No abstract available.

No abstract available.
Leiomyoma*

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.
Decompression* ; Ossification of Posterior Longitudinal Ligament*

Immune complex deposits have been found in the choroid plexus in patients with systemic lupus erythematosus, and it can be assumed that an immune complex injury to the choroid plexus might be related to the neuropsychiatric disorder seen in patients with SLE. Acute serum sickness was experimentally induced in rabbits by intravenous injection of crystalized BSA. Prednisolone in conventionl dosage was administered to study the immunologic injury of the choroid plexus as well as the mechanisms involved in the prednisolone effect. Light, electron microscopic and immunofluorescent studies were made. The host immunoglobulins(IgG, IgA, IgM) and beta 1 C globulin were demonstrated in the choroid plexus. Histopathological findings included mild to moderate interstitial and perivascular lymphocyte and plasma cell infiltrations and edema. Control animals showed no immune deposits and no histopathologic changes. Electron microscopic findings comparing the immunofluorescent and histopathologic changes were minimal, and showed sparse, vague electron dense deposits particularly in the interstitial spaces, knob-like focal thickening of vascular basement membrane, swelling of endothelial cells, and some accentuation of interstitial cells. The morphologic and functional similarities of the choroid plexus and glomerular basement membrane, the findings in morphologic, electron microscopic and immunofluorescent examinations of the experimental rabbits, along with the observed effects of prednisolone, together with similar reports in the recent literature suggest that immunologic injury of the choroid plexus could be considered as a new disease entity. This immunologic injury might play a significant role in neuropsychiatric disorders in the long standing immune complex deposit diseases. The very interesting finding is the nature and function of the interstitial cell between the endothelial (vascular) and epithelial side basement membranes, and speculation as to whether or not the role of this interstitial cell in choroid plexus injury may be in its possible analogy with glomerular mesangial cells.
Acute Disease ; Animal ; Choroid Plexus/drug effects ; Choroid Plexus/immunology* ; Choroid Plexus/pathology ; Lupus Erythematosus, Systemic/etiology ; Prednisolone/pharmacology* ; Rabbits ; Serum Sickness/chemically induced ; Serum Sickness/complications* ; Serum Sickness/immunology

OBJECTIVE: To quantify the improvement in ultrasonographic fetal imaging following diagnostic amnioinfusion for the indication of unexplained midtrimester oligohydramnios. METHODS: Eight patients were referred for unexplained midtrimester oligohydramnios were retrospectively reviewed. Videotapes of those undergoing diagnostic antenatal amnioinfusion were analyzed for quality of visualiztion of routinely imaged structures before and after the infusion procedure. And genetic amniocentesis was performed in all patients. RESULTS: The overall rate of adequate visualization of fetal structures improved from 64.1% to 95.2% (P=0.008). In most cases we were able to achieve a definitive diagnosis. CONCLUSION: Diagnostic amnioinfusion can facilitate fetal imaging and increase diagnostic precision in the setting of unexplained severe oligohydramnios.
Amniocentesis ; Diagnosis ; Female ; Fetus ; Humans ; Membranes* ; Oligohydramnios* ; Pregnancy ; Pregnancy Trimester, Second ; Retrospective Studies ; Ultrasonography ; Videotape Recording

BACKGROUNDs: A retrospective study was performed to define objective radiologic parameters in diagnosing epiglottitis on soft-tissue lateral neck radiographic study. METHODS: Parameters of soft-tissue structures(epiglottis width, third vertebral body width, ratio of epiglottic width to third vertebral body width) in 30 adult patients compared with those of age and sex-matched controls with foreign body in throat whose radiographic reading was normal. RESULTS: Epiglottis width of more than 11mm, ratio of epiglottis width(EW) to the third vertebral body width(C3W) of more than 0.5 were, respectively, found to be 100% sensitive and specific in differentiating between patients with and without epiglottitis. CONCLUSION: These preliminary results suggest that EW/C3W ratio of more than 0.5, EW of more than 11mm, respectively, may be useful in the diagnosis of epiglottitis in adult patients.
Adult* ; Diagnosis* ; Epiglottis ; Epiglottitis* ; Foreign Bodies ; Humans ; Neck ; Pharynx ; Retrospective Studies

CT scans of 23 patients with gallbladder carcinoma were retropectively reviewed to determine the incidence of lymphatic spread and to access the pattern of regional lymph node metastases. The lymphatic spread were noted in 74%(17/23). The involved patterns of regional lymph node metastases were nodes of porta hepatis 65%, portocaval nodes 41%, superior pancreaticoduodenal nodes 47%, posterior pancreaticoduodenal nodes 59%, nodes around the celiac trunk 35%, nodes around the superior mesenteric artery 29% and paraaortic nodes 35%. The findings suggested that the pattern of regional lumph node metastases in gallbladder carcinoma occurred along the normal lymphatic pathway of the gallbladder.
Gallbladder* ; Humans ; Incidence ; Lymph Nodes* ; Mesenteric Artery, Superior ; Neoplasm Metastasis* ; Tomography, X-Ray Computed*

CT scans of 23 patients with gallbladder carcinoma were retropectively reviewed to determine the incidence of lymphatic spread and to access the pattern of regional lymph node metastases. The lymphatic spread were noted in 74%(17/23). The involved patterns of regional lymph node metastases were nodes of porta hepatis 65%, portocaval nodes 41%, superior pancreaticoduodenal nodes 47%, posterior pancreaticoduodenal nodes 59%, nodes around the celiac trunk 35%, nodes around the superior mesenteric artery 29% and paraaortic nodes 35%. The findings suggested that the pattern of regional lumph node metastases in gallbladder carcinoma occurred along the normal lymphatic pathway of the gallbladder.
Gallbladder* ; Humans ; Incidence ; Lymph Nodes* ; Mesenteric Artery, Superior ; Neoplasm Metastasis* ; Tomography, X-Ray Computed*

No abstract available.
Rhabdomyoma*