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

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

The glucose nonfermenting gram-negative bacilli encountered about 10% of all gram-negative bacilli isolated from clinical material. Therefore, a rapid and correct identification of glucose nonfermenting gram-negative bacilli is impotent for a better management of infectious disease. There are many conventional systems for the identification of glucose nonfermenting gram-negative bacilli but most of them have problems and difficulties. Commercial Kit Systems exist and they are too expensive for daily use in Korea because of high cost. Based on 12 selected tests we propose a new code system, MCRCODE-N for rapid and inexpensive identification of glucose nonfermenting gram-negative bacilli. The selective 12 tests are oxidase, glucose oxidation motihty, urease, DNase arginine dehydrolase, nitrate reduction, gelatin Liquefaction, esculin hydrolysis, mannitol oxidation, maltose oxidation, Lactose oxidation. The 12 tests are divided 4 group and then each group has 3 tests. The result of each group is expressed by the number as below. The positive test is given by specific number (1st test=1, 2nd test=2, 3rd test=4), while any negative result is 0. Each 3 numbers of one group are added and make number of 1 digit. Four digit number is referred to the code book of MCRCODE-N system or MCRCODE system using computer (Apple-II model) created by authors. This MCRCODE-N system is suitable ones for out use in Korea. We propose the MCRCODE-N system for clinical use.
Arginine ; Clinical Coding* ; Communicable Diseases ; Deoxyribonucleases ; Esculin ; Gelatin ; Glucose Oxidase ; Glucose* ; Hydrolysis ; Korea ; Lactose ; Maltose ; Mannitol ; Urease

A clinical observation in 8 cases of multiple laminectomies under the age of 16 years who had been followed for more than 3 years was carried out to analyze deformities and its results of treatment, and the following results were obtained. 1. Spinal deformities were developed in 5 cases-4 kyphosis and 1 lordosis. 2. The kyphosis was developed in 1 case at cervical spine, 1 at thoracic, 1 at thoracolumbar junction and 1 at lumbar, and the lordosis was developed in 1 case at lumbar spine. 3. Anterior interbody fusion was carried out on two cases of kyphosis who had severe pain and neurological symptoms and posterolateral spinal fusion was carried out on one case of lumbar lordosis, with satisfactory results in all cases. 4. Since the incidence of spinal deformities following multiple laminectomies in children is high, laminectomy should be performed only when it is definitely indicated, and when it is done, damage to the posterior complex should be minimized. 5. For the prevention and treatment of the spinal deformities, brace or close observation should be necessary postoperatively, and spinal fusion should be performed in increasing or severe deformities.
Animals ; Braces ; Child ; Congenital Abnormalities ; Humans ; Incidence ; Kyphosis ; Laminectomy ; Lordosis ; Spinal Fusion ; Spine

Atopic dermatitis is one of the common dermatoses characterized by its chronicity with an uncertain prognosis and usually occurs in patients with a personal or familial history of atopy. There is a dearth of information on the incidence and clinical manifestation of atopic dermatitis in Korea. This study was aimed to elucidate the relative frequency of atopic dermatitis on the hospital base during 1973~1981 period, and to investigate the clinical manifestation hy analysing 333 patients with atopic dermatitis seen from March, 1981 to July, 1982 at the Department of Dermatology, Seoul National University Hoapital. (countinued..)
Dermatitis, Atopic* ; Dermatology ; Humans ; Incidence ; Korea ; Prognosis ; Seoul ; Skin Diseases

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

INTRODUCTION: It has been proposed that narcolepsy and REM sleep behavior disorder (RBD) have overlapped symptom profile and pathophysiology. This study was aimed at measuring and comparing changes in EEG frequency band of REM sleep in narcolepsy and RBD, applying EEG spectral analysis method. METHODS: Nine patients diagnosed as narcolepsy and the same number of RBD patients were studied. Spectral analysis of the REM sleep EEG was performed in each patient on 9 epochs selected evenly from the first, second, and third REM periods. Then, we compared frequency band percentages of REM sleep EEG in narcolepsy and RBD. RESULTS: Narcolepsy patients had significantly higher delta frequency ratio than RBD ones (p=0.00). In alpha and beta2 frequency bands, RBD patients showed higher percentage than narcolepsy ones. Slow wave sleep was more prevalent in narcolepsy patients. But, no difference of REM sleep percentage was found between the two groups (p=0.93). CONCLUSION: Higher delta frequency ratio in REM sleep of narcolepsy patients than RBD ones reflects that sleep-promoting mechanism is more dominant in narcolepsy than in RBD.
Electroencephalography ; Humans ; Narcolepsy ; REM Sleep Behavior Disorder ; Sleep, REM

No abstract available.
Alcoholism* ; Hospitals, General* ; Humans ; Prevalence*

No abstract available.
Bile*

We evaluated the role of endoseopic balloon dilatation for esophageal strictures caused by postoperative anastomosis in 5 cases, sclerotherapy in 4 cases, caustic injury in 6 cases, and malignancy in 16 cases. The success rate of balloon dilatation was 100% in postoperative anastomotic and post-scle- rotherapy strictures, 16.7% in caustic stricture, and 62.5% in malignant stricture. The addition of bougienage increased the final success rate of dilatation therapy from 16.7 to 66.7% in caustic stricture, and 62.5 to 93.8% in malignant stricture. The overall one-year recurrence rate in benign stricture was 34.5%. All of the recurrent strictures were successfully retreated by balloon dilatation. In conclusion, endoscopic balloon dilatation is a safe, effective, and easy method for the management of benign esophageal strictures except longstanding caustic stricture, and can be used as an auxiliary therapy prior to more definitive treatments such as esophageal intubation in malignant stricture.
Constriction, Pathologic* ; Dilatation ; Esophagus ; Intubation ; Recurrence ; Sclerotherapy