No abstract available.
Gyeonggi-do* ; Mental Health*

No abstract available.

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

Mass casualty disasters have complex communication requirement. The involvement of many different communication systems and agencies and the difficulty of exchanging information between them is a perplexing problem. This may be compounded by telecommunication systems overload or failure, and electric service disruptions in the disaster area. In addition, emergencies are characterized by a sudden need for an increased information flow, an explosion in the topographical complexity of the information network, and a feeling of intense psychological pressure among the participants. The rescue, treatment, evacuation of a lot of patients from a natural disaster or mass casualties must be performed in accordance to several national agencies. Without an effective communication system, morbidity and mortality will needlessly rise. The stabilization and evacuation off lot of patients in a disaster is a serious and complex medical problem that must be resolved expeditiously. The potential far maximizing care depends on an well-organized rescue. However, without adequate communications, the patient may experience needless delays into the health care system an6 thus compromise prognosis. Established communication systems in most communities consist of private services, provincial and national agencies, and military and amateur radio operator. A disaster situation can severely disrupt routine telephone and radio communication. Customary frequencies may be incompatible with military and emergency civilian frequencies or become overloaded and useless because of intense activity. In a disaster, local telephone communication resources may be destroyed: qualified staffing of communications networks may be inadequate or unavailable to cope with the demands of the emergency. So, we recommend, that Amateur Radio should be provide as a effective emergency communication in a disaster.
Delivery of Health Care ; Disasters* ; Emergencies* ; Explosions ; Humans ; Information Services ; Mass Casualty Incidents ; Military Personnel ; Mortality ; Prognosis ; Telecommunications ; Telephone

No abstract available.
Animals ; Osteomyelitis* ; Rats*

No abstract available.
Animals ; Hyperbaric Oxygenation* ; Osteomyelitis* ; Rats*

PURPOSE: We investigated the effects of phosphatase and tensin homologue deleted on chromosome 10 gene phosphatase and tensin homologue deleted on chromosome 10 gene (PTEN) expression on the cell proliferation and on the responsiveness of troglitazone in osteosarcoma cells. MATERIALS AND METHODS: Western blotting alnalysis was performed to detect the expression of PTEN in U-2OS cells treated with troglitazone. WST (water-soluble tetrazolium) assay was used to evaluate cell proliferation. Flow cytometry was used to determine cell apoptosis. Further, transfection of wild-type PTEN plasmid DNA was used to upregulate PTEN expression. RESULTS: Troglitazone treatment induced growth inhibition of U2-OS cells in a dose- and time-dependent manner. Troglitazone increased the expression of PTEN in a dose-dependent manner. PTEN upregulation induced by troglitazone treatment resulted in cell growth inhibition and apoptosis in U-2OS cells. PTEN over-expression by plasmid transfection enhanced these effects of troglitazone. Moreover, no changes were observed in the mutant type-PTEN group. CONCLUSION: Upregulation of PTEN is involved in the inhibition of cell growth and induction of cell apoptosis by troglitazone. Further, PTEN over-expression can cause cell growth inhibition in osteosarcoma cells and these cell growth inhibitions could be enhance by troglitazone treatment.
Apoptosis ; Blotting, Western ; Cell Proliferation ; Chromans ; Chromosomes, Human, Pair 10 ; DNA ; Flow Cytometry ; Humans ; Microfilament Proteins ; Osteosarcoma ; Plasmids ; Thiazolidinediones ; Transfection ; Up-Regulation

Three cases of Wilms's tumor observed during the period from January, 1969 to October, 1969 are presented and related literature reviewed.
Wilms Tumor

No abstract available.
Spinal Cord Injuries* ; Spinal Cord*

No abstract available.
Tuberculosis*