On July 3, 1928, the Wonsan Labor Union established the Wonsan Laborers' Hospital in Seoku-dong, Wonsan for the purpose of reducing medical consultation fees for its members. The union's efforts to improve the welfare of its members include the establishment of an educational institute, a consumers union, a barbershop, and a relief department. The Laborers' Hospital, which began with ten wards, was led by a team of two doctors, one midwife, two pharmacists, and four nurses. The two doctors were Cheol-sun Cha and Jeong-kwon Lee, and the midwife/nurse was Sun-jeong Kim. Union members received a 40% discount on medicine, and this was utilized by a daily average of 60 to 70 workers, or 21,000 workers annually. The Laborers' Hospital was clearly distinct from medical facilities founded as charity institutions in that funds were raised by the recipients themselves, and that the recipients formed a community based on their common status as laborers. However, the Wonsan Laborers' Hospital was shut down in roughly April 1929 due to the breaking of the general strike, and the heightened suppression of union activities prevented any additional opening of laborers' hospitals until Korea's liberation from Japan. Nevertheless, the history of the Wonsan Laborers' Hospital represents a key development in Korea's health coverage. It is not adequate to declare, as was the case in past research, Korea's health coverage to be simply an imitation of the Western system and lacking its own history. Despite some differences in scale and operation, the development of health coverage in the Korean peninsula is in line with the history of health coverage development in the West. The Wonsan Laborers' Hospital, founded and operated by the laborers themselves, thus holds great significance in the history of Korea's health coverage, The findings of this study are expected to stimulate new and more diverse discussions on the history of health coverage in Korea.
Asian Continental Ancestry Group* ; Charities ; Fees and Charges ; Financial Management ; Humans ; Japan ; Korea ; Labor Unions ; Midwifery ; Occupations* ; Pharmacists ; Strikes, Employee

BACKGROUND: The aging of the patient population is one of rhe most important factirs influencing health care delivery. Currently 5% of the Korean population is elderly, defined as older than 65years of age, with this group projected to increase to 13.1% by the year 2021. Cardiovascular disease is the leading cause of death and of disability in the elderly age group. mong them, coronary heart disease is the most importane. METHOD: Study population composed of 216 patients who were admittied to the hospital with first acute myocardial infarction and they were divided into two groups according to the age(older than 65 years of age vs younger). Clonical features, risk factors of coronary heart disease, in-hospital outcome and complication were compared in elderly patients and others group. Results : 1) The risk factors of coronary heart disease is similar to younger patients but pattern of chest pain is less typical than younger patients. 2) Clinical presentation of elderly patients is similar to younger patients except Killip class on admission.(1.66vs 1.91,P=0.04) 3) In-hospital mortality of elderly patients in higher than younger patients. In addition to an increased incidence of death, recurrent ischemia, stroke, AV block, ventricular arrythmia, pulmonary edema occured more frequently with advanced age. 4) Especially in the thrombolytic therapy group, in-hospital death, reinfarction and recurrent ischemia is higher than primary PTCA group in elderly patients. CONCLUSIONS: Diagnosis of acute chest pain is difficult in elderly patients and in-hospital mortality and morbidity is higher than in younger patients. Thus more accurate diagnosis and discriminative therapeutic modality is needed.
Aged ; Aging ; Arrhythmias, Cardiac ; Atrioventricular Block ; Cardiovascular Diseases ; Cause of Death ; Chest Pain ; Coronary Disease ; Delivery of Health Care ; Diagnosis ; Hospital Mortality ; Humans ; Incidence ; Ischemia ; Myocardial Infarction* ; Pulmonary Edema ; Risk Factors ; Stroke ; Thrombolytic Therapy

BACKGROUND: In a health examination program, advice from physician for change of health-related behavior and distribution of health educational pamphlets is routine. This study was done prospectively to analyze factors such as personal general characteristics, results of health examination, health examination satisfaction that relate to change of health promotion attitudes and compliance towards overweight, smoking, heavy drinking, elevated blood pressure, dyslipidemia, chronic diseases such as diabetes, hypertension. METHODS: The subject population was 689 cases from May 1997 to June 1997 in a general hospital health examination center. After health examination, 60.2%(415 cases) showed personal satisfaction by questionnaire. Three to four months later 78.4%(540 cases) responded to the telephone survey on change of health beliefs, health-related attitudes and compliance. RESULTS: In the telephone survey, 239 cases(46.0%) comprised high compliance group that had positive attitudes toward abnormal health examination results, 145 cases(27.9%) were mid compliance group, and 135cases(26.0%) were low compliance group. In males there was higher frequency of high compliance group than females(p<0.05). According to age, the older, the higher frequencies of high compliance group(p<0.05). In educational level group, the higher the educational level, the lower the frequencies of high compliance group(p<0.01). There was no difference in frequency of each compliance group between symptom motive and non-symptom motive group with each satisfaction group(p>0.05). In positive responders to the correspond advice of physician or health educational pamphlets, the frequencies for quit smoking, reduction of drinking amount, regular exercise, Compliance with taking antihypertensives, blood sugar control, diet control for dyslipidemia, taking antihyperlipidemics were higher(p<0.01). CONCLUSIONS: Health examination service includirg advice of physician and education changed health belief and influenced positively to health promotion attitudes. Health examination is not only important for early detection of disease but also to promote positive change of health-related behavior. Further studies are needed to understand the changing process of management of health and disease.
Antihypertensive Agents ; Blood Glucose ; Blood Pressure ; Chronic Disease ; Compliance ; Diet ; Drinking ; Dyslipidemias ; Early Diagnosis ; Education ; Health Education ; Health Promotion ; Hospitals, General ; Humans ; Hypertension ; Hypolipidemic Agents ; Male ; Overweight ; Pamphlets ; Personal Satisfaction ; Prospective Studies ; Smoke ; Smoking ; Telephone ; Surveys and Questionnaires

Many studies have reported structural or functional brain changes in patients with alcohol-dependence (ADPs). However, there has been an insufficient number of studies that were able to identify functional changes along with structural abnormalities in ADPs. Since neuronal cell death can lead to abnormal brain function, a multimodal approach combined with structural and functional studies is necessary to understand definitive neural mechanisms. Here, we explored regional difference in cortical thickness and their impact on functional connection along with clinical relevance. Fifteen male ADPs who have been diagnosed by the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) underwent highresolution T1 and resting-state functional magnetic resonance imaging (MRI) scans together with 15 male healthy controls (HCs). The acquired MRI data were post-processed using the Computational Anatomy Toolbox (CAT 12) and CONN-fMRI functional connectivity (FC) toolbox with Statistical Parametric Mapping (SPM 12). When compared with male HCs, the male ADPs showed significantly reduced cortical thickness in the left postcentral gyrus (PoCG), an area responsible for altered resting-state FC patterns in male ADPs. Statistically higher FCs in PoCG-cerebellum (Cb) and lower FCs in PoCG-supplementary motor area (SMA) were observed in male ADPs. In particular, the FCs with PoCG-Cb positively correlated with alcohol use disorders identification test (AUDIT) scores in male ADPs. Our findings suggest that the association of brain structural abnormalities and FC changes could be a characteristic difference in male ADPs. These findings can be useful in understanding the neural mechanisms associated with anatomical, functional and clinical features of individuals with alcoholism

BACKGROUND: EEG shows a sequence of progressive changes in status epilepticus (SE). Timely antiepileptic drug treatment is an important factor for the prognosis of SE. Here we investigated the effect of treatment according to EEG staging in a lithium-pilocarpine SE rat model. METHODS: By analyzing the on-going EEG of SE, we injected propofol (PF) or propofol and valproate (PF+VA) on each defined EEG stage [early period, merging stage; middle period, continuous stage; late period, early periodic epileptiform discharges stage (ePED)]. We measured the duration of each stage after the treatment and the number of principal cells at three hippocampal areas (CA1, CA3, dentate gyrus] after SE. RESULTS: Both PF- and PF+VA-treated groups showed lower mortality rate in the merging stage-treated subgroup than in ePED-treated subgroup. Seizure duration was significantly shortened in the merging stage of both PF- (p<0.005) and PF+VA-treated groups than in untreated group (p<0.002). The durations of the continuous stage and ePED were shortened in the merging stage-treated subgroup, but ePED duration did not decrease in ePED-treated subgroup. The shortening of the continuous stage and ePED was more prominent in the PF+VA-treated group than in PF-treated group. Neuronal loss in both PF- and PF+VA-treated groups was so severe that CA1 and CA3 neuronal loss was decreased more markedly in the ePED-treated group than in the merging stage-treated group (p<0.01). CONCLUSIONS: Early therapy based on the defined EEG staging might be an effective option for shortening duration of SE and decreasing neuronal damage at the hippocampus. Early combination therapy adopting PF+VA requires further investigation for new treatment option.
Animals ; Electroencephalography ; Hippocampus ; Neurons ; Pilocarpine ; Prognosis ; Propofol ; Rats ; Secondary Prevention ; Seizures ; Status Epilepticus ; Valproic Acid

Malignant tumors associated with chronic empyema have been reported in the literature, and a majority of these tumors are lymphomas. Epithelial tumors originating from the post-pneumonectomy space in patients with chronic empyema are extremely rare. Here, we present the cases of 2 patients with squamous cell carcinoma arising from the pleural cavity after pneumonectomy for chronic empyema.
Carcinoma, Squamous Cell* ; Empyema* ; Epithelial Cells* ; Humans ; Lymphoma ; Pleural Cavity* ; Pneumonectomy*

BACKGROUND: In a noisy hospital setting, it is not easy to induce hypnosis or sedation calmly. Although the noise stress has been neglected, it seems to disturb a patient's sleep or induction of sedation. Therefore, we tried to evaluate the effects of loud operating room (OR) background noise on bispectral index (BIS) during monitored anesthesia care (MAC) by using an audiometer and BIS monitor. METHODS: Thirty adult patients (ASA class I) were scheduled two times for nasal or dental procedures at an interval of two or three days. In a randomized, cross-over study design, we prospectively compared the BIS values according to the loudness of OR noise in two different depths of sedation during MAC. Propofol target controlled infusion (TCI) was started at a propofol target concentration (CT) 2.0 microgram/ml using a DiprifusorTM with flash mode until a BIS 80 and/or a modified Observer's Assessment of Alertness/Sedation (mOAAS) score of 4 (group 1), and BIS 75 and/or mOAAS score 3 (group 2) was obtained. We evaluated the effect site concentrations and the elapsed time and checked the BIS at 50, 80, 110, and 120 dB of sound pressure level (SPL) in both groups. RESULTS: The BIS at 80, 110 and 120 dB of SPL in group 1 was significantly increased compared to those at 50 dB (P < 0.05). Similarly, the BIS at 110 and 120 dB of SPL in group 1 was significantly increased compared to those at 80 dB (P < 0.05). The patients in their twenties were most susceptible to loud OR noise during sedation. CONCLUSIONS: The loud OR background noise might be possible to interfere with induction of sedation to a degree, which was more noticeable on light to moderate sedation than for deep sedation.
Adult ; Anesthesia* ; Conscious Sedation ; Cross-Over Studies ; Deep Sedation ; Humans ; Hypnosis ; Noise* ; Operating Rooms* ; Propofol ; Prospective Studies

BACKGROUND: We evaluated the optimal concentrations of eye opening and orientation after propofol- fentanyl TCI by CSDT of the pharmacokinetic model using DiprifusorTM in adults retrospectively. Furthermore, we tried to compare those data with the cases of using propofol TCI alone that had been reported. METHODS: After obtaining informed consent and IRB approval, 124 patients of ASA class I or II scheduled for elective surgery were allocated into 3 groups according to age. Three groups were group 1 (n = 40): 18 - 29 years, group 2 (n = 42): 30 - 39 years, group 3 (n = 42): 40 - 54 years. Propofol infusion was started at a propofol target concentration (CT) of 6 microgram/ml by using DiprifusorTM. Anesthesia was mostly maintained with propofol CT 3.5 microgram/ml and fentanyl CT 1.5 ng/ml using a Stelpump and 67% nitrous oxide in oxygen. We estimated the average concentrations of propofol at eye opening and orientation in each group with DiprifusorTM, and we also evaluated the correlation coefficient. RESULTS: Total requirements of propofol in cases of propofol-fentanyl TCI were decreased by 18-26% than in propofol TCI alone. The average concentrations of propofol at eye opening and orientation after surgery were 1.2 - 1.4 microgram/ml. The times to show eye opening and orientation after surgery from stopping of nitrous oxide and infusion were 10.4 - 14.5 min in the propofol-fentanyl group compared with 7.5 - 11 min using propofol TCI alone. CONCLUSIONS: We concluded that the optimal concentrations of propofol at eye opening and orientation after surgery in cases of combination with fentanyl were 1.2 - 1.4 microgram/ml instead of 1.4 - 1.6 microgram/ml with using propofol alone.
Adult ; Anesthesia ; Ethics Committees, Research ; Fentanyl ; Humans ; Informed Consent ; Nitrous Oxide ; Oxygen ; Propofol* ; Retrospective Studies

This study was performed in order to evaluate the usefulness of the crush cytologic features and differential diagnosis between meningiomas and schwannomas in the central nervous system. Deeply seated and unusually located meningiomas and schwannomas with equivocal or erroneous frozen section diagnosis can be correctly diagnosed cytologically in crush preparations. Twenty-four meningiomas and nine schwannomas were studied by frozen section and crush preparation technique. These tumors displayed distinctive cytologic features. In meningiomas, the tumor tissue fragments were easy to crush, and the tumor cells were arranged in small clusters, flat sheets, papilla-like, whorling pattern or singly. Individual tumor cells displayed round or oval nuclei with finely granular chromatin pattern and inconspicuous small nucleoli. Occasionally psammoma bodies, nuclear pseudoinclusion or nuclear grooves were found. In schwannomas, tissue fragments were hard in consistency and difficult to crush. The crushed tissue presented as thick, irregular fragments with sharp borders. The cells showed ill-defined cytoplasm and round, oval, cigar-shaped or curved nuclei. It is important to emphasize that the smear pattern under low-power view and cytologic features are helpful in discriminating between these two tumors.
Central Nervous System* ; Chromatin ; Cytoplasm ; Diagnosis ; Diagnosis, Differential* ; Frozen Sections ; Meningioma* ; Neurilemmoma*

No abstract available.
Adult* ; Fistula* ; Humans