OBJECTIVE: This is designing the part of Electronic Medical Record using HL7 Development Framework and Reference Information Model to realize the building medical standard data model for sharing medical record between heterogeneous hospital systems. METHODS: The process used development of HL7 specifications consists of the following seven activities: 1.Project initiation. 2.Requirements Documentation. 3.Specification Modeling. 4.Specification Documentation. 5.Specification Approval. 6. Specification Publication. 7.Implementation Profiling. Each activity is briefly described in the subsections that follow and described in detailed in the methodology chapters that follow this introduction.3. Result. The steps, after 4 step, needs to standardized the results. So we didn't followed that steps1). RESULTS: We got the diagrams at each steps of the HDF methodology: 1.A dynamic description. 2.A static description of the concepts involved in the business process. 3.A Use Case model which identifies the system involved in the actual HL7 data/information exchange1). CONCLUSION: It was confirmed that HL7 RIM could take in the domestic demands of medical records, and concrete methodology was applied in practice. It can be a good reference for the hospitals constructing new information system and for the enterprises developing medical information systems to apply the HL7 version 3 to their works.
Commerce ; Electronic Health Records* ; Health Level Seven* ; Health Status* ; Information Systems ; Medical Records ; Publications

BACKGROUND: Throat culture is the golden standard for diagnosis of group A streptococcal (GAS) pharyngitis. However, because it is a time-consuming procedure, antibiotics are often empirically administrated. Rapid antigen tests (RATs) can detect bacterial infections within 15 minutes, thus helping to reduce unnecessary administration of antibiotics. METHODS: In total, 108 patients, between 3 and 17 yr of age, who visited our hospital from August 2011 to July 2012, were tested for suspected acute pharyngitis with two RATs––SD Bioline Strep A (SD, Korea) and BinaxNOW Strep A (Binax, Inc., USA)––as well as throat culture. We compared the sensitivity, specificity, and consistency of the two RATs and assessed the clinical manifestations of GAS pharyngitis. RESULTS: Of the 108 patients, 15 were confirmed to have GAS pharyngitis by throat culture. The SD test showed a sensitivity of 93.3% and a specificity of 97.8%; the positive and negative predictive values were 87.5% and 98.9%, respectively. The Binax test showed a sensitivity of 86.7% and a specificity of 100%; the positive and negative predictive values were 100% and 97.9%, respectively. The Kappa values for conformity degree were high, 0.887 and 0.918 in the SD and the Binax tests, respectively (P=0.00). Clinical manifestation assessment of GAS pharyngitis indicated that scarlatiniform rash and strawberry tongue were significantly associated signs (P<0.05). CONCLUSIONS: GAS pharyngitis diagnosis based on clinical manifestations alone has practical limitations. The two RATs are useful as substitutes for throat culture and their frequent use in clinical settings is advisable.
Animals ; Anti-Bacterial Agents ; Bacterial Infections ; Diagnosis ; Exanthema ; Fragaria ; Humans ; Pharyngitis* ; Pharynx ; Rats ; Sensitivity and Specificity ; Streptococcus pyogenes ; Tongue

OBJECTIVES: The microdose of gonadotrophin-releasing hormone agonist (GnRHa) has been suggested as a beneficial method of ovulation induction for poor responders. However, the effect of microdose of GnRHa itself has not been evaluated yet. We performed a prospective sutdy to assess the effect of microdose of GnRHa (5 microgram of triptorelin acetate) on the luteinizing hormone (LH) and follicle stimulating hormone (FSH). Secondary objective of this study is to assess how long the down-regulation of gonadotrophin secretion by microdose GnRHa persists. METHODS: Five microgram of triptorelin was injected daily into five normally menstruating women for 7 days starting from cycle day 3. The blood sample was drawn for 12h with 4h interval, then for 6days with 4 h interval and once a day for 14days, In next cycle, same amount of triptorelin was injected into the same subjects daily for 3 days. The blood sample was drawn twice a day for 20days. Serum FSH, LH and extradiol level was measured. RESULTS: The serum LH and FSH level increased rapidly after injection of first GnRHa. The FSH level reached peak (27.53+/-6.34 IU/l) in 5h while LH level reached peak (34.35+/-7.18 IU/l) in 4h. The flare of gonadotrophins persisted even after second and third day injection of GnRHa, although the peak levels were not as high as first injection. The down regulation of gonadotrophin was established in 4-5 days. The estradiol level increased for 4-5 days then decreased. When GnRHa was given for 7days, the estradiol level began to rise 7-8 days after last injection; when given for 3days, the estradiol level began to rise 3-6 days after last injection. CONCLUSION: Even with ultra-low dose of GnRHa, the down-regulation of gonadotrophin could be achieved. The flare-up of gonadotrophin would persist for 3days with this dose. The duration of down regulation was influenced by the duration of GnRHa administration.
Down-Regulation ; Estradiol* ; Female ; Follicle Stimulating Hormone ; Gonadotropin-Releasing Hormone* ; Gonadotropins* ; Humans ; Luteinizing Hormone ; Ovulation Induction ; Prospective Studies ; Triptorelin Pamoate

No abstract available.
Thrombocytopenia, Neonatal Alloimmune*

No abstract available.
Thrombocytopenia, Neonatal Alloimmune*

No abstract available.
Skin

No abstract available.
Skin

We present a case of mandibular involvement with Langerhans cell histiocytosis (LCH), diagnosed by ultrasound-guided aspiration and subsequently confirmed by incisional biopsy and immunohistochemistry in an eight-year-old boy. The cytologic findings included the presence of characteristic Langerhans cells of both mononucleate and multinucleate form. Diagnostic confirmation was obtained by immunopositivity for S-100 protein and CD1a of Langerhans histiocytes on paraffin-embedded sections obtained during incisional biopsy of the right mandibular area. By reporting a case of childhood LCH, we correlate the cytologic findings with histologic features and discuss the role of aspiration cytologic diagnosis in such a rare and cytomorphologically characteristic case.
Biopsy ; Biopsy, Fine-Needle ; Child ; Histiocytes ; Histiocytosis ; Histiocytosis, Langerhans-Cell ; Humans ; Immunohistochemistry ; Langerhans Cells ; Mandible ; S100 Proteins

BACKGROUND: This study was proposed to examine the effects of butorphanol on propofol dose requirements and hemodynamic responses during propofol-N2O-O2 anesthesia. In addition, the effects of butorphanol on the recovery time, sedation score and postoperative first analgesic request time were assessed. METHODS: Forty patients were allocated to 2 groups. Twenty patients received butorphanol (20 microgram/kg, group (B) and the others received an equal volume of placebo (group P) 3 minutes before induction with propofol. After induction, anesthesia was maintained with propofol (6 - 10 mg/kg, iv)-N2O (70%)-O2 (30%). Propofol doses for induction and maintenance and hemodynamic responses (blood pressure, heart rate) were checked. After surgery, sedation score, recovery profiles, and postoperative first analgesic request time were assessed. RESULTS: The induction doses of propofol were lower in group B than in group P. Diastolic pressure and heart rate decreased in group B compared to group P after endotracheal intubation and before skin incision. After skin incision, decreased diastolic pressure and heart rate returned to preanesthetic levels in group P, but the decreased level was sustained in group B. There were group differences in sedation score at 5 and 10 minutes after extubation. In group B, recovery was delayed and more time elapsed before the first analgesic request. CONCLUSIONS: Butorphanol co-administered with propofol reduces the induction dose of propofol and delays the first analgesic request time, but there are significant fluctuations in blood pressure and heart rate during endotracheal intubation and skin incision.
Anesthesia* ; Blood Pressure ; Butorphanol* ; Heart ; Heart Rate ; Hemodynamics* ; Humans ; Intubation, Intratracheal ; Propofol* ; Skin