The authors developed a computer program for use in report printing as well as data storage and retrieval for the gastrointestinal endoscopy service. This program used IBM PC XT and was written in dBASE III plus language. We applied the automatic SNOMED coding method, which is one of the most efficient and accurate method of computerization of medical data. The working sheet which contained the results of previous endoscopic studies could be printed during registration. The dBASE word processor enabled issuing of the formal report of endoscopic result, and the data storage was carried out during the typewriting of the report. Two kinds of data files were stored in the hard disk; the temporary file contained full informations and the permanent file contained patients identification data and SNOMED code. Searching of a specific case was performed by chart number, patients name, date of study, or SNOMED code within a second. All the cases were arranged by SNOMED codes of procedure, topography and morphology codes. Every new data was copied to the diskette automatically. with which data could be restored in case of hard disk failure. The main advantages of this program in comparison to the large main frame computer system are low price, flexibility and easy accessibility. Based on our experience (including surgical pathology department, radiology, clinical pathology), we assume that this program may fit every endoscopy room where there are less than 20,000 cases per year.
Information Storage and Retrieval ; Clinical Coding* ; Computer Systems ; Endoscopy ; Endoscopy, Gastrointestinal* ; Humans ; Information Storage and Retrieval* ; Pathology, Surgical ; Pliability ; Systematized Nomenclature of Medicine

BACKGROUND: Decreased heart rate variability(HRV) has been shown to be an independent predictor of poor outcome after acute myocardial infarction, Spectral analysis of HRV has recently been shown to be a reliable noninvasive test for quantiative assessment of cardiovascular autonomic regulatory response. We estimated the reproducibility and circadian rhythm of HRV parameters in patients with acute myocardial infarction. METHODS: Three consecutive 24-hour ambulatory electrocardiographic recordings were made in 24 patients with acute myocardial infarction, with 10~14 days after the acute attack, and analyzed for HRV parameters of both frequency and time domains. Parameters of frequency domain include low frequency(LF) and high frequency(HF) components. Parameters of time domain include sdRR, SDANN, SD, pNN50, rMSSD, HRV index. RESULTS: Mean total, low frequency and high frequency amplitude spectral densities were 33msec, 19msec and 11msec, respectively. Mean values of sdRR, SDANN, SD, rMSSD, pNN50 and HRV index were 103msec, 90msec, 47msec, 28msec, 7% and 32, respectively. Coefficients of variation(CV) of total amplitude spectral density, and low and high frequency components were 7%, 9% and 12%, respectively. CV of most HRV parameters of time domain were also around 10% except rMSSD and pNN50. Heart rate increased in the morning to be sustained during the day time and decreased in the night. Heart rate variability of high frequency component decreased in the early morning to be sustained during day time with increase in the night. CONCLUSIONS: We conclude that in the predischarge period of acute myocardial infarction, HRV parameters of frequency and time domains are reproducible and there are some morning fall of cardiac vagal activity.
Circadian Rhythm ; Electrocardiography ; Heart Rate* ; Heart* ; Humans ; Myocardial Infarction*

OBJECTIVES: The length ratio of the second to the fourth finger (2D : 4D) is a known indirect measure of prenatal sex hormone exposure. Sex hormones influence brain development through structural and epigenetic modifications of neurons. We examined the 2D : 4D in schizophrenia patients and normal controls to investigate the relationship between prenatal sex hormone exposure and the genesis of schizophrenia. METHODS: The participants were 187 schizophrenia patients (94 male, 93 female) and 190 normal controls (95 male, 95 female). We determined handedness via the Edinburgh Handedness Inventory and age of onset of schizophrenia via clinical records or directly questioning the patients. We measure digit length using vernier caliper and performed T-tests, ANOVA, and ANCOVA to analyze the data. RESULTS: There were no significant 2D : 4D differences between schizophrenic participants and normal controls. Also, there was no significant correlation between the 2D : 4D and the age of onset of schizophrenia. Among the controls, the 2D : 4D was significantly higher (more "feminized") in females than in males (F=4.937, p=.027). But, there were no significant 2D : 4D sex differences among the schizophrenia patients (F=3.429, p=.066). CONCLUSION: These results imply that sex hormone changes during fetal development might play some role in the development of schizophrenia.
Age of Onset ; Brain ; Epigenomics ; Female ; Fetal Development ; Fingers ; Functional Laterality ; Gonadal Steroid Hormones ; Humans ; Male ; Neurons ; Schizophrenia ; Sex Characteristics

Dizziness is a very common symptom encountered by primary care physicians. Dizziness can be divided into five subgroups according to symptoms. These subgroups can be determined by a patient's history and allow the physician to deduce the etiology. A careful and systematic approach to dizzy patients is the key to a correct diagnosis and finding the optimal treatment. Physicians should obtain a detailed history from the patient in an open-ended fashion. Brief and comprehensive bedside neuro-otologic examinations, such as cranial nerve examinations, the Dix-Hallpike test, and the head thrust test cannot be omitted for an accurate diagnosis. Knowledge about the numerous disease entities that may contribute to dizziness can be essential for differential diagnosis. In addition, this article provides information about frequently prescribed drugs, including vestibular suppressants and antiemetics.
Antiemetics ; Cranial Nerves ; Diagnosis, Differential ; Dizziness ; Head ; Humans ; Physicians, Primary Care ; Primary Health Care

To observe the antihypertensive effects of the angiotensin-converting enzyme inhibitor, enalapril, a daily average dosage of 20mg was administred to 38 patients with essential hypertension for 4 weeks. Changes in blood pressure and heart rate, and the frequencies of adverse reactions during the drug administration were constantly observed. At the end of the 4th week of administration the mean diastolic blood pressure decreased from 104+/-11.3 to 91+/-7.9mmHg(<0.001), and the mean systolic blood pressure from 165+/-16.8 to 142+/-10.6mmHg(P<0.001), An effective antihypertensive action of enalapril was observed in 31 out of 38 cases(82%), and normalization of diastolic blood pressure below 85mmHg was shown in 27 cases(71%). The most remarkable antihypertensive effects were shown at the end of first week, and the effect increased progressively until the end of 4th week of therapy. There were no significant changes in heart rate during the observation period. Adverse reactions occured in only 7 cases(18%). These reactions included headache, dizziness, fatigue, skin rash and facial flushing in the order of frequency. Almost all of these reaction were mild and transient, disappearing spontanously without discontinuation of the medication. In conclusion, enalapril seems to be a safe and effective primary antihypertensive drug for the treatment of essential hypertension.
Blood Pressure ; Dizziness ; Enalapril* ; Exanthema ; Fatigue ; Flushing ; Headache ; Heart Rate ; Humans ; Hypertension

The Di(a+b-) phenotype is extremely rare among Caucaclans and mostly confined to mongoloids. The incidences of Di antigen among Koreans were reported to be 6.1 to 14.5%, with an average of 9.6%; it can be calculated that the frequency of Di(a+b-) is 0.25% on the average. Authors report the first case of hemolytic disease of the newborn due to anti-Dib in Korea. The Diego phenotypes of the mother, baby and father were Di(a+b-), Di(a+b+) and Di (a-b+), respectively. The mother's serum and eluate from infant's erythrocytes contained anti-DP antibody active in the antiglobulin phase. After transfusions of Di-negative red cells from the mother and mother's relative, the patient was recovered from anemia and jaundice.
Anemia ; Erythrocytes ; Fathers ; Humans ; Incidence ; Infant, Newborn* ; Jaundice ; Korea ; Mothers ; Phenotype

The purpose of this study is to present the results of the clerkship evaluation by the students using questionnaire, to discuss the problems revealed in performing the evaluation, and to find out the ways to improve the evaluation. In 2000, the evaluation has been conducted by the Department of Radiology, Seoul National University College of Medicine. The questionnaires filled-up by 97 junior students who completed the clerkship schedule of 2 weeks were analyzed in this study. The questionnaire consisted of 28 structured items with 5-grade scale each, the contents of which included the amount and level of the overall clerkship course and those of 5 subtypes of the clerkship(self-learning, student conference, student seminar, on-site clerkship, and small group discussion with faculty). In small group discussion, enthusiasm of each faculty, delivery effect, and difficulty of the contents were also evaluated. As a result, the most items were assessed to be slightly better than average(3 or 4 point of 5 scale). It was found that the small group discussion was most favored, whereas the student seminar was least favored. Faculty activity was also scored to be better than average. There were no significant differences among all faculty activity. The limitation of this study is failure of assessing the validity and reliability of the student response. In order to improve the evaluation, we should consider following four subjects: First, all the items are carefully developed to enhance the validity and reliability of the evaluation. Second, students should be fully informed of the objects of the evaluation before it is carried out. Third, teaching support facilities for the faculty are needed. Finally, an organization which takes complete charge of the instruction evaluation must be established.
Appointments and Schedules ; Humans ; Reproducibility of Results ; Seoul ; Surveys and Questionnaires

Recently, we have experienced with various changes in the health insurance. Korean government is implementing the prospective payment system(PPS) as a pilot project to reduce medical expenditure. Case management is an effective way to reduce costs, while not sacrificing quality of service, under the PPS. In this study, the integrated decision support system(DSS) for case management was presented to support two case management activities ; utilization management and discharge planning. This system can be used in three ways ; prospective, concurrent, and retrospective management. By monitoring cases from medical record database, the DSS provides basic patient information, payment information, medical service information to the case manager. In the future, data warehouse should be introduced to integrate various databases related to case management and to improve quality of information produced by the DSS.
Case Management* ; Cesarean Section* ; Critical Pathways ; Diagnosis-Related Groups* ; Female ; Health Expenditures ; Humans ; Insurance, Health ; Medical Records ; Patient Discharge ; Pilot Projects ; Pregnancy

The inevitable deterioration in hearing ability that occurs with age, age-related hearing loss (ARHL) or presbycusis, is a multifactorial process that can vary in severity from mild to profound. The number of cases of age-related hearing loss is growing due to the rapid growth of South Korea's aging population. According to the Korean Health Statistics of 2009, the incidence of unilateral hearing loss in people aged 65 or older is 17.5 percent, while the incidence of bilateral hearing loss exceeds 25.9 percent. Left untreated, age-related hearing loss of a moderate or greater degree affects communication and can decrease quality of life. Comprehensive rehabilitation by hearing aids or cochlear implant are widely available but underused in part because of social attitudes that undervalue the effect of hearing on life, in addition to the cost and stigma associated with hearing aids. Proper screening tests for ARHL should be developed and primary care physicians should screen and refer their elderly patients for assessment and remediation. In addition, development of hearing aids with a low cost of distribution and an increase in the size of government subsidies to hearing aids are imperative.
Aged ; Aging ; Cochlear Implants ; Financing, Government ; Hearing ; Hearing Aids ; Hearing Loss ; Hearing Loss, Bilateral ; Hearing Loss, Unilateral ; Humans ; Incidence ; Korea ; Mass Screening ; Physicians, Primary Care ; Presbycusis ; Quality of Life ; Republic of Korea

The incidence of hearing impairment is increasing due to growth of the population of the elderly, industrialization and noise exposure. Evaluation of hearing impairment are frequently made in purpose of compensation, indemnification or welfare policy of the disabled. Evaluation of hearing impairment is a process to diagnose and to evaluate the disability under objective criteria. Several domestic and international standards have been proposed including legal acts such as the disable welfare law, industrial accident compensation insurance and the national pensions act. There are also medical counsel standards such as Korean academy of medical sciences disability evaluation standards, disability standards of American medical association and disability evaluation of McBride. In order to assess the hearing impairment fairly, thorough understanding about the difference of the purposes and standards of each guideline of hearing impairment is needed. Therefore in this article, the domestic and the international standards for the evaluation method of hearing impairment which was revised recently and their differences are discussed.
Accidents, Occupational ; Aged ; American Medical Association ; Compensation and Redress ; Disability Evaluation ; Hearing ; Hearing Loss ; Humans ; Incidence ; Insurance ; Jurisprudence ; Noise ; Pensions ; Industrial Development