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

The pinching motion is thought to be one of fundamental hand functions, the power of which has been quantified by measuring it isometrically with variously devised pinch-meters. The present authors describe the investigations on the pinching power of 350 healthy persons, 200 male and 150 female Koreans, by the use of Preston Pinch Gauge. Six kinds of pinch were chosen: (1) thumb index finger tip pinch (1-2TP), (2) thumb-middle finger tip pinch (1-3TP), (3) thumb-index finger pulp pinch (1-2PP), (4) thumb-middle finger pulp pinch (1-3PP), (5) thumb-index-middle finger pulp pinch (3PP), (6) key pinch (KP), which were classified again into 19 kinds according to the shape of thumb, index, middle, or other fingers during each pinch. We describe those as principal type, hyperextension-flexion type, hyperextension type and other type into four. It should be justified to calculate the mean normal value of principal type pinching power in Korean. Principal type of pinch involves 1-2TP, 1-3TP, 1-2PP, 1-3PP, 3PP and KP, as to Hyperextension type of 1-2PP, 1-3PP, 3PP and KP. Other type of pinch involving 1-2TP, 1-3TP, 1-2PP, 1-3PP, 3PP and KP is different from Principal type simply because of the shape of nonjoining fingers during pinch. Generally, the pinching power of Principal type was clearly highest among the four types except for pulp pinches.
Asian Continental Ancestry Group ; Female ; Fingers ; Hand ; Humans ; Male ; Reference Values ; Thumb

The Sertoli-Leydig cell tumor is a gonadal tumor of sex-cord stromal type, similar to that seen in of the various phases of testicular development in the male. This tumor is exceedingly rare, accounting for only 0.1% to 0.5% of all primary ovarian neoplasms. It occurs predominantly in the second and third decades(mean age about 25 years), less than 10% after menopause. We investigated a case of poorly differentiated Sertoli-Leydig cell tumor of right ovary, occured in a 76-year-old woman. Grossly, the tumor measured 2, 100 gm in weight and 25 x 19 x 8 cm in dimensions. The outer surface was smooth and glistening without rupture of the capsule. Cut sections revealed a multilobulated brown solid mass with multiple cystic change. Microscopically, it showed the typical findings o a Sertoli-Leydig cell tumor. The characteristic feature is hemangiopericytoma paftem of sarcomatoid spindle cells. Therefore, we present it with a brief review of the literature.
Female ; Humans

PURPOSE: The purpose of this study is to investigate the impact of job stress, self-efficacy and empowerment of 119 Emergency medical technicians in Jeollanam-do. METHODS: This study used the data collected from 346 respondents working for first aid in a fire station. To answer research questions, this study employed frequency analysis, reliability test, F (t)-test, ANOVA, Scheffe' post-hoc test, and multiple-regression analysis. RESULTS: In terms of demographic characteristics, marital status and age had significant impact on job stress, but sex and education did not. In terms of job characteristics, first placement, rank, and tenure made significant difference on job stress, whereas certificate, department, and area did not. These results address that general characteristics, self-efficacy and job stress are critical variables on empowerment. CONCLUSION: From the research findings, it is concluded that fire fighters' job stress can be reduced if professional development programs are given to them, which is likely to provide better public services such as first aids and welfare, as well as to increase job satisfaction.
Surveys and Questionnaires ; Emergencies ; Emergency Medical Technicians ; Fires ; First Aid ; Humans ; Job Satisfaction ; Marital Status ; Power (Psychology)

PURPOSE: This study was done to identify whether the program, improving adjustment to military life would have an effect on stress, depression, idea of suicide, adjustment to military living, and self-esteem in auxiliary police. METHOD: This quazi experimental study using a non-equivalent control group pretest and posttest design was conducted from February 1 to May 30, 2007. Using convenience sampling, the researcher recruited 120 auxiliary police and randomly assigned each to either the experimental and the control group. The experimental group received an 8-week program to improve adjustment to military life. RESULTS: Anxiety, stress, depression, idea of suicide, self-esteem, and adjustment to military living were significantly different between the experimental and control groups. CONCLUSION: These results suggest that programs to improve adjustment to military life would improve psychological health and adaptation of military living in auxiliary police. Replication studies are needed to confirm the effects of this program and to identify the long-term maintenance effects of the program.
Anxiety ; Depression ; Humans ; Military Personnel ; Police ; Social Adjustment ; Suicide

PURPOSE: The purpose of this study was to identify the degree and relationship between self-esteem, depression, and suicidal ideation of youths in the auxiliary police force. METHOD: This descriptive study was conducted using a structured questionnaire from February 1 to March 25, 2007. The participants were 180 youths from 19 to 25 years old (average 20.82 years old) who were auxiliary policemen. The data were analyzed using the SPSS Win 12.0 program. RESULTS: Six of the auxiliary police (3.34%) reported critical scores in suicidal ideation. There was a significant difference in depression according to work area. Self-esteem showed a significant negative correlation with depression (r=-0.38, p<.001) and suicidal ideation (r=-0.39, p<.001). There was a positive correlation between depression and suicidal ideation(r=0.53, p<.001). CONCLUSION: The findings suggest that auxiliary policemen have higher levels of depression and suicidal ideation. Therefore, further study is needed to develop and examine nursing interventions the enhance self-esteem, so that depression and suicidal ideation can be minimized.
Adolescent ; Depression ; Humans ; Police ; Questionnaires ; Suicidal Ideation ; Suicide

PURPOSE: Experience of chest pain may be different in women from that of men and this discrepancy may cause misdiagnosis of angina contribute to mortality by this disease in women. The purpose of this study was to analyze the characteristics of chest pain and responses to the symptoms in women. METHOD: A content analysis was conducted with interviewed data obtained from women who underwent the treadmill test RESULT: Seven major categories were identified from this content analysis: attributes of chest pain; accompanied symptoms; precipitating factors; relief strategies; family support; communication with physicians; and effects of chest pain on their lives. Characteristics of pain were described as heaviness, tightness, heating sensation, tearing, and others. Duration and intensity of pain varied in a wide range. Radiating pain presented in 9 patients, and the locations of radiation were throat, neck, shoulder arm and fingers. Women tended not to respond actively to their chest pain, and didn't get appropriate support either from their family or from their physicians when they reported chest pain. CONCLUSION: Women express non-typical as well as typical patterns of pain when they experience chest pain. Clinicians have to consider the variability of symptoms when they assess women with suspicions of angina.
Angina Pectoris* ; Arm ; Chest Pain* ; Diagnostic Errors ; Exercise Test* ; Female ; Fingers ; Heating ; Hot Temperature ; Humans ; Male ; Mortality ; Neck ; Pharynx ; Precipitating Factors ; Sensation ; Shoulder ; Thorax*

Drug-induced acute interstitial nephritis is characterized by renal interstitial inflammatory cell infiltration and commonly presents as acute renal failure. This is caused mainly by methicillin, non-steroidal antiinflammatory drugs, sulfonamide diuretics such as thiazide, but cases induced by furosemide are rare. We report a patient with acute interstitial nephritis causing reversible acute renal failure and dermatitis while she was taking furosemide. A 37-year old woman was referred to our hospital because of generalized skin rash and non-oliguric acute renal failure. She had peripheral eosinophilia (1,577/mm3) and serum creatinine level of 6.8mg/dL. Skin biopsy showed leukoclastic vasculitis and percutaneous renal biopsy showed severe interstitial infiltration of lymph ocyte and mild interstitial fibrosis with focal tubular atrophy. After withdrawal of furosemide, renal function and skin lesions were completely recovered.
Acute Kidney Injury ; Adult ; Atrophy ; Biopsy ; Creatinine ; Dermatitis ; Diuretics ; Eosinophilia ; Exanthema ; Female ; Fibrosis ; Furosemide* ; Humans ; Methicillin ; Nephritis, Interstitial* ; Skin ; Vasculitis

PURPOSE: This study was to identify behaviors preventing the recurrence of breast cancer and the level of quality of life. METHODS: This descriptive study was conducted using a structured questionnaire from November 1, 2006 to December 25, 2006 . One hundred and twenty two women breast cancer survivors were recruited by convenience sampling. RESULTS: The most frequent behavior for preventing recurrence of the breast cancer was dietary treatment (90.9%) and exercise (86.8%) was the second behavior. In addition, most of them perceived these behaviors as 'very effective' (82.8%). The degree of the quality of life of a breast cancer survivor was 5.34 point indicating a 'medium level'. CONCLUSION: Breast cancer survivors pursued various behaviors for preventing recurrence of breast cancer. Therefore, the nursing interventions should be focused on a systematic educational approach considering healthy behaviors to prevent breast cancer recurrence for breast cancer survivors.
Adaptation, Psychological ; Adult ; Aged ; Breast Neoplasms/prevention & control/*psychology/therapy ; Data Interpretation, Statistical ; Demography ; Dietary Supplements ; Exercise Therapy ; Female ; *Health Behavior ; Humans ; Life Style ; Middle Aged ; Neoplasm Recurrence, Local/*prevention & control ; *Quality of Life ; Questionnaires ; Recurrence ; Survivors/*psychology

Aprotinin is a serine protease inhibitor and a powerful antifibrinolytic agent, derived from the inhibition of plasmin and kallikrein. Therefore, it is widely used in cardiopulmonary bypass surgery or major surgery for reducing bleeding and blood transfusion requirements. Aprotinin is rapidly eliminated from the circulation by glomerular filtration and is actively reabsorbed in the renal tubular system, where it is stored, metabolized, and eliminated over the following 5-6 days. Because of this metabolism, concerns have been raised regarding the possibility that aprotinin may impair renal function due to a toxic effects on proximal tubular cells. We report three cases of postoperative renal failure after aprotinin had been used during surgery. Two patients, Jehovah's Witnesses who refused blood transfusion, required hemodialysis. One patient, who underwent spinal orthopedic surgery, was administered aprotinin to reduce intraoperative blood loss, and developed acute renal dysfunction. The patient recovered after supportive therapy.
Acute Kidney Injury* ; Aprotinin* ; Blood Transfusion ; Cardiopulmonary Bypass ; Fibrinolysin ; Filtration ; Hemorrhage ; Humans ; Jehovah's Witnesses ; Kallikreins ; Metabolism ; Orthopedics ; Renal Dialysis ; Renal Insufficiency ; Serine Proteases