In modem medical industries as in others, it has been emphasized by many experts such as Dr. Mayer and Dr. Donabedean that there should be quality assurance activities applying statistical knowledges in the processes of medical management and medical staff themselves for the better medical care and customer satisfaction. Three of our quality assurance programs for the purpose of shortening the treatment time In the department of emergency medicine in Keimyung University, Dong-San Medical Center had been carried out during the period of June 94 through December 95. Our methodology was mainly the process emphasized ; finding the causes of delaying factors in various processes related to the works of nurses, doctors, laboratory services, radiology services etc. in the emergency room, holding various meetings among the related groups with genuine discussions, notifying the new results in each step, encouraging the positive ones and also applying the new leadership technics. During the period of June 94 through December 95(for 1.5 years), the average E.R. patient treatment time from registrations to dispositions had been reduced by about 2 hours (from 5 hours 3 minutes to 2 hours 5 minutes) and its variations among the different specialities had been narrowed down to significant degree (p<0.05) revealing the preprogram base line standard deviation of 2.43 to 1.28 in post program through continuous quality assurance programs. It was also noted that the successful results of Q/A program have been closely related to the fact that the process should be designed and redesigned repeatly as needed and that all the participants related were actively involved in the planning and redesigning processes.
Emergency Medicine ; Emergency Service, Hospital ; Humans ; Leadership ; Medical Staff ; Modems

Recently tnere have been many reports about scabies aggravated during treatment with topical fluorinated st roid. We describe bere two cases of scabies showing unusual clinical features associated. with topical steroid a.nd morphology of different s.zges of 5arcoptes scabiei coliected from the patient. In first case who was 20 year-old riiale patient treated with topical betamethasone cream and antihistaminics per os for 2 months, we collected 62 mites from 130 burrows: 45 adult females, 5 adult males, 6 deutonymphs, 4 protonymphs and 2 larvae. In second case who was 29 year old male patient treated with topical steroid (Esperson), for one month, we rollected 9 adult female itch mites and two (male & female) Dermatophagoides pteronyssnus from 48 burrows.
Adult ; Betamethasone ; Female ; Humans ; Larva ; Male ; Mites ; Pyroglyphidae ; Scabies* ; Young Adult

As the incidence of acute myocardial infarction been increasing with prolongation of life spans, improvement in foods and life styles in Korea, rapid diagnosis and treatment is critical in survival of acute myocardial infarction patient. Most of the acute myocardial infarction result from atherosclerotic plaque forming thrombus and occlusion of coronary artery. Because early thrombolytic therapy is important to maintain the left ventricular function and survival rate, there have been many trials to reperfuse the occluded coronary artery. We have studied the many aspects of acute myocardial infarction such as sex, age, infarction site, chief complaints, change of ECG, change of serum enzyme, time delay on emergency room arrival, and compared the effectiveness of thrombolytic therapy. Total number of patient was 212, and males were 141(66.5%) and females were 71(33.5%). The most common infarction site was ant, fuel wall(102 cases,48%)of the heart and the most common chief complaint was chest pain(204 cases,97%). Among the 106 patients who received thrombolytic therapy, 101 patients(95%) had survived and 5 patients(5%) had died. Among the 64 patients who didn't receive thrombolytic therapy, 56 patients (87.5%) were alived and 8 patients(12.5%) were dead.
Ants ; Coronary Vessels ; Diagnosis* ; Electrocardiography ; Emergency Service, Hospital ; Female ; Heart ; Humans ; Incidence ; Infarction ; Korea ; Life Style ; Life Support Care ; Male ; Myocardial Infarction* ; Plaque, Atherosclerotic ; Survival Rate ; Thorax ; Thrombolytic Therapy ; Thrombosis ; Ventricular Function, Left

No abstract available.
Laurence-Moon Syndrome*

No abstract available.
Laurence-Moon Syndrome*

No abstract available.
Bone Marrow Transplantation* ; Bone Marrow* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Recurrence*

Although the peritoneum is rare site for a primary neoplasm, certain malignant neoplasms may arise from it. A case of 63-year-old woman who had a serous papillary carcinoma of peritoneal origin is reported. Extraovarian peritoneal serous papillary carcinoma was characterized by ascites, malignant washings, and omental involvement with bulky infiltration and/or multiple tumor nodules. The symptoms caused by diffuse spreading of the neoplasm over the peritoneum are the most important manifestation for clinical diagnosis of malignant primary neoplasm of peritoneum, especially serous papillary carcinoma. This behaving tumor was at least partially responded to therapy. In this report, we describe a case of serous papillary carcinoma of peritoneum carring on proper management with brief review.
Ascites ; Carcinoma, Papillary* ; Diagnosis ; Female ; Humans ; Middle Aged ; Peritoneum*

The authors conducted an investigation focusing mainly on the activities of the inhibitory factors of the coagulation and fibrinolysis processes in 35 normal adults and 72 liver cirrhosis and/or hepatoma patients. The activities of antithrombin III, protein C, and alpha 2-plasmin inhibitor were reduced to less than 50% in patients with decreased hepatic synthetic function while lupus anticoagulant was detected in more than 50% of patients with decreased hepatic synthetic function. Hemostatic abnormalities in advanced lived diseases may be caused partly by a decrease of coagulation and fibrinolysis inhibitors and the presence of lupus anticoagulant.
Adult ; Antifibrinolytic Agents/blood ; Blood Coagulation Factors/antagonists & inhibitors/immunology/metabolism ; Carcinoma, Hepatocellular/*blood ; Hemostasis ; Humans ; Liver Cirrhosis/*blood ; Liver Neoplasms/*blood ; Lupus Coagulation Inhibitor

BACKGROUND: Mushroom poisonings are infrequent but potentially fatal. Most fatalities are due to the amatoxin containing species, particularly Amanita phalloides, Amanita virosa, Amanita verna which cause fulminant hepatic failure often with encephalopathy. METHODS: We experienced twenty two patients with acute mushroom poisoning admitted to Dong San hospital, Keimyung University through emergency department between January 1990 and September 1997. RESULTS: Mean age of the patients was 40.0 years and the ratio of male to female was 1 : 0.83. Seasonal distribution is 10 patients in July, 3 in August and 9 in September. The mean interval between ingestion and early symptom onset was 9.7 hours. Most of the patients had early gastrointestinal symptoms; abdominal pain, nausea, vomiting and diarrhea. except for a patient with associated mental change. The subsequent symptoms and signs follow up admission were fulminant hepatic failure(72.7%), renal failure(31.8%), mental change(27.3%), acute pancreatitis(9.1%), pericardial effusion(4.5%) and erythematous rash(4.5%). The outcomes of the patients were recovery(72.7%), death(18.2%) and hopeless discharge(9.1%). CONCLUSION: The patients who have mushroom poisoning are misdiagnosed as having viral gastroenteritis and are discharged frequently. The doctors and people should be educated not to overlook the severity of mushroom poisoning.
Abdominal Pain ; Agaricales* ; Amanita ; Diarrhea ; Eating ; Emergency Service, Hospital ; Female ; Follow-Up Studies ; Gastroenteritis ; Humans ; Liver Failure, Acute ; Male ; Mushroom Poisoning* ; Nausea ; Seasons ; Vomiting

BACKGROUND: Baseline prostate volume (PV) is related with the progression of benign prostatic hyperplasia (BPH). Although recent studies have reported the relationship between BPH and metabolic syndrome, the findings are inconsistent. Thus, this study was performed to investigate the association of PV with metabolic factors and prostate-specific antigen (PSA) in individuals with normal PV and clarify the factors associated with benign prostate enlargement (BPE), including PSA. METHODS: We selected 3,915 health examinees aged >40 yr with a PSA level <4 ng/mL who underwent ultrasonography of the prostate as part of a routine health check-up. These individuals were classified into two groups according to PV: normal PV (PV <30 mL) and BPE (PV > or =30 mL). We investigated the association of PV with metabolic factors and PSA using multiple linear regression analysis, and clarified the factors associated with BPE using logistic regression analysis. RESULTS: The factors associated with PV were PSA, age, and waist circumference in individuals with normal PV. The factors associated with BPE were age, body mass index (BMI), and PSA. The logistic regression analysis adjusted for age and confounding factors showed that individuals with a BMI of 23-24.9 kg/m2, 25-29.9 kg/m2, and > or =30 kg/m2 had higher odds ratios of 1.580 (95% confidence interval, 1.171-2.131; P=0.003), 1.767 (1.332-2.344; P<0.001), and 2.024 (1.042-3.933; P=0.038), respectively, for BPE than individual with a BMI <23 kg/m2. CONCLUSIONS: Abdominal obesity was significantly associated with PV in individuals with normal PV, whereas obesity was an associated metabolic factor of BPE. PSA level was positively associated with PV.
Body Mass Index ; Linear Models ; Logistic Models ; Obesity ; Obesity, Abdominal ; Odds Ratio ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Hyperplasia ; Ultrasonography ; Waist Circumference