No abstract available.
B-Lymphocytes* ; Lymph Nodes* ; Pertussis Toxin* ; Whooping Cough*

No abstract available.
Anthrax*

OBJECTIVE: To evaluate the maternal complications and perinatal outcomes in twin pre-gnancies with one fetal demise PATIENTS: From January 1990 to December 1996, 20 twin pregnancies with single fetal death were observed in Seoul National University Hospital : in 6 cases(group 1) between 20 ~26 weeks and in 14 cases(group 2) after 26 weeks gestation by gestational age of fetal death ; in 7 cases of monochorionic and in 13 cases of dichorionic placentation. RESULTS: The incidence of one fetal death was 5.4% in twin pregnancy. Diagnosis-to- delivery interval of group 1 was longer than group 2(61.0 days : 8.9 days). So it was thou- ght that the gestational age of delivery in group 1 was not always earlier than in group 2. And other parameters(chorionicity, preterm delivery, cesarean section, coagulopathy, IUGR, perinatal mortality, neurologic sequelae, IVH) didn't show the statistical differences between group 1 and group 2. According to chorionicity, it seemed that the perinatal mortality rate of monochorionic group was higher than dichorionic(86% : 62%) and that cesarean section rate was higher in dichorionic group(54% : 14%). But there were no statistical significances between two gruops. All other parameters also didn't show differences statistically. CONCLUSION: We fail to demonstrate that monochorionic placentation is associated with increased risks for the survivor in twin pregnancies of single fetal demise. It may be part- ially explained due to small numbers of cases in this study.
Cesarean Section ; Chorion ; Female ; Fetal Death ; Fetal Growth Retardation ; Gestational Age ; Humans ; Incidence ; Perinatal Mortality ; Placentation ; Pregnancy ; Pregnancy, Twin* ; Seoul ; Survivors

No abstract available.
Animals ; Autografts* ; Rats*

Oncogenous or tumor-induced rickets is recognized as Vitamin D-resistant hypophosphatemic rickets that heals after excision of a coexisting tumor in either bone or soft tissue. Its pathogenesis is not clarified, but it has been suggested that the tumor elaborates a homoral substance inhibiting tubular reabsorption of phosphate or that the tumor inhibits the synthetic process of 1, 25-dihydroxcholecalciferol. We present two cases of vitamin D-resistant rickets, one associated with intrasseous well-differentiated osteosarcoma in the pelvis and the other associated with fibrosarcoma of distal femur. The case with low grade osteosarcoma showed immediate improvement of rickets after excision of the tumor, but the case with fibrosarcoma showed no improvement after amputation and was fatally terminated 5 months later due to lung metastasis.
Amputation ; Femur ; Fibrosarcoma ; Lung ; Neoplasm Metastasis ; Osteosarcoma ; Pelvis ; Rickets ; Rickets, Hypophosphatemic ; Vitamins

No abstract available.

No abstract available.

A case of Dariers disease was presented and the literatures were reviewed. The patient was 20 year old male whose skin lesions revealed normal skin colored, dirty, scaly, keratotic papules with mild itching on face, anterior chest, back, abdomen, axillae, groins and flexural surfaces of extremities. They had a tendency to aggrevate in summer and improve in winter. Histopathologically, suprabasal lacunae, hyperkeratosis, papiIIomatosis, moderate degree of acanthosis and corps ronds in Iacuna were demonstrated in the epidermis. Dermal papillae surrounded with single layer of basal cells proliferated inta the lacunae. Upper dermis revealed mild nonspecific inflammatory cell infiltrates.
Abdomen ; Axilla ; Darier Disease* ; Dermis ; Epidermis ; Extremities ; Groin ; Humans ; Male ; Pruritus ; Skin ; Thorax ; Young Adult

Service diversification is recognized as an important strategy against turbulent environmental change. This study is designed to find out the trend of service diversification in Korean health care organizations and also to identify factors associated with the degree of service diversification. Data were collected from 69 hospitals out of 71 hospitals with over 300 beds. Important findings are summarized below. 1. Types of diversification are closely related to hospital size. Large hospitals have a tendency to provide sophisticated service requiring specialized skills and equipment, while small hospital have concentrated their efforts on health screening programs. 2. The more competitive and bigger hospitals are, the greater number of services that provide. Also, hospitals operating rational management information systems provide more services. Contrary to the expectation, hospitals with a low performance during last 3 years showed more service diversification. 3. A trend of more diversification was observed in hospitals whose chief executive officer used a prospector strategy. 4. A multiple regression analysis revealed that bed size, competitive environment, degree of rational management, and the growth pattern were significantly associated with teh service diversification.
Delivery of Health Care ; Health Facility Size ; Hospital Bed Capacity ; Management Information Systems ; Mass Screening

Demand for high quality medical care has recently been increasing in step with high level of income and education. Patients prefer the use of large general hospitals to small community hospitals. Large hospitals, usually located at urban area, expand their capacities to cope with the increasing demand, therefore, they easily secure revenue necessary for growth and development of hospitals. However, small community hospitals are facing with serious financial difficulties caused from the reduction of patients in one hand and the inflation of cost in another. If small rural hospitals were closed, the closure would have negative impacts on local economies in addition to the decrease in access to medical care. Community leaders should have an insight on the contribution of community hospitals to local economies. They could make a rational decision on the hospital closure only with the understanding of hospital's contribution to the community. This study is designed to develop an economic model to estimate the contribution of rural hospital to local economies, and also to apply this model with a specific hospital. The contribution of a hospital to local economies consists of two elements, direct effect and multiplier effects. The direct impacts include hospital's local purchasing power, employee's local purchasing power, and the consumption of patients coming from outside the community. The direct impact induces multiplication effect in the local economy. The seed money invested to other industries grows through economic activities in the economy. The seed money invested to other industries grows through economic activities in the region. This study estimated the direct effect with the data of expenditure of the case hospital. The total effect was calculated by multiplied the direct effect with a multiplier. The multiplier was drown from the ratio of marginal propensity of income and expenditure. Beside the estimation of the total impacts, the economic effect from the external resources was also analyzed by the use of the ratio of patients coming outside the region. The results are as follows. 1. The direct economic contribution of the hospital to the local economy is 1,104 million won. 2. The value of multiplier in the region is 2.976. 3. The total economic effect is 3,286 million won, and the multiplication effect is 2,182 million won. 4. The economic contribution from the external resources is 245 million won which is 7.5% of the total economic effect.
Education ; Growth and Development ; Hand ; Health Expenditures ; Health Facility Closure ; Hospitals, Community ; Hospitals, General ; Hospitals, Rural* ; Humans ; Inflation, Economic ; Models, Economic