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.

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

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

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

The use of totally implantable central venous access devices (chemoport) has increased with the development of chemotherapeutic agents in oncologic patients, especially with no venous access site. However, there can be various complications such as port site infection, thromboembolism, injury of central vein, fracture of catheter, and migration of catheter. We report a rare case of migration of catheter to right atrium due to the separation of the catheter from the chemoport.
Catheters ; Heart Atria ; Humans ; Thromboembolism ; Veins

In Korea, physicians of the public health sector have significantly contributed to health services such as prevention and treatment of disease. However, advances in the field of public health have not provided sufficient institutional strategies and systems for reinforcement of administrative capabilities and health services. As a result, the satisfaction of physicians working in community health centers has been decreasing and their advances in the field of public health have also decreased. This study was conducted to examine the work status, working conditions, and overall job satisfaction physicians in order to strengthen of the role of physicians who work in community health centers. The subjects of the study included 191 individuals. The data were analyzed by frequency analysis and descriptive analysis using SAS. It was found that among physicians working in a community health center, the overall degree of job satisfaction was satisfactory, at 52.2% of respondents. However, it was found that employment stability (81.3%), salary increases (78.8%), the abolition of new recruitment of managing physicians on the basis of temporary (5-year term) employment (75.4%), and the provision and support for education (71.2%) should be improved to increase the job satisfaction of physicians in the community health center. Regarding this, the physicians responded that the most important conditions for them to work in the community health center were actualization of salary (63.3%) and the change of job status from temporary to full-time employment (17.0%). In conclusion, we must increase the job satisfaction of physicians working in community health centers to improve the quality of the public health care system in Korea and systematically improve the personnel system, salary, administration, and job status to increase job satisfaction.
Community Health Centers ; Employment ; Health Services ; Job Satisfaction ; Korea ; Phenothiazines ; Public Health ; Reinforcement (Psychology) ; Salaries and Fringe Benefits ; Surveys and Questionnaires

PURPOSE: To evaluate the usefulness of cardiac MRI in the diagnosis of clinically suspected arrhythmogenic right ventricular dysplasia (ARVD). MATERIALS AND METHODS: Between February 1991 and January 1999, 15 patients [M:F=13:2, aged 2 -60 (mean, 37 -7) years] with clinically suspected ventricular arrhythmia due to unknown causes underwent MR imaging. Using a CP body array coil and the single slice breath hold technique, ECG-gated T1-weighted images were obtained. In all patients, these were acquired transaxially from the diaphragm to the aortic arch and along the true short and long axis, and in two, coronal images were obtained. On the basis of clinical and MRI diagnostic criteria, ARVD was classified as one of four types. The significance of differences in diagnostic grades between clinical and MRI criteria was determined using Wilcoxon's signed rank test. RESULTS: According to both clinical and MRI criteria, it was highly probable that three of the 15 patients had ARVD. In eleven, both sets of criteria indicated the same diagnostic grade. Wilcoxon's signed rank test indicated no significant differences in diagnostic grades between clinical and MRI criteria (p > 0.05). CONCLUSION: For the diagnosis or exclusion of ARVD, MR imaging is a useful modality.
Aorta, Thoracic ; Arrhythmias, Cardiac ; Arrhythmogenic Right Ventricular Dysplasia ; Axis, Cervical Vertebra ; Diagnosis* ; Diaphragm ; Humans ; Magnetic Resonance Imaging*