The purpose of this study was to examine the trends of length of hospital stay (LOS), which is most likely to be a major attribute to hospital performance From 1984 to 1994, an average LOS of each hospital was analyzed by factors such as medical departments, bed size, occupancy rate, region and ownership. This study was analyzed changing rate of LOS during 11 years. This rate was calculated by simple regression, which was used only with hospital without missing data during 11 years. This study findings are as follows. 1. The results indicated that the average LOS was steadily increased until 1990 but it was slightly decreased after 1990. 2. This trend could be found in all hospital scale and all group of occupancy rate. Specifically this trends of LOS were found in internal medicine, corporate owned hospitals, and hospitals in major city. But LOS of individual owned hospital was continuously increased until 1994. 3. Means of changing rates of LOS were calculated from 1984 to 1994. If we divided it into two parts, before 1990 and after 1990, most changing rates of LOS before 1990 except individual owned hospital were found positive sign. The changing rates after 1990 were negative sign but small hospital(lesser then 200 bed), individual owned hospital, national & public hospital and hospital in small urban have little change of LOS after 1990. Finally from this results we thought that most hospitals in korea began to be concerned with LOS. Nevertheless LOS of several hospital such as small hospital or individual owned hospital was increased. And this trend may be caused by a few patients, low occupancy rate, or low profit. This trend of LOS is different from that of other countries. Perhaps this phenomenon is resulted from the reimbursement method. Because of fee for service reimbursement system in korea the hospitals didn't need to shorten LOS in order to save the cost and increase the profit. Therefore reform of hospital cost reimbursement method will be reduced to reduce hospital cost in korea. we thought that the korean health authority should consider the reimbursement method by unit of bundle of services, for example DRG and prepayment in the united states. This study presents some limitations such as on insight of severity of disease, case-mix measurement of hospital, and other clinical characteristics that can possibly affect LOS, However, this study reports an important trend in LOS from 1984 to 1994.
Diagnosis-Related Groups ; Fee-for-Service Plans ; Hospital Bed Capacity ; Hospital Costs ; Hospitals, Public ; Humans ; Internal Medicine ; Korea* ; Length of Stay* ; Ownership ; United States

This is to describe a neonatal hepatitis with pericellular hepatic fibrosis and Mallory bodies in a sero-positive infant for IgM anti-CMV. A necropsy of the liver revealed severe heaptocellular swelling with many intracytoplasmic hyaline bodies, pronounced fibrosis of a creeping type, bile stasis with ductular proliferation, and the lack of parenchymal regeneration. These microscopical changes of the liver resembled those of Indian Childhood Cirrhosis (ICC). In the present case the patient's serum IgM anti-CMV is the only clue for the etiological diagnosis.
Infant ; Child ; Male ; Female ; Infant, Newborn ; Humans

We developed an animal model to recreate the condition of an open fracture in communication with the maxillary sinus. We then studied wound healing of the sinus wall structures following fracture in the presence of autogenous bone and alloplastic implant. This model is designed to simulate the repair of an orbital floor fracture in humans. The New Zealand White rabbit was used as the animal model. Standardized 8mm defects were made bilaterally in the maxillary sinuses to include bone and mucosa in 36 rabbits. Two different implants and autogenous calvarial bone graft were placed in the soft-tissue pockets to obturate the defects, exposing one surface of the implant to the open sinus. Medpor porous polyethylene, silicone and calvarial bone implant were compared. Animals were killed at 1, 2 and 8 weeks after implantation. Gross examination of the specimens for the amount of mucosal closure and implant tissue fixation was performed. Histological sections were evaluated for bone and soft-tissue morphology juxtaposed to the implant. Complete closure of the mucosal defect was demonstrated with each type of implant. Medpor implants showed both vascular and soft-tissue ingrowth into pores by week 1. Bone ingrowth was seen by week 2. Closure of the Medpor obturated defects occurred more rapidly than in the silicone group. The Medpor implants and calvarial bone demonstrated bone and soft-tissue fixation, callus formation and maturation, while mature overlying mucosa was reconstituted over the defects. Silicone implants demonstrated a fibrous tissue reaction within 1 week of implantation and they never became fixed to bone or soft tissue. Maxillary sinus wall regeneration occurred in all defects. This study supports clinical observations of maxillary sinus wall regeneration in humans.
Animals ; Bony Callus ; Fractures, Open ; Humans ; Maxillary Sinus ; Models, Animal ; Mucous Membrane ; New Zealand ; Orbit ; Polyethylene ; Rabbits ; Regeneration ; Silicones ; Tissue Fixation ; Transplants ; Wound Healing

PURPOSE: To investigate the subjective health and health-related quality of life (HRQoL) in Haenyo. METHODS: Subjects were 100 elderly Haenyo in Jeju island who belonged to a fishing-village society. Main variables were activities of daily living (ADL), instrumental ADL (IADL), the HRQoL, subjective health, and depression. Subjective health and differences of HRQoL by variables were analyzed by t-test or ANOVA using IBM SPSS Statistics 23. Hierarchical multiple regression was executed to examine the effects of the major factors on the quality of life. RESULTS: The mean age was 69.9 years, the mean period for diving career was 51.5 years, and work hours per month were 37.8. Comorbidity of diseases was 2.74, and the common health problems were osteoporosis and headache/dizziness. HRQoL was significantly different by age (F=4.52, p=.013), education (F=6.10, p=.003), muljil work years (F=3.93, p=.050), depression (t=-3.04, p=.030), subjective health state (F=30.62, p < .01), and degenerative arthritis (F=-2.38, p=.019). In the final model by hierarchical multiple regression, ADL/IADL (β=.41, p < .001), depression (β=-.29, p < .001), and subjective health (β=.43~.51, p < .001) were significant and explained 63.5% of the total variance of HRQoL. CONCLUSION: Haenyo have specific health problems different from those of elderly women in general. ADL/IADL, depression and subjective health affected their HRQoL. It is clear that Haenyos' health problems need further study to improve their health.
Activities of Daily Living ; Aged* ; Comorbidity ; Depression ; Diagnostic Self Evaluation* ; Diving ; Education ; Female ; Humans ; Osteoarthritis ; Osteoporosis ; Quality of Life*

Bone scan using 99m Tc-MDP is the most accurate and reliable method for the early detection of fracture, andgive the most accurate in formation about the healing process of fractured bone. Recent days, the medicolegalproblem about the injured time is frequently provoked in vertebral fracture patient by trauma. The authorsanalyzed the bone scan of vertebral fracture patients from March to Dec. 1983. The authors obtained results asfollows: 1. The minimum time for a fracture to return to normal on a bone scan was 4 month in cervical spine. 2.It was 12 month in thoracic spine. 3. It was 6 month in lumbar spine. 4. Surrounding soft tissue injury was healedwithin 10 days after trauma in our cases. 5. Focal hot uptake is persisted in case of callus deposition on plainfilm, although very small in amount. 6. Healing time is delayed in case of severely compressed vertebral body,belowed the half than normal height. 7. With bone scan it is possible to differentiate the fresh fracture from oldhealed, impossible by plain film. 8. Healing time is delayed in old age.
Bony Callus ; Humans ; Methods ; Soft Tissue Injuries ; Spine

B13 analogues are being considered as therapeutic agents for cancer cells, since B13 is a ceramide analogue and inhibits ceramidase to promote apoptosis in cancer cells. B13 sulfonamides are assumed to have biological activity similar to B13, since they are made by bioisosterically substituting the carboxyl moiety of B13 with sulfone group. Twenty B13 sulfonamides were evaluated for their in vitro cytotoxicities against human colon cancer HT-29 and lung cancer A549 cell lines using MTT assays. Replacement of the amide group with a sulfonamide group increased cytotoxicity in both cancer cell lines. The sulfonamides with long alkyl chains exhibited activities two to three times more potent than that of B13 and compound (15) had the most potent activity with IC50 values of 27 and 28.7microM for HT-29 and A549, respectively. The comparative molecular field analysis (CoMFA) and comparative molecular similarity indices analysis (CoMSIA) were used to carry out QSAR molecular modeling of these compounds. The predictive CoMSIA models for HT-29 and A549 gave cross-validated q2 values of 0.703 and 0.830, respectively. From graphical analysis of these models, we suppose that the stereochemistry of 1,3-propandiol is not important for activity and that introduction of a sulfonamide group and long alkyl chains into B13 can increase cytotoxicity.
Apoptosis ; Cell Line ; Ceramidases ; Colonic Neoplasms ; Humans ; Inhibitory Concentration 50 ; Lung Neoplasms ; Models, Molecular ; Quantitative Structure-Activity Relationship ; Sulfonamides

Recently, informations that clinicians should know to perform the daily practice increase so rapidly thatappropriate use of computer system is needed to handle the large amount of informations efficiently. But little isknown about which system is appropriate to use or how much can we do with personal computer. Authors describe theexperience in developing computer management and data storage system for cardiovascular radiology section in seoulNational University Hospital with APPLE II personal computer and report the experience which we got during recentone year. The results are as follows; 1. Authors describe the data input format for carciovascular radiologysection in Seoul National University Hospital. 2. Authors can get various sums, average and count of datacollected during one month's clinical trial (202 cases) in an hour using our system. 3. Authors suggest that wecan computerize the unite as large as 3,000 to 10,000 examinations per year using personal computer with two 51/4" floppy disk system if length of record is adequately modified. 4. But for more efficient use of accumulateddata(Database), authors recommend the use of large external memory device, such as hard disk.
Computer Systems ; Humans ; Information Storage and Retrieval ; Memory ; Microcomputers ; Seoul

Most silica-contaminated wounds of the skin heal without complications. Cutaneous silica granuloma is a poorly understood, uncommon condition resembling a sarcoidosis. We report a case of silica granuloma after intermittent intramuscular injections. A 70-year-old man presented a painless mass in his right buttock for 2 weeks. He had received intermittent intramuscular injections of antihistamine drugs due to chronic dermatitis for 30 years. The histolopathological findings showed numerous hyalinized collagenous nodules with concentric layers, and an ill-defined chronic granulomatous inflammation containing foreign material. A polarized light microscopic examination revealed birefrigent particles. The presence of silica components was confirmed by scanning electron microscopy and energy dispersive X-ray microanalysis.
Aged ; Buttocks ; Collagen ; Dermatitis ; Electron Probe Microanalysis ; Granuloma* ; Humans ; Hyalin ; Inflammation ; Injections, Intramuscular* ; Microscopy, Electron, Scanning ; Sarcoidosis ; Silicon Dioxide* ; Skin ; Wounds and Injuries

It has been well known that dilated cardiomyopathy (D-CMP) has characterized by systolic dysfunction of left ventricle (LV). But there are few studies about LV diastolic and right ventricular (RV) dysfunction in D-CMP. The purpose of this study is to assess the LV and RV systolic function as well as diastolic function in D-CMP. The purpose of this tudy is to assess the LV and RV systolic function as well as diastolic function in D-CMP. The gated blood pool scan (GBPS) was undertaken in 14 patients with D-CMP and 14 normal controls. The results are as follows : 1) Compared to normal controls, the global and regional ejection fraction of LV were significantly reduced (P<0.001) in D-CMP. But, there was no significant difference in LV ejection time between the two groups. 2) Peak filling rate and peak filling time were significantly reduced (P<0.001, P<0.05) in D-CMP 3) Global ejection fraction of RV was also significantly reduced in D-CMP compared to normal controls (P<0.001) But there was no significant difference in ejection rate of right ventricle between the two groups. 4) There was close correlation (R=0.802) between ejection fraction and filling rate of LV : filling rate was also reduced as ejection fraction decreased. And LV filling rate was also reduced with reduction of ejection rate. It is concluded that D-CMP shows diastolic impairment as well as systolic pumping failure and this systolic dysfunction is accounted for the diastolic impairment in D-CMP. And D-CMP shows also right ventricular dysfunction in almost all cases, as well as left ventricular dysfunction.
Cardiomyopathy, Dilated* ; Heart Ventricles ; Humans ; Ventricular Dysfunction, Left ; Ventricular Dysfunction, Right

PURPOSE: To evaluate RBM surface implant which has its good character like that good initial stability, early bone formation. MATERIAL AND METHODS: In this study fixures have divided in 2 group: Machined(Group I), RBM(Group II). Total 10 fixtures were implanted on rabbit which sacrificed on week 2 and week 4 for the histological specimens. By these specimens polarized microscopic view, micro CT view, ISQ value were measured, compared and analysed by each group to figure out the evidence that clinical use of RBM implant. RESULT: ISQ value had no significance differences between 2 groups, However in each group 4, 8 weeks had higher ISQ value than 2 weeks. In polarized microscope, calcification level was following : Group II, Group I. In micro CT, formation of cancellous bone level was following : Group II, Group I. CONCLUSION: RBM implant was the most excellent on the early bone formation and good initial stability.
Osteogenesis