No abstract available.
Subclavian Artery* ; Thoracic Outlet Syndrome* ; Thromboembolism*

The purpose of this study was to examine the trends of length of hospital stay (LOS), which is most likely to be a major attribute to hospital performance From 1984 to 1994, an average LOS of each hospital was analyzed by factors such as medical departments, bed size, occupancy rate, region and ownership. This study was analyzed changing rate of LOS during 11 years. This rate was calculated by simple regression, which was used only with hospital without missing data during 11 years. This study findings are as follows. 1. The results indicated that the average LOS was steadily increased until 1990 but it was slightly decreased after 1990. 2. This trend could be found in all hospital scale and all group of occupancy rate. Specifically this trends of LOS were found in internal medicine, corporate owned hospitals, and hospitals in major city. But LOS of individual owned hospital was continuously increased until 1994. 3. Means of changing rates of LOS were calculated from 1984 to 1994. If we divided it into two parts, before 1990 and after 1990, most changing rates of LOS before 1990 except individual owned hospital were found positive sign. The changing rates after 1990 were negative sign but small hospital(lesser then 200 bed), individual owned hospital, national & public hospital and hospital in small urban have little change of LOS after 1990. Finally from this results we thought that most hospitals in korea began to be concerned with LOS. Nevertheless LOS of several hospital such as small hospital or individual owned hospital was increased. And this trend may be caused by a few patients, low occupancy rate, or low profit. This trend of LOS is different from that of other countries. Perhaps this phenomenon is resulted from the reimbursement method. Because of fee for service reimbursement system in korea the hospitals didn't need to shorten LOS in order to save the cost and increase the profit. Therefore reform of hospital cost reimbursement method will be reduced to reduce hospital cost in korea. we thought that the korean health authority should consider the reimbursement method by unit of bundle of services, for example DRG and prepayment in the united states. This study presents some limitations such as on insight of severity of disease, case-mix measurement of hospital, and other clinical characteristics that can possibly affect LOS, However, this study reports an important trend in LOS from 1984 to 1994.
Diagnosis-Related Groups ; Fee-for-Service Plans ; Hospital Bed Capacity ; Hospital Costs ; Hospitals, Public ; Humans ; Internal Medicine ; Korea* ; Length of Stay* ; Ownership ; United States

Five cases of tennis elbow seen during the time period from Jaunary 1983 to January 1985 had operative treatment. Of the five clinical cases, four elbows in three patients were treated with Nirschl and Pettrone operation. This operative technique included exposure of the extensor carpi radialis brevis, excision of the identified lesion, and repair. The following results were obtained. 1. Correct analysis of the patient's emotional stability was essential prior to undertaking surgical procedure for tennis elbow. 2. The results of Nirschl and Pettrone operation were graded as excellent in three elbows and fair in one.
Elbow ; Humans ; Mortuary Practice ; Tennis Elbow ; Tennis

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

No abstract available.
Eustachian Tube*

Actinomycosis is a chronic suppurative and granulomatous bacterial infection characterized by contiguous spread, abscess formation and sinus tract formation. There are four clinical forms according to the lesional site, as 1) cervicofacial, 2) thoracic, 3) abdominal, and 4) disseminated form. Recently, we experienced a case of 54 year-old patient with left mandibular actinomycosis. The pathognomonic findings of actinomycosis is sulfur granule with multiple filaments in Gram-stain and the treatment of actinomycosis is surgical excision of mass or sinus tract with massive antibiotics (esp. Penicillin) therapy for 6 to 12 months.
Abscess ; Actinomycosis* ; Anti-Bacterial Agents ; Bacterial Infections ; Humans ; Penicillins ; Sulfur

No abstract available.
Esophageal Neoplasms*

BACKGROUND: It is well known that atrial fibrillation is common cardiac arrythmia in old age and poses a definitive risk factor of cerebral infarction. Therefore, effective treatment of atrial fibrillation is very important in the prevention of cerebral infarction. However, oral anticoagulant medication for the prevention of embolic ischemic stroke may be dangerous due to cerebral hemorrhage side effects. METHODS: This is a controlled case study designed to identify the risk factors in a large numbers of stroke and atrial fibrillation patients and to assess those patients with atrial fibrillation as a high risk group for cerebral infarction. All patient discharged from Chonnam National University Hospital were identified over a 42 month period who met our case standards of atrial fibrillation and ischemic stroke (n=62), and compared them with the control groups who were discharged with atrial fibrillation without stroke(n=68). We excluded the atrial fibrillation due to valvular heart disease, ischemic heart disease and congestive heart failure during the selection of subjects. RESULTS: Subjects and the controls were characteristically similar with common past medical histories of diabets, smoking, and hyperlipidemia. Sex, familial history, left ventricular hypertrophy in 2D-echocardiogram were also similar in both groups, however differences did exist. Subjects were significantly older than controls(68.9 : 63.9, p<0.001) and more likely to have a history of hypertension(56.5% : 23.5%, p<0.001) and left atrial enlargement(>40mm)(52.6% : 29.0%, p<0.001). Each of these 3 factors were assinged a measure of 1 point as a risk score, ischemic embolic stroke was found in 4 out of 28 patients(14.3%) with a risk score of 0, in 16 out of 39 patients(41.0%) with a risk score of 1, in 29 out of 41 patients(70.7%) with a risk score of 2, in 8 out of 11 patients(72.7%) with a risk score of 3. CONCLUSIONS: Based on the above results, a subject having more than two risk factors should be regarded as a high risk group for cerebral infarction and the long term anticoagulant therapy for the prevention of stroke may also be necessary even though some complications are present.
Arrhythmias, Cardiac ; Atrial Fibrillation* ; Cerebral Hemorrhage ; Cerebral Infarction* ; Heart Failure ; Heart Valve Diseases ; Humans ; Hyperlipidemias ; Hypertension ; Hypertrophy, Left Ventricular ; Jeollanam-do ; Myocardial Ischemia ; Patient Selection ; Risk Factors* ; Smoke ; Smoking ; Stroke

This paper reports a case of a patient aged 63 years who developed a delayed pneumothorax after thoracic paravertebral block (TPVB). TPVB is a non-invasive procedure that is known to be relatively safe. A 63-year-old female was admitted with back pain. TPVB T9–10 left was then performed. Two days after the procedure, she complained of dyspnea in the emergency room. X-ray showed a pneumothorax in her left side with partial left lung collapse. The pneumothorax was managed by surgical intervention, and an intercostal tube was inserted. The post-procedural X-ray showed a fully expanded lung. A chest tube was taken out after 72 hours. A delayed pneumothorax can occur after TPVB. Therefore, careful observation is required after this procedure.

OBJECTIVE: We analyzed 200 cases of prenatal amniocentesis and compared them with other reported studies. Thus we propose the necessity of metanalysis for prenatal amniocentesis. METHOD: We analyzed 200 cases that have undergone amniocentesis at Masan Samsung hospital from January 1996 to December 1997. The results of our study was compared with other reported studies of amniocentesis by indication and maternal age. The proportion of age-class and indication are compared between previous study subjects and our 200 cases. RESULTS: Triple marker abnormality was the most common indication of amniocentesis(51%) and the most common age distribution was 25-29 years (43.5%). Chromosomal aberration was diagnosed in 20 cases (10%) of which the numerical aberration was 9 cases (4.5%) and the structural aberration was 11 cases (5.5%). 5 cases (2.5%) out of ll cases of the structural aberration were normal variant. There were 7 cases (trisomy 21) of autosomal aberration and 2 cases (Turner syndrome) of sex chromosome aberration. Arnong the structural aberration, there was only one reported case of 46, t(7:10) reciprocal translocation. There were no cases of fetal death except for a little self limited preterm labor. There were no neonatal complications. In the comparison of indication and maternal age with other studies, abnormal triple test was the most common indication of amniocentesis. The number of young pregnant women under 35 years old who underwent genetic amniocentesis was increased year by year. CONCLUSION: Triple maker screening test and genetic amniocentesis become popular method of antenatal diagnosis in Korea. Now, it is the proper time to establish standard indication of prenatal amniocentesis in this country by systemic and objective statistic examination. So we address the need for metanalysis in our country as comparing with other studies.
Adult ; Age Distribution ; Amniocentesis* ; Chromosome Aberrations ; Female ; Fetal Death ; Humans ; Korea ; Mass Screening ; Maternal Age ; Obstetric Labor, Premature ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnant Women ; Prenatal Diagnosis ; Sex Chromosome Aberrations