This study aims to find factors that affect variations in cesarean section frequency rates among OBGY clinics in Metropolitan areas. The factors include patient, medical supplier characteristics and economic factors. This study is a cross-sectional analysis using health insurance delivery claims from July to December 2000 and files of the NHIC(national health insurance corporation). Multiple regression was used to analyze the dependent variable of cesarean section frequency rate at each clinic. The results are as follows : Cesarean section frequency rate is increasing in proportion to the number of the following patients : repeated caesarean section, disproportion, obstructed labour, fetal distress, emergency caesarean section and self-employed patients. There are geographic variations as well. Cesarean section frequency rates are higher in Inchon and Gyonggi province than in Seoul. The higher number of total delivery the clinic has, the lower rate of cesarean section it has. Clinics with high frequency rates in 1999 showed higher rates the next year. Further research is required to develop evidence based delivery modes and change strategies for increasing normal delivery and activating midwife clinics.
Cesarean Section* ; Cross-Sectional Studies ; Emergencies ; Female ; Fetal Distress ; Humans ; Incheon ; Insurance, Health ; Midwifery ; Pregnancy ; Seoul ; Small-Area Analysis

INTRODUCTIONHyperlipidaemia is a major risk factor for coronary artery disease (CAD). Its effective treatment has been shown to reduce the incidence of cardiovascular events, both in secondary and primary prevention. An essential component of risk factor management at the community level is public awareness and knowledge of treatment benefits. However, this data is limited in Singapore.

METHODSA cross-sectional survey questionnaire of public perception and knowledge on cholesterol treatment among adult Singaporeans aged 30-69 years was commissioned by the Singapore Heart Foundation and conducted by a professional market survey company. Regional quota sampling was performed to ensure that the sample was representative of the Singapore population. This was followed by random sampling of households and respondents.

RESULTSOf the 365 respondents, 40.9% were male, 70.3% were Chinese, 18.8% Malay and 10.9% Indian. The mean age was 47.5 years. Although 81.9% of respondents had medical check-ups involving blood tests, only 11.0% knew their actual cholesterol levels. A third of the respondents saw herbal medicine as healthier and safer than Western medication. More than 80% of respondents believed that diet and exercise were equally effective at lowering cholesterol as medication. About half of the respondents associated long-term use of statins with damage to the liver and kidney, while a third associated chronic statin use with the development of cancer.

CONCLUSIONThere are gaps in the level of public awareness and understanding of cholesterol treatment in Singapore. Common misconceptions should be addressed, as they could potentially impair effective management or treatment compliance.

Adult ; Aged ; Asian Continental Ancestry Group ; Cholesterol ; metabolism ; Cross-Sectional Studies ; Female ; Health ; Health Knowledge, Attitudes, Practice ; Health Literacy ; Humans ; Hyperlipidemias ; diagnosis ; Male ; Middle Aged ; Perception ; Pilot Projects ; Prospective Studies ; Public Opinion ; Risk Factors ; Singapore ; Surveys and Questionnaires

Behcet's disease was originally described as a triple symptom complex of oral aphthous ulceration, genital ulceration, and hypopyon iritis. It is now known to have a wide systemic manifestations. Among them, the central nervous system involvement should be diagnosed earlier because of it's lethal potential. Recently the authors experienced a case of Behcet's disease with CNS involvement. A 51-year-old female patient was admitted due to deterioration of mentality and generalized ache since 2 years prior to admission. The findings on physical examination were compatible with Behcet's disease, but without cerebrospinal pleocytosis. The manifestations were improved with medications of prednisolone, chlorambucil, colchicines, but relapsed relapsed 2 months later during subsequent tapering of prednisolone and chlorambucil. The patient is now on medication again. A case of Behcet's disease with CNS manifestations is reported with review of literature.
Behcet Syndrome ; Central Nervous System ; Chlorambucil ; Female ; Humans ; Iritis ; Leukocytosis ; Middle Aged ; Physical Examination ; Prednisolone ; Stomatitis, Aphthous ; Ulcer

Intramedullary myelitis due to bacterial meningitis associated with cervical epidural abscess is very rare. Its cause and clinical features are non-specific, therefore exact diagnosis is often missed or mistaken for other disease and immediate treatment may be delayed. We report a case of intramedullary myelitis due to epidural abscess presented with prominent symptoms of meningitis and manifestations of acute cerebrovacular accident. A 69 -year-old man was admitted due to right hemicranial headache with pain on right posterior neck and febrile sensation. At first, the patient's headache was improved by conservative therapy. Three weeks later, the patient showed abrupt right hemiparesis (MRC grade 2/5) with drowsy mentality. The CSF findings of the patient were compatible with acute bacterial meningitis. Cervical spine MRI showed cervical epidural abscess and extensive intramedullary myelitis from cervical to lumbar spinal cord. After antibiotic therapy, mentality of the patient became to be alert and right hemiparesis was improved to MRC grade 4/5. Follow up cervical spine MRI after several weeks represented that the lesions of cervical epidural abscess and intramedullary myelitis were significantly diminished.
Diagnosis ; Epidural Abscess* ; Follow-Up Studies ; Headache ; Humans ; Magnetic Resonance Imaging ; Meningitis ; Meningitis, Bacterial* ; Myelitis* ; Neck ; Paresis ; Sensation ; Spinal Cord ; Spine

No abstract available.
Cytomegalovirus Infections*

No abstract available.
Urticaria Pigmentosa* ; Urticaria*

OBJECTIVE: This study aimed to investigate the prevalence of metabolic syndrome, associated factors in schizophrenia patients and whether metabolic syndrome have an effect on health related quality of life (QoL) and body image. METHODS: 81 subjects were included in this study, who were diagnosed as schizophrenia defined by DSM-IV criteria and admitted in neuropsychiatric department, Wonkwang University Hospital. For each subject, anthropometric index and laboratory parameters were measured. Metabolic syndrome defined by National Cholesterol Education Program-Adult Treatment Panel III. The subjects were evaluated health related QoL with Short-Form 36 Health Survey-Korean (SF-36-K), and were evaluated body image with Body Image Scale. RESULTS: Of patients, 24.7% had metabolic syndrome. Metabolic syndrome was associated with long duration of illness. The patients with metabolic syndrome showed poorer QoL, especially role physical and bodily pain in SF-36-K. Also, the patients with metabolic syndrome had negative body image, especially body feature, compared to the patients without metabolic syndrome. CONCLUSION: This study suggests that metabolic syndrome is common among patients with chronic schizophrenia. Also It may lead to lowering of QoL and deterioration of body image. So clinicians should be cautious to aware the increased risk for the metabolic syndrome and intervene actively to prevent and treat metabolic morbidity among chronic patients with schizophrenia.
Body Image ; Cholesterol ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Prevalence ; Quality of Life ; Schizophrenia

BACKGROUND: Interest in pharmacist participation in the multidisciplinary intensive care team is increasing. However, studies examining pharmacist interventions in the medical intensive care unit (MICU) are limited in Korea. The aim of this study was to describe the current status of pharmacist interventions and to identify common pharmacologic problems requiring pharmacist intervention in the MICU. METHODS: Between September 2013 and August 2014, a retrospective, observational study was conducted in the 22-bed MICU at a university hospital. Data were obtained from two trained pharmacists who participated in MICU rounds three times a week. In addition to patient characteristics, data on the cause, type, related drug, and acceptance rate of interventions were collected. RESULTS: In 340 patients, a total of 1211 pharmacologic interventions were performed. The majority of pharmacologic interventions were suggested by pharmacists at multidisciplinary rounds in the MICU. The most common pharmacologic interventions were adjustment of dosage and administration (n = 328, 26.0%), followed by parenteral/enteral nutritional support (n = 228, 18.1%), the provision of drug information (n = 228, 18.1%), and advice regarding pharmacokinetics (n = 118, 9.3%). Antimicrobial agents (n = 516, 42.6%) were the most frequent type of drug associated with pharmacist interventions. The acceptance rate of interventions was 84.1% with most accepted by physicians within 24 hours (n = 602, 92.8%). CONCLUSIONS: Medication and nutritional problems are frequently encountered pharmacotherapeutic problems in the MICU. Pharmacist interventions play an important role in the management of these problems.
Anti-Infective Agents ; Humans ; Critical Care ; Intensive Care Units* ; Korea ; Nutritional Support ; Observational Study ; Pharmacists* ; Pharmacokinetics ; Retrospective Studies

In this review, we mainly focus on zoonotic encephalitides caused by arthropod-borne viruses (arboviruses) of the families Flaviviridae (genus Flavivirus) and Togaviridae (genus Alphavirus) that are important in both humans and domestic animals. Specifically, we will focus on alphaviruses (Eastern equine encephalitis virus, Western equine encephalitis virus, Venezuelan equine encephalitis virus) and flaviviruses (Japanese encephalitis virus and West Nile virus). Most of these viruses were originally found in tropical regions such as Africa and South America or in some regions in Asia. However, they have dispersed widely and currently cause diseases around the world. Global warming, increasing urbanization and population size in tropical regions, faster transportation and rapid spread of arthropod vectors contribute in continuous spreading of arboviruses into new geographic areas causing reemerging or resurging diseases. Most of the reemerging arboviruses also have emerged as zoonotic disease agents and created major public health issues and disease epidemics.
Africa ; Alphavirus* ; Animals, Domestic ; Arboviruses* ; Arthropod Vectors ; Asia ; Encephalitis ; Encephalitis Virus, Venezuelan Equine ; Encephalitis Virus, Western Equine ; Encephalitis Viruses ; Encephalomyelitis, Equine ; Epidemiology* ; Flaviviridae ; Flavivirus* ; Global Warming ; Humans ; Population Density ; Public Health ; South America ; Togaviridae ; Transportation ; Urbanization ; Zoonoses

Anterograde amnesia in Behcet's disease is a rare occurrence. A 50-year-old man presented with anterograde amnesia. He had been suffering multiple oral aphthous ulcers and genital ulcers with erythema nodosum. A neurological examination revealed prominent anterograde memory disturbance. Brain MRI revealed high signal intensity lesions involving the anterior thalamus, posterior part of the basal ganglia and the mesial temporal lobe. We report a rare case of Behcet's disease manifesting severe anterograde amnesia resulting from thalamic and mesial temporal lesions.
Amnesia, Anterograde* ; Basal Ganglia ; Brain ; Erythema Nodosum ; Humans ; Magnetic Resonance Imaging ; Memory ; Middle Aged ; Neurologic Examination ; Stomatitis, Aphthous ; Temporal Lobe ; Thalamus ; Ulcer