We studied prospectively on the grade of severity of reflux gastritis after Billroth- I (15 patients and B-II (66 patients) using gastrofiberscopy mostly 3~4 montsh after operations from December 1988 to February.The grade of severity af gastritis was arbitarily defined as follows; Grade 0-almost no reflux of bile and no redness on gastric mucosa. Grade 1-mild redness of the mucosa limited within an inch from anastomotic line. Giade 2-Edema and mucosal redness involves almost one half of remaining gastric mucosa. Grade 3-the above cbanges involves most of remnant gastric mucosa. Gtade 4-in addition to grade 3, friability of mucosa and/or, erosions is noted. Grade 5- ulceraitions of mucosa in addition to the above changes. Using the above defined criteria, we obtained the following results; 1) there was no rieflux gastritis in one patient in B- I group and remainders have varing grades of reflux gastritis, ie; 93% (14/15) (see Table 2). 2) In B- II reconstructed patients, grade 0 was 2 patients and remainder had reflux gastrits, ie; 96% (64/66) (see table 4). 3) Grade 5 patients have ulcerations in the esophagus and grade 2 changes in the stomach.
Bile ; Esophagus ; Gastrectomy* ; Gastric Mucosa ; Gastritis* ; Humans ; Mucous Membrane ; Prospective Studies ; Stomach ; Ulcer

No abstract available.
Classification* ; Humans ; Stomach Neoplasms* ; Survival Rate*

BACKGROUND: This study intends to clear that the current cost reimbursement system of Korean medical insurance of health care. METHODS: By using insured medical record of Federation of Korean Medical Insurance Societies used in the demand tendency research of the type of services from feburary 1st to 28th of the year 1990, authors analyze the characterist,ic of components of charges per case in the type of health care facilities. RESULTS: The charge per case in the out-patient care of primary health care facility is 13,498 won, which is 54.6% by comparison with the secondary health care facility and 30.7 % by comparison wit,h the tertiary health care facility. Among these charges the amount of the cost for medical examinations and oral drugs are 73.9% in the primary health care facility and 71.8% in the secondary and 67.5% in the tertiary. Consequently, the services in the primary care are chiefly composed with the medical examinations and oral drugs. In addition to this point the author also finds that the charge per case is 3.5 times, the cost for oral drugs is 5.6 times larger than those of primary care, and therefore tertiary health care facility conduct various diagnostic examinations and prescript more expensive. CONCLUSIONS: There is a difference of basic medical cost ratio between primary, secondary and tertiary health care facility. These points can be lead to the presumption that the diseases under the structure of current medical insurance are overlapped irrespective of the charact.erisitcs of the type of health care facilites, and this is profitable to the tertiary health care facilities which can conduct various types of services. In conclusion, the frame a policy is needed to encourage primary care which are nothing but simple structure of charges.
Delivery of Health Care ; Humans ; Insurance* ; Medical Records ; Outpatients ; Primary Health Care

Ultrasonography is most commonly utillized diagnostic tool in obstetric and gynecology for the evaluation ofpatient with a pelvic mass or pregancy. For it is characterized by no radiation hazard, noninvasive examinationand high diagnoastic accuracy. Also it affords an accurate assessment of the presence, size, location and internalconsistency of a pelvic mass. The recent availability and improved resolution of realtime scanning have afforded amore flexible and complete approach to evaluation of normal and abnormal structures in the pelvis. We analyzedultrasonographic findings in 154 pathologically proven cases of pelvic mass examined at Korea General hospitalfrom Jan. 1983 to Apr. 1984. The results were as follows; 1. The age distribution was from 12 years to 66 yearsand the majority of patients were between the ages of 21 and 50 yeasrs (91.4%). 2. The incidence of pelvic masswas 27.9% in uterine leiomyoma, 22.7% in ovarian cyst, 13.0% in addenomyosis and 8.4% in serous cystadenoma. 3. Mild to moderately echogenic nodular uterine enlargement with some cystic change(81.5%) of leiomyoma and multiplesmall vesicular pattern of intrauterine contents with uterine enlargement of Homole were the most common ultrasonographic findings. The location and type of leiomyoma were most common in the fundus and body (95.3%), and intramural myoma(53.5%). The most frequent finding of ovarian teratoma was cystic mass with echogenic focus(41.7%) but the echogenic appearance of the lesions was extremely variable. The ultrasonographic findings ofectopic pregnancy were cystic or complelx adnexal mass(80.0%), with or without fluid in cul-de-sac and deviationof uterus by adenxal mass. 4. Accuracy of ultrasonography in detemining the overall correct diagnosis of thepelvic masses compared with proven diagnosis was approximately 61.7%. The diagnostic accuracy was 90.7% inluterine leiomyoma, 100% in H-mole nad 80.0% in ectopic pregnancy.
Age Distribution ; Cystadenoma, Serous ; Diagnosis ; Female ; Gynecology ; Humans ; Incidence ; Korea ; Leiomyoma ; NAD ; Ovarian Cysts ; Pelvis ; Pregnancy ; Pregnancy, Ectopic ; Teratoma ; Ultrasonography ; Uterus

Herpes simplex esophagitis can occur in those with normal immune function, but is more often seen in those who are immunocompromised. In one series, 5 percent of post-kidney transplant recipients had herpes esophagitis. We experienced a case of herpes simplex esophagitis, following renal transplantation in a 9 year old male. He complained of epigastric pain, nausea and blood-tinged vomiting. Endoscopic examination showed volcano ulcer, mucosal friability and multiple confluent ulcers covered by whitish exudates on elevated margin in the middle and lower esophagus. Microscopic findings revealed multinucleated giant cells, margination of chromatin, intense nonspecific inflammation and strong positive for herpes simplex virus immunohistochemical staining. Esophageal lesions and symptoms improved after acyclovir therapy.
Acyclovir ; Child* ; Chromatin ; Esophagitis ; Esophagus ; Exudates and Transudates ; Giant Cells ; Herpes Simplex* ; Humans ; Inflammation ; Kidney Transplantation ; Male ; Nausea ; Simplexvirus* ; Transplantation ; Ulcer ; Vomiting

0.05). There was considerable difference in the upper and lower position of mandibular foramen between control and experimental group. It appeared that the distance of mandibular foramen from mandibular notch is 20.66mm (average) for the normal occlusion and 17.785mm(average)for the mandibular prognathism. So we can see the distance of mandibular foramen from mandibular notch for patients is more near 2.815mm (average) than normals. For the distance of mandibular foramen from the extension line of occlusal plane, it's 0.92mm (average) lower than occlusal plane for the normal and 0.5mm (average) upper for the patient. It's located 1.42mm (average) upper part of the patient.]]>
Dental Occlusion ; Hand Strength ; Humans ; Mandibular Nerve ; Prognathism

To determine the perinatal mortality and morbidity of fetuses with absent end-diastolic velocities (AEDV) of the umbilical artery in severe pre-eclampsia and eclampsia, the outcome of 5 fetuses with AEDV was compared with that of 35 fetuses with positive end-diastolic velocities (PEDV). The study population comprised 38 cases of severe pre-eclampsia and 2 cases of eclampsia with structurally normal singletons, who had had umbilical artery Doppler velocimetry weekly from admission to delivery. The Doppler velocimetry result was not used for the clinical management. Perinatal death and neonatal morbidity from both groups were further examined in gestational age category to control the influence of preterm births. The incidence of AEDV of the umbilical artery Doppler velocimetry in severe pre-eclampsia and eclampsia was 12.5% (5/40). The AEDV group had a significantly higher incidence than the PEDV group in terms of ceasarean section due to fetal distress (60% : 17%), Apgar score < 7 at 5 minutes (60% : 14%), perinatal death (25% : 0%) and assisted mechanical ventilation (67% : 9%) both at 32-36 weeks. Time intervals from the detection of AEDV to delivery of live neonates varied from the day to 15 days. In conclusion, AEDV in the umbilical artery might be of clinical value in routine surveillance of pregnancies complicated by severe pre-eclampsia and eclampsia, and predict hypoxic fetal condition which needs operative interventions before or during labor and mechanical ventilation after birth.
Apgar Score ; Cesarean Section ; Dystocia ; Eclampsia* ; Female ; Fetal Distress ; Fetus ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Maternal Death ; Mortality ; Parturition ; Parturition* ; Perinatal Mortality ; Pre-Eclampsia* ; Pregnancy ; Premature Birth ; Respiration, Artificial ; Rheology ; Trial of Labor ; Umbilical Arteries* ; Uterine Rupture

No abstract available.
Hernia, Umbilical* ; Ultrasonography*

No abstract available.
Female ; Fibronectins* ; Hypertension, Pregnancy-Induced* ; Plasma* ; Pregnancy ; Pregnancy*

No abstract available.
Hernia*