The purpose of this study is to demonstrate a new postoperative analgesic which minimize the physiological changes of patients. Recently, it has become popular to administer opioids to epidural space rather than intravenously or by intramuscular administration. However, the side effects of opioids have limited the usefulness of this procedure. We tried to find out a way of providing postoperative analgesia while minimizing the side effects of opioids. This study has tested the effects of administering a mixture of small doses of morphine, fentanyl and bupivacaine and epidural morphine alone. The data of this study has taken from 20 paturients who have scheduled for cesarean section. We have classified into two groups which consist of 10 paturients each. We have administered epidural morphine alone to the first group and a small doses of morphine-fentanyl-bupivacaine mixture to second group. We have evaluated analgesic effects by comparing both groups' pain scores of the operative day and of the first postoperative day and evaluated such side effects as the degree of itching, nausea, vomiting, dizziness and respiratory depression by asking to paturients. This study has found the followings: 1) Pain scores of the first group in the operative day and the first postoperative day are 1.2+/-0.4 and 0.4+/-0.5. The second group's pain scores are 0.2+/-0.4 and 0, and the second group's pain scores have significantly reduced (p<0.05). 2) Frequencies of such side effects as itching, nausea and vomiting are higher in the first group (8) than in the second group(4). In conclusion, small doses of morphine-fentanyl-bupivacaine mixture has demonstrated a more effective postoperative analgesia with minimum side effects in pain controlling after cesarean section than epidural morphine alone.
Analgesia* ; Analgesics, Opioid ; Bupivacaine ; Cesarean Section* ; Dizziness ; Epidural Space ; Female ; Fentanyl ; Humans ; Morphine* ; Nausea ; Pregnancy ; Pruritus ; Respiratory Insufficiency ; Vomiting

The cellular alteration following the electric welding light on the rabbit corneal epithelial cells were studied in several conditions wearing various corneal contact lenses on the corneal surface exposed to the light for 5 minutes at 50 cm in each. The enucleated rabbit eyes 5 hours following the application of electric welding light were histopathologically investigated on the cellular structures of the cornea. The result were as follows: 1. The cellular alterations in a group of soft contact lens wearing consisted of multiple vacuole enlargement, separation of interdigitation and Desmosome, intracellular edema, and loss of organelles in superficial and wing cells layer. Loss of microvilli of the corneal superficial cells were observed. 2. Loss of cytoplasmic microorganelles and microvilli intercellular edema in superficial cell layer, and slight vacuoles enlargement in wing cells layer were demonstrated in a group of the direct light exposure group without contact lenses. 3. Loss of microvilli and intercellular edema with separation of interdigitation in superficial cell layer but no specific changes in wing cells layer were exhibited in a group of hard contact lens wearing. 4. The most destructive features of the corneal epithelial cells were observed in a group of soft contact lens wearing, and it was suggested that the doubtful effects of protection on the corneal superficial tissue in the case of soft contact lens wearing were noteworthy.
Cellular Structures ; Contact Lenses ; Contact Lenses, Hydrophilic ; Cornea* ; Cytoplasm ; Desmosomes ; Edema ; Epithelial Cells ; Microvilli ; Organelles ; Vacuoles ; Welding*

BACKGROUND: Trauma is the third leading cause of death, irrespective of age, and the leading cause of death in persons under 40 years of age. Computed tomography (CT) is an effective technique in the initial emergent evaluation of the abdomen and head following blunt trauma. Most chest indies are not seen on conventional chest radiography, or may be underestimated. But routine use of CT in the initial emergent evaluation of chest trauma is controversial. CT, however, has been shown to be useful in the diagnosis of unsuspected chest injuries and in directing therapeutic interventions. This review discusses the efficacy of emergent CT in patients with blunt trauma on the chest. METHODS: To evaluate the efficacy of CT of the thorax, a retrospective study comparing early thoracic CT scanning with initial chest roentgenogram(CXR) was carried out on 121 patients with blunt trauma on the chest. The interval between CXR and CT was less than 1 hour. RESULTS: Among 121 patients, 42 patients had normal initial chest roentgenogram in whom 19 patients showed normal CT findings. Sensitivities of diagnosing pneumothorax and pleural effusion by CXR were low (49.3%and 45.1%respectively), whereas 65.7% (44/67) of patients had thoracostomy only by CXR. CONCLUSIONS : Although sometimes abused in patients with chest trauma, CT of the thorax is an effective method of detecting thoracic injuries and provides accurate information regarding their pattern and extent in the initial emergent diagnosis.
Abdomen ; Cause of Death ; Diagnosis ; Emergencies* ; Head ; Humans ; Pleural Effusion ; Pneumothorax ; Radiography ; Retrospective Studies ; Thoracic Injuries ; Thoracostomy ; Thorax* ; Tomography, X-Ray Computed

OBJECTIVES: The Health Level Seven Interface Engine (HL7 IE), developed by Kyungpook National University, has been employed in health information systems, however users without a background in programming have reported difficulties in using it. Therefore, we developed a graphical user interface (GUI) engine to make the use of the HL7 IE more convenient. METHODS: The GUI engine was directly connected with the HL7 IE to handle the HL7 version 2.x messages. Furthermore, the information exchange rules (called the mapping data), represented by a conceptual graph in the GUI engine, were transformed into program objects that were made available to the HL7 IE; the mapping data were stored as binary files for reuse. The usefulness of the GUI engine was examined through information exchange tests between an HL7 version 2.x message and a health information database system. RESULTS: Users could easily create HL7 version 2.x messages by creating a conceptual graph through the GUI engine without requiring assistance from programmers. In addition, time could be saved when creating new information exchange rules by reusing the stored mapping data. CONCLUSIONS: The GUI engine was not able to incorporate information types (e.g., extensible markup language, XML) other than the HL7 version 2.x messages and the database, because it was designed exclusively for the HL7 IE protocol. However, in future work, by including additional parsers to manage XML-based information such as Continuity of Care Documents (CCD) and Continuity of Care Records (CCR), we plan to ensure that the GUI engine will be more widely accessible for the health field.
Antineoplastic Combined Chemotherapy Protocols ; Computer Graphics ; Continuity of Patient Care ; Dietary Sucrose ; Etoposide ; Health Information Systems ; Health Level Seven ; Ifosfamide ; Medical Informatics ; Software Design

No abstract available.

Fetal teratomas rarely complicate pregnancy,having an incidance of only 20,000:1 to 40,000:1 of live births. Overthere, cervical teratomas are rare and accounts for only 5.5% of all neonatal teratomas. We have experienced a large cervical immature teratoma and present this case with a brief review of literatures.
Live Birth ; Teratoma*

OBJECTIVES: We design and develop an electronic claim system based on an integrated electronic health record (EHR) platform. This system is designed to be used for ambulatory care by office-based physicians in the United States. This is achieved by integrating various medical standard technologies for interoperability between heterogeneous information systems. METHODS: The developed system serves as a simple clinical data repository, it automatically fills out the Centers for Medicare and Medicaid Services (CMS)-1500 form based on information regarding the patients and physicians' clinical activities. It supports electronic insurance claims by creating reimbursement charges. It also contains an HL7 interface engine to exchange clinical messages between heterogeneous devices. RESULTS: The system partially prevents physician malpractice by suggesting proper treatments according to patient diagnoses and supports physicians by easily preparing documents for reimbursement and submitting claim documents to insurance organizations electronically, without additional effort by the user. To show the usability of the developed system, we performed an experiment that compares the time spent filling out the CMS-1500 form directly and time required create electronic claim data using the developed system. From the experimental results, we conclude that the system could save considerable time for physicians in making claim documents. CONCLUSIONS: The developed system might be particularly useful for those who need a reimbursement-specialized EHR system, even though the proposed system does not completely satisfy all criteria requested by the CMS and Office of the National Coordinator for Health Information Technology (ONC). This is because the criteria are not sufficient but necessary condition for the implementation of EHR systems. The system will be upgraded continuously to implement the criteria and to offer more stable and transparent transmission of electronic claim data.
Ambulatory Care ; Centers for Medicare and Medicaid Services (U.S.) ; Electronic Health Records ; Electronics ; Electrons ; Fees and Charges ; Health Level Seven ; Humans ; Insurance ; Malpractice ; Medical Informatics ; Relative Value Scales ; United States

BACKGROUND: The automated border detection(ABD) echocardiography has the ability of recognizing the endocardial-blood interface, and therefore, on-line estimation of the left ventricular(LV) volume every cardiac cycle. Compared with the off-line conventional 2-dimensional echocardiographic method that requires tracing the endocardial border manually, the ABDd system can be a convenient and objective method in the estimation of the LV volume and the ejection fraction(EF). The purpose of this study is to compare the LV volume and EF between the on-line ABD system and the convertional off-line echocardiographic method. METHODS: In two weeks, 83 adult patients older than 16 years of age were referred to our echocardiographic laboratory. Among these 83 patients, 64 patients who had a normal sinus rhythm were included to our study. Using the Hewlett-Packard SONOS 1500, a 2.5 MHz transducer was placed dat the cardiac apex. Patients with an apical 4 chamber view of the LV in which at least 75% of the endocardium was clearly seen were selected for study. On that view, the ABD system was turned on, and the reansmit power and the time-gain compensation controls were adjusted in order to approximate the automated border to the visually apparent endocardial surface. The LV end-diastolic volume(LVESV) and LV end-systolic volume(LVESV) were calculated by the method of disc. LVEDV, LVESV, and EF were displayed every cardiac cycle. Also the off-line estimation of the LV volume was performed by the method of disc, after manually tracing the endocardial border on the apical 4 chamber view. RESULTS: 44 patients(69%) of 64 patients had > or =75% of the LV endocardium visualized. LVEDV, LVESV, and Ef with the ABD system were highly correlated with those with the off-line, manually traced method(r=0.95, 0.8, respectively), but LVEDV and EF with toe ABD system were significantly less than those with the latter(p<0.01). The limits of agreement between tow methods(off-line, manually traced method-ABD system) were somewhat wide. Those of LVEDV, LVESV and EF were +22~-10ml(mean 6ml), +15~-14ml(mean 0.1ml), and +19~-12%(mean 3.8%), respectively. CONCLUSION: LVEDV,LVESV, and EF measurements by the ABD system and the off-line manually traced methods thve a strong correlation, The ABD system should habe clinical applications in setting, in which measurements of LV volume and Ef are important, But, the comparison with a more reliable method is necessary.
Adult ; Compensation and Redress ; Echocardiography* ; Endocardium ; Humans ; Toes ; Transducers

OBJECTIVES: This study was aimed to compare abstract reasoning in patients with mental disorders;Depression, Schizophrenia, Organic Brain Syndrome(OBS), and normal control group using Standard Progressive Matrices(SPM), known as a test measuring visual pattern matching ability and reasoning ability by analogy. METHODS: SPM test in Vienna Test System was administered to 82 normal adults, 29 schizophrenic patients, 22 depression patients, and 32 OBS patients. SPM total score and 5 subtest scores in four groups were compared, using ANOVA and post-hoc comparison. SPM subtest scores in OBS and normal group were compared, using discriminant function analysis. RESULTS: SPM total score and all subtest scores in mental disorders group(schizophrenia, depression, OBS) were lower than in normal control group. SPM total score and all subtest scores in OBS group were lower than in schizophrenia and depression group. No difference between SPM total score in Schizophrenia and depression group was found. Discriminant function of B, E subtest was the hightest. CONCLUSION: The impairment of higher cognitive function, especially abstract reasoning impairment in OBS, was qualitatively different from that of schizophrenia and depression. SPM can differentiate specific pattern of abstract reasoning impairment in mental disorders, so SPM can be used not only as a substitute for intelligence test but also as a neuropsychological test.
Adult ; Brain ; Depression ; Humans ; Intelligence Tests ; Mental Disorders* ; Neuropsychological Tests ; Schizophrenia

BACKGROUND: Overweight and obesity are associated with increased mortality and morbidity. Obesity is influenced by multiple factors, both genetic and environmental factors. We investigated the relationship between socioeconomic, behavioral, dietary, reproductive factors and body mass index(BMI). METHODS: The subject were 3000 adults who had visited the Health Screening and Diagnosis Center of Yeungnam University School of Medicine from February to June, 1997. We evaluated BMI and occupation, exercise, smoking, alcohol intake, total calory intake, fat and carbohydrate intake in both gender and reproductive factors in women. Then, we analyzed the association between BMI and such variables as above. RESULTS: 1629 men and 1371 women were analyzed. The mean BMI was 23.4+/- 2.8kg/M(2) in men, 22.9+/- 3.1kg/M(2) in women. In both gender, 9.7% of our population had BMl over 27. Mean BMI increased with age. Those who were active and light smokers( 20cigarette/day) had the lowest BMI in men. But no relationship was observed between BMI and exercise, smoking in women. Heavy alcohol drinkers(> 1cup/day) had higher BMI than other group in both gender. We found significant correlation between BMI and total calory intake, calory intake to recommended calory ratio in both gender. In women, the group whose number of parity was above 3 had significantly higher BMI than the other. And age at first birth was significantly correlated with BMI in a negative direction. CONCLUSIONS: Our results showed that BMI was associated with age, smoking, alcohol, total calory intake, calory intake to recommended calory ratio, parity, age at first birth. Socioeconomic class, exercise and diet composition appeared to have little influence.
Adult* ; Birth Order ; Body Mass Index* ; Diagnosis ; Diet ; Female ; Humans ; Male ; Mass Screening ; Mortality ; Obesity ; Occupations ; Overweight ; Parity ; Smoke ; Smoking ; Social Class