According to the need for objectivity and convenience the whole planning process is devided into a secries of 8 systematic stages. But it is an unending upward spiral of incremented efforts toward improvement. So many activities should be carried out concurrently, providing a mutual supportive flow back and forth between various stages of the process depending on local conditions and requirements. The eight stages are : (1) Planning the Planning and Developing Planning competence, (2) Statements of Policy and Broad Goals, (3) Data Gathering, (4) Priority Statement, (5) Statement of Major Alternative Proposals, (6) Development of Detailed Plan, (7) Implementation as a Part of the Planning Process, (8) Evaluation. The frame and function of the planning machinery must be adjusted to local conditions, and also flexibility is desirable, especially at the start, when adaptations are more necessary and more frequent.
Mental Competency ; Pliability ; Regional Health Planning*

No abstract available.
Chungcheongnam-do* ; Family Planning Services* ; Humans

Monosymptomatic enuresis(bed-wetting without other symptoms) is a common problem in children, affecting 15% of five-year-olds and occurring more frequently in boys than in girls. Because it is usually caused by a physiologic maturational delay, the prevalence decreases with age. Children with enuresis have a small bladder capacity. Failure to awake to the micturition urge is not necessarily related to being a "deep sleeper", and children with enuresis may pass urine involuntarily because of the immature central nervous pathways. As the CNS pathways matures with age, most children are more easily aroused from sleep. There is strong evidence of a genetic predisposition for enuresis. Children with enuresis must be evaluated to reveal any underlying physiologic conditions or disease states, such as urinary tract infection or structural abnormality. Once these are ruled out, the goal is to stop the bed-wetting while preserving the child's self-esteem. However, before treatment of enuresis, concurrent problems, such as daytime enuresis and urgency or chronic constipation, should be managed. For the treatment of enuresis, the child wears a moisture alarm-a small, portable, transistorized device-to bed. The alarm sounds or vibrates when wet, awakening the child. Drug therapy for enuresis includes desmopressin, which decreases the urine volume, and imipramine and oxybutynin, which inhibit bladder contraction. Both delayed urinary control and current enuresis are associated with a markedly increased risk of behavioral, emotional, and academic problems.
Child ; Constipation ; Deamino Arginine Vasopressin ; Drug Therapy ; Enuresis* ; Female ; Genetic Predisposition to Disease ; Humans ; Imipramine ; Prevalence ; Problem Behavior ; Urinary Bladder ; Urinary Tract Infections ; Urination

BACKGROUND AND OJBECTIVES: Nystagmus produced by static placement of the head in different orientations is termed positional nystagmus and in most instances the cause is a peripheral vestibular disorder, as in benign paroxysmal positioning vertigo (BPPV). However, the physiologic basis of the isolated positional downbeat nystagmus has not been fully understood. The goal was to find a possible pathomechanism of dizzy patients who showed isolated positional downbeat nystagmus (pDBN). MATERIALS AND METHOD: Twelve consecutive patients with isolated positional DBN and 50 normal volunteers underwent evaluation of spontaneous, head-shaking and positional nystagmus, smooth pursuit, saccades, and VOR. The patients with focal neurologic signs, abnormal hearing, caloric paresis or acute lesion on brain imaging were excluded. RESULTS: Positional downbeat nystagmus was developed during lying down, straight head-hanging and/or Dix-Hallpike position. Perverted head-shaking nystagmus was observed in seven patients (58.3%). Gait disturbance revealed in six patients. Other cerebellar manifestations including saccadic dysmetria and gaze-evoked nystagmus were not observed. The gains of VOR were increased than normal controls. However, the gains of visual enhancement and visual cancellation of the VOR were not different from controls and OKN/OKAN were normal. The mean VOR time constants did not differ between patients and normal controls. However, tilt suppression of the post-rotatory nystagmus was impaired in the patients (p<0.01). All patients showed normal findings in head thrust test, caloric response, BAEPs, and brain imaging. CONCLUSION: Isolated positional downbeat nystagmus (pDBN) in patients complained intermittent dizziness showed frequently accompanied perverted head-shaking nystagmus (HSN) and increased gain of VOR and impaired tilt suppression. This finding tells us that isolated positional downbeat nystagmus (pDBN) reflects pathologic central nystagmus results from cerebellar (uvulonodular) dysfunction.
Cerebellar Ataxia ; Deception ; Dizziness ; Gait ; Head ; Head Impulse Test ; Healthy Volunteers ; Hearing ; Humans ; Neuroimaging ; Neurologic Manifestations ; Nystagmus, Physiologic* ; Paresis ; Pursuit, Smooth ; Reflex, Vestibulo-Ocular ; Saccades ; Vertigo

Medical images wit high resolution are coded to be archived communicated in PACS. In this pater, we have studied on coding of Cardio-Angiography. Our coding technique is method is Subband-Vector Quantization. This technique is irreversible coding method. This technique's objects are removing blocking artifact and edge degradation, adapting for drastic image change because of dye injection, and fast decoding, We achieved good results for Cardio-Angiography data, but the study on more sophisticated motion estimation techniques and VQ techniques must be performed.
Artifacts ; Clinical Coding* ; Statistics as Topic

BACKGROUND: It is expected that the demand for the information about the primary medical service in the forthcoming supersede age of communication will be on the increase. For that reason, family doctors who are in charge of the primary medical service have to play an important part in constructing a data-base for furnishing the medical information. This article presents a model which includes the roles of family doctors, constructing medical-related information site of family medicine in the communications net with PC to gat,her fundamental data in operating the system of medical information and elucidating the formation of medical-related information site and the effect of operating that system. METHODS: Since Aug. 20 in 1996, the site of family medicine, the program of medical information, has been set up in Unitel. The medical information of the site of family medicine is to be classified into two parts : for doctors and for the public. The former is composed of medicine documents, several kinds of medical data, a linkage with medicine site in Internet, movements of an academic society and information exchanges for friendship. The latter is mainly made up of some practical medical sense and medical counsel. RESULTS: From the opening the medical information site to Jul. 30 in 1997, 250 persons a day have connected with medical information site and this fact implied 15 hours connection a day in terms of the daily mean. The cases of health counsel averaged 6 cases connection a day and the annual statistics of those cases were about, 1980 cases. The major content of health counsel was related to common symptoms that could be settled in primary medical problem. According to the survey for connectors, most of connectors answered that the medical information through communications net was much more effective t.han that from other media in the educational aspects and very helpful in the prevention of diseases and in the medical expenditure. Above all, the medical information through communications net was very effective in correcting the mistaken practical medical sense. CONCLUSIONS: It is necessary for family doctors to give thought to the connection of both information communication and medicine and to have correct understanding of medical domain in the cyberspace. On the foundation of these necessities, all the family doctors have to make the best of their way to construct a database with rnedical data and to transfer these data into the computer sites.
Friends ; Health Expenditures ; Humans ; Internet

No abstract available.
Child* ; Glomerulonephritis* ; Humans ; Nephrotic Syndrome* ; Plasma* ; Renin*

Adhesive forces between the retina and the retinal pigment epithelium, which is mainta ined by active mechanisms unique for living animals, deteriorates rapidly after death and leads to spontaneous retinal detachment. Change of retinal adhesiveness in rabbits after death was investigated using a new method. Retinal detachment was induced by applying various levels of aspiration power from 0 to 1OO mmHg to the vitreous cavity using a vitrectomy instrument immediately after the rabbit was killed without enucleation. And the time required for creating the retinal detachment was measured. Retinal adhesiveness deteriorated and spontaneous retinal detachment occurred 28 minutes and 35 seconds after death confirming the active adhesion between the retina and the retinal pigment epithelium before death Increase of aspiration power led to shortening of time required for creating retinal detachment. From aspiration powers of 0 to 100 mmHg, the common logarithm of time required for retinal detachment was inversely proportional to the aspiration power [IogY = 1.45215 - 0.01113X, (R2=0.99041), X: aspiration power (mmHg), Y: time required for creating retinal detachment (minutes)]. Thus, presumed time of retinal detachment could be estimated between the aspiration powers of 0 to 100 mmHg.
Adhesiveness ; Adhesives* ; Animals ; Postmortem Changes* ; Rabbits ; Retina* ; Retinal Detachment ; Retinal Pigment Epithelium* ; Retinaldehyde* ; Vitrectomy

No abstract available.
Multiple Endocrine Neoplasia*

A flow cytometric analysis of the nuclear DNA content of solid tumors using paraffin-embedded tissues has become available since 1983, and its ploidy pattern has been designated as an important prognostic parameter in many human tumors. Hepatocellular carcinoma(HCC) is one of the most common malignant tumors among Koreans, but little information is consolidated about the significance of ploidy pattern. We measured the nuclear DNA content of 62 surgically resected HCCs and 45 non-neoplastic tissues from the surrounding parenchyma by flow cytometry. Aneuploid was detected in 18 cases(29.0%) in HCCs and 2 cases(4.4%) in nonneoplastic hepatic parenchyma(p<0.005). Correlations between the DNA ploidy pattern and various clinicopathologic findings of HCCs were analized. The mean tumor size was significantly different(p<0.05) between the aneuploid group(8.8 cm) and the diploid group(6.1 cm). Mean age of the aneuploid group was younger(47 year) than the diploid group(51 years), but the difference was not statistically significant(p=0.052). The DNA pattern did not show any meaningful correlation with the gross and microscopic features of HCC except for the presence of capsule. These results suggest that DNA ploidy correlates with growth rate of the tumor and it may be a possibly useful prognostic factor in HCCs.
Humans ; Carcinoma, Hepatocellular