While Joint Commission on Accreditation of Healthcare Organizations(JCAHO) and American College of Surgeon(ACS) have identified certain audit filters in trauma care, there are few studies to substantiate the value of these audit filters. Some researchers found that audit filters qualifiers were significantly associated with adverse outcomes, however, others were unable to reproduce such association. It is also necessary to test their validity and applicability in Korea. The purpose of this present study was to validate two trauma audit filters proposed by the JCAHO and the ACS, through the analysis of the relationship between timeliness of operation and risk-adjusted mortality. Among trauma audit filters, timeliness of operation in epidural or subdural hematoma(EDH/SDH) and intraabdominal injury were selected. By stratified random cluster sampling, 19 emergency medical centers (EMCs) were selected from 30 EMCs and all patients who received craniotomy or laparotomy in 1996 were evaluated in each hospital. Six medical records administrators reviewed medical records of 463 patients with EDH/SDH and of 508 patients with intraabdominal injury retrospectively. In other to adjust risk of mortality, timeliness of operation, age, Revised Trauma Score(RTS), ICD-9CM based ICISS, and experiences of transfer were included in logistic regression model. In the logistic regression models of all EDH/SDH or intraabdominal injury patients, timeliness of operation was not significant predictor of mortality. However, if patients who have been operated later than 12 hours were excluded from the statistical model, timeliness of operation showed significant or marginally significant relationship with mortality in the following situations; craniotomy > 4 hours in EDH(OR=30.46, p=0.032), craniotomy > 8 hours in SDH(OR=6.50, p=0.020), laparotomy > 2 hours in shock patients(OR=9.26, p=0.055). In addition to timeliness of operation, RTS and ICISS were significant variables in every logistic regression model, and experience of transfer and types of EMC were significant or marginally significant only in EDH. Timeliness of operation as audit filters for trauma care could not be applied to all cases. Early operations seem to improve clinical outcome only in the patients for whom emergent craniotomy or laparotomy were indicated. It could be interpreted as a phenomenon of 'confounding by indication'. Additional studies to establish more objective eligibility criteria for these audit filiters are needed.
Accreditation ; Administrative Personnel ; Craniotomy ; Delivery of Health Care ; Emergencies ; Humans ; Joint Commission on Accreditation of Healthcare Organizations ; Joints ; Korea ; Laparotomy ; Logistic Models ; Medical Records ; Models, Statistical ; Mortality ; Retrospective Studies ; Shock

No abstract available.
Gastrointestinal Stromal Tumors*

No abstract available.
Animals ; Interleukin-4* ; Mice*

No abstract available.
Maxillary Sinus* ; Maxillary Sinusitis*

The folling results were obtained through the clinical review and Virology Laboratory of 100 cases of meningitis seen at ward of the pediatric department of Has Sung Hospital during the period from May to June, 1993. 1) Early childhood period was the most frequent age group and male was predominant in aseptic meningitis. 2) The common chief complaints were fever, vomiting, headache in order. 3) On physical examination meningeal irritation signs were not prominent. 4) On admission, leukocytosis (WBC count>10.000/mm(3)) on peripheral blood was showed in 36%. 5) The findings of cerebrospinal fluid showed that cells (Mean WBC count 671.8/mm(3)) were increased in all cases, and protein and sugar were mostly within normal limit. 6) Echovirus 9 was thought to be main causative agent according to the cerebrospinal fluid culture and antibody test. 7) On follow up study 2 months after discharge, 14 cases showed minimal abnormalities of EEG but no abnormal finding in BERA.
Cerebrospinal Fluid ; Echovirus 9 ; Electroencephalography ; Fever ; Follow-Up Studies ; Headache ; Humans ; Leukocytosis ; Male ; Meningitis ; Meningitis, Aseptic* ; Physical Examination ; Virology ; Vomiting

PURPOSE: The purpose of this research was to analyze the effects of an eye protective device and ear protective device application on sleep disorder with coronary disease patients in CCU. METHODS: The research design was set up as a nonequivalent control group non-synchronized design. The subjects were coronary disease patients in the CCU of a tertiary hospital. The subjects were composed of 20 in the group with an eye protective device, 18 in the group with an ear protective device, 17 in the group with an eye protective device and ear protective device and 20 in the control group. The data was analyzed by chi-square-test, ANOVA, Repeated measures ANOVA, Sheffe-test, Simple main effect and Time contrast using SPSS Win 12.0. RESULTS: The hypothesis, 'There are significant differences in sleep quantity among the four groups' was supported (F=1,342.71, p=.000). The hypothesis, 'There are significant differences in the subjective evaluation of the general sleep patterns among the four groups' was supported (F=3,638.73, p=.000). In addition the hypothesis, 'There are significant differences in degree of sleep among the four groups' was supported (F=1,616.61, p=.000). CONCLUSION: It is cost effective and a simple eye protective device and ear protective device should be applied to patients according to their preference and characteristics in the clinical setting.
Aged ; Chi-Square Distribution ; Coronary Care Units ; Coronary Disease/*complications ; *Ear Protective Devices ; *Eye Protective Devices ; Female ; Health Facility Environment ; Humans ; Inpatients ; Lighting ; Male ; Middle Aged ; Noise ; Sleep Disorders/complications/*prevention & control

Actinomycosis, in which the principal causative agent in man is known to Actinomyces israelii, is a chronic, suppurative diseases characterized by extensive fibrosis, multiple abscesses, and formation of sinus tracts that drain suppurative exudates. On the basis of the anatomical sites involved; it can be subclassified into the cervicofacial form, which is the most common form, pulmonary form and abdominal form. Kidneys are rarely affected. Clinically, radiologically, and at operation it is difficult to differentiate the renal actinomycosis from renal tuberculosis and renal carcinoma. The prognosis is excellent after nephrectomy followed by appropriate antibiotic therapy. We presented a case of renal actinomycosis with a brief review of the literatures.
Male ; Humans

Clinical study has been carried out on the 108 cases (108 eyes) of nonperforating traumatic hyphema who had been admitted to Kyungpook National University Hospital during the past five years. Male patients were 95(87.9%) of 108 and the third decade occupied about 40% of all cases. Grade I hyphema(less than one third of the height of the anterior chamber) was 66 cases(61.1%). Various projectiles accounted for nearly one third of the injuries. The most commonly associated ocular injuries included angle re cession, retinal edema, and eyelids laceration. Secondary hemorrhage occurred in 7.4% of all cases, and it seems that rebleeding increased the risk of secondary glaucoma. Although the final visual acuities were worse in eyes with larger hyphema and secondary hemorrhage, the associated ocular injuries such as vitreoretinal disorder, cataract, etc. accounted for the decreased visual acuity.
Cataract ; Eyelids ; Glaucoma ; Gyeongsangbuk-do ; Hemorrhage ; Humans ; Hyphema* ; Lacerations ; Male ; Papilledema ; Visual Acuity

No abstract available.
Rupture* ; Uterus*

To examine prospectively the efficacy and reliability of excimer laser photorefractive keratectomy for myopia. we treated 147 eyes of 86 patients with a VisX Twenty/Twenty excimer laser and followed them up for 1 year and follow up 48 eyes of 26 patients for 2 years. The patients were divided into two groups with preoperative myopia: group 1 with diopters between -1.50 and -6.00, group 2 with diopters between -6.01 and -10.00. At 1 year, the group 1 with a mean preoperative refractive error of -4.61D changed to -0.40D, the group 2 changed from -7.50D to -0.92D. At 2 years, the group 1 with a mean preoperative refractive error of -4.28D changed to -0.41D, the group 2 changed from -7.75D to -1.04D. At 1 yera, in group 1, 90.91% (70 of 77) of eyes and in group 2, 64.29%(45 of 70) of eyes were corrected within 1D of intended refraction,respectively. At 1 years, in group 1, 94.81% (73 of 77) of eyes and in group 2, 84.29%(59 of 70) of eyes achieved an uncorrected visual acuity of 0.5 or better. And at 2 years, in group 1, 81.82% (18 of 22)of eyes, and in group 2, 50.00% (13 of 26) of eyes were corrected within 1D of intended refraction, respectively. At 2 years, in group 1, 95.50% (21% of 22) of eyes and in group 2, 84.62%(22 of 26) of eyes achieved an uncorrected visual acuity of 0.5 or better.
Follow-Up Studies* ; Humans ; Lasers, Excimer* ; Myopia* ; Photorefractive Keratectomy* ; Prospective Studies ; Refractive Errors ; Visual Acuity