In order to discover difference that may exist in quantity of medical care services, length of stay and hospital changes between insured and non-insured patients, records for primary Cesarean section patients discharged between July 1978 and June 1980 from a university hospital were examined. In addition, Cesarean section rates among the total deliveries for a two-year period between the groups were studied. The results showed that volume of services was greater and length of stay was longer among the insured, however, charges were higher among the non-insured. Cesarean section rates were statistically significantly different between insured and non-insured patients for every age group except the group of 35 or more.
Cesarean Section* ; Female ; Humans ; Length of Stay ; Pregnancy

To assess the proportion of spectacles-wearing and an aspect of familial aggregation of myoptic spectacles-wearing and to observe the birth cohort for myoptic spectacles-wearing, a nationwide self-administered questionnaire survey was conducted from March 11 to September 19, 1985. A probability sample of 13,346 persons was taken from 180 enumerated districts designated by the fifth nationwide tuberculosis prevalence survey from Korean Institute of Tuberculosis. The major findings of this survey are as follows: 1) Total of 62.5% of the study population lived in urban area whereas 37.5% lived in Eup-Myun area. There was statistically significant difference in age and sex distribution between two residential area. 2) The percentage of spectacles-wearing was 8.3% and among these, myoptic and hyperoptic spectacles were 6.0%, 2.3%, respectively. A total of 8.8% of the male study population wore spectacles and this was slightly higher than the female (8.0%). 3) Among the occupational groups, students were the highest myoptic spectacles-wearing group whereas professionals were the highest hyperoptic spectacles-wearing group. 4) The proportion of myoptic spectacles-wearing was higher in female students than in male students respectively 11.6%, 8.7%. There was an increasing tendency of spectacles-wearing as age increased. 5) The age-sex adjusted prevalence rate of myoptic spectacles-wearing by residential areas was 2 times higher in urban area than Eup-Myun area. 6) A wearing of the myoptic spectacles in early age was observed in recent birth cohort than remote birth cohort. 7) There was a tendency of familial aggregation for myoptic spectacles-wearing. The proportion of myoptic spectacles-wearing was 6 times higher for those who had parents wearing spectacles. 8) 60.9% of the total myoptic spectacles-wearing persons received the eye-specialist's order and 44.9% for the hyperoptic spectacles wearing.
Cohort Studies ; Eyeglasses ; Female ; Humans ; Korea* ; Male ; Occupational Groups ; Parents ; Parturition ; Prevalence ; Surveys and Questionnaires ; Sampling Studies ; Sex Distribution ; Tuberculosis

PURPOSE: Scanning laser ophthalmoscope (SLO) has improved Infrared (IR) imaging. Since greater penetration of IR light permitted better visualization of subretinal structures, we evaluated chorioretinal layer in various chorioretinal dieases with SLO. METHODS: Cases of central serous chorioretinopathy (CSC), drusen, age-related macular degeneration (AMD), Vogt-Koyanagi-Harada disease, MEWDS (multiple evanesant white dot syndrome) and inflammatory choroiditis, toxoplasmosis, Stargardt's disease, proliferative diabetic retinopathy (PDR) and submacular hemorrhage were included. We used SLO (101, Rodenstock, Germany) for IR image and compared argon laser image with monochromatic IR image (780 nm wave length). RESULTS: The demarcation and extent of serous retinal detachment and macular star were more distinct in IR image. Small drusen, subretinal deposit and RPE atropy which could not be seen in argon green laser image were visible and appeared brightly with high reflectance in IR image. The CNV membrane which was not seen in full extent in argon laser image were observed completely in IR image. In case of inflammatory choroiditis, patch-like hot spot with surrounding high reflectance was observed in IR image. The subretinal structures and new vessels were clearly visible in IR image despite overlying thick preretinal fibrous prolifertive membrane and vitreous hemorrhage. CONCLUSIONS: The IR image using SLO is a fast and non-invasive diagnostic tool. Compared to fluorescein angiography, IR image gave a improved image for subretinal structure and additional information. Therefore IR imaging is recommended along with clinical symptom, FAG, ICGA for the diagnosis and treatment.
Argon ; Central Serous Chorioretinopathy ; Choroid ; Choroiditis ; Diabetic Retinopathy ; Diagnosis ; Fluorescein Angiography ; Hemorrhage ; Macular Degeneration ; Membranes ; Ophthalmoscopes ; Retina ; Retinal Detachment ; Toxoplasmosis ; Uveomeningoencephalitic Syndrome ; Vitreous Hemorrhage

PURPOSE: Kinetic automated perimetric tests were performed with OCTOPUS 101 perimeter using Goldmann module. Normal isopter positions in the peripheral visual field were visualized by the average position +/- 2 standard deviations. METHODS: We examined 102 eyes of 51 normal healthy Koreans who had no family history of glaucoma, no specific ophthalmologic disease, best corrected visual acuity more than 1.0 and normal intraocular pressure less than 21 mmHg with OCTOPUS 101 perimeter using Goldmann module in 5 isopters (I1e, I2e, I3e, I4e, II4e) at 8 meridians (0degree, 45degrees, 90degrees, 135degrees, 180degrees, 225degrees, 270degrees, 315degrees). RESULTS: The visual field was oval shape, and widest at the inferotemporal area, followed by temporal, and inferior. CONCLUSIONS: The normal position of 4 isopters can be used as a reference index for the peripheral visual field test.
Glaucoma ; Humans ; Intraocular Pressure ; Meridians ; Octopodiformes* ; Visual Acuity ; Visual Field Tests ; Visual Fields* ; Vitelliform Macular Dystrophy

Purpose: To determine whether the clinical features of intermittent exotropia (IXT) needing muscle surgery were different in the ophthalmologist-detected and non-specialist-detected groups (including parents). Methods: Medical records of 218 children (mean age: 5.9 ± 1.4 years) with IXT of ≥ 20 prism diopters (PD) were reviewed retrospectively. The angles of deviation were measured using the prism and alternate cover test and assessed by two ophthalmologists using photographs with a translucent occluder (photographic angle). The IXT subtype, fusional control, stereopsis, suppression, and spherical equivalent (SE) were compared between the ophthalmologist-detected and non-specialist-detected groups. Results: Mean 25.8 ± 6.8 PD of distant angle of IXT was first detected by the ophthalmologist in 41 patients (18.8%) and the non-specialists in 177 patients (81.2%). The deviated eye was more myopic in the ophthalmologist-detected than non-specialist- detected group (-0.77 ± 1.59 diopters [D] vs. -0.19 ± 1.48 D, p = 0.03). There were no other differences between the two groups. A comparison of 39 age- and non-dominant eye SE-matched pairs demonstrated that the measured angles for distant and near fixation were smaller in the ophthalmologist-detected than non-specialist-detected group (24.0 ± 6.8 PD vs. 28.5 ± 6.4 PD and 26.9 ± 6.6 PD vs. 31.0 ± 6.4 PD, respectively, p < 0.01), while the remaining characteristics, including the photographic angle, were similar. Conclusions In cases with small angles of deviation or myopia, IXT with angles requiring surgical correction were commonly first detected by ophthalmologists during examinations.

We reviewed a total of 15 cases of heterotopic pancreatic tissue within the gastrointestinal wall(intramural type), and compared with 3 extramural ones. Intramural heterotopic pancreatic lesions were located in the antrum(33%), pylorus(20%), and body of stomach(7%), and the remainders in the duodenum(40%). Only two cases presented with chinical symptoms by their existence. Two of them were situated within the submucosa, 3 in the muscularis, 6 in submucosa-muscularis, 2 in the muscularis-subserosa, and 1 in the susbmucosa-subserosa. Intramural type was featured with their structural heterogeneity compared to the extramural ones; 10 cases showed participation of gastrointestinal mucosal elements, and some accompanied tissue elements that were indistinguishable from submucosal epithelial heterotopia or microduplication cyst of the stomach. Langerhans islets were found in 67%, and one developed islet cell tumor. The above results suggest that the initially engrafted heterotopic pancreatic tissue becomes modified and presents with heterogeneity of endodermal and mesodermal tissue-derived components by its intramural growth during the gastrointestinal organogenesis; failure of opening of its drainage system into the gastrointestinal lumen may result in the increase of intraductal pressure with subsequent atrophy of the acinar tissue and various metaplastic changes of ductal epithelium, aside from induction of smooth muscle coat around the heterotopic tissue.
Cysts

The purpose of this study was to compare the difference of two survey methods for health services research. Data were collected by means of two types of household survey conducted from March 11 to September 19, 1985. A probability sample of 30,613 persons was taken from 180 Enumerated Districts designated by the Economic Planning Board. The sample was divided into two groups systematically. One group was surveyed by the self-administered questionnaire and the other group was interviewed. Response rates were 81.4% and 90.6% respectively. The data were analyzed by the ratio of the results of the self-administered survey to those of the interview survey. No difference was observed in sex, age, residence, or occupation between the two groups. However the respondents' characteristics were statistically different between the two groups. The major findings of this study are as follows : 1. The morbidity rate was 142.5 per 1,000 persons during the two week period by the self-administered questionnaire survey and 74.3 per 1,000 persons with the interview survey method. The ratio of the morbidity rate by the self-administered questionnaire to that by the interview was 1.92, and the difference between the two rates were due to the personal characteristics. 2. The out-patient utilization rate was 10.2 visits per person per year by the self-administered questionnaire survey and 5.4 by the interview survey, and the ratio was 1.89; the admission rate was 3.2 times per 100 persons per year by the self-administered questionnaire survey and 1.9 times by the interview survey, and the ratio was 1.68. Differences due to the sociodemographic characteristics were greater in the out-patient utilization rates than in the admission rates. 3. Percentages of effective medical care demand were 90.2% in the self-administered survey and 92.3% in the interview survey; the ratio was 0.98 which was less than that of the morbidity rate and medical care utilization. But, differences of effective medical care demand occurred in persons with no occupation, and aged or low educated respondents. 4. Respiratory illness had the highest frequency in the two survey methods. But there was a slight difference between the two survey methods in morbidity composition. 5. It was concluded that data collected by the interview survey were inclined to be underestimated and this problem can be corrected by a modified self-administered survey.
Surveys and Questionnaires* ; Family Characteristics ; Health Services Research* ; Health Services* ; Humans ; Occupations ; Outpatients ; Surveys and Questionnaires* ; Sampling Studies

This study was performed in a rural community, Kanghwa county which was introduced to a regional medical insurance pilot program in 1982. The purposes of this study were, firstly, to observe the changes in ambulatory care utilization in the three years 1982, 1983 and 1987 ; secondly, to analyse factors which convert perceived medical care needs to effective medical care demand. During the three periods, a serial interview survey was performed to determine the changes in medical utilization before and after the regional medical insurance program implementation. The number of subjects was 3,356 persons in the year 1982, 3,705 in 1983 and 2,745 in 1987. The results of the study were as follows : 1. Total ambulatory care utilization rates per 100 persons during a 2-week period were 23.6 in the year 1982, 21.8 in 1983, and 29.3 in 1987 ; and physician visit rates were 6.1 in 1982, 11.7 in 1983, and 14.9 in 1987. Thus, compared to the total utilization rate there was a definite increase in physician visit, and during the study periods there was a decrease in drug stores visits whereas an increase in hospital or clinic visits was noticed. 2. The rates of effective demand for medical care need were 70.7% in 1982, 70.5% in 1983 and 75.9% in 1987 ; and the rates of patients who visited physicians were 20.2% in 1982, 42.8% in 1983 and 35.6% in 1987. Thus, physician visits increased sharply by introducing the medical insurance program, but after the latent medical care demands were fulfilled, there was a slight decrease in the physician visits. 3. The number of acute symptoms and the number of chronic symptoms were common determinants of total ambulatory care utilization and physician visits. Besides the medical care need factors, age in 1982, sex and accessibility in 1983, and accessibility in 1987 were statistically significant determinants of the total utilization ; sex and accessibility in 1983, and education in 1987 were also statistically significant determinants of the physician visit. 4. For persons with perceived acute symptoms during the 2-week periods, accessibility in total utilization and age in physician visits were common discriminating factors of ambulatory care utilization in the three years, and education and income were also statistically significant variables For persons with perceived chronic symptoms, occupation and income were statistically significant discriminating variables commonly observed in total utilization and physician visits.
Age Factors ; Ambulatory Care* ; Education ; Humans ; Insurance* ; Occupations ; Rural Population*

Island regions suffer from a shortage of health care in part because they are less developed, they cover a widespread area relative to the population, and due to transportation barriers. The purpose of this study was to assess the level of illness and the magnitude of medical care utilization, and to investigate the determinants of utilization in these area. The data were collected by means of a household survey conducted from February 16 to 25, 1987 on 5 islands which were selected in consideration of the size of the population, the distance from the main land, and the distribution of health care facilities. The household response rate was 89.1% (491 of 551 households), and 1971 persons were surveyed. The major findings of this study are as follows: 1) The morbidity rate of the island inhabitants was 27.7% during the two weeks, and 25.5 chronic illnesses and 9.1 acute illnesses per 100 persons, were noted. Differences in the magnitude of illness were statistically significant by sex, age, education, and family size. 2) The magnitude of total ambulatory care utilization was 16.8 visits per 100 persons during the two weeks, which was less than that of other regions; and differences in the magnitude of total ambulatory care were statistically significant by sex, age, education, occupation, and family size. 3) Unmet needs were classified as 56.0% in chronic illnesses and 19.6% in acute illnesses; and differences in unmet needs were statistically significant by sex, age, education, occupation, income, and family size. 4) Statistically significant determinants in medical care utilization included the frequency of acute illness and chronic illness, and income in total utilization; the frequency of chronic illness and acute illness, and medical care insurance in physician visits. 5) According to the results of the path analysis, need factors had the greatest effect on utilization, and predisposing factors had more indirect effects through enabling or need factors than direct effects.
Ambulatory Care ; Causality ; Chronic Disease ; Delivery of Health Care* ; Education ; Family Characteristics ; Humans ; Insurance ; Islands ; Occupations ; Transportation

No abstract available.
Gait* ; Humans ; Spinal Cord Diseases*