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

Isolated dorsal dislocation of the trapezoid is an unusual injury. In 1990 Ostroski found only 15 cases of dorsal dislocation of the trapezoid in the world literature. The trapezoid is a wedge-shaped bone with the larger dorsal and smaller volar surface area, and stabilized by strong palmar ligaments. Therefore the dislocation of the trapezoid is produced hy a violent force against the dorsum of the hand on a rigid object and often associated with other injuries of the hand. The diagnosis is often missed or delayed perhaps secondary to the difficulty in interpreting the X-ray if you have not kept in mind. Several therapeutic modalities are performed from the collected experience of the authors reporting this injury. A rare example of an isolated dorsal dislocation of the trapezoid bone is described.
Diagnosis ; Dislocations* ; Hand ; Ligaments ; Trapezoid Bone

No abstract available.
Toluene* ; Xylenes*

The effect of taxol on the production of nitric oxide(NO) and reactive oxygen radicals(O2- and H2O2)and on the function of phagocytic activity of murine microglial cells were investigated. Stimulated cells also showed increased production such reactive oxygen radicals as surperoxide and hydrogen peroxide measured by luminometer after stimulated with phorbolmyristate acetate(PMA). Taxol alone had only being small effect on NO synthesis, whereas taxol in combination with rIFN-gamma synergistically increased NO synthesis in a dose dependent manner. The production of NO by taxol plus rIFN-gamma was reduced by such L-arginine analogues as N(G)-mono-metyl-L-arginine Monohydrate(N(G)MMA), and N-amino-L-arginine(NAA) and arginase which decomposes L-arginine. Collectively, the data illustrate the potential for taxol to activate microglia-mediated anticancer mechanisms in the brain in addition to its better characterized effects on ovarian, beast, and lung cancer.
Arginase ; Arginine ; Brain ; Hydrogen Peroxide ; Lung Neoplasms ; Oxygen ; Paclitaxel* ; Reactive Oxygen Species

The common errors in preoperative treatment plan for the orthognathic surgery can be occurred during cast impression, cast mounting procedure with face-bow transfer, surgical stent fabrication, and so on. One of the most common errors exists during mounting process of the model on the articulator. Accurate mounting of dental casts to articulator should be achieved by transferring the 3- dimensional spatial relationship of the maxillary arch to an articulator. A face-bow is used for transfer this relationship to articulator, usually by relating the face-bow to a plane of reference of maxillary cast. The purpose of this study is evaluation of the accuracy of face-bow transferring of maxillary model to the articulator. The maxillary casts of thirty patients for orthognathic surgery were mounted on articulator with an face-bow instrument. The relationship of occlusal plane angle to Frankfort horizontal plane relations were compared the cephalogram with the cast-mounted articulator. As a result of this study, the significant difference between the maxillary occlusal planes angle in the cephalogram and articulator were found . The results were followed,1. The mean occlusal plane angle in cast-mounted articulator was 13.5.(SD+/-5.4).2. The mean occlusal plane angle in cephalogram was 10.4.(SD+/-4.3).3. The mean difference of occlusal plane angle between cast-mounted articulator and cephalogram was 3.3.(SD+/-4.6).According to the result, we should suggest that the occlusal plane angle to Frankfort plane in cast-mounted articulator is more steeper than that of cephalogram.And then, maxillofacial surgeon should try to get a more predictable result by suggesting the proper correction method and mounting the cast accurately.
Dental Articulators ; Dental Occlusion* ; Humans ; Orthognathic Surgery ; Stents

No abstract available.
Information Management* ; Occupational Health*

Ratio analysis allows a hospital to evaluate its own performance over time and to compare its performance with that of other hospitals. For this study, three types of ratio analysis were conducted based on some data on hospitals in Massachusetts. First, Key ratios influencing financial performance were identified using discriminant analysis. Second, the financial structures of the teaching and the non-teaching hospitals were compared using ratios and multiple comparison method. Third, the effects of the prospective reimbursement law of the state on financial performance were examined using ratios and paired t-test. The purpose of the law is to reduce hospital costs by setting the revenue ceiling prior to the effective budget year. The findings of this study were as follows: 1) When hospitals were divided into three groups, according to their operating income, only profitability ratios showed a consistent difference among the groups. 2) In the discriminant analysis, five ratios were selected: current ratio, operating margin, return on assets, fixed assets turnover, and inventory turnover. They are the key ratios to be monitored periodically for the purpose of evaluating the financial performance of hospitals. 3) When teaching hospitals were compared with non-teaching hospitals, acid ratio, days of cash on hand, and inventory turnover were statistically significant before the law went into effect, whereas only fixed assets turnover and inventory turnover were significant afterward. Contrary to previous studies, profitability ratios of teaching hospitals were higher than those of non-teaching hospitals, although the differences were not statistically significant. 4) When the ratios between the two periods (before and after the law) were compared, three profitability ratios (operating margin, return on assets, and return on equity) were significant for teaching hospitals, whereas three activity ratios (total assets turnover, fixed assets turnover, current assets turnover) were significant for non-teaching hospitals. Furthermore, while both total operating revenue and expenses were decreased, net operating income was increased, due to a greater decrease in total operating expenses. This shows that the law can indeed, simultaneously, achieve both a reduction in costs as well as improvement in the financial situation of hospitals.
Budgets ; Hand ; Hospital Costs ; Hospitals, Teaching ; Jurisprudence ; Massachusetts ; Prospective Payment System

Telomerase is an enzyme that maintains telomeres and prevents telomere shortening, and may be linked with cellular proliferation or the aging process. The purpose was to examine telomerase activity in human chorionic villi from early and term normal pregnancies, and to analyze the correlation of telomerase activity (TA) with MIB-1 & bcl-2. A total of 37 placentae were obtained from 16 early and 21 term pregnancies. TA was assayed by telomeric repeat amplification protocol, and immunohistochemical staining was performed for MIB-1 & bcl-2 expression. TA & MIB-1 expression were strong in early placenta, but bcl-2 was highly expressed in term placentae. Thirteen (81.25%) of 16 early placentae showed TA, but only 2 (9.52%) of 21 term placentae expressed TA (p<0.01). MIB-1 was observed in nuclei of cytotrophoblast, and the expression rate was 16.09% in early placentae and 2.87% in term placentae (p<0.01). bcl-2 was observed only in the cytoplasm of syncytiotrophoblast. Term placenta demonstrated stronger expression of bcl-2 compared to early placentae (p<0.05). These findings suggest that TA, MIB-1 & bcl-2 expression are critically regulated over the course of gestation: cytotrophoblast, main cells of early chorionic villi, may be a common source of telomerase and proliferative activity. The TA showed good correlation with cellular proliferative activity. Syncytiotrophoblast, may be a main source of bcl-2 expression which is stronger in the term placentae.
Aging ; Cell Proliferation ; Chorion* ; Chorionic Villi* ; Cytoplasm ; Humans* ; Placenta ; Pregnancy* ; Telomerase* ; Telomere ; Telomere Shortening ; Trophoblasts

The purpose of this study was to identify important items from the medical records to be used in the standardized discharge abstract. Common items were identified by analyzing medical records from the 11 largest hospitals in Seoul. Non-common items were identified by a questionnaire survey from the directors of medical record departments of 152 teaching hospitals. The results of research was follows; 1. Thirty eight common items were included in the analyzed sheet of 11 hospitals. 2. Eighty two non-common items were identified from the analyzed. Of these,10 items were found to be important items for the discharge abstract. 3. Another 26(half) or 18(first quarter) important non-common items were identified from the survey. 4. It was notified in the non-common standardized items group that the importance of some items like the patient's occupation, underlying cause of death, nosocomial infection, complications, house staff code in charge of completing records, and items concerning quality improvement showed difference by the number of beds. The importance of house staff code who is responsible for completion of the record also showed statistically significant difference by the number of beds per medical record professional and by regions. The item of the types of nosocomial infection also showed statistically significant difference between the regions. Most hospitals obtain a lot of medical information from the computerized discharge abstract. One of the results of the study showed that the concerned sheet can housed as both the data for the medical insurance claims and the basic data for medical quality improvement. Therefore, the discharge abstract should be regarded as the most necessary sheet to be standardized. It was found that 92.8% of the directors of medical record departments of nationwide teaching hospitals acknowledged the necessity of standardization of medical record data set.
Cause of Death ; Cross Infection ; Dataset ; Hospitals, Teaching ; Insurance ; Internship and Residency ; Medical Records ; Occupations ; Quality Improvement ; Surveys and Questionnaires ; Seoul

The purpose of this study was to identify important items from the medical records to be used in the standardized discharge abstract. Common items were identified by analyzing medical records from the 11 largest hospitals in Seoul. Non-common items were identified by a questionnaire survey from the directors of medical record departments of 152 teaching hospitals. The results of research was follows; 1. Thirty eight common items were included in the analyzed sheet of 11 hospitals. 2. Eighty two non-common items were identified from the analyzed. Of these,10 items were found to be important items for the discharge abstract. 3. Another 26(half) or 18(first quarter) important non-common items were identified from the survey. 4. It was notified in the non-common standardized items group that the importance of some items like the patient's occupation, underlying cause of death, nosocomial infection, complications, house staff code in charge of completing records, and items concerning quality improvement showed difference by the number of beds. The importance of house staff code who is responsible for completion of the record also showed statistically significant difference by the number of beds per medical record professional and by regions. The item of the types of nosocomial infection also showed statistically significant difference between the regions. Most hospitals obtain a lot of medical information from the computerized discharge abstract. One of the results of the study showed that the concerned sheet can housed as both the data for the medical insurance claims and the basic data for medical quality improvement. Therefore, the discharge abstract should be regarded as the most necessary sheet to be standardized. It was found that 92.8% of the directors of medical record departments of nationwide teaching hospitals acknowledged the necessity of standardization of medical record data set.
Cause of Death ; Cross Infection ; Dataset ; Hospitals, Teaching ; Insurance ; Internship and Residency ; Medical Records ; Occupations ; Quality Improvement ; Surveys and Questionnaires ; Seoul