No abstract available.
Primary Health Care*

No abstract available.
Congenital Hypothyroidism*

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.
C-Reactive Protein* ; Child* ; Diagnosis, Differential* ; Humans ; Meningitis*

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

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

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*

PURPOSE: Kawasaki disease is notorious for coronary arterial complication which is usually developed as a febrile disease in early childhood. Increased polymorphonucleus(PMN) cell levels in acute phases may be associated with the pathophysiology of Kawasaki disease. We studied the relationship between coronary arterial dilatation and elastase activity which was excreted from PMN cell and roles as an important factor for vasculitis. METHODS: Ten patients diagnosed with Kawasaki disease in Yonsei University Medical Center were examined between November, 2001 and January, 2002. In addition, 15 patients with other febrile diseases were also examined. Echocardiography was done in patients with Kawasaki disease on the first day of admission and four weeks after the onset of the disease. At each time, venous samples were drawn and separated into plasma and leukocytes. In patients with other febrile disease, samples were drawn on admission. Elastase activities in plasma and neutrophil extracts were measured. RESULTS: The significant increased plasma elastase activity, 6.19+/-0.74 U/mL, found in Kawasaki disease patients compared with the other febrile disease patients, 4.86+/-1.17 U/mL(P<0.05). And there was no significance between the above two diseases in terms of the elastase activity in neutrophil extracts. The relationship between initial elastase activity and the coronary arterial complication which was shown in subacute phase wasn't significant. CONCLUSION: Plasma elastase activity was increased in Kawasaki disease significantly, but the initial plasma elastase activity in the acute phase could not reflect the range of coronary arterial complication.
Academic Medical Centers ; Dilatation* ; Echocardiography ; Humans* ; Leukocyte Elastase* ; Leukocytes ; Mucocutaneous Lymph Node Syndrome* ; Neutrophils* ; Pancreatic Elastase ; Plasma ; Vasculitis

The purpose of this study was to compare the sleep characteristics between the prone and the supine position in healthy newborns. The 48 newborns were observed in the prone position and the supine position respectively on the 2nd day after birth. The data were collected from January to May, 1999. The state of a newborn was classified and categorized to 6 states (deep sleep, light sleep, drowsy, quiet alert, active alert, crying) by Barnard. The movements of eyes, face and extremities, pulse and arterial oxygen were observed and recorded continuously from the start of sleep after feeding until the time of being woken for the next feeding by a trained nurse. The data was analyzed by using paired t-test. The results of this study were as follows; 1. There was no significant difference in the length of sleeping time between the prone and the supine position. 2. There was no significant difference in the length and frequencies of each states(deep sleep, light sleep, drowsy, quiet alert, active alert, crying) between the prone and the supine position. But the frequency of light sleep in the supine position was significantly higher than that of the prone position. 3. There was no significant difference in the numbers of eyes movements between the prone and the supine sleep position. But the amount of facial and extremity movement in the supine position was significantly higher than those in the prone position 4. There was no significant difference in the arterial oxygen content between the prone and the supine sleep position. 5. There was no significant difference in the heart rates between the prone and the supine sleep position. The above results indicated that the newborns in the prone position moved less and slept deeper than those in the supine position, though there was no difference in the length of sleep or arterial oxygen content between the prone and the supine sleep position. But, Nurses and mothers should consider the relationship between the sleep position and SIDS suggested by previous researches. The infant's 'awakening' during sleep is a normal process and rather valuable because it can provide an opportunity to promote a stronger relationship between mother and baby. So, It is suggested that the supine sleep position is better than the prone sleep position for infants.
Extremities ; Heart Rate ; Humans ; Infant ; Infant, Newborn* ; Mothers ; Oxygen ; Parturition ; Prone Position ; Sudden Infant Death ; Supine Position ; Child Health