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

BACKGROUND: The purpose of this study was to develop and apply a prevention program for needle-stick injuries among health care workers who have a high occupational risk of such injuries, and to analyze the effect of the program on the subjects' knowledge regarding such injuries and compliance with protocols, as well as the incidence of needle-stick injuries among subjects. METHODS: The subjects of this study were nurses (RNs) and nurse's aides (NAs) working at a university hospital in Daegu. The data were collected by conducting surveys and determining the incidence of needle-stick injuries during a 1-year period before the application of the program. The program consisted of preventive education on needle-stick injury, the use of standardized boxes to measure blood sugar test, and the use of intravenous catheters with safety needles. Six months after the intervention, surveys were conducted to analyze the incidence of needle-stick injuries. The data on knowledge and compliance related to needle-stick injuries before and after program application were analyzed using the paired t-test, and data on the incidence of injuries were analyzed using the chi-square test. RESULTS: The scores on knowledge (RN, P<0.001; NA, P=0.007) and compliance (RN, P<0.001; NA, P=0.038) were significantly higher after the intervention than before. However, the number of reports on the incidence of needle-stick injuries before and after the intervention were not significantly different (RN, P=0.691; NA, P=0.079). CONCLUSION: The prevention program for needle-stick injuries was effective in improving the knowledge and compliance related to needle-stick injuries among RNs and NAs, but the number of reports on the incidence of injuries showed no difference. Therefore, the prevention program must be reevaluated and further developed after continuously monitoring and analyzing it in a hospital setting in order to decrease the incidence of needle-stick injuries.
Blood Glucose ; Catheters ; Compliance ; Delivery of Health Care ; Humans ; Incidence ; Needles ; Needlestick Injuries ; Nurses' Aides ; Plant Extracts

Acute hematogenous osteomyelitis adjacent to hip, though uncommon, should be included in the differential diagnosis of the patients presenting symptoms suggestive of septic arthritis of hip. When it occurs in children, it is particularly serious, because the diagnosis at first may be very difficult to be made. Our observations on seven cases reported here suggest the following findings to be helpful for early differential diagnosis of osteomyelitis of innominate bones from septic hip. 1. Among 7 cases, 4 had lesions in ischium, and 3 in os ilii. 2. The initial diagnosis on admission in 3 cases out of 7 was wrongly made to be septic arthritis of hip. 3. Early accurate diagnosis is essential to initiate early treatment, and there by shortens the convalescent time and minimize sequelae. 4. The diagnosis could be made in the cases by clinical and roentgenographic findings, such as fever, pain nature, antalgic posture of hip together with range of hip motion, tender point around hip and positive soft tissue and bony X-ray findings, but K-ray taken on early stage of infection could not provide any clue until bone lesion appears. 5. Gentle passive motion of hip is more easily permitted without eliciting severe pain and restriction of motion in the infection of innominate bone than in the septic hip. This also can be another clue to differentiate the acute osteomyelitis of innominate bone from septic arthritis of the hip.
Arthritis, Infectious ; Child ; Diagnosis ; Diagnosis, Differential ; Fever ; Hip ; Humans ; Ischium ; Osteomyelitis ; Pelvic Bones ; Posture

Purpose: The purpose of this study is to identify the relationship among calling, nurse’s image, satisfaction in major, self-efficacy and nursing professionalism and to identify the predictors of nursing professionalism among nursing students. Methods: The research design for this study was a descriptive survey using convenience sampling. Data collection was done using online questionnaires completed by 358 nursing students in G city. The data were analyzed using percentage, mean, standard deviation, t-test, ANOVA, Scheffé test, Pearson correlation analysis and hierarchical multiple regression with the SPSS Win 25.0 Program. Results: The mean score of nursing professionalism was 3.56±0.55 out of a possible 5. Nursing professionalism showed a significantly positive correlation with calling (r=.51, p<.001), nurse’s image (r=.53, p<.001), satisfaction in major (r=.65, p<.001) and self-efficacy (r=.20, p<.001). In the hierarchical multiple regression analysis, satisfaction in major (β=.44, p<.001), nurse’s image (β=.26, p<.001), calling (β=.21, p<.001), self-efficacy (β=.14, p=.002) and servable occupation (β=.15, p=.020) were significant predictors and explained 51% of nursing professionalism. Conclusions The results of the study show factors that influence nursing professionalism in nursing students. Based on the results of the study, nursing professionalism education programs need to include factors that improve calling, nursing image, satisfaction in major and self-efficacy.

Bcl-2 is a proto-oncogene initially described in follicular lymphoma, associated with chromosomal translocation(14;18). Recent studies have shown the presence of Bcl-2 in nonhematolymphoid tissue, especially in hormonally responsive tissue. The endometrium is an attractive model for studying the hormone dependent regulation of Bcl-2 expression. We have studied the immunoreactivity of Bcl-2 oncoprotein in relation to the immunoreactivity of estrogen receptors(ER) and progesterone receptors(PR) by immunohistochemistry in 52 human endometrial carcinomas, according to nuclear grade. The results obtained are summarized as followings, 1) Immunohistochemical grade of Bcl-2 showed a significant inverse correlation with nuclear grade. 2) Immunohistochemical grades of ER and PR also showed a significant inverse correlation with nuclear grade, and were well correlated with each other. 3) Immunohistochemical grades of Bcl-2 and hormone receptors showed a strongly significant correlation. On the basis of the above results, we suggest that Bcl-2 expression may be under hormone dependent control and that it can be used in prognosis and choice of hormonal therapy in the presence of hormone receptor.
Humans

No abstract available.
Ultrasonography, Prenatal*

The author examined the number of AgNORs and PCNA labeling indices by histochemical and immunohistochemical studies in 20 cases of renal cell carcinoma, composed of 5 cases according to the nuclear grades. The results obtained are summarized as follows; 1) Mean number of AgNORs according to the nuclear grades of renal cell carcinoma were 1.38+/-0.40 (mean+/-standard deviation) for Grade I, 2.53+/-0.33 for Grade II, 5.43+/-0.66 for Grade III, and 7.88+/-0.72 for Grade IV. The mean numbers of AgNORs according to the nuclear grades were significantly increased(p=0.0005). 2) PCNA labeling indices (positive nuclear ratio) according to the nuclear grades of renal cell carcinoma were 5.90+/-2.36 for Grade I, 19.30+/-6.71 for Grade II, 45.73+/-8.62 for Grade III, and 61.83+/-6.34 for Grade IV. Also, the PCNA labeling indices according to the nuclear grades were significantly increased(p=0.0008). 3) The mean numbers of AgNORs directly correlated with the PCNA labeling indices (r=0.9861, p<0.001). On the basis of the above results, it was considered that the numbers of AgNORs and PCNA labeling indices as markers of proliferative activity of tumor cells correlate well with the nuclear grades of renal cell carcinoma.

Malignant small cell tumor(MSCT) of the thoracopulmonary region(Askin tumor) is extremely rare and is seen predominantly in children and adolescents. This tumor represents a distinct clinicopathologic entity of neuroectodertnal origin, arising from the soft tissues of the chest wall or peripheral lung. This tumor tends to recur locally, but does not seem to disseminate widely. The overall survival is poor. Recently, we experienced a case of the MSCT of the thoracopulmonary region of a 12-year-old female. She was admitted because of a chest wall mass on radiographic examination, and a complaint of intermittent chest pain. Grossly, the mass was lobulated, round and had a solid appearance with focal necrosis and hemorrhage on the cut surface. Histologically, small round to oval cells were arranged in compact sheets, nests and lobular patterns with intervening fibrovascular stroma. Ultrastructurally, the presence of loose-fitting membrane-bound neurosecretory granules was noted.
Child ; Adolescent ; Male ; Female ; Humans

Telecanthus is abnormal widening between the medial canthi. There are two kinds of telecanthus which are congenital and acquired. Many authors have described and reported about the surgical procedures and their results of telecanthus. We have had 5 cases of surgical experiences for correction of congenital telecanthus by means of transnasal wiring from 1983 to 1986. After surgery, we obtained good cosmetic results without significant complications. The mean postoperative decrease of intermedial canthal distance at 3 months after surgery was 7.2mm (from 38.2mm to 31mm). Transnasal wiring for telecanthus was combined with Y-V plasty for epicanthus inversus after lateral canthoplasty for blepharophimosis. Blepharoptosis was corrected by frontalis sling. More details about surgical procedures and results are described.
Blepharophimosis* ; Blepharoptosis*

The Sertoli-Leydig cell tumor is a gonadal tumor of sex-cord stromal type, similar to that seen in of the various phases of testicular development in the male. This tumor is exceedingly rare, accounting for only 0.1% to 0.5% of all primary ovarian neoplasms. It occurs predominantly in the second and third decades(mean age about 25 years), less than 10% after menopause. We investigated a case of poorly differentiated Sertoli-Leydig cell tumor of right ovary, occured in a 76-year-old woman. Grossly, the tumor measured 2, 100 gm in weight and 25 x 19 x 8 cm in dimensions. The outer surface was smooth and glistening without rupture of the capsule. Cut sections revealed a multilobulated brown solid mass with multiple cystic change. Microscopically, it showed the typical findings o a Sertoli-Leydig cell tumor. The characteristic feature is hemangiopericytoma paftem of sarcomatoid spindle cells. Therefore, we present it with a brief review of the literature.
Female ; Humans