During 2 months from December 1979 to January 1980, Medical practitioners in chonnam province were grouped into Si (city), Eup(town) and Myun (rural area) groups according to the locations of their clinic. 40 practitioners were randomly selected in each group and were asked their opinions about rural medical care in general. Total of 88 practitioners replied to the question as 73.3 percent of response rate in average. The most frequently mentioned advantages of rural practice were ease of clinic opening in Si-and Myun-group respondents and good social relationship in Eup-group respondents. The most frequently mentioned disadvantages were medical isolation in Si-group respondents and resident's ignorance in medicine in Eup-and Myun-group respondents. In all groups, most respondents though that rural medicine care should be delivered by and controled by physician. Suggestions made by Eup-and Myun-group respondents for improving rural medical care by structural change focused on the regional medical insurance system, while Si-group respondents noted district hospital or hospital linkage as most preferable system.
Surveys and Questionnaires ; Hospitals, District ; Insurance ; Jeollanam-do

A study was made on 50 cases of epileptic children who had been observed at the pediatric department of Chungnam National University Hospital Taejeon Eul Ji Hospital during the period from July, 1986 to June, 1991. The result are as follows: 1) Epilepsy was most frequent in children from 1 year to 10 year of age (80%). Epilepsy was commoner in female children compare to male representing male to female ratio, 1:1.2. 2) Intractable cases with VPA were 40%, and male to female ratio was 1.2:1. Intractable cases were most common between 1 and 5 years (65%). 3) The most common epileptic type was generalized tonic clonic seizure (38%). 4) The clinical effect of valproic acid was the worst in severely abnormal EEG finding. 5) The mean plasma VPA level was significantly lower for the polytherapy (57.7microgram/ml) than for the monotherapy (69.5microgram/ml). The VPA dose of steady-state was significantly higher for polytherapy (27.9mg/kg/d) than for the monotherapy (20.9mg/kg/d). VPA level: dose ratio was reduced in the polytherapy (2.1) as compared to monotherapy (3.3). 6) The plasma VPA level increased according to dosage. In the same dose, plasma level of monotherapy was significantly higher than polytherapy. 7) The VPA dose of stead-state was highest under 1 year (monotherapy: 24.8mg/kg/day, polytherapy: 33.4mg/kg/day). The VPA dose decreased in accordance with an increase of the age. 8) There was no correlation between EEG change and plasma concentration of VPA. 9) There was linear correlation between clinical affect and plasma VPA level, and plasma concentration of VPA reached 51 to 100microgram/ml at that time. 10) The clinical effect was good in abscence seizure, simple partial seizure, myoclonic seizure, and generalized tonic clonic seizure in decreasing order. 11) The incidence of side effect were gastrointestinal disturbance, behavior disorder, laboratory abnormality, neurologic abnormality in order of frequency. The frequency of overall side effects observed was 40% but toxic effects were generally mild.
Child* ; Chungcheongnam-do ; Daejeon ; Electroencephalography ; Epilepsy ; Female ; Humans ; Incidence ; Male ; Plasma ; Seizures ; Valproic Acid*

Purpose: This study analyzed the changes in the number of surgeries and surgical patterns due to the adoption and diffusion of new medical technology while focusing on radical prostatectomy. Materials and Methods: Medical equipment status report data and the National Health Insurance claims data from 2007 to 2019 were used. A total of 62798 radical prostatectomies from 135 medical facilities were analyzed. Radical prostatectomy was classified into open radical prostatectomy (ORP), laparoscopic radical prostatectomy (LRP), and robot-assisted laparoscopic radical prostatectomy (RARP) using the fee schedule codes. A linear mixed model was used to determine whether the adoption of a robotic surgical system had an effect on the number of surgeries and surgical patterns after adjusting for medical characteristics. Results: The number of radical prostatectomies performed in Korea increased from 1756 in 2007 to 8475 in 2019. During this period, the proportion of RARP in total surgery increased from 17.5% to 74.3%. The mean number of surgeries at medical facilities adopting the robotic surgical system was 128.3, which was higher compared to 18.5 cases in medical facilities that did not adopt it. The adoption of a robotic surgical system increased the number of radical prostatectomy surgeries by 12.1 cases and the RARP share by 47.2% in a linear mixed model.  Conclusion The adoption and diffusion of robotic surgical systems in Korea increased the number of surgeries as well as the share of robotic surgery. It is necessary to manage a technology that is widely used in a state where its clinical effectiveness is uncertain.

The exposures to carbamate pesticides (BPMC specifically) of agricultural workers were estimated by collecting pesticide in air by personal sampler and by analyzing with gas chromatography. Data revealed that the highest BPMC concentration in the aspirated air was 7.7 mg/m3. Concentrations were generally higher in the group whose spray conditions were controlled than the group uncontrolled. Actual concentrations were relatively lower than the values predicted theoretically. These findings suggest that personal sampler be useful in the estimation of pesticide exposure.
Farmers ; Chromatography, Gas* ; Humans ; Pesticides ; Pilot Projects* ; Rural Health

No abstract available.
Neurofibroma*

No abstract available.
Free Tissue Flaps*

Although medical insurance claims data provide an increasingly accessible and widely used source of data for health care research, there are few studies about their sensitivity. This study was conducted to investigate the sensitivity of diagnosed cancers in medical insurance claims data. Every case of Kwangju Cancer Registry registered during 1998-1999 was checked for its status in medical insurance claims. The sensitivity of medical insurance claims was expressed as the proportion of cases who were reported as having cancer among cancer registry cases. The sensitivities of Kwangju and nationwide medical insurance claims data for overall cancer were 87.2% and 92.8%, respectively. For cancer sites, the sensitivity of medical insurance claims data was the highest for breast, followed by thyroid, lymphoma and colorectum, and the lowest for pancreas and kidney. Medical insurance claims data would provide reasonably high sensitivity for the detection of cancer, especially if nationwide medical insurance claims are included. Further studies should examine false positive cases to measure other dimensions of accuracy, such as specificity and predictive value.
Breast ; Gwangju ; Health Services Research ; Insurance* ; Kidney ; Lymphoma ; Pancreas ; Sensitivity and Specificity ; Thyroid Gland

OBJECTIVES: This study was conducted to investigate the association between health risk factors and mortality in Juam cohort. METHODS: The subjects were 1,447 males and 1,889 females who had been followed up for 68.5 months to 1 January 2001. Whether they were alive or not was confirmed by the mortality data of the National Statistical Office. A total of 289 persons among them died during the follow-up period. The Cox's proportional hazard regression model was used for survival analysis. RESULTS: Age, type of medical insurance, self cognitive health level, habit of alcohol drinking, smoking, exercise and BMI level were included in Cox's proportional hazard model by gender. The hazard ratio of age was 1.07(95% CI: 1.05-1.10) in men, 1.09(95% CI: 1.06-1.12) in women. The hazard ratio of medical aid(lower socioeconomic state) was 1.43(95% CI 1.02-2.19) in women. The hazard ratios of current alcohol drinking and current smoking were respectively 1.69(95% CI: 1.01-2.98), 1.52(95% CI: 1.02-2.28) in women. The hazard ratio of underweight was 1.56(95% CI 1.08-2.47) in men. The hazard ratios of underweight, normoweight, overweight, and obesity were respectively 1.63(95% CI: 1.02-2.67), 1.0(referent), 0.62(95% CI: 0.32-1.63), 1.27(95% CI: 0.65-3.06), which supported the U-shaped relationship between body mass index and mortality among the men over 65. CONCLUSIONS: The health risk factors increasing mortality were age, underweight in male, age, lower socioeconomic state, current alcohol drinking, current smoking in female. To evaluate long-term association between health risk factors and mortality, further studies need to be carried out.
Alcohol Drinking ; Body Mass Index ; Cohort Studies* ; Female ; Follow-Up Studies ; Health Status ; Humans ; Insurance ; Male ; Mortality* ; Obesity ; Overweight ; Proportional Hazards Models ; Risk Factors* ; Smoke ; Smoking ; Thinness

The medical curriculum is designed to provide a core of scientific knowledge and technical skills that ultimately enables a student to care for primary patients. In addition to specific knowledge, the school offers an environment in which students have the opportunity to acquire the habits of study, the sound attitud, and the sense of responsibility for patients that characterize the true physician. To achive these purposes, the clerkship of medical student is very important. We investigated current problems in clinical clerkship of Chonnam University Medical School, and the problems were as follow: (1) relatively short period of clinical training especially in main subjects, (2) lack of presonnels in charge of clinical training, (3) lack of objective test, (4) lack of clinical training in primary care hospital, (5) lack of opportunity of self learning. The methods to improve clinical training were to promote interests in clinical education of staffs, to prolong the duration of clinical clerkship, to select and educate the personnel in charge of clinical education, to do the objective tests, to do the elective tests, to do the elective course, to use of integrated course and problem oriented education, and to let the student care the patients under supervision.
Clinical Clerkship ; Curriculum ; Education ; Education, Medical ; Humans ; Jeollanam-do ; Learning ; Linear Energy Transfer ; Organization and Administration ; Primary Health Care ; Schools, Medical ; Students, Medical*

To evaluate the possible functional role of serum during the process of parturition, 15 serum samples were collected and analyzed for the nickel concentrations in each 3 groups(Group 1 for the period during parturition, Group 2 for the period from delivery of fetus to delivery of placenta, and Group 3 for the period after delivery of placenta) of normal, uncomplicated full term vaginal delivery and one control group composed of healthy unmarried women in 3rd decades of age. Data revealed that average serum nickel concentration of Group 2(26.6 microgram/l) and Group 1(22.2 microgram/l) were significantly higher than that of Control group(13.7 microgram/l), but Group 3's(13.8 microgram/l) was almost same as Control group's. There were significant negative correlation between age and serum nickel concentration in group 2, and a tendency of higher nickel concentration in women who have no previous experiences of pregnancy than who have previous experiences of pregnancy, although it was not significant. These result could be indicative of close causal relationship between serum nickel concentration and the entire process of parturition.
Female ; Fetus ; Humans ; Nickel* ; Parturition ; Placenta ; Pregnancy ; Single Person