OBJECTIVES: The purposes of this study were to examine the status of children and adolescents with regard to enrollment in private medical insurance (PMI) and to investigate its influence on their utilization of medical services. METHODS: The present study assessed 2973 subjects younger than 19 years of age who participated in five consecutive Korea Health Panel surveys from 2009 to 2012. RESULTS: At the initial assessment, less than 20% of the study population had not enrolled in any PMI program, but this proportion decreased over time. Additionally, the number of subjects with more than two policies increased, the proportions of holders of indemnity-type only ('I'-only) and of fixed amount+indemnity-type ('F+I') increased, whereas the proportion of holders with fixed amount-type only ('F'-only) decreased. Compared with subjects without private insurance, PMI policyholders were more likely to use outpatient and emergency services, and the number of policies was proportionately related to inpatient service utilization. Regarding out-patient care, subjects with 'F'-only PMI used these services more often than did uninsured subjects (odds ratio [OR], 1.69), whereas subjects with 'I'-only PMI or 'F+I' PMI utilized a broad range of inpatient, outpatient, and emergency services relative to uninsured subjects (ORs for 'I'-only: 1.39, 1.63, and 1.38, respectively; ORs for 'F+I': 1.67, 2.09, and 1.37, respectively). CONCLUSIONS: The findings suggest public policy approaches to standardizing PMI contracts, reform in calculation of premiums in PMI, re-examination regarding indemnity insurance products, and mutual control mechanisms to mediate between national health insurance services and private insurers are required.
Adolescent ; Ambulatory Care/*utilization ; Child ; Child, Preschool ; Female ; Health Surveys ; Humans ; Income ; Infant ; Infant, Newborn ; Insurance, Health/economics/*statistics & numerical data ; Male ; Medically Uninsured ; Odds Ratio ; Republic of Korea

OBJECTIVES: This study investigates the effects of using customized walking aids individualized for stroke patients by measuring the effects of different cane lengths to determine the ideal length of walking aids for stroke patients. METHODS: Cane lengths were determined from the greater trochanter with walking aids measured 5cm below, at the greater trochanter and 5cm above. All patients walked for ten meters with each cane length to measure speed. Then, we measured the opto gait, timed up go test, and electromyography three times each. Statistical analysis was performed using a linear mixed model, and in the case of significance, the p-value was corrected using the Bonferroni method. RESULTS: There was a statistically significant differences in time up and go test(TUGT), 10m walking, stride and speed between the groups. CONCLUSIONS: Long cane length increases body symmetry, stride, increasing muscle activity, and short cane length increases balance and walking.
Canes* ; Cerebrovascular Disorders ; Electromyography ; Femur ; Gait ; Humans ; Methods ; Stroke* ; Walking*

OBJECTIVES: This study was performed to examine the sugars intake through processed foods and its related factors in college students. METHODS: The findings of this study was based on the data obtained from the self-administered questionnaire survey of the sugars intake through processed foods. The self-administered questionnaire survey was conducted among 245 college students between March and April, 2015. RESULTS: The amount of sugars intake through processed foods was 45.9g in male collegians and 47.1g in female collegians. In the bivariate analysis, the amount of sugars intake was significantly different by department of major, current smoking status, subjective health status in female collegians (p<0.05). In the multivariate analysis, the amount of sugars intake was related significantly with current drinking status, sleeping time, degree of depression in male students and student's department of major, current smoking status, whether or not of snack intake in female (p<0.05). CONCLUSIONS: The program for college students to decrease the sugars intake through processed foods would be necessary, especially in student of non-health department.
Carbohydrates* ; Depression ; Diagnostic Self Evaluation ; Drinking ; Female ; Humans ; Male ; Multivariate Analysis ; Smoke ; Smoking ; Snacks

No abstract available.
Pyelonephritis, Xanthogranulomatous* ; Wilms Tumor*

Amiodarone is a potent antiarrhythmic agent and can cause potentially life-threatening pulmonary fibrosis. Of the numerous side effects associated with amiodarone therapy, lugn toxicity is one of the most serious adverse reactions. Recently, we experienced a case of amiodarone-induced pulmonary toxicity (APT), which induced severe dyspnea and productive coughing, confirmed by cytologic and electron microscopic examination of the bronchoalveolar lavage (BAL). The symptoms and abnormalities in the chest X-ray were improved after the withdrawal of amiodarone. Cytologic examination of the BAL revealed numerous foam cells with cytoplasmic vacuoles or small particles. Ultrastructurally, the foam cells demonstrated characteristic lysosomal inclusions, which were electron-dense multilamellated bodies, crystalloid bodies, and mixed forms with small lipid vacuoles. It is strongly suggested that only cytologic and electron microscopic examination of the BAL without open lung biopsy is enough for diagnosis of APT, when APT is clinically suspected in a patient who has a history or ingestation of amiodarone.
Amiodarone ; Biopsy ; Bronchoalveolar Lavage* ; Cough ; Cytoplasm ; Diagnosis ; Dyspnea ; Foam Cells ; Humans ; Lung ; Microscopy, Electron ; Pulmonary Fibrosis ; Thorax ; Vacuoles

We present the case of a 7 year-old child who underwent angioplasty with a stent for anastomosis site stenosis between a left subclavian artery free graft and the left main coronary artery in an arterial switch operation.
Angioplasty* ; Child* ; Constriction, Pathologic ; Coronary Vessels ; Humans ; Stents* ; Subclavian Artery ; Transplants ; Transposition of Great Vessels

No abstract available.

OBJECTIVE: We compared a few variables such as the type of needle, the direction of bevel, and the effect of stimulation duration in percutaneous peripheral nerve blockade. We also studied the real distribution of injected drug through nerve biopsy. METHOD: The sciatic nerve-tibialis posterior muscle preparation of rabbit was chosen as a model. Experimental rabbits were divided into 3 groups: Group 1 (16 legs), use of insulated needle and 100 microsecond stimulation duration; Group 2 (9 legs), use of insulated needle and 240 microsecond stimul ation duration; Group 3 (6 legs), use of uninsulated needle and 100 microsecond stimulation duration. The mixed solution, 0.1 cc, of 5% phenol and indian ink was injected in 10 legs and the muscles were obtained to observe the spreads of injected solution after 2 weeks. RESULTS: The minimal stimulation currents of group 1, 2, 3 were 0.49 mA, 0.37 mA, 2.07 mA, respectively. The distance between needle and sciatic nerve sheath of group 1, 2, 3 were 0.09 mm, 0.11 mm, 0.20 mm in width, and 1.84 mm, 3.33 mm, 4.50 mm in depth, respectively. The current required to stimulate the nerve increased rapidly as the tip of the insulated needle passed the nerve, and the direction of bevel had no effect on the minimal stimulation current. Injected indian ink was located alongside the perineurium. CONCLUSION: In three methods, the most exact method was the use of insulated needle and 100s stimulation duration. The needle tip was located 1.84 mm past the nerve.
Biopsy ; Ink ; Leg ; Muscles ; Needles ; Nerve Block ; Peripheral Nerves* ; Phenol ; Rabbits ; Sciatic Nerve

PURPOSE: Hypernatremia most frequently occurs in the immature newborn and be severe in association with intraventricular hemorrhage (IVH). This study examined the frequency, onset and risk factors of hypernatremia, and the relationship between hypernatremia and IVH in very low birth weight (VLBW; <1,250 g) infants. METHODS: We retrospectively reviewed the medical records of 55 VLBW infants admitted between January 2006 and December 2009 to the neonatal intensive care unit of Wonkwang University Hospital and who survived over 7 days. Serum sodium concentration, sodium intake, fluid and weight loss, as suggested risk factors of hypernatremia, and the incidence of IVH were evaluated. The infants were divided into a hypernatremia group (> or =150 mEq/L) and nonhypernatremia group, and were compared. RESULTS: Incidence of hypernatremia in the VLBW infants was 52.7%, and mean starting time of hypernatremia was 2.8+/-1.3 days. There were no differences in the sodium and fluid intake between the two groups. Weight loss at day 3 after birth was significantly higher in the hypernatremia compared to the nonhypernatremia group (P<0.05); thereafter weight loss was non-significantly higher. The incidence of IVH in VLBW infants was 38.2%, and the difference between the two groups was not significant. CONCLUSION: Hypernatremia occurs commonly in VLBW infants and is most commonly caused by weight loss in the early days after birth. Incidence of IVH is not likely influenced by hypernatremia with marginally elevated sodium concentration.
Hemorrhage ; Humans ; Hypernatremia ; Incidence ; Infant ; Infant, Newborn ; Infant, Very Low Birth Weight ; Intensive Care, Neonatal ; Medical Records ; Parturition ; Retrospective Studies ; Risk Factors ; Sodium ; Weight Loss

Duodenal diverticulitis is a rare cause of upper abdominal pain and is usually not considered when evaluating patients with acute upper abdominal pain. Furthermore, the duodenum is located near the pancreas and bile duct, and duodenal diverticulitis can be misdiagnosed as acute pancreatitis, cholangitis, cholecystitis, or other pancreatobiliary disorders such as pancreatic cystic neoplasms. Recently, we experienced a rare case of duodenal diverticulitis in the 3rd portion of the duodenum. The patient presented with deep seated upper abdominal pain aggravated by supine posture and relieved by sitting up. The patient was initially diagnosed with acute pancreatitis. However, serum levels of pancreatic enzymes were normal and abdominal CT scan revealed diverticulitis in the 3rd portion of the duodenum. The patient was successfully managed conservatively. Delayed diagnosis of duodenal diverticulitis can result in substantial morbidity and mortality if duodenal perforation occurs and should be considered as a possible cause of upper abdominal pain.
Abdominal Pain* ; Bile Ducts ; Cholangitis ; Cholecystitis ; Delayed Diagnosis ; Diverticulitis* ; Duodenum* ; Humans ; Mortality ; Pancreas ; Pancreatic Cyst ; Pancreatitis ; Posture ; Tomography, X-Ray Computed