• Journal of Preventive Medicine and Public Health
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• v.17 no.1
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• pp.37-45
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• 1984

This study was conducted to identify the problems in the medical aid program by reviewing the medical care utilization pattern of the beneficiaries. The data were abstracted from the monthly bills and vouchers for medical care of the whole benefi챠aries(17,527) in Gyeongsan Gun submitted by the physicians to county government for the period of 1 calendar year from October 1981 to September 1982. The number of medical aid beneficiary accounted for 12.7% of the total county population, a higher proportion than the national average-9.5%. Monthly primary care utilization rate per 100 beneficiaries was 9.3 persons with 14.0 visits and 42.9 medication days. for the 2nd and 3rd care, there were 1.7 admissions and 9.3 OPD visits per 100 beneficiaries per year. The beneficiaries of the first class medical aid program had a higher utilization rate of both the primary and secondary/tertiary care facilities. Females utilized more the primary care facilities than males while males utilized more the secondary/tertiary care facilities than females. A significantly lower utilization rate was observed in January than in the other months and this was seemed due to the renewal process of the medical aid certificate. Among 1,931 patients utilized the 2nd/3rd care facilities 84.4% was out-patients and the lowest ratios were in the minor specialties including ENT, ophthalmology, dermatology and urology. The average hospital days per in-patient were 21.2 days and OPD days per out patient were 4.7 days. The average hospital days for a psychiatry in-patient was 74.4 days which was the longest average hospital days among all the specialties. Average medical care cost per beneficiary in a year was W9,821:W24,240 for the 1st class and W7,464 for the 2nd class. The medical care cost for the primary care per patient was W3.901 and W840 per day compared with W49,875 per patient and W5,822 per day for the secondary/tertiary care. From the findings of this study following recommendations were made to improve the medical care program: 1) The renewal process of the medical care certificate should be expedited. 2) Minor specialty clinics should be designated as the primary medical care facility for the medical aid program to reduce the expenses by absorbing more patients referred to the secondary/tertiary care facilities directly. 3) The medical care cost for the primary care facility should be escalated to reduce the differential between the primary and secondary/tertiary care facilities.

• Journal of Preventive Medicine and Public Health
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• v.28 no.1 s.49
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• pp.59-72
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• 1995

This study was carried out to analyze the food intake and associated factors of the urban poor elderly by comparing poor district, Unbong rental apartment in Bansong 2 dong with other areas in Pusan. 135 elderlies(men 36, women 99) in Unbong rental apartment, 136 elderlies(men 45, women 91) in the other areas were investigated during the period of March to August in 1994. The assumption that the study area represented poor district was satisfied because the age and sex distribution was not significantly different, and the income of the study area was significantly lower than that of the control area. The variables of hospitalized in previous 12 month, gastrointestinal problem, alcohol drinking, cigarette smoking did not differ significantly. But the variables of chronic disease, take medicine, perceived health, vitamin supplement differed significantly between two groups. Therefore some factors associated with health state in the study area are worse than those of the control area. At most of all variables, nutrients intake of the study area did not reach the recommended dietary allowances(RDA) for Koreans, and that nutrient intakes of the study area were significantly lower than those of the control area. The hypothesis of this study that nutrient status depends on economical status was proved. As for the score of nutritional knowledge, the study area was significantly lower than the control area. But as for the score of nutritional behavior, two areas were not significantly different. The latter is counter result of our hypothesis, owing to the effect of the confounding factors including education etc. As for the correlation of variables, not only economic status and educational level, but the score of nutritional knowledge effects strongly on nutrient status in the study area, the poor district. Therefore, adequate nutritional education to the elderly in e poor district should be considered.

• Childhood Kidney Diseases
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• v.14 no.2
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• pp.154-165
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• 2010

Purpose : We know little about the natural course of IgA nephropathy (IgAN) in association with histologic changes especially in children. We investigated clinicopathologic features with long-term follow-up biopsy to clarify the outcomes and prognostic indicators for childhood IgAN. Methods : From our patients' medical records, we retrieved 20 patients with IgAN, to whom renal biopsies had been performed for the initial diagnosis and follow-up to find out any histologic changes. Initial and follow-up biopsies were classified by Haas classification. The changes of these parameters were compared with the evolution of clinical features. Results : Patients were treated with angiotensin-converting enzyme inhibitors in combination with angiotensin receptor blockers (in subclass II or above) and short-term cyclosporine A(in patients showing nephrotic syndrome). Histologic improvement in 7 cases and deterioration in 3 cases were observed. At the time of last biopsy, 10 cases (50%) showed clinical remission and the others showed improved clinical features. These clinical outcomes did not correlate with initial Haas classifications. Hypertension at onset observed in 5 cases (25%) revealed significant correlation with clinical outcome (P =0.01) and last Haas classification (P =0.007). None of the cases showed progression to CRF or ESRD. Conclusion : During a mean follow-up of $10.8{\pm}3.4$ years, childhood IgAN showed good clinicopathologic outcome. Hypertension at onset was only a strong predictor of clinicopathologic outcomes, but initial Haas classification cannot predict outcomes in children. Histologic change of IgAN in long term follow-up period cannot be completely predicted by clinical data and vice versa. Therefore, a renal biopsy should be considered as a part of follow-up plan.

• Childhood Kidney Diseases
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• v.12 no.2
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• pp.213-220
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• 2008

Purpose : This study aims to verify the effectiveness of initial empirical antibiotic choice recommended by the International Society for Peritoneal Dialysis(ISPD) guide among Korean children. Methods : We have collected data on peritonitis from January 2001 to December 2007 in Samsung Medical Center. Results : Of the 42 patients, 48 episodes of peritonitis had occurred in 21 patients. The rate of peritonitis was one episode over 35.3 patient-months. Mean dialysis duration before peritonitis was 18.06$\pm$15.81 months. Gram-positive organisms accounted for 58.3% of all episodes. Of the gram-positive organisms, the most common pathogen was Staphylococcus aureus(29.2%), the next common pathogens were Coagulase negative staphylococcus(14.6%) and Streptococcus species(6.3%). 35.7% of gram-positive pathogens were resistant to 1st cephalosporin. However, in patients younger than 4 years old, 50% of gram-positive pathogens were resistant to 1st generation cephalosporin. 10 episodes of peritonitis were methicillin-resistant and were treated by vancomycin. Of the gram-negative organisms, E. coli was the most common (8.3%). 64.8% of all pathogens were sensitive to cephalothin or ceftazidime. Conclusion : The empirical therapy with 1st generation cephalosporin and ceftazidime can be also effective to peritoneal dialysis associated peritonitis in Korean children. However, in patients younger than 4 years old, glycopeptide should be considered as the first empirical therapy in Korean children.

• Korean Journal of Soil Science and Fertilizer
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• v.20 no.3
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• pp.199-204
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• 1987

This study was conducted to verify the identity and the effects on soil improvements by the application of Barley stone which has been recently named as miraculous mineral on account of being propagandized as health stone because of several special effect of medicine, the supplement of micronutrients for agriculture, prevention against diseases and insects of plant, and the increase of nutrient holding capacity of soil. The results were summarized as follows; 1. Barley stone is considered as Diabase Porphyrite by the analysis of X-ray Diffraction, chemical composition and microspore's observation. This mineral stone called as Barley stone has been deducted because of being seen as if the feature was attatched with cooked barley and appearently scattered about feldspar's phenocryst on the dark-green stone base. 2. In chemical characteristics of barley stone, the pH 8.7 was higher but C.E.C. 9.0 me/100g was lower then those of other clay minerals such as Bentonite and Zeolite, and so barley stone material was not considered suitable for improvement of sandy loam soil. 3. Effects of Bentonite and Zeolite application on yield of paddy rice were 108-109% compare to non-treated plot, but Barley stone has not increased rice yield. Notwithstanding the increase of application of barely stone to 5 ton per 10a, the yield increase was not significantly showing only 102-103% and the effects of Peanut, hot pepper and chinese cabbage were not recognized either.

• Radiation Oncology Journal
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• v.11 no.2
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• pp.241-247
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• 1993

Between July 1988 and December 1992, we treated 45 patients who had deep seated inoperable or residual and/or recurrent intracranial tumors using LINAC based stereotactic radiosurgery at the Department of Therapeutic Radiology, Kangnam St. Mary's Hospital, Catholic University Medical College. Treated intracranial tumors included pituitary tumors (n=15), acoustic neurinomas (n=8), meningiomas (n=7), gliomas (n=6), craniopharyngiomas (n=4), pinealomas (n=3), hemangioblastomas (n=2), and solitary metastatic tumor from lung cancer (n=1). The dimension of treatment field varied from 0.23 to 42.88 $cm^3\;(mean;\;7.26\;cm^3)$. The maximum tumor doses ranging from 5 to 35.5 Gy (mean; 29.9 Gy) were given, and depended on patients' age, target volume, location of lesion and previous history of irradiation. There were 22 male and 23 female patients. The age was varied from 5 to 74 years of age (a median age; 43 years). The mean duration of follow-up was 35 months (2~55 months). To date, 18 $(39.1\%)$ of 46 intracranial tumors treated with SRS showed absent or decrease of the tumor by serial follow-up CT and/or MRI and 16 $(34.8\%)$ were stationary, e.g. growth arrest. From the view point of the clinical aspects, 34 $(73.9\%)$ of 46 tumors were considered improved status, that is, alive with no evidence of active tumor and 8 $(17.4\%)$ of them were stable, alive with disease but no deterioration as compared with before SRS. Although there showed slight increase of the tumor in size according to follow-up imagings of 4 cases (pituitary tumor 1, acoustic neurinomas 2, pinealoma 1), they still represented clinically stable status. Clinically, two $(4.4\%)$ Patients who were anaplastic astrocytoma (n=1) and metastatic brain tumor (n=1) were worsened following SRS treatment. So far, no serious complications were found after treatment. The minor degree headache which could be relieved by steroid or analgesics and transient focal hair loss were observed in a few cases. There should be meticulous long term follow-up inall cases.

• Radiation Oncology Journal
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• v.25 no.2
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• pp.93-100
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• 2007

[ $\underline{Purpose}$ ]: To evaluate the outcome and prognostic factors of postoperative radiotherapy in endometrial carcinoma. $\underline{Materials\;and\;Methods}$: From September 1991 to August 2003, 76 patients with endometrial carcinoma received postoperative adjuvant radiotherapy after hysterectomy at Asan Medical Center. Stage was classified as FIGO I in 41 (53.9%), II in 12 (53.9%), and III in 23 (30.3%). Histologic grade 1, 2 and 3 were in 29 (38.2%), 20 (26.3%), and 27 (35.5%) respectively. Forty two patients received both external beam radiation therapy (EBRT) and intracavitary radiation (ICR), 34 patients were treated with EBRT or ICR alone. EBRT dose was 50.4 Gy, ICR was performed in $4{\sim}6$ fractions with $4{\sim}5\;Gy$ per fraction. Median follow-up period was 51 (range $5{\sim}121$) months. $\underline{Results}$: Five-year overall survival was 89.6%. In univariate analysis, statistically significant factors to overall survival were FIGO stage, lymph node metastasis and histologic grade. In disease free survival, FIGO stage, lymph node metastasis and lymphovascular invasion were significant prognostic factors. Recurrence was seen in 11 patients. Of these, systemic failure was in 10 patients. There were no moderate to severe complications after radiation therapy. $\underline{Conclusion}$: The outcome of postoperative adjuvant radiotherapy in endometrial carcinoma was good. Main pattern of failure after postoperative radiotherapy was distant metastasis. So, adjuvant chemotherapy may help in improving outcome. Further study on chemotherapy in combined with postoperative radiotherapy will be needed, especially for patients with high risk factors such as high FIGO stage, lymphovascular invasion, and high histologic grade.

• Journal of the Korean Wood Science and Technology
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• v.2 no.2
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• pp.22-24
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• 1974

1. Object and importance of the research. The exports of plywood are increasing annually and it has ranked first in the world market because of the high quality product developed and manufactured using modern techniques. However, it is known that the exports of the other wood products, except plywood, is inactive because of their low quality. Accordingly, to increase the exports of various wood products investigations were carried out on kiln drying techniques to improve the quality of the wood. 2. The details and scope of the research Wet wood should be kiln dried before use to prevent various drying defects such as distortion, shrinkage etc, which would develop after processing, and also wet wood is not suitable for cutting, gluing and finishing. Therefore, the kiln drying properties of lumber from such species as Persimmon, Oak, Ramin and Meranti which are used in large quantity for manufacturing exporting wood products have been studied. Also the real state of kiln drying industry in Korea was investigated. 3. Results and proposal for practical use of the research 3. 1 Results of the research 3.1.1 The end checks and the time for drying from intial moisture content of about 40 percent to 5 percent moisture content in ovendry were investigated as Table 1. 3.1.2 The kiln dried results, for 30mm stock, which are presented by using kiln schedule Table 2 are as Table 3. 3.1.3 The kiln schedule for Persimmon which has a normal drying properties is given in Table 4. However, the persimmon which has easy checking properties should be air dried under a relative humidity of above 85% until reaching about 25 percent moisture content. 3.1.4 The kiln schedules for ramin, meranti and oak are given respectively as follows. Ramin kiln schedule ............ Table 5 and Table 6 Meranti kiln schedule ............ Table 7 Oak kiln schedule ............ Table 8 3.2 Proposal for practical use of the research Firms using the above species should be informed the results of the research so they can be used to preventing drying defects and shortening drying time.

• Journal of Chest Surgery
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• v.35 no.3
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• pp.209-216
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• 2002

Background: Valvular heart disease is still the most common health problem in Korea. By the end of the year 1999, there has been 94,586 cases of open heart surgery since the first case in 1958. Among them, 36,247 cases were acquired heart diseases and 20,704 of those had valvular heart disease. But there was no database system and every surgeon and physician had great difficulties in analysing and utilizing those tremendous medical resources. Therefore, we developed a valve registry database program and utilize it for risk factor analysis and so on. Material and Method: Personal computer-based multiuser database program was created using Microsoft AccessTM. That consisted of relational database structure with fine-tuned compact field variables and server-client architecture. Simple graphic user interface showed easy-to-use accessability and comprehensibility. User-oriented modular structure enabled easier modification through native AccessTM functions. Infinite application of query function aided users to extract, summarize, analyse and report the study result promptly. Result: About three-thousand cases of valve replacement procedure were performed in our hospital from 1968 to 1999. Total number of prosthesis replaced was 3,700. The numbers of cases for mitral, aortic and tricuspid valve replacement were 1600, 584, 76, respectively. Among them, 700 patients received prosthesis in more than two positions. Bioprosthesis or mechanical prosthesis were used in 1,280 and 1,500 patients respectively Redo valve replacements were performed in 460 patients totally and 40 patients annually Conclusion: Database program for registry of valvular heart disease was successfully developed and used in personal computer-based multiuser environment. This revealed promising results and perspectives in database management and utilization system.

• Journal of Chest Surgery
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• v.36 no.11
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• pp.839-845
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• 2003

Background: Even today when chemotherapy has been established as a treatment for tuberculosis and the prevalence of tuberculosis is gradually decreasing, multi-drug resistance tuberculosis still results in poor treatment performance and lowered survival periods. This research sought to analyze the surgery of multi-drug resistance tuberculosis, and determine the usefulness and danger of surgery in connection with this disease. Material and Method: Starting from February 1990 to February 2002, retrospective surveys were conducted targeted at 21 cases involving 20 patients who underwent surgery due to multi-drug resistance tuberculosis. The survey included 14 males cases and 6 females cases with the age averaging 42.8$\pm$12.1 years. 10.3$\pm$7.6 years on average passed after patients were initially diagnosed with tuberculosis. 13 patients (65%) tested positive in the pre-operative sputum AFB test, and all showed resistance against an average of 3.5 anti-tuberculosis agents including INH and RFP. Pre-operative radiologic examinations revealed cavitary lesions in 15 patients (75%), and three patients had lesions in the both lung fields, with the major lesions existing in the unilateral area. 13 patients (75%) failed negative conversion with medical treatment, while two patients (10%) with recurrent hemoptysis and five patients (25%) with lesions involving high recurrence-rate received the operation. Operations included nine cases (40%) of pneumonectomy, nine cases (45%) of lobectomy, and three cases of lobectomy with segmentectomy. The average follow-up period of patients stood at 23 months. Result: There was no post-operative death, and found were a total of eleven cases involving complications were found: three cases of long-term air leakage, three cases of bleeding requiring re-operation, two cases of empyemas due to broncho-pleural fistula, and one case of atelectasis, wound infection and chest wall fistula each. Eleven cases (85%) of negative conversion were completed immediately after the operation, and two cases failed negative conversion. Eleven months after the operation, the disease recurred in one case of negative conversion patients, and the patient was cured by completion pneumonectomy. Conclusion: If patients' lung function was sufficient and appropriate resection was possible, multi-drug resistance tuberculosis could achieve high-rate negative conversion and cure using combination of surgical and medical treatment, and also there were not many serious complications.