No abstract available.
Humans ; Multiple Birth Offspring ; Twins*

No abstract available.
Leiomyoma*

No abstract available.
Meconium* ; Prospective Studies* ; Statistics as Topic*

In modem medical industries as in others, it has been emphasized by many experts such as Dr. Mayer and Dr. Donabedean that there should be quality assurance activities applying statistical knowledges in the processes of medical management and medical staff themselves for the better medical care and customer satisfaction. Three of our quality assurance programs for the purpose of shortening the treatment time In the department of emergency medicine in Keimyung University, Dong-San Medical Center had been carried out during the period of June 94 through December 95. Our methodology was mainly the process emphasized ; finding the causes of delaying factors in various processes related to the works of nurses, doctors, laboratory services, radiology services etc. in the emergency room, holding various meetings among the related groups with genuine discussions, notifying the new results in each step, encouraging the positive ones and also applying the new leadership technics. During the period of June 94 through December 95(for 1.5 years), the average E.R. patient treatment time from registrations to dispositions had been reduced by about 2 hours (from 5 hours 3 minutes to 2 hours 5 minutes) and its variations among the different specialities had been narrowed down to significant degree (p<0.05) revealing the preprogram base line standard deviation of 2.43 to 1.28 in post program through continuous quality assurance programs. It was also noted that the successful results of Q/A program have been closely related to the fact that the process should be designed and redesigned repeatly as needed and that all the participants related were actively involved in the planning and redesigning processes.
Emergency Medicine ; Emergency Service, Hospital ; Humans ; Leadership ; Medical Staff ; Modems

No abstract available.

A microemulsion formulation of cyclosporine (CsE) is more bioavailable than conventional cyclosporine (CsA) in renal transplants. Because the risk of acute and chronic rejection is related inversely to cyclosporine bioavalability and cyclosporine has a low therapeutic window, these benefits of CsE with an improved pharmacokinetic profile on clinical efficacy are also of interest. To assess the long-term safety and tolerability of CsE, this comparable study was performed. One hundred thirty one primary living donor renal recipients were included in this study. They were divided two groups in the CsE group (N=50) and CsA group (N=81) who had been received either CsE or CsA as a main immunosuppressant since their transplantation for two years. There were no differences between two groups in initial dose at that time of transplantation, target trough level, strategies of anti-rejection therapy. Acute rejections occurred less frequently in CsE group than CsA group (9/50 vs. 28/81, p=0.041). No significant differences were noted in incidence of chronic rejection, graft loss, drug-associated com plications such as hypertension, diabetes mellitus, infection and survival rates of grafts and patients. Renal function, as measured by serum creatinine levels was comparable over time in both groups. The mean daily doses of CsE were higher than CsA group since post-transplant six months, but, no significant differences in trough levels between the two grups. There were marked decreases in standard deviation of daily doses and trough level those meant inter-individual variations in CsE group compared to those of CsA group. In conclusion, despite the more predictable and stabilized pharmacokinetic benefits in CsE group, no significant increases in the incidence of drug-associated adverse effects were observed within post-transplant two years. The safety, tolerability, efficacy of CsE and CsA were comparable.
Allografts* ; Creatinine ; Cyclosporine* ; Diabetes Mellitus ; Graft Rejection ; Humans ; Hypertension ; Immunosuppression ; Incidence ; Kidney Transplantation ; Living Donors ; Survival Rate ; Transplants

Mycophenolate mofetil (MMF) is being widely used as a maintenance imunosuppressive therapy in renal transplant patients. Myelotoxicity and gastrointestinal symptoms are the well-known adverse effects of this immunosuppressant. However, there areexistonly two reports on oral ulceration associtated with MMF. Although oral ulcerations are not life-threatening, they may seriously affect the quality of life. We report ourthe experience of a case of a 57-year-old female patient with painful oral mucosal ulcerations that improved following MMF discontinuation.
Female ; Humans ; Kidney Transplantation ; Middle Aged ; Mycophenolic Acid ; Oral Ulcer ; Quality of Life ; Transplants ; Ulcer

A 49-year-old woman with spasmodic torticollis was treated with interventional muscle and nerve stimulation (IMNS). Her neck was tilted to the left, and her chin was rotated and tilted to the right. Based on patient history, physical examination, and X-ray findings, the right C2-3, C3-4, C4-5 and C5-6 facet joints were selected for IMNS treatment. Under ultrasound guidance, an Ahn's Needle (a specially designed needle for IMNS) was inserted from the midline of the posterior neck and advanced toward a point over the capsule of the facet joints. The needle was moved gently forward and backward within a 1-2 mm range until no resistance was felt at the tip. After undergoing three rounds of IMNS treatment, the dystonic features were grossly normal but spontaneous activities of the muscles innervated by C6 remained. Although we did not demonstrate complete improvement of spasmodic torticollis, our report suggests that IMNS has therapeutic value for spasmodic torticollis.
Chin ; Female ; Humans ; Middle Aged ; Muscles ; Neck ; Needles ; Physical Examination ; Torticollis ; Zygapophyseal Joint

BACKGROUND: This study estimated the number of Korean adults with osteoarthritis from a representative sample. METHODS: We analyzed the data from phase 2 of the fourth Korea National Health and Nutrition Examination Survey conducted in 2008 using surveyfreq procedure of the SAS statistical package and estimated the number of Korean adults who reported that they experienced osteoarthritis lasting for three or more months during the past year (chronic patients) or were suffering from osteoarthritis at the time of survey (current patients). RESULTS: It was estimated that there were 3,597,774 (proportion, 9.8%; 95% confidence interval, 3,238,651-3,956,897) chronic patients and 3,916,417 (10.7%; 3,548,768-4,284,066) current patients among 36,744,994 Korean adults aged 20-89 years in 2008. CONCLUSIONS: Further efforts to investigate exact number of Korean adults with osteoarthritis and improve treatment outcomes of osteoarthritis are needed.
Adult ; Aged ; Humans ; Korea ; Nutrition Surveys ; Osteoarthritis ; Phenothiazines ; Prevalence ; Stress, Psychological

STUDY DESIGN: Prospective study. OBJECTIVES: To assess the correlation between symptom improvement and spinal canal dimensions in patients who underwent selective nerve root block for lumbar spinal stenosis. SUMMARY OF LITERATURE REVIEW: When the canal size is relatively small, the pressure on the nerve root increases. Decompressive surgery relieves more pain in such patients. MATERIALS AND METHODS: From July 2009 to March 2011, 141 patients received selective nerve root block for 1-level central lumbar spinal stenosis in our hospital. We evaluated the patients using a visual analog scale (VAS) before the procedure and 1 hour, 1 month, and 3 months following the procedure. We measured the spinal canal using magnetic resonance imaging. RESULTS: There was no significant correlation between spinal canal dimensions and the pre-procedure VAS. We divided the patients into 3 groups using the average and the standard deviation of the patients' spinal canal dimensions (<73.1 mm², 73.1-172.5 mm², >172.5 mm²) (p<0.01). One hour after the procedure, the VAS scores changed by 1.43±1.8, 1.62±1.7, and 1.53±1.5, respectively, with no significant differences among the 3 groups. However there were significant differences in the VAS changes 1 month and 3 months following the procedure, with results of 2.39±1.7 and 1.39±1.5, 4.65±2.1 and 4.28±2.3, and 4.97±2.2 and 6.83±1.9 (p<0.01), respectively. CONCLUSIONS: The smaller the area of the spinal canal, the less likely symptoms were to improve after selective nerve root block. The results of this study will help predict the effects of selective nerve root block in spinal stenosis patients.
Humans ; Lumbosacral Region ; Magnetic Resonance Imaging ; Nerve Block ; Prospective Studies ; Spinal Canal* ; Spinal Stenosis* ; Visual Analog Scale