Background: Limited access to medical services causes problems in patients’ health and life. Also, hospital closures cause concentration towards general hospitals, which leads to worsening National Health Insurance finance. Therefore, hospital closure is an important topic to be analyzed. Methods: This paper analyzed the factors that affect hospital closures using survival analysis with the data of 970 hospitals opened between 2010 and 2019 in Korea. The number of medical personnel, hospital rooms, sickbeds, and medical departments were used as explanatory variables. Results: The number of medical personnel and hospital rooms increased the survival probability while the number of sickbeds and medical departments decrease the survival probability. Conclusion The results suggest that hospitals have economies of scale and diseconomies of scope in management.

Parosteal lipoma is a rare and generally asymptomatic benign tumor of mature adipose tissue that is located in direct apposition to the external surface of the bone. These tumors are occasionally associated with reactive changes in the underlying bone. The reactive bone formation is generally restricted to the base of the tumor, that is, near the periosteum. We recently experienced a case of parosteal lipoma in the proximal femur, which displayed exuberant bone and cartilage formation, and this led us to a misdiagnosis of chondroblastic osteosarcoma on the initial biopsy. We report here on this case with a special emphasis on making the differential diagnosis from osteosarcoma.
Adipose Tissue ; Biopsy ; Cartilage ; Chondrocytes ; Diagnosis, Differential ; Diagnostic Errors ; Femur* ; Lipoma* ; Osteogenesis ; Osteosarcoma ; Osteosarcoma, Juxtacortical ; Periosteum

OBJECTIVE: The object of this study was to compare the diagnostic accuracy of a sonographic morphologic scoting system, the serum CA-125 assay, and a combination of both in patients undergoing laparotomy for a clinically diagnosed adnexal mass. METHODS: In 129 consecutive patients, the morphology of the mass was evaluated and scored by the morphologic scoring system of Sassones using transabdominal or transvaginal sonography and blood samples were obtained for CA-125 assay before planning surgery, RESULTS: The sensitivity of the sonographic morphologic scoring system was 90.6%, the specificity 84.5%, the positive predictive value 65.9%, and the negative predictive value 96.5%, compared with 68.8, 77.3, 50.0, and 88.2% for CA-125 and 96.9, 66.0, 48.4, and 98.5% for the two tests combined, respectively. Only one case of serous borderline ovarian tumor was missed when the two tests were combined. The sensitivity and mean value of the serum CA-125 increased with the stage of ovarian cancer. CONCLUSION: The combination of sonographic findings with a serum CA-125 assay was more sensitive, but less specific, than sonography or the serum CA-125 assay alone in predicting the malignancy of an adnexal mass. The serum CA-125 level generally reflected the stage of the disease. We think that it is reasonable to check the serum CA-125 only in cases of ovarian malignancy diagnosed by sonography.
Diagnosis* ; Humans ; Laparotomy ; Ovarian Neoplasms* ; Sensitivity and Specificity ; Ultrasonography*

No abstract available.
Antibodies, Neutralizing* ; Feces* ; Rotavirus*

Early-life stress (ELS), a complex traumatic stress including abuse, neglect and bullying during childhood or adolescence, is closely related to the development of psychiatric disorders. Conduct of a prospective study on the effect of ELS in human subjects is difficult due to ethical issues and limitations, and animal model study can be a reasonable alternative. Articles regarding structural and functional changes in the animal brain associated with ELS have been reviewed in this study. An up-to-date literature search on the effect of ELS on animal brain was performed ; keywords included ELS, central nervous system (CNS), and animal study using PubMed. A total of 623 articles were found and important articles were reviewed. First, we summarized the neurobiological changes in CNS associated with ELS, and then the effects of ELS on emotional and cognitive function and behavioral characteristics were recapped. ELS can induce overreactivity of the hypothalamus-pituitary-adrenal axis and cortical-subcortical structural changes including prefrontal cortex, hippocampus, and amygdala. These changes may be associated with neuroendocrine, cognitive, and emotional dysfunctions and related behavioral changes. Although most animal model studies used a single mode of stress, ELS tends to be experienced with complex types in human-life. Design of a new animal model examining the effects of complex trauma during early-life is important. Studies on the association between complex trauma and brain development can provide important insights regarding the pathogenetic mechanism of complex psychiatric disorders such as personality disorder and treatment-resistant depression.
Adolescent ; Amygdala ; Animals* ; Brain ; Bullying ; Central Nervous System* ; Cognition ; Depression ; Ethics ; Hippocampus ; Humans ; Models, Animal* ; Personality Disorders ; Prefrontal Cortex ; Prospective Studies

The final degrees of education for the third and fourth authors were mutually misplaced.

Purpose: Granular corneal dystrophy type 1 (GCD1) is a genetic disorder characterized by grayish-white granular deposits in the corneal stroma, typically manifesting before age 10. The specific characteristics of GCD1 in the Korea population remain insufficiently described. This study investigated the morphological features of GCD1 corneas with confirmed genetic mutations in this population. Methods: Medical records of GCD1 patients with the R555W mutation confirmed through transforming growth factor β induced (TGFBI) gene testing on oral epithelium or blood samples from 2005-2022, were analyzed. Corneal photographs obtained using a slit lamp biomicroscope were also examined. Results: The study group included 11 males and 19 females with an average age of 35.7 years, ranging from 3-70 years. All participants were heterozygotes. In 28 individuals (56 eyes, representing 93.3% of the total), there were signs of corneal deposit detachments, known as “drop-off”, observed in patients aged 6 years and above. Surface deposits reemerged at the peripheral margin of previous locations and expanded toward the center. The number and shape of opacities significantly changed with age, showing cycles of deposition and shedding. There were variations in the severity of opacities within the same family, particularly with advancing age, and distinct opacities extending into deeper stromal layers. Conclusions This study outlines the morphological characteristics of corneas in Korean GCD1 patients, based on corneal photograph analysis. These findings provide a basis for future comparative studies with GCD2 and may aid rapid clinical diagnosis based on clinical findings, prior to genetic testing confirmation.

PURPOSE: To evaluate the clinical effectiveness of topical diquafosol tetrasodium (DQS) after laser epithelial keratomileusis (LASEK). METHODS: This randomized prospective study included 97 eyes of 49 patients who were scheduled for LASEK. Patients in the DQS group used both 0.3% sodium hyaluronate and 3% DQS for 3 months after surgery while patients in the control group used only 0.3% sodium hyaluronate. Corneal staining score, tear film break-up time (TF-BUT), Schirmer test and ocular surface disease index (OSDI) were evaluated before surgery and 2, 4, 8, 12 and 16 weeks after surgery. RESULTS: There was no significant difference in visual acuity, spherical equivalent and corneal haziness between the 2 groups after surgery. Corneal staining score was significantly lower in the DQS group than in the control group 2 weeks after LASEK (p < 0.01) and increased in the control group after LASEK compared with the preoperative value (2 weeks after LASEK, p < 0.01), but decreased in the DQS group (12 and 16 weeks after LASEK, p < 0.05). TF-BUT was significantly higher in the DQS group than in the control group 2 to 16 weeks after LASEK (p < 0.01) and increased values were observed in the DQS group after LASEK compared with the preoperative value (4 to 16 weeks after LASEK, p < 0.05). The mean OSDI was significantly higher 4 to 16 weeks after LASEK in the control group than in the DQS group (p < 0.01). CONCLUSIONS: Subjective dry eye symptoms and objective markers were worse for 4 weeks after LASEK. The use of 3% DQS for 12 weeks after surgery improved these symptoms and markers with the effect lasting 16 weeks after LASEK.
Dry Eye Syndromes ; Humans ; Hyaluronic Acid ; Keratectomy, Subepithelial, Laser-Assisted ; Prospective Studies ; Refractive Surgical Procedures ; Tears ; Visual Acuity

PURPOSE: Recently, allergic disorders in children have increased. The cause of allergic disorders made not clear. Therefore study in aspect of food and nutrition was required to prevent allergic disorders in children, show guide of dietary management. METHODS: This study was done in 78 children with allergy from July, 1997 to September, 1997, investigated family history of allergy and general environment with questionnaire, besides growth levels of children with allergic symptoms, nutrient intakes, eating behavior, and allergy-inducing foods. RESULTS: The results of this study are summarized as follows. 1) Allergic symptoms with a age 2-3 years old were asthma (46%), dermatitis (39%), hypersensitivity skin (7%), urticaria (5%) and rhinitis (5%). At age 4-6 years, asthma was 54%, dermatitis 44%, rhinitis 28%, hypersensitivity skin 10%, and urticaria 3%. Most of the dermatits was caused by unknown etiology, temperature change and house dust mite. Asthma was caused by house dust mite and temperature change. Urticaria was caused by foods and rhinitis was caused by house dust mite. 2) Tomato was the most common food as a cause of allergic disease and peach, mackerel, yoghurt, cheese, and egg were included. Urticaria was provoked mainly by tomato and peach, diarrhea was induced by milk, yoghurt and cheese, vomiting by quail eggs, and swelling lip was induced by tomato. 3) The average daily calory intake was 80% of the RDA at the age of 2-3 years old, 66% at the age of 4-6 year old. Protein and fat intake were similar as RDA. The other nutrients intake at the age of 2-3 and 4-6 years old were 106% and 71% for calcuim, 49% and 52% for iron, 30% and 31% for zinc, respectively. The amount of vitamin intake also lower than RDA for both age groups. CONCLUSION: The average calory intake and other nutrients intake for the children with allergic symptoms were lower than RDA. But they showed relatively normal growth pattern compared with the Korean growth standard. It is necessary to findout the food that provoke the allergic symptoms and make guideline for diet therapy for the children with a various allergic symptoms.
Asthma ; Cheese ; Child* ; Dermatitis ; Diarrhea ; Diet Therapy ; Eggs ; Feeding Behavior ; Humans ; Hypersensitivity ; Iron ; Lip ; Lycopersicon esculentum ; Milk ; Ovum ; Perciformes ; Prunus persica ; Pyroglyphidae ; Quail ; Surveys and Questionnaires ; Rhinitis ; Skin ; Urticaria ; Vitamins ; Vomiting ; Yogurt ; Zinc

BACKGROUND: Motor conduction slowing in diabetic distal symmetrical polyneuropathy (DSP) generally exceeds that in distal axonal polyneuropathy. Additional mechanisms secondary to axonal injury may contribute towards this slowing. However, clinical and pathophysiological significances of motor conduction slowing have been rarely discussed. The purpose of this study is to evaluate the clinical and pathophysiological significance of conduction slowing in DSP. METHODS: We analyzed motor conduction studies of 39 patients with symptomatic painful DSP and 24 patients with asymptomatic painless DSP. Motor conduction studies of 39 patients with amyotrophic lateral sclerosis (ALS) were used as controls for the amplitude-dependent slowing of conduction. Percentages of normal limits were calculated for the compound muscle action potential amplitude (CMAP), distal motor latency (DL), and conduction velocity (CV), and converted to a square root (SQRT) form. The changes of SQRT-DL or SQRT-CV according to SQRT-CMAP changes were plotted and analyzed. RESULTS: Regression analysis showed that DL and CV were amplitude-dependent in both painless DSP and ALS. The changes of DL and CV in painful DSP did not show amplitude-dependency except DL in the lower extremities. CONCLUSIONS: This data supports the hypothesis that the mechanism of slowing is similar in both painless DSP and ALS and results from the loss of large, fast-conducting fibers. Lack of amplitude-dependency of conduction slowing in painful DSP may reflect the combined axonal and demyelinating changes, possibly due to inflammation.
Action Potentials ; Amyotrophic Lateral Sclerosis ; Axons ; Diabetic Neuropathies* ; Electrophysiology ; Humans ; Inflammation ; Lower Extremity ; Neural Conduction ; Polyneuropathies