No abstract available.

BACKGROUND: The implementation of health care delivery system(HCDS) in 1989 affected the visit pattern of tertiary care hospital. In this study we analyzed the effect of implementation of HCDS in a university hospital. METHODS: We analyzed the yearbook of a university hospital from 1986 to 1992. The clinical departments were divided into three groups of medical departments, surgical departments with application of HCDS and clinical departments without application of HCDS. RESULTS: The total outpatient visits increased after implementation of HCDS. The new outpatient visits decreased after implementation in the medical departments and surgical departments but re-visit patients increased in all clinical departments. The number of emergent patients increased at year 1889, but decreased in 1990, then little changed. Admission rate via emergency room decreased in surgical departments and clinical departments without application of HCDS. The patient from Pusan in which hospital is located was little changed but patients that from other areas increased. So the proportion of patients from Pusan decreased, and from other regions increased. The visit of patients with self pay decreased, but patients with medical insurance increased. CONCLUSIONS: In spite of increased total outpatient visits, the new outpatient visits and patient visits from near place decreased through implementation of HCDS. The new outpatient visits decreased in the medical departments and surgical departments in clinical departments with application of HCDS, but the new outpatient visits increased in clinical departments without application of HCDS.
Busan ; Delivery of Health Care* ; Emergency Service, Hospital ; Humans ; Insurance ; Outpatients ; Tertiary Healthcare

Migraine is a common neurologic disorder with recurrent headache and variable accompanying symptoms. Patients with migraine have suffered by an enormous burden on daily life and impairment of quality of life (QoL), but migraine is still underdiagnosed and undertreated. For early and better diagnosis and treatment of migraine, headache education and instruments for evaluation of headache outcomes including QoL and disability are essential. Nonpharmachological treatment like cognitive-behavior therapy, mindfulness-based stress reduction, lifestyle modification and trigger avoidance, biofeedback, relaxation training can reduce frequency of pain, disability, so headache education might be helpful. Headache diary and instruments for evaluation of QoL, disability and comorbidity like Migraine Disability Assessment Scale (MIDAS), Headache Impact Test-6 (HIT-6), Migraine-Specific Quality of Life Questionnaire (MSQ) are useful tools to decide plans of treatment. When nonpharmachological treatment and headache education are well applied and evaluation of the QoL and disability are reflected, it will help improve the quality of life for migraine patients.
J Korean Neurol Assoc 38(3):169-174, 2020

Although rare, agranulocytosis is the most serious, potentially fatal side effect of antithyroid drug. We experienced a 13-year-old girl who developed methimazole-induced agranulocytosis at 1 month after the initiation of treatment. Her granulocyte count recovered after discontinuation of methimazole and treatment with broad spectrum-antibiotics, G-CSF, and methylprednisolone. After recovery from agranulocytosis she was treated with radioiodine ablation therapy. Early detection and proper management of antithyroid drug-induced agranulocytosis is very important.
Adolescent ; Agranulocytosis* ; Female ; Granulocyte Colony-Stimulating Factor* ; Granulocytes* ; Humans ; Methimazole ; Methylprednisolone*

Acute suppurative cholangitis is a severe inflammatory process of the bile duct occurred as a result of partial or complete obstruction of the bile duct, and may manifest clinically severe from of disease, rapidly deterioration to life-threatening condition. We analyzed emergency percutaneous transhepatic biliary drainage in 20 patients of acute suppurative cholangitis with biliary sepsis to evaluate the therapeutic effect and complication of the procedure. The underlying causes were 12 benign diseases(stones) and eight malignant tumors and among eight malignant tumors, bile duct stones(n=4) and clonorchiasis (n=1) were combined. Percutaneous transhepatic biliary drainage was performed successfully in 17 of 20 patients improvement of general condition and failed in three patients. The procedures were preterminated due to the patient's condition in two and biliary-porto fistula was developed in one. After biliary decompression by percutaneous transhepatic biliary drainage, effective and successful elective surgery was performed in nine cases, which were seven biliary stones and two biliary cancer with stones. Our experience suggests that emergency percutaneous transhepatic biliary drainage is an initial and effective treatment of choice for acute suppurative cholangitis with sepsis and a safe alternative for nonsurgical treatment.
Bile Ducts ; Cholangitis* ; Clonorchiasis ; Decompression ; Drainage* ; Emergencies ; Fistula ; Humans ; Sepsis*

PURPOSE: The objective of this study was to understand the expression of BAG-1 in the human breast cancer. MATERIALS AND METHODS: We studied its expression in one hundred and thirteen patients diagnosed with breast cancer in Dong-A university hospital between 1992 and 1996 by performing immunohistochemical staining with BAG-1 monoclonal antibody. RESULTS: Of the 113 breast carcinoma examined, 62.0% were positive for BAG-1 cyto- plasmic expression, 28.0% were positive for nuclear BAG-1 expression and 9.7% were positive for both BAG-1 cytoplasmic and nuclear expression. The higher histologic grade was correlated with the higher cytoplasmic expression (p<0.05). Except for histologic grade, no correlation was observed between BAG-1 expression and conventional prognostic factors such as age, menopausal status, metastatic status of the axillary lymh nodes, cathepsin-D, p53, C-erbB-2, DNA ploidy, S-phase fraction, PCNA (proliferating cell nuclear antigen). CONCLUSION: The high histologic grade was found to correlate with positive BAG-1 cyto- plasmic staining which did not correlate with conventional prognostic factors. Our data indicate that furthermore investigation is warranted to define the role of BAG-1 as an meaningful prognostic factor in patients with newly diagnosed breast cancer.
Breast Neoplasms* ; Breast* ; Cytoplasm ; DNA ; Humans ; Ploidies ; Proliferating Cell Nuclear Antigen

No abstract available.
Antibodies, Neutralizing* ; Feces* ; Rotavirus*

PURPOSE: Tension-free vaginal tape(TVT) procedure in patient with stress urinary incontinence has become a favorable technique to many urologists because it has many advantages including short duration of admission, low complication and high success rates. We performed TVT folding technique in 2 patients with failed TVT procedure. MATERIALS AND METHODS: In the 52 cases who have received TVT procedure in our institute, 2 patients with failed TVT procedure were received TVT folding technique. After midline incision in the anterior vaginal wall under local anesthesia, TVT was dissected from the periurethral tissue. Folding TVT with Z-shape with proper tension was done. RESULT: 2 patients who had received TVT folding technique since march 2001 in our institute became dry day and night after 3 months follow up. CONCLUSION: TVT folding technique shows a new promising technique in case of loosely placed TVT.
Anesthesia, Local ; Follow-Up Studies ; Humans ; Urinary Incontinence*

No abstract available.
Humans ; Longitudinal Ligaments* ; Spine*

PURPOSE: To compare the peripapillary retinal nerve fiber layer (RNFL) thickness of normal patients and those with various glaucoma diseases by time domain (Stratus) and spectral domain (Spectralis) optical coherence tomography (OCT). METHODS: The RNFL thickness as measured by the Stratus and Spectral OCT was compared (paired t-test). The relationship and agreement of RNFL thickness between the two OCT modalities were evaluated by Pearson correlation, Bland-Altman plot, and area under the receiver operating characteristic curve. RESULTS: Two-hundred seventeen eyes of 217 patients, including twenty-four normal eyes, ninety-one glaucoma suspects, seventy-six normal tension glaucoma cases, and twenty-six primary open angle glaucoma cases (POAG) were analyzed. The peripapillary RNFL thicknesses as measured by Stratus OCT were significantly greater than those measured by Spectralis OCT. However, in quadrant comparisons, the temporal RNFL thickness obtained using Stratus OCT were significantly less than those obtained using Spectralis OCT. Correlations between RNFL parameters were strong (Pearson correlation coefficient for mean RNFL thickness = 0.88); a high degree of correlation was found in the POAG group. Bland-Altman plotting demonstrated that agreement in the temporal quadrant was greater than any other quadrant. CONCLUSIONS: Both OCT systems were highly correlated and demonstrated strong agreement. However, absolute measurements of peripapillary RNFL thickness differed between Stratus OCT and Spectralis OCT. Thus, measurements with these instruments should not be considered interchangeable. The temporal quadrant was the only sector where RNFL thickness as measured by Spectralis OCT was greater than by Stratus OCT; this demonstrated greater agreement than other sectors.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Area Under Curve ; Female ; Glaucoma, Open-Angle/*pathology ; Humans ; Low Tension Glaucoma/*pathology ; Male ; Middle Aged ; Nerve Fibers/*pathology ; ROC Curve ; Retina/*pathology ; Tomography, Optical Coherence/*methods ; Young Adult