The healthcare laws and healthcare system, which includes healthcare delivery system and network hospital and attending hospital system etc., have much influence on the application of Internet. Whereas government-driven healthcare delivery system had little desirable effects including increased efficiency in patient care and balanced development of various types of medical service facilities, the private hospital network was successful with the help of information interchange. The network hospital is a kind of private hospital network for patient delivery preparing for the current healthcare management issues such as the separation of pharmacy and clinic and expansion of DRG. Network hospitals has been used the internet to transfer the information of patients. Internet is not the main success factor of the network, but the it may not be successful without Internet. The attending hospital system is in it's early stage in Korea. As the number of participating physician increases, the need of information interchange will be increased. The future of the internet healthcare delivery system would be composed of web application and databases, ASP, team approach to assist physicians. The major obstacle of the system is the technical level of information system in medium and small sized hospitals. The governmental financial assistance is needed in that hospitals. The most important issue is the standardization of information. The participation of KMA in standardization is needed.
Delivery of Health Care* ; Diagnosis-Related Groups ; Hospitals, Private ; Humans ; Information Systems ; Internet* ; Jurisprudence ; Korea ; Patient Care ; Pharmacy ; Viperidae

Thumb reconstruction with a free neurovasculsr wrap around flap from the great toe by microsurgery had been first reported by O'Brien, Macleod and Morrison in 1980. We have performed one case of thumb reconstruction with psrtial first metstarsus for loss of thumb except pulp and one digital vessel by microsurgery. The results were summerized as followings ; 1. This one stage procedure has the unique advantage to reconstruct a thumb almost identical to the origin. 2. This technique allows preservstion of the toe and the secondary defect results in no significant morbidity.
Free Tissue Flaps ; Microsurgery ; Thumb ; Toes

Supracondylar fracture of the humerus is the most common fracture about the elbow in children, and frequently accompanies neurovascular complications. It is one of the most difficult to manage and is frequently associated with significant residual complications. In the treatment of supracondylar fracture of the humerus, prompt and accurate reduction without additional trauma is mandatory. 114 patients with supracondylar fracture of the humerus who were admitted and treated at the Department of Orthopedic Surgery of Hanyang University Hospital from May, 1972 to May, 1981 have been reviewed. The results obtained are as follows: 1. Supracondylar fractures of the humerus frequently occurred between the ages of 5 and 12 years (77.2%), and the sex ratio was 2.5:1 in male to female. 2. Of all fractures, 96.5% were the extension type and 3.5% were the flexion type. According to the Holmberg classification, type IV fractures were most common. 3. In the injuries associated with fracture, there were 6 ipsilateral forearm fractures, 6 neural injuries, 4 vascular injuries, and 2 neurovascular injuries. In 8 traumatic neuropathies, median nerve was involved most commonly, and they were recovered spontaneously within 6 week except 1 case, which was repaired surgically. 4. Most cases were treated successfully by early manipulative reduction, but in the presence of neurovascuiar signs and symptoms, continuous traction or open reduction was indicated. 5. The result of treatment of the conservative treatment group was better than that of the operative treatment group.
Child ; Classification ; Clinical Study ; Elbow ; Female ; Forearm ; Humans ; Humerus ; Male ; Median Neuropathy ; Orthopedics ; Sex Ratio ; Traction ; Vascular System Injuries

No abstract available.
Neural Tube Defects*

No abstract available.
Child* ; Cyclophosphamide* ; Humans ; Nephrotic Syndrome* ; Retrospective Studies*

A microvascular osteocutaneous free flap is totally detached from its origin and reattached at a distant site, in one stage, by the use of microvascular anastomosis to maintain its viability. The advantages of microvascular osteocutaneous free flap trsnsfer are more rapid healing, greater resistance to infection, less risk of absorption than conventional bone grafts, and shortened hospitalization. Two cases of microvascular osteocutaaeous free flap transfer were performed at the department of Orthopaedic surgery of Hanyang University Hospital, and satisfactory results were obtained.
Absorption ; Free Tissue Flaps ; Hospitalization ; Transplants

Primary phycomycosis of the stomach within the ulcerative portion of early gastric carcinoma is presented in a sixty one year old male alcoholics. In the center of IIc type submucosal adenocarcinoma was a large deep ulcer (UL-IV) which was the only seat of phycomycetes infection accompanied with angioinvasion and exudative endovasculitis aside from unusual granuloma formation with Splendore Hoeppli phenomenon and eosinophilic response as in allergic granulomatous aspergillosis. The above features were reconstructed to indicate that the phycomycetes infection was confined to the type III area of IIc + III early gastric carcinoma, and that the local ulcerogenic lesion seems more contributory in its development than systemic factors including gastric carcinoma per se or alcoholic consumption.
Male ; Humans ; Adenocarcinoma

Lymphoepithelial carcinoma is a rare subtype of undifferentiated carcinoma in the salivary gland. The incidence of lymphoepithelial carcinoma is about 0.4% among the patients with major salivary gland tumors. It has a racial preference; about 75% of the patients are of Mongolian ancestry. We report a case of lymphoepithelial carcinoma arising in the left parotid gland of a 52-year-old man. Grossly, the tumor was relatively well demarcated, gray-white, and solid. Microscopically, the irregular shaped syncytial tumor cell islands were evident within lymphoplasma cell-rich and desmoplastic stroma. The carcinoma cells had large vesicular nuclei and prominent nucleoli. The tumor invaded the surrounding salivary gland tissue. Epstein-Barr virus (EBV) was demonstrated by in situ hybridization for EBV-encoded RNA-1 (EBER-1) and polymerase chain reaction for EBV nuclear antigen-1 (EBNA-1).
Carcinoma ; Herpesvirus 4, Human* ; Humans ; In Situ Hybridization ; Incidence ; Islands ; Middle Aged ; Parotid Gland* ; Polymerase Chain Reaction ; Salivary Glands

The role of the Orthodontist in cleft lip and cleft palate therapy is primarily ill correction of malocclusion which is required by practically every child who has these defects. He can contribute to the assessment of dento-facial growth and development. We may gain the possible limited correction of delayed malocclusion due to cleft lip and palate. The authors have attempted delayed orthodontic treatment of a cleft lip and palate of 12.9 years old girl, who had a cleft lip and palate of surgical closure at 2,3 and 4 years old.
Child ; Child, Preschool ; Cleft Lip* ; Cleft Palate ; Female ; Growth and Development ; Humans ; Malocclusion ; Palate*

A clinical study including physical examination, electromyographic and roentgenological studies of the 2. Taekwondoists hands who mainly practiced the object-breaking maneuver with a hand who were cared at the department of orthopedic surgery, Hanyang University Hospital from November 1, 1981 to January 31, 1982, The results of the survey were as follows. 1. The average age of the athletes was 26.7 years, the average Taekwondo-practicing career was 9.7 years, the average object breaking career was 6.4 years, and the startmg age of breaking was 20.1 years in average. 2. The main parts of the hand for the breaking were Joomeok(fist) and Sonnal (ulnar edge of the palm; hand knife). 3. Bricks and tiles were commonly used as materials for breaking. Seventeen(74%) athletes could break 1 to 2 layers brick blocks, and twenty(87%) could break the 10 to 15 layers roof-tile blocks. 4. Twelve (52.1%) athletes got injuries during breaking practice. The most common injury was metacarpal fracture (7/14, 58.5%), dislocation (2/14, 16.7'lo), subluxation, sprain, and contusion (1 each/14, 8.3%) were less frequent. 5. The thickness of the knuckle pad varied from 2 to 3.9mm in 16/23 (69.5%). The average grasping power of the athletes was 97.6 1bs, and it was stronger than normal person by 9.3 lbs. 6. The electromyographic study showed no isgnificant difference in nerve conduction velocity between the af- fected and unaffected hands, which was within the normal range. It was found that the muscle primarily used was flexor digitorum profundus. 7. In the roentgenological study, the length of the second metacarpal on the affected side was the same or 0 tc 2mm shorter than the unaffected side, and when the athlete was in the growth period, the metacarpal short ness was more marked. 8. Roentgenologically no hypertrophy of the metacarpal and phalangeal bones noted.
Athletes ; Clinical Study ; Contusions ; Dislocations ; Hand Strength ; Hand ; Humans ; Hypertrophy ; Neural Conduction ; Orthopedics ; Physical Examination ; Reference Values ; Sprains and Strains