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

In this paper I report two cases of subconjunctival lipoma in a 16 years old female and in a 12 years old male. The diagnosis was made on the basis of clinical and histopathological findings. Histopathologically the lipoma was composed of several groups of mature fat cells separated from other groups by delicate fibrovascular septae. Lipoma is a benign tumor occurring frequently in the orbit, but they were very large in size and in case 2 the mass had spreaded over the both tarsal conjunctiva and retrobulbar spaces which wasJmpossible to be removed completely.
Adipocytes ; Adolescent ; Child ; Conjunctiva ; Diagnosis ; Female ; Humans ; Lipoma* ; Male ; Orbit

PURPOSE: It is agreed that tumor stage is the definitive prognostic indicator for patients with renal cell carcinoma. We investigated pathologic grade and cell subtype as another prognostic in each tumor stage. MATERIALS AND METHODS: We reviewed the medical records of 206 patients who underwent partial or radical nephrectomy for renal cell carcinoma between January 1991 and June 1998. Renal cell carcinoma grade, stage and cell subtype (conventional [clear cell], papillary, chromophobe, sarcomatoid type) were evaluated using the 1997 Union International Contre Ie cancer (UICC) and the American Joint Committee on Cancer (AJCC) grading, TNM staging criteria and renal cell carcinoma classification. Kaplan -Meier survival curves were used to determine 5-year survival for all patient groups. Univariate analysis using log rank test was performed to evaluate the prognostic significance of TNM stage, Fuhrman nuclear grade, cell subtype and tumor size. We investigated pathologic grade and cell subtype with log rank teat whether those were another significant prognostic factors in each tumor stage. Multivariate analysis was performed to determine which factors had an independent impact on survival of patients with renal cell carcinoma. RESULTS: Univariate analysis revealed that TNM stage (p<0.001), pathologic grad (p<0.001) were the important prognostic indicators for renal cell carcinoma. Survival was affected significantly by tumor size when cutoff diameter for localized T1 lesions was 7cm but not 2.5cm. Pathologic grade had a significant impact on patient survival (p<0.0001). In the cell subtype chromophobe type had the best survival and sarcomatoid type had the worst survival though cell subtype did not appear to affect survival significantly (p=0.0583). Multivariate analysis revealed that N classification (p=0.009) and M classification (p=0.018) were the most important prognostic indicators for cell subtype (p=0.841) were not shown to have any independent impact on patient survival. In the group of localized disease(TXN0M0 stage) at the diagnosis, cell subtype had a significant impact on survival in T1(p<0.001), T2(p=0.01) and T3(p=0.029) and grade in T1(p=0.0016) and T3(p=0.0054). CONCLUSIONS: Pathologic grade and cell subtype were significant predictors of survival in each T stage of localized disease though they didn't have independent impact on the patient survival.
Carcinoma, Renal Cell* ; Classification* ; Diagnosis ; Humans ; Joints ; Medical Records ; Multivariate Analysis ; Neoplasm Staging ; Nephrectomy

No abstract available.

No abstract available.
Humans

A 46 years old male patient had visited to our Ophthalmology department due to abrupt onset of decreased visual acuity in his left eye. He had taken an operation for correction of high myopic astigmatism on both eyes 23 years ago in Japan by Dr. Sato. His visual acuity was: (R)0.3(0.7 x Sph. + 0.75D. = Cyl. - 5.50D.A10 degrees) (L)0.15(0.2 x Sph. - 2.50D. = Cyl. - 2.25D. A180 degrees). On slit lamp examination. hoth cornea had 3mm. (length) radiated linear scars in a number about 50 resulted from myopic operation. In his left cornea, several small vesicles and mild corneal central opacity were observed. We have diagnosed this symptom as artificial corneal endothelial Dystrophy.
Astigmatism ; Cicatrix ; Cornea ; Humans ; Japan ; Male ; Middle Aged ; Myopia* ; Ophthalmology ; Visual Acuity

According to the reports, the prevalence of anti-HCV is about 1%. In past, the results of the high prevalence of anti-HCV in the patients of Hansen's disease were reported. So we study about the status of Hepatitis C of persons affected Hansen's disease. 1. The prevalence of anti-HCV is 35.1%(persons affected Hansen's disease), 0%(health contact), 0.71%(control, general populations). 2. Positivity of RT PCR is 88% in HCV-Ab-positive persons affected Hansen's disease. In the genotype of hepatitis C, type 1 genotype is 68%, and type 2 is 32%. 3. Statistical signification between patients & non-patients in ALT and HCV-Ab-positivity is found P=0.02, P=0.00) and statistical signification according to result of Hepatitis C antibody in ALT, GTT, and AFP is found in persons affected Hansen's disease(P=0.015, P=0.036, P=0.017).
Genotype ; Hepacivirus ; Hepatitis ; Hepatitis C ; Humans ; Leprosy ; Polymerase Chain Reaction ; Prevalence

No abstract available.

To evaluate the etiology and treatment of options in patients with hemospermia, we retrospectively reviewed 21 patients who had both transrectal ultrasound and MRI and have been followed for more than 6 months after initiation of treatment. Mean age was 40 years (range 20 - 50 years) with duration of infliction being 24 months (range 1 week to 16 years). Among the 14 patients with prostatic cyst, 9 patients underwent transurethral unroofing (TUUR) of cyst. All 9 patients were completely cured, but one patient developed postoperative epididymitis. Among the 6 patients with prostatitis, hemospermia was resolved in 4 patients after mean treatment of 12 weeks with antibiotics. In DES (Diethylstilbestrol) group, 50 % showed resolution of symptoms among 6 patients after 4 weeks of treatment, and two patients complained breast discomfort which were developed after medication. In conclusion, the antibiotic treatment is advisable in hemospermia patients with prostatitis. Prostatic cystic lesion is believed to be a factor in hemospermia, thus TUUR of cyst wall and removal of stone and hematoma in cyst can be a viable option.
Anti-Bacterial Agents ; Breast ; Epididymitis ; Hematoma ; Hemospermia* ; Humans ; Magnetic Resonance Imaging ; Male ; Prostatitis ; Retrospective Studies ; Ultrasonography

No abstract available.
Adenocarcinoma* ; Cervix Uteri* ; Fallopian Tubes* ; Female