In the complexity and diversity of modem society, there is an urgent need for an information system which can systematically collect, manage and analyze data. Especially in the discipline of Nursing, a nursing information system is necessary to maximize nursing resources and improve nursing care in the present system which is faced with increases in client needs and multiple changes in recent hospital environment. This research was done to provide a basis for the development of nursing information system, which was extracted from an analysis of the demand of nurses and other medicine staffs in the general wards excluding the special unit(ER, OR, CSR, etc.). The ward nursing information system was analysed through analysis of nursing practice related to recordings, such as the work book, work list, kardex, other nursing practice recording on 24 wards, and open questionnaire of 288 nurses. Through this process, only four subsystems of output material for nursing practice were described in this study; (1) order communication system in nursing, (2) ward management system in nursing, (3) census reporting system in nursing, (4) materials management system.
Censuses ; Information Systems* ; Modems ; Nursing Care ; Nursing* ; Patients' Rooms ; Surveys and Questionnaires

A retrospective quality assurance study of intraoperative consultation (frozen section) was carried out to assess the accuracy and to determine the reasons of discordance. Of 14,977 surgical pathology cases accessioned over a 6-month period in Asan Medical Center, frozen sections were done on 1,270 (8.5%) patients and 2,392 frozen sections (1.88 frozen sections/case) were performed. Discordance was noted in 106 cases (4.4%) and diagnosis was deferred in 26 cases (1.1%). All deferred cases were reviewed with the result of 53.8% justified and 46.2% unjustified. The discordant cases were divided into three categories as to their clinical significances: category A (no affect on patient care) 61.3%, B (minimal affect) 9.4%, and C (major affect) 29.2%. Of 31 category C cases, 7 cases were false positive and 24 cases were false negative. Misinterpretation (70.8%) was the leading cause of discordance, followed by sampling error (15.1%), failure to identify lesion (8.5%), and technical problem (5.7%). More than one-third (35.8%) of all discordances were of central nervous system cases. Total central nervous system cases were 403 (16.8%) with a significantly higher disordance rate (9.8%) and deferral rate (2.5%) in comparison to the other cases with 3.4% discordance rate and 0.8% deferral rate. There were 43 colorectal cancer cases of intraoperative consultation for adequacy of resectional margins. The surgical margins were between 0.4 cm and 28 cm (mean: 6.7 cm) away from the tumor and there was no tumor-positive case. The study indicates surgical pathology should 1) promote interpretative skills in cases involving minute fragments of neurosurgical cases, 2) defer the diagnosis and ask for more tissue on inadequate or inappropriate specimens and 3) give only gross opinions without unnecessary frozen section procedures in the event of simple, clear-cut cases.
Abscess ; Anti-Bacterial Agents ; Biopsy ; Central Nervous System ; Chungcheongnam-do ; Colitis, Ulcerative ; Colorectal Neoplasms ; Diagnosis ; Diagnosis, Differential ; Endoscopy ; Enterocolitis, Pseudomembranous* ; Frozen Sections* ; Humans ; Mucous Membrane ; Necrosis ; Pathology ; Pathology, Surgical ; Retrospective Studies ; Selection Bias

BACKGROUND: IgE antibodies have been considered to play an important role in the pathogenesis of atapic asthma. However, there have been only few studies on the role of IgE in airway secretion in the pathogenesis of bronchial asthma. This might be partly due to difficulty in sampling of airway seceretion from asthmatic patients. Recently, sputum induction method by inhalation of nebulized hypertonic saline was developed, and proved to be valid and useful method for obtaining airway secretion from asthmatic patients for studying airway inflammation. OBJECTIVE AND METHOD: To evaluate the usefulness of sputum induction method for studying IgE antibodies in airway secretion from atopic asthmatic patients, total IgE levels in induced sputum from 54 atopic asthmatics were measured by enzyme-linked immunosorbent assay(ELISA) and tried to find an association with sputum eosinophilia. RESULT: Total IgE levels in induced sputum were significantly higher in atopic asthmatic patients(1.27+82.066 IU/ml) than in controls(0.203+0.291 IUgmP)(p<0.05). In atopic asthmatic patients, total IgE levels in induced sputum were not significantly different between patients with and without sputum eosinophilia(>5% of 200 counted leukocytes). There was a significant correlation of total IgE levels between induced sputum and serum in atopic asthmatic patients(r=0.60, p<0.05). Total IgE levels in induced sputum(1.278+ 2.066) were significantly higher than saliva sample(0.504 + 1.111 IU/ml) from atopic asthmatic patients(p<0.05). CONCLUSION: These results suggest that total IgE levels are increased in the induced sputum of atopic asthmat,ic patients and sputum induction method is a useful tool for studying IgE antibodies in airway secretion from asthmatic patients.
Antibodies ; Asthma ; Eosinophilia ; Humans ; Immunoglobulin E* ; Inflammation ; Inhalation ; Saliva ; Sputum*

BACKGROUND: There have been a few reports suggesting involvement of neutrophil as well as eosinophil in inducing bronchoconstriction aft,er inhalation of TDI. OBJECTIVE: In order to observe the source of chemokines in TDI-induced asthma, this investigation was designed to determine whether IL-8 and RANTES could be produced by human bronchial epithelial cells and whether dexamethasone had any effects on their production. Materials and METHODS: We cultured Beas-2B, a bronchial epithelial cell line, with five concentrations of TDI-human serum albumin (HSA) conjugate and compared them with those having no conjugate. The levels of IL-8 and RANTES in the supernatant were measured by ELISA. To evaluate the effect of pro-inflammatory cytokines, cells were incubated with peripheral blood mononuclear cell (PBMC) culture supernatant, which was derived from PBMC culture of a TDI -induced asthmatic subject under exposure to TDI-HSA conjugate, and then compared to those without PBMC supernatant addition. To evaluate the effect of dexamethasone, four concentrations of dexamethasone were pre-incubated and the same steps were repeated. RESULTS: There was significant production of IL-8 from bronchial epithelial cells with addition of TDI-HSA conjugate in a dose-dependent manner (p<0.05, respectively), which was significantly augmented with additions of PBMC supernatant (p<0.05, respectively) at each concentration. RANTES production was negligible, however, it increased significantly with addition of PBMC supernatant and TDI-HSA conjugate in a dose response manner(p<0.05, respectively). Compared to the untreated sample, pre-treatment of dexamethasone induced remarkable inhibitions of IL-8 and RANTES production. CONCLUSION: These results suggest that IL-8 and RANTES released from bronchial epithelial cells may contribute to neutrophil and eosinophil recruitment occurring in TDI-induced airway.
Asthma ; Bronchoconstriction ; Chemokine CCL5* ; Chemokines ; Cytokines ; Dexamethasone ; Enzyme-Linked Immunosorbent Assay ; Eosinophils ; Epithelial Cells* ; Humans ; Inhalation ; Interleukin-8 ; Neutrophils ; Serum Albumin ; Toluene 2,4-Diisocyanate* ; Toluene*

PURPOSE: To evaluate the clinical outcome of frontalis sling operation using preserved fascia lata with modified direct tarsal fixation in congenital ptosis patients. METHODS: Forty-seven congenital ptosis patients (60 eyes) who underwent a frontalis sling operation using preserved fascia lata with modified direct tarsal fixation method between March 2001 and December 2008 with a mean follow-up time of 52 months (range, 26 to 122 months) were included in this study. The medical records were reviewed retrospectively. RESULTS: A retrospective chart review was conducted in patients who were diagnosed with congenital ptosis and underwent frontalis suspension surgery using preserved fascia lata with modified direct tarsal fixation from 2001 through 2008 at Dong-A University Hospital. The patients were 34 males and 14 females. The age of the patients ranged from 1 to 18 years with an average age of 4.51 years. At a mean follow-up of 60 months, good final results were achieved in 46 eyes (76.6%), fair in 8 eyes (13.3%), and poor in 6 eyes (10%). The poor results consisted of undercorrection of 1 eye and recurrence in 5 eyes. The accumulative survival rate was 87.2%, with all recurrences occurring within 12 months postoperatively. CONCLUSIONS: Frontalis sling operation by preserved fascia lata with modified direct tarsal fixation appears to be an effective treatment for severe congenital ptosis, showing good long term results.
Adolescent ; Blepharoplasty/*methods ; Blepharoptosis/congenital/*surgery ; Child ; Child, Preschool ; Fascia Lata/*transplantation ; Female ; Follow-Up Studies ; Graft Survival ; Humans ; Infant ; Male ; Recurrence ; Retrospective Studies ; *Suture Techniques ; Transplantation, Autologous

PURPOSE: Knee IVIR images were repeatedly obtained after intravenous administration of gadopentetate dimeglumine to evaluate the arthrographic effect and to determine the optimal scan timing and technique. MATERIALS AND METHODS: Sagittal Tl-weighted (650/15) sequences were repeated before and after intravenous gadolinium enhancement in 26 patients who were divided into exercise (14/26) and nonexercise (12/26) groups. Fourteen patients in exercise group were allowed to move the affected knee joint actively for 10 minutes immediately after the first post-enhancement scan and before repeating scans. The signal intensities in central and peripheral portions of the joint were measured and compared between these two groups. RESULTS: In all cases, enhancement of joint fluid began at peripheral portion and progressed toward central portion. The diffusion rate in exercise group was far faster than that in nonexercise group and homogeneous arthrographic image was revealed within 10 minutes after completion of joint movement. The arthrographic effect continued and the rate of signal decrease was quite slow. CONCLUSION: MR arthrographic image of knee joint can be obtained within 10 minutes after completion of a few minute exercise following intravenous injection of gadopentetate dimeglumine. Intravenous MR arthrography is expected to become an useful method as a convenient alternative to direct MR arthrography.
Administration, Intravenous ; Arthrography* ; Diffusion ; Gadolinium ; Gadolinium DTPA ; Humans ; Injections, Intravenous ; Joints ; Knee Joint ; Knee*

OBJECTIVE: In order to confirm the local production of total and specific IgE antibodies in the nasal polyp tissues. MATERIAL AND METHOD: We measured total IgE and house dust mite(Dermatophagoides pteronpssinus .' DP)-specific IgE antibody using enzyme-linked immunosorbent assay(ELISA) in the supernatant of nasal polyp homogenates from 72 subjects undergoing nasal polypectomy. The subjects were divided into three groups according to skin reactivity to DP: 20 strongly atopic subjects to group I(mean wheal diameter) 3mm), 19 weakly atopic subjects to group II (mean wheal diameter 1-3mm) and 33 negative skin responders to group III. RESULT: Group I showed significantly higher levels of total and DP-specific IgE levels in the nasa
Antibodies ; Dust* ; Immunoglobulin E* ; Nasal Polyps* ; Pyroglyphidae* ; Skin ; United States National Aeronautics and Space Administration

Vibrio vulnificus infection is one of the most fatal diseases in Korea. This study was undertaken to determine the cellular fatty acid (CFA) compositions of ninety-five clinical strains of V. vulnificus isolated from Korea during 1985-1995. We compared these results with the CFA profile of V. vulnificus in the Microbial Identification System (MIS) (CLIN library version 3.9; Microbial ID Inc., Newark, Del.), and also evaluated the MIS ability to identify V. vulnificus. Subgrouping of V. vulnificus by CFA analysis was performed and its results were compared with those of serotyping. Most of the CFAs in V. vulnificus strains were similar to the CFA profile of V. vulnificus in the MIS, but some distinctive differences were observed. First, means of two major CFAs, 16:0 and 16:1w7c, were 22.16% and 18.26% in this study, but 23.52% and 25.44% in the MIS respectively. Second, all isolates had 11:Oiso3OH, which was not present in the MIS. Eighty-five strains (89.5%) disclosed the first choice identification of V. vulnificus by the MIS, but only two strains (2.1%) were identified with SI values of 0.6. Remaining ten strains (10.5%) showed 'NO MATCH' results. Cluster analysis of CFA could separate V. vulnificus into nine subgroups, and predominant subgroups were subgroup VII (45 strains) and V (36 strains). There was heterogeny between subgroups by CFA and serotypes of V. vulnificus. The strains of 04 serotype which accounted for 80% (76/95) of the isolates were distributed into six different subgroups such as VII (40 strains), V (27 strains), III (4 strains), I (2 strains) and VI (1 strain). These showed that V. vulnificus strains isolated from Korea had different characteristics in the CFA composition in comparison with the MIS V. vulnificus library. Subgrouping by the CFA analysis might be a useful tool for the epidemiological study of V. vulnificus infection in Korea.
Korea* ; Serotyping ; Vibrio vulnificus* ; Vibrio*

The venous malformation in head and neck is a developmental vascular disease which arises from the arrest in the certain stage of vascular embryogenesis. However, the lesion extends along the fascia and has a tendancy to recur after incomplete therapy. Retrospectively, the authors reviewed radiologic studies of 20 patients diagnosed as venous malformation during the last 5 years. The diagnosis was verified by histopathology (5 patients) and direct puncture angiography (15 patients). The radiologic studies included. CT with intravenous contrast injection (20 patients), RI angiography with 99m Tc-pyrophosphate (6 patients), and direct puncture angiography (15 patients). Multiplicity of venous malformation was noted in 9 patients. On CT scan, the lesions had lobulated irregular shape, with heterogeneous appearance, showed delayed enhancing characteristics, and had the phleboliths(21 lesions). The venous malformations were located at the masticator space (including masseter muscle) (n=12), retrobulbar space(n=6), submandibular space(n=4), paravertebral space(n=3) and so on. In two cases, the lesions were very extensive involving entire neck and parapharynx. On RI angiography using 99mTc-pyrophosphate, all of the lesions showed persistent and delayed uptake. With direct punture angiography the lesions could be classified as acinar pattern (n=17) and mixed pattern (acinar and saccular) (n=2). Venous connections were noted in 10 lesions. In conclusion, if a soft tissue mass on head and neck shows a heterogeneous attenuation density with or without calcified phlebolith on CT scan, RI angiography is recommended as a next diagnostic study. If it shows delayed persistent uptake, venous malformation can be suspected. Finally direct puncture angiography can verify the nature and extent of the lesions.
Angiography ; Diagnosis* ; Embryonic Development ; Fascia ; Female ; Head* ; Humans ; Neck* ; Pregnancy ; Punctures ; Retrospective Studies ; Technetium Tc 99m Pyrophosphate ; Tomography, X-Ray Computed ; Vascular Diseases

BACKGROUND AND OBJECTIVES: The aim of this study was to determine the effect of ethanol on the regulation of vascular tone. MATERIAL AND METHODS: Using rat aorta ring, isometric contraction and 45Ca uptake were measured. Phorbol 12,13-dibutyrate (PDBu), phenylephrine, KCl were used for the regulation of smooth muscle tone. RESULTS: Ethanol induced transient contraction in rat aorta ring by dose-dependent manner. Ethanol suppressed the dose dependent contractile responses of vascular strip by phenylephrine, KCl and PDBu. Endothelium-dependent relaxation by acetylcholine was inhibited by ethanol. Ethanol depressed 45Ca uptake by high KCl but not by phenylephrine or PDBu in rat aorta. n-butanol selectively suppressed tonic contraction by high KCl, but t-butanol did not at the same concentration of butanol in rat aorta. PDBu-induced contraction was selectively suppressed by n-butanol but not by t-butanol. CONCLUSIONS: These findings suggest that the action of ethanol on phospholipase D is involved in the decreased response of rat aorta strip by vasoconstrictors.
1-Butanol ; Acetylcholine ; Animals ; Aorta* ; Ethanol* ; Isometric Contraction ; Muscle, Smooth* ; Phenylephrine ; Phorbol 12,13-Dibutyrate ; Phospholipase D ; Protein Kinase C ; Rats* ; Relaxation ; tert-Butyl Alcohol ; Vasoconstrictor Agents