A physician survey was done by mailing for the purpose of performing hospital services evaluation and ranking. A slightly over one thousand samples were drawn from the list of professional societies, and 324 physicians(about 32 percent) replied. This study has focused on developing easy and simple method to evaluate hospital services, and providing patients with useful information. Hospital service structure and process were evaluated without outcome evaluation, because it is difficult to obtain reliable data regarding health services outcome indicators. Clinical specialty was targeted to evaluate, and three specialties were chosen, that is obstetrics & gynecology, cardiology, and proctology. Among 16 structural indicators, four indicators were finally chosen in each specialty by respondent specialists. And then using these indicators, structural score was calculated for study hospitals. For process evaluation, physicians were requested to nominate five most famous hospitals. The nomination score and structural score were summed up to produce final score and hospital ranking. This method is very easy to conduct rather than other hospital services evaluation methods prevailing in Korea. And it is more useful for patients to choose hospitals, according to his/her own purpose, because it gives high ranking hospitals with specific clinical specialty.
Cardiology ; Colorectal Surgery ; Surveys and Questionnaires ; Gynecology ; Health Services ; Humans ; Korea ; Obstetrics ; Postal Service ; Specialization

Transcranial cerebral oximetry has been successfully used in a variety of neurosurgical conditions, primarily those associated with disturbed cerebral circulation. It has been also used in intraoperative monitoring of aortic dissection and surgical procedures performed under deep hypothermia and circulatory arrest. During disending aortic arch exposure, sudden cerebral oxygen saturation change from 63% to 48% was detected. After therapeutic bypass, cerebral oxygen saturation was increased to 65%. During aortic arch repair, deep hypothermic circulatory arrest with retrograde cerebral perfusion was applied for 130 min and cerebral oxygen saturation slowly decreased from 65% to 52%. Patient was discharged from hospital without neurologic complication and cognitive funtion disturbance.
Aorta, Thoracic ; Circulatory Arrest, Deep Hypothermia Induced ; Humans ; Hypothermia ; Monitoring, Intraoperative ; Oximetry ; Oxygen* ; Perfusion

No abstract available.
Child* ; Gastritis* ; Humans

CT scans of 21 patients(intrathoracic goiter=7. Castleman disease=6, pulmonary carcinoid tumor=3, parathyroid adenoma=1, thyroid carcinoma=1, paraganglioma=1, benign pleural mesothelioma=1, sclerosing hemangioma=1) with mediastinal tumors that are known to be enhanced with intravenous injection of contrast media, were studied retrospectively to investigate the enhancing capabilities f those tumors and to describe their CT findings. The degree of enhancement was estimated by visual inspection with a grading system. All but one case of cystic parathyroid adenoma showed enhancement on post-contrast scan. The degree of enhancement was not helpful in differentiating these tumors. Characteristic location and pattern of tumor extension were found in cases of intrathoracic goiter, parathyroid adenoma, thyroid carcinoma and paraganglioma. Calcifications were found in intrathoracic goiter(5/7). Castleman disease(2/6). Pulmonary carcinoid(1/3), thyroid carcinoma. Necrotic low-attenuation areas were in intrathoracic goiter(7/7), parathyroid adenoma, thyroid carcinoma and paraganglioma. In conclusion, mediastinal tumors that are known to be enhanced in the literature were enhanced with rare exception, and if we consider the predilection site of those tumors, the scope of differential diagnosis can reasonably be narrowed.
Carcinoid Tumor ; Contrast Media ; Diagnosis, Differential ; Goiter, Substernal ; Injections, Intravenous ; Paraganglioma ; Parathyroid Neoplasms ; Retrospective Studies ; Thyroid Gland ; Thyroid Neoplasms ; Tomography, X-Ray Computed

BACKGROUND: It has been generally accepted that Cisapride (Prepulsid?or propulsid?), a widely used gastrointestinal prokinetic agent, is associated with Torsades de Points, a life-threatening arrhythmia. Recently, cisapride-induced APD (action potential duration)-prolongation was inhibited by glibenclamide, a KATP channel blocker. But the direct effect of cisapride on K(ATP) channels has not been studied until now. Therefore, we investigated cisapride's effects on KATP channels of isolated rat ventricular myocytes. METHODS: After the isolation of rat ventricular myocytes, we analysed the single channel current with patch pipettes. The method of analysis was the student t-test. RESULTS: 1) Cisapride (10(-6) M- 10(-4) M) inhibited KATP channel opening without changing channel conductance Ki was about 20micronM, and Hill coefficient was 0.75. 2) Cisapride inhibited pinacidil-induced KATP channel opening in the cell attached mode. CONCLUSIONS: These results suggest that cisapride-induced APD prolongation and arrythmic effects may be partly related to KATP channel inhibition.
Animals ; Arrhythmias, Cardiac ; Cisapride* ; Glyburide ; Humans ; KATP Channels ; Muscle Cells ; Rats

No abstract available.
Nephritis, Interstitial* ; Yersinia pseudotuberculosis* ; Yersinia*

OBJECTIVES: The aim of this study is to analyze the utilization behaviour and influencing factors of complementary and alternative medicine (CAM) therapies among elderly people with chronic diseases. METHODS: The study population was selected among 9 welfare facilities for the aged in 2 cities among Daegu Metropolitan City & Gyeongsangnam Province by two-stage cluster sampling. 250 senior citizens participated in a face-to-face interview using a structured questionnaire. Logistic regression analysis was performed to examine the association between the utilization of CAM therapies and various characteristics of the elderly. All statistics were analyzed using the PASW (ver 18.0). RESULTS: Among 233 elderly peoples, 70.4% (164 persons) had used various kinds of CAM therapies (including nutritional methods, pharmacologic and biologic treatments, etc.) more than once during the last year. 48.8% (64 persons) ~ 60.7% (88 persons) of the elderly used CAM therapies without health and medical experts' counsel. The elderly with perceptions of CAM therapy used it 2 times more than those without knowledge of CAM therapies. The number of chronic diseases was more likely to increase the usage of nutritional methods (OR=2.92, 95% CI: 1.07-7.97), manipulative and body-based practices (OR=5.85, 95% CI: 1.97-17.34), pharmacologic and biologic treatments (OR=2.92, 95% CI: 1.49-8.17). Elderly with diabetes used nutritional methods 3.76 (95% CI: 1.49-9.47) more than elderly without diabetes. CONCLUSIONS: CAM therapies use in the aged with chronic diseases appears common. The findings suggest that the clinical efficacy and safety of CAM therapies on medical management of chronic disease may be investigated and that patient-physician communication need to be strengthened.
Aged ; Chronic Disease ; Complementary Therapies ; Humans ; Logistic Models ; Surveys and Questionnaires

No abstract available.

PURPOSE: In advanced case of periodontitis, surgical treatment without bone contouring may result in residual pockets inaccessible to proper cleaning during post-treatment maintenance. This problem can be avoided or reduced by applying guided tissue regeneration. MATERIALS AND METHODS: All of 3 patients had deep periodontal pocket depth and bleeding on probing, and radiograph revealed osseous defect, so we planned guided tissue regeneration using resorbable membrane with or without xenograft. RESULT: 6 months later, periodontal pocket depth and bleeding on probing was improved and gingiva was stable. CONCLUSION: Guided tissue regeneration using resorbable membrane with or without xenograft in osseous defect is predictable.
Gingiva ; Guided Tissue Regeneration ; Hemorrhage ; Humans ; Membranes ; Periodontal Pocket ; Periodontitis ; Transplantation, Heterologous

The medical records of six cases of nesidioblastosis were examined to determine the diagnostic approach, treatment, and neurologic sequelae. All six patients were male, and their ages at the onset of the disease ranged from one day to six months (mean 3.36 +/- 2.5 mo.). Initial clinical features were seizure, cyanosis, poor feeding, and apnea. Other subsequent symptoms were developmental delay, hyperactivity, and cold sweating. The Birth weight of the neonatal onset group was heavier than the postneonatal onset group (4.4 +/- 0.3 vs 3.26 +/- 0.04 kg). Before the diagnosis of hyperinsulinism, steroids of ACTH proved effective for seizure control. Initially, hyperinsulinemia (serum insulin greater than 10 microU/ml) was detected in four cases, but another two cases also showed hyperinsulinism by insulin/glucose(I/G) ratio greater than 0.3 during the fasting test. The glucagon response performed in 2 cases, showed normal and partial responses. Euglycemia was obtained by near total pancreatectomy (95% pancreatic resection)without malabsorption or persistent diabetes. In one case, nesidioblastoma coexisted with nesidioblastosis. Developmental delay was noted in three cases. In this group, the mean duration between symptom onset and operation was longer than the group without developmental delay (1.25 +/- 0.47 vs 0.38 +/- 0.19 yr).
Brain Damage, Chronic/*etiology ; Child, Preschool ; Developmental Disabilities/etiology ; Humans ; Hypoglycemia/blood/*etiology ; Infant ; Infant, Newborn ; Insulin/*blood ; Male ; Pancreatic Diseases/complications/*diagnosis/therapy ; Postoperative Complications/epidemiology