In order to discover difference that may exist in quantity of medical care services, length of stay and hospital changes between insured and non-insured patients, records for primary Cesarean section patients discharged between July 1978 and June 1980 from a university hospital were examined. In addition, Cesarean section rates among the total deliveries for a two-year period between the groups were studied. The results showed that volume of services was greater and length of stay was longer among the insured, however, charges were higher among the non-insured. Cesarean section rates were statistically significantly different between insured and non-insured patients for every age group except the group of 35 or more.
Cesarean Section* ; Female ; Humans ; Length of Stay ; Pregnancy

To assess the proportion of spectacles-wearing and an aspect of familial aggregation of myoptic spectacles-wearing and to observe the birth cohort for myoptic spectacles-wearing, a nationwide self-administered questionnaire survey was conducted from March 11 to September 19, 1985. A probability sample of 13,346 persons was taken from 180 enumerated districts designated by the fifth nationwide tuberculosis prevalence survey from Korean Institute of Tuberculosis. The major findings of this survey are as follows: 1) Total of 62.5% of the study population lived in urban area whereas 37.5% lived in Eup-Myun area. There was statistically significant difference in age and sex distribution between two residential area. 2) The percentage of spectacles-wearing was 8.3% and among these, myoptic and hyperoptic spectacles were 6.0%, 2.3%, respectively. A total of 8.8% of the male study population wore spectacles and this was slightly higher than the female (8.0%). 3) Among the occupational groups, students were the highest myoptic spectacles-wearing group whereas professionals were the highest hyperoptic spectacles-wearing group. 4) The proportion of myoptic spectacles-wearing was higher in female students than in male students respectively 11.6%, 8.7%. There was an increasing tendency of spectacles-wearing as age increased. 5) The age-sex adjusted prevalence rate of myoptic spectacles-wearing by residential areas was 2 times higher in urban area than Eup-Myun area. 6) A wearing of the myoptic spectacles in early age was observed in recent birth cohort than remote birth cohort. 7) There was a tendency of familial aggregation for myoptic spectacles-wearing. The proportion of myoptic spectacles-wearing was 6 times higher for those who had parents wearing spectacles. 8) 60.9% of the total myoptic spectacles-wearing persons received the eye-specialist's order and 44.9% for the hyperoptic spectacles wearing.
Cohort Studies ; Eyeglasses ; Female ; Humans ; Korea* ; Male ; Occupational Groups ; Parents ; Parturition ; Prevalence ; Surveys and Questionnaires ; Sampling Studies ; Sex Distribution ; Tuberculosis

PURPOSE: Scanning laser ophthalmoscope (SLO) has improved Infrared (IR) imaging. Since greater penetration of IR light permitted better visualization of subretinal structures, we evaluated chorioretinal layer in various chorioretinal dieases with SLO. METHODS: Cases of central serous chorioretinopathy (CSC), drusen, age-related macular degeneration (AMD), Vogt-Koyanagi-Harada disease, MEWDS (multiple evanesant white dot syndrome) and inflammatory choroiditis, toxoplasmosis, Stargardt's disease, proliferative diabetic retinopathy (PDR) and submacular hemorrhage were included. We used SLO (101, Rodenstock, Germany) for IR image and compared argon laser image with monochromatic IR image (780 nm wave length). RESULTS: The demarcation and extent of serous retinal detachment and macular star were more distinct in IR image. Small drusen, subretinal deposit and RPE atropy which could not be seen in argon green laser image were visible and appeared brightly with high reflectance in IR image. The CNV membrane which was not seen in full extent in argon laser image were observed completely in IR image. In case of inflammatory choroiditis, patch-like hot spot with surrounding high reflectance was observed in IR image. The subretinal structures and new vessels were clearly visible in IR image despite overlying thick preretinal fibrous prolifertive membrane and vitreous hemorrhage. CONCLUSIONS: The IR image using SLO is a fast and non-invasive diagnostic tool. Compared to fluorescein angiography, IR image gave a improved image for subretinal structure and additional information. Therefore IR imaging is recommended along with clinical symptom, FAG, ICGA for the diagnosis and treatment.
Argon ; Central Serous Chorioretinopathy ; Choroid ; Choroiditis ; Diabetic Retinopathy ; Diagnosis ; Fluorescein Angiography ; Hemorrhage ; Macular Degeneration ; Membranes ; Ophthalmoscopes ; Retina ; Retinal Detachment ; Toxoplasmosis ; Uveomeningoencephalitic Syndrome ; Vitreous Hemorrhage

PURPOSE: Kinetic automated perimetric tests were performed with OCTOPUS 101 perimeter using Goldmann module. Normal isopter positions in the peripheral visual field were visualized by the average position +/- 2 standard deviations. METHODS: We examined 102 eyes of 51 normal healthy Koreans who had no family history of glaucoma, no specific ophthalmologic disease, best corrected visual acuity more than 1.0 and normal intraocular pressure less than 21 mmHg with OCTOPUS 101 perimeter using Goldmann module in 5 isopters (I1e, I2e, I3e, I4e, II4e) at 8 meridians (0degree, 45degrees, 90degrees, 135degrees, 180degrees, 225degrees, 270degrees, 315degrees). RESULTS: The visual field was oval shape, and widest at the inferotemporal area, followed by temporal, and inferior. CONCLUSIONS: The normal position of 4 isopters can be used as a reference index for the peripheral visual field test.
Glaucoma ; Humans ; Intraocular Pressure ; Meridians ; Octopodiformes* ; Visual Acuity ; Visual Field Tests ; Visual Fields* ; Vitelliform Macular Dystrophy

Purpose: To determine whether the clinical features of intermittent exotropia (IXT) needing muscle surgery were different in the ophthalmologist-detected and non-specialist-detected groups (including parents). Methods: Medical records of 218 children (mean age: 5.9 ± 1.4 years) with IXT of ≥ 20 prism diopters (PD) were reviewed retrospectively. The angles of deviation were measured using the prism and alternate cover test and assessed by two ophthalmologists using photographs with a translucent occluder (photographic angle). The IXT subtype, fusional control, stereopsis, suppression, and spherical equivalent (SE) were compared between the ophthalmologist-detected and non-specialist-detected groups. Results: Mean 25.8 ± 6.8 PD of distant angle of IXT was first detected by the ophthalmologist in 41 patients (18.8%) and the non-specialists in 177 patients (81.2%). The deviated eye was more myopic in the ophthalmologist-detected than non-specialist- detected group (-0.77 ± 1.59 diopters [D] vs. -0.19 ± 1.48 D, p = 0.03). There were no other differences between the two groups. A comparison of 39 age- and non-dominant eye SE-matched pairs demonstrated that the measured angles for distant and near fixation were smaller in the ophthalmologist-detected than non-specialist-detected group (24.0 ± 6.8 PD vs. 28.5 ± 6.4 PD and 26.9 ± 6.6 PD vs. 31.0 ± 6.4 PD, respectively, p < 0.01), while the remaining characteristics, including the photographic angle, were similar. Conclusions In cases with small angles of deviation or myopia, IXT with angles requiring surgical correction were commonly first detected by ophthalmologists during examinations.

PURPOSE: To evaluate the relation between recovery of visual function and microperimetric fixation area in eyes with idiophthic macular hole after vitrectomy. METHODS: We used SLO (Scanning laser microscope, Rodenstock, Germany) microperimetry to examine foveal retinal function and fixation area in 14 eyes with idiopathic macular hole following pars plana vitrectomy. The relation between those preoperative and postoperative best corrected visual acuity and fixation area was studied. RESULTS: The macular hole size was correlated with preoperative visual acuity (p=0.026) and the closure of hole was related to the size of fixation area (p=0.003). The postoperative visual acuity was related to symptom duration before the vitrectomy (p=0.03), but not related to preoperative macular hole size. The fixation area correlated with the postoperative best corected visual acuity (p=0.043) and the direction of movement was variable. In most eyes, fixation area was located above the horizontal meridian. CONCLUSIONS: The fixation area was correlated with postoperative visual acuity and we think functional macular hole closure as well as anatomical closure were useful parameter of the success of macular hole surgery.
Ophthalmoscopes* ; Retinal Perforations* ; Retinaldehyde ; Visual Acuity ; Vitrectomy*

We have attempted to measure parafoveal retinal acuity directly on the exact retinal locus, while observing the retinal image in real time using the scanning laser ophthalmoscope(SLO 101, Rodenstock, Munish, Germany). By the SLO Visumetry software(Rodenstock v. 3.0), thirty eyes of healthy volunteers were examined in 20degrees image field. Using Snellen E as stimulus, the examination was performed from the fovea by the radial pattern. The maximal retinal distance point, which responded to stimulus, was recorded by the pixel, and the distance(mm) from the fovea was calculated by the Bennett formula. The maximum distance from the fovea at the given stimulus size was achieved as follows: 0.32+/-0.01mmat the 15 x15 arc of minute(0.333), 0.63+/-0.01mm at the 17 x17 arc of minute(0.294), 1.05+/-0.03 mmat 20 x 20 arc of minute(0.25), and 1.44+/-0.0 5 mmat the 23 x23 arc of minute(0.217). It was also revealed that the horizontal maximal distance from fovea at given stimulus size was statistically superior to the vertical maximal distance(p<0.05). In conclusion we were able to establish the normal range of parafoveal retinal acuity in healthy volunteers. It may serve as the baseline for subsequent study of retinal pathology and functional evaluation as well as its treatment.
Healthy Volunteers* ; Pathology ; Reference Values ; Retinaldehyde* ; Visual Acuity*

Fundus perimetry is the device that provides visualization of the fundus and the precise localization of the stimuli on it. With the increasing importance of the direct fundus perimetry for certain focal retinal morphologic abnormalities, the scanning laser ophthalmoscope[SLO]has been utilized as a system to eliminate some of the classic technical problems in fundus perimetry. The aim of this study was to evaluate the normal light sensitivity values for microperimetryusing SLO system. Thirty eyes of thirty normal subjects were examined in 60 degrees image field using stimuli of variable intensity. The maximal retinal distance point which responded to stimulus was recorded, point which responded to stimulus was recorded, and the distance[millimeter]from the fovea was calculated by the Bennett formula. The maximum distance from the fovea at the given stimulus intensity was measured as follows :0.7596 +/-0.5262millimeter at 28decibel, 2.2050 +/-0.5878millimeter at 26decibel, 3.0571 +/-0.7151millimeter at 24decibel, 4.3690 +/-1.0973millimeter at 22decibel, and 5.6557 +/-1.3458millimeter at 20decibel. In conclusion, we were able to establish the normal range of light sensitivity in Microperimery examination. It may serve as the baseline for subsequent study of retinal pathology and functional evaluation as well as its treatment.
Ophthalmoscopes* ; Pathology ; Photophobia ; Reference Values* ; Retinaldehyde ; Visual Field Tests

PURPOSE: We compared the clinicopathologic effects of TTT between pigmented and albino rabbits. METHODS: TTT was delivered using infrared diode laser at 810 nm(Iris Medical Instrument, Mountain Veiw, CA, USA) and applied with spot size of 3 mm, duration of 60 seconds. At 1 week and 4 weeks after TTT, fundus photographs and simultaneous FAG/ICG angiogram were taken with SLO(Scanning Laser Ophthalmolscopy, Rodenstock, Munish, Germany). Light and electron microscopic examination were performed. RESULTS: In pigmented rabbits, visible funduscopic change was visible even with minimal power setting(100 mW). Obliteration of choroidal vessels was observed on ICG angiogram. In microscopic examination, entire layers of neural retina, retinal pigment epithelial cells, and deep choroid were severely damaged at the center of treated fields. Whereas, in albino rabbits fundus changes were not observed at any power setting. However, focal thrombosis at margin of lesion was identified on ICG angiogram after power of 300 mW. In microscopic examination, tissue damage was developed up to 600 mW and the lesion extended into the superficial choroid posteriorly and outer neural retina anterioly. CONCLUSIONS: The effect of TTT was increased with fundus pigmentation. Clinically we should adjust TTT power setting according to the amount of melanin pigmentation in the fundus.
Choroid ; Epithelial Cells ; Lasers, Semiconductor ; Melanins ; Pigmentation ; Rabbits ; Retina* ; Retinaldehyde ; Thrombosis

In this study, the number of physicians presently living in Korea thoroughly estimated by several means and, on this bases, their productivity and level of supply were estimated. The results were as follows : First, the number of physicians who did not notify the Korea Medical Association in May 1987 were 10,110, including 4,093 emigrant physicians(40.5%), 861 military medical officers, 745 public health doctors, and 107 decreased physicians. A total of 1,330 physicians could not be identified by any effort. Second, among the 34,897 registered physicians as of May 1987, 29,933(85.8%) were residing in Korea, 4,115 physicians(11.8%) had emigrated to other countries, and 849 physicians(2.4%) were decreased. Practicing physicians defined as those in Korea who were not retired, serving in the military, or completing residencies or internships, comprised 78.6%(27,414 physicians) of the total number of registered physicians. Third, it is estimated that in the year 2000 the number of registered physicians, physicians residing in Korea, and practicing physician will be 75,040, 64,038 and 57,655, respectively and these are increases of 115.0%, 113,9%, and 110.3%, respectively, compared to 1987. Fourth, the population physician ratio will be 759 to one physician in the year 2000. Fifth, the productivity of physicians, as calculated by relative values defining the productivity of 35 to 44 year-old male physicians as 10, will increase 110.7% in the year 2000 compare to that of 1987, and this increment is almost the same level as that of physicians supply. From the results of the present analysis of physicians manpower and supply projection, it can be recognized that the development of a regular notification system is necessary in order to identify precisely the number of physicians. Also a policy a physician supply is essential in order to adjust in advance the number of physicians, otherwise there will be surplus to the medical demand.
Adult ; Efficiency ; Emigrants and Immigrants ; Humans ; Internship and Residency ; Korea* ; Male ; Military Personnel ; Public Health