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*

To evaluate the surgical results of superior rectus recession with different amount according to the degree of eyeball deviation.We reviewed the surgical records of 36 eyes in 23 patients who had undergone superior rectus recession and followed up for at least 6 months.Patients were divided into 3 groups according to the degree of deviation : Group 1[8-10PD, 4.0 mm recession], Group 2[11-20PD, 6.0 mmrecession], Group 3[21PD or greater, 8.0 mmrecession].Five PD or less after operation was regarded as acceptable. The success rate of Group 1 was 86.6%at the 6th month, 87.5% at the 12th month, and 83.8%at the 24th onth, respectively.In group 2 those were 87.5%, 75%, and 80%, respectively.In group 3 those were 60%, 50%, and 50%, respectively.The overall success rate as 83.3%at the 6th month, 75% at the 12th month, 75%at the 24th month.These results indicate that superior rectus recession with the different amount according to the degree of eyeball deviation is effective for the deviation under 20PD but not over 21PD.
Humans

No abstract available.
Papaverine*

No abstract available.
Papaverine*

No abstract available.
Brain Ischemia* ; Glutamic Acid* ; Microdialysis ; Nitric Oxide Synthase* ; Nitric Oxide*

The purpose of this study was to evaluate the effect of the alginic acid sodium salt on the delayed adjustable strabismus surgery by preventing the post operative tissue adhesion. 30 eyes of 15 rabbits had received an adjustable suture surgery. The alginic acid sodium salt of 4% was used during operation in 16 eyes among them by injecting it around the muscle, between the sclera and the conjunctiva. In the 3rd, 5th, 7th, 10th, and 14th day postoperatively, we measured the pulling forces and the moving distances of the muscles during the adjustment. Then the eyes were enucleated and the histopathologic changes of the eyes were determined using the light microscope. The pulling forces and the moving distances of the muscles during the adjustment were significantly different between the alginic acid sodium salt free group and the alginic acid sodium salt used group. In the alginic acid sodium salt used group, the pulling forces were decreased and the moving distances were increased than those of the alginic acid sodium salt free group. The light microscopic examination showed more fibrosis in the alginic acid sodium salt free group than in the alginic acid sodium salt used group. These results suggest that the alginic acid sodium salt is an effective substance for the delayed adjustable suture surgery.
Conjunctiva ; Fibrosis ; Muscles ; Rabbits ; Sclera ; Sodium* ; Strabismus* ; Sutures ; Tissue Adhesions

Clear cell sarcoma of tendon and aponeurosis is a rare malignant tumor. It occurs chiefly in young adults, predominates in women and is most common in the regions of the foot and ankle. We report a case of clear cell sarcoma of tendon and aponeurosis in s 22-year-old man. he pstient had had a asymptomatic, normal skin colored, relativerly hard, dome shsped nodule on the anterior chest for 6 months. Histopsthologic findings revealed uniform pattern composed of compact nests of round or fusiform cells which had clear cytoplasm and were surrounded by delicate framework of fibrocollagenous tissue, and the individual tumor cell had a fairly regular appearance of possessing round to avoid vesicular nucleus with prominent basophilic nucleolus. One year after surgical excision and post operative radiotherapy, there was no recurrence.
Ankle ; Basophils ; Cytoplasm ; Female ; Foot ; Humans ; Radiotherapy ; Recurrence ; Sarcoma, Clear Cell* ; Skin ; Tendons ; Thorax* ; Young Adult