No abstract available.
Emergencies* ; Emergency Service, Hospital* ; Emergency Treatment* ; Humans

No abstract available.
Dysentery, Bacillary*

No abstract available.
Otitis Media* ; Otitis*

No abstract available.

Scimitar syndrome (SS) is a rare congenital anomaly characterized by hypoplasia of the right lung and partially anomalous pulmonary venous drainage to the inferior vena cava. The term scimitar derives from the shadow created by the anomalous pulmonary vein on chest X-ray that closely resembles that of a curved Turkish sword. It rarely presents as an isolated abnormality. Various cardiac and non-cardiac anomalies have been association with SS, such as right lung hypoplasia, dextroposition of the heart, hypoplasia of the right pulmonary artery, systemic arterial blood supply to the right lower lung from the infra-diaphragmatic aorta, and a secundum type of atrial septal defect. However, an imperforate anus has not been reported previously in association with SS. We describe the first case of infantile scimitar syndrome accompanied with an imperforate anus in a newborn who presented with tachypnea and right pulmonary atelectasis.
Anus, Imperforate ; Aorta ; Drainage ; Heart ; Heart Septal Defects, Atrial ; Humans ; Infant, Newborn ; Lung ; Pulmonary Artery ; Pulmonary Atelectasis ; Pulmonary Veins ; Scimitar Syndrome ; Tachypnea ; Thorax ; Vena Cava, Inferior

The objective of this study was to analyze the influence of the hospital and insurer in causing delayed reimbursement of medical insurance benefits. We analyzed major variables at three different sized hospitals to examine the effect of the hospital and insurer using the two-way ANOVA method. The results were as follows: 1. The time interval between claim by hospitals and payment of the benefit was statistically different according to hospital in both admission and outpatient care. 2. The time needed by the insurer for investigating the claimers was statistically different according to hospital and insurer in both admission and outpatient care. There was interaction between the hospital and insurer factors in outpatient care. 3. Although there was interaction between the hospital and insurer factors in admission care, the time interval between claim and payment was statistically different. In outpatient care, the payment interval between claim and payment was also statistically different according to the hospital and insurer.
Ambulatory Care ; Insurance Benefits* ; Insurance Carriers ; Insurance*

Objective: : Extremely low alanine transaminase (ALT) levels are associated with all-cause mortality in frail elderly individuals; the clinical significance of ALT as a reliable biomarker is now being considered. Predicting mortality with routine tests at the time of diagnosis is important for managing patients after intracranial hemorrhage. We aimed to investigate whether an extremely low ALT level is associated with mortality in the elderly after intracranial hemorrhage. Methods: : A retrospective review was performed on 455 patients with intracranial hemorrhage admitted to a university-affiliated tertiary care hospital from February 2014 to May 2019. Multivariate Cox regression analysis was performed for all ages and for each age group to determine whether an extremely low ALT level is an independent predictor of mortality only in the elderly. Results: : Overall, 294 patients were enrolled, and the mean age of the subjects was 59.1 years, with 99 (33.8%) aged ≥65 years. The variables associated with all-cause mortality in all subjects were age, C-reactive protein (CRP) levels, hemoglobin (Hb) levels (<11 g/dL), and initial Glasgow coma scale (GCS) scores. In young patients, CRP, low Hb levels, and initial GCS scores were significantly associated with all-cause mortality. However, in the elderly (≥65 years), the variables significantly associated with allcause mortality were extremely low levels of ALT (<10 U/L) (adjusted hazard ratio, 3.313; 95% confidence interval, 1.232–8.909; p=0.018) and initial GCS scores. Conclusion : Extremely low ALT level (<10 U/L) at the time of diagnosis is a significant risk factor for all-cause mortality in the elderly after intracranial hemorrhage.

Objective: : Extremely low alanine transaminase (ALT) levels are associated with all-cause mortality in frail elderly individuals; the clinical significance of ALT as a reliable biomarker is now being considered. Predicting mortality with routine tests at the time of diagnosis is important for managing patients after intracranial hemorrhage. We aimed to investigate whether an extremely low ALT level is associated with mortality in the elderly after intracranial hemorrhage. Methods: : A retrospective review was performed on 455 patients with intracranial hemorrhage admitted to a university-affiliated tertiary care hospital from February 2014 to May 2019. Multivariate Cox regression analysis was performed for all ages and for each age group to determine whether an extremely low ALT level is an independent predictor of mortality only in the elderly. Results: : Overall, 294 patients were enrolled, and the mean age of the subjects was 59.1 years, with 99 (33.8%) aged ≥65 years. The variables associated with all-cause mortality in all subjects were age, C-reactive protein (CRP) levels, hemoglobin (Hb) levels (<11 g/dL), and initial Glasgow coma scale (GCS) scores. In young patients, CRP, low Hb levels, and initial GCS scores were significantly associated with all-cause mortality. However, in the elderly (≥65 years), the variables significantly associated with allcause mortality were extremely low levels of ALT (<10 U/L) (adjusted hazard ratio, 3.313; 95% confidence interval, 1.232–8.909; p=0.018) and initial GCS scores. Conclusion : Extremely low ALT level (<10 U/L) at the time of diagnosis is a significant risk factor for all-cause mortality in the elderly after intracranial hemorrhage.

PURPOSE: To study inter- and intra-observer reliabilities of computerized measurements of the angular parameters of hallux valgus deformity, using two different kinds of software tools for angle measurement on the digital radiography. MATERIALS AND METHODS: On 35 digital radiographies of standing foot anteroposterior view of hallux valgus, two observers (A, B) independently measured hallux valgus angle (HVA) and 1-2 intermetatarsal angle (IMA1-2) twice, using two methods. In method I, an angle was determined from duplicated lines to longitudinal axes made for bisecting line on the target bones with software tool. In method II, an angle was calculated automatically and directly from bisecting lines (longitudinal axes) made on the target bones. We compared two methods using paired t-test to determine significance of differences. Inter- and intra-observer reliabilities were evaluated using the intraclass correlation coefficients (ICC). RESULTS: There were no significant differences between measurements of method I and II for each observer (p>0.05) and intraobserver reliability were good. (ICC>0.9) Inter-observer reliability for method I and II was good of the HVA (ICCs, 0.912 and 0.905) and moderate of the IMA1-2 (ICCs, 0.505 and 0.537). There were interobserver differences in HVA of method I and II. CONCLUSION: No significant difference was found statistically between measurements of method I and II. Both methods I and II would be acceptable to measure angular parameters of hallux valgus deformity.
Congenital Abnormalities ; Foot ; Hallux ; Hallux Valgus ; Software

BACKGROUND AND OBJECTIVES: The etiology of Idiopathic sudden sensorineural hearing loss (ISSHL) is uncertain, but viral infection and disturbance of blood circulation in the inner ear are suspected as the causes of the disease, and a stellate ganglion block (SGB) and antiviral agent (Acyclovir) have been used in its treatment. The purpose of this study was to find out the effect of SGB and antiviral agent in the treatment of ISSHL and to find out appropriate patients to evaluate the therapeutic effect. MATERIALS AND METHODS: We reviewed the records of 193 patients (202 ears) who were admitted to the Presbyterian Medical Center from January 1994 to August 2000. Fifty-eight ears were treated with acyclovir and sixty nine ears were treated with SGB and seventy five ears were treated as a control group. RESULTS: The therapeutic result of SGB was better than that of control group and acyclovir had more effect on the subgroups when the initial hearing loss was 41dB~70dB. In the patients with initial hearing level worse than 71dB, the recovery rates were constant regardless of the group. And the patients who were treated after 8 days from the onset had analogic recovery rate to each remedy. CONCLUSION: The patients with the initial hearing level of worse than 71dB and who visited the clinic within 7days of the onset were found to be appropriate candidates for the evaluation of therapeutic effects of ISSHL and SGB. SGB was recommended for the treatment of ISSHL and antiviral agents for patients between the hearing levels of 410dB-70dB.
Acyclovir ; Antiviral Agents ; Blood Circulation ; Ear ; Ear, Inner ; Hearing ; Hearing Loss ; Hearing Loss, Sensorineural* ; Humans ; Protestantism ; Stellate Ganglion*