No abstract available.
Child* ; Colon* ; Humans

No abstract available.
Respiratory Syncytial Virus Infections* ; Respiratory Syncytial Viruses*

No abstract available.
Cervical Intraepithelial Neoplasia* ; Colposcopy* ; Conization*

This study was designed to investigate factors relating to fiscal deficit for regional health insurance. The financial statements for the fiscal year 1990 of nationwide 254 regional medical insurance societies were analyzed. Important findings are summarized below: 1. There were differences in the main reason for the financial deficit among regions when deficit and surplus societies were compared by regions. The total revenue per enrollee, especially revenue from the premium contribution of a deficit society was significantly smaller than that of a surplus society in large cities and counties. On the other hand, the total expenditure per enrollee of a deficit society was larger than that of a surplus society in small cities. 2. Both low premium irate at the beginning of health insurance program and less effort to increase the premium rate were main factors for the smaller revenue from the contribution of a deficit society in large cities and counties. 3. Larger expenditures per covered person of a deficit society in small cities were explained with larger medical expenditures especially for out-patients services rather than larger administrative expenses. 4. A regression analysis showed that utilization rates in out-patient services were significantly associated with income and numbers of total medical care institution per capita within a region where a health insurance society located. Also expenses paid by insurer per visit were associated with the proportion of utilization for tertiary care hospitals as well as the proportion of utilization of public health centers.
Hand ; Health Expenditures ; Humans ; Insurance ; Insurance Carriers ; Insurance, Health* ; Korea* ; Outpatients ; Public Health ; Tertiary Healthcare

No abstract available.
Accidents, Traffic* ; Fistula*

PURPOSE: This quasi-experimental study was done to develop image-use medication education for older inpatients and to evaluate the effects on their knowledge, self-efficacy, and misuse of medication.
Aged ; Chronic Disease ; Education ; Humans ; Inpatients ; Non-Randomized Controlled Trials as Topic ; Patient Education as Topic

BACKGROUND: The present study was designed to develop a combined spinal epidural (CSE) anesthesia using single segment technique(SST) for cesarean section. We attempted to find the most suitable spinal and epidural local anesthetic doses providing high quality of surgical analgesia and minimal side effects during CSE anesthesia. METHODS: 40 patients scheduled for elective cesarean section under the CSE technique were randomly divided into four groups. 2.5mg(Group 1), 5mg(Group 2), 7.5mg(Group 3) and 10mg(Group 4) of 0.5% hyperbaric bupivacaine was injected into the subarachnoid space through a 26-gauge long Quincke needle. If the block did not reach the T4 level in 15min., it was extended by fractionated doses of 2% lidocaine with 1:200,000 epinephrine administered through the epidural catheter. RESULTS: All patients in Group 1, 2 and 3 needed epidural lidocaine, 21.0+/-0.8 ml(Group 1), 11.1+/-0.6 ml(Group 2) and 7.4+/-0.7 ml(Group 3). Anesthesia in Group 4 was mostly due to spinal block. Group 2 and 3 resulted in satisfactory anesthesia with rapid onset, good surgical analgesia and muscle relaxation and minimal side effects. Group 1 provided insufficient muscle relaxation and Group 4 had higher incidence(60%) of maternal hypotension than other groups. CONCLUSIONS: The CSE technique, using 5mg or 7.5mg of subarachnoid bupivacaine and with sufficient epidural lidocaine to reach a T4 level, had the advantages of both spinal and epidural anesthesia with few of the complications of either.
Analgesia ; Anesthesia ; Anesthesia, Epidural* ; Anesthetics ; Bupivacaine ; Catheters ; Cesarean Section* ; Epinephrine ; Female ; Humans ; Hypotension ; Lidocaine ; Muscle Relaxation ; Needles ; Pregnancy ; Subarachnoid Space

With the remarkable progress of modern medicine, many monitoring systems and technics have been designed and applied clinically, but the monitoring of the central venous pressure is the most simple, convenient and dependable method to, monitor for a cert patients diagnosis and treatment among the varieties of the monitoring systems. There is need for a convenient and dependable method for estimating fluid volume requirement under diverse circumstances. An adequate circulation depends upon three factors: a. the pumping action of the heart b. the volume of blood being pumped c. the capacity of the vascular system and its resistance. Therefore central venous pressure (C.V.P.) is one of the guides for the adequate circulation. C.V.P. monitoring is indicated in: a. Suspected blood volume deficit: major trauma, severe burns, or penetrating wounds of major body cavity. b. Hypotensive patient c. During and after the open heart surgery or major neurosurgery d. When shock origin is obscure, for diagnostic and therapeutic reasons e. Pulmonary edema and acute heart failure f. Instruction of young physicians in the physiology of the shock. The technic of internal jugular vein cannulation using one of the needle catbeters and its complications are described.
Blood Volume ; Burns ; Catheterization* ; Catheters* ; Central Venous Pressure* ; Diagnosis ; Heart ; Heart Failure ; History, Modern 1601- ; Humans ; Jugular Veins* ; Methods ; Needles ; Neurosurgery ; Physiology ; Pulmonary Edema ; Shock ; Thoracic Surgery ; Wounds, Penetrating

We are reporting a case of fatality due to the acute hemolytic reaction during the whole blood transfusion. The minor reactions of the blood transfusion are relatively transfusion. But one of the most serious and difficult reaction is the acute hemolytic reaction, and it is not rare. The symptoms and treatment for the acute hemolytic reaction are described.
Blood Transfusion*

During the lest 7 years 21 children with vesicoureteral reflux and neurogenic bladder dysfunction and 46 children with primary vesicoureteral reflux were followed. At the time of initial presentation, the mean age of the former group was 5.5 years and the letter group, 2.8 years. The grade of reflux and the nephropathy were more severe in the children with neuropathic bladder than in the children with primary vesicoureteral reflux But in the same reflux grade, there was no statistical difference in the nephropathy between the two groups. The children with vesicoureteral reflux and neuropathic bladder were managed with drug therapy, intermittent catheterization, urinary diversion and ureteral reimplantation. Radiological followup revealed that resolution or improvement of reflux occurred in 36 per cent of renal units managed by intermittent catheterization and 100 per cent in which the ureters were reimplanted. As in the non-neurogenic bladder successful management of reflux and prevention of upper tract deterioration can be achieved by conservative management as well as by ureteroneocystostomy.
Catheterization ; Catheters ; Child ; Drug Therapy ; Follow-Up Studies* ; Humans ; Replantation ; Spinal Cord Injuries* ; Spinal Cord* ; Ultrasonography* ; Ureter ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Urinary Catheterization ; Vesico-Ureteral Reflux