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Geographic Distribution of Physician Manpower by Gini Index (GINI계수에 의한 의사의 지역간 분포양상)

  • Moon, Byung-Wook;Park, Jae-Yong
    • Journal of Preventive Medicine and Public Health
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    • v.20 no.2 s.22
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    • pp.301-311
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    • 1987
  • The purpose of this study is to analyze degree of geographic maldistribution of physicians and changes in the distributional pattern in Korea over the years 1980-1985. In assessing the degree of disparity in physician distribution and in identifying changes in the distributional pattern, the Gini index of concentration was used. The geographical units selected for computation of the Gini index in this analysis are districts (Gu), cities (Si), and counties (Gun). Locational data for 1980 and 1985 were obtained from the population census data in the Economic Planning Board and regular reports of physicians in the Korean Medical Association. The rates of physicians located counties to whole physicaians were 10.4% in 1980 and 9.6% in 1985. In term of the ratio of physicians per 100,000 population, rural area had 9.18 physicians in 1980 and 12.95 in 1985, 7.13 general practitioner in 1980 and 7.29 in 1955, and 2.05 specialists in 1980 and 5.66 in 1985. Only specialists of genral surgery and preventive medicine were distributed over 10% in county and distribution of every specialists except chest surgery in county increased in 1955, comparing with that rates of 1980. The Gini index computed to measure inequality of physician distribution in 1985 indicate as follows; physicians 0.3466, general practitioners 0.5479, and specialists 0.5092. But the Gini index for physicians and specialists fell -15.40% and -10.42% from 1980 to 1985, indication more even distribution. The changes in the Gini index over the period for specialists from 0.3639 to 0.4542 for districts, from 0.2510 to 0.1949 for cities, and 0.5303 to 0.5868 for counties indicate distributional change of 24.81%, -22.35%, and 10.65% respectively. The Gini indices for specialists of neuro-surgery, chest surgery, plastic surgery, ophthalmology, tuberculosis, preventive medicine, and anatomical pathology in 1985 were higher than Gini indices in 1980.

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Staging of Esophageal Cancer Using Positron Emission Tomography : Comparing to Computed Tomography (양전자방출단층촬영술(PET)을 이용한 식도암 환자의 병기 결정 -전산화단층촬영술(CT)과의 비교-)

  • 심영목;박승준;김병태;김성철
    • Journal of Chest Surgery
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    • v.32 no.4
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    • pp.388-393
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    • 1999
  • Background: Correct preoperative staging of esophageal cancer is a prerequisite for adequate treatment. We prospectively compared the accuracy of positron emission tomography (PET) with [fluorine-18]FDG in the staging of esophageal cancer to that of computed tomography (CT). Material and Method: The findings of FDG PET and of chest CT including lower neck and the upper abdomen of 20 biopsy-proven squamous cell carcinoma patients (male, 19; female, 1; mean age, 61) were compared with the pathologic findings obtained from a curative esophagectomy with lymph node dissection. Result: The sensitivities of FDG PET and CT for diagnosis of primary tumor were the same, 90.0% (18/20). Both FDG PET and CT failed to show the primary tumor in 2 of 20 patients; one had a 1cm sized carcinoma in situ and the other had T1 stage cancer. By using the results of the pathologic examinations of 193 removed lymph node groups, we calculated the diagnostic sensitivities, specificities and accuracies of PET and CT (*$\chi$2 p < 0.005). Sensitivity** Specificity Accuracy* PET 55.6%(30/54) 97.1%(135/139) 85.5%(165/193) CT 13.0%(7/54) 98.6%(137/139) 74.6%(144/193) One of four patients with a false-positive for PEThad had active pulmonary tuberculosis. Among the 24 tumor involved lymph node groups, PET failed to show tumor metastasis in 5 lymph node groups abutting the tumor and in 14 lymph node groups located where the decay correction was not performed. Conclusion: Based on the above findings, it is suggested that [F-18]FDG-PET is superior to CT in the detection of nodal metastases and in the staging of patients with esophageal cancer.

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The Clinical Effects of Surgical Treatment for Hemoptysis due to Inflammatory Lung Disease (염증성 폐질환에 의한 객혈에 대한 수술적 치료 효과)

  • Yun, Ju-Sik;Na, Kook-Joo;CheKar, Jay-Key;Jeong, In-Seok;Song, Sang-Yun;Oh, Sang-Gi
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.144-149
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    • 2010
  • Background: Many studies have demonstrated the various therapeutic options for treating hemoptysis caused by inflammatory lung disease. However, there is debate over the surgical management of the ongoing hemoptysis. Therefore, we evaluated the clinical results of pulmonary resection that was done due to hemoptysis in patients with concomitant inflammatory lung disease. Material and Method: We performed a retrospective analysis of 75 patients who received pulmonary resection for hemoptysis and concomitant inflammatory lung disease between 2001 and 2007. The mean age was $52.1{\pm}12.5$ years old, and the male; female ratio was 52:23. Result: The underlying disease was aspergilloma in 30 patients (40%), pulmonary tuberculosis in 20 patients, bronchiectasis in 18 patients and other causes in 7 patients. The surgical treatment included lobectomy in 55 patients, bilobectony in 2 patients, pneumonectomy in 17 patients and wedge resection in 1 patient. There were 3 early deaths, and the causes of death were pneumonia in 1 patient and BPF in 2 patients. The early mortality was statistically higher for such risk factors as a preoperative Hgb level <10 g/dL, COPD and an emergency operation. Conclusion: In conclusion, pulmonary resection for treating hemoptysis showed the acceptable range of mortality and it was an effective method for the management of hemoptysis in patients with inflammatory lung disease. However, relatively high rates of mortality and morbidity were noted for an emergency operation, and so meticulous care is needed in this situation.

A Study of Job Satisfaction and Related Factors of the National Hospital Nurses (국립병원 간호사의 직무만족과 관련요인 연구)

  • Suh Gil-Hee;Kim Ok-Hee
    • Journal of Korean Public Health Nursing
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    • v.7 no.2
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    • pp.53-66
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    • 1993
  • By this time, a few of previous studies of factors related to separation from their jobs and job satisfaction only have dealt with the separation rate. the cause of separation and related factors that induce job satisfaction and incentive factors, the actualities of morale some suggestions for reduction of the separation rate. This study is attempted to determine factors that have effect on job satisfaction of national hospital nurses. and to proide information and materials for the development of the administration of nursing through the appreciation of factors influencing on job satisfaction between isolated ward nurses and general ward nurses working at national hospitals. 185 nurses of national hospitals responsed th this study, and were divided into two groups. Group 1: 57 nurses working at isolated wards for tuberculosis patients and Group 2 : 128 nurses at general wards. Relevant data were collected from August, 5, 1992 through August 20, 1992. The questionnaire consisted of 8 genalized items and 4 items concerning job satisfaction. The collected data were processed with SPSS, and the relationship among vaviables was analyzed by means of $X^2-test$, Pearson Correlation, Multiple Regression. The results of this study are as follows: 1. There is no significant difference between two groups in terms of generalized items. Age distributions show $44.3\%$ under the category of less than 34. and $55.7\%$ under the category more than 35, $19.3%$ was single and $74.6\%$ was married respectively. 2. $79.4\%$ of the nurses have the desire to have in-service education under the satisfactory physical environments such as welfare system, accommodating structures and facilities, instruments or management systems of the hospital, but under the category of unsatisfactory circumstances, $60.3\%$ have the intention of having in- service education. The concern in terms of in-service education shows statistically significant difference between two groups $(X^2=8.85,\;p<0. 05)$. This result accepts the hypothesis that good physical environments could intensify interests in service education. 3. The extent of satisfaction related to psychological environments is heightend according to good physical environments. In result, the hypothesis that the extent of satisfaction in terms of physical environments could raise satisfaction about psychological environment is accepted. 4. In the light of the extent of satisfaction about physical environments, $33.3\%$ of isolated ward nurses are satisfied with physical environments, but only $11.7\%$ of general ward nurses are satisfied. $(X^2=10.88,\; p<0.01)$. This result shows that the satisfaction degree about phusicalenvironments of isolated war nurses was higher than that of general ward nurses in spite of high physical and psychological risks due to exposure to infection. Consequently. the hypothesis was rejected that the satisfaction degree about physical environments would be lower in isolated ward nurses than in general ward nurses. 5. The fact that $87.7%$ of isolated ward nurses took interest in service education and $53.19\%$ of general ward nurses took interest in service education demonstrats that isolated ward nurse have more interest in service education than gerneral ward nurses. The result shows that the hypothesis is accepted that isolated ward nurses would have mor interests in service education than general ward nurses. 6. In the extent of satisfaction about physical environments such as morale human relationship promotion, there is no significant difference between two groups in terms of statistics. The hypothesis is rejected that satisfaction about psychologic environments would be high in isolated ward nurses than in general ward nurses. In conclusion. factors influencing on job satisfaction are considered to have effect on. another, and also interdisciplinary amelioration of factors accompanied with systematic inter cooperative investigation is necessary.

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A Survey Research on Family Health Care : Focusing on Married Women in Seoul (가족 건강관리 행위에 관한 조사연구 -서울시내 일부 기혼부인들을 대상으로-)

  • 주혜진;김초강
    • Korean Journal of Health Education and Promotion
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    • v.13 no.1
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    • pp.1-27
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    • 1996
  • Recently diseases related to personal health habit and lifestyle have become common in modern industrial society. These kinds of diseases can be prevented simply by changing one's lifestyle to be more healthy. As a result of realization our interest in general health has become stronger. The most basic environment for human-being in society is the home. Humans secure their livelihood, physically. mentally, and socially at home. Therefore health care at home is very important. In modern society the responsibility for this task is traditionally given to housewives. The purpose of this study was to measure the degree of the health knowledge, health concern, health behavior and family health care of the married women and to analyze its related factors. The subjects for this study. 1,100 married women who studied at social education institutes and who had children attending an elementary school or a kindergarten, were surveyed with questionnaires. The preliminary survey was carried out from Aug. 7, to Aug. 19, 1995. With complement of questions, the main survey was carried out from Sep. 11, to Sep. 30, 1995. The data was analysed by using the SAS program. The results were as follows. 1. General Characteristics (1) In the individual characteristics of the respondents, the married women aged 30-39 were 54.8%, the average age was 39.8 years old. 33.8% of respondents had 6-10 years of marriage period, and the average marriage period was 14.9 years. Most of them(96.5%) lived with their husband. Those who graduated from college and graduate school were 53.4%. And 68.3% of respondents had no job. (2) In the family characteristics, 69.3% of the married women had 3 or 4 family members and the average family size was 4.1 person. 60.0% of the respondents had 2 children. Most of the respondents(90.9%) had no married children. 84.8% of the respondents lived with their parents. Those who reported that the total family income was more than 2,500,000 won a month were 32.3%. When making the decisions, 68.5% of the married women discussed the family matter with their husband. (3) In the individual characteristics of the respondents, 51.5% answered they were in good health. 61.7% of the married women answered they obtained the health knowledge through mass media. 24.3% of the women answered they had patients in their family in these days. 67.5% of the respondents answered they could generally control their health by themselves. 2. The Health Knowledge, Concern and Behavior. (1) For the health knowledge, the average score was 11.8. The lowest percent of correct answer(27.8%) was in the item about the skin tests for tuberculosis. And the highest percent(97.%) was in the item about taking a rest. (2) For the health concern, the married women had the highest concern about washing hands. But they were indifferent to smoking. (3) For the health behavior, the highest score was in "changing socks and underwear everyday", and the lowest one was in "taking a regular dental examination". 3. The Family Health Care (1) For the family health care, the item of "using a drug with the order of doctor or pharmacist" had the highest grade(4.78), and "consulting with the family physician about the health problem" had the lowest grade(2.03). (2) Older women and the women with a longer period of marriage had the highest level of the family health care(p<0.001). The married women who had 3 children had the highest level of the family health care(p<0.001). Those who had 5 or 6 family member and higher income had the highest level had the high level of the family health care(p<0.01). Women in good health and those who had the health knowledge from health experts had a high level of the family health care. (3) For the correlation of the family health care and other variables, the health behavior showed the highest correlation with family heath care practice(r=0.74) and the second was health concern(r=0.43). The variables which could explain the family health care were health behavior, the health concern and married women's health status(r²=55.87). The most closely associated with family health care was health behavior(r²=54.93)

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한국농촌의 식품금기에 관한 연구

  • 모수미
    • Journal of the Korean Home Economics Association
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    • v.5 no.1
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    • pp.733-739
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    • 1966
  • A 371 agricultural households from 26 different communities in South Korea was subjected on a study of food taboos in January of 1966. To the pregnant women, those to whom a high protein diet is particurally important, as many as 14 different kinds of foods, mostly portein rich foods, were avoided to eat. It is believed that if duck is eaten while pregnant her baby may walk like a duck in later life. Some mother have a strong aversion to the rabbit meat that her unborn baby must be a harelip. It is feared to eat chicken, shark or carp by the pregnant mother for her baby may get a gooseflesh appearance, or fish scale-like skin in later life. It is thought that if mother eats soup made of meat borns, especially chicken bones, a disfigured baby may be born. Some area informed that if mother eats crab meat her future baby will always bubble. To the child-bearing mothers 13 different kinds of foods were avoided to eat. Some believe that if raddish kimchi, soybean curd, squash are eaten while dilivery that mother may get dental decay or to lose all her teeth. Other think that highly spiced raddish kimchi cause delivery difficult. To the lactating mothers 7 different items of foods were not recommended to eat. It is a common belief that eating green vegetables, especially fresh lettuce, are restricted that her baby may stool greenish. It is said that eating ginsen-chicken soup, or ginsen tea during lactating reduces breast milk secretion. To the weaning babies 7 different kinds of foods were prohibited to fee. Eggs are not eaten because mothers think her babies will start to talk very late. Eight different items of foods in cases of gastro-intestinal diseases, 5 items for liver disease, 7 items for high blood pressure as well as for paralysis were respectively restricted. It is said that meats including pork, beef, and chicken are neither desirable for the patients of high blood pressure nor those of paralysis. To the measles children 10 varieties of foods were restricted. Especially soybean products and meats were not encouraged to use for avoiding asecond attack of measles. For the common cold 8 different kinds of foods were aversed and men think that eating of soup of undria delays a recovery. For the tuberculosis 4 kinds of foods were prohibited to eat. It is said that wine, red pepper and ginsen will stimulate lung bleeding. Many mothers had a strong aversion to fermented shrimp and fish in case of style. and 5 different items of foods were restricted. In case of menstration not so many foods were restricted as other cases, but meat soup is not eaten in this condition in some areas. Majority of food taboos in Korean villages are neither based on tribal nor religious factors. But no one knows how, since what ages, from where, these food taboos have been transmitted and spread over the country. This survey found a great variety of food taboos, aversions, traditional beliefs and prohibitions latent unknown reseasons, or non-scientific conceptions, or completely different ideas from the modern medical aspect, or somewhat fallacious and superstitious beliefs. For the vascular disease contrasting approach were found between modern the oritical therapy and popular remedy among the rural populations who largely depend on the eastern medication. Further scientific study on either side should be done to lead the patient proper way. Many restricted foods such as rabbit, duck, chicken and fish are best resources of protein rich foods which are available in the village. Emphasis should be laid upon breaking down fallacious and supersititious food taboos through the extended nutrition education activities in order to improve food habit and good eating pattern for healthier and stronger generations of Korea.

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The Outcome of Conventional External Beam Radiotherapy for Patients with Squamous Cell Carcinoma of the Esophagus (식도의 편평상피세포암 환자에서 외부방사선치료의 결과)

  • Jang, Ji-Young
    • Radiation Oncology Journal
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    • v.26 no.1
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    • pp.17-23
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    • 2008
  • Purpose: The best treatment for advanced esophageal cancer is chemoradiotherapy followed by surgery. In spite of the advance of multimodality therapy, most patients with esophageal cancer are treated with radiation therapy alone. This study reports the outcome of the use of conventional external beam radiotherapy alone for the treatment of esophageal cancer. Materials and Methods: Between January 1998 and December 2005, 30 patients with squamous cell carcinoma of the esophagus were treated with external beam radiotherapy using a total dose exceeding 40 Gy. Radiotherapy was delivered with a total dose of 44-60 Gy(median dose, 57.2 Gy) over $36{\sim}115$ days(median time, 45 days). Thirteen patients(43.3%) had a history of disorders such as diabetes, hypertension, tuberculosis, lye stricture, asthma, cerebral infarct, and cancers. Four patients metachronously had double primary cancers. The most common location of a tumor was the mid-thoracic portion of the esophagus(56.7%). Tumor lengths ranged from 2 cm to 11 cm, with a median length of 6 cm. For AJCC staging, stage III was the most common (63.3%). Five patients had metastases at diagnosis. Results: The median overall survival was 8.3 months. The survival rates at 1-year and 2-years were 33.3% and 18.7%, respectively. The complete response rate $1{\sim}3$ months after radiotherapy was 20%(6/30) and the partial response rate was 70%(21/30). Sixteen patients(53.3%) had an improved symptom of dysphagia. Significant prognostic factors were age, tumor length, stage, degree of dysphagia at the time of diagnosis and tumor response. Cox regression analysis revealed the aim of treatment, clinical tumor response and tumor length as independent prognostic factors for overall survival. Twenty-eight patients had local failure and another four patients had metastases. Three patients were detected with double primary cancers in this analysis. A complication of esophageal stricture was observed in three patients(10%), and radiation pneumonitis occurred in two patients(6.7%). Conclusion: The prognosis of esophageal cancer remains poor, in spite of advances in radiotherapy techniques. Radiotherapy is one of the main treatment modalities for the relief of dysphagia and treatment related complications are minimal. It is expected that the addition of chemotherapy or another systemic modality to radiotherapy will improve tumor control and increase the survival rate in advanced esophageal cancer.

A Basie Health Survey of the Yonsei Community Health Service Area, Seoul (연세지역(延世地域)에 대(對)한 보건기초조사(保健基礎調査))

  • Yang, Jae-Mo;Kim, Myung-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.1 no.1
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    • pp.25-36
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    • 1968
  • Introduction In order to improve medical education through the introduction of a concept of comprehensive health care of a community, an area surrounding the University Campus was chosen for the Community Health Service Project. It has been on operation for last 4 years with its major emphasis on family planning services, and maternal and child health care. The major objectives of this survey at the area are to obtain: 1) The demographic data, 2) The health need and trend of medical care, 3) The attitude and practice in maternity care to be used for further improvement of the planning and the services of the project. Population and Survey Method Out of three Dongs of the Community Health Service Area, only two Dongs namely Changchun and Yonhee were selected for the survey. Total number of households and population in the area studied was 3,683 and 21,857 respectively. An interview was performed with questionnaire schedule which was recorded by interviewers. This includes the degree of utilization of health services provided by the Community Health Service Program such as family planning, prenatal care during their last pregnancy, delivery history and complications of the delivery as well as the incidence of illnesses in general. Prior to the interview, all interviewers were trained for interviewing technique for two days. The survey was carried out during the period from October December 1967. Results 1) Demographic Data : 41.3% of the population studied were children under age 15 and only 3.5% were over 60 years of age. Crude birth rate and crude death rate of this area studied during the period of November 1966-October 1967 were 20.5 and 7.7 respectively. Infant mortality rate during the same period was 35.9. 50.4% of the 2,832 households fell into the category of middle class, 39.8% to the lower class and 9.5% to the upper class in economic condition. 19.8% of 2,832 householders had no formal education, 22.7% primary school, and 57.5% middle or higher school education. 2) Health Status and Utilization of the Community Health Service: Those who suffered from many illnesses during the month of October, 1967 were 690(4.6% of 14,891 persons). Classification of these patients into the type of disease shown respiratory diseases 27.4%, gastrointestinal diseases 18.1%, tuberculosis 10.9%, skin and genitourethral diseases 4.5% and gynecologic patients 4.5%. Only 55.9% of the patients received medical care at hospital or doctor's clinic. But among TB and gynecologic patients, 70.7% and 72.4% were treated at medical facilities. 10.6% of 2,832 householders interviewed has ever utilized the Community Health Service Program provided by the Yonsei Medical School, Classifying these clients into the type of service, 35.9% utilized the wellbaby clinic, 31.0% the family planning clinic, 14.7% the home delivery care, and the rest utilized other services such as the premarital guidance cinlic and the sanitary inspection service. 3) Maternity Care: 23.6% of 2,151 deliveries were done at medical facilities such as hospital, private clinic, while 76.4% were done at home. Acceptance rate of prenatal care was 32.6% as whole, but 49.6 of 774 women who had the prenatal care service had their deliveries at medical facility. 45.1% of total deliveries were attended by medical and or paramedical personnel. 75.8% of the deliveries of those received prenatal care were attended by medical and or paramedical personnel while only 27.8% of the deliveries of those who did not have prenatal care attended by medical and or paramedical personnel. 49.8% of deliveries of the upper class, 29.8% of the middle class and 9.9% of the lower class were attended by medical and or paramedical personnel. 6.2, 3.3% and 24.8% of mothers reported about their xeperience of edema, coma and fever during the period of trimester of pregnancy and puerperium. 4) Family Planning: The rate of practice of family planning was 27.9%. 31.7% of them were by IUD, 2.9% by oral pill, 15.2% by sterilization and the rest by traditional methods. Those women who had 3 to 4 children had highest(30.2%). Practice rate among the various methods of family planning, oral pill was the most popular method to whom had 2 or less children. In relation between the practicing rate of family planning and living standard, the upper, middle and lower class practiced 37.5, 29.4 and 19.9% respectively.

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Result of Tracheal Resection and End-to-end Anastomosis (기관 절제 및 단단문합술의 성적 고찰)

  • 유양기;박승일;박순익;김용희;박기성;김동관;최인철
    • Journal of Chest Surgery
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    • v.36 no.4
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    • pp.267-272
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    • 2003
  • Background: Common treatment modalities for tracheal stenosis include conservative methods such as repeated balloon dilatation, removal of obstructive material through bronchoscopy and T-tube insertion as well as operative treatment methods. Recent advances in surgical approaches through tracheal resection and end-to-end anastomosis have been reported to give better functional and anatomical results. Material and Method: Between March 1990 and July 2002, 41 patients who received tracheal resection and end-to-end anastomosis at Asan Medical Center, University of Ulsan were studied retrospectively. Result: The causes for tracheal resection and end-to-end anastomosis included 26 cases of postintubation stenosis, 10 cases of primary tracheal tumors (3 benign, 7 malignant), 1 case of endobronchial tuberculosis, 2 cases of traumatic rupture, and 2 cases of tracheal invasion of a thyroid cancer, Of the 41 patients who received tracheal resection and reconstruction, 29 received tracheal resection and end-to-end anastomosis, and 12 received laryngotracheal anastomosis with cricoid or thyroid cartilage resection. Four of these patients received supralaryngeal release. The average length of the resected trachea was $3.6{\pm}1.0$cm. Of the 41 patients who received tracheal resection and end-to-end anastomosis, 30 (73.2%) experienced no postoperative complications, and 8 (19.5%) experienced granulation tissue growth and/or minor infections which improved after conservative management. Good or satisfactory results were therefore achieved in 92.7%. Complications included repeated granulation tissue growth in 7, wound infection in 2, anastomotic site dehiscence in 2, restenosis resulting in dyspnea on exertion in 1, and repeated postoperative aspiration requiring retracheostomy in 1. There was no early postoperative mortality. There were 3 cases of hospital death. Conclusion: In cases of proper length of tracheal lesion, excellent results were obtained after tracheal resection and end-to-end anastomosis. But, granulation tissue growth is so serious complication, it is necessary for continuous study and efforts to prevent it.

Clinical Evaluation of Open Thoracotomy Cases in Spontaneous Pneumothorax (자연 기흉의 개흉례에 대한 임상적 고찰)

  • 이연재;황산원
    • Journal of Chest Surgery
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    • v.30 no.12
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    • pp.1225-1231
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    • 1997
  • Spontaneous pneumothorax is the sudden collapse of a lung usually caused by air leakage from a subvisceral pleural blob. Responses to closed thoracostomy,thoracentesls and simple observation are usually prompt and effective. But in some cases, these are unsucceful and open thoracotomy is indicated. A clinical evaluation was performed on 242 cases(236 patients) of open thoracotomy in spontaneous pneumoth rax who were admitted and treated at department of Thoracic and Cardiovascular Surgery. Masan Samsung General Hospital during the past 9 years from January 1988 to December 1996. The results were as follows 1. The sex ratio was male predominance(M:F=11.7:1) 2. The most common age group were 2nd, 3rd decades(2nd=29.3%, 3rd=30.2%). 3. The most common chief complaints were chest pain and dyspnea(chest pain=41.7%. dryspnea= 36.8). 4. The etiologic factors of spontaneous pneumothorax were primary spontaneous pneumothorax(86.4%), tuberculosis(9.1%), COPD(3.7%) and pleuritis(0.8%). 5. The site of spontaneous pneumothorax was 52.1% in right, 45.4% in left and 2.5% in both. 6. The common indications of open thoracotomy were recurrence(44.2%), persistent air leakage(31.8%) and inadequate expansion(15.7%). 7. The operative procedures were bullectomy or mechanical pleurodesis through posterolateral thoracotomy or median sternotomy. 8. The most frequent location of bulla or blob were apical segme t oi RUL(35.1%) and apicoposterior segment of LUL(41.3 %). 9. The number of bulla or blob were mainly 1 to 5(88%), and there were no significant differences among operation indications. 10. The size of bulla or bleb were mainly below 5cm(81%)and small bulla($\leq$1cm) were predominant in recurrence group but large bulla(>5cm)were predominant in persistent air leakage and inadequate expansion group. 11. The pleural adhesion was seen in 54.5%.(Recurrence group 64.1%,Persistent air leakage group 51.9%,Inadequate expansion group 47.4%).

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