The onprovement of civil registration reguires continuous study rather than periodic efforts. More and better statistics, however, are urgently required to formulate development programs and planning, Data obtainable from the civil registration are usually marred by errors of omission which are difficult to correct. This study aimed at finding out the problems occurring when a set of crude birth registration data in a rural area is used. Data Sources of this study are : 1) For birth registration : government birth registration records obtained from myun office and other government offices. 2) for the actual number of births : birth and child records from the Kang Wha Community Health Project. The study area is Sunwon Myun and Naega Myun in Kang Wha Gun, Gyunggido. The reference period for the accumulated data is one full year : Jan. 1st 1975 - Dec. 31st 1975. Major findings are as follows : If the number of registered birth is compared with the actual number of births which occurred in the target area, the former os far greater than the latter. The general assumption usually is , that the actual number of exceeds the registered number of birth in Korea. The observation from this specific study in this specific target area, shows the opposite trend. The number of births which actually occurred during the year of 1975 in the study area namely 256. The difference comes mainly from the fact that many cases of births from other areas were registered in the target area. In other words birth is not registered where it occurred but where the permanent residence address is. Among 550 births registered in the target area 66% did not occur in the target area. Only one third of all registered births were registered within the legal period for birth registration which is 2 weeks. 34% of the registered births actually occurred in 1974, but were registered in 1975. In 55% of the cases a difference was observed between the actual data of birth and the registered data of birth. From the 256 births which occurred in the target area, only 153 births (59%) were registered at the myun office and the remaining 130 births (41%) were not resistered there in the year of study. 6% of the 550 cases listed as registered have no separate registration sheets. Nevertheless, they definitely have been registered in the birth list at the myun office. 3% of the 550 cases are not recorded in this list but have a separate registration sheet at the myun offices. In conclusion, birth registration data have many errors and problems. Their usefulness as a source for vital and other statistics should be reconsidered. A series of sound methological studies will be necessary to establish their actual usefulness. A continuous and permanent compulsory system of birth recording is needed.
Birth Certificates ; Child ; Humans ; Korea* ; Parturition* ; Information Storage and Retrieval

Extraosseous tuberculosis of the extremities is relatively rare even in the wide spread incidence of bone and joint tuberculosis. And few reports about extraosseous tuberculosis of the extremities have been published in the literatures. Eight cases of the extraosseous tuberculosis of the extremities were experienced at the Department of Orthopaedic Surgery, National Medical Center, from 1975 to Sep. 1979. Five out of 8 extraosseous tuberculosis were tenosynovitis and the others were bursitis in location. All cases were surgically excised and combined with antituberculous chemotherapy, and primarily cured.
Bursitis ; Drug Therapy ; Extremities ; Incidence ; Tenosynovitis ; Tuberculosis ; Tuberculosis, Osteoarticular

Ewing's sarcoma had never been described as a primary tumor outside bone, although other malignant skeletal tumors, such as osteogenic sarcoma & chondrosarcoma, are known to arise from extraskeletal soft tissues. In 1975, Angervall & F.M. Enzinger reported 39 cases of small, round or oval cell sarcomas occuring in the soft tissues and considered histologically indistinguishable from Ewing's sarcoma of bone. Recently, We experienced one case of extraskeletal neoplasm resembling Ewing's sarcoma of bone which it was located deeply in the calf area of young female patient and the case review has been followed until the death, approxlmately 10.5 months after removal.
Chondrosarcoma ; Female ; Humans ; Osteosarcoma ; Sarcoma ; Sarcoma, Ewing

Prosthetic replacement was performed in 31 patients (32 cases) with femoral neck fractures at National Medical Center from 1968 to 1981. We reviewed the records of 28 patients having Austin-Moore prosthetic arthroplasty in 29 cases, and of 3 patients having Thompson prosthetic arthroplasty; then obtained following results. l. Of the 31 patients, 23 were female and 8 were male. The left hip was involved in 20 patients, right in 10, and the both sides in one. 2. The age range was between 35 and 84 years, with the average age of 61.2 years. 74.2% of patients were older than 51 years of age. 3. The most common cause of fracture was slipping or fall (65.6%), and the fracture sites were subcapital in 11 (34.4%), transcervical in 12 (37.4%), and basilar in 3 (9.4%). 4. Three cases (9.4%) were operated within a week, and 21 cases (65.6%) more than 3 weeks after injury. Good results were obtained in fresh fracture which was operated within a week. 5. In comparing the blood loss in Moores and modified Gibson's surgical approaches, the average total loss by the former was 1,290 ml and 1,720 ml by the latter. 6. In complications, one case of fracture of the posterior rim of acetabulum with subsequent subluxation and two cases of fracture of the greater trochanter were notable as operative complicatiens. 7. In a follow-up study averaging 13.1 months, good to excellent results were obtained in 8 cases, fair in 6, poor or bad in 5, respectively.
Acetabulum ; Arthroplasty ; Female ; Femoral Neck Fractures ; Femur ; Femur Head ; Follow-Up Studies ; Hip ; Humans ; Male

Benign chondroblastoma of bone is a relatively rare primary bone tumor which develops in the 2nd to 3rd decade involving the epiphysis of the long bone. The over-all reported cases of the world have been lesser than 400 after determining the entity as benign chondroblastoma in 1942 by Jaffe and Lichtenstein. A case of the benign chondroblastoma with involvement of the greater trochanter of the femur of a 19 years old boy is presented. The conclusive diagaosis was led by histological examination. Considerable new bone formation and bony spicules which might be derived from previous multiple puncture made us to confuse with osteogenic sarcoma. The specimen was composed of reddish brown hemorrhagic and fragile tissue with scattered either yellowish gritty calcified material or bluish translucent ones. The postoperative course has been smooth and there has been no evidence of recurrence for postoperative 15 months.
Chondroblastoma ; Epiphyses ; Femur ; Humans ; Male ; Osteogenesis ; Osteosarcoma ; Punctures ; Recurrence

Painful stiff shoulder after trauma may be one of the difficult situation. Incomplete brachial plexus palsy may cause painful stiff shoulder. Symptoms and signs of this entity are vague. It is not rare to miss detecting subtle damage of the brachial plexus. We analysed these cases to identify specific clues on history and physical examination that help making the diagnosis of this entity. We have experienced 14 cases of incomplete brachial plexus palsy that showed painful stiff shoulder in Asan Medical Center from March 1995 to February 1996. All the charts and letters from primary care hospitals were reviewed. Initial diagnosis of the primary hospital, duration of delay of diagnosis after initial trauma, clues for the diagnosis in history and physical findings, patterns of the nerve injuries were analyzed. Average age was 48 years (from 25 to 84). Nine cases were male, and five cases were female. The most common primary diagnosis was proximal humerus fracture. Delayed diagnosis was the most remarkable feature. Average duration of delayed diagnosis was about three months (from one to thirteen months). Tentative diagnosis was made on the base of history and physical examination. The most frequent clue on the history was long standing painful stiff shoulder inappropriate to the initial diagnosis. The most common physical finding was tenderness at the brachial plexus area. Definite diagnosis was confirmed with electromyography. Careful history taking and thorough physical examination are essential for every shoulder injury. Incomplete brachial plexus palsy is one of the cause of painful stiff shoulder. It is important to keep in mind this entity to arrive correct diagnosis. Eletromyography should be done for the suspected cases.
Brachial Plexus ; Chungcheongnam-do ; Delayed Diagnosis ; Diagnosis ; Electromyography ; Female ; Humans ; Humerus ; Male ; Paralysis* ; Physical Examination ; Primary Health Care ; Shoulder*

Squamous cell carcinoma is a primary malignant tumor of the skin arising from the epidermis with etiology unknown, and chronie irritations are considered as predisposing factors such as prolonged exposure to sunlight, chronic ulceration of the scar, persistent draining sinus of the chronic osteomyelitis. Habitual pipe smoking and exposure to heavy metal or chemical agents are also thought to be contributing factors to produce this tumor. Orthopaedic surgeons are occasionally concerned in case of patients with squamous cell carcinoma developed in the extremities particularly arising from the persistent draining sinus of the chronic osteomyelitis. We reviewed 12 patients with squamous cell carcinoma in the extremities treated at National Medical Center between 1963 and 1975. All cases were definitely diagnosed clinically and histopathologically. 1) Male to female ratio was 11:1. Average sge of the patients was 52. 2) Farmer is predominant in incidence as 10 out of 12. 3) Sites of invoIvement were buttock and lower extremities in all cases. 4) Predisposing factors of the tumor were chronic skin ulceration in 7 cases, persistent draining sinus of chronic osteomyelitis in two and unknown in three cases. 5) Duration of the skin ulceration or draining sinus before producing tumor was considerably long between 10 and 30 years in majority of the cases. 6) Duration of newgrowth before operation was less than one year in 5, between one and two years in three, and more than two years in four cases. 7) Pre-operative chest X-ray was normal in all cases. However X-ray of the bones of affected limbs showed no bony change in two cases, and various bony changes in 10 cases such as periosteal reaction, cortical erosion, findings of pre-existing chronic osteomyelitis etc. In detail, two cases revealed direct infiltration and active bony destruction into the cortex and medulla by tumor mass. 8) We performed amputation or disarticulation at various levels in 5 cases, radical excision in 3 and biopsy in one case. 9) Within 6 months postoperatively, four cases showed local recurrence of newgrowth as well as metastasis to the lung concomitantly. Three of them were the cases of radical resection. One of them developed distant metastasis to the clavicle.
Amputation ; Biopsy ; Buttocks ; Carcinoma, Squamous Cell ; Causality ; Cicatrix ; Clavicle ; Disarticulation ; Epidermis ; Epithelial Cells ; Extremities ; Farmers ; Female ; Humans ; Incidence ; Lower Extremity ; Lung ; Male ; Neoplasm Metastasis ; Osteomyelitis ; Recurrence ; Skin ; Skin Ulcer ; Smoking ; Sunlight ; Surgeons ; Thorax ; Ulcer

No abstract available.
Child* ; Dehydration* ; Humans

The purpose of this study is to investigate the effect of the ball-cone contact interface variation on the ceramic ball stress which is the dominant factor of the design of the moldular artificial hip joint. A contact stress analysis problem is formulated using the optimization principle and finite element analysis technique on the ball-cone system of three dimensional axi-symmetrical model, Numerical procedure is employed to get the solution for varying angles of cones and angular mismatches between the ball and cone interfaces. There is a fair amount of friction in the interface and included in the analysis model.
Ceramics ; Finite Element Analysis ; Friction ; Hip Joint ; Hip

Reorganization of myun health care service is one of the main issues in health care delivery in rural Korea. The fundamental, concept of the role and function of the myun health subcenter is that it is the basic unit of rural health care service and is to provide comprehensive health care service through the integration of curative and preventive services. The aim of this study is to analyze the patterns of curative activities in the myun health subcenter in terms of the most prevalent types of diseases, necessary diagnostic methods and required equipment, types of treatment, necessary drugs and materials, and finally the cost of curative services. The population on which this study was done was the 1596 patients who visited the two myun health subcenters (Sunwon Myun and Naega Myun) in Kang Hwa County, the area of the Yonsei University Community Health Teaching Project, during period from May 1, 1975 to June 10, 1976. For the patient's record in the clinic, problem oriented medical records were used. Decisions regarding the disease classification, the diagnostic methods used and selection of the most appropriate and adequate medical treatment were made by a group of three experienced physicians after reviewing the medical records which had been written by public physicians who were treating patients in the study area. The records were reviewed by resident staff members of the Department of Preventive Medicine, of Yonsei University College of Medicine. A brief summary of results of the study is as follow: 1. 29.9% of the patients who visited the clinics were ages between 0-4. No sex difference was observed among patients less than 20 years of age. However, among patients over 20 years old, females predominated. Thus it is evident that the majority of patients were either children or mothers and grandmothers. 2. The distance from the individual villages to the myun health subcenter was one of important factors in determining the ratio of clinic visits. However, other factors such as the activities of the health workers also affected the rates substantially. 3. The most common 25 diseases comprised 90.2% of all the diseases recorded. Acute respiratory infection (25.5), skin (12.7%), diarrheal diseases (6.8%), neuralgia and back pain (4.9%) and all other injuries (3.9%) were the five most common diseases. 4. Of all the diseases diagnosed and treated, 9.2% required simple laboratory tests for diagnosis, 6.5% required X-ray examination, and altogether 13.6% required either laboratory test of X-ray examination. 5. Treatment and management of 42.0% of the cases could be accomplished with simple, inexpensive drugs, 12.8% required the use of more expensive drugs (mostly antibiotics) and injections were required in 19.7% of the cases. Minor surgery and referral were necessary in 5% of the cases. 6. The cost for diagnosis and treatment was estimated with a standard which was set by general concensus. The average cost of diagnosis was 144 per case and the cost of treatment was 726 per case. The total average cost per visit was 870.
Ambulatory Care ; Back Pain ; Child ; Classification ; Comprehensive Health Care ; Delivery of Health Care ; Diagnosis ; Female ; Humans ; Korea ; Medical Records ; Medical Records, Problem-Oriented ; Mothers ; Neuralgia ; Preventive Medicine ; Referral and Consultation ; Rural Health ; Sex Characteristics ; Skin ; Surgical Procedures, Minor ; Young Adult