No abstract available.
Primary Health Care*

No abstract available.
C-Reactive Protein* ; Child* ; Diagnosis, Differential* ; Humans ; Meningitis*

Hospitals have been very susceptable to changes in external environment. Accordingly, they have been experiencing great financial difficulty due to low insurance rates and increasing competition. As a remedy, hospitals have attempted to use computer in a strategic manner. Such system is called strategic information system (SIS) , and order communication system (OCS) is an example of SIS in hospital setting. While OCS has known to be effective in reducing waiting time for outpatients, many hospitals are reluctant to introduce this system mainly because there are no real data or methods for justifying the cost of the system. Cost-benefit analysis has been traditionally used for such purpose, but this method deals with limited portion of benefits and therefore not very useful for analyzing the economic feasibility of SIS. In this paper, information economics tools which expand cost with value was used to analyze the economic feasibility of OCS. To assist the analysis, financial simulation model was developed using simulation package, called IFPS (Interactive Financial Planning System).
Cost-Benefit Analysis ; Humans ; Information Systems ; Insurance ; Outpatients

No abstract available.
Congenital Hypothyroidism*

Congenital hypoprothrombinemia is a rare congenital coagulation defect. The clinical signs are manifestation of generalized tendency such as; mucosal bleeding, hypermenorrhea and post tooth extraction hemorrage. It is associated with prolongation of PT and PTT with normal thrombin time and decreased serum prothrombin level. A case with congenital hypoprothrombinemia was experienced by the authors. A 36 days old male baby was admitted with palor skin and vomiting started one day before admission. Right side brain parenchymal hemorrhage and left shift of lateral ventricle were on brain CT scan. Prologation of prothrombin time and partial prothrombin time with decreased serum prothrombin level were resulted. Serum factor I, V, VII, VIII, IX and X were within normal level. We report a case congenital hypoprothrombinemia with a brief review of relaed literatures.
Brain ; Female ; Fibrinogen ; Hemorrhage ; Humans ; Hypoprothrombinemias* ; Lateral Ventricles ; Male ; Menorrhagia ; Prothrombin ; Prothrombin Time ; Skin ; Thrombin Time ; Tomography, X-Ray Computed ; Tooth Extraction ; Vomiting

Nausea and vomiting are common problems after strabismus surgery in pediatric patients. We compared the effect of propofol with N2O with the effect of a conventional regimen consisting of halothane - N2O on the occurrence of oculocardiac reflex(OCR), recovery characteristics and the incidence of postoperative emesis after strabismus surgery in 46 ASA physical status I children. After intravenous injection of atropine(0.02 mg/kg), patients were randomly assigned to one of two groups. Group l(conrol) received thiopental, vecuronium, halothane and N2O; Group 2(study), propofol 2 mg/kg and vecuronium bolus followed by infusion of propofol 160 mg/kg/min. Patients in group 2 had more episodes of OCR response than group 1, but had shorter time to recovery from anesthesia(p<0;05). But there was no significant difference in the incidence of postoperative nausea and vomiting between two groups. We conclude that the sufficient doses of propofol only regimen and atropine preadministration(0.02 mg/kg) will be necessary in the strabismus surgery of children for the purposes of the prevention of intraoperative OCR, rapid recovery from anesthesia and reduction of postoperative emesis.
Anesthesia ; Atropine ; Child ; Halothane ; Humans ; Incidence ; Injections, Intravenous ; Nausea ; Postoperative Nausea and Vomiting* ; Propofol* ; Reflex, Oculocardiac ; Strabismus* ; Thiopental ; Vecuronium Bromide ; Vomiting

BACKGROUND: Skin thickness for parameter of skin aging has been analysed with various methods. Skin thickness variations between the young and the old has been studied with various methods such as biopsies, calipers, micrometers, computer tomography, ultrsonography. But none of these methods evaluates skin thickness exactly. OBJECTIVE: For the evaluation of age-dependent skin thickness changes, we compared the skin thickness of an old-aged group and a young group with 20MHz-ultrasonography. METHODS: In order to identify the skin thickness variation between different age groups, 60 subjects, 30 aged 23-33, and 30 over 60, were studied with 20MHz-high frequency ultrasonogrphy (Dermascan C, Cortex Technology, Hadsund, Denmark) on fourteen skin sites. This machine was designed to measure the thickness from the top of the epidermis to the bottom of the dermis. After storage of cross-sectional skin imaging, skin thickness was calculated with a computer assisted image-analysis program. Skin thickness of the old was analysed by age, sex, height and weight.
Biopsy ; Dermis ; Epidermis ; Humans ; Skin Aging ; Skin* ; Ultrasonography*

While lipomas are common in the rest of the body, intracranial lipomas are rare condition which are usually found in the midline of the brain. The majority of these lesions show few or even no symptoms and hardly ever produce alarming neurological defects. We experienced a case of corpus callosum lipoma in a 7 year old boy, who has had headache and loss of consciousness twice. He was diagnosed by skull x-rays and brain CT. We made a brief review of literatures. @PG 428.
Brain ; Child ; Corpus Callosum ; Headache ; Humans ; Lipoma* ; Male ; Skull ; Unconsciousness

The question has been raised whether the medical fee schedule is very low in Korea. However, studies that empirically address this matter on a national scale are rare. This study attempted to determine the level of Korea's medical fees for caesarean section (C-section), cataract, and appendectomy surgeries by comparing and analyzing them with other Organization for Economic Cooperation and Development (OECD) countries' medical cost data obtained from other studies. There are two ways to compare the level of medical fees: one is a direct comparison, which obtains each country's medical fee schedule and compares them with each other. Another is indirect comparison, a method which compares data such as physician income. For direct comparison, fees were calculated using data provided by the OECD and Health Insurance Review and Assessment. For indirect comparison by physician income, data obtained from Korea Employment Information Services were used to represent Korean physician income. When compared with other OECD countries, the results suggest that, overall, the Korean fee schedule could be low, based on the fees for C-section, cataract, and appendectomy surgeries. The study results also confirm that Korean physicians' average earnings ranked relatively low among OECD countries. These results are meaningful in that they empirically support the contention that Korean medical fees could be low. In addition, under what is known as national health insurance, in which the medical fee schedule is determined by a single payer, an empirical analysis on medical fee levels, as in this study, has substantial political implications because it may be utilized for medical fee schedule negotiation in the near future. An attempt to directly research fees and the range of services of OECD countries is still needed in order to provide more established data.
Appendectomy ; Appointments and Schedules ; Cataract ; Cesarean Section ; Employment ; Fee Schedules ; Fees and Charges ; Fees, Medical ; Female ; Information Services ; Insurance, Health ; Korea ; National Health Programs ; Negotiating ; Pregnancy

The scimitar syndrome is a rare malfomation that can be defined as a partial or complete right pulmonary venous return into inferior vena cava immediately above or below the siaphragm. This malfomation is often associated with hypoplasia of right lung, anomalous arterial supply of the lower part of the lung, and cardiac dextroversion. We experienced a case of scimitar syndrome in a 15 years old girl and presenting the case with a brief review of the literature.
Adolescent ; Female ; Humans ; Lung ; Scimitar Syndrome* ; Vena Cava, Inferior