OBJECTIVES: To identify the factors affecting users' satisfaction with the Order Communicating System(OCS) and to highlight the factors important for the successful establishment of OCS. METHODS: A Users Satisfaction survey was sent to 4,513 people, consisting of 1,503 doctors, 2,379 nurses, 255 pharmacists and 370 administrative workers in 16 hospitals which had introduced OCS. The response rate was 63.9%. Measurement of users' satisfaction was performed with the instrument which was used in Doll's study. Some aspects of Doll's instrument were adjusted according to the aims of this study. The classifying sections of this survey included age, job and status classification, computer experience , OCS education, duration of daily OCS use, type of order entering, number of personnel in the Hospital Information System's department, cost of OCS, problem frequency, proportion of work managed by hand, OCS type, and Hospital establishment type. RESULTS: There was a positive correlation between satisfaction level and managerial status throughout all job classifications. Irrespective of the importance of OCS education as a factor relating to users' satisfaction, the additional work load caused by OCS lowered users' satisfaction. Different factors affected users' satisfaction according to job and status classification. The composition of factors affecting the pharmacist and administrative worker satisfaction levels was simpler than that of the doctor and nurse levels. There were no statistically significant differences between the actual computer experience duration of daily OCS use and users' satisfaction with OCS. CONCLUSIONS: There was an understandable relationship between users' attitude to OCS and factors affecting users' satisfaction. The results of this study could be used as a basis for the successful expansion of the operation of OCS. But more detailed studies on users' satisfaction and further improvements of methodologies are required for the successful establishment of OCS.
Classification ; Education ; Hand ; Humans ; Pharmacists

PURPOSE: The purpose of this study is to determine the actual educational condition of contact lenses in Korean ophthalmology residency training hospitals. METHODS: A questionnaire survey about the educational condition of contact lenses was performed twice between October 2000 and September 2002 in 75 Korean ophthalmology residency training hospitals. In the second examination, the same primary questionnaire was administered to confirm the improvement of educational condition. RESULTS: Nine percent of the subjects were satisfied with the educational condition of contact lenses in the first examination and 12% in the second examination. Most residents were not satisfied because of lack of manpower and interest. The ratio of hospitals conducting the contact lens education program increased from 12% in the first examination to 45% in the second examination. Most of the residents agreed to alter the contact lenses fitting into obligatory provision during the residency training period; 80% in the first examination and 75% in the second examination. CONCLUSIONS: Most residents agreed with the necessity of contact lens education, but the program was not performed well. Thus, the interest and education of the Korea ophthalmologic society and each ophthalmology residency training hospital will be required to educate the information about contact lenses and their correct wearing.
Contact Lenses ; Education ; Internship and Residency* ; Korea ; Ophthalmology* ; Surveys and Questionnaires

Leiomyoma is the most common benign tumor of the esophagus, but it still occurs rarely as compared with the incidence of carcinoma in this area. Most of leiomyomas may manifest itself with unusual and inconsistent symptoms, and found incidentally during endoscopic or radiographic examination. Those who menifested symptoms are included as dysphagia and vague pain mostly. We experienced recently two cases with esophageal leiomyoma who underwent successful surgical resection and endoscopic enucleation, respectively.
Deglutition Disorders ; Esophagus* ; Incidence ; Leiomyoma*

PURPOSE: The purpose of this study is to present points of improvement data in developing a public educational approach for the correct understanding and use of contact lenses with a focus on the actual condition of wearing contact lenses, side effects and problem of circulation. METHODS: The questionnaires were distributed to contact lens wearers of 175 local clinics, 75 universities and general hospitals and 202 opticians were interviewed. RESULTS: This survey showed that many respondents had incorrect knowledge about contact lenses (purchase, prescription, complication, method of contact lens use), including persons who are not optometrists handling contact lenses. CONCLUSIONS: Nationwide pre-education is necessary for the correct understanding and purchase, prescription, and side effects of contact lenses, as well as to prohibit opticians from illegally prescribing the lenses; ophthalmologists should prescribe all contact lenses for proper vision correction.
Contact Lenses* ; Surveys and Questionnaires ; Hospitals, General ; Humans ; Korea* ; Prescriptions

Recently the changes in medical informatics enabled us to use medical information whenever we want and wherever we are. However, there are few information supporting systems on the web in occupational health field. So we have tried to make an occupational health information system (OHIS) based on the Internet and to provide occupational information to occupational health personnel. There were two steps for developing OHIS. First, we analyzed user's needs and existing information systems and then developed contents of our OHIS. Second, we constructed web server under the environment of Windows user, using operating system of windows NT 4.0 and web browsers of Netscape Navigator. Many users in worksites wanted information through the Internet. The contents of OHS which they wanted were information related to health education of workers, health counselling, news, and so on. The contents of OHIS which we forwarded were occupational health service, information about organization of occupational health, book references and journals, link-sites related to occupational health. In the future, this Interned-based OHIS will be an useful site offering a lot of information to occupational health personnel.
Health Education ; Health Information Systems* ; Information Systems ; Internet* ; Medical Informatics ; Occupational Health ; Occupational Health Services ; Occupations* ; Web Browser ; Workplace

Dysferlinopathy is caused by mutations in the DYSF gene. To characterize the clinical spectrum, we investigated the characteristics of 31 Korean dysferlinopathy patients confirmed by immunohistochemistry. The mean age of symptom onset was 22.23 +/- 7.34 yr. The serum creatine kinase (CK) was highly increased (4- to 101-fold above normal). The pathological findings of muscle specimens showed nonspecific dystrophic features and frequent inflammatory cell infiltration. Muscle imaging studies showed fatty atrophic changes dominantly in the posterolateral muscles of the lower limb. The patients with dysferlinopathy were classified by initial muscle weakness: fifteen patients with Miyoshi myopathy phenotype (MM), thirteen patients with limb girdle muscular dystrophy 2B phenotype (LGMD2B), two patients with proximodistal phenotype, and one asymptomatic patient. There were no differences between LGMD2B and MM groups in terms of onset age, serum CK levels and pathological findings. Dysferlinopathy patients usually have young adult onset and high serum CK levels. However, heterogeneity of clinical presentations and pathologic findings upon routine staining makes it difficult to diagnose dysferlinopathy. These limitations make immunohistochemistry currently the most important method for the diagnosis of dysferlinopathy.
Adolescent ; Adult ; Age of Onset ; Creatine Kinase/blood ; Distal Myopathies/pathology ; Female ; Humans ; Immunohistochemistry ; Male ; Membrane Proteins/genetics ; Middle Aged ; Muscle Proteins/genetics ; Muscular Atrophy/pathology ; Muscular Dystrophies, Limb-Girdle/*diagnosis/genetics/pathology ; Mutation ; Phenotype ; Republic of Korea ; Tomography, X-Ray Computed ; Young Adult

Marfan's syndrome is a an autosomal dominant disorder of connective tissue that is characterized by ocular, skeletal, and cardiovascular manifestation. It is estimated to have a prevalence of 4-6 per 10,000 people, and at least 25 percent of the cases occur in the absence of a family history. Coronary artery ectasia is a diffuse abnormality of the vessel wall, which has been reported in associated with coronary atherosclerosis, infectious process, congenital heart lesion, syphilis, Ehlers-Danlos syndrome. We reported a case of 25-year-old male who presented with Marfan's syndrome associated with dissecting ascending arotic aneurysm and diffuse dilatated coronary artery ectasia. Coronary angiographic study demonstrated the diffusely dilatated coronary artery ectasia.
Adult ; Aneurysm ; Connective Tissue ; Coronary Artery Disease ; Coronary Vessels* ; Dilatation, Pathologic* ; Ehlers-Danlos Syndrome ; Heart ; Humans ; Male ; Marfan Syndrome* ; Prevalence ; Syphilis

The use of extracorporeal membrane oxygenation (ECMO) has increased after the 2009 pandemic H1N1 infections, and the ECMO-related complications have also increased. Specifically, the mechanical vessel injury due to catheter cannulation seems to be less frequent than other complications, but there is a risk of hemorrhagic shock which requires special attention. We experienced a case of successful management with graft stenting during ECMO operation for iliac vein injury. A 56-year-old female patient with non-small cell lung cancer developed endobronchial obstruction, and ECMO was applied for the ECMO-assisted rigid bronchoscopy. During catheter cannulation, hypovolemic shock was developed due to her right external iliac vein injury. We detected the hemorrhage with bedside ultrasound at an early stage and the hemorrhage was effectively managed with graft stenting on ECMO.
Bronchoscopy ; Carcinoma, Non-Small-Cell Lung ; Catheterization ; Catheters ; Extracorporeal Membrane Oxygenation ; Female ; Glycosaminoglycans ; Hemorrhage ; Humans ; Iliac Vein ; Pandemics ; Shock ; Shock, Hemorrhagic ; Stents ; Transplants

Pumpless extracorporeal interventional lung assist (iLA) is a rescue therapy allowing effective carbon dioxide removals and lung protective ventilator settings. Herein, we report the use of a pumpless extracorporeal iLA in a tuberculosis destroyed lung (TDL) patient with severe hypercapnic respiratory failures. A 35-year-old male patient with TDL was intubated due to CO2 retention and altered mentality. After 11 days, Ventilator Associated Pneumonia (VAP) had developed. Despite the maximal mechanical ventilator support, his severe respiratory acidosis was not corrected. We applied the iLA for the management of refractory hypercapnia with respiratory acidosis. This case suggests that the iLA is an effective rescue therapy for TDL patients with ventilator refractory hypercapnia.
Acidosis, Respiratory ; Carbon Dioxide ; Humans ; Hypercapnia ; Lung ; Male ; Pneumonia, Ventilator-Associated ; Respiratory Insufficiency ; Retention (Psychology) ; Tuberculosis ; Ventilators, Mechanical

BACKGROUND AND PURPOSE: The clinical implications of echocardiography findings for long-term outcomes in atrial fibrillation (AF)-related stroke patients are unknown. METHODS: This was a substudy of the Korean ATrial fibrillaTion EvaluatioN regisTry in Ischemic strOke patieNts (K-ATTENTION), which is a multicenter-based cohort comprising prospective stroke registries from 11 tertiary centers. Stroke survivors who underwent two-dimensional transthoracic echocardiography during hospitalization were enrolled. Echocardiography markers included the left-ventricle (LV) ejection fraction (LVEF), the left atrium diameter, and the ratio of the peak transmitral filling velocity to the mean mitral annular velocity during early diastole (E/e′ ratio). LVEF was categorized into normal (≥55%), mildly decreased (>40% and <55%), and severely decreased (≤40%). The E/e′ ratio associated with the LV filling pressure was categorized into normal (<8), borderline (≥8 and <15), and elevated (≥15). Kaplan-Meier and Cox regression analyses were performed for recurrent stroke, major adverse cardiac events, and all-cause death. RESULTS: This study finally included 1,947 patients. Over a median follow-up of 1.65 years (interquartile range, 0.42–2.87 years), the rates of recurrent stroke, major adverse cardiac events, and all-cause death were 35.1, 10.8, and 69.6 cases per 1,000 person-years, respectively. Multivariable analyses demonstrated that severely decreased LVEF was associated with a higher risks of major adverse cardiac events [hazard ratio (HR), 3.91; 95% confidence interval (CI), 1.58–9.69] and all-cause death (HR, 1.95; 95% CI, 1.23–3.10). The multivariable fractional polynomial plot indicated that recurrent stroke might be associated with a lower LVEF. CONCLUSIONS: Severe LV systolic dysfunction could be a determinant of long-term outcomes in AF-related stroke.
Atrial Fibrillation ; Cohort Studies ; Diastole ; Echocardiography ; Follow-Up Studies ; Heart Atria ; Hospitalization ; Humans ; Prospective Studies ; Registries ; Stroke ; Survivors