Demand for high quality medical care has recently been increasing in step with high level of income and education. Patients prefer the use of large general hospitals to small community hospitals. Large hospitals, usually located at urban area, expand their capacities to cope with the increasing demand, therefore, they easily secure revenue necessary for growth and development of hospitals. However, small community hospitals are facing with serious financial difficulties caused from the reduction of patients in one hand and the inflation of cost in another. If small rural hospitals were closed, the closure would have negative impacts on local economies in addition to the decrease in access to medical care. Community leaders should have an insight on the contribution of community hospitals to local economies. They could make a rational decision on the hospital closure only with the understanding of hospital's contribution to the community. This study is designed to develop an economic model to estimate the contribution of rural hospital to local economies, and also to apply this model with a specific hospital. The contribution of a hospital to local economies consists of two elements, direct effect and multiplier effects. The direct impacts include hospital's local purchasing power, employee's local purchasing power, and the consumption of patients coming from outside the community. The direct impact induces multiplication effect in the local economy. The seed money invested to other industries grows through economic activities in the economy. The seed money invested to other industries grows through economic activities in the region. This study estimated the direct effect with the data of expenditure of the case hospital. The total effect was calculated by multiplied the direct effect with a multiplier. The multiplier was drown from the ratio of marginal propensity of income and expenditure. Beside the estimation of the total impacts, the economic effect from the external resources was also analyzed by the use of the ratio of patients coming outside the region. The results are as follows. 1. The direct economic contribution of the hospital to the local economy is 1,104 million won. 2. The value of multiplier in the region is 2.976. 3. The total economic effect is 3,286 million won, and the multiplication effect is 2,182 million won. 4. The economic contribution from the external resources is 245 million won which is 7.5% of the total economic effect.
Education ; Growth and Development ; Hand ; Health Expenditures ; Health Facility Closure ; Hospitals, Community ; Hospitals, General ; Hospitals, Rural* ; Humans ; Inflation, Economic ; Models, Economic

This study was designed to investigate factors relating to fiscal deficit for regional health insurance. The financial statements for the fiscal year 1990 of nationwide 254 regional medical insurance societies were analyzed. Important findings are summarized below: 1. There were differences in the main reason for the financial deficit among regions when deficit and surplus societies were compared by regions. The total revenue per enrollee, especially revenue from the premium contribution of a deficit society was significantly smaller than that of a surplus society in large cities and counties. On the other hand, the total expenditure per enrollee of a deficit society was larger than that of a surplus society in small cities. 2. Both low premium irate at the beginning of health insurance program and less effort to increase the premium rate were main factors for the smaller revenue from the contribution of a deficit society in large cities and counties. 3. Larger expenditures per covered person of a deficit society in small cities were explained with larger medical expenditures especially for out-patients services rather than larger administrative expenses. 4. A regression analysis showed that utilization rates in out-patient services were significantly associated with income and numbers of total medical care institution per capita within a region where a health insurance society located. Also expenses paid by insurer per visit were associated with the proportion of utilization for tertiary care hospitals as well as the proportion of utilization of public health centers.
Hand ; Health Expenditures ; Humans ; Insurance ; Insurance Carriers ; Insurance, Health* ; Korea* ; Outpatients ; Public Health ; Tertiary Healthcare

This study was conducted to identify the demand of work-site health promotion program of employees. A self-administered questionnaire method was uses to collect data from 492 employees from 40 work-sites in Taegu City and Kyungpook Provincial area. The work-site health screening programs conducted for several years were placed low value by employees. The out-door exercise was the most popular heath promotion activity implemented at work-site as a whole. The employees expressed that periodic health check-up, the health counseling, indoor exercise would be implemented as a health promotion program in the future. The male employees regarded that the periodic health check-up program should be established preferentially at work-site. However, the female employees gave priority to fitness program. The health related behavioral patterns slightly influenced the preference of health promotion program. The health screening program for employees should be improved and the health education of nutrition and diet for female employees should be implemented.
Counseling ; Daegu ; Diet ; Female ; Gyeongsangbuk-do ; Health Education ; Health Promotion* ; Humans ; Male ; Mass Screening ; Questionnaires ; Workplace*

This study was conducted to identify the demand of work-site health promotion program of employees. A self-administered questionnaire method was uses to collect data from 492 employees from 40 work-sites in Taegu City and Kyungpook Provincial area. The work-site health screening programs conducted for several years were placed low value by employees. The out-door exercise was the most popular heath promotion activity implemented at work-site as a whole. The employees expressed that periodic health check-up, the health counseling, indoor exercise would be implemented as a health promotion program in the future. The male employees regarded that the periodic health check-up program should be established preferentially at work-site. However, the female employees gave priority to fitness program. The health related behavioral patterns slightly influenced the preference of health promotion program. The health screening program for employees should be improved and the health education of nutrition and diet for female employees should be implemented.
Counseling ; Daegu ; Diet ; Female ; Gyeongsangbuk-do ; Health Education ; Health Promotion* ; Humans ; Male ; Mass Screening ; Questionnaires ; Workplace*

BACKGROUND: Skin organ culture is widely used as a tool to investigate skin biology or skin disease. OBJECTIVE: The objective of the present study was to develop an ideal skin organ culture model for evaluation of melanin pigmentation. METHODS: An air-liquid interface and submerged method were used. The histology of the cultured skin was studied with H&E stain. To examine the epidermal pigmentation, Fontana-Masson stain and NKI/beteb stain were performed. Pigment modifiers (arbutin, LY294002) were applied to the culture medium for 3 days as an air-liquid interface culture. RESULTS: The general architecture of the skin was well maintained for 5 days. The melanin pigment decreased during culture without change of the number of melanocytes. As expected from previous reports, the effect of pigment modifiers (arbutin, LY294002) on cultured skin was demonstrated. CONCLUSION: The results indicate that this skin organ culture model is useful in evaluating the melanin pigmentation
Biology ; Melanins* ; Melanocytes ; Organ Culture Techniques* ; Pigmentation* ; Skin Diseases ; Skin*

Carcinoma of lung is classified by histologic cell type, this is based on predominant major cell population by tissue specimen. But in fact a range of 13% to 63% of lung cancer has been appeared to be heterogeneous cell type at the light microscopic level. After treatment of the mixed lung cancer and/or with time there are reports that cell type is changed. Because it is possible that the tumor were pleomorphic and that the antitumor therapy eliminated the more sensitive cell population and permitted the subsequent emergence of the more resistant cell population. The authors reported here, a case of 32 year old female patient with mixed lung cancer composed of three cell type, and this is the first case in Korea.
Adult ; Female ; Humans ; Korea ; Lung ; Lung Neoplasms ; Population Characteristics

On psychological aspect, premature ejaculation in psychosexual dysfunction is generally associated with anxiety. Psychiatrists consider that the treatment of choice for premature ejaculation is directive sextherapy with psychotherapy. We screened psychopathology according to the Symptom Checklist-90-Revision (SCL-90-R) in premature ejaculation group (n=120) and control group (n=92). The rate of abnormal RESULTS of both groups were similar as 5 (4.1%) in patient group and 4 (4.3%) in control group. And there was statistical significance in T scores on 5 symptom dimensions of Obsessive-Compulsive, Interpersonal Sensitivity, Depression, Anxiety and Psychoticism, but all of the T scores of those dimensions were with in the normal range. The psychological personality test does not reflect all of the psychosexual factors. But with the psychological screening, we could find that the psychological factors are not absolutely associated with premature ejaculation.
Anxiety ; Depression ; Humans ; Mass Screening ; Personality Tests* ; Premature Ejaculation* ; Psychiatry ; Psychology ; Psychopathology ; Psychotherapy ; Reference Values ; Sexual Dysfunctions, Psychological

A 46-year-old woman was admitted with an ulcerative lesion on the posterior neck. Four months before admission, the patient took part in a faith healing ritual, which the pastor performed with his fingernails causing wounds. This abnormal method of healing caused repeated injury to the patient in the posterior neck area. Treatment with cefazolin was begun, but the lesion did not improve. Biopsy of the skin lesion and cervical lymph nodes was performed. Microscopical examination revealed findings highly suggestive of syphilis. Serological tests for syphilis were positive and a computed tomographic (CT) scan of the neck showed enlargement of regional lymph nodes and tonsils. A single dose of penicillin G 2.4 million units was given intramuscularly. Two weeks later, the wound had healed. Eight weeks after treatment, the Venereal Disease Research Laboratory titer had decreased and a CT scan of the neck showed a decrease in the size of the lymph nodes. We reasoned that syphilis was non-sexually transmitted, and that the healing ritual was the cause. Our case suggests that skin trauma by scratching with the fingernails may cause an accidental direct inoculation of Treponema pallidum, resulting in extragenital primary syphilis.
Biopsy ; Cefazolin ; Faith Healing ; Female ; Humans ; Lymph Nodes ; Middle Aged ; Nails* ; Neck ; Palatine Tonsil ; Penicillin G ; Serologic Tests ; Sexually Transmitted Diseases ; Skin ; Syphilis* ; Tomography, X-Ray Computed ; Treponema pallidum ; Ulcer ; Wounds and Injuries

We report a case of primary mucosa-associated lymphoid tissue (MALT) lymphoma in the esophagus that manifested as a large submucosal tumor (SMT). Primary esophageal lymphoma is very rare, occurring in less than 1% of all patients with gastrointestinal lymphoma. Only a few cases of MALT lymphoma in the esophagus have been reported in the English literature. A 53-year-old man was referred to Dongguk University Ilsan Hospital (Goyang, Korea) in July 2012 for further evaluation and treatment of an esophageal SMT. Endoscopy showed a cylindrically elongated submucosal mass with normal overlying mucosa in the mid esophagus, 25-30 cm from the incisor teeth. He underwent surgery to confirm the diagnosis. Pathologic findings showed diffuse small atypical lymphoid cells which were stained with Bcl-2, CD20, but not with CD3, CD5, CD23, Bcl-6, or cyclin D1. These cells showed a positive monoclonal band for immunoglobulin heavy chain gene rearrangement. Based on the pathological, immunohistochemical, and molecular biological features, the esophageal mass was diagnosed as extranodal marginal zone B-cell lymphoma of the MALT type.
Antigens, CD20/metabolism ; Bone Marrow/pathology ; Esophageal Neoplasms/*diagnosis/pathology/surgery ; Gastroscopy ; Humans ; Immunohistochemistry ; Lymphoma, B-Cell, Marginal Zone/*diagnosis/pathology/surgery ; Male ; Middle Aged ; Mucous Membrane/pathology ; Proto-Oncogene Proteins c-bcl-2/metabolism ; Tomography, X-Ray Computed

Endotracheal intubation and tracheostomy may be an urgent, and essential procedure in cases of general anesthesia, airway obstruction, major head & neck surgery, etc, but it may cause many serious complications. The iuthors experienced a case of bilateral pneumothorax and generalized subcutaneous emphysema in a tracheostomized patient during general anesthesia with inhalation anesthetics. Herein the suthors present a case report and a review of the literature relating to the pneumothorax.
Airway Obstruction ; Anesthesia, General* ; Anesthetics, Inhalation ; Head ; Humans ; Intubation, Intratracheal ; Neck ; Pneumothorax* ; Subcutaneous Emphysema* ; Tracheostomy