The Korean government launched the medicaid program for the poor people as a wing of the social development and welfare programs beginning in 1977 when the fourth 5-year national economic development program started. The charts of the medicaid recipients who visited Jonglo-Gu Health Center for the period from 1981 to 1983 were reviewed and analysed. Major findings from the analysis are as follows. 1. The medical recipients occupied 5.19% in 1981, 2.90% in 1982 and 2.00% among the total residents of Jonglo district in 1983, respectively. 2. The mean number of physician visits per person year of medicaid recipients who visited the Jonglo-Gu Health Center was 4.73 in 1981, 4.90 in 1982 and 4.41 in 1983, respectively. 3. The consultation/referral rate at the Jonglo-Gu Health Center was 2.65% in 1981, 1.77% in 1982 and 2.18% in 1983 while the rate at the department of family practice, Seoul National University Hospital was 3.18% in 1983. 4. Classifying into 17 major categories, the pattern of diseases of the poor outpatients who visited the Hallym College Medical Center both in 1981 and 1982 showed a statistically similar pattern of the 5,169 medicaid patients who visited the Jonglo-Gu Health Center in 1981 and 401 patients in 1983. 5. Classifying into 17 major categories, the disease of outpatient visits at the department of family practice, Seoul National University Hospital from 1st May, 1983 to 31st Oct., 1983 revealed statistically significant similarity with both the 5,169 medicaid patients in 1981 and the 401 patients sampled in 1983. 6. Classifying into 17 major categories, the disease of community diagnosis at the Ihwa Dong, Jonglo-Gu also showed a statistically significant similarity with the 5,169 medicaid patients who visited the Jonglo-Gu Health Center in 1981. 7. Classifying into 17 major categories, the disease of 5,169 medicaid patients at Jonglo-Gu Health Center in 1981 showed a statistically significant similar distribution with that of the 401 sampled medicaid patients at this center in 1983. 8. Among the medicaid patents who utilized the Jonglo-Gu Health Center in 1983, 401 sampled patients who are practicable routine urinalysis composed of 131 indigent group and 270 low income group. The sample composed of 127 males and 274 females. There were more old patients than the young ones among the 401 sampled patients. 9. Age-adjusted prevalence rate of the hypertension computed by the direct method using estimated of midyear population of 1980 year as the standard is the highest in the Yonsei area and the lowest in the Shindongmyun. Furthermore age-adjusted prevalence rate was higher for males than that of females. 10. The group of hypertension patients using routine urinalysis profile composed of pyuria, hematuria, proteinuria and glycosuria is the most statistical significant, the pyuria alone is very significant, hematuria is significant and proteinuria is also significant.
Diagnosis ; Economic Development ; Family Practice ; Female ; Glycosuria ; Hematuria ; Humans ; Hypertension ; Male ; Medicaid ; Outpatients ; Poverty ; Prevalence ; Proteinuria ; Pyuria ; Seoul* ; Social Change ; Urinalysis*

A case of fibrocalcifying pseudotumor occuring at a very unusual site, the intraosseous region of axis, is presented. Previous reports of similar lesions in skull base, intracranial parenchyme, soft tissue around spine, mediastinum, and pleura have been described under the designation 'fibro-osseouslesions' and 'calcifying pseudoneoplasm' The etiology, pathogenesis and natural course of the lesion are still unknown. Bvt the lesion is probably benign nature and reactive lesion rather than neo-plastic. Authors performed resection of lamina, spinous process, and a portion of pedicles and occipitocervical fusion to prevent spinal cord compression due to cortical expansion or fracture. Microscopically, amorphous, basophilic, hyaline, and chondroid calcifying masses were rimmed by palisading histiocytes and foreign body-type giant cells. No evidence of malignancy was found.
Axis, Cervical Vertebra* ; Basophils ; Giant Cells, Foreign-Body ; Histiocytes ; Hyalin ; Mediastinum ; Pleura ; Skull Base ; Spinal Cord Compression ; Spine

STUDY DESIGN: We retrospectively reviewed nine patients of lumbar extraforaminal disc herniation which underwent conservative or surgical treatment. OBJECTIVES: We evaluated the clinical characteristics, accuracy of diagnostic methods, and result of conservative or surgical treatment for the lumbar extraforaminal disc herniation. SUMMARY OF BACKGROUND DATA: Lumbar extraforaminal disc herniation represents an important component of lumbar disc herniation because of the difficulty in diagnosis and the difference in clinical characteristics and surgical approaches in contrast to usual intracanalicular disc herniation. MATERIALS AND METHODS: Nine patients which we have experienced from March 1994 to February 1997 were evaluated by physical examination, magnetic resonance imaging, EMG, and disco-enhanced computed tomogram. There were 4 males and 5 females, and average age was 42.4 years. RESULTS: The level of herniation was 4 cases at L4-5 and 5 at L5-S1. Radiating pain was chief complaint but low back pain was absent or mild. Accuracy of disco-enhanced computed tomogram was superior to that of magnetic resonance imaging. The results of conservative treatment were good in 2 cases(40%), fair in 2 cases(40%), and poor in 1 case(20%). And those of surgical treatment including partial laminectomy, medial facetectomy, and discectomy or extraforaminal approach were excellent in 3 cases(75%), good in 1 case(25%) according to the grading of MacNab. CONCLUSIONS: Lumbar extraforaminal disc herniation represents compressive symptoms of upper lumbar root of the involved level characteristically. Location and degree of disc herniation is an important tractor for determining the surgical approach, and disco-enhanced computed tomogram is a definite diagnostic method.
Diagnosis* ; Diskectomy ; Female ; Humans ; Laminectomy ; Low Back Pain ; Magnetic Resonance Imaging ; Male ; Physical Examination ; Retrospective Studies

Traumatic atlanto-occipital dislocation is usually fatal. To date, few cases have been reported in the literature because survival after traumatic atlanto-occipital dislocation is extremely rare. We present the case of a 47-year-old man with traumatic atlanto-occipital rotatory posterior dislocation combined with atlanto-axial rotatory subluxation and treated by occipito-cervical fusion using Bohlman's triple wiring technique.
Dislocations* ; Humans ; Middle Aged

The functional knee hrace has been used to provide or to assist knee stahility in the anterior cruciate ligament (ACL) deficient knee, Nowadays, it is more indicated in the postoperative care of ACL injury to protect the reconstructed or repaired ligament, but eontroversies still exist regarding the effectiveness and the selection of an appropriate model. For successful application, it must restrict the knee motion within the range of certain arc, especially hyperextension, during weight bearing together with convenience and comfort.. The six commercial functional knee braces, which were introduced in Korea, were ehecked to detect the angle discrepancy between angle of brace and knee joint motion. The purpose of this study was to guide correct application of the functional knee brace in preventing hyperextension of the knee joint. Each brace was grouped into small, medium and large by size, and fixed with the arc of motion 30 to 90. The brace was applied to 3 healthy volunteers whose size was just fit mth the brace size small, rnedium and large, respectively. True lateral X-ray of the knee joint was taken in active flexion and extension state under the fluoroscopic control and measured the lateral intershaft angle of femur and tibia. Average angle discrepancy between the brace and the intershaft ang]e of femur and tibia in active extension was 22 and 3 in acTive flexion. In active extension at 30, angle discrepancy of Denzo brace was the large:st recording 26, that of Sentry hrace was the smallest recording 17. In active flexion at 90', angle discrcyancy of Sentry hrace was the largest recording 13, that of ACL brace (custom made modified Sentry brace) was the smallest recording 2. There was no statistically significant difference of the angle discrepancy among each size of brace. This study suggests that, at least 20 of angle discrepancy must be considered in appling the knee brace for prevention of hyperextension of the knee joint and careful selection of the brace, which may be affected by the design of hrace and the soft tissue compliance, is mandatory.
Anterior Cruciate Ligament ; Braces* ; Compliance ; Femur ; Healthy Volunteers ; Knee Joint ; Knee* ; Korea ; Ligaments ; Postoperative Care ; Tibia ; Weight-Bearing

BACKGROUND: Angiogenesis is an essential process for the growth and metastatic ability of solid tumors. One of the key factors known to be capable of stimulating tumor angiogenesis is the vascular endothelial growth factor (VEGF). The serum VEGF concentration has been shown to be a the malignant pleural effusion showing a correlation with the biochemical parameters. The VEGF has been shown to play a role in the inflammatory diseases, but rarely in the tuberculosis (TB). The serum and pleural fluid VEGF levels were measured in patients with lung cancer and TB. Their relationship with the clinical and laboratory parameters and repeated measurement 3 months after various anticancer treatments were evaluated to assess the utility of the VEGF as a tumor marker. METHODS: Using a sandwich enzyme-linked immunosorbent assay, the VEGF concentration was measured in both sera and pleural effusions collected from a total of 85 patients with lung cancer, 13 patients with TB and 20 healthy individuals. RESULTS: The serum VEGF levels in patients with lung cancer (619.9±722.8ph/ml) were significantly higher than those of healthy controls (215.9±191.1pg/ml), However, there was no significant difference between the VEGF levels in the lung cancer and TB patients. The serum VEGF levels were higher in large cell and undifferentiated carcinoma than in squamous cell carcinoma and adenocarcinoma. The serum VEGF levels of lung cancer patients revealed no significant relationship with the various clinical parameters. The VEGF concentrations in the malignant effusion (2,228.1±2,103.0pg/ml) were significantly higher than those in the TB effusion (897.6±978.8pg/ml). In the malignant pleural effusion, the VEGF levels revealed significant correlation with the number of red blood cells (r=0.75), the lactate dehydrogenase (LDH)(r=0.70), and glucose concentration (r=-0.55) in the pleural fluid. CONCLUSION: The serum VEGF levels were higher in the lung cancer patients. The VEGF levels were more elevated in the malignant pleural effusion than in the tuberculous effusion. In addition, the VEGF levels in the pleural fluid were several times higher than the matched serum values suggesting a local activation and possible etiologic role of VEGF in the formation of malignant effusions. The pleural VEGF levels showed a significant correlation with the numbers of red blood cells, LDH and glucose concentrations in the pleural fluid, which may represent the tumor burden.
Adenocarcinoma ; Carcinoma ; Carcinoma, Squamous Cell ; Enzyme-Linked Immunosorbent Assay ; Erythrocytes ; Glucose ; Humans ; L-Lactate Dehydrogenase ; Lung Neoplasms* ; Lung* ; Pleural Effusion ; Pleural Effusion, Malignant ; Tuberculosis ; Tuberculosis, Pleural* ; Tumor Burden ; Vascular Endothelial Growth Factor A*

To more fully define the nature of the antibody response to melanocytes which is associated with vitiligo, a Western immunoblot assay was used to test the sera of 28 patients with vitiligo (21 with active non-segmental, and 7 with stable segmental diseases) and 26 normal individuals for antibodies to antigens in detergent extracts of melanocyte membrane fractions. Antibodies to melanocytes were found in 26 (93%) of the patients with vitiligo, and in 16 (62%) of the control individuals. Patients with vitiligo and control individuals both had antibodies to an 80 approximately 83 kD antigen. The patient with vitiligo, in addition, had antibody responses to antigens with MWs of 45, 65, and 110 kD. Antibodies to these antigens were present in 46, 25, and 31% of vitiligo patients, but in only 19%. 0%, amd 0%, respectively, of the normal individuals. The heterogeneity of the antibody responses to melanocytes in vitiligo was further confirmed by the presence of antibodies to at least 3 distinct antigens in one-third of vitiligo patients but in none of the normal individuals. There was no difference in antibody response between patients with generalized and segmental vitiligo, suggesting that the pathogenesis of diseases was similar in both cases.
Antibodies/*analysis ; Antigens/immunology ; Blotting, Western ; Human ; Melanocytes/*immunology ; Reference Values ; Support, Non-U.S. Gov't ; Vitiligo/*immunology/*pathology

A case of nonfunctioning pancreatic islet cell tumor is described. A 34 years old female patient had intermittent epigastric pain and nausea for 6 months and she had nothing suggestive of neuroendocrine symtoms. Physcial examination showed an epigastric mass which wae deepseated, nontender, and well-demarcated. The routine upper endoscopic evatuation was negative. Abdominal ultrasonography and computed tomography showed a well-defined round solid mass with multifocal necrosis but did not revealed the origin of the lesion. Endoscopic retrograde pancreatography showed upward and rightward displacement of the proximal body portion of main pancreatic duct with nonvisualization of the secondary branches of pancreatic duct, suggesting that the mass originated from the pancreas. Resection of the mass with partial pancreatectomy and Roux-en-Y pancreaticojejunostomy was perfomed and the pathology was coafirmed as nonfunctioning pancreatic islet cell tumor containing somatostatin by immunohistochemical technique.
Adenoma, Islet Cell ; Adult ; Female ; Humans ; Immunohistochemistry ; Islets of Langerhans* ; Nausea ; Necrosis ; Pancreas ; Pancreatectomy ; Pancreatic Ducts ; Pancreaticojejunostomy ; Pathology ; Somatostatin ; Ultrasonography

The Korea National Health and Nutrition Examination Survey (KNHANES) is a national program designed to assess the health and nutritional status of the noninstitutionalized population of South Korea. The KNHANES was initiated in 1998 and has been conducted annually since 2007. Starting in the latter half of 2008, ophthalmologic examinations were included in the survey in order to investigate the prevalence and risk factors of common eye diseases such as visual impairment, refractive errors, strabismus, blepharoptosis, cataract, pterygium, diabetic retinopathy, age-related macular degeneration, glaucoma, dry eye disease, and color vision deficiency. The measurements included in the ophthalmic questionnaire and examination methods were modified in the KNHANES IV, V, and VI. In this article, we provide detailed information about the methodology of the ophthalmic examinations in KNHANES in order to aid in further investigations related to major eye diseases in South Korea.
*Epidemiologic Methods ; Eye Diseases/*epidemiology ; Humans ; Nutrition Surveys/*statistics & numerical data ; Ophthalmology/*methods ; Prevalence ; Republic of Korea/epidemiology ; Risk Factors ; *Surveys and Questionnaires

PURPOSE: To estimate the factors and prevalence of eye care service utilization in the South Korean population. METHODS: This cross-sectional, population-based study included data from 22,550 Koreans aged ≥5 years who participated in the Korea National Health and Nutrition Examination Survey from 2010 to 2012. For people aged 5 to 11 years (young children), information was based on self-reports of contact with eye care service in the past year; for people aged ≥12 years (older population), the information was based on the self-reported lifetime contact with eye care service. Univariate and multivariate logistic regression analyses of the complex sample survey data were performed. RESULTS: The prevalence of eye care service use in young children during the past year was 61.1% (95% confidence interval, 58.1%–64.1%), while that in the older population during their lifetime was 73.5%. Subjects aged 7 to 11 years were more likely to have had an eye examination in the past year than subjects aged 5 to 6 years (odds ratio, 3.83; 95% confidence interval, 2.37–6.19). Multivariate logistic regression analysis indicated that higher monthly household income, being a National Health Insurance holder, and having private health insurance were related to more frequent use of eye care services in young children. For the older population and women, those living in an urban area and those with a best-corrected visual acuity less than 20 / 40 in the worse-seeing eye were more likely to have had an eye examination during their lifetime. Low education level was associated with low lifetime use of eye care services in the older population. CONCLUSIONS: There are sociodemographic disparities with use of eye care services in South Korea. This population-based study provides information that is useful for determining different intervention programs based on sociodemographic disparities to promote eye care service utilization in South Korea.
Child ; Education ; Family Characteristics ; Female ; Healthcare Disparities ; Humans ; Insurance, Health ; Korea* ; Logistic Models ; National Health Programs ; Nutrition Surveys* ; Prevalence* ; Socioeconomic Factors ; Visual Acuity