BACKGROUND AND OBJECTIVES: The goal of this study was to examine the safety and feasibility of a primary (direct) stenting in acute myocardial infarction (AMI). In the treatment of AMI, Percutaneous transluminal coronary angioplasty (PTCA) has documented superior reperfusion rate and improved clinical outcomes than thrombolytic therapy. However, there are several limitations of PTCA, such as recurrent ischemia in 10 to 15%, reinfarction in 3 to 5% and restenosis in 30 to 50% of patients. There are several reports that, compared with PTCA, the implantation of coronary stent has been shown to reduce angiographic restenosis and improve late clinical outcomes. But in general, stenting has been contraindicated in thrombus containing lesion due to the risk of subacute thrombosis. With advance in technique and the recognition of the importance of adequate platelet inhibition, the incidence of subacute thrombosis has fallen in patients with acute coronary syndrome and thrombus laden lesion. Methods and Results: In our study, primary stenting was performed in 42 patients of AMI. There are 6 cases (22.5%) target lesion restenosis during the follow up coronary angiography (150+/-86day) and no in-hospital death. Three cases (7.1%) of them require revascularization including two re-PCTA and a coronary artery bypass graft for the recurrent ischemic symptoms. There were no reinfarction and death after discharge. Six-months event free survival reate was 85.7%. CONCLUSION: Primary stenting is safe and feasible in the majority of patients with AMI and results in excellent mid-term outcomes compared with PTCA.
Acute Coronary Syndrome ; Angioplasty, Balloon, Coronary ; Blood Platelets ; Coronary Angiography ; Coronary Artery Bypass ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Incidence ; Ischemia ; Myocardial Infarction* ; Reperfusion ; Stents* ; Thrombolytic Therapy ; Thrombosis ; Transplants

OBJECTIVE: This study was conducted to identify 3 to 5 years of future management issues in hospital information systems (HIS). METHODS: Two rounds of interview surveys were conducted based on the sample survey of 50 managers from 28 hospital information centers utilizing the Delphi method. RESULTS: From the survey, management issues in HIS were identified in the following order: 'top management support', 'close relationship with users', 'PACS', 'disaster recovery', improving IS strategic planning'. Compared with the 1999 survey, the issues that rank within the top 10 management issues were as follows: 'top management support', 'security and control', 'close relationship with users'. Recently surfaced issues are 'disaster recovery' and 'standardization'. The issues that dropped out of the top 10 ranks were 'network management', 'recruiting and developing IS human resource'which were very fundamental issues in the initial state of the introduction of the hospital information system. CONCLUSION: The two main significance of this study involves predicting future management issues based on the comparison of the current issues with the 1999 issues and recommendingmanagement strategies based on the classification of issues by importance and persistence.
Classification ; Hospital Information Systems* ; Humans ; Information Centers

A 36-year-old woman was presented with extensive anterior wall myocardial infarction. We tried to perform direct coronary angiography for the purpose of primary stenting. However, coronary angiogram revealed normal coronary arteries without intracoronary thrombi. We continued further evaluations to find out the cause of normal coronary myocardial infarction. The findings of severe hypertensive retinopathy and concentric left ventricular hypertrophy suggested that she had secondary hypertension. The detailed history, laboratory and radiological findings revealed the pheochromocytoma. The tumor was successfully removed by operation.
Adult ; Anterior Wall Myocardial Infarction ; Coronary Angiography ; Coronary Vessels ; Female ; Humans ; Hypertension ; Hypertensive Retinopathy ; Hypertrophy, Left Ventricular ; Myocardial Infarction* ; Pheochromocytoma* ; Stents

BACKGROUNG AND OBJECTIVES: Diabetes mellitus is a significant risk factor for adverse outcome after PTCA, which is associated with an increased late mortality and target lesion revascularization (TLR) rates. The beneficial role of coronary stenting on the clinical and angiographic outcomes of diabetic patients is not clearly defined. The aim of this study was to evaluate the early and mid-term outcomes in diabetic patients undergoing elective stenting of native coronary lesions compared with those in non-diabetic patients. MATERIALS AND METHODS: Between July 1997 and June 1998, coronary stenting was performed on 46 lesions in 38 diabetic patients and 126 lesions in 117 non-diabetic patients. Follow-up angiography at mean day of 189+/-45 was performed in 58.7% (91 patients) and analysed by quantitative coronary angiography (QCA). RESULTS: There was a higher incidence of multi-vessel disease in diabetic patients than non-diabetic patients but not statistically significant (71.1% vs 51.3%, p=0.106). There were no differences in major procedural complications and in-hospital events (myocardial infarction, angina and death) in diabetics and non-diabetics. During the follow-up, the incidence of target lesion revascularizton (TLR) and cardiac event free survival did not differ between two groups. CONCLUSION: Coronary stenting in diabetics resulted in a low rate of immediate procedural com-plications and early major adverse cardiac event (MACE), similar to non-diabetics. There were no differences in the mid-term clinical and angiographic outcomes in diabetics and non-diabetics.
Angiography ; Coronary Angiography ; Diabetes Mellitus ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Incidence ; Infarction ; Mortality ; Risk Factors ; Stents*

BACKGROUNG AND OBJECTIVES: It was reported that low molecular weight heparin (LMWH) was more effective than unfractionated heparin in patients with acute coronary syndrome. Recent studies have shown that the pathophysiology of restenosis in stented lesions was different from those of nonstented lesions. Treatment strategies designed to limit cellular proliferation that were ineffective in nonstented lesions may be efficacious in reducing in-stent restenosis. This study was aimed to compare the clinical and angiographic results of LMWH (nadroparin) after coronary stenting with those of conventional ticlopidine regimen. MATERIALS AND METHODS: Patients were eligible for inclusion if they had angina and/or objective evidence of myocardial ischemia, and a significant (>50%) stenosis that was documented on a recent coronary angiogram. After stenting, prospective randomized comparison study was performed. Patients were randomly assigned to either nadroparin (200 IU/kg, sc, bid) or ticlopidine (250 mg bid) plus aspirin (200 mg qd) treatment groups. Repeat coronary angiography (KERN=*)was performed at 236+/-90days after stenting, and quantitative coronary angiographic analysis (QCA) was done. RESULTS: Intracoronary stent implantation was performed in eighty five lesions in eighty one patients (ticlopidine:40, nadroparin:41). There was no significant difference in any baseline clinical/angiographic variables between the two treatment groups. There were no subacute stent thrombosis, infarction and death in both groups. Six-month event-free survival was 36 (90%) in the ticlopidine group and 35 (85.4%) in the nadroparin group. Follow-up quantitative angiographic data such as late loss (1.35+/-0.70 vs 1.32+/-0.69), loss index (0.53+/-0.70 vs 0.56+/-0.23) and restenosis rate (36% vs 25.8%) were not different between ticlopidine and nadroparin groups. CONCLUSION: Effects of nadroparin were not different from those with ticlopidine therapy in the prevention of restenosis and subacute stent thorombosis after coronary stenting. Clinical outcomes between two strategies were similar. Low molecular weight heparin may be an alternative to ticlopidine in patients that ticlopidine cannot be administered because of severe adverse effects.
Acute Coronary Syndrome ; Aspirin ; Cell Proliferation ; Constriction, Pathologic ; Coronary Angiography ; Disease-Free Survival ; Follow-Up Studies ; Heparin ; Heparin, Low-Molecular-Weight ; Humans ; Infarction ; Myocardial Ischemia ; Nadroparin* ; Prospective Studies ; Stents* ; Thrombosis ; Ticlopidine*

PURPOSE: The study tried to suggest the ways to improve the national disability welfare information projects with evaluating the present condition of the projects. METHOD: Firstly, the study analyzed the disability information system and disability websites. Secondly, the study found out the problems of the registration of disability and management system through the situation analysis. Finally, the study conducted a survey of the disabled and the information system workers and performance evaluation of the information system. RESULTS: The study offered a proposal of The Disability Unity Management System(DUMS) for the disability registration and management. When the disabled visit the hospital or the public health center, their information is registered automatically in The Disability Unity Management System(DUMS), which helps not to miss out the disability registration. Through this system, they are given the proper service which they need, and the information can be shared with the facilities providing the service for the disabled. CONCLUSION: The Disability Unity Management System(DUMS) contributes significantly in avoiding the repetition of the support for the disabled and improving the quality of service.
Disabled Persons ; Humans ; Information Systems* ; Public Health ; Registries

Although a popliteal cyst is most commonly identified as an asymptomatic mass occurring just below the popliteal fossa, the fluid may further extravasate into a deep compartment, causing compression with symptoms of local pain and tenderness. When the popliteal vein is compressed by a popliteal cyst, it may develop the symptom simulating the deep vein thrombosis, when the popliteal artery is compressed, it may develop the symptom simulating the ischemic pain and intermittent claudication. It is unusual for popliteal cysts to involve a nerve. When such does occur, it usually involves the tibial nerve, very rarely the peroneal nerve. It is important to diagnose a popliteal cyst early and to differentiate it from a ganglionic cyst, thrombophlebitis or a popliteal aneurysm, to effect optimal therapy and to obviate a potential neuropathy. We are now reporting a case of a thirty four-year-old male who had a popliteal cyst causing tibial nerve compression.
Aneurysm ; Ganglion Cysts ; Humans ; Intermittent Claudication ; Male ; Peroneal Nerve ; Popliteal Artery ; Popliteal Cyst* ; Popliteal Vein ; Thrombophlebitis ; Tibial Nerve* ; Venous Thrombosis

OBJECTIVES: This study was conducted to evaluate the adoption behavior of a newly developed Electronic Medical Record (EMR)-based information system (IS) at three public hospitals in Korea with a focus on doctors and nurses. METHODS: User satisfaction scores from four performance layers were analyzed before and two times after the newly develop system was introduced to evaluate the adoption process of the IS with Rogers' diffusion theory. RESULTS: The 'intention to use' scores, the most important indicator for determining whether or not to adopt the IS in Rogers' confirmation stage for doctors, were very high in the third survey (4.21). In addition, the scores for 'reduced medication errors', which is the key indicator for evaluating the success of the IS, increased in the third survey for both doctors and nurses. The factors influencing 'intention to use' with a high odds ratio (>1.5) were the 'frequency of attendance of user training sessions', 'mandatory use of system', 'reduced medication errors', and 'reduced medical record documentation time' for both doctors and nurses. CONCLUSIONS: These findings show that the new EMR-based IS was well accepted by doctors. Both doctors and nurses also positively considered the effects of the new IS on their clinical environments.
Diffusion of Innovation ; Diffusion* ; Electronic Health Records* ; Hospitals, Public* ; Information Systems* ; Korea ; Medical Records ; Odds Ratio

The postmortem stature was measured in 57 Korean adult males (age range: 20-86 years old, mean: 52.3 years old) in supine position. After dissection of the corpses, we measured the maximum length of the remaining limb-bones (humerus, radius, ulna, femur, tibia and fibula). The correlation coefficients between the stature and each limb-bone length were calculated. Simple regression equations for estimating stature from each limb-bone length and multiple regression equations from the combination of limb-bone lengths were also obtained.
Adult ; Aged ; Aged, 80 and over ; Body Height* ; Bone and Bones/anatomy & histology* ; Extremities/anatomy & histology* ; Human ; Male ; Middle Age ; Regression Analysis

OBJECTIVE: To measure the performance of a hospital enterprise resource planning (ERP) system and suggest various system improvements. METHODS: A survey based on a 5-point Likert scale questionnaire and an exclusive interview was administered to 102 employees with a one-year experience of using an ERP system at one university hospital. In order to analyze the factors affecting the ERP system performance, multiple regression analysis and Chi-square test were conducted. RESULTS: All three examined variables-system quality, information quality and integration of hospital information resources-affected the ERP system performance positively. However, the system quality variable had the lowest mean score indicating that the ERP system was difficult to understand for many users. User characteristics were not significantly associated with information quality satisfaction. CONCLUSION: On the basis of the study results, we recommended some suggestions to improve the ERP system performance. In order to reduce users' dissatisfaction with the new system, hospitals should publicize the needs of the ERP system for the employees, design more effective training programs, and provide more decision-supporting information for managers.
Education ; Surveys and Questionnaires