This study was to evaluate hospital characteristics as composition of manpower and facilities to the death rate of patient; and to earmark the factors affecting the overall hospital mortality rates. The data utilized were derived from survey material conducted by the Korean Hospital Association on 32 tertiary referral hospitals in Korea between 1986 and 1994. The findings are: 1. Those hospitals having the most capacity per bed had little difference to the mortality rates than the others. 2. Those hospitals having the most daily patients per specialist had significantly higher mortality rates than the others, but the number of daily patients per nurse had little effect on the mortality rates. 3. Those hospitals which had a relatively sufficient number of quality assurance activities revealed a lower mortality, and particularly in case where such effort was directed to the clinicians, the outcome was remarkable. we concluded that the major factor affecting the hospital mortality rates seems to be the number of specialists per number of beds, the degree of quality assurance assessment of the clinicians, the quality assurance activities of each hospital as a whole, and the number of daily patient per specialist. According to the findings of this study, the composition and quality of specialist and adequate quality assurance activities seemed to be the essential for the improvement of hospital care. Therefore, in this regard the proper implementation of policy and support is highly recommended. Due to lack of available research material, the personal characteristics of specialists haven't been considered in this study However, this longitudinal observation of 32 tertiary referral hospitals over a nine year period has significant merit alone.
Hospital Mortality* ; Humans ; Korea* ; Mortality ; Specialization ; Tertiary Care Centers*

The geographical distribution of active physicians who graduated from medical schools before 1985 were studied. Those who had emigrated, hold non-medical jobs, are in the military service, or work as public health physicians and resident staff were excluded from the study. A total of 27,728 physicians were analyzed. Our studies have shown a relationship between the location of the medical schools from the which the physicians have graduated and the geographical regions in which they practice. A statistically significant number of physicians are working near the medical colleges from which they have graduated. That is, those who had graduated from medical schools located in the southern area of the country are presently working in the same region. This relationship was shown to be especially significant for older physicians and female doctors, who work around the area of the medical colleges from which they graduated.
Female ; Humans ; Military Personnel ; Public Health ; Schools, Medical

No abstract available.

OBJECTIVE: To examine the association between age at menopause and mortality in a population-based sample of women in Kangwha, Korea. METHODS: From the Kangwha Cohort, followed-up from 1985 to 1999, the data of the over 55 year old female group(n=3,596) was used in this study to examine the association between age at menopause and mortality. We calculated the all causes mortality risk ratio and the cancer mortality risk ratio by age at menopause grouping using the Cox Proportional Hazards Model with adjustments for age, BMI, smoking, education, chronic disease, self-rated health status, alcohol consumption and age at first birth. RESULT AND CONCLUSION: Compared to women who had menopause at 45-49 years, the all causes mortality risk ratio was 1.24 for women with menopause at less than 40 years(95% CI=1.01-1.53) and 1.05 for women with menopause at over 50 years(95% CI=0.92-1.20). Also, compared to women who had menopause at 45-49 years, the cancer mortality risk ratio was 1.53 for women with menopause at less than 40 years(95% CI=0.78-2.98) and 1.17 for women with menopause at over 50 years(95% CI=0.77-1.80).
Alcohol Drinking ; Birth Order ; Chronic Disease ; Cohort Studies* ; Education ; Female ; Humans ; Korea ; Menopause* ; Middle Aged ; Mortality ; Odds Ratio ; Proportional Hazards Models ; Smoke ; Smoking

This study aims to suggest potential steps required for the integration of medical and oriental medical school by comparing the curriculum and its content between the two. The analysis was based on the specific behavioral objectives(SBOS) of the Korean Medical Association and Oriental Medical School Association. We used the school's catalog as well to get information on courses that are offered, hours, and credits. Major findings were as follows. 1. Clinical courses that are taught in oriental medical schools cover about 75% of the courses offered in medical schools on the basis of SBOS. This suggests that western medical knowledge is required for training oriental medical doctors in Korea. 2. If the SBOS of clinical medicine is taught for another 1 year at the oriental medical school, it will cover the entire content of the medical school. Also if 1.5 years of oriental medicine content is taught at medical school, it will include the whole SBOS offered in orienta medical school. Including a 1 year of clinical practicum, the extra years of required education would be 2 years for oriental medical students and 2.5 years for the medical students. Planning for an integrated for medical and oriental medicine requires close cooperation between all parties in practice and academics. A newly developed level of medicine will emerge from this if the plan takes into account the establishment of medical and oriental medical graduate schools and KMA's movement to reduce the number of SBOS to be taught in medical schools.
Clinical Medicine ; Curriculum* ; Education ; Humans ; Korea ; Medicine, East Asian Traditional ; Schools, Medical* ; Students, Medical

We have experienced a 50-year-old male patient, who died of multiple metastatic nodular melanoma which had the primary lesions on the right hallux and forefoot with eventual involvement of skin and internal organs. An autopsy was performed for the evidence of metastatic features of the internal organs and their spreading routes, with concurrent histopathologic findings. The autopsy findings revealed diffuse metastases to the ipsilateral femoral and inguinal lymph nodes via ascending vascular channels and to the internal organs: 1. The heart had multiple metastatic lesions on the pericardium and right ventricular wall. And the mediastinal, periaortic and periesophageal lymph nodes were also involved. 2. The both lungs were moderately indurated and focally discolored, and showed metastatic lesions in the right lower lobe and hilar areas, Melanoma cells were diffusely invaded to the interstitia and alveoli. 3. The right 5th and 6th ribs showed the invsion of melanoma cells on their bone marrows, periostia, and Haversians canals. 4. The liver was enlarged and showed multiple various sized nodules on the surface with adesion to the parts of peritoneum, omentum and diaphragm. Melanoma cells were seen mostly on and around the sinusoidal spaces and parenchyma. 5. The stomach wall had an ulcerated metastatic lesion and the melanoma cells invaded deeply into the muscle layer. 6. The pancreas was normal in its size and shape but had multiple metastatic lesions on the head and body with melanoma celi infiltration. 7. The both kidneys were grar ular surfaced and showed two metastatic lesions on the right renal cortex and two on the left. Renal tubules and parenchyma were widely invaded by melanoma cells but the glomerular tufts were intact. 8. The adreral and thyroid glands showed four and two metastatic lesions respectively and diffuse invasion of melanoma cells into the parenchyma. 9. The brain was normal in gross appearance, but the cortex was edematous and showed settered melanoma cell infiltration.
Autopsy* ; Bone Marrow ; Brain ; Diaphragm ; Hallux ; Head ; Heart ; Humans ; Kidney ; Liver ; Lung ; Lymph Nodes ; Male ; Melanoma* ; Middle Aged ; Neoplasm Metastasis ; Omentum ; Pancreas ; Pericardium ; Peritoneum ; Ribs ; Skin ; Stomach ; Thyroid Gland ; Ulcer

The purpose of this study is to grasp the attitude among personnels and to investigate the factors influencing the attitude about the operation of computer system in a new hospitals. Data was collected from 234 employees of two general hospital located in Seoul and Kyung-Ki Do, Korea, using a self-administered questionnaire. Self-administered questionnaire were given to study socioeconomic characteristics, the level of knowledge, aptitude, attitude and behavior of computerization about the operation of computer system in a new hospitals. The major findings were as follows; 1. Job position had not statistically significant relationship with the attitude about the operation of computer system. But according to age, sex, aptitude, the level of attitude about the operation of computer system was statistically significant relationships. 2. Generally, those who were had higher period of computer usage and frequency of computer education showed a higher positive attitude about the operation of computer system. Also, those who answers to improve of efficiency and satisfaction of computer system showed a higher positive attitude about the operation of computer system. 3. In the results of multiple regression, the period of computer usage, satisfaction of computer system and sex were significantly related to attitude about the operation of computer system. Also, those with good aptitude were significantly related to attitude about the operation of computer system. However, job position and duration of work was not statistically significant relationship with attitude about the operation of computer system.
Aptitude ; Computer Systems* ; Education ; Gyeonggi-do ; Hand Strength ; Hospitals, General ; Korea ; Surveys and Questionnaires ; Seoul

The purpose of this study is to grasp the attitude among personnels and to investigate the factors influencing the attitude about the operation of computer system in a new hospitals. Data was collected from 234 employees of two general hospital located in Seoul and Kyung-Ki Do, Korea, using a self-administered questionnaire. Self-administered questionnaire were given to study socioeconomic characteristics, the level of knowledge, aptitude, attitude and behavior of computerization about the operation of computer system in a new hospitals. The major findings were as follows; 1. Job position had not statistically significant relationship with the attitude about the operation of computer system. But according to age, sex, aptitude, the level of attitude about the operation of computer system was statistically significant relationships. 2. Generally, those who were had higher period of computer usage and frequency of computer education showed a higher positive attitude about the operation of computer system. Also, those who answers to improve of efficiency and satisfaction of computer system showed a higher positive attitude about the operation of computer system. 3. In the results of multiple regression, the period of computer usage, satisfaction of computer system and sex were significantly related to attitude about the operation of computer system. Also, those with good aptitude were significantly related to attitude about the operation of computer system. However, job position and duration of work was not statistically significant relationship with attitude about the operation of computer system.
Aptitude ; Computer Systems* ; Education ; Gyeonggi-do ; Hand Strength ; Hospitals, General ; Korea ; Surveys and Questionnaires ; Seoul

No abstract available.
Pericardial Effusion* ; Radionuclide Imaging* ; Technetium Tc 99m Medronate*

Treatment of unstable cervical spine fracture by skull traction is time consuming procedure, and treatment by Halo appratus has many advantages but it is very expensive. Bone cement has been applied occasionally as an adjunct to metallic internal fixation in treating patient with malignancy, i.e. limited life expectancy. Internal fixation with bone cement in addition to routine posterior fusion with bone graft is tried eliminate the need of application of complicated external immobilization in treating unstable cervical spine fracture of young patient. We experienced two cases of posterior cervical fusion using bone cement with satisfactory results. The advantages of this method are: 1. Rapid and solid fixation 2. Early ambulation 3. Reduce complicated external support 4. Reduce the date of hospitalization.
Early Ambulation ; Hospitalization ; Humans ; Immobilization ; Life Expectancy ; Methods ; Osteotomy ; Skull ; Spine ; Traction ; Transplants