) are the most common type of gastric polyps. They are assumed to be caused by chronic inflammation and regenerative proliferation, although this has not been clearly investigated yet. Many studies suggested the development of fundic gland polyps and carcinoid during long-term proton pump inhibitor (PPI) therapy, but the relationship between PPIs and HPPs is still unclear. We encountered a patient who showed aggravation of HPPs after long-term use of PPIs. A 58-year-old male patient with liver cirrhosis visited our hospital because of hematemesis. We started PPI medication after confirming esophageal variceal bleeding and duodenal ulcer with blood clot in its base via emergency endoscopy. He took PPIs for three years because of an intractable duodenal ulcer. There was a marked increase in the size of the pre-existing polyps and in the development of new polyps. We presumed that the PPIs caused the aggravation of the HPPs, so we stopped their administration. After five months, the HPPs shrank and the polyps were partially degraded. More prospective studies are needed to investigate the relationship between HPPs and PPIs.
Carcinoid Tumor ; Duodenal Ulcer ; Emergencies ; Endoscopy ; Esophageal and Gastric Varices ; Hematemesis ; Humans ; Inflammation ; Liver Cirrhosis ; Male ; Middle Aged ; Polyps* ; Proton Pump Inhibitors* ; Proton Pumps* ; Protons*

Primary adenocarcinoma of the duodenum is a rare disease, representing 0.35% of all gastrointestinal neoplasm and 0.042% of all malignant neoplasm. Since Ham-burger described the first duodenal caricinoma in 1746, the incidence has shown an increasing tendency. Compared with upper gastrointestinal contrast studies, the gastroduodenoscopy has gained an increasing popularity as an invesitigative tool in recent years. But the diagnosis is usually made at a very late stage because the symptoms are often non-specific, which contributes to delayed diagonsiss and poorer prognosis. We have experienced two cases of the primary carcinoma of the duodenal bulb and one case of carcinoma of the second portion, which were diagnosed by biopsy with gastrofiberoscopic endoscopy and operative finding. So we report three csses with a brief review of literature.
Adenocarcinoma* ; Biopsy ; Diagnosis ; Duodenum* ; Endoscopy ; Gastrointestinal Neoplasms ; Incidence ; Prognosis ; Rare Diseases

This study was aimed for comparison of efficacy in detecting epileptiform discharges, which was originating from mesiobasal temporal lobe, among the four non-standard non-mvasive skm surface electrodes such as ear lobe(Al/A2), zygomatic(Zl/Z2), surface sphenoidal(SS1/SS2) and true anterior temporal electrode(Tl/T2). The study was performed with simultaneous placement of the nonstandard electrodes including standard electrodes(F7/F8). The resul ts were as follows. Among the non-standard electrodes, zygomatic and true anterior temporal electrodes detected more epileptiform discharges compared to the other two electrodes, although there was no statistical significancy. Compared to the standard electrodes, zygomatic and true anterior temporal electrode showed statistically high significant detecting rate (p<0. 01). Also average detection rate of epileptiform discharges of the whole non-standard electrodes which was compared to the rate of the standard electrodes showed statistically significance (p<0.05). In conclusions, non-standard surface electrodes, especially zygomatic and true anterior temporal electrode, are considered as valuable to detect the epileptiform discharges from temporal lobe if they were used at the routine initial EEG examination.
Ear ; Electrodes* ; Electroencephalography ; Epilepsy, Temporal Lobe* ; Humans ; Temporal Lobe*

The primary malignant tumor of the peritoneum also known as primary peritoneal carcinoma or primary peritoneal papillary serous carcinoma is rare and involves the peritoneum, especially the pelvic peritoneum of female patients. It is difficult to differentiate histologically between papillary mesothelioma, primary ovarian tumor and primary peritoneal carcinoma. We report two cases of the primary peritoneal carcinoma with clinical presentation and histologic characteristics.
Diagnosis, Differential ; Female ; Humans ; Mesothelioma ; Peritoneum*

Central neurocytoma is a rare, well-differentiated neuronal tumor and is usually located in the lateral or third ventricle of young adults. Its overall prognosis is excellent with a low proliferative index. The majority of previously reported malignant variants rarely did recurred after tumor removal and regarded as benign tumor despite of histopathological malignant feature. Nevertheless, we experienced a case of malignant variant of the central neurocytoma with high proliferative index(Ki-67 labeling index >30%), which showed recurrence immediately after surgery and died within 3 months POD. Here, we describe the case with a review of the literatures.
Humans ; Neurocytoma* ; Neurons ; Prognosis ; Recurrence ; Third Ventricle ; Young Adult

Typhoid fever is an acute systemic febrile disease caused by Salmonella typhi. The classic picture of the disease consists of prolonged continuous or remitting fever, abdominal pain, diarrhea, rose spots and delirium. Salmonella infection can lead to diffuse organ involvement, including bone, lung, thyroid, kidney, liver, spleen, heart, pericardium, intestine and skin and cause a variety of complications. Pulmonary manifestations occur in only 1 percent of the patients. Mild cough with sticky sputum is the earliest symptom and bronchitis, pneumonia and lung abscess were presented. Recenfly we experienced a case of typhoid fever complicated by bronchitis, dysplasia in a 37-year-old male physician who was improved with ceftriaxone and ciprofloxacin We report this case with a review of the literature.
Abdominal Pain ; Adult ; Bronchitis* ; Ceftriaxone ; Ciprofloxacin ; Cough ; Delirium ; Diarrhea ; Fever ; Heart ; Humans ; Intestines ; Kidney ; Liver ; Lung ; Lung Abscess ; Male ; Pericardium ; Pneumonia ; Salmonella Infections ; Salmonella typhi ; Skin ; Spleen ; Sputum ; Thyroid Gland ; Typhoid Fever*

OBJECTIVES: The purpose of this study was to investigate the prevalence of sleep problems in Korean elementary school children and the differences in sleep problems related to their school grade and gender. METHODS: One public elementary school in Dae-gu, Korea was randomly selected. And, parents who agreed to participate this study were asked to complete a modified version of Tucson Children's Assessment of Sleep Apnea screening questionnaire (TuCASA). RESULTS: The most common sleep problem was 'falling asleep in a vehicle (44.2%)' and the prevalence rate of this problem differed by school grade. The prevalence rate of falling asleep while watching TV before 8 P.M. (8.0%), daytime fatigue (21.9%) and nocturnal enuresis during the past 6 months (5.3%) were significantly differed by school grade. The prevalence rate of falling asleep while doing home work, falling asleep during a lesson, snoring and bruxism were 12.6%, 1.0%, 26.7% and 13.2% respectively. Although these rates did not show any differences between grades, snoring was more in boys and daytime fatigue was more in girls.. CONCLUSION: This study demonstrates that many elementary school children may have various sleep problems. Lower grade elementary schoolers had sleep problems which related to neuro-developmental factors, whereas higher grade elementary schoolers had sleep problems related to sleep deprivation and stress. Finally, more female schooler showed signs of fatigue or sleepiness than male schoolers.
Bruxism ; Child ; Fatigue ; Female ; Humans ; Korea ; Male ; Mass Screening ; Nocturnal Enuresis ; Parents ; Prevalence ; Sex Characteristics ; Sleep Apnea Syndromes ; Sleep Deprivation ; Snoring ; Surveys and Questionnaires