According to the need for objectivity and convenience the whole planning process is devided into a secries of 8 systematic stages. But it is an unending upward spiral of incremented efforts toward improvement. So many activities should be carried out concurrently, providing a mutual supportive flow back and forth between various stages of the process depending on local conditions and requirements. The eight stages are : (1) Planning the Planning and Developing Planning competence, (2) Statements of Policy and Broad Goals, (3) Data Gathering, (4) Priority Statement, (5) Statement of Major Alternative Proposals, (6) Development of Detailed Plan, (7) Implementation as a Part of the Planning Process, (8) Evaluation. The frame and function of the planning machinery must be adjusted to local conditions, and also flexibility is desirable, especially at the start, when adaptations are more necessary and more frequent.
Mental Competency ; Pliability ; Regional Health Planning*

A flow cytometric analysis of the nuclear DNA content of solid tumors using paraffin-embedded tissues has become available since 1983, and its ploidy pattern has been designated as an important prognostic parameter in many human tumors. Hepatocellular carcinoma(HCC) is one of the most common malignant tumors among Koreans, but little information is consolidated about the significance of ploidy pattern. We measured the nuclear DNA content of 62 surgically resected HCCs and 45 non-neoplastic tissues from the surrounding parenchyma by flow cytometry. Aneuploid was detected in 18 cases(29.0%) in HCCs and 2 cases(4.4%) in nonneoplastic hepatic parenchyma(p<0.005). Correlations between the DNA ploidy pattern and various clinicopathologic findings of HCCs were analized. The mean tumor size was significantly different(p<0.05) between the aneuploid group(8.8 cm) and the diploid group(6.1 cm). Mean age of the aneuploid group was younger(47 year) than the diploid group(51 years), but the difference was not statistically significant(p=0.052). The DNA pattern did not show any meaningful correlation with the gross and microscopic features of HCC except for the presence of capsule. These results suggest that DNA ploidy correlates with growth rate of the tumor and it may be a possibly useful prognostic factor in HCCs.
Humans ; Carcinoma, Hepatocellular

No abstract available.
Hemodynamics* ; Hypertension, Pulmonary*

No abstract available.
Humans ; Irritable Bowel Syndrome*

No abstract available.
Child* ; Humans ; Infant* ; Intussusception*

80 cases of Cysticercosis were studied and analysed, which were diagnoses by biopsy at Seoul National University in the past three years from January-1978 to March-1980. The results were summerized as follows. 1. The relative incidence ratio of cysticercosis among 18,941 surgical specimens was 0.42%. 2. The age group between 11 and 50 years old occupied 87.5%. 3. Of the 80 cases, there were 38 males and 42 female patients, without significant sex predominence. 4. The common sites of cysticercosis were upper extremities (35.0%) and anterior surface of the trunk (37.5%) 5. Epidemiologically, there was marked predominence of rural area over urban area. 6. There were 8 cases (10%) of definite cerebral cysticercosis and 4 cases (5%) of suspicious cerebral cysticercosis. 7. In the cases of nodular masses of extremities, the parasitic infection, especiaily cysticercosis celluiosae, must be included in differential diagnosis distinguished from other soft tissue tumors.
Biopsy ; Cysticercosis ; Diagnosis ; Diagnosis, Differential ; Extremities ; Female ; Humans ; Incidence ; Male ; Seoul ; Upper Extremity

Evaluation and management of the anterior cruciate ligament (ACL) deficient knee pose several problems. For acute injuries, the essential factors are diagnosis of the ACL rupture and associated injuries, and selection of the appropriate method of the management. Until recently, the frequency of complete disruption of the ACL was though to be less than that of the medial collateral ligament. However, there is little doubt that the ACL is the most frequently torn ligament in the knee. Diagnosis may be made with a combination of tests: Anterior drawer, valgus or varus stress test, Lachman, and pivot shift. If the patients is unable to relax because of pain or fear, examination under the anesthesia should be performed. Treatment can be surgical or nonsurgical. Since the ACL is vital to normal knee function, surgical intervention is advisable in the majority of cases of acute disruption. Authors analyzed the records of 58 cases of acute knee ligament injuried patients treated at the department of Orthopaedic Surgery, Kang-Nam St. Marys Hospital, Catholic Medical College and Center, from November 1982 to January 1984, with follow-up range from 6 to 20 months. 1. Among 58 cases, 41(71%) had anterior cruciate ligament injury and 39(67%) had medial collateral ligament injury. 2. The causes of injury were mostly traffic accident (77%) and majority of the patients was in their twenties and thirties of age. 3. Among 41 cases of ACL Injury, 5 had isolated anterior cruciate injury, 27 cases (66%) had associated medial collateral injury, 9 (22%) had associated lateral collateral injury, and 7 (17%) had associated posterior cruciate ligament injury. 4. Meniscal injury was found only in 6 cases (15%); 4 medial and 2 lateral menisci. 5. Majority of anterior cruciate injured patients (71%) had more than 5mm joint openning than normal side in valgus or varus stress radiogram with the knee in extension. 6. In all cases of anterior cruciate ligament injured patients, the Lachman test was positive under the general anesthesia, hut anterior drawer test was positive in 80%. 7. In about 90% of the cases, the anterolateral rotatory instability (ALRI) test was positive and this finding was accentuated when the lateral collateral ligament was torn. 8. Among 41 cases, 16 (39%) had failure at the insertion site, 7 (17%) had tibial spine avulsion, and 9 patients each (22%) had tear at the ligament substance level and had grade II sprain. 9. In twenty-three, primary repair was done, in 9, primary intra-articular recopstruction was performed and 9 were treated conservatively. The result was from fair to excellent almost in all cases.
Accidents, Traffic ; Anesthesia ; Anesthesia, General ; Anterior Cruciate Ligament ; Clinical Study ; Collateral Ligaments ; Diagnosis ; Exercise Test ; Follow-Up Studies ; Humans ; Joints ; Knee ; Lateral Ligament, Ankle ; Ligaments ; Menisci, Tibial ; Methods ; Posterior Cruciate Ligament ; Rupture ; Spine ; Sprains and Strains ; Tears

Congenital scoliosis is defined as a lateral curvature of the spine caused by congenital anomalies of the vertebral development. In this study seventeen congenital scoliosis patients seen and treated by either Milwaukee brace or surgical intervention at Department of Orthopedic Surgery, Seoul National University Hospital from December 1972 to April 1978 were evaluated according to frequency of the curve pattern, character of the deformity, method of treatment and its correctability. The following results were obtained in this study. 1. Age distribution was from 2 to 39 years and mean age was 13.4 years. 2. The most common deformity pattern was hemivertebra in 8 cases (47.1%), unilateral unsegmented bar in 4 (23.6%) and mixed type in 3 (17.6%). 3. The most common curve level was thoracic in 6 cases (35.3%), followed by thoracolumbar in 4 (23.5%) and lumbar in 4 (23.5%). 4. The best corrected type by Milwaukee brace was trapezoid vertebra (29.4%) and then mixed type(26.1%), followed by block type (20%) and hemivertebra(2.3%). 5. The operative treatment was performed in the cases of unilateral bar and progressive type with Milwaukee brace. In terms of the correctability of the curvature, the surgical intervention was better than the conservative treatment, with the result of its average correction of 33.5% that is compared with 15.9% of Milwaukee brace. 6. Halofemoral traction was effectively applied in the cases of rigid and severe curve; the initial curve 76.3 degress with 21.3% of flexibility. 7. Loss of correction in operative treatment was 2.3 degrees (6.5%).
Age Distribution ; Braces ; Congenital Abnormalities ; Humans ; Methods ; Orthopedics ; Pliability ; Scoliosis ; Seoul ; Spine ; Traction

PURPOSE: To determine the necessity of site-specific bone mineral density(BMD) measurement and the difference between the BMD of the two femora using DXA in the evaluation of osteoporosis. MATERIALS & METHODS: Total BMD and regional BMD(Lumbar spine, femoral neck, Ward's area, intertrochanter area) were measured on seventy-eight healthy persons without previons diseases, and the statistical significance analyzed. RESULTS: Total BMD did not reliably reflect the site-specific BMD. There was a high correlation between BMD in opposing femora. Correlation coefficients between the femoral neck, Ward's area, trochanter area were 0. 939, 0.874 and 0.916 respectively. CONCLUSION: We conclude that a measuremnt of site-specific BMD is necessory because the total BMD can not reliably predict the regional BMD. The measurement of BMD in one femur can predict the BMD of the contralateral femur. If there is no history of femoral neck disease, unilateral BMD measurement is recommended for femoral evaluation.
Absorptiometry, Photon* ; Femur ; Femur Neck ; Humans ; Osteoporosis ; Spine

PURPOSE: To assess the characteristic features of MR imaging in the diagnosis of spinal tuberculosis. MATERIALS AND METHODS: We retrospectively reviewed MR imaging of 27 cases with pathologically-proven spinal tuberculosis and analyzed the MR findings including the extent of the lesions on non-contrast T1, proton density, and T2*VI, and the specific contrast enhancement patterns of the lesion on Gd-DTPA enhnced TIWI. RESULTS: The inflammatory lesions showed low signal intensity on T1WI in 25 patients(93%) and high signal intensity on T2*gradient echo image in 25 patients(93%). Bone destruction was noted in 15 patients(55%), disc-space narrowing in 21 patients(77%), paravertebral abscess in 16 patients(59%), subligamentous extension in 23 patients(85%), kyphosis in 8 patients(29%), and spinal canal narrowing in 19 patients(70%). After Gd-DTPA was administrated, rim-enhancement was noted in all patients(100%). CONCLUSION: We conclude that MR imaging is an excellent imaging modality for establishing the diagnosis of spinal tuberculosis as well as delineating the extent of soft tissue involvement. Characteristic peripheral rim enhancement after injection of Gd-DTPA may provide rather specific diagnosis in spinal tuberculosis.
Abscess ; Diagnosis ; Gadolinium DTPA ; Kyphosis ; Magnetic Resonance Imaging* ; Protons ; Retrospective Studies ; Spinal Canal ; Tuberculosis, Spinal*