OBJECTIVES: Coding Systematized Nomenclature of Medicine, Clinical Terms (SNOMED CT) with complex and polysemy clinical terms may ask coder to have a high level of knowledge of clinical domains, but with simpler clinical terms, coding may require only simpler knowledge. However, there are few studies quantitatively showing the relation between domain knowledge and coding ability. So, we tried to show the relationship between those two areas. METHODS: We extracted diagnosis and operation names from electronic medical records of a university hospital for 500 ophthalmology and 500 neurosurgery patients. The coding process involved one ophthalmologist, one neurosurgeon, and one medical record technician who had no experience of SNOMED coding, without limitation to accessing of data for coding. The coding results and domain knowledge were compared. RESULTS: 705 and 576 diagnoses, and 500 and 629 operation names from ophthalmology and neurosurgery, were enrolled, respectively. The physicians showed higher performance in coding than in MRT for all domains; all specialist physicians showed the highest performance in domains of their own departments. All three coders showed statistically better coding rates in diagnosis than in operation names (p < 0.001). CONCLUSIONS: Performance of SNOMED coding with clinical terms is strongly related to the knowledge level of the domain and the complexity of the clinical terms. Physicians who generate clinical data can be the best potential candidates as excellent coders from the aspect of coding performance.
Clinical Coding ; Electronic Health Records ; Humans ; Medical Record Administrators ; Neurosurgery ; Ophthalmology ; Specialization ; Systematized Nomenclature of Medicine

PURPOSE: To evaluate the effects of dexamethasone(D) on blood pressure(BP) in infants with bronchopulmonary dysplasia(BPD). METHODS: We retrospectively reviewed 10 infants with BPD(mean birth weight: 1,383+/-17 gm, mean gestational age: 29.0+/-1.7 weeks) treated with D at Wonkwang University Hospital from January 1994 to June 1998. D was started at 0.5 mg/kg/day intravenously for first week, followed by 0.3 and 0.1 mg/kg/day for second and third week, respectively. Changes in BP during pre-D, 1st wk(D1), 2ndwk(D2), 3rd wk(D3), and post-D periods were compared using Turkey Kramer multiple comparison test. RESULTS: Mean systolic pressure(sBP) significantly increased in Dl, D2, D3 compared to pre-D(63+1.3, P<0.01; 66+1.7, P<0.001; 683.4, P<0.001 vs 591.9 mmHg, respectively) but significantly decreased in post-D compared to D3(64+/-2.4 mmHg, P<0.05). Mean diastolic pressure(dBP) significantly increased in D2 and D3 compared to pre-D(42+/-1.1, P<0.001; 43+/-2.6, P<0.001, vs 382.1 mmHg, respectively). Mean dBP deed slightly in post-D(41+/-4.1 mrnHg, P>0.05). The sBP and dBP significantly increased from day 2 after initiation of D and were highest on day 17 and 17-18 of 3rd week, respectively. The number of hypertensive infants who were considered for antihypertensive medications were 2(20%) for sBP >or= 80-90 mmHg, 3(30%) for dBP >or= 50 mmHg and 1(10%) for dBP> or =60 mmHg. These infants, however, remained asymptomatic. CONCLUSION: Significant elevation of BP was observed during dexamethasone therapy for infants with BPD especially after 2nd day. However, BP elevation was transient, not requiring antihypertensive medications.
Birth Weight ; Blood Pressure* ; Bronchopulmonary Dysplasia* ; Dexamethasone* ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Retrospective Studies ; Turkey

Dermatophytes infect the human hair, skin, nail and cause the dermatophytosis. The extracellular and intracellular proteinases of the dermatophytes commonly occur in the genus Trichophyton like T. rubrum, T. mentagrophytes, and T. granulosum. These enzymes play a prominent role in growth, multiplication and infection of the host tissue. Extracellular proteinases have been purified from the species of Trichophyton and Microsporum. We purified the proteinase partially from the culture filtrate of the Trichophyton tonsurans through Mono-Q and Superose 12 column and investigated its biochemical and enzymatic characters. The molecular size of the proteinase was estimated to be 41 kDa by SDS-PAGE. And pI was 3.2. The optimal temperature and pH for an enzymatic activity were 27C and 7.5, respectively. The purified porteinase degraded the keratin, bovine serum albumin, hemoglobin. The serine proteinase inhibitor like PMSF and DFP inhibited the proteolytic activity of the purified enzyme whereas the cysteinase inhibitor did not. These results demonstrated that the purified proteinase is a serine proteinase and can contribute the tissue invasion.
Arthrodermataceae ; Electrophoresis, Polyacrylamide Gel ; Hair ; Humans ; Hydrogen-Ion Concentration ; Isoflurophate ; Microsporum ; Peptide Hydrolases ; Serine Proteases* ; Serine* ; Serum Albumin, Bovine ; Skin ; Tinea ; Trichophyton*

Recently the use of hydrochloric acid as a toilet disinfectant has become more common, and the risk of its ingestion is though to be increasing. We experienced a case of 67 year-old man who accidentally ingested hydrochloric acid and as a result developed a postprandial epigastric fullness end pain 3 weeks thereafter, The patient underwent an UGI series, fiberoptic gastroscope and abdominal ultrasonography and was found to have a gastric midbody stricture. A total gastreetomy and Roux-en- Y esophagojejunostomy was performed. We report this case with brief review of the literature.
Aged ; Constriction, Pathologic ; Eating ; Gastritis* ; Gastroscopes ; Humans ; Hydrochloric Acid* ; Ultrasonography

The authors statistically analysed transferred patients among 110 ocular perforation injury patients who were admitted to the Seoul Paik Hospital between January 1, 1984 and December 31, 1988. Male was 85.9% and third decade was most common decades(30.5%). Left eye was more affected(59.8%) than right eye. The most common cause was traffic accident(37.%) and perforated site was corneo-sclera(43.%). Subconjunctival hemorrhage was the most common accompanied ocular manifestation(47.0%). Most of the perforated eyes were treated with primary closure of the wound. The final visual acuity was better in patients who were treated at only one hospital two or more hospitals before being transferred. With the above results, the final visual acuity may be related with the number of the hospital which the patients were treated before transferred.
Hemorrhage ; Humans ; Male ; Seoul ; Visual Acuity ; Wounds and Injuries

The spinal schwannomas are the most common spinal cord tumors and they make some regressive changes such as necrosis, mucous or cystic degeneration, caseation or calcification occasionally. We experienced a case of intradural ossifying schwannoma in 17 years old male, which occurred in the 2nd 3rd thoracic region. On operative finding, it was a very hard, pinkish gray and bean sized mass, and it firmly adhered to the spinal cord. We found dark bluish necrotic changes at the adhered sites of the spinal cord. On microscopical finding it revealed multiple foci of myxoid degeneration and osseous metaplasia with fibromatosis structure in schwannoma.
Adolescent ; Fibroma ; Humans ; Male ; Metaplasia ; Necrosis ; Neurilemmoma* ; Spinal Cord ; Spinal Cord Neoplasms

Sclerosing cholangitis is a chronic cholestatic disease characterized by inflammation and obliterative fibrosis of the bile ducts, leading to biliary cirrhosis and ultimately to liver failure. In children, sclerosing cholangitis is known to be associated with Langerhans cell histiocytosis, as well as with congenital immunodeficiencies and cystic fibrosis. Secondary sclerosing cholangitis is suspected in Langerhans cell histiocytosis with chronic cholestasis, liver dysfunction and portal hypertension. Unlike primary sclerosing cholangitis, the cholangitis associated Langerhans cell histiocytosis is destructive in nature and progresses more rapidly to biliary cirrhosis, therefore uniformly the prognosis is poor. In this setting, liver transplantation should be considered early in children with sclerosing cholangitis complicating Langerhans cell histiocytosis before end-stage liver failure and variceal bleeding. We experienced a case of secondary sclerosing cholangitis in Langerhans cell histiocytosis in a 2-year-old boy. We report this case with brief review of the related literatures.
Bile Ducts ; Child ; Child, Preschool ; Cholangitis ; Cholangitis, Sclerosing* ; Cholestasis ; Cystic Fibrosis ; Esophageal and Gastric Varices ; Fibrosis ; Histiocytosis, Langerhans-Cell* ; Humans ; Hypertension, Portal ; Inflammation ; Liver Cirrhosis, Biliary ; Liver Diseases ; Liver Failure ; Liver Transplantation ; Male ; Prognosis

A case of Wilms' tumor in a 67 year-old female is presented. The tumor totally replaced the left kidney with extension to Gerota's fascia, the adrenal gland and ureter, with tumor thrombi in the left renal vein. Multiple bony metastases to the skull, shoulder, rib, ilium, acetabulum and femur were noted also. Microscopically, the tumor was composed predominantly of blastemal tissue with diffuse anaplasia with areas of tubular differentiation and chondroid elements. Clear cell nests were found in the proximal ureter with gradual maturation downward.
Aged ; Bone Neoplasms/secondary ; Case Report ; Female ; Human ; Kidney/pathology ; Kidney Neoplasms/*pathology/radiography ; Nephroblastoma/*pathology/radiography ; Tomography, X-Ray Computed ; Ureter/pathology

PURPOSE: As the first-line pharmacotherapy for erectile dysfunction (ED), phosphodiesterase type 5 (PDE5) inhibitors are widely used and their clinical efficacy is well established. But up to now, most of these comparative studies have been based on questionnaires, and Udenafil and Mirodenafil, which have recently been developed in South Korea, have not yet to be compared in clinical studies. We compared and analyzed the efficacy of five PDE5 inhibitors using the sexual stimulated (SS)-Penogram. MATERIALS AND METHODS: A total of 347 patients taking PDE5 inhibitors for the treatment of ED and underwent SS-Penogram was enrolled in this study. AUC (area under the curve) of SS-Penogram was compared in each PDE5 inhibitors. Differences in AUC according to age, combined disorders, serum testostereone and prolactin, cholesterol and IIEF were also analysed using Chi-square and Kruskal-Wallis test. P-value less than 0.05 was considered as statistically insignificant. RESULTS: Ratios of Type I curves in medication groups with normal erection were not statistically different before and after medication. Ratios of the excellent response (>50 % increase in area under the curve) and non-response groups (no increase or even decrease in area under the curve) in each medication group were not statistically different. CONCLUSIONS: In this clinical comparative study of the efficacy of PDE5 inhibitors using the SS-Penogram, there were no definite differences in efficacy among PDE5 inhibitors.
Area Under Curve ; Cholesterol ; Cyclic Nucleotide Phosphodiesterases, Type 5 ; Erectile Dysfunction ; Humans ; Male ; Phosphodiesterase 5 Inhibitors ; Prolactin ; Pyrimidines ; Pyrimidinones ; Surveys and Questionnaires ; Republic of Korea ; Sulfonamides

To understand the role of IGF2 gene in development of human ovary, IGF2 expression was detected by monoclonal antibody for IGF2 to its producted protein with immunohistochemical technique on human ovarian tissues. The results was as follows. IGF2 was highly expressed in ovum of mature follicle, IGF2 expression, however, was not high in granulosa and the cells. IGF2 was not highly expressed in ovum of primary follicle. Highly expressed IGF2 was found on corpus luteum and no expression of IGF2 was found in stroma and epithelial cells. These results suggest that IGF2 is important role in ovulation and in production of progesterone. Abnormal IGF2 expression may be concerned to carcinogenesis of ovarian tumor because most of all tumor from ovary is originated from epithelium.
Carcinogenesis ; Corpus Luteum ; Epithelial Cells ; Epithelium ; Female ; Humans* ; Ovary* ; Ovulation ; Ovum ; Progesterone ; Theca Cells