Objective:To inve tigate the value o electron beam tomography and echocardiography or diagno ing the comple congenital heart di ea e . Method :Thirty our patient with comple congenital heart di ea e underwent both echocardiography and electron beam tomography,which wa con irmed by angiocardiography in 18 patient .Twenty one patient were operated on.All data were comparatively analyzed Re ult :The rate o diagno i coincidence in diagno ing comple congenital heart di ea e wa 82 4% or electron beam tomography,and 73 5% or echocardiography.The accuracy o electron beam tomography in diagno ing e tracardiac abnormal tructure wa 97 9% and obviou ly higher than 53 2% by echocardiography.The accuracy o echocardiography in diagno ing intracardiac abnormal tructure wa 95 9% and higher than 81 6% by electron beam tomography.Electron beam tomography and echocardiography had a imilar accuracy or diagno ing abnormal tructure at the junction o ve el with cardiac chamber. Conclu ion:Electron beam tomography combined with echocardiography can greatly improve the diagno i accuracy o comple congenital heart di ea e and can al o reduce the u e o inva ive angiocardiography.

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Objective To explore management models for asthmatic children in primary hospitals.Methods A total of 465 children with asthma,all of whom were outpatients,were managed according to general medicine principles from January 2000 to October 2002.The children were divided into two groups,depending on whether they were enrolled in the management before or after January 2002 (before:after=186:279).Based on Global Initiative for Asthma and individual requirements,different treatment measures were applied,and all the patients,their parents and community health care workers received education of basic knowledge on asthma.The extent to which the knowledge was grasped by the study populations at different stages was analyzed,and difference in progression of the disease before and after the introduction of management was compared.Results There were significant differences (P0.05].Of all 465 children,the mean frequency of asthma attack per year,asthma-based mean hospitalization per year and cases with normal predicted value of peak expiratory rate of flow were 4.23?1.55,0.61?0.59,36/190 and 0.83?0.86,0.03?0.17,179/190 before and after the introduction of the management respectively (P

Objective To summarize the clinical characteristics of female pseudohermaphroditism (FPH) in the publication from 1994 to 2009 and the cases diagnosed and treated in our hospital from 2000.Methods We employed Chinese and English name of female pseudohermaphroditism as a key word separately to retrieve published articles of FPH during 1994 to 2009.A meta-analysis was performed together with the ten cases in our hospital.Results Among 342 cases involved in this study,only twenty-seven children were diagnosed immediately after birth and the other 315 cases at the age of 1 month to 59 years with median age of 29.54 years.The etiological factors were mostly congenital adrenal hyperplasia (70.47%).Clinical manifestations were advanced bone age (95.52%),clitoromegaly (84.14%) and early virilization (77.24%).The treatment mainly included drug and operation.Early diagnosis and available therapy were very important for the prognosis.Conclusion FPH is not rare,so we should improve our knowledge for its early diagnosis,good intervention and final better prognosis.

OBJECTIVE：To construc t the evaluation system of the research quality of medical insurance budget impact analysis （BIA），and to provide feasible evaluation tool for related departments as medical insurance department. METHODS ：Based on BIA guidance documents and relevant empirical literatures of ISPOR ，Canada，Poland，the United States and other countries ， combined with expert interview ，the relevant elements of medical insurance negotiation BIA material were confirmed （including key elements and adjuctive elements ）. The scale and system was established to calculate total score of BIA research quality evaluation. RESULTS ：Key elements included three data blocks as target population ，market situation and treatment cost ，involving 14 key elements such as total population ，new drug scenario market share ，treatment cost ，etc.. According to the degree of compliance，0-3 points were assigned and the lowest score after normalization was taken as the basic score of BIA research quality. The adjunctive elements included five data blocks as title & abstract ，research background ，analysis framework ，result presentation and other ，including 23 adjunctive elements such as title ，abstract，research angle ，research time limit ，etc.. According to whether there is quality grade difference ，the elements were divided into type A and type B ；the grade score （0-4 points）and 0/1 score（1 point for yes and 0 point for no ）were used respectively ，and the additional score of BIA research quality was obtained after calculation and addition. According to the addition of different weights （0.67 and 0.33）of basic score and additional score ，the total score system of BIA research quality evaluation could be calculated. CONCLUSIONS ：This study successfully constructed a new BIA quality evaluation system ，which can be used for the quality evaluation of BIA research submitted by medical insurance drug negotiation.

BACKGROUND: This study was conducted to investigate risk factors for perioperative periods between general anesthesia (GA group) and thoracic epidural blockade combined with general anesthesia (CEA group) for consecutive hepatic resections. METHODS: A retrospective chart review was carried out regarding 85 patients who had undergone hepatic resections. We compared the effects of postoperative pain control in the two groups, including pulmonary complications and durations of hospital stay. RESULTS: There was no significant difference in demographic data between the two groups. The perioperative fluid requirement and transfusions were lower in the CEA group. Supplemental analgesics requirement was significantly lower in the CEA group than the GA group in the 3 days postoperatively. There were no statistical difference between the two groups in nausea, vomiting, urticaria, constipation or urinary retention, but hypotension was more pronounced in the CEA group than the GA group. Postoperative pulmonary and surgical complications were similar between the two groups, but the duration of hospital stay was longer in the GA group than the CEA group. CONCLUSIONS: We conclude that the thoracic epidural blockade combined with general anesthesia provided lower surgical blood loss and better postoperative analgesia and hospital stay than general anesthesia for hepatic resections.
Analgesia ; Analgesics ; Anesthesia, General* ; Blood Loss, Surgical ; Constipation ; Hepatectomy* ; Humans ; Hypotension ; Length of Stay ; Nausea ; Pain, Postoperative ; Perioperative Period ; Retrospective Studies ; Risk Factors ; Urinary Retention ; Urticaria ; Vomiting

Acute necrotizing esophagitis (AEN), also called "black esophagus," is a rare disorder with an unknown pathogenesis. Endoscopic findings generally show black pigmentation throughout the esophagus. This case also offered rare views of the gross anatomy of this disorder. Histological examination revealed that the mucosal and submucosal layers of the esophagus were involved in the severe necrotizing inflammation. The chief manifestation of this disease is hematemesis from hemorrhage of the upper gastrointestinal tract with a typically multifactorial etiology. AEN is also characterized by a clear boundary at the gastroesophageal junction where the necrosis stops. In this study, we report an autopsy case of a 61-year-old man with necrotizing inflammation throughout the esophagus and esophageal necrosis from the laryngopharynx to the gastroesophageal junction. The patient was a disabled person with a history of alcohol abuse who was also diagnosed with mild coronary arteriosclerosis and fatty liver on the basis of the underlying diseases. In this case, the main etiology for poor perfusion from the distal esophageal area was likely underlying illness, history of alcoholism, and malnutrition.
Alcoholism ; Autopsy* ; Coronary Artery Disease ; Disabled Persons ; Esophagitis* ; Esophagogastric Junction ; Esophagus ; Fatty Liver ; Hematemesis ; Hemorrhage ; Humans ; Hypopharynx ; Inflammation ; Malnutrition ; Middle Aged ; Necrosis ; Perfusion ; Pigmentation ; Upper Gastrointestinal Tract

Although listeria monocytogenes is widely distributed in nature, it rarely causes clinical infection in previously healthy people. However, this microorganism may cause severe infectious disease in pregnant women and newborns due to impaired cell-mediated immunity. Various clinical symptoms have been described such as sepsis, central nervous system infections, endocarditis, gastroenteritis and localized infections. A clinical presentation of listeriosis in an early third trimester pregnant woman and in a preterm infant is emphasized in addition to taking a careful patient history, early empirical administration of antibiotics, aggressive ventilation therapy and also pharmacological support.
Anti-Bacterial Agents ; Central Nervous System Infections ; Communicable Diseases ; Endocarditis ; Female ; Gastroenteritis ; Humans ; Immunity, Cellular ; Infant, Newborn ; Infant, Premature ; Listeria monocytogenes ; Listeriosis* ; Pregnancy ; Pregnancy Trimester, Third* ; Pregnant Women* ; Sepsis ; Ventilation

PURPOSE: This study examined the effects of music therapy on pain, anxiety and length of stay of patients undergoing laparoscopic hysterectomy in the postanesthesia care unit (PACU). METHODS: Sixty patients who received laparoscopic hysterectomy under general anesthesia from a PACU in a university hospital located in Cheonan city participated in this study. The experimental group (n=30) was offered the option to listen to their preferred music by using MP3 players and headphones for 30 minutes. The control group (n=30) received routine postoperative nursing care. Visual analogue scale was used to measure participants' pain and anxiety, length of stay in the PACU was examined by using their medical records. Data were collected from December 2013 to February 2014 and analyzed by descriptive statistics, chi2-test, Fisher's exact test, and independent t-test using SPSS version 21.0. RESULTS: The result showed that the level of post-operative pain (t=2.44, p=.018), anxiety (t=2.37, p=.021), and the length of stay in PACU (t=3.06, p=.004) significantly decreased in the experimental group as compared to the control group. CONCLUSION: This study indicated that music therapy with the patients' preferred music showed positive effects. Therefore, it can be used as a therapeutic intervention for postoperative pain management of patients with laparoscopic hysterectomy.
Anesthesia, General ; Anxiety* ; Chungcheongnam-do ; Humans ; Hysterectomy* ; Length of Stay* ; Medical Records ; MP3-Player ; Music Therapy* ; Music* ; Nursing Care ; Pain, Postoperative

Information on the blood safety management system in Japan was collected by visiting the Ministry of Health, Labour and Welfare (MHLW), Japanese Red Cross Blood Service Headquarter, Kanto-Koshinetsu Block Blood Center, and Yurakucho Blood Room of Tokyo Metropolitan Blood Center, in July 2014, to improve the quality of the blood management system in Korea. In Japan, all blood products are supplied by the Japanese Red Cross Blood Service. In April 2012, the function of screening tests and blood product production of the provincial blood centers was transferred to the block blood centers. Donor suitability is assessed by medical doctors and EKG was tested for donors over 40 years old annually. To prevent bacterial contamination, the shelf life of platelets was shortened to 4 days after production, but routine bacterial screening test was not performed. Adverse reactions and infection following transfusions are reported to MHLW through the Red Cross Blood Service, and the case was reviewed by Pharmaceuticals and Medical Devices Agency (PMDA). Before transfusion, HBsAg, anti-HBs, anti-HBc, anti-HCV, and HCVcAg of the recipient is tested, and testing for HIV antigen is performed if the recipient has risk factors for HIV infection. Even when hepatitis B NAT is positive, look back is not performed if anti-HBc is negative and there is no history of blood donation within 125 days before the current donation. Good Manufacturing Practice (GMP) for blood centers was introduced in the 1990s and PMDA performs the test every 5 years. In introduction of GMP in Korea, it is necessary to decide how to absorb the expense.
Asian Continental Ancestry Group ; Blood Donors ; Blood Safety ; Electrocardiography ; Hepatitis B ; Hepatitis B Surface Antigens ; HIV ; HIV Infections ; Humans ; Japan* ; Korea ; Mass Screening ; Red Cross ; Risk Factors ; Tissue Donors