A number of application systems for medical information services were developed. However, each of those application systems was developed independently out of consideration for other applications. Therefore, there are many problems in operation of the systems. Users(hospitals) have to prepare communication lines and equipments for using each service redundantly, and facilities for operation of those systems are also furnished individually. Thus, it is necessary to integrate the medical information systems in standardized environment in order to reduce operating costs and upgrade the services. This paper analyzes the methodology for development of an integrated medical information system in common environment and summarizes the result of the integration and standardization. Finally, we studies the directions for expanding the integrated system and activating the services.
Delivery of Health Care* ; Information Services ; Information Systems*

Spontaneous hematomas of the iliacus muscle are rare lesions and these are seen in individuals receiving anticoagulation therapy or patients with blood dyscrasias such as hemophilia. It can cause femoral neuropathy and resultant pain and paralysis. Although there is no clear consensus for the treatment of femoral neuropathy from iliacus muscle hematomas, delays in the surgical evacuation of hematoma for decompression of the femoral nerve can lead to a prolonged or permanent disability. We report here on a rare case of a spontaneous iliacus muscle hematoma that caused femoral neuropathy in a patient who was taking warfarin for occlusive vascular disease and we discuss the treatment.
Consensus ; Decompression ; Femoral Nerve ; Femoral Neuropathy ; Hematoma ; Hemophilia A ; Humans ; Muscles ; Paralysis ; Vascular Diseases ; Warfarin

This study aims to develop a translator for coexistence of VAN EDI and XML EDI methods in an e-Commerce system. The electronic documents are translated in two steps. At the first step, the translation is performed in the conceptual level. The EDI standard is translated to XML schema. The stage includes the class diagram modelling of EDI standard using the extended mechanism of UML and the following translation to XML schema. And, at second step, the definitive translation is performed. The contents of documents are translated each other for EDI and XML documents. In this step, the information necessary for contents translation is extracted from the XML schema created in the first step, and then the mapping table is constructed using the information. The document translation is completed by this mapping table. A translator developed by this study is superior to the existing flat file mapping method, in terms of maintenance and expansion.

This study aims to develop a translator for coexistence of VAN EDI and XML EDI methods in an e-Commerce system. The electronic documents are translated in two steps. At the first step, the translation is performed in the conceptual level. The EDI standard is translated to XML schema. The stage includes the class diagram modelling of EDI standard using the extended mechanism of UML and the following translation to XML schema. And, at second step, the definitive translation is performed. The contents of documents are translated each other for EDI and XML documents. In this step, the information necessary for contents translation is extracted from the XML schema created in the first step, and then the mapping table is constructed using the information. The document translation is completed by this mapping table. A translator developed by this study is superior to the existing flat file mapping method, in terms of maintenance and expansion.

PURPOSE: To compare the radiologic and clinical outcomes of total knee arthroplasty (TKA) performed using a navigation system with those obtained using the conventional technique. MATERIALS AND METHODS: Forty-one TKAs were performed using a navigation system (navigation group) and forty-eight by conventional surgery (conventional group). Radiologic results outside the range defined by +/-3degrees of optimum were classified as outliers. Range of motion and HSS scores at final follow-up were also compared. RESULTS: Mean mechanical axes were 0.3degrees valgus for navigation and 0.5degrees varus for the conventional group, which were not statistically different. However, two outliers occurred in the navigation group, which was significantly less than the 14 that occurred in the conventional group. Mean coronal inclination of the femoral component was significantly different in the two groups as were the outlier numbers. Although outlier numbers significantly differed in sagittal inclination of the femoral or tibial components or coronal inclination of the tibial component, there were no statistical differences in terms of mean values. Differences in ROM and HSS scores were also not observed between the two groups. CONCLUSION: The navigation system helped increase alignment accuracy of the lower extremity, but no significant difference was observed in clinical results between the two study groups.
Arthroplasty* ; Follow-Up Studies ; Knee* ; Lower Extremity ; Range of Motion, Articular

BACKGROUND AND OBJECTIVES: It is important to figure out the location between the internal carotid artery (ICA) and the Eustachian tube (ET) for conducting safe ET surgery. Using computed tomography (CT), this study was aimed to evaluate the anatomical relationship between ET and ICA according to age and gender. SUBJECTS AND METHOD: Contrast enhanced CT scans of the paranasal sinus taken between January 2005 and December 2010 were reviewed retrospectively. A total of 216 patients (432 ears) were enrolled. In each patient, we measuresed the distance from the anterior cushion of torus tubarius to ICA (AC-ICA), the distance from the posterior cushion of torus tubarius to ICA (PC-ICA), the distance from the Rosenmuller fossa to ICA, the shortest distance from ET lumen to ICA (ET-ICA), and the angle between the imaginary lines from the orifice of ET to the posterior end point of nasal septum to point ICA (ET-NS-ICA). Patients were divided into 10 groups based on age difference of 15-years. RESULTS: For the female patients aged 65 to 80 years old, AC-ICA, PC-ICA were closest from the nasopharynx. For this group, at p<0.05, the distances of AC-ICA, PC-ICA and ET-ICA showed a negative correlation with increasing age, whereasET-NS-ICA (p<0.05) showed a positive correlation, indicating a tendency of medicalization with increased age. CONCLUSION: The distance between ET and ICA represents a variety of distribution according to gender and age. When performing a surgery for the nasopharyngeal portion of ET, the surgeon should be aware of the location of ICA in the preoperative CT findings.
Carotid Artery, Internal* ; Eustachian Tube* ; Female ; Humans ; Medicalization ; Nasal Septum ; Nasopharynx ; Retrospective Studies ; Tomography, X-Ray Computed

Renal graft recipients with hepatitis B virus(HBV) infection are at increased risk of fatal outcome, when 1they have serological evidence of active viral replication, such as HBV-DNA and/or HBeAg. Some patients have been treated successfully with interferon. But the major drawback of this therapy is acute rejection. Lamivudine is a potent inhibitor of hepatitis B virus replication. The aim of this study was to determine the efficacy and safety of lamivudine therapy in HBsAg positive renal recipients with active viral replication. Of the 20 HBsAg positive renal transplants, 12 patients with positive HBV-DNA, determined by hybridization method, were given lamivudine. The doses of lamivudine ranged from 37.5 to 150mg/day according to the graft function of patients. Alanine aminotransferase(ALT), aspartate aminotransferase (AST), HBsAg, HBeAg, anti-HBe, HBV-DNA and creatinine were regularly monitored. Lamivudine was well tolerated without significant side effect. Viral replication was effectively suppressed, as evidenced by negative conversion of serum HBV-DNA in 11 of 12 patients and reduction in HBV-DNA titer in 1 patient. In 3 patients who stopped lamivudine due to economic reason, HBV-DNA promptly increased to high titer, but decreased to undetectable level after retrial of medication. In 2 patients with initial negative conversion of HBV-DNA and under continued medication, HBV-DNA reappeared at 7 and 16 months respectively after initiation of lamivudine, with deterioration of hepatic function in 1 patient. These patients with lamivudine-resistant mutant continued medication with persistent low titer of HBV-DNA and without further aggravation of hepatic dysfunction. Lamivudine seems to inhibit HBV replication effectively in HBV-infected renal recipients and seems to be helpful in delaying the progression of liver disease. However, the optimal duration of treatment and long term efficacy and safety remain to be determined.
Alanine ; Aspartate Aminotransferases ; Creatinine ; Fatal Outcome ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis B* ; Hepatitis B, Chronic ; Hepatitis* ; Humans ; Interferons ; Kidney Transplantation* ; Lamivudine* ; Liver Diseases ; Transplants

BACKGROUND AND OBJECTIVES: A distortion product otoacoustic emission (DPOAE) is a non-invasive method which is commonly used to assess the hearing function of the cochlea and to reflect objective information of specific frequency in the cochlea. We hypothesize that after applying a broad band noise (BBN), the outer hair cell's function will change and cause reduction in the amplitude of DPOAEs and signal to noise ratio (SNR). SUBJECTS AND METHOD: We performed the examination on 40 subjects (80 ears) who have a normal hearing function. DPOAEs were recorded before and after BBN stimulation (intensity: 90 dB HL, duration: 10 minutes). RESULTS: After the BBN stimulation, the amplitude of DPOAEs and SNR were decreased at all frequencies. The amplitude of DPOAEs and SNR decreased 0.3-1.6 dB SPL, 0.6-1.5 dB SPL, respectively. Decreases in the amplitude had statistical significances after 3 and 6 minutes in 1 kHz, 3 and 6 minutes in 2 kHz, immediately after noise exposure, and after 3 and 6 minutes in 6 kHz. However, the SNR changes had statistical significance only after 3 minutes in 1 kHz. After the stimulation, pure tone threshold at 4 kHz increased 3.2+/-3.9 dB HL. After the BBN exposure, the amplitude of DPOAEs and SNR decreased at all frequencies and most of them recovered within 12 minutes. CONCLUSION: These results suggest that DPOAE could be a clinically useful method for the purpose of screening, managing and assessing the prognosis of acoustic trauma and noise induced sensorineural hearing loss.
Auditory Fatigue ; Cochlea ; Hair ; Hearing ; Hearing Loss, Noise-Induced ; Hearing Loss, Sensorineural ; Mass Screening ; Noise ; Prognosis ; Signal-To-Noise Ratio

BACKGROUND AND OBJECTIVES: The purpose of this study was to evaluate the advantages and limitations of using fibrin glue for securing bioresorbable panels to reconstruct the fractured orbital floor by transantral approach. SUBJECTS AND METHOD: A retrospective study was conducted from July 2009 to July 2015 in 35 patients with pure orbital floor fractures. Nineteen patients underwent reduction surgery for inserting the bioresorbable panel and 16 patients underwent reduction surgery using fibrin glue for securing the bioresorbable panel via a transantral approach. In both groups, a chart review of preoperative and postoperative ocular symptoms, operation records, and complications was conducted. RESULTS: There was no significant difference between two groups in the demographic data of patients. Comparing the surgical outcomes between two groups, diplopia and mean discrepancy between fractured bone chip and intact orbital floor based on computed tomography scans showed much better results in the group that used bioresorbable panel secured by fibrin glue than in the bioresorbable only group. Furthermore, we carried out revision operations in six cases in the bioresorbable panel only group, where we found that the main cause of fracture to be the dislocation of bioresorbable panel. On the other hand, in the bioresorbable panel secured by the fibrin glue group, there were no reoperation and postsurgical complications. CONCLUSION: During the course of the study, we sensed orbital floor fracture repair using bioresorbable panel secured by fibrin glue via a transantral approach as an easy and effective technique with good postoperative results, and minimal implant related complications. This novel procedure is recommended as a surgical option for the reduction of orbital floor fractures, especially in large and posterior fractures.
Diplopia ; Dislocations ; Fibrin Tissue Adhesive* ; Fibrin* ; Hand ; Humans ; Methods ; Orbit* ; Orbital Fractures ; Reoperation ; Retrospective Studies

Allelic differences in A and B mating-type loci are a prerequisite for the progression of mating in the genus Pleurotus eryngii; thus, the crossing is hampered by this biological barrier in inbreeding. Molecular markers linked to mating types of P. eryngii KNR2312 were investigated with randomly amplified polymorphic DNA to enhance crossing efficiency. An A4-linked sequence was identified and used to find the adjacent genomic region with the entire motif of the A locus from a contig sequenced by PacBio. The sequence-characterized amplified region marker 7-2299 distinguished A4 mating-type monokaryons from KNR2312 and other strains. A BLAST search of flanked sequences revealed that the A4 locus had a general feature consisting of the putative HD1 and HD2 genes. Both putative HD transcription factors contain a homeodomain sequence and a nuclear localization sequence; however, valid dimerization motifs were found only in the HD1 protein. The ACAAT motif, which was reported to have relevance to sex determination, was found in the intergenic region. The SCAR marker could be applicable in the classification of mating types in the P. eryngii breeding program, and the A4 locus could be the basis for a multi-allele detection marker.
Breeding ; Cicatrix ; Classification ; Dimerization ; DNA ; DNA, Intergenic ; Inbreeding ; Pleurotus ; Transcription Factors