OBJECTIVE: This study was conducted to investigate public opinion regarding personal health management service using Personal Health Record (PHR) in Korea. Specifically, the relationships between consumer's demographic characteristics, need for health information, consumer's benefit and concern, type of health information, type of management and security of patient information using PHR and attitude to PHR were explored. METHODS: A survey was conducted, using questionnaire developed by the study team based on literature review. Structured questionnaires were completed through a telephone survey for 715 consumers. RESULTS: A key finding was the significant difference for customer's attitude towards using PHR by customer's characteristics. Regarding factors affecting attitudes of customers with higher concern about their health, considering authorization level to access their private information and using reliable method to certificate were more likely to prefer PHR system positively. CONCLUSION: Public opinion is reflected in policy of health information. Meeting consumers' needs sufficiently, the goal of health information service to improve consumers' accessibility to and satisfaction will archive successfully.
Archives ; Health Records, Personal ; Humans ; Information Services ; Korea ; Public Opinion ; Surveys and Questionnaires ; Telephone

BACKGROUND: Coronary artery bypass grafting without cardiopulmonary bypass (Off-Pump Coronary Artery Bypass Grafting, OPCAB) causes significant hemodynamic derangement by displacement of the beating heart. The purpose of this study was to analyze the hemodynamic changes caused in relation to grafted arteries by displacing the heart and stabilizing the coronary arteries in patients undergoing OPCAB. METHODS: Nineteen patients underwent OPCAB using two deep pericardial sutures and tissue stabilizers (Octopus Tissue Stabilization Syetem, Medtronic, USA). The hemodynamic variables were obtained after induction of anesthesia, after deep pericardial sutures, before and after anastomosis of each coronary artery during epicardial stabilizing, after sternal closure, and after postoperative 6 hours and 12 hours in the intensive care unit. RESULTS: The hemodynamic variables were maintained with the Trendelenburg position, volume loading and low dose vasopressors after deep pericardial stay sutures. Displacement of the heart and placement of the stabilizer on all coronary territories except the obtuse marginal artery before anastomosis showed no significant difference in hemodynamics compared with baseline. Positioning for the graft to the obtuse marginal artery decreased cardiac index (1.6+/-0.4 L/min/m2) and stroke index (27.6+/-9.9 L/beat/m2) and increased systemic vascular resistance (2318.9+/-673.7 dyne sec cm(-5)), resulting in hemodynamic compromise (P<0.01). There were no significant hemodynamic and electrocardiographic changes before or after grafting of other coronary arteries but there was a significant increase in cardiac index after postoperative 6 and 12 hours compared with baseline values (P<0.05). CONCLUSIONS: Although the complete revascularization of most coronary arteries is feasible on the beating heart without significant hemodynamic compromise with minimal vasopressor support, the positioning for the graft to the obtuse marginal artery needs special attention because two deep pericardial stay sutures and Octopus tissue stabilizers on the obtuse marginal artery territory induce significant hemodynamic disturbances.
Anesthesia ; Arteries ; Cardiopulmonary Bypass ; Coronary Artery Bypass ; Coronary Artery Bypass, Off-Pump* ; Coronary Artery Disease ; Coronary Vessels ; Electrocardiography ; Head-Down Tilt ; Heart* ; Hemodynamics* ; Humans ; Intensive Care Units ; Octopodiformes ; Stroke ; Sutures ; Transplants* ; Vascular Resistance

BACKGROUND: Among various measures to prevent deep venous thrombosis (DVT) in surgical patients, intermittent pneumatic compression of the legs is known to be effective without increasing the risk of bleeding. In this study, the coagulation/ fibrinolysis profile in patients undergoing gastrectomy with SCD Response Compression System, which detects individual venous refill time, was compared to that with elastic stocking using thromboelastography (TEG). METHODS: Fifty-eight ASA class I-II patients undergoing gastrectomy were randomized into two groups. Patients in ES group (n = 29) were treated with elastic stocking and patients in SCD group (n = 29) were treated with SCD Response Compression System. TEG analysis and traditional coagulation tests were performed on arrival in the operating room, after surgery in the postanesthetic care unit and on the morning of postoperative day 1. RESULTS: There was no significant difference in laboratory data between the two groups. Laboratory data at all time points were within normal limit in all patients. There was no significant difference in TEG data between the two groups. No evidence of a postoperative clinical coagulopathy (DVT or pulmonary embolism) was observed on routine history and physical examinations in any patient during hospitalization. CONCLUSIONS: The effectiveness of SCD Response Compression System in patients undergoing major abdominal surgery on coagulation/fibrinolysis system was similar to that of elastic stocking during perioperative period.
Fibrinolysis* ; Gastrectomy* ; Hemorrhage ; Hospitalization ; Humans ; Leg ; Operating Rooms ; Perioperative Period ; Physical Examination ; Stockings, Compression* ; Thrombelastography* ; Venous Thrombosis

A 23-year-old woman with pulmonary arteriovenous malformation was scheduled for open reduction and internal fixation due to her mandible fracture. Total intravenous anesthesia using propofol and remifentanil was selected as the anesthetic method in order to avoid the inhibition of hypoxic pulmonary vasoconstriction and the exacerbation of intrapulmonary shunting. After the standard monitoring devices were applied, anesthesia was then induced and maintained with a target controlled infusion of propofol and remifentanil in the range of 2.5-3.0 microg/ml and 2-3 ng/ml, respectively. Anesthesia was performed uneventfully and the patient was discharged without complication.
Anesthesia ; Anesthesia, Intravenous ; Arteriovenous Malformations ; Female ; Humans ; Mandible ; Piperidines ; Propofol ; Vasoconstriction ; Young Adult

PURPOSE: To evaluate differences in regional density of normal lung, as seen on CT, according to respiration and gravity. MATERIALS AND METHODS: The subjects were 15 healthy volunteers, all non-smokers and without previous pulmonary disease. CT scans were obtained at three selected levels through the apex, middle and basal lung at the aortic arch, carina and just above the diaphragm, respectively at both full inspiration (FVC) and full expiration (RV). Within these regions of interest and at the three scanning levels, lung density was measured in the anterior, lateral, and posterior portions of the peripheral lung field. RESULTS: Attenuation of the anterior portion of the lung was lower than that of the posterior portion(p<0.005); average lung attenuation increase from the anterior to the posterior portion was significantly greater during full expiration than full inspiration (p<0.005), and was significantly greater at the base of the lung than at the apex (p<0.005 on expiration, p=0.006 on inspiration). Lung density during inspiration was lower than during expiration (p<0.005); average lung density increase from full inspiration to full expiration was significantly greater in the posterior portion than in the anterior (p<0.005). In the former, the average increase at the base of the lung was greater than at the apex (p=0.007), but in the latter, the average increase at the apex was greater than at thebase (p<0.005). CONCLUSION: In normal lung, respiration and gravity cause regional density changes, as seen on CT, and result in difference of lung attenuation between dependent and nondependent portions and between the apex, middle and base of the lung, according to inspiration and expiration.
Aorta, Thoracic ; Diaphragm ; Gravitation ; Healthy Volunteers ; Lung Diseases ; Lung* ; Respiration ; Tomography, X-Ray Computed

PUROSE: There are numerous biopsy protocols that have been described in the clinical literature. We especially assess the role of the use of an enema before a transrectal prostate biopsy by comparing the post biopsy- infectious complications rate. MATERIALS AND METHODS: From January 2007 to August 2007 we retrospectively evaluated 302 men who underwent transrectal needle biopsy of the prostate according to the inclusion criteria. Patients in group 1(121 patients) did not receive an enema and were given oral ciprofloxacin(500 mg) for 3 days. Those in group 2(181 patients) received an enema before the biopsy and were also administered intravenous ciprofloxacin(400mg) and an additional oral form(500mg) for five days. Only complications related to infection were evaluated, that is, fever and chills with systemic inflammatory symptoms, within two weeks after the biopsy. RESULTS: Patients demographics, such as age and prostate size did not differ between the two groups(p>0.05), but the level of prostate-specific antigen (PSA) in group 2 was significantly higher than in group 1 (12.70ng/ml versus 28.88ng/ml, p<0.05). The cancer detection rate was 36.1%(109/ 302) overall and there was no significant difference between the two groups(32.2% versus 38.7%, p>0.05). The infectious complications rate was 2.6%(8/302) overall and did not differ significantly between the two groups(2.5% versus 2.8%, p>0.05). Especially for group 2 patients, there were two cases of bacteremia and Escherichia coli was reported as the pathogen. CONCLUSIONS: Our findings suggest that the use of a pre-biopsy enema shows no significant benefit given the considerations of infectious complications rate, and the patient quality of life.
Male ; Humans ; Biopsy

BACKGROUND: The aim of this study was to investigate the incidence and clinical characteristics of intravenous (IV) or inhaled (IH) colistin-associated acute kidney injury (AKI) using the Risk, Injury, Failure, Loss, End-stage Renal Disease criteria. METHODS: From 2010 to 2014, 160 patients were treated with IV or IH colistin. Of these, we included 126 patients who received colistin for > 72 hours for the treatment of pneumonia and compared the incidence and clinical characteristics of patients in the IV (n = 107) and IH (n = 19) groups. RESULTS: The patients included 104 men and 22 women, with a mean age of 69 years (range, 24–91 years). The mortality rate was 45%, and AKI occurred in 75 (60%) patients. At the end of therapy, the bacteriologic cure rate was 66%. There were no differences in the clinical characteristics between the IV and IH groups except for age. In comparison with patients in the IV group, the patients in the IH group were older (74 ± 8 vs. 68 ± 12 years, P = 0.026). The incidence of AKI was not different between the 2 groups (62 vs. 47%, P = not significant), and there was no difference in the severity of AKI according to the Risk, Injury, Failure, Loss, End-stage Renal Disease criteria. Of the 83 patients with AKI, 6 and 1 patients underwent renal replacement therapy, respectively. CONCLUSION: The incidence of AKI in patients with colistin therapy is 60% in our center. It seems that IH colistin therapy could not be better in safety than IV colistin therapy.
Acute Kidney Injury* ; Colistin* ; Female ; Humans ; Incidence ; Kidney Failure, Chronic ; Male ; Mortality ; Nebulizers and Vaporizers ; Pneumonia ; Renal Replacement Therapy

Retinal detachment is a rare disease in children but cases of serous retinal detachment due to use of systemic corticosteroids have been reported in and out country. Rhematogenous retinal detachment has developed in a child with oral and steroid pulse therapy due to nephrotic syndrome. He was treated with laser and buckling in right and left eye respectively. Currently he is under observation through the out patient department.
Adrenal Cortex Hormones ; Child* ; Humans ; Nephrotic Syndrome* ; Rare Diseases ; Retinal Detachment* ; Retinaldehyde*

Liposarcoma of vulva is a rare malignant tumor. Only fifteen cases of vulvar liposarcoma have been reported in English literature. Because of extreme rarity of vulvar liposarcoma, it is initially misdiagnosed as benign tumor such as lipoma. This paper aims to present a unique case of liposarcoma of bilateral vulvae with a review of the literature of previously reported cases.
Lipoma ; Liposarcoma* ; Radiotherapy ; Vulva

No abstract available.
Colon, Ascending* ; Neurilemmoma*