Health Status and Medical Utilization of Women in Rural Area / 農村醫學 地域保健

OBJECTIVES: This study was conducted to examine health inequality for gender and region in Korea. Especially it focused on health status such as disease prevalence and medical utilization of rural women. METHODS: Data from the Korea national health and nutrition survey in 2001 were used. The final sample size was 37,108 individuals with age 20 and over. This study applied the logistic regression for nominal variables such as disease prevalence and unmet care needs and with the regression for continuos variables such as the length and costs of medical services. RESULTS: Rates of disease prevalence and unmet care needs for chronic disease in rural area are higher than those in middle cities and big cities, and regional differences of those for women are more than those for mens with controlling ages. There could be interaction effect with region and sex. CONCLUSIONS: This study suggests that health policy maker should take consider of special status of rural women who are in health inequality.

Thrombophlebitis of the Penile Superficial Vein, Penile Mondor's Disease: A Case Report

Mondor's disease is commonly known as thrombophlebitis of the superficial vein in the breast, and this disease occurs rarely in the penis. Despite extensive information about the clinical presentation and course of this disease, imaging findings for this disease are limited. We report gray scale and power Doppler sonographic findings of penile Mondor's disease.

High-Resolution Ultrasonography (US) of Appendiceal Specimens: Differentiation of Acute Non-perforated Appendicitis from Perforated Appendicitis

PURPOSE: To analyze surgical specimens from patients with acute non-perforated and perforated appendicitis using high-resolution ultrasonography (US), and to correlate the US features with the pathologic findings. MATERIALS and METHODS: One hundred and six surgical appendix specimens obtained from patients with suspected acute appendicitis were evaluated. The following US features were evaluated for differentiating acute non-perforated appendicitis from perforated appendicitis: circumferential loss of the echogenic submucosal layer, disruption of the serosal layer, asymmetrical wall thickening, the sum of opposing walls > or = 9 mm and the presence of appendicoliths. The sensitivity and specificity of the US findings for diagnosing perforated appendicitis were determined. RESULTS: All US features were detected significantly more often in the perforated appendicitis group of specimens. The disruption of the serosal layer was the most significant independent predictor of perforation (p or = 9 mm, and the presence of appendicoliths individually was 84.6%, 69.2%, 61.5%, 73.1% and 46.2%, respectively. The specificity for all of these findings was 86.3%, 98.7%, 95.0%, 85.0% and 85.0%, respectively. CONCLUSION: High-resolution US of appendiceal specimens was very useful for differentiating acute non-perforated from perforated appendicitis.

comparison of Vecuronium - induced Neuromuscular Blockade in Pregnant and Nonpregnant Patients / 대한마취과학회지

This investigation was carried out in healthy twenty-four pregnant women undergoing elective Caesarean section and twelve nonpregnant women of the same age group, The premedication was performed with glycopyrroiate 0.2 mg and hydroxyzine l mg/kg IM respectively in the nonpregnant women, and glycopyrrolate 0.2 mg IM only in the pregnant women. Anesthesia was induced with IV pentothal sodium(4-5 mg/kg), vecuronium(0.08 mg/ kg) and ketamine(0.2 mg/kg) in the nonpregnant(Group I, N =12) or pregnant women(Group II, N=12), and pentothal sodium(4-Smg/kg), vecuronium(reducing dose of 20% from 0.08mg/kg) and ketamine(0.2 mg/kg) in the pregnant women(Group III, N=12). Anesthesia was maintained with 1-2% enflurane, 50% N2O, and O2. The ulnar nerve was stimulated supramaximally at the wrist with train-of-four stimuli every 20 sec. with ABM(Datex Co.) and the electromyographic response of the adductor pollicis muscle was measured. The onset of 50% block of first twitch height(T1) was faster in the group II(1.33+/-0.3min) than in the group I(1.9+/-0.6 min) and group III(1.6+/-0.3 min)(p<0.05). Also, the onset of 95% block of T 1 was faster in the group II(2.5+/-0.5 min) and III(1.6+/-0.3 min) than in the group I(3.8+/-0.9min)(p<0,05). The time of recovery of Tl to 10%, 25% and 50% of control were longer in the group II(34.9+/-5.3, 43.1+/-7.2 and 53.3+/-9.1 min respectively) and III(22.3+/-3.2, 29.5+/-4.5, 38.8+/-8.3 min respectively) than in the group I(21.1+/-4.8, 25.6+/-4.8 and 32.6+/-6.3 min respectively)(p<0.05). The conditions of intubation at 50% block of Tl were adequate in the group I and II but poor in the group III(p<0.05). Apgar score at 1 and 5 minutes after delivery were not significantly different between group II and III. Conclusively, administration of vecuronium dose on body weight basis in the pregnant women resulted in a more rapid onset and prolonged recovery of neuromuscular block than in the nonpregnant women without any adverse effects. Moreover, the conditions of intubation was poor when the dose of vecuronium was reduced by 20% in the pregnant women, Therefore, it is inadequate to reduce the dose of vecuronium concerning about relative overdose in the pregnant women undergoing Caesarean section.

The Effect of Regional Hypothermia of Neuromuscular Transmission / 대한마취과학회지

To determine the influence of hypothermia on the neuromuscular transmission, 25 patients were studied during O2-N2O(50%)-enflurane(1-2%) anesthesia without any muscle relaxants. Ventilation was controlled to maintain normocapnia and neuromuscular transmission was monitored by delivering train-of-four(TOF) stimuli to the ulnar nerve at wrist(Accelograph, Biometer) while the circulation to the ipsilateral forearm was occluded by tourniquet for 20 minutes. Regional hypothermia was induced to the isolated arm by intravenous injecton of 20ml normal saline cooled by 10degrees C and by surface cooling with ice pack in 15 patients (hypothermia group). To compare the neuromuscular transmission in hypothermia with 10 patients in normothermia whose temperature were maintained at normothermia by intravenous injection of 20ml normal saline of 36degrees C(normothermia group), TOF response was measured following temperature gone down. The results obtained were as follows. First twitch height of TOF response(T1) was not changed, significantly in normothermia group for 20 minutes. In hypothermia group, T1 was decreased insignificantly until the temperature fell to 32degrees C, but it began to decrease significantly from below 31degrees C as compared to normothermia group, e. g., 82.4+/-31.2/o(p<0.05), 73.1+/-29.6%(p<0.0l), 53.2+/-14.4%(p<0.01), 38.7+/-18.7% (p<0.01), and 35.9+/-16.3%(p<0.01) at 31, 30, 29, 28 and 27C respectively. T4 ratio was not affected in both normothermia and hypothermia groups. In 5 eases of 15 hypothermia patients, we observed transient increase of T, under the moderate hypothermia(35~32degrees C) before markedly diminution of T, under the profound hypothermia(< or =31degrees C)