OBJECTIVE: As an electronic health record system is implementing in Korean health care sectors, concerns about key functionalities of electronic health record systems are increasing. The purpose of this study was to identify core functions and set the priority in electronic health record systems under the Korean contexts in order to assure and improve the quality of the systems. METHODS: A survey was conducted using questionnaire developed by the study team based on literature review. The subjects were medical record administrators working at medical record department in general hospitals. RESULTS: The response rate was 59.8%(55/92). The functions which more than ninety percent of subjects responded as necessary right now and/or in near future related to 'drug alert', 'clinical guideline', 'chronic disease management', 'automated real-time surveillance', 'coded data', 'result reporting', 'de-identifying data', 'disease registry', and 'provider-provider communication and connectivity'. CONCLUSION: The results showed the high prioritized functions were decision support and health information/data management.
Electronic Health Records* ; Health Care Sector ; Hospitals, General* ; Humans ; Medical Record Administrators ; Medical Records ; Needs Assessment* ; Surveys and Questionnaires

BACKGROUND: The present study was performed to elicit what effect nalbuphine would have on isoflurane MAC (minimum alveolar concentration) in the patients undergoing lower abdominal surgery. METHODS: Sixty-two women were randomly allocated to one of five study groups to receive an intravenous injection of no nalbuphine (group I), 0.25 mg/kg (group II), 0.5 mg/kg (group III), 1.0 mg/kg (group IV), 1.5 mg/kg (group V). Anesthesia and tracheal intubation were induced with propofol 2 mg/kg, succinylcholine 1 mg/kg. Patients were inhaled at a preset end-tidal concentration of isoflurane, which was maintained for 20 min. Response to skin incision, movement or no movement, was determined 30 minutes after nalbuphine injection. The isoflurane concentration of the next patient in the same group moved up or down in steps of 0.1~0.3%, according to the previous patient's response. MAC was determined using the "up-down" method and logistic regression. RESULTS: The MAC's of isoflurane were 1.09 vol% end-tidal in the control group, 0.89 vol% in group II, 0.65 vol% in group III, 0.55 vol% in group IV, and 0.51 vol% in group V. CONCLUSIONS: It would be suggested that nalbuphine dose-dependently reduce the isoflurane MAC, and have ceiling effect on the reduction of isoflurane MAC.
Anesthesia ; Female ; Humans ; Injections, Intravenous ; Intubation ; Isoflurane* ; Logistic Models ; Nalbuphine* ; Propofol ; Skin ; Succinylcholine

Mucinous eccrine carcinoma of the skin is a rare skin adnexal malignant tumor that origins from mucin-secreting dark cells, and it arises from the deepest portion of eccrine ducts. It usually affects people in their fifth to seventh decades of life and it predominantly occurs in men. It appears to exhibit a predilection for the head and neck. The histopathologic characteristics are a large mucinous pool with fibrous septae and clusters of tumor cells. The treatment of choice is surgical removal. We present here the case of a patient with a mucinoous eccrine carcinoma on the infraorbital area of the right side of his face and we review the related literature
Head ; Humans ; Male ; Mucins ; Neck ; Skin

The clinical value of the pre-(165 pts) and post-operative(149 pts) serum levels of carcinoembryogenic antigen(CEA) in 190 patients(pts) with colorectal cancer was investigated, who had a curative surgery and an abnormally elevated levels of CEA (> or=5 ng/ml) at Department of General Surgery, Chonbuk National University Hospital during 1989 to 1996. The results are as follows: 1) The preoperative positive rates of CEA level were 49(29.7%) of 165 patients, so preoperative CEA level measurement was no usefulness for screening test of colorectal cancer. The incidence of preoperatively elevated CEA levels in Dukes stages A, B, C, and D were 0, 28.6, 32.8 and 42.9% respectively, There was significant association between increased proportion of patients with preopertive serum CEA(> OR = 5 ng/ml) and the progressive stages of colorectal cancers(P<0.05). 2) There was no significant association between the frequency of abnormal CEA level and histologic differentiation of tumor. 3) The recurrence rate was 16.4% and 30.6% in patients with preoperative CEA < 5 ng/ml and > OR =5 ng/ml, respectively(p<0.05). 4) In patients with recurrence, the lymph node positive group(70.6%) was larger than the negative(29.4%)(p<0.05), and preoperative positive rate of CEA value was 44%. 5) The recurrence rate in Dukes stages A, Bl, B2, Cl, C2, and D were 0, 8.7, 12.7, 16.7, 32.3, and 90.0% respectively(p<0.01). 6) There was no significant association between the frequency of abnormal CEA level and location of tumor. 7) The recurrence rate was 12.3% and 65.7% in patients with postoperative CEA < 5 ng/ml and > OR = 5 ng/ml, respectively(p<0.01). 8) In patients with metastasis, postoperative positive rate of CEA level was 63%(p< 0.01).
Colorectal Neoplasms ; Humans ; Incidence ; Jeollabuk-do ; Lymph Nodes ; Mass Screening ; Neoplasm Metastasis ; Recurrence

Biohybrid artificial organs encompass all devices capable of substituting for an organ or tissue function and are fabricated from both synthetic materials and living cells. The viability of engineered tissue could be related to the viability of implanted cells. The system of viability assay for mammalian cell culture can be applied to the determination of cell viability for engineered tissue. This review explores various methods of cell viability assay which can be applied to the viability evaluation of engineered tissue. The major criteria employed in viability assays include survival and growth in tissue culture, functional assay, metabolite incorporation, structural altercation, and membrane integrity. Each viability assay method is based on different definitions of cell viability, and has inherent advantages and disadvantages. In order to be able to assess the viability of cells with one assay method, it is desirable to compare the viability measurements from various assays derived from different criteria.
Animal ; Biomedical Engineering*/methods ; Cell Division ; Cell Survival ; Human

Collagen-based membranous materials of various shapes (gel, film, sponge) are known to be the most promising materials in terms of facilitating the regeneration of dermal defects. In this study, dense and porous collagen membranes were fabricated using air-drying and freeze-drying processes, respectively, and the effect of ultraviolet (UV) radiation on the degree of membrane crosslinking was evaluated by in vitro biodegradation and mechanical testing. A non-irradiated membrane group was used as the negative control and a glutaraldehyde (GA) treated group as the positive control. Scanning electron microscopy showed that, as the freezing temperature decreased to -196 degrees C, the resultant mean pore sizes also decreased; optimal pore size was obtained at a freezing temperature of -70 degrees C. In vitro biodegradation and mechanical testing demonstrated that GA treatment or 4 hours of exposure to UV radiation significantly increased both resistance to collagenase and mechanical strength versus the untreated controls, regardless of the collagen membrane type (dense or porous). Our results suggest that UV treatment is a useful tool for the fabrication of collagen membranes designed to be used as dermal dressings.
Animal ; Cattle ; Collagen/ultrastructure ; Collagen/radiation effects* ; Collagen/metabolism ; Elasticity ; Membranes, Artificial* ; Microscopy, Electron, Scanning ; Porosity ; Tensile Strength ; Ultraviolet Rays*

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD), one of the components of Agent Orange, has been reported to be a deadly poison despite its presence at extremely small doses. TCDD is reported to cause various kinds of cancers and other harmful effects on humans. However, a correlation between exposure to TCDD and acute coronary syndrome (ACS) is not yet proven. Thus, we examined the correlation between exposure to TCDD and ACS through an analysis of coronary angiograms from veterans of the Vietnam War. Two hundred fifty-one consecutive men undergoing coronary angiograms owing to ACS between April 2004 and May 2009 at Gwangju Veterans Hospital were analyzed. Included subjects were between 50 and 70 years of age. The patients were divided into two groups: 121 patients who had been exposed to TCDD (Group I) and 130 patients who had not been exposed to TCDD (Group II). Clinical and coronary angiographic findings were evaluated. Baseline clinical characteristics, inflammatory markers, and echocardiographic parameters were not significantly different between the two groups. The incidence of hypertension (71.1% vs. 60.0%, p=0.039) and hyperlipidemia (27.3% vs. 16.9%, p=0.038) was higher in Group I than in Group II. Total occlusion, stent length, stent use, and coronary lesion characteristics were not significantly different between the two groups. The rate of major adverse cardiovascular events (MACE) had no relationship with exposure to TCDD. Exposure to TCDD might not affect severity or the rate of MACE in persons with ACS.
2,4,5-Trichlorophenoxyacetic Acid ; 2,4-Dichlorophenoxyacetic Acid ; Acute Coronary Syndrome ; Angiography ; Citrus sinensis ; Hospitals, Veterans ; Humans ; Hyperlipidemias ; Hypertension ; Incidence ; Male ; Stents ; Tetrachlorodibenzodioxin ; Veterans ; Vietnam

The isomorphic response of Koebner is a well-known phenomenon commonly associated with psoriasis, but it has been also described in conjuction with a host of other disorders. However it has seldom been associated with necrobiosis lipoidica diabeticorum, a rare skin manifestation of diabetes mellicuts. In this report, we describe a 59-year-old woman who developed necrobiosis lipoidica diabeticorum on the left shin where a mosquito had bitten her 2 months ago. Four months ago, she was diagnosed as necrobiosis lipoidica diabeticorum on the right forearm and shin by biopsy and the lesions were improved with corticosteroids intralesional injection. The lesions were asymptomatic and had grown slowly. Histopathological findings showed a large palisading granulomas composed of histiocytes, epithelioid cells and areas of necrobiosis of collagen with multinucleated giant cells. Van Gieson stain showed decreased and fragmented elastic fibers and there were no deposits of mucin in the necrobiotic areas. The lesions were improved with triamcinolone acetonide intralesional injection and there was no recurrence during 4 months.
Adrenal Cortex Hormones ; Biopsy ; Collagen ; Culicidae ; Elastic Tissue ; Epithelioid Cells ; Female ; Forearm ; Giant Cells ; Granuloma ; Histiocytes ; Humans ; Injections, Intralesional ; Middle Aged ; Mucins ; Necrobiosis Lipoidica* ; Necrobiotic Disorders* ; Psoriasis ; Recurrence ; Skin Manifestations ; Triamcinolone Acetonide

Polytetrafluoroethylene (PTFE), polyurethane (PU) and silicone are widely known biocompatible polymers which are commonly used for vascular grafts. However, in vitro and in vivo calcifications of these polymers have been found to seriously compromise their quality as biomaterials. In consideration of this problem, the present study compared the calcification rate and extent of PTFE, PU and silicone. Using the in vitro flow-type method, PTFE, PU and silicone films were tested for 1, 4, 7, 10, 14 and 21 days. After 21 days of in vitro calcification test, the calcium levels on PTFE, PU and silicone were 35.89 5.01 microgram /cm2, 23.73 0.68 microgram/cm2 and 19.86 5.28 microgram/cm2, respectively. The higher observed calcium level for PTFE may be due to the effect of the rough surface of PTFE in accumulating calcium ions on the polymer surface. From the 7th day of test, the [Ca]/[P] molar ratio started to decrease over time, and PTFE showed a faster calcification process. This decreasing [Ca]/[P] molar ratio demonstrated the typical calcification mechanism consisting of phosphorus ion accumulation following calcium ion accumulation. This study concluded that PU and silicone are less calcified than PTFE film, a finding in good agreement with previously published studies.
Biocompatible Materials/*adverse effects ; *Blood Vessel Prosthesis ; Calcinosis/*etiology ; Comparative Study ; Microscopy, Electron, Scanning ; Polytetrafluoroethylene/*adverse effects ; Polyurethanes/*adverse effects ; Silicones/*adverse effects

PURPOSE: To assess the clinical reliability of the Bosniak IIF category and to determine the proper radiologic follow-up duration and intervals for category IIF complex renal cysts. MATERIALS AND METHODS: We studied 201 patients with category IIF renal cysts from January 1996 to January 2011. Renal cyst progression to category III was defined as an increase in complexity of the cyst in follow-up radiologic studies. We monitored radiologic changes and progression of renal cysts during the follow-up period and analyzed the pathologic results of those patients who were treated surgically. RESULTS: At a mean follow-up of 20 months, only 14 cases (7%) showed evidence of progression to stage III, with a mean time to progression of 11 months (range, 3 to 65 months). There were no significant differences in age, gender, cyst size, or change in cyst size between the progressive and non-progressive groups. Of 12 cases treated surgically, 10 cases (83.3%) showed renal cell carcinoma with pT1 stage, and there was no recurrence during postoperative follow-up of 23 months. Of the 187 patients without radiologic progression, 23 cases were treated surgically, and all of them showed benign cysts. CONCLUSIONS: The IIF category showed significant clinical reliability by a low rate of radiologic progression and a high rate of malignancy in the radiologic progressive group but a low rate of malignancy in the non-progressive group. Although it is hard to decide on a proper follow-up duration because of the variable time to progression, too frequent follow-up study seems to be unnecessary considering that most malignant cases were of a low stage.
Carcinoma, Renal Cell ; Disease Progression ; Follow-Up Studies ; Humans ; Kidney ; Recurrence