Unmet healthcare needs are being used as an important indicator of the accessibility of healthcare services worldwide. To examine current status and trends of unmet needs in Korea, we used data from four sources: the Korea National Health and Nutrition Examination Survey (KNHANES, 2007–2017); the Community Health Survey (CHS 2008–2017); the Korea Health Panel Survey (KHP 2011–2015); and the Korean Welfare Panel Study (KOWEPS 2006–2017). The proportion of individual reporting unmet healthcare needs as of 2017 was 8.8% (KNHANES), 10.6% (CHS), and 12.4% (KHP as of 2015). The proportion of households reporting unmet healthcare needs due to cost was 0.5% (KOWEPS). Annual percentage change was −19.2%, −13.3%, −5.8%, and −13.3% respectively. Low income populations had more unmet healthcare needs than high income populations. However, unlike the last two studies, the main reason for unmet medical reasons was that there was no time regardless of income level.
Delivery of Health Care ; Family Characteristics ; Health Surveys ; Korea ; Nutrition Surveys ; Population Growth ; Poverty

Localized fibrous tumor is an uncommon submesothelial origin tumor found in pleura most commonly. Sixty five-year-old man with right lower quadrant pain was admitted. He was treated with resection of tumor and was diagnosed as localized fibrous tumor of pelvic cavity. He is now being followed up without any evidence of recurrence for 34 months. This case is presented with reviewing references.
Pleura ; Recurrence

In Korea, there are about 8 million motor vehicles and one-fourth of it is motorcycle. Last year Korean government report on the motor vehicle accidents claimed 12,781 cases of motorcycle accidents and it account for 5.1% of all of motor vehicle accidents occurred in Korea. But this is too broad analysis and lack of statical values. In general, most of people think motorcycle rider will suffer or die from head injuries sustained with motorcycle accident. Even though mandatory law on wearing helmet during motorcycle ride, but we see too many motorcycle riders not wearing helmet, especially in teenagers. The loss of young person by accident is great loss for family, society and economy of nation. No one will doubt the effectiveness of helmet on reduced incidence of head injuries. And multiple studies from United States of America have clearly demonstrated the benefit of helmets in motorcycle accidents. The following study was undertaken to determine the relationship between head injuries and helmet use in motorcycle accident, as well as analysis of general motorcycle accident.
Adolescent ; Americas ; Craniocerebral Trauma ; Head Protective Devices ; Humans ; Incidence ; Jurisprudence ; Korea ; Motor Vehicles ; Motorcycles* ; United States

Suicide is becoming a public health issue in many countries, and even more so in Korea. Korea has the highest suicide rate in the Organization for Economic Cooperation and Development countries. To address these issues, we investigated the recent trends in suicidal ideation and suicide attempts among the adult population. We used data from four sources: Korean National Health and Nutrition Examination Survey (KNHANES, ‘2007–2012, ‘2013, ‘2015), Korean Community Health Survey (KCHS, ‘2008–2009, ‘2013), Korean Wealth Panel Study (KOWEPS, ‘2012–2015), and Korea Health Panel Survey (KHP, ‘2010–2013). Weighted frequencies and trend tests were used. The rate of suicidal ideation as recent year was 5.10% (KNHANES, ‘2015), 8.95% (KCHS, ‘2013), 2.34% (KOWEPS, ‘2015), or 5.39% (KHP, ‘2013). Regarding the suicide attempts, the rate of suicide attempts as recent year was 0.61% (KNHANES, ‘2015), 0.41% (KCHS, ‘2013), or 0.04% (KOWEPS, ‘2015). Average percent change of suicidal ideation during survey year was -2.80% (KNHANES, ‘2007–2012), 5.78% (KNHANES, ‘2013–2015), 0.62% (KCHS, ‘2008–2013), -5.63% (KOWEPS, ‘2012–2015), and -10.94% (KHP, ‘2010–2013). Average percent change of suicide attempts during survey year was -3.84% (KNHANES, ‘2007–2012), 4.55% (KNHANES, ‘2013–2015), -2.54% (KCHS, ‘2008–2013), and -18.96% (KOWEPS, ‘2012–2015). Those who had lower income level were more likely to have self-reported suicidal ideation and suicide attempts. Our results suggest that further efforts are needed for more effective intervention to identify and manage low income strata with suicide problem.
Adult ; Health Surveys ; Humans ; Korea* ; Nutrition Surveys ; Organisation for Economic Co-Operation and Development ; Public Health ; Suicidal Ideation ; Suicide*

Complications of penile prosthesis include malfunction, infection and patient dissatisfaction. Herein, a rare complication of a retained reservoir having eroded into the bladder after the removal of the penile components of a three-piece penile prosthesis, is reported. A 39-year-old man complained of irritative voiding symptoms. The symptoms had developed 4 years after the removal of the penile components of the prosthesis. The erosion of the reservoir into the bladder was discovered incidentally during the treatment of bladder calculi. The reservoir was removed by an open vesicolithotomy.
Adult ; Calculi ; Cytochrome P-450 CYP1A1 ; Humans ; Penile Prosthesis* ; Prostheses and Implants ; Urinary Bladder Calculi* ; Urinary Bladder*

PURPOSE: The aim of this study was to investigate treatment results, toxicity and efficacy of hyperfractionated radiation therapy combined with paclitaxel for paraaortic node recurrence in cervix cancer. MATERIALS AND METHODS: Between September 1997 to March 1999, 12 patients with paraaortic node recurrence in cervix cancer who previously received radical or postoperative radiotherapy were treated with hyperfractionated radiation therapy combined with paclitaxel. Of these, 2 patients who irradiated less than 30 Gy were excluded, 10 patients were eligible for this study. Median age was 5 1 years. Initial FlGO stage was 1 stage IB1, 2 stage IIA, 7 stage IIB. For initial treatment, 7 patients received radical radiotherapy and 3 received postoperative radiotherapy. The paraaortic field encompassed the gross recur rent disease with superior margin at T 12, and inferior margin was between L5 and S 1 with gap for previously pelvic radiation field. The radiation field was initially anterior and posterior opposed field followed by both lateral field. The daily dose was 1.2 Gy, twice daily fractions, and total radiotherapy dose was between 50.4 and 60 Gy(median, 58.8 Gy). Concurrent chemotherapy was done with paclitaxel as a radiosensitizer. Dose range was from 20 mg/m to 30 mg/m (median, 25 mg/m'), and cycle of chemotherapy was from 3 to 6 (median, 4.5 cycle). Follow-up period ranged from 3 to 21 months. RESULTS: Interval between initial diagnosis and paraaortic node recurrence was range from 2 to 63 months (median, 8 months). The 1 year overall survival rate and median survival were 75% and 9.5 months, respectively. The 1 year disease free survival rate and median disease free survival were 30% and 3 7 months, respectively. At 1 month after treatment, 4 (40%) achieved a complete response and 6 (63%) experienced a partial response and all patients showed response above the partial response. There was distant metastasis in 6 patients and pelvic node recurrence in 2 patients after paraaortic node irradialion. There was 2 patients with grade 3 to 4 leukopenia and 8 patients with grade 1 to 2 nausea/ vom ting which was usually tolerable with antiemetic drug. There was no chronic complication in abdomen and pelvis during follow up period. CONCLUSION: Hyperfractionated radiation therapy combined with paclitaxel as a radiosensitizer showed high response rate and few complication rate in paraaortic node recurrence in cervix cancer. Therefore, present results suggest that hyperfractionated radiation therapy combined with paclitaxel chemotherapy can be used as optimal treatment modality in this patients.
Abdomen ; Cervix Uteri* ; Diagnosis ; Disease-Free Survival ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Leukopenia ; Neoplasm Metastasis ; Paclitaxel* ; Pelvis ; Radiotherapy ; Recurrence* ; Survival Rate ; Tolnaftate ; Uterine Cervical Neoplasms*

Recently, continuous epidural catheter insertion is common practice not only in anesthesia but also in pain clinic. Meningitis is rare but serious complication of epidural analgesia. Acute bacterial meningitis occurred in a 82-year-old female patient with thoracic herpes zoster after continuous thoracic epidural analgeia. An MRI of thoracic region did not show an epidural abscess or granulation tissue. Gram stain and culture of the epidural catheter tip and the CSF yielded Staphylococcus aureus. Immediate treatment with antibiotics and supportive therapy was instituted and then the patient discharged without neurologic sequalae.
Aged, 80 and over ; Analgesia, Epidural* ; Anesthesia ; Anti-Bacterial Agents ; Catheters ; Epidural Abscess ; Female ; Granulation Tissue ; Herpes Zoster ; Humans ; Magnetic Resonance Imaging ; Meningitis ; Meningitis, Bacterial* ; Pain Clinics ; Staphylococcus aureus

PURPOSE: To investigate the effect of unilateral inferior oblique weakening procedures on contralateral inferior oblique muscle functions and factors that may have an effect on contralateral inferior oblique muscle overaction (IOOA). METHODS: A retrospective chart review was conducted of medical records of 40 patients who underwent unilateral inferior oblique (IO) muscle weakening procedures from 2007 to 2011 and were observed during a follow-up period of more than 6 months. These patients were composed of primary IOOA (4 patients), secondary IOOA due to superior oblique muscle (SO) palsy (21 patients), secondary IOOA due to inferior rectus muscle palsy (1 patient), and dissociated vertical deviation (DVD) accompanied with IOOA (14 patients). Factors that may have an effect on contralateral IOOA after undergoing the operation were assessed. RESULTS: There were 7 patients (17.5%) who had over +2 IOOA after operation. IOOA on contralateral eye was increased from average of +0.00 to average of +0.66 +/- 0.14 in 6 months after operation (p < 0.01). There were no statistically significant differences between preoperative factors and functional changes in contralateral IO muscle. CONCLUSIONS: There were no statistical factors that may have an effect on contralateral IOOA but the possibility of masked SO palsy before performing unilateral IO weakening procedures should be considered. In patients who have unilateral DVD associated with IOOA or small hypertropia, the contralateral IOOA can be more definite after operation; thus caution should be taken before operation.
Follow-Up Studies ; Humans ; Masks ; Medical Records ; Paralysis ; Retrospective Studies ; Strabismus

Spontaneous rupture of subcapsular liver hematoma in pregnancy is rare but potential life threatening complication of preeclampsia. We experienced a case of spontaneous rupture of subcapsular hematoma of liver that was treated with conservative method. So, we present the case with a brief review of literatures as first report in Korea.
Hematoma* ; Korea ; Liver* ; Pre-Eclampsia ; Pregnancy* ; Rupture, Spontaneous

Objectives: This study used data from the seventh National Health and Nutrition Survey, a dataset which signifies that dental services in the country exhibit relatively low health insurance coverage and high copay rates compared to other medical healthcare services. We surveyed the utilization rate of dental care and the prevalence of untreated conditions among Korean elders aged over 65.Furthermore, we aimed to present policy implications to improve dental care accessibility and expand health insurance coverage for elders, especially vulnerable individuals who are bedridden or living alone. Methods: We used raw data from the seventh National Health and Nutrition Survey to investigate Korean elders’ dental service utilization and untreated conditions. We opted for elders aged over 65 and finalized 1,712 subjects for the analysis. Statistical analysis was performed using IBM SPSS 25.0 (IBM Corp., Chicago, IL, USA). Groups were detailed in terms of strata of variation estimation and elders aged over 65, cluster of district enumeration, and weighted oral survey. We generated a scheme file and employed complex sampling analysis with a statistical significance level of P<0.05. Results: This study intended to survey the rate of dental care use and untreated care of Korean elders over 65 using the seventh National Health and Nutrition Survey data which represents our country. 1. Dental care use rate based on general traits showed statistically significant relevance (P<0.01) with lower age, higher income, higher education level, residence of ‘Dong’, and ‘with’ private insurance. 2. In untreated rate of dental care by general traits showed the significant total of 26.1% with female, lower income, lower education level, ‘recipient’ of basic living, and subjectively poor status of oral health. 3. The multiple answers of the patients who went to the dentists over the past year showed dental care details of dental checkups 54.3%, prosthetic dentistry 32.1%, preventive treatment 30.9%, cavity of root canal treatment 25.7%, gum treatment 17.1%, and tooth extraction 14.7%. 4. The reasons for untreated dental care of those untreated subjects showed the highest 34.0% of economic reason, mild condition 32.3%, lack of time 8.2%, and scared of treatment 8.0% in order. Based on this analysis, we intended to suggest policy implications for the necessity of dental checkup expansion and the activation of prevention treatment. Conclusions To improve dental care accessibility for elders aged 65 and above, especially the vulnerable individuals who are bedridden or living alone, it is imperative to expand outpatient insurance coverage and tailor the dental services as per their specific needs. Shifting the focus from treatment-oriented health insurance to preventive measures and examination service expansion and invigoration is essential to improve dental health and overall quality of life. It is deduced that expansion of dental care health insurance coverage and checkup services is critical for vulnerable elders, such as those who are bedridden or living alone.