This study was conducted for the purpose of obtaining basic information on the patterns of medical care expenditures, and identifying some determinants of medical care expenditures in the rural Korea. Nine guns were chosen from the eight porvinces, excluding Cheju island. One gun in each province and two villages were selected from the each myon or ub within the selected guns. The total number of households was 1,789 and the sample size was 9,826 non-institutionalized people. Followings are the major findings of the study. 1) Medical care expenditures increase proportionally with age in terms of cost per patient, per episode of illness, per treated case, and per person. Averagely, it cost 2,756 won per patient, 2,614 won per spell of illness, 4,361 won per treated case, and 413 won per person. 2) Medical care expenditures increase proportionally with educational level of patients. College graduates spent the most, 4,726 won per patient, 5,987 won per treated case, and 670 won per person. 3) The male spent a little more than the female in terms of per patient, per episode, and per person. For example, a male spent 23 won more than a female. 4) Those who were suffering from illnesses longer than 1 year spent three times mort than that had illnesses of less than 1 year duration. 5) The simple correlation coefficient between activity restriction and medical care expenditures was the highest among others, 0.491. The next was 0.294 between duration of illness and medical care expenditures. 6) Attempts are made to identify the explanatory variables in medical care expenditures. Thirty one per cent of the variances in the expenditures can be accounted for by the selected 15 predictors. Those predictors belonged to clinical conditions, such as activity restriction, duration of illness, and nature of conditions, are proved to be the most potent independent variables. Level of education and monthly family income are also significant in terms of beta coefficient. Further studies are called for to unreveal the determinants of medical expenditures.
Education ; Family Characteristics ; Female ; Firearms ; Health Expenditures* ; Humans ; Jeju-do ; Korea ; Male ; Sample Size

No abstract available.
Prions*

No abstract available.
Prions*

OBJECTIVE: Quantitative analysis of both apoptosis and proliferation should provide important insight into tumor biology. The aim of this study is to clarify the significance of apoptosis in the progression of uterine cervical neoplasia, including cervical intraepithelial neoplasia, and microinvasive and invasive squamous cell carcinoma categories. in relation to cell proliferation. METHODS:: Forty five cases of cervical intraepithelial neopasia. 10 of microinvasive carcinoma, and 10 of invasive squamous cell carcinoma were examined using formalin fixed and paraffin embedded samples. The TdT mediated dUTP-biotin nick end labelling(TUNEL) method for apoptotic cells, and Ki-67 and Topo-II immunojhistochemistry for proliferating activity were performed. RESULTS: Apoptotic and proliferative indices, calculated by counting positive nuclei among 1,000 nuclei of cancer cells, should significant positive correlation with histological malignancy grading in CIN and tumor cell invasion into stroma, and showed also significant positive correlation between them. CONCLUSION: These findings suggest that apoptosis in cervical neoplasia may be closely related to tumor cell differentiation and progression.
Apoptosis* ; Biology ; Carcinoma, Squamous Cell ; Cell Differentiation ; Cell Proliferation ; Cervical Intraepithelial Neoplasia ; Cervix Uteri* ; Female ; Formaldehyde ; Paraffin

BACKGROUND: The relation between clinical characteristics and a change of thymid functions in patients with hyperemesis gavidarum(HO) has not been well described. In order to clarify this characteristics, we evaluated thyroid function in patients with HG and compared the relationship to clinical characteristics of gestational thyrotoxicosis and hyperemesis. METHODS: From March, 1991, to April, 1997, 20 patients were admitted to the department of obstetrics in Chonbuk National University Hospital because of HG. We examined clinical characteristics of patients with HG(age, marrital age, levels of educations, obstetrical history, gestational duration, vomiting duration, degree of weight loss, infant's birth weights, duration of pregnancy). Thyroid functions, liver functions and serum electrolytes was measured. Also, we compared to the clinical characteristics of patients with HG according to thyroxine concentration. RESULTS: An increased free thyroxine concentration was observed m 65% of 20 pregnancies complicated by severe HG. The level of serum ALT was greater in thyrotoxicosis patients(91.2+-76.6 IU/L, mean +-SD) than normothyroxemic patients(20.3+-12.7 IU/L, P=0.027). Also, increased level of serum AST was observed in patients with HG. In patients with thyrotoxicosis, the long durations of vomiting was observed. CONCLUSIONS: Increased free thyroxine concentration is found in severe HG. Because the relatively higher risk for thyrotoxicosis, patients with severe hyperemesis, they must be evaluated about thyroid functions.
Birth Weight ; Electrolytes ; Humans ; Jeollabuk-do ; Liver ; Obstetrics ; Pregnancy ; Thyroid Gland* ; Thyrotoxicosis ; Thyroxine ; Vomiting ; Weight Loss

Background/Aims: Pancreatitis is one of the major complications of ERCP. The purpose of this study is to evaluate the incidence rate and risk factors of ERCP- induced pancreatitis. Method: We analysed 99 consecutive patients(45 males and 44 females) undergoing ERCP from March to September, 1994. The level of serum amylase was measured and clinical assessment of pancreatitis was performed before, 24 hour, 48 hour, and 72 hour after ERCP. We defined clidical pancreatitis as combination of elevated amylase level over 2 days with abdomial pain and tenderness.(continue..)
Amylases ; Cholangiopancreatography, Endoscopic Retrograde* ; Humans ; Incidence ; Male ; Pancreatitis* ; Risk Factors

To clarify the characteristics of HBV-associated renal lesions, renal biopsies obtained from 22 HBsAg seropositive patients(M:F=32:1) were studied. Other than two(age 4 and 12), all were adults(17-77 y.o.). Twelve of the patients had nephrotic syndrome(NS), 5 NS and hematuria(H), 10 proteinuria and H, one gross H, one microscopic H, and 4 normal urinalysis at the time of biopsy. Light microscopy showed minimal change lesion(MCL) in 9 cases, mesangial proliferative glomerulonephritis(MSPGN) in 6, MPGN type I in 7, MPGN type III in 6, and mebranous nephropathy(MGN) in 5 cases. There were variable immunofluorescent(IF) findings of 25 cases studied; IF staining were predominant with IgG in 10 cases, with IgA in 5 and with IgM in 2 cases. Complements tended to be more strong for C1 &/or C4 than C3. In electron microscopic(EM) studies of MCL group, rare mesangial deposits were noted(3/5). In MSPGN, aside from mesangial deposits, there were occasional subendothelia(2/4) or subepithelial(1/4) deposits. In MPGN type I, in addition to the usual EM features of MPGN, some subepithelial deposits were also observed in 5 cases. In MGN, 3 out of 4 showed subendothelial deposits. Among 7 cases stained for HBsAg all were negative with IF and 2 were positive with PAP method. It is concluded that clinico-pathological findings of HBV-associated nephropathy are variable and partly show lupus-like features, different from primary glomerulopathy.
Adult ; Male ; Female ; Humans ; Biopsy

Recent advance in the field of microvacular surgery has popularized the reattachment of severed digit, with increasing success rate and improving functional regain. Reattachment surgery was performed in six digits, two thumbs and four fingers, which had been amputated at or distal to the level of DIP joint. Microvascular anastomosis of one digital artery was done and the venous drainage was reestablished with blood letting from the pulp of each digit. There was one failure in which hypersensitivity to heparin was present, while all other five showed success. Postoperatively considerable sensory recovery was present in all.
Arteries ; Drainage ; Fingers ; Heparin ; Hypersensitivity ; Joints ; Linear Energy Transfer ; Thumb

Kienbock's disease is a rare disease that is suspected to be caused by the circulatory impairment or/and trauma to the lunate. The various modes of etiology, progression and the treatment have been suggested without any definite ones. The authors report 13 cases of the Kienbock's disease and the results are as follows:1. The male(10 of 13 patients) and the dominate hand(10 of 13 hands) were the more prevalent. 2. Eight cases had a definite history of trauma and the 5 of them were injured by the hyperextension of the wrist. 3. Eight cases were stage III B according to the Lichtman's classification. 4. Nine cases(69%) showed ulna minus variant, which was thought to have certain significant relation with the cause of this disease.
Classification ; Clinical Study ; Osteonecrosis ; Rare Diseases ; Ulna ; Wrist

Carpal tunnel syndrome is the most common peripheral nerve entrapment syndrome that characterized by pain, especially in night, sensory disturbance in median nerve dermatome of the hand, and thenar muscle atrophy. Open decompression was a treatment of choice, when operative intervention is necessary. But, endoscopic or percutaneous decompression is introduced recently. Authors analyzed 21 cases of open decompression and 22 cases of percutaneous decompression and they could be follow up over 6 months at Dept. of Orthopedics, Chonnam University Hospital from June 1990 to January 1995. The results are as follows. 1. There were no difference in age, sex, lesion side, symptoms duration until operation, etiology and occupation between percutaneous and open decompression. 2. There were excellent or good results in clinical symptom in 19 cases(90%) of open procedures and 19 cases(86%) of percutaneous procedure and more rapid relief of the pain, and grip power in percutaneous procedure than open procedure. 3. The EMG, recorded at 1 week, 4 weeks, 3 months and 6 months after operation, revealed improvement in sensory than motor function. There was more rapid recovery in percutaneous procedure than open procedure especially latency and amplitude of sensory nerve. There were 2 cases in open procedure and 3 cases in percutaneous procedure who did not respond to treatment. As a result, percutaneous procedure was more simple and rapid recovery than open procedure in clinical progressions and EMG reports, but recovery rate of symptomatic relief was similar. Therefore percutaneous procedure is thought to be more reasonable method in the treatment of carpal tunnel syndrome if surgical intervention is indicated.
Carpal Tunnel Syndrome ; Decompression ; Follow-Up Studies ; Hand ; Hand Strength ; Jeollanam-do ; Median Nerve ; Methods ; Muscular Atrophy ; Occupations ; Orthopedics ; Peripheral Nerves