After medical insurance came into effect in Korea, health care system has undergone tremendous changes. Changing patterns of newly established clinics is one of them. To investigate changes and trends, a total of 10,184 clinics which were newly established from 1981 to 1990 were analysed. Data were obtained from the file of contracting medical facilities of the Federation of Medical Insurance Societies. The proportion of newly establishied clinics has increased gradually, so that they amount to 13% of the total medical facilities in Korea. Meanwhile, the number of newly established medium-size hospitals and general hospitals have decreased. The number of newly established clinics per 100, 000 populations has increased in the all areas, but the rate of increase has decreased in the cities except in 6 major cities in 1990. The rate of increase in newly established clinics surpasses that of population increase. This study has identified the trend of young physicians' early driving into their solo medical practice than before. This indicates chance of the medical specialty training nowadays toughen due to the limited openings in residency programs. However, the sex ratio of physicians at newly established clinics has not changed. The decreasing tendency to open medical practice without beds and the increasing size of clinics are found in this study(The size has been measured in terms of medical manpower, of beds, and of medical equipment in this study). Two thirds of general practitioners have opened their clinics without beds, although such trend has been less in the case of specialists. All three indicators show increasing size, especially in the case of rural clinics. However, among them, the number of medical equipments has increased most significantly from 8.9 items in 1981 to 12.9 in 1990.
Delivery of Health Care ; General Practitioners ; Hospitals, General ; Humans ; Insurance ; Internship and Residency ; Korea* ; Sex Ratio ; Specialization

The results in thrity-six adolescent idiopathic scoliosis patients(thirty-nine curves) who have been treated with the Boston brace are reported. The average follow-up was two years and three months(range, one year to four years ten months). Before treatment, all the patients had a curve that measured 20 to 35 degrees; 26 patients were in Risser sign of zero or 1, 10 patients in Risser sign 2 to 4. Although the magnitude of the curve was generally reduced about 40 percent by the initial application of the brace, a gradual loss of this initial correction was observed both during active treatment and after the wearing of the brace. Although eleven(28.2 percent) of the curves had progressed more than 5 degrees at follow up. Sixty-seven percent of the thoracic curve, 33.3 percent of the thoracolumbar, 27.8 percent of the lumbar curve had progression of more than 5 degrees. Twelve patients wore the brace for sixteen hours a day, 19 patients wore for 16 to 20 hours a day and 5 patients wore more than 20 hours a day. 41.7 percent of sixteen hours bracing, 15,8 percent of 16 to 20 hours bracing and 60 percent of 20 hours bracing had progression of more than 5 degrees. Our finding indicates that the Boston brace prevents deterioration in certain cases but does not convert major deformity into minor ones, and part time bracing can prevent progression of the curve and can even afford some correction.
Adolescent ; Braces ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Scoliosis

Congenital dislocation of the hip has been known as one of the most common congenital anomalies in the orthopedic field since the time of Hippocrates (460-357 B.C.). The occurence of C.D.H. in twin babies is extremely rare thus few if any papers have been reported. During the period of January 1971 through June 1976 the authors have treated a total of 49 cases as inpatients. Two of these were twin babies. In both cases the hip was surgically reduced and followed by open reduction and femoral derotation osteotomy. Clinically and radiologically the results were good during the duration of follow-up seven months after operations.
Dislocations ; Follow-Up Studies ; Hip ; Humans ; Inpatients ; Orthopedics ; Osteotomy ; Twins

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

We have shown that hyaluronic acid stimulates the proliferation of quiescent NIH 3T3 cells. We have shown that treatment of 1 mg/ml hyaluronic acid results in increase of tyrosine phosphorylation of two proteins, MW 124 kDa and 60 kDa as detected by anti-tyrosine antibodies by Western blot analysis. Maximum phosphorylation occurred within 2 h after addition of 1 mg/ml hyaluronic acid. Stimulation of proliferation was also accompanied by increase in c-Myc protein, which was inhibited by amlloride, an inhibitor of Na+/H+ antiporter and EGTA and increase in the steady state level of pRb, the RB gene product. These results suggest that the intracellular signal transduction pathways that mediate the stimulatory effects of hyaluronic acid on cellular proliferation are similar to those of growth factors.
3T3 Cells ; Amiloride/pharmacology ; Animal ; Cell Division ; Dose-Response Relationship, Drug ; Egtazic Acid/pharmacology ; Hyaluronic Acid/pharmacology* ; Mice ; Mitogens/pharmacology* ; Phosphoproteins/metabolism* ; Phosphorylation ; Proto-Oncogene Proteins c-myc/metabolism* ; Retinoblastoma Protein/metabolism* ; Signal Transduction ; Sodium-Hydrogen Antiporter/antagonists & inhibitors ; Tyrosine

PURPOSE: This study aims to identify the ADL and IADL of bed-ridden elderly. Also it is used to show fuctional status, and to investigate the content and the level of nursing services provided. METHOD: The subjects were 191 elderly who received visiting nurse service through public health centers in the Seoul Metopolitan and Chungnam Province. Data collection was conducted by public health center nurses during four months in 2000. Result: As for daily living activities, 100% of subjects had at least one difficulty in ADL and IADL. Among them, only 0.5% had moderate disabilities and 99.5% had severe disabilities by HFS, 27.9% were in a semi bed-ridden state and 72.1% were completely bed-ridden by JABC. The major service provided was a visiting nurse service which was preferable to the social welfare service. In the visiting nurse service, there was no significant difference according to the elderlys' functional status. In addition there was no standadization about the qualification of the visiting nurse, and single entry point for the nursing service. CONCLUSION: The researchers urgently suggest that a community based comprehensive service model has to be developed to respond to the needs of the elderly in Korea.
Activities of Daily Living ; Aged* ; Chungcheongnam-do ; Data Collection ; Humans ; Korea ; Nurses, Community Health ; Nursing Services ; Public Health ; Seoul ; Social Welfare

PURPOSE: It was identified that how many homebound bedridden elderlies and their primary caregivers were depressed, and which factors affected the bedridden elderly's depression. METHOD: The subjects were 191 homebound bedridden elderlies and their primary caregivers. The affecting factors were classified into two categories: bedridden elderly and their primary caregiver related factors. Then bedridden elderly's factors were classified demographic and disease-related factors again. The stepwise regression was used to identify significant factors. RESULT: The prevalence of bedridden elderly's and caregiver's depression was 77.8% and 67.0%, respectively. And the model explained 33.3% of variance of bedridden elderly's depression. Cognitively-impaired female elderlies who had depressed caregivers were found to be more depressed. And caregivers who perceived burden were identified to be more depressed. CONCLUSION: It is recommended that the health professionals need to identify bedridden elderlies and caregivers at risk of depression. Especially elderlies who is in poor cognition, those who are female, and those whose caregivers were depressed might be considered carefully in all counseling or follow-up. Also the primary caregivers must be helped to access already available formal and informal support.
Aged ; Caregivers ; Cognition ; Counseling ; Depression* ; Female ; Health Occupations ; Humans ; Prevalence

Authors studied the workers' knowledge about the health problems detected through the previous workers' periodic health examination, content of follow-up management and actions taken for their health problem detected on previous health examination. From June to September 1992, workers' periodic health examination was performed on workers employed in 10 companies located in 2 middle-sized Korean cities. A questionnaire survey was done for 150 workers who reported to have D2 result of either hypertension or liver disorder at the previous workers' periodic health examination done in 1991. The results are as follows; 1. Of 160 workers who had D2 result of either hypertension or liver disorder in previous examination one year before, only 85 workers(51.3%, 43 workers with hypertension, 38 workers with live disorder) responded that they have such disorders. The other 65 workers responded to questionnaire were all those with C results. Respondents' knowledge about their diagnoses was relatively precise (95.2% in hypertension group, 94.6% in liver disorder group) but knowledge about classification of diseases was poor. 2. The main efforts to solve the health problem was self management (26 spells, 55.3%), visiting clinic or hospital (6 spells, 12.8%), use of herb medicine (2 spells, 4.3%) and use of drug store (2 spells, 4.3%) in hypertension group. In liver disorder group, 30 spells (71.4%) relied on self management, 6 spells (14.3%) on hospital or clinic and 9 spells (21.4%) had no effort to improve the health problem. Content of self management was low salt diet, quit smoking, regular exercise and quit alcohol drinking in order. Avoidance of salt in diet was high in hypertension group and quitting alcohol drinking was high in liver disorder group. In those with self management, 80.7% of hypertension group and 83.3% of liver disorder group continued previous effort. Those, however, who utilized clinic or hospital, only 16.7% and 50.0% were still visiting hospital or clinic. 3. Fifty seven percent of hypertension group and 64.3% of liver disorder group was presently smoking, 8.5% and 11.9% reduced smoking and 21.3% and 14.3% stopped smoking. Forty nine percent of hypertension group and 28.6% of liver disorder group was presently drinking. Reduced alcohol intake was reported in 29.8% and 40.5%, 12.8% and 23.8% stopped alcohol drinking. Sixty six percent of hypertension group and 73.8% of liver disorder group did no regular exercise, but 12.8% and 11.9% of each group increased their physical exercise for last one year. Forty three percent of hypertension group and 38.1% of liver disorder group was overweight (defined by bodymass index greater or equal than 25). Reduced body weight was reported in 17.2% and 16.7% of each group. Reduced dietary salt intake was high in hypertension group (51.5%). The study results suggest that follow-up management after workers' periodic health examination is not satisfactory. In order to improve this situation, adequate information on the result of the workers' periodic health examination should be distributed to each worker group with health education and counselling.
Alcohol Drinking ; Body Weight ; Classification ; Diagnosis ; Diet ; Drinking ; Exercise ; Follow-Up Studies ; Health Behavior ; Health Education ; Hypertension ; Liver ; Liver Diseases ; Overweight ; Surveys and Questionnaires ; Self Care ; Smoke ; Smoking

The effects of social support on post-stroke depression were investigated. Social support was classified into three categories: primary caregiver's. significant other's. and professional support. And primary caregiver's and significant other's support were divided into their relation, living state (which means they living together or not), frequency which they met at. and perceived satisfaction about the support, respectively. Professional support was divided into number of professionals who take care of. frequency they met at. and perceived satisfaction. The subjects were 254 stroke patients who had been discharged and were taken follow-up care at the outpatient department. The depression was measured using CES-D. Out of the primary caregiver's support. only relation and perceived satisfaction were identified to affect the post-stroke depression. The patients who primarily their spouse takes care of were less depressed than those who their adult children take care of. None of the significant other's support affects the post-stroke depression. Only perceived satisfaction of the professional support was found to affect the post-stroke depression. So it was found that the quality, not the amount, of care was important to post-stroke depression. These results also support the claim that the facilities and teaching programs for primary caregivers are necessary
Adult Children ; Caregivers ; Depression* ; Follow-Up Studies ; Humans ; Outpatients ; Spouses ; Stroke

BACKGROUND: Recently the Korean society has been challenged with the rapid growth of obese population due to the improved socioeconomic status and lifestyle changes over the past decades. Not only has obesity been known as one of major risk factors for various diseases including cardiovascular diseases(e.g. hypertension, coronary heart disease and stroke) and diabetes mellitus, but it has also increased the death from obesity-related diseases. It has been required, however, to establish our own obesity criteria adjusted for Korean since much difference is expected to exist in the degree of obesity between white and Asian people. Therefore, this study was designed to provide with primary data to help establish new criteria through identifying the distribution of Body Mass Index(BMI), and then analysing its relatian with some obesity-related diseases. METHODS: This study calculated BMI and related it to some obesity-related diseases by analysing data from 1995 National Health Interview Surveys, in which a random sample of 5,750 Korean at the age of 15-69 had self-reported their heights, body weights and diagnoses with obesity-related diseases by physicians. Variables under consideration include potential risk factors(e.g. alcohol intakes, smoking, exercise, etc.) as well as demographics of the sample population. RESULTS: Average BMI(kg/m(2)) were 21.6+/- 2.6 for male and 21.7+/-4.8 for female(mean+/-SD), which increased in direct proportion to the increase of age until the age reached the group of 40-59, and then followed by the inverse in its relation with the age at 60 and over. It was revealed, however, that prevalences of obesity-related diseases such as hypertension, diabetes mellitus etc. were the highest among the population group with their BMI of 23.8~35.6. In short, this study identified the proportional relation of BMI with the prevalence of obesity-related diseases. CONCLUSIONS: In this study, the prevalence for hypertension and diabetes mellitus was shown to be higher than the average among population with their BMI of 21.9~238, whose figure is much lower than both 26.4, the value of the 90th percentile proposed in MONICA prot and 25, the current WHO criteria of obesity. However, a Japanese study reported that the health risk began to increase at the BMI of 23 with risks for obesity-related diseases dramatically increased at the BMI of 26-27 and over, and concluded that because Asian has more body fats accumulated within the upper body part compared with the white, the Asian persons are more obese, though less in terms of BMI, than the white. Therefore, future works should be focused on establishing our own criteria for obesity with health risks through determining the association of BMI with prevalence of various diseases in Korea.
Adipose Tissue ; Asian Continental Ancestry Group ; Body Height ; Coronary Disease ; Demography ; Diabetes Mellitus* ; Diagnosis ; Humans ; Hypertension* ; Korea ; Life Style ; Male ; Obesity ; Population Groups ; Prevalence* ; Risk Factors ; Smoke ; Smoking ; Social Class ; Weights and Measures