No abstract available.
Graft Survival* ; Humans ; Living Donors* ; Risk Factors* ; Transplants*

With expanded and extended coverage of the national medical insurance and fast growing health care expenditures, appropriateness of health service utilization and quality of care are concerns of both health care providers and insurers as well as patients. An accurate patient classification system is a basic tool for effective health care policies and efficient health services management. A classification system applicable to Korean medical information-Korean Diagnosis Related Groups (K-DRGs)-was developed based on the U. S. Refined DRGs, and the performance of the developed system was assessed in this study. In the process of the development, first the Korean coding systems for diagnoses and procedures were converted to the systems used in the definition of the U. S. Refined DRGs using the mapping tables formulated by physician panels. Then physician panels reviewed the group definition, and identified medical practice patterns different in two countries. The definition was modified for the difference in K-DRGs. The process resulted in 1,199 groups in the system. Several groups in Refined DRGs could not be differentiated in K-DRGs due to insufficient medical information, and several groups could not be defined due to procedures which were not practiced in Korea. However, the classification structure of Refined DRGs was retained in K-DRGs. The developed system was evaluated for its performance in explaining variations in resource use as measured by charges and length of stay(LOS), for both all and non-extreme discharges. The data base used in this evaluation included 373,322 discharges which was a random sample of discharges reviewed ad payed by the medical insurance during the five-month period from September 1990. The proportion of variance in resource use which was reduced by classifying patients into K-DRGs-r-square-was comparable to the performance of the U. S. Refined DRGs: .39 for charges and .25 for LOS for all discharges, and .53 for charges and .31 for LOS for non-extreme discharges. Another measure analyzed to assess the performance was the coefficient of variation of charges within individual K-DRGs. A total of 966 K-DRGs (87.7%) showed a coefficient below 100%, and the highest coefficient among K-DRGs with more than 30 discharges was 159%.
Classification ; Clinical Coding ; Delivery of Health Care ; Diagnosis* ; Diagnosis-Related Groups* ; Health Expenditures ; Health Personnel ; Health Services ; Humans ; Inpatients* ; Insurance ; Insurance Carriers ; Korea

No abstract available.
Pseudohypoaldosteronism*

Bone materials diggd up from the Haemi nameless martyrdom holy place burial sites were severely broken into fragments of various size, clay matrix filled the bone marrow cavities, grass roots were spreaded into the periosteum and the fragments were very soft enough to be flaken. To make permanent specimens, bony fragments impregnated within unsaturated polyester resin with catalyzer MEKP, promotor 8% cobalt octoate, and UV absorber. Permanent specimens were so very transparent that all the macroscopic structures can be observed, and they were hard enough not to be broken or cracked. This method of preserving bony fragments is considered to be used in archaeologic preservation and in making teaching materials of various human organs or tissues.
Bone Marrow ; Burial* ; Cobalt ; Humans ; Methods ; Periosteum ; Poaceae ; Polyesters ; Teaching Materials

The aim of this study was to determine the photocatalytic effect of doped-TiO 2 nanoparticles (NPs) on teeth bleaching with an aid of 3% H2O2 and laser irradiation. For the study, Mo-N-TiO2 NPs were prepared. The characteristics of the prepared NPs, NPs morphology and light absorbance, were evaluated. Photocatalytic reactions of NPs were tested using 10 ppm methylene blue (MB) solution. Extracted teeth were pasted using carbomer gel for color differences measurements. Mo-N-TiO2 NPs have close to round shape with some tens nm size. Their absorbance was higher and longer than that of TiO 2 NPs. For MB solution, Mo-N-TiO2 with 3% H2O2 condition showed much decrease in absorbance after laser irradiation for 20 min. Also, regardless of wavelength, Mo-N-TiO2 NPs produced much greater color difference (whitening) on teeth after 3 h than that by 15% H2O2 .

The purpose of this study was the presence of accessory tendon and its anatomical variation of insertion of the abductor pollicis longus and extensor pollicis brevis. 1. Among 46 cases, all had one or more accessory tendon except one which inserted into the base of the first metacarpal bone on its anterolateral surface with a single tendon. 2. Among 45 cases (which had one or more accessory tendon), the abductor pollicis longus tendon inserted into the trapezium in 30 cases(66.6%), and thenar muscles in 38 cases (84.4%). 3. Among 46 cases, the extensor pollicis brevis tendon inserted into the proximal phalanx in 30 cases(65%) and into the distal phalanx with extensor pollicis longus in 8 cases (18%) and into both in 8 cases (18%). 4. Among 22 cadavers, symmetry of insertion of the abductor pollicis longus noticed in 16 cases (88 and extensor pollicis brevis in 21 cases (95%).
Cadaver ; Muscles ; Tendons

Congenital brachymetatarsia causes minor disability in daily life. However, patients suffer cosmetically or psychologically and often demand correction of the deformity when they reach adolescence. Thirty-eight skeletal lengthenings were performed on twenty-three patients with congenital brachymetatarsia between March 1992 and July 1993. Short metatarsal bones were osteotomized subperiosteally, and held by a small external fixator and then subjected to slow axial distraction. All the patients were female with an average age of patients at the time of operation was twenty-one years. The average lengthenings was 15.8mm. The average healing index was 80.6(day/cm). The average lengthenings percentage was 35.2%. There was a metatarso-phalangeal joint subluxation with pain in one patient. We believe that the callotasis method was no need for bone grafting and permitted early weight bearing. The result was good cosmetically.
Adolescent ; Bone Transplantation ; Congenital Abnormalities ; External Fixators ; Female ; Humans ; Joints ; Metatarsal Bones ; Methods ; Osteogenesis, Distraction ; Weight-Bearing

BACKGROUND: In patients after acute myocardial infarction, signal-averaged electrocardiography is used as the one of the non-invasive methods for the prediction for ventricular arrhythmia, one of the causes ofn death in acute myocardial infarction. Signal-averaged electrocardiography has allowed the identification of low-amplitude, high-frequency signals(late potentials)in the terminal portion of the QRS complex. They are thougt to be occured in the portion of electrophysiologically unstable myocardium. The presence of late potentials identifies regions of delayed conducton in the elctrophysiologically unstable border zone of an acute infarction. These electrophysiologic change of myocardium is influenced by the patency of infarct-related artery. A patent artery is associated with electrical stability of myocardium, decreased in cidence of late potentials and improved survival. METHODS: 58 patients of acute myocardial infarction underwent signal-averaged electrocardiography, coronary angiography within 10 days after AMI, 20 of healthy persons underwent signal-averaged electrocardiography. RESULTS: In patent group, late potentials were recorded in 7 of 38 patients(18%) as compared with 13 of 20 patients(65%) of non-patent group. The statistically significant parameters of signal-averaged electrocardiography beteen patent and non-patent group were filtered total QRS duration(TQRS, 106.7+/-20.9msec), high frequency low amplitude signal (HLAS, 30.8+/-7.5 vs 41.3+/-16.5 msec)with HLAS being the most powerful varialble in the model. CONCLUSION: These results suggest that the patency of infarct-related artery is associated with electrophysiologic stability of myocardium and signal-averaged electrocardiography is one of the useful non-invasive method in risk stratification of acute myocrdial infarction.
Arrhythmias, Cardiac ; Arteries* ; Coronary Angiography ; Electrocardiography* ; Humans ; Infarction ; Myocardial Infarction* ; Myocardium

We present a case of medial plantar nerve injury by screw tip after open reduction and internal fixation of intraarticular calcaneus fracture. We reviewed the risk and prevention technique of medial plantar nerve injury in fixing the calcaneus fracture.
Calcaneus* ; Tibial Nerve*

Single or scattered sequential hamartomatous juvenile polyps are common in the large intestine, especially the rectosigmoid area, where they are usually nonfamilial. Juvenile polyps arising in the small inestine are very rare. Juvenile polyps are usually found in children aged between 1 and 10 years, the majority of cases are between 2 and 4 years of age. Bleeding is the most common symptom, but some children may suffer from autoamputation or prolapse through the anus, and rare cases are presented as intussusception. Approximately six cases of juvenile polyps in the small bowel have been reported. Jejunal intussusception arising from juvenile polyp is uncommon in comparison with the ileocolic form. It has an atypical subacute presentation. It must be better understood for its diagnosis can be made too late. Surgical exploration is the treatment of choice because of the recurrence of various clinical symptoms. We report a case of single juvenile polyp of jejunum found in a 10-year-old girl who presented with signs of intussusception.
Anal Canal ; Child ; Diagnosis ; Female ; Hemorrhage ; Humans ; Intestine, Large ; Intestine, Small ; Intussusception* ; Jejunum ; Polyps* ; Prolapse ; Recurrence