This study was conducted to assess the referral patterns to specialist from general practitioners in health center and perceived needs of referred patients for specialist care in health center. The study subjects were 249 patients who visited to health centers and were referred to other medical facilities. The data were obtained from questionnaire survey which was conducted in Kyongjuu-city Health center, Seongju-Gun Health center and Koryong-Gun Health center in Kyongsangbuk-Do, from June 10 to october 17, 1995. The total referral rate was 2.7%. The proportion of patients who wished to be referred to medical specialists was 85.9%, and the proportion of patients referred by general practitioners in health centers was 14.1%. Among the patients who wished to be referred to medical specialists, 45.9% visited directly to health centers, 34.6% visited health centers via local clinics and 19.5% visited health centers to get referral permission only. The reasons for getting referral permission in health centers were easy geographical accessibility(34.6 %), easy to get referral permission in health centers(27.l%), and very difficult to get referral permission in local clinics(l6.4%). Among the diseases of referred patients, diseases of the musculoskeletal system and connective tissue were most prevalent on a whole, but diseases of nervous system and sensory organs were comparatively high among the patients who wished to be referred to medical specialists and infectious and parasitic diseases were comparatively high among the patients referred by general practitioners in health centers. The most favorable medical facility was general hospital including university hospital in both groups of patients who wished to be referred to medical specialist and the patient referred by general practitioners in health centers. Regarding the needs for specialist care in health center, 75.2% patients who wished to be referred to medical specialists and 74.3% of patients referred by general practitioners in health center wanted the specialist care. The most frequently requested speciality is internal medicine(47.1%), and then orthopedics and general surgery. Based on above results, this study revealed that the majority of patients referred from health center wished to be referred to medical specialists at their own will, so, referral system at health center level should be changed. And if specialist care in health center be provided, the medical care by internist could be provided first, and then that of orthopedics and general surgery could be provided. These kinds of medical cares could be covered by local clinicians as a part-time job on a voluntary basis.
Connective Tissue ; General Practitioners ; Gyeongsangbuk-do ; Hospitals, General ; Humans ; Musculoskeletal System ; Nervous System ; Orthopedics ; Parasitic Diseases ; Surveys and Questionnaires ; Referral and Consultation* ; Specialization*

PURPOSE: The aim of this presentation is to analyze the factors influencing on retrograde insertion of double-J catheter in urethral obstruction due to malignancy and to predict the possibility of stunting with double-J catheter. MATERIALS AND METHODS: A retrospective analysis of 43 patients who had underwent retrograde double-J catheter insertion for urethral obstruction secondary to pelvic malignancy, from January 1993 to April 1997, was performed to evaluate the success rates of double-J ureteral stenting according to the factors such as age, sex, presence or absence of flank pain, degree of hydronephrosis, renal function, stage of tumor, laterality of ureter, past history of radiotherapy, operation and chemotherapy. RESULTS: According to the degree of hydronephrosis, the success rate was 100, 73.7 and 50% in grade I II and III, respectively(p<0.05). According to the renal function, the success rate was 81.3% in the group with normal renal function and 45.5% in the group with abnormal venal function(p<0.05) According to the stage of disease, the success rate was 100, 70.7 and 58.3% in stage I, II and III, respectively. According to the absence or presence of flank pain, the success rate was 56.3% in the group with flank pain and 81.5% in the group without flank pain. According to the past history of radiotherapy, the success rate was 65.6% in the group treated with radiotherapy and 90.9% in the group not treated with radiotherapy. The age, sex, laterality of ureter, past history of operation and chemotherapy were not significantly correlated to the success rates. CONCLUSIONS: The factors influencing on double-J ureteral slanting were the degree of hydronephrosis, renal function, absence or presence of flank pain, stage of disease and past history of radiotherapy Further study will be needed to demonstrate the accurate timing of urethral stenting with doublets ureteral catheter.
Catheters* ; Drug Therapy ; Flank Pain ; Humans ; Hydronephrosis ; Radiotherapy ; Retrospective Studies ; Stents ; Ureter* ; Ureteral Obstruction* ; Urethral Obstruction ; Urinary Catheters

This study was conducted to clarify the relationship of body fat percent with serum lipid level and blood pressure in adults. The study subjects were 472 men and l89 women who visited Multiphasic Health screening center of Yeungnam university Hospital in Taegu from May 20 to September 30, 1994. The relationship of serum lipid and blood pressure with BMl, Katsura index, atherogenic index, which calculated from the health screening data and body fat percent measured by impedance fat meter(model SIF-819) were analyzed. Three groups were classified as Group I(men: body fat percent > or= 20, women: body fat percent > or= 25, Group II (men: 15 < or = body fat percent <20, women: 20 < or = body fat percent<25, Group III(men: body fat percent <15. women: body fat percent<20) In this study, Group I accounted for 3.2%in men, 3.7%in women. Weight was significantly different among three groups in both sexes(p<0.01) and height was not significantly different among three groups. In men, serum total cholesterol, triglyceride, high density lipoprotein, low density lipoprotein. atherogenic index were significantly different(p<0.01). In women, serum total cholesterol and low density lipoprotein were significantly different(p<0.05 but there was no differences in triglyceride and high density lipoprotein among three groups. BMl and Katsura index were significantly different among three groups in both sexes(p<0.01). In men, body fat percent was positively correlated with weight, BMl, Katsura index, total cholesterol, triglyceride, low density lipoprotein, atherogenic index and systolic and diastolic blood pressures, and negatively correlated with high density lipoprotein. In women, body fat percent was positively correlated with age, height, weight, BMl, Katsura index, total cholesterol, triglyceride, low density lipoprotein and atherogenic index, and negatively correlated with high density lipoprotein. But there was no significant correlation between body fat percent and blood pressure in women. In multiple regression analysis for total cholesterol, fat percent, age and BMl were significant independent variables in men(p<0.05, R2=0.1286), and body fat percent and age in women(p<0.05, R2=0.3399). In case of LDL/HDL ratio, only BMl was a significant independent variable in men(p<0.01, R2=0.0954), and body fat percent, age and BMl in women(p<0.05, R2=0.3164). In multiple regression analysis, age, low density lipoprotein and total cholesterol were significant independent variables on systolic blood pressure in men(p<0.05, R2=0.1297), age and total cholesterol in women(p<0.055, R2=0.1705). On diastolic blood pressure, only age was a significantly independent variable in men(p<0.01, R2=0.0972) and women(p<0.01, R2=0..1218). From the result of this study, it could concluded that body fat percent was significantly associated with other obesity indices and serum lipid, but had no significant association with blood pressure. To establish the relationship of body fat percent with blood pressure, further study which consider other variables that may have an effect on blood pressure should be performed.
Adipose Tissue* ; Adult* ; Blood Pressure* ; Cholesterol ; Daegu ; Electric Impedance ; Female ; Humans ; Lipoproteins ; Male ; Mass Screening ; Obesity ; Triglycerides

No abstract available.

No abstract available.
Cholesteatoma* ; Fistula* ; Otitis Media* ; Otitis*

It has been studied that a variety of fauna and flora are sensitive biological indicators which reflect the severity of regional pollution of heavy metals, but in the center of part of Taegu city the controversial issue of lead poisoning attributable to the atmosphere which contains an increased concentrations of lead has been raised recently, it is usually hard to find suitable plants or animal in the areas with heavy traffic. Pigeons are ubiquitous in and around Taegu city area, inhabiting even the most densely populated areas with heavy traffic with its small body size, high metabolic turnover, and rather limited mobility, a pigeon, as a biological indicator is expected. This study was conducted to monitor lead pollution in the Taegu and kyongju city in Korea. We measured the lead content of the various tissue of three groups of feral pigeon(Columbia livia) and soil and atmospheric lead concentration. First group was obtained io heavy traffic area in Taegu City, the second group was obtained a park in Taegu city and the third group was obtained light traffic area in kyongju city. The air and soil lead concentration of heavy traffic area in Taegu city was 0.11 microgram/m2, 4.96 microgram/g, that of park in Taegu city was 0.05 microgram/m3, 2.65 microgram/g and that of light traffic area in kyonngju city was 0.03 microgram/m3, 0.01 microgram/g. The lead content of lung, blood, kidney, femur and liver of feral pigeons in heavy traffic area in Taegu city was significantly higher than pigeons obtained in a park in Taegu city and low traffic density area in Kyonfju city(p<0.01). But stomach lead content of three group did not reflect a significant difference. In this study positive correlation was found between atmospheric lead concentrations and the concentration of lead in the pigeon's lung(r=0.5040, p<0.001), blood(r=0.3322, p<0.01), kidney(r=0.4824, p<0.001), femur(r=0.7214, p<0.001) and liverer (r=0.4836, p<0.01). we can also found positive correlation between soil lead concentrations and the concentration of lead in the pigeon's femur(r=0.4850, p<0.001), kidney(r=0.4850, p<0.001) and liver(r=0.4386, p<0.01). In the pigeon`s tissue there were significant correlations between concentration of lead in the blood and kidney(r=0.4818, p<0.001), femur(r= 0.6157, p<0.001) and liver(r=0.3889, p<0.001). In conclusion, at the heavy traffic area in Taegu city, lead concentrations found in the atmosphere and soil are reflected in the lead concentrations of different tissue of urban pigeons. It is suggested that the tissue of pigeons can be good biological indicators of environmental lead pollution.
Animals ; Atmosphere ; Body Size ; Columbidae ; Daegu ; Femur ; Gyeongsangbuk-do ; Kidney ; Korea ; Lead Poisoning ; Liver ; Lung ; Metals, Heavy ; Soil* ; Stomach

Many researchers report that the measurement of urine calcium concentration during antenatal period is helpful in prediction of having preeclampsia,but some don`t. The purpose of this clinical study is to evaluate the relationship of low calcium level in urine and the develpoment of preeclampsia, and effects of other variables. 24hour urine were collected and measured for the concentration of calcium and creatinine from 769 pregnant women who visited our department of obstetrics at Young-Dong Severeance hospital, Yonsei university medical college for antenatal care from March 1, 1993 to May 31, 1996. One group of 41 women developed preeclampsia and the other didn`t. There were no diffrences in ages and gestational age at urine collection between two groups, but a group with preeclampsia had an increased mean arterial blood pressure. There were signiificant difference in calcium concentration in urine and ratios of concentration of calcium and creatinine from urine collected between gestational ages of 25 weeks and 32 weeks and also in those women younger than 25 years old and their first pregnancy. Our study suggests that the measure ment of calcium level and ratios of urine calcium concentration and creatinine concentration at gestational ages between 25 weeks and 32 weeks in women younger than 25 year old with their first pregnancy is quite helpful inpredicting the develpoment of preeclampsia.
Adult ; Arterial Pressure ; Calcium ; Creatinine ; Female ; Gestational Age ; Humans ; Obstetrics ; Pre-Eclampsia* ; Pregnancy ; Pregnant Women ; Urine Specimen Collection ; Weights and Measures

Impaired endothelium dependent relaxation occurs in diabetic rabbit corpus cavernosum and normal corpus cavernosum exposed to elevated glucose. Elevation of glucose can change the activities of two key enzymes, protein kinase C (PKC) and Na+-K+ ATPase. This study addresses the question of whether impaired endothelium dependent relaxation in isolated corpus cavernosum from normal rabbit exposed to elevated glucose is related to PKC and Na+-K+ ATPase activities and, if so, whether it is associated with altered ouabain sensitive 86-Rb uptake, an index of Na+-K+ ATPase activity, and contractile response of corpus cavernosum tissue to ouabain. Corpus cavernosal tissue suspended for measurement of isometric tension were incubated for 6 hours in control (5.5mM) or elevated glucose (44mM) to mimic euglycemic and hyperglycemic conditions. Relaxations of corpus cavernosum tissue in response to the endothelium-dependent vasodilator acetylcholine (ACh)were unaffected in control groups while significantly inhibited in the elevated glucose group. Relaxations of corporeal tissue to endothelium-independent vasodilators, sodium nitroprusside (SNP) were similar in the control and elevated glucose groups. Corporeal tissue treated with 4-phorbol 12-myristate 13-acetate (PMA), a PKC activator, showed decreased relaxations to ACh, similar to normal corporeal tissue exposed to elevated glucose. Relaxations in response to SNP were unaffected by treatment with PMA or exposure to elevated glucose. 1(5-isoquinolinylsulfonyl)-2-methylpiperazine (H-7), PKC inhibitor, restored the abnormal Ach-induced relaxation in corporeal tissue exposed to elevated glucose. The contractions caused by ouabain, Na+-K+ ATPase inhibitor, were smaller in elevated glucose groups than control and elevated glucose groups treated with H-7. Ouabain sensitive 86-Rb uptake of elevated glucose groups was significantly less than that of control groups but ouabain sensitive 86-Rb uptake of elevated glucose groups treated with H-7 was similar to those of control groups. These results suggest that activation in PKC activity and inhibition in Na+-K+ ATPase activity caused by elevated glucose contribute to impaired endothelium dependent relaxation in corpus cavernosum smooth muscle.
1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine ; Acetylcholine ; Adenosine Triphosphatases* ; Endothelium ; Glucose* ; Muscle, Smooth ; Nitroprusside ; Ouabain ; Protein Kinase C* ; Protein Kinases* ; Relaxation* ; Vasodilator Agents

BACKGROUND: The goal of this study was to examine the health behaviors of nurses and provide basic information on health promotion for nurses. MATERIALS AND METHODS: A self-administered questionnaire survey was completed by 340 nurses working at a university hospital in Daegu, Korea from March 6 to March 30, 2006. The questionnaire included demographic characteristics, working environment, health behaviors, self-assessed health status, and the practice of health promotion activities according to the work group(shift group vs. non-shift group). RESULTS: There were significant differences in 'regular diet', 'drinking', 'ordinary health management', 'regular exercise', 'leisure activities', 'rest', and 'feeling of fatigue' between the two groups. The score for the practice of health promotion activities of the non-shift group was 121.9, which was higher than the 115.4 for the shift group. By field of practice of health promotion activities, there were significant differences in 'self-realization' and 'nutrition' between the two groups. CONCLUSION: The shift group did not appear to have enough time to take care of their health. It is therefore important to provide a working environment in which nurses are encouraged to increase their interest and efforts to maintain healthy behaviors. In addition, programs for education and training should be developed to help nurses adopt healthy life styles and enhance their self-esteem.
Daegu ; Education ; Health Behavior* ; Health Promotion ; Korea ; Life Style ; Surveys and Questionnaires

BACKGROUND: The purpose of this study was to discover ways to screen urine culture specimens through Gram stains, urine stick analyses and microscopic examinations for the laboratory cost saving. METHODS: One hundred and fifty-eight urine specimens for culture were included. Fifty uL of urine were inoculated onto one well each of 10-well slide, dried on the hot plate, and Gram-stained. The results combined with routine urinalyses including urine nitrite and leukocyte esterase, and pyuria, were compared with the routine culture results. RESULTS: The screening of bacteriuria by Gram stains, urinalyses and microscopic examinations revealed the high sensitivity (91.9%) and negative predictive value(95.5%) with cost saving of 41.8% of inoculating media. Not considering the Gram stains, the screening revealed 83.8% sensitivity and 92.5% negative predictive value, even if the cost saving of inoculating media were as high as 50.1%. CONCLUSION: It was demonstrated that it was sensitive and economic and produced rapid preliminary results to screen bacteriuria by the Gram stains combined with urinalyses and microscopic examinations.
Bacteriuria ; Coloring Agents ; Cost Savings ; Leukocytes ; Mass Screening* ; Pyuria ; Urinalysis*