No abstract available.
Humans ; Outpatients* ; Psychotherapy*

The rapid change of hospital environment emphasizes the importance of hospital information system. To be effective, the definitions and codes of data which will be required by the health professionals workstation should be standardized. In Korea, many hospitals are implementing order communication system in order to expedite the patient management process, to enhance the service, and for effective management of medical information. Various codes those are in use in hospitals should be standardized for effective interdepartmental and interhospital communication. This paper shows the current status of implementing order communication system in hospitals which have more than 400 beds in Korea, application status of operation an procedure classification systems, e.g., International Classification of Procedures in Medicine, and International Classification of Diseases-9th-Clinical Modification. 22 hospitals (29.0%) are implementing inpatient OCS and 29 hospitals(38.2%) for outpatient OCS. 46 hospitals(60.5%0 are applying ICPM and among them 23 hospitals(50.0%) showed dissatisfaction for that classification system. 30 hospitals(39.5%) are applying ICD-9-CM and none of them revealed dissatisfaction for that classification system. 64 hospitals(84.2%) want new classification system for operation and procedures and 58 hospitals(76.3%) revealed the necessarily of standardization of code of physicans, clinical departments and administrative departments.
Classification ; Health Occupations ; Hospital Information Systems ; Humans ; Inpatients ; International Classification of Diseases ; Korea ; Outpatients

PURPOSE: To analyze contrast-enhancement pattern of stomach cancer on dynamic MRI and to verify the efficacy of intravenous contrast agent in the evaluation of stomach cancer. MATERIALS AND METHODS: Twelve patients with proven stomach cancer underwent dynamic MRI, By using 1.0T scanner, we obtained precontrast FLASH images, and 30, 60, 90 second delay FLASH images after intravenous contrast injection. All patients ingested on liter of water and had intramuscluar injection of Buscopan just before MR study. For quantitative analysis we measured signal to noise ratio (S/N) of stomach cancer on each image, and signal difference to noise ratio (SD/N) between cancer and intraluminal fluid, cancer and the pancreas. For qualitative analysis two radiologists evaluated lesion conspicuity on each image by grading system(grade 0, 1, 2, 3: poor, fair, good, excellent). RESULTS: S/N of stomach cancer increased gradually by time(precontrast, 30, 60, 90 second delay:38.7, 42.5, 57.4, 65.7). SD/N between cancer and intraluminal fluid significantly increased after contrast enhancement(1.24, 25.01, 39.30, 45.89). SD/Ns between cancer and the pancreas were 10.5, 9.33, 9.99, 10.66 respectively. In qualitative analysis, precontrast images were better than postcontrast images for delineation of stomach cancer, Postcontrast images showed clear endo-luminal side of stomach cancer, but outer margin of stomach cancer was more distinct on precontrast images. CONCLUSION: Precontrast MR images are better than postcontrast MR images in the depiction of stomach cancer. Intravenous contrast agent is not imperative in the evaluation of stomach cancer.
Butylscopolammonium Bromide ; Humans ; Magnetic Resonance Imaging* ; Noise ; Pancreas ; Signal-To-Noise Ratio ; Stomach Neoplasms* ; Water

OBJECTIVES: Polycystic ovary syndrome (PCOS) has the feature of excessive LH, hyperandrogenism and disturbance of folliculogenesis. Also, insulin, IGF-I and IGFBP-1 are involved in the pathogenesis of PCOS. Various surgical and medical therapies have been used and the action mechanisms are related to the endocrine effect. Laparoscopic ovarian electrocautery or laser vaporization is effective in the restoration of ovulation and normal menstrual cycle with minimal invasive procedure especially in the patients resistant to medical therapy. Clomiphen citrate (CC) is used for the ovulation induction in PCOS and the resistance is known to be related to insulin, IGF-I, IGFBP-1 levels. This study was performed to evaluate the effect of the laparoscopic laser vaporization on the levels of LH, FSH, testosterone, IGF-I and IGFBP-1 and on the ovarian response to clomiphen citrate in patients with CC-resistant PCOS. MATERIALS AND METHODS: The fasting basal serum LH, FSH, testosterone, IGF-I and IGFBP-1 level were measured in 10 PCOS patients with CC-resistance and 7 normal controls with regular menstrual cycle. In PCOS, after laparoscopic CO2 laser vaporization, endocrine levels were measured in 1 week interval for 4 weeks and then compared with preoperative levels. RESULTS: In PCOS group, mean serum LH/FSH ratio, testosterone, IGF-I levels were higher and IGFBP-1 level was lower than control. LH/FSH ratio decreased from 2.51+/-0.67 to 1.7+/-0.6 (p<0.05) in 2 weeks, to 0.56+/-0.2 (p<0.01) in 3 weeks and to 1.41+/-0.3 (p<0.01) in 4 weeks after operation. Testosterone level decreased from 1.51+/-0.82 ng/ml to 0.65+/-0.34 ng/ml (p<0.05) in 2 weeks, to 0.56+/-0.67 ng/ml (p<0.01) in 3 weeks after operation. IGF-I level also decreased from 436+/-47.5 microgram/l to 187+/-38 microgram/l (p<0.01) in 1 week, to 167+/-42 microgram/l (p<0.01) in 2 weeks, 179+/-55 microgram/l (p<0.01) in 3 weeks and to 120 +/-43 microgram/l (p<0.01) in 4 weeks after operation. IGFBP-1 level showed no significant change. In 8 of 10 PCOS patients, ovulation was induced with low dose clomiphen citrate. CONCLUSION: Laparoscopic CO2 laser vaporization restores normal menstrual cycle and ovulation through endocrine effect of decreasing LH/FSH ratio, testosterone and IGF-I level and increases the response to CC. Therefore it is useful for restoration of normal menstruation and induction of ovulation in CC resistant PCOS patients.
Citric Acid ; Electrocoagulation ; Fasting ; Female ; Humans ; Hyperandrogenism ; Insulin ; Insulin-Like Growth Factor Binding Protein 1 ; Insulin-Like Growth Factor I ; Laser Therapy* ; Lasers, Gas ; Menstrual Cycle ; Menstruation ; Ovulation ; Ovulation Induction ; Polycystic Ovary Syndrome* ; Testosterone ; Volatilization

No abstract available.
Humans ; Infant* ; Infant, Newborn* ; Radial Artery*

To investigate whether the prostatic biopsy specimen can be used for the estimation of total prostatic histologic ratio or not. we compared the relative volume density of glandular lumen from the open prostatectomy specimens with the relative area density of glandular lumen from the biopsied specimens in five patients with benign prostatic hypertrophy. We took four core biopsy specimens from each prostate. The overall correlation coefficiencies between volume densities and area densilies of each one to four combinations were 0.795, 0.898. 0.941 and 0.965 respectively. Furthermore. the probabilities of obtaining statistically significant values from each of one to four biopsy combinations were 50%, 65%, 100% and l00% respectively. In conclusion, the random biopsy specimens taken from more than three different sites would be enough to get the precise and reliable information about the histologic content of prostate.
Biopsy* ; Humans ; Prostate ; Prostatectomy ; Prostatic Hyperplasia*

Epithelioid hemangioendothelioma(EH) is a low-grade tumor of vascular endothelial cell origin, which most commonly occur in the lower extremities of middle-aged patients with an equal gender distribution. It may occur on internal organs such as the liver or lung or bones. A 54-year-old woman who had a history of metastatic adenocarcinoma of unknown origin on the right inguinal lymph node, was presented to us because of a 1.0 x 1.0cm-sized and 2 x 2cm-sized two subcutaneous nodule on her right shin. On H & E stain, there were nests of round nucleated, polygonal, vacuolated cells, some of which contained fragmented erythrocytes. Factor VIII related antigen, CD31 was positive. A diagnosis of epithelioid hemangioendothelioma was established based on histologic, immunohistochemical studies. Wide excision was performed. There was no recurrence nor the development of new lesions so far.
Adenocarcinoma ; Diagnosis ; Endothelial Cells ; Erythrocytes ; Female ; Hemangioendothelioma, Epithelioid* ; Humans ; Liver ; Lower Extremity ; Lung ; Lymph Nodes ; Middle Aged ; Recurrence ; von Willebrand Factor

No abstract available.
Bile Duct Neoplasms* ; Bile Ducts* ; Bile*

Nontuberculous mycobacteria usually cause systemic disease and often appear as a primary pulmonary infection. However, a cutaneous lesion may be the first or only sign of infection. The most frequent human diseases caused by Mycobacterium fortuitum are cutaneous or soft tissue infections, usually preceded by injection, trauma or surgery. We report a case of a cutaneous lesion due to Mycobacterium(M.) fortuitum occuring in a 50-year-old man with a subcutaneous flat nodule on his left anterior tibia. He had received a small injury to his left shin in a swimming pool. The culture from the skin biopsy specimen on Lowenstein-Jensen medium yielded clolnies after 5 days. The microorganism was subsequently identified as M. fortuitum by selected biochemical reactions. Therapy was instituted with minocycline for 5 months.
Biopsy ; Humans ; Middle Aged ; Minocycline ; Mycobacterium fortuitum* ; Mycobacterium* ; Nontuberculous Mycobacteria ; Skin ; Soft Tissue Infections ; Swimming Pools ; Tibia

We compared the clinical performance of central 24-2(C-24-2 test) and central 30-2 full threshold test(C-30-2 test) in detecting glaucomatous visual field defect. Thirty glaucoma patients underwent automated perimetry were enrolled. One eye of each patient was examined with both C-24-2 test and C-30-2 test by a simple crossover design. MD, CPSD, SF, test time and number of question asked were compared using two tests. Whether the differences between two tests would be related to the order of test, the duration between two tests, patient's age, and the degree of visual field loss were performed. C-24-2 test showed 24.4% saving in test time(p<0.001), a lower number of question asked(p<0.001) as well as a increase of MD(0.68+/-1.43dB)(p=0.02). CPSD and SF showed no significant differences between two tests(p>0.05). The increase in MD in C-24-2 test was not related to patient`s age, order of tests, the duration between two tests and degree of visual field defect(p>0.05). In conclusion, C-24-2 test reduced test time and increased MD compared to C-30-2 test. It is suggested that the conventional C-30-2 test can be replaced with C-24-2 test without compromising the reliability and ability to detect localized defects.
Cross-Over Studies ; Glaucoma* ; Humans ; Visual Field Tests ; Visual Fields