Background: Limited access to medical services causes problems in patients’ health and life. Also, hospital closures cause concentration towards general hospitals, which leads to worsening National Health Insurance finance. Therefore, hospital closure is an important topic to be analyzed. Methods: This paper analyzed the factors that affect hospital closures using survival analysis with the data of 970 hospitals opened between 2010 and 2019 in Korea. The number of medical personnel, hospital rooms, sickbeds, and medical departments were used as explanatory variables. Results: The number of medical personnel and hospital rooms increased the survival probability while the number of sickbeds and medical departments decrease the survival probability. Conclusion The results suggest that hospitals have economies of scale and diseconomies of scope in management.

Augmentation mammoplasty can be done in various manners according to the way of approach. the type of implant or implatation site depending on the status and demand of the patients or the operator's preferrence. In reviewing the many published reports about augmentation mammoplasty, they compare their surgical outcomes with mixed factors, so it is difficult to compare the results of mammoplasty simply with one factor under the same conditions. We think that analyzing the surgical results with one consistent method enables to compare and decide the influencing effect of one factor within it in augmentation mammoplasty. We could find the fact that the Korean women who wanted augmentation mammoplasty had same physical characteristics and demands, so developed the standardized method of augmentation mammoplasty among those debatable data for the purpose of increasing the patients' satisfaction, decreasing the complications, and shortening the operation time. The method we adopted was placing the implant through transaxillary subpectoral approach and using the endoscope auxiliarily in additional dissection and hemostasis. We employed saline-filled implants of round, textured type with the size ranging fro 125cc to 175cc and overinflated them by 10 to 30% beyond its original volume. After irrigation of the dissected pocket, we placed the suction drainage system into the subpectoral pocket. We educated the patients to massage their breasts right after removal of the drain. During the period of follow-up (from 6 months to 24 months), most of the patients were satisfied with their operative results. Though we experienced one case of capsular contracture, one case of malposition of the implant, and three cases of scar contracture on axillar incision site, as a whole, we could minimize the complications associated with augmentation mammoplasty. We present our postoperative results with the conclusion that our standardized method of augmentation mammoplasty can bring results of high satisfaction rate, minimal complication, predictability of postoperative results, shortening of operation time when applied consistently to the Korean patients whose physical characteristics are similar. We also hope that stanadardized method can be used to compare the influencing effect of many factors in the case of changing one factor within the standardized in the future follow up period.
Breast ; Cicatrix ; Contracture ; Endoscopes ; Female ; Follow-Up Studies ; Hemostasis ; Hope ; Humans ; Mammaplasty* ; Massage ; Suction

No abstract available.
Humans

Anti-E and anti-c is one of the clinical significant irregular antibodies developing a delayed hemolytic transfusion reaction and hemolytic disease of the newborn. Since anti-c occurs frequently with anti-E in immunized people whosoe cells are E-and c-, it has been recommended to select blood of the patient's own R1 phenotype for transfusion, even when the presence of anti-c cannot be demonstrated in his/her serum. To determine the utility of this approach, we reviewed the blood bank laboratory records of patients identified anti-E and anti-c in his/her serum in Severance hospital over a 12 year period (1985-1996). During the 12-year period of study, 53 patients were identified with anti-E and/or anti-c; 30(56.6%) patients had anti-E alone, 6(11.3%) had anti-c, and 17(32.1%) had both. Thirty eight of forty two patients whose Rh-hr phenotypes were tested were R1R1. Of these 38 R1R1 patients, 16 patients (42.1%) presented with anti-c concomitant with anti-E. Ouru study showed that the incidence of antni-c in R1R1 patients with anti-E is similar to that of studies reported in Caucasian groups. We highly suggest the transfusion protocol of prophylactic use of c negative blood for R1R1 patients with anti-E. Furthermore, because anti-c may be present in concentrations too low to be detected, the enzyme technique is recommended in parallel with standard serologic methods for the identification of irregular antibodies.
Antibodies ; Blood Banks ; Blood Group Incompatibility ; Humans ; Incidence ; Infant, Newborn ; Phenotype

No abstract available.
Blood Donors* ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Humans

No abstract available.

No abstract available.
Ehlers-Danlos Syndrome*

In May 1974, authors encountered a 37 year old Korean male who was suffering from very serious condition of acute abdomen. On exploratory laparotomy, a ruptured granulomatous mass in the proximal portion of the ileum showing extensive inflammatory and gangrenous changes was found and about 4 ft. long of the bowel was resected. From the honey-combed fibrous capsules in the mass, four plerocercoid larvae, spargana, measuring about 3 to 7 cm in lengths were extirpated. The patient had a past history of having eaten the raw flesh of a snake as a tonic about 7 months prior to admission. Four cases of intra-abdominal sparganosis reported previously in Korea and the present case were discussed briefly. Snakes and frogs in Korea are very important second intermediate hosts for the 1arva, Sparganum stage. It is most preferable that the habitual ingestion of the raw fleshes of them should be avoided in this country.
parasitology-helminth-nematoda ; Spirometra sp. ; sparganum ; sparganosis ; laparatomy ; intestine ; perforation ; case report

BACKGROUND: Oxidative stress occurs in white adipose tissue and dysregulates the expression of adipokines secreted from adipocytes. Since adipokines influence inflammation, supplementation with antioxidants might be beneficial for preventing oxidative stress-mediated inflammation in adipocytes and inflammation-associated complications. β-Carotene is the most prominent antioxidant carotenoid and scavenges reactive oxygen species in various tissues. The purpose of this study was to determine whether β-carotene regulates the expression of adipokines, such as adiponectin, monocyte chemoattractant protein-1 (MCP-1), and regulated on activation, normal T cell expressed and secreted (RANTES) in 3T3-L1 adipocytes treated with glucose/glucose oxidase (G/GO). METHODS: 3T3-L1 adipocytes were cultured with or without β-carotene and treated with G/GO, which produces H2O2. mRNA and protein levels in the medium were determined by a real-time PCR and an ELISA. DNA binding activities of transcription factors were assessed using an electrophoretic mobility shift assay. RESULTS: G/GO treatment increased DNA binding affinities of redox-sensitive transcription factors, such as NF-κB, activator protein-1 (AP-1), and STAT3. G/GO treatment reduced the expression of adiponectin and increased the expression of MCP-1 and RANTES. G/GO-induced activations of NF-κB, AP-1, and STAT3 were inhibited by β-carotene. G/GO-induced dysregulation of adiponectin, MCP-1, and RANTES were significantly recovered by treatment with β-carotene. CONCLUSIONS: β-Carotene inhibits oxidative stress-induced inflammation by suppressing pro-inflammatory adipokines MCP-1 and RANTES, and by enhancing adiponectin in adipocytes. β-Carotene may be beneficial for preventing oxidative stress-mediated inflammation, which is related to adipokine dysfunction.
Adipocytes ; Adipokines ; Adiponectin ; Adipose Tissue, White ; Antioxidants ; beta Carotene ; Chemokine CCL2 ; Chemokine CCL5 ; DNA ; Electrophoretic Mobility Shift Assay ; Enzyme-Linked Immunosorbent Assay ; Inflammation ; Oxidative Stress ; Oxidoreductases ; Reactive Oxygen Species ; Real-Time Polymerase Chain Reaction ; RNA, Messenger ; Transcription Factor AP-1 ; Transcription Factors

Urine discoloration occurs in the intensive care unit (ICU) due to many causes such as medications, metabolic disorders, and infections. Propofol is advocated as one of the first line sedatives in the ICU, but it is not well known to the intensivists that propofol can induce urine color change. We experienced two cases of green urine after propofol infusion. Propofol should be warranted as the cause of urine discoloration during ICU stay.
Hypnotics and Sedatives ; Intensive Care Units* ; Propofol*