OBJECTIVE: This study was conducted to identify 3 to 5 years of future management issues in hospital information systems (HIS). METHODS: Two rounds of interview surveys were conducted based on the sample survey of 50 managers from 28 hospital information centers utilizing the Delphi method. RESULTS: From the survey, management issues in HIS were identified in the following order: 'top management support', 'close relationship with users', 'PACS', 'disaster recovery', improving IS strategic planning'. Compared with the 1999 survey, the issues that rank within the top 10 management issues were as follows: 'top management support', 'security and control', 'close relationship with users'. Recently surfaced issues are 'disaster recovery' and 'standardization'. The issues that dropped out of the top 10 ranks were 'network management', 'recruiting and developing IS human resource'which were very fundamental issues in the initial state of the introduction of the hospital information system. CONCLUSION: The two main significance of this study involves predicting future management issues based on the comparison of the current issues with the 1999 issues and recommendingmanagement strategies based on the classification of issues by importance and persistence.
Classification ; Hospital Information Systems* ; Humans ; Information Centers

PURPOSE: Insulin-like growth factor-I (IGF-I) is an important mitogen in many types of malignancies. The purpose of this study was to evaluate the role of the IGF system on cell proliferation and cell death in mouse lung cancer cell lines (3LL). MATERIALS AND METHODS: Northern analysis was performed in 3LL cells. We evaluated the phosphorylation of IGF-I receptor (IGF-IR) with IGF-I stimulation. MTT assay was performed after treating 3LL cells with IGF-I and the treatment effect on cell death in the presence of anticancer drug was investigated. RESULTS: Northern analysis revealed the presence of IGF-I and IGF-IR mRNA expression in 3LL cells. IGF-I increased cellular proliferation in serum free media. IGF-I also stimulated the tyrosine phosphorylation of two proteins: one, with a molecular mass of 95 kDa, was the beta-subunit of IGF-IR; the other, with an approximate molecular mass of 185 kDa, was originally identified as the insulin receptor substrate-I (IRS-I). IGF-I at a low concentration inhibited the cell death induced by adriamycin. CONCLUSION: IGF-I, a mitogen through the phosphorylation of the IGF-IR beta-subunit, acts as a survival factor to inhibit cell death. Therefore, these findings suggest that IGF-I and IGF-IR are involved in both the cell proliferation and cell death associated with cancer cell growth.
Animals ; Cell Death ; Cell Line ; Cell Proliferation ; Culture Media, Serum-Free ; Doxorubicin ; Insulin-Like Growth Factor I ; Lung Neoplasms* ; Lung* ; Mice* ; Phosphorylation ; Receptor, IGF Type 1 ; Receptor, Insulin ; RNA, Messenger ; Tyrosine

BACKGROUND: IGF-I is an important mitogen in many types of malignancies. Tumors also express many IGF binding proteins, which modulate IGF action. The purpose of this study was to evaluaste the effect of IGF-I and IGFBP on cell proliferation in mouse lung cancer cells (3LL). METHODS: The cellular proliferation of 3LL with the treatment of growth factors was evaluated using MTT assay. Western ligand blot was performed in order to determine whether 3LL cells secrete IGFBPs and we evaluated the effect of IGFBP on cellular proliferation. RESULTS: The treatment of 3LL cells with IGF-I increased cellular proliferation in a serum free media. Western ligand blot of conditioned medium of 3LL with 125I-IGF-I demonstrated one single major band with an estimated molecular mass of 24 kDa. This band was identified as IGFBP-4 with immunoblot analysis using antisera. The addition of anti-IGFBP-4 antibody to abrogate the effect of IGFBP-4 resulted in increased cellular prolife ration suggesting that IGFBP-4 inhibits cell growth. CONCLUSION: IGF-I increases cellular proliferation, however the secreted IGFBP- 4 has an ingibitory function on cell growth in 3LL. These findings suggest that IGF-I and IGFBP are involved in the cell proliferation.
Animals ; Carrier Proteins* ; Cell Proliferation ; Culture Media, Conditioned ; Culture Media, Serum-Free ; Immune Sera ; Insulin-Like Growth Factor Binding Protein 4 ; Insulin-Like Growth Factor Binding Proteins ; Insulin-Like Growth Factor I ; Intercellular Signaling Peptides and Proteins ; Lung Neoplasms* ; Lung* ; Mice*

Acute aseptic meningitis is a rare complication of herpes zoster. It is usually regarded as a complication of the cutaneous infection in patients with impaired cellular immunity. Herpes zoster virus is a rare cause of viral meningitis. In one of three patients with herpes zoster meningitis, varicella-zoster virus DNA was detected by the polymerase chain reaction in the cerebrospinal fluid. We report three cases of acute aseptic meningitis followed by herpes zoster.
Cerebrospinal Fluid ; DNA ; Herpes Zoster* ; Herpesvirus 3, Human ; Humans ; Immunity, Cellular ; Meningitis ; Meningitis, Aseptic* ; Meningitis, Viral ; Polymerase Chain Reaction

Acute aseptic meningitis is a rare complication of herpes zoster. It is usually regarded as a complication of the cutaneous infection in patients with impaired cellular immunity. Herpes zoster virus is a rare cause of viral meningitis. In one of three patients with herpes zoster meningitis, varicella-zoster virus DNA was detected by the polymerase chain reaction in the cerebrospinal fluid. We report three cases of acute aseptic meningitis followed by herpes zoster.
Cerebrospinal Fluid ; DNA ; Herpes Zoster* ; Herpesvirus 3, Human ; Humans ; Immunity, Cellular ; Meningitis ; Meningitis, Aseptic* ; Meningitis, Viral ; Polymerase Chain Reaction

Arterial dissection begins with spontaneous or traumatic rent of intima, which sometimes allows blood to penetrate the layers of the arterial wall. Dissections of the craniocervical arteries are separated according to whether they are extracranial or intracranial, spontaneous or traumatic. Dissection of intracranial portions of the carotid system is rare, but it may be one of the important causes of ischemic stroke in the young adults. Cerebral angiography, MRI, and Doppler sonography are important diagnostic methods in this case. Initial treatment with anticoagulants or antiplatelet agents are effective in many cases, but sometimes surgical method is recommended. We presented ischemic infarctions in young men secondary to traumatic and spontaneous intracranial arteries dissection
Anticoagulants ; Arteries* ; Cerebral Angiography ; Humans ; Infarction* ; Magnetic Resonance Imaging ; Male ; Platelet Aggregation Inhibitors ; Stroke ; Young Adult

Herpes zoster is a viral disease that produces inflammatory lesions in the posterior root ganglia and is characterized clinically by pain and a skin eruption in the distribution of the affected ganglia. Involvement of motor roots or the CNS occurs in a small percentage of the patients. There are few reports about multiple cranial and upper cervical nerve involvement. We report a herpes zoster with multiple cranial(VI, VII, VIII, XII) and upper cervical(C2,3) nerves involvement. The patient was a 79-year-old woman who presented with painful vesicular eruption on left side of face and neck. She complained of decreased hearing and hyperacusis of left ear. Neurologic examination showed decreased taste sensation of left anterior tongue, left facial palsy, and tongue deviation to the left side.
Aged ; Ear ; Facial Paralysis ; Female ; Ganglia ; Hearing ; Herpes Zoster* ; Humans ; Hyperacusis ; Neck ; Neurologic Examination ; Sensation ; Skin ; Tongue ; Virus Diseases

Torsion dystonia (TD) is a clinical syndrome characterized by prolonged spasms of muscle contraction, which distort the body into typical dystonic posture. The pathological or biochemical basis of either the familial types or of most sporadic forms of idiopathic or primary TD is unknown. We present a 40-year old man who showed a kinesigenic axial dystonia with ipsilateral upper extremity atrophy for 14 years. The symptoms and signs were spontaneous onset, nonprogrwsive course, and induced by voluntary activity but relieved by rest and sleep and responded to trihexyphenidyl medication.
Adult ; Atrophy* ; Dystonia Musculorum Deformans ; Dystonia* ; Humans ; Muscle Contraction ; Posture ; Spasm ; Trihexyphenidyl ; Upper Extremity*

Methotrexate(MTX) is currently one of the most important antineoplastic drugs used in chemotherapy. Intrathecal(IT) MTX is widely used to treat or prevent meningeal leukemia and lymphoma. Aseptic meningitis following IT MTX is not uncommon, but not reported frequently in neurological field. We report a case of aseptic meningitis following IT MTX in acute lymphocytic leukemia.
Antineoplastic Agents ; Drug Therapy ; Leukemia ; Lymphoma ; Meningitis, Aseptic* ; Methotrexate* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma

Almost all advanced glomerular diseases have glomerular sclerotic changes to varying degrees whatever causes their primary glomerular disease are. Pathogenesis of these sclerosis has been thought of as the hyperfiltration in the primary glomerulosclerosis due to development of glomerular hypertension in each insulted glomeruli. This background gave the theoretical bases for antihypertensive therapies for supporting chronic renal insufficient patients. Angiotensin converting enzyme (ACE) inhibitor, one of the antihypertensive drugs, has received attention recently for its effectiveness. The aims of this study determined the effects and mechanism of the ACE inhibitor, enalapril, on the glomerulosclerosis in FGS/NgaKist mice, which was an animal model of chronic renal failure by generating spontaneously heavy proteinuria and progressive glomerulosclerosis. Five-week-old FGS/NgaKist mice (n=38) were assigned to four groups. Group 1a (n=6) and group 2a (n=8) fed with a vehicle, were sacrificed at the end of 10 weeks and 15 weeks, respectively. Group 1b (n=12) and 2b (n=12) received enalapril (100 mg/L) in drinking water for 5 weeks and 10 weeks from 6th week of age respectively, and were sacrified on the same day as the control groups. Doses of enanapril were maintained to 2 mg/kg/day by measuring the amount of water consumption. In enalapril groups 1b and 2b, systemic blood pressure (74.7 14.0 mm Hg, 74.3 15.9 mmHg) were significantly lower than control group 2a (116.1 4.6 mmHg, P<0.001). Similarly, degree of proteinuria lowered in enalapril group 2b versus control group 2a (0% and 50.0%, P<0.001). Glomerulosclerosis percentage significantly decreased (P<0.001) (group 1b and 2b; 1.9 6.5, 5.6 7.0 vs control 1a and 2a; 32.8 15.5, 31.4 13.8). Glomerulosclerosis score also decreased (P<0.001) (group 1b and 2b; 0.02 0.08 vs control 1a and 2a; 0.48 0.12, 0.30 0.14). The immunofluorescent staining of enalapril groups showed negative for mesangial deposition of IgG, IgA, IgM, and C3 which were positive in control groups. Immunohistochemical staining with TGF-beta1 was negative in enalapril groups and sclerotic glomeruli both enalapril groups and control groups. These results support that the ACE inhibitor has a renoprotective effect on glomerulosclerosis not only by decreasing the blood pressure but also by suppressing the immune deposits on glomeruli.
Angiotensins* ; Animals ; Antihypertensive Agents ; Blood Pressure ; Drinking ; Drinking Water ; Enalapril ; Humans ; Hypertension ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Kidney Failure, Chronic ; Mice ; Models, Animal ; Peptidyl-Dipeptidase A* ; Proteinuria ; Sclerosis* ; Transforming Growth Factor beta1