BACKGROUND:Acute vestibular neuronitis is the disease of which the etiology and pathophysiology are largely unknown . But the viral infection and ischemia of the labyrinth and the vestibular nerve are considered as general etiology. This study was performed to support the viral infection rather than the ischemic theory. MATERIALS & METHODS:We studied seventy years old female patient who showed painful vesicles on left auricle and vertigo with spontaneous nystagmus to the right side. We performed physical examination, serologic test, ENG test, pure tone audiogram, brain magnetic resonance imaging and polymerase chain reaction. RESULTS:We found small vesicles and vascular injection in left EAC, herpes zoster IgG positive, spontaneous right beating in electronystagmograpy, 54% left canal paresis in Caloric test , decreasing left side Tc in velocity step rotatory test, decresed gain, deviation to left in symmetry and phase lead in sinusoidal harmonic acceleration test, normal range hearing in pure tone audiogram, microangiopathy on cortex in brain MRI and negative PCR. CONCLUSION:This case supports viral infection etiology rather than ischemia in vestibular neuritis. But more studies to find the etiology of vestibular neuronitis are required.
Acceleration ; Brain ; Caloric Tests ; Ear, Inner ; Female ; Hearing ; Herpes Zoster ; Herpes Zoster Oticus ; Humans ; Immunoglobulin G ; Ischemia ; Magnetic Resonance Imaging ; Paresis ; Physical Examination ; Polymerase Chain Reaction ; Reference Values ; Serologic Tests ; Vertigo ; Vestibular Nerve ; Vestibular Neuronitis

OBJECTIVE: The measurement of liver size can be used for the diagnosis of the fetal growth abnormality (FGR, macrosomia etc.). The purpose of this study was to evaluate a mathematical relationship between the fetal liver size(liver length or volume) and the gestational age in the normal pregnancies. Brief comparisons were also tried on the base of the degree of the correlation between liver length and its volume. METHODS: We collected 54 singleton pregnancies of 20 to 36weeks of gestation for measuring fetal liver length and 57 singleton pregnancies for measuring fetal liver volume. We used Combison 530 utrasonic machine(Kreztechnik AG, Zipf, Austria). RESULTS: There was significant correlation between liver size( length and volume) and gestation age. And the liver volume better correlated with gestational age than liver length(r=0.93 : r=0.78, p<0.0001, p<0.0001). CONCLUSION: Ultrasonic measurement of fetal liver size is a reliable indicator of fetal growth, especially liver volume. Therefore these data may have a potential value for the prediction of abnormal fetal growth(FGR, macrosomia).
Diagnosis ; Fetal Development ; Gestational Age* ; Liver* ; Pregnancy* ; Ultrasonics

PURPOSE: The purpose of this research was to find out factors affecting job stress and job satisfaction of nurses working at the welfare centers. METHODS: This study was performed with 140 nurses who were working at or had retired within 1 year from general welfare centers in Seoul during the period from March 29 to February 29 2004. We used a questionnaire asking about general characteristics. work characteristics. stress factors and job satisfaction. We analysed 103 subjects who replied to the questionnaires. RESULTS: The mean job stress level was 2.84 out of 5 and. as for the sub-factors of job stress. income was 4.19, career development 3.69, service environment 3.26 and support system 1.90. The mean job satisfaction level was 3.32 out of 5 and. as for the sub-factors of job satisfaction, job control was 3.58, efficiency of organization 3.27, job burden and responsibility 2.92 and role ambiguity 2.25. When the nurses' job stress was compared according to their general and work characteristics. stress level was significantly high in nurses who had a short experience. were working at the department of senior welfare center. or were the only staff at their workplace (p<0.05). In addition. satisfaction level was significantly high in nurses who were working at the department of senior welfare center and medical welfare team. were the only staff at their workplace or had a heavy work load (p<0.05). According to the results of multiple regression analysis. job stress level was influenced by age (R2=0.212, p<0.01). and job satisfaction level by the number of staffs and work load (R2=0.272, p<0.1). CONCLUSIONS: The results of the study suggest that good atmosphere should be made up to communicate between the departments at the workplace in order to lessen job stress and enhance job satisfaction of nurses working at welfare centers. In addition. role division and job duties among special staffs should be reviewed in order to achieve high efficiency in performing job duties.
Atmosphere ; Job Satisfaction* ; Seoul ; Surveys and Questionnaires

Background: This study aimed to examine international students’ perceptions, characteristics, use of public medical services, and satisfaction with the National Health Insurance System, and compared the results with the Health Insurance System Perception Survey conducted on Korean population to understand the differences between the two groups’ perceptions of the health insurance system and their use of medical services. Methods: A survey was conducted from May 23, 2022 to June 21, 2022 to measure various data of international students related to the National Health Insurance System and analyzed the results. Results: Most international students were in their 20s (the average age was 23±2.06 years), which showed that they were less likely to use medical services compared to Korean population in their 20s. Both Korean population and international students viewed their subjective health as generally good. Regarding the perceptions of the National Health Insurance System, 75.6% of the Korean population responded positively, while only 16% of international students responded positively. The biggest reason for the negative responses was the higher contributions compared to private health insurance, showing that financial hardship played a large role in the negative perceptions. The insurance contribution calculation methods by the Government showed differences.International students receive the same insurance contributions regardless of their nationality, age, income, or assets. Conclusions Through this study, it has been confirmed that further research and examination are needed regarding the application of Korean health insurance to foreign residents and the appropriate calculation of insurance contributions.

As the healthcare environment has changed both socially and politically importance of public health doctors' roles has increased and ongoing revision of their roles is also needed in Korea. However, many problems have decreased the job satisfaction of public health doctors. This study aims to determine the factors that influence public health doctors' satisfaction. The survey was conducted over the course of 2 months by questionnaire methodology. A total of 881 respondents (response rate, 90.1%) participated and 778 valid responses were analyzed using SAS version 9.1. Items about arranged organization, work task, employee welfare and services, education, public health doctor's system, and the role of public health doctors were included in the questionnaire. It was found that the satisfaction of many respondents was not high and they had negative perceptions of arranged organization, work, environment, employee welfare and services, education, system, and their own role. Although the public health doctors have professional knowledge of healthcare, they were not satisfied with their role because they were required to do inappropriate work, improperly arranged and found performing work difficult when treated unfairly or not paid fairly. Therefore, policies focused on financial compensation or system improvement must be established to increase the satisfaction of public health doctors. This study's limitation was that the survey was done through two modalities. However, it is meaningful that issues related to the public health doctors were dealt with more comprehen-sively in this study than other studies.
Compensation and Redress ; Delivery of Health Care ; Job Satisfaction ; Korea ; Phenothiazines ; Public Health ; Surveys and Questionnaires ; Surveys and Questionnaires

Tools for assessing methodological quality or risk of bias in randomized controlled trials (RCTs) and non-randomized studies (NRS) were reviewed. The van Tulder scale and Cochrane's assessment of risk of bias are the two most useful methodological quality evaluation tools for RCTs. Cochrane's tool includes sequence generation, allocation of sequence concealment, blinding, incomplete outcome data, selective outcome reporting, and other potential sources of bias. The Cochrane Collaboration Group recommends the Downs and Black instrument and the Newcastle-Ottawa Scale for evaluating the quality of NRS. In conclusion, this study offers useful information to physicians about tools for assessing the quality of evidence in clinical guidelines. Further research is needed to provide an essential core for evidence-based decision making regarding levels and/or grades of recommendations.
Bias (Epidemiology) ; Cooperative Behavior ; Decision Making

PURPOSE: This study aims to abstract the differences of scores between the clinical instructors and standardized patients (SPs) in a clinical performance examination (CPX) using SPs and to correlate the concordance between the evaluation scores and the school records. METHODS: The CPX was administered in 2003 to a total of thirty-six fifth year medical students at Gachon Medical School. The examination consisted of four cases, and four stations were duplicated, each requiring a total of 7.5 minutes per station. Evaluation of the student' s performances was conducted by both clinical instructors and SPs using a formatted checklist. Results were analysed by t-test, agreement rates, and Pearson correlation. RESULT: The mean scores given out by the clinical instructors and the SPs for the newly developed case were significantly different, while those scores for pre-existing cases were not in the old cases. The correlation coefficients between these two evaluation groups were relatively high. And agreements between the two evaluation groups were 0.37~0.72. The mean scores among clinical instructors were not significantly different, but the correlation coefficients and agreement rates were relatively high. The correlation between the evaluation scores and school records did not correlate significantly. CONCLUSION: It is concluded that the CPX is a useful tool to measure the students' essential competences in areas of knowledge, skills and attitude during the subinternship stage. In conducting a successful CPX, it is crucial to reconsider the recycling of cases and the selection and training of SPs aside from the development of an objective checklist.
Checklist ; Clinical Competence ; Humans ; Recycling ; Schools, Medical* ; Students, Medical

BACKGROUND: The clinical manifestations of peritonitis in long-term PD patients may be more severe due to structural and functional alterations of the peritoneum caused by repeated exposure to the bioincompatible dialysate. However, the study in which outcome of peritonitis was compared to the duration of PD has been reported rarely. This study was performed to evaluate the effect of PD duration on the outcome of peritonitis. METHODS: Medical records of patients cared for in Kyungpook University Hospital between June 1998 and May 2001 were reviewed retrospectively. Patients were divided into three groups by PD duration: group 1, < or =12 months; group 2, 13-36 months; group 3, > or =37 months. RESULTS: There were 303 episodes (156 patients) of peritonitis during the study periods: 77 episodes in group 1, 115 episodes in group 2 and 111 episodes in group 3. There was no difference in gram- positive, gram-negative or fungal rate of peritonitis among three groups. In group 3, 16.2% of the patients transferred to hemodialysis, while 3.9% and 7.0% of patients in group 1 and 2 transferred to hemodialysis (p<0.05). CONCLUSION: Patients maintained on PD for over three years are associated with higher rate of technique failure than patients maintained on PD for less than three years. PD duration may be considered as a factor for predicting prognosis of peritonitis. Peritonitis in patients on long-term PD needs special attention.
Gyeongsangbuk-do ; Humans ; Medical Records ; Peritoneal Dialysis* ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritoneum ; Peritonitis* ; Prognosis ; Renal Dialysis ; Retrospective Studies

PURPOSE: To determine whether there is any difference in variceal distribution between patients with and without a history of esophageal variceal bleeding. MATERIALS AND METHODS: To compare the distribution of varices, abdominal CT scans of 24 patients with a history of esophageal variceal bleeding (hemorrhagic group) and 90 patients without a history of bleeding (non-hemorrhagic group) were retrospectively assessed. RESULTS: The most common varices in both the hemorrhagic (n = 21, 87.5 %) and nonhemorrhagic group (n = 53, 58.9 %) were coronary varices, with a statistically significant frequency (p < .01). Esophageal varices were also more common in the hemorrhagic than the nonhemorrhagic group (n=19, 79.2 % vs n = 36, 40.0 % : P < .005). Splenorenal shunts were more common in the nonhemorrhagic (n = 8, 8.9 %) than in the hemorrhagic group(n = 0, 0 %) (P < .05). Other types of varice such as paraumbilical (n = 10, 41.7 % vs n = 21, 23.3 %), perisplenic (n = 6, 25 % vs n = 15, 16.7 %) and retroperitoneal-paravertebral (n = 11, 45.8 % vs n = 24, 26. 7 %) were more common in the hemorrhagic group, but without a statistically significant frequency. CONCLUSION: The frequency of coronary and esophageal varices was significant in patients with a history of esophageal variceal bleeding. In patients without such a history, splenorenal shunts were seen.
Esophageal and Gastric Varices ; Hemorrhage ; Humans ; Hypertension, Portal* ; Retrospective Studies ; Splenorenal Shunt, Surgical ; Tomography, X-Ray Computed ; Varicose Veins

Intramuscular stimulation (IMS) therapy has been used widely ever since Gunn introduced the effect of IMS in his study in 1980. Usually IMS has been based on Cannon's radiculopathic model, known for its effectiveness in chronic pain relief. In this study we systematically review the effectiveness and safety of IMS. In order to accomplish a systematic review, we searched for IMS-related studies through 12 bibliographical databases and 19 studies were included (4 randomized controlled trials (RCTs), 2 non-RCTs and 13 case reports/studies). Study selection was conducted independently by two researchers based on title and abstract. As a result, most included studies of 16 showed significant improvement in range of motion, decrease of drug consumption as well as pain relief after IMS treatment; the other 3 studies reported adverse events. In terms of the effectiveness of IMS, the results of intervention were good, so we concluded that IMS therapy is a useful method of pain treatment; with respect of safety, few adverse events that could have been caused by IMS were observed. However, it is not certain that there was a causal relationship between IMS and the adverse events that were reported due to a lack of evidence. Therefore, clinicians who have sufficient knowledge and experience of IMS will have to perform the procedure after thorough clinical examinations to determine its appropriateness for target patients. This study provided meaningful data on the current state of IMS treatment. We expect that the result of this study will stimulate further more extensive research on IMS.
Chronic Pain ; Humans ; Range of Motion, Articular