The year 2007 US-Korea FTA contracting may have removed a international border hurdle in terms of custom tax problem that may have been protected by each country. After that, there remains an infinite competition between the two countries for international trades especially for medical service. Private medical insurance can play an important role in suppressing oversea hospital use in top-level medical consumers and in introducing the high-level of domestic medical technology to low-income medical consumers. And thus, the private insurance system is expected to lead the patients of both extremes in terms of their salary income to domestic medical consumption. Private medical insurance system is also expected to help lessen medical expenses and lower the price of pre-existing medical technology. For activating normally the private medical insurance, one of practical methods is to ensure the neutralized and efficient network by the central role play of medical profession groups. Now is the high change that we can make a better medical welfare environment, if the advantage and the meaning of each insurance (including private insurance system) institution can be substantiated.
Contracts ; Dietary Sucrose ; Humans ; Imidazoles ; Insurance ; Nitro Compounds ; Salaries and Fringe Benefits ; Taxes

The increase of health care expenditures is an important problem in the almost countries. Also, suppression of the health care expenditures is an important problem in the health field of Korea since the national health insurance for total people in 1989. Thus, it is very important to grasp the change of the health care expenditures of family and proportions of the health care expenditures to total expenditures of family, because they are the basis of national health care expenditures in Korea. While the health care expenditures of urban family were increased during 1980-1993 by 12.8% annually, the total expenditures of urban family were increased by 14.8% annually. consequently, the proportions of health care expenditures to total expenditures were decreased from 5.98% to 4.76%. The proportions of health care expenditure for 3 years to come were predicted to 4.75% in 1994, 4.67% in 1995, and 4.63% in 1996 by the time-series ana]ysis. That is, it was predicted that they would be decreasing slowly. The product elasticity of health care expenditure was less than 1 in the multiple regression analysis, so the health care is normal good rather than superior good. Therefore, it seems that the household economy is able to bear the expense pursuing the improvement of quality of health care by actualizing the medical insurance fee.
Delivery of Health Care* ; Elasticity ; Family Characteristics ; Fees and Charges ; Hand Strength ; Health Expenditures* ; Humans ; Insurance ; Korea ; National Health Programs ; Quality of Health Care

The serous papillary cystadenoma of low malignant potential in the paratesticular tissue is a tumor characterized by its resemblance to ovarian serous papillary tumor of low malignant potential. Several possible origins have been proposed but it is thought to originate from the Mullerian-type epithelium just like ovarian serous tumor of low grade malignancy. Because of the rarity of this tumor, the natural history and treatment have not been established. Herein we report on a serous papillary cystadenoma arising in the paratesticular tissue of a 12 year old . To our knowledge, this is the first reported case in the Korean literature. The size of this cystic tumor in this patient was 0.9x0.9x0.8 cm and had a sponge-like cut surface. The papillary structure was lined by both ciliated and nonciliated secretory cells, the same cellular structure as the salpinx. Areas with just a few mitoses and stratification of epithelial cells were noted, but invasion into the paratesticular tissue was absent, suggesting borderline malignancy. He is doing well after 5 months follow up. Prognosis of this scrotal tumor is thought to be better than the ovarian tumor of similar histology due to a better possibility of early detection.

The purpose of this study was to evaluate the bone age and hand anomaly in Down syndrome patients. We reviewed radiographs in 52 children and youths with Down syndrome, aged from 2 to 23 years. The characteristic findings of hand anomaly were observed in the middle phalanx of the fifth finger, with the following incidence; brachymesophalangia (44%), clinodactyly (48%), and dysmesophalangia (15%). Pseudoepiphysis (21%) was found typically at the distal end of the first metacarpal bone and proximal end of the second metacarpal bone. Up to 8.5 years of age, bone maturation was retarded and thereafter bone age accelarated in advance of chronologic age. These findings may provide valuable information relative to the diagnosis and treatment of hand anomaly in Down syndrome.
Adolescent ; Child ; Diagnosis ; Down Syndrome* ; Fingers ; Hand* ; Humans ; Incidence

Dermatologist should be aware of the practical importance of proper selection of ski.n lesions for histologic examination, the correct methods for performing biopsy, and steps involved in tissue preparation. They should be acquainted with factors producing various artifacts and ways to prevent these changes. This study was undertaken to investigate the artifacts of 300 dermatopathologic tissue sections which prepared by 3 general hospitals in Seoul in 1983. The results were summarized as follows. [.The percentage of artifacts produced by selection of inapropriate lesion was 4. 0% artifacts during biopsy procedure was 18. 3% inadequate size and depth of specimen was 7. 3%, faulty embedding was 12. 0%, tissue tearing or loss was 49. 3% artifactal dermoepidermal separation was 3.0%, linear knife marking was 17.0% thick or thin section was 8. 3% tissue overlapping was 12. 0% uneven stiining or precipitation was 3. 7%, and foreign body contamination was 3, 7% The percentage of good specimen was 21, 7% diagnostic was 56. 3% not diagnostic but suggestive was 8.7% and reading impossible was 13. 3% 3. The major causes of reading impossible specimen which attributed to the procedures of dermatologist were 40.0% to the proccss of technician were 47.5% and to both were 12. 5%
Artifacts* ; Biopsy* ; Foreign Bodies ; Hospitals, General ; Seoul ; Skin*

An immunohistochemical and electron microscopic study of an atypical fibroxanthoma of the skin (AFX) was reported. The lesion developed on the left scapulararea in a 70-year-old man. The result using antibody to S-100 protein was negative and the tumor cells observed with electron microscope were undifferentiated, fibroblast-like, histiocyte-like and multinucleated giant cells. But Langerhans-like cells or Langerhans were not found.
Aged ; Giant Cells ; Humans ; S100 Proteins ; Skin*

To investigate the factors influencing workers' perception and attitude toward special periodic health screening test for workers, a survey with self-administered questionnaires was performed on 279 workers who had special periodic health screening test from september 1 to October 15, 1994. A study model was developed by modifying the health belief model. The end and intermediate response variables of the model were the voluntary participation and necessity perception on the special screening for workers, and The result of analysis was consistent with the study model. Rates for the necessity perception and voluntary participation on the special1 screening for workers were 77.2%, 79.2%, respectively. Factors influencing on the voluntary participation were necessity perception, benefit of special screening for workers, and cue to action. And on the necessity perception were susceptibility and severity to occupational disease, knowledge to special screening for workers, and support of company. General and occupational characteristics influencing on the susceptibility and severity to occupational disease were sex, age, educational level, work duration, and health education. On the knowledge to special screening for workers were age, educational level, work duration, and locus-of-control. On the benefit of special screening for workers were age, locus-of-control, pride on health, and health education. Therefore, to increase the voluntary participation and necessity perception on the special periodic health screening for workers, l) if a worker is judged as occupational disease, the judgment should be widely known in his workplace, 2) the screening result forms should be directly sent to the workers themselves, 3) for the positivity of employers, the campaign and education program subjected to them should be planned, 4) health education should give the first consideration to the younger, lower educational level, and newly employed women, and its frequency should be increased and it should be more frequently dealt with occupation-related subjects, and 5) the employers should have a careful concern in not being disadvantageous to workers due to result of screening.
Cues ; Education ; Female ; Health Education ; Humans ; Judgment ; Mass Screening* ; Occupational Diseases ; Surveys and Questionnaires

The human trachea is normally lined by a pseudostratified ciliated columnar epithelium where ciliated, goblet, intermediate and basal cells are mainly represented. However the fetal tracheal epithelium was found to be composed of ciliated, non-ciliated and basal cells. The present study was designed to characterize the development of ciliated cells in the fetal trachea at mid (19 weeks) and last (32 weeks) trimester of gestation. At 19 weeks of gestation, the tracheal epithelium, 35 µm in height, was composed of surface, intermediate and basal layers. The surface cells were subdivided into ciliated, immature ciliated, non-ciliated, granule containing and goblet cells. The ciliated cells covered approximately half of the luminal surface area. The immature ciliated cells contained basal bodies, but the apical membrane was not invested with cilia. The granule containing cells contained numerous dense granules, 0.3-0.7 µm in diameter, in the apical cytoplasm. The goblet cells contained less electron dense granules, 1-2 µm in diameter, in the apical cytoplasm. The cells in intermediate layer were relatively undifferentiated and contained poorly developed organelles. Submucosal gland were well differentiated and were composed of the mucous and serous cells. At 32 weeks of gestation, the tracheal epithelium, 50µm in height, was also composed of surface, intermediate and basal layer. The surface cells were composed of ciliated, non-ciliated and goblet cells. The ciliated cells, dominant type of surface cells, were subdivided into mitochondria-rich cells (type I) and smooth endoplasmic reticulum-rich cells (type II). The non-ciliated cell were of three subtypes : mitochondria-rich cells (type A), glycogen and microfilament-containing cells (type B) and cells with bulging apical surface into the lumen (type C). Small granule containing cell appeared in the basal layer. These cells contained clear vesicles, 50 ㎚m in diameter, and dense granules, 100-300 ㎚m in diameter. Submucosal gland were well developed and consisting of mucous, serous and myoepithelial cells. These results indicate that the cell populations of the tracheal epithelium at late stage of pregnancy have essential features similar to those of adult. and show that the different steps of ciliogenesis could be identified.
Adult ; Basal Bodies ; Cilia ; Cytoplasm ; Epithelium* ; Fetus* ; Glycogen ; Goblet Cells ; Humans* ; Membranes ; Organelles ; Phenobarbital ; Pregnancy ; Trachea

Primary chondrosarcoma of the lung is an extremely rare tumor, and classified into two types, tracheobronchial & lung variety. The tracheobronchial variety is usually localized and lacked lymph nodal or distant spread with good prognosis. The lung variety tends to be more invasive associated with mediastinal lymph node involvement and thoracic metastasis. Authors experienced a case of primary chondrosarcoma, lung variety, of the lung involving left lower lobe with thoracic metastasis, not yet reported in Korean literatures. The patient was 55-year-old Korean female and chief complaints were cough, dyspnea & chest pain. Pathologically, it was confused with the metastatic adenocarcinoma in the first pleural fluid cytology. But bronchoscopic biopsy revealed typical morphology of chondrosarcoma with concentric growth encircling the bronchial tree and partial destruction of the bronchiols, suggesting its primary origin. Later pleural biopsy and aspiration materials during ches tube insertion revealed also metastatic chondrosarcoma. Radiologic studies were also campatible findings to chondrosarcoma. After admision, the patient underwent progressively downhill course & expired at 31st hospital day.
Female ; Humans ; Adenocarcinoma ; Biopsy ; Neoplasm Metastasis

Thymic cyst is relatively rare tumor which usually occurs in the neck or mediastinum. Cervical thymic cyst is usually situated laterally and deep to the anterior border of the sternocleidomastoid muscle, simulating a branchial cyst. Thymic cyst of the mediastinum is usually detected incidentally and differential diagnoses include cystic degeneration of thymoma, and cystic teratoma. Two case of a cervical and a mediastinal thymic cysts were reported. The one was a cervical thymic cyst developed slowly growing mass in a 53-year-old male a for 10 years. The cyst was unilocular and measures 5.4x2.9x2.8 cm with columnar or squamous cell linings. The other is a mediastinal thymic cyst developed in a 37-year-old female with chest discomfort for 7 months. The cyst was uniocular and measures 2.8x2.2x2.0 cm. The epithelial lining of the cyst was largely desquamated and covered by macrophages with cholesterol granuloma. Involutional thymic stissue in their walls were noted in both cysts. In both cases presence of thymic tissue in the wall of the cyst thought to be the most important diagnostic feature.
Female ; Male ; Humans ; Diagnosis, Differential ; Cysts