No abstract available.
Humans ; Myocardial Infarction* ; Young Adult*

No abstract available.
Fluorides*

BACKGROUND: Herpes zoster is an important and troublesome disease. OBJECTIVE: The purpose of this study was the elucidation of the epidemiological and clinical characteristics of herpes zoster through patient assessrnent. METHODS: During a 5- Year period, January 1990 to December 1994, 215 patients with herpes zoster were assessed with regard to annual and monthly frequency in occurrence, age and gender incidence. Associated conditions, dermatomic distributions, the relationship of onset of pain and skin lesions, Multi-CMI test and complications were also evaluated. RESULTS: 1. The annual freguency of herpes zoster ranged from 0.88% to 1.78% (mean 1.23%) during the 5-year period. The highest number of herpes zoster patients was observed in winter (p<0.001) especially in January. 2. Herpes zoster was found to most frequently afflict persons aged 50-59 (27.9%). 71% of the patients were over 40 years of age. 3. In 76 patients (41.8%), neuralgia occurred several days (4 days mean) before the development of skin lesions. In 92 patients (50.5%), pain and skin lesions developed simultaneously while skin lesion development occurred before the onset of pain in 14 patients (7.7%). 4. Among the patients, 42.8% had associated conditions such as diabetes mellitus, hypertension, pulmonary tuberculosis, liver diseases, peptic ulcer, hypothyroidism, pharyngitis, fracture, etc. 5. The dermatomic invclvement of herpes zoster patients having one dermatome was most frequent in thoracic dermatome ca. es (52.6%). Others included cervical (16.7%), trigeminal (11.6%), sacral (6. 0%), lumbar (4.2%), facial (0.5%). Cases having two different dermatomes constituted 8.4%. 6. The most common complication of herpes zoster was postherpetic neuralgia although instance of ophthalmologic compiications, secondary bacterial infection, scar formation, Ramsay-Hunt syndrome, keloid formation, and urinary difficulty were also documented. 7. Multi-CMI (Cell-mediated immunity) tests were done on 88 herpes zoster patients. Thirteen of them (14.8%) were found to have comparatively depressed scores. Ten of the 79 single dermatome involvement patients (12.7%) and three of the 9 two dermatome involvement patients (33.3%) exhibited similar scores. CONCLUSION: These results are in accordance with those of previous reports with the exception of the higher incidence ot two different dermatome involvements and seasonal variation.
Bacterial Infections ; Cicatrix ; Diabetes Mellitus ; Herpes Zoster* ; Humans ; Hypertension, Pulmonary ; Hypothyroidism ; Incidence ; Keloid ; Liver Diseases ; Neuralgia ; Neuralgia, Postherpetic ; Peptic Ulcer ; Pharyngitis ; Seasons ; Skin ; Tuberculosis

OBJECTIVE: This study was designed to evaluate whether maternal serum human chorionic gonadotropin(hCG) level measured during second trimester could be used as a predictor of pregnancy-induced hypertension. METHODS: Between March 1996 and November l997, 505 pregnant women undergoing second trimester(14-22 weeks of amenorrhea) triple marker screening for neural tube defect and Down syndrome who delivered at our institution were reviewed. All samples were assayed in the same laboratory and medical records were reviewed about medical and obstetrical history. RESULTS: Maternal serum human chorionic gonadotropin level(multiples of the median, MoM) was significantly higher in the pregnancy-induced hypertension group than in the control group. With the use of 2. l multiples of the median as a cutoff value, the sensitivity of human chorionic gonadotropin as a screening marker for development of pregnancy-induced hypertension was 38.7%, the specificity was 95.9%, positive predictive value was 38.7% and negative predictive value was 95.9%. Conlusion: We suggest that second trimester maternal serum human chorionic gonadotropin levels can be used clinically as an early predictive marker for pregnancy-induced hypertension.
Chorion ; Chorionic Gonadotropin* ; Down Syndrome ; Female ; Humans ; Humans* ; Hypertension* ; Hypertension, Pregnancy-Induced ; Mass Screening ; Medical Records ; Neural Tube Defects ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy* ; Pregnant Women ; Sensitivity and Specificity

Although the incidence of tuberculous arthritis of the hip is being decreased with improvement of hygiene and preventive measures and chemotheraphy, it remains as important disease in orthopedic surgery. In order to evaluate which treatment is best in the view of eradication of the tuberculosis and preservation of the function, seventy two patients of tuberculous arthritis of the hip who were treated at the Department of Orthopedic Surgery, Seoul University Hospital for periods of 14 years between January 1970 and August 1983 were analysed clinically. The results are as follows: 1. Age distribution showed that patients below 15 years were thirty (41.7%) and those above 16 years were forty two (58.3%). 2. Onset of the symptoms above 1 year occupied forty two patients (58.3%). 3. Duration of follow up is between 1 year and 14 years with average duration of 3.5 years. 4. Recurrence rate according to the modality of treatment was 12.9% as 4 cases among 31 cases of hip fusion group, 15,2% as 5 cases among 33 cases of synovectomy group, and 28.6% as 2 cases among 7 cases of conservative group. 5. Follow up of the functional evaluation of the hip was 92.9% of “above Fair” as 26 cases among 28 cases of synovectomy group, 60% of “above Fair” as 3 cases among 5 cases of conservetive treatment group, and 25.7% of “above Fair” as 9 cases among 35 cases of hip fusion group. 6. Although the recurrence rate of synovectomy group is a little higher than that of hip fusion group, synovectomy is a better treatment in the view of the preservation of the function of the hip considering Korean life style.
Age Distribution ; Arthritis ; Follow-Up Studies ; Hip ; Humans ; Hygiene ; Incidence ; Life Style ; Orthopedics ; Recurrence ; Seoul ; Tuberculosis

To provide the information necessary for the insurance medicine management plan, price discount rates among the insurance medicines were studied. A total of 2,107 items of insurance medicine of which prices were discounted via government inspections of real transactional process of insurance medicine were analysed. The conclusions are as follows; 1. Among the variables relevant to the characteristics of manufacturers, price discount rates of insurance medicines were statistically significant with production rankings of manufacturers, incorporation year, existence of investments by foreign corporation, existence of a research institute, and enrollment in the exchange. And among the variables relevant to the properties of medicines, the number of enrolled items which have the same components, classification, the date of new enrollment, the sales of items, and the number of raw materials in the items were statistically significant. 2. Stepwide multiple regression was done to identify the factors which affect the price discount rates of insurance medicines. The number of enrolled items which have the same components, production rankings of manufactures, classification number (medicines for function of tissue cells), incorporation year (1940-1949), existence of investments by foreign corporations, classification number (anti-germ medicines), number of raw materials in the items, the sales of items, and medicines whose major objective is not treatment were significant variables and the R2-value for these variables was 21.2%. Considering all of the above results, for management of insurance medicines, it seems important that the real transactional prices of insurance medicines should be identified systematically, focusing on the properties which affect the price discount rates of insurance medicines.
Academies and Institutes ; Classification ; Commerce ; Insurance* ; Investments

No abstract available.
Arteriovenous Fistula* ; Fistula*

No abstract available.
Pancreaticoduodenectomy*

BACKGROUND: The aim of this study was to evaluate the influence of an improved method of endotracheal suction on nosocomial pneumonia (NP) and tracheal colonization by Pseudomonas aeruginosa and Acinetobacter baumannii in intensive care units (ICUs). METHODS: The study was carried out in both the medical and surgical ICUs of a tertiary-care university hospital; 2,347 patients were admitted in the ICUs from January 2003 to December 2004. The method of endotracheal suction to remove secretions was improved by using a sterile, individually packed catheter and sterile fluid filled in a small container for a single use instead of sterile catheters and fluid packed or filled in large containers for a multiple use. Then, we compared the incidence of NP, the colonization rates of P. aeruginosa and A. baumanni in the respiratory tract, and their carbapenem resistance before and after the intervention. RESULTS: The incidence of NP (1,000 patient-day rate) was decreased from 4.08 to 2.46 in the SICU and from 1.4 to 0.8 in the MICU after the intervention, but the differences were not significant. The colonization rate by A. baumannii was decreased significantly from 35.7% to 4.6% in the SICU (P<0.001) and from 12.7% to 7.6% in the MICU (P<0.001). The colonization rate by P. aeruginosa was decreased significantly from 17.7% to 7.4% in the SICU (P<0.001), but not in the MICU. There was also a marked decrease in carbapenem resistance, 21% to 8% in P. aeruginosa and 70% to 16% in A. baumannii. CONCLUSION: Endotracheal suction with a sterile catheter and sterile fluid is important in preventing respiratory infections and colonization by P. aeruginosa and A. baumannii in the ICU.
Acinetobacter baumannii* ; Acinetobacter* ; Catheters ; Colon* ; Drug Resistance, Bacterial ; Humans ; Incidence ; Intensive Care Units* ; Critical Care* ; Pneumonia* ; Pseudomonas aeruginosa* ; Pseudomonas* ; Respiratory System ; Respiratory Tract Infections ; Suction*

Service diversification is recognized as an important strategy against turbulent environmental change. This study is designed to find out the trend of service diversification in Korean health care organizations and also to identify factors associated with the degree of service diversification. Data were collected from 69 hospitals out of 71 hospitals with over 300 beds. Important findings are summarized below. 1. Types of diversification are closely related to hospital size. Large hospitals have a tendency to provide sophisticated service requiring specialized skills and equipment, while small hospital have concentrated their efforts on health screening programs. 2. The more competitive and bigger hospitals are, the greater number of services that provide. Also, hospitals operating rational management information systems provide more services. Contrary to the expectation, hospitals with a low performance during last 3 years showed more service diversification. 3. A trend of more diversification was observed in hospitals whose chief executive officer used a prospector strategy. 4. A multiple regression analysis revealed that bed size, competitive environment, degree of rational management, and the growth pattern were significantly associated with teh service diversification.
Delivery of Health Care ; Health Facility Size ; Hospital Bed Capacity ; Management Information Systems ; Mass Screening