BACKGROUND: As measurement of Ki-67 proliferation index is an important part of breast cancer diagnostics, we conducted a multicenter study to examine the degree of concordance in Ki-67 counting and to find factors that lead to its variability. METHODS: Thirty observers from thirty different institutions reviewed Ki-67-stained slides of 20 different breast cancers on whole sections and tissue microarray (TMA) by online system. Ten of the 20 breast cancers had hot spots of Ki-67 expression. Each observer scored Ki-67 in two different ways: direct counting (average vs. hot spot method) and categorical estimation. Intraclass correlation coefficient (ICC) of Ki-67 index was calculated for comparative analysis. RESULTS: For direct counting, ICC of TMA was slightly higher than that of whole sections using average method (0.895 vs 0.858). The ICC of tumors with hot spots was lower than that of tumors without (0.736 vs 0.874). In tumors with hot spots, observers took an additional counting from the hot spot; the ICC of whole sections using hot spot method was still lower than that of TMA (0.737 vs 0.895). In categorical estimation, Ki-67 index showed a wide distribution in some cases. Nevertheless, in tumors with hot spots, the range of distribution in Ki-67 categories was decreased with hot spot method and in TMA platform. CONCLUSIONS: Interobserver variability of Ki-67 index for direct counting and categorical estimation was relatively high. Tumors with hot spots showed greater interobserver variability as opposed to those without, and restricting the measurement area yielded lower interobserver variability.
Breast Neoplasms* ; Breast* ; Observer Variation* ; Online Systems

China ; Disease Notification ; Online Systems ; Population Surveillance ; methods ; Quality Control

The domestic syringe production enterprises detect syringe needle point burrs by visual check and hand touch which causes problems such as visual fatigue, scratching hand, and missing detection. To solve these problems, an on-line detection system of disposable syringe needle point burrs has been designed and developed through machine visual technology, PLC and touch screen. It has been proved that this system has extremely high application value for its high speed and accurateness.
Disposable Equipment ; Needles ; Online Systems ; Quality Control ; Syringes

This study was carried out to reduce children's sugar, natrium and fat intakes and establish their healthy lifestyle. To achieve these goals, we developed an educational web site and an e-learning system. The targets of this web site are children, parents and educators. This site has various information about sugar, natrium and fat, and has special menus for each target: such as the 'Let's study' for children, 'Guides for child's eating' for parents, and 'Educational softwares, Lesson plans/materials, and Textbooks/Teaching guides' for educators. We developed three nutrient characters and applied them to the web site. We provided information in the form of texts, images, flash and sounds. This site has special boards in 'Nutrition cafe' menu to interchange information or their successful stories between the connecters. We developed an e-learning system with two courses. One is for junior elementary students and the other is for senior students. Children can study each nutrient step by step in a course according to their academic ability and concern. Also, they can evaluate their academic achievement in this system, which was uploaded into 'Let's study' in children menu in the web site. Conclusively this web site and e-learning system could contribute to reducing children's sugar, natrium and fat intakes by helping children study them systematically and effectively by on-line system. We expect this e-learning system would be a new nutrition education system to make nutrition education more active.
Achievement ; Child ; Humans ; Life Style ; Online Systems ; Parents

PURPOSE: This study aimed to set priorities for improving the medical device distribution structure and to suggest an innovative improvement plan for the distribution structure using the analytic hierarchy process (AHP) method, focusing on stakeholders in the medical device industry. METHODS: This study conducted a survey with 35 specialists using the AHP method, which is a multiple-criteria decisionmaking methodology, in order to set priorities for improvement plans to address the problems faced by the medical device distribution structure. RESULTS: The AHP analysis showed that supply stability was the most important factor, followed by greater transparency, efficiency, smart supply, and cost reduction. CONCLUSIONS: It is necessary to establish a stable supply system and manage crises through supply stability, as well as to provide opportunities for fair trade through greater transparency. As steps towards those goals, we propose establishing a unique device identification system, an information disclosure system, online distribution, and a group purchasing organization system in Korea.
Disclosure ; Group Purchasing ; Korea ; Methods ; Online Systems ; Specialization

No abstract available.
Adolescent Psychiatry ; Mental Health ; Periodicals as Topic ; Publishing ; Online systems

No abstract available.
Child ; Data Collection ; Delivery of Health Care* ; Humans ; Online Systems ; Text Messaging*

OBJECTIVES: Rare disease research requires a broad range of disease-related information for the discovery of causes of genetic disorders that are maladies caused by abnormalities in genes or chromosomes. A rarity in cases makes it difficult for researchers to elucidate definite inception. This knowledge base will be a major resource not only for clinicians, but also for the general public, who are unable to find consistent information on rare diseases in a single location. METHODS: We design a compact database schema for faster querying; its structure is optimized to store heterogeneous data sources. Then, clinicians at Seoul National University Hospital (SNUH) review and revise those resources. Additionally, we integrated other sources to capture genomic resources and clinical trials in detail on the Korean Rare Disease Knowledge base (KRDK). RESULTS: As a result, we have developed a Web-based knowledge base, KRDK, suitable for study of Mendelian diseases that commonly occur among Koreans. This knowledge base is comprised of disease summary and review, causal gene list, laboratory and clinic directory, patient registry, and so on. Furthermore, database for analyzing and giving access to human biological information and the clinical trial management system are integrated on KRDK. CONCLUSIONS: We expect that KRDK, the first rare disease knowledge base in Korea, may contribute to collaborative research and be a reliable reference for application to clinical trials. Additionally, this knowledge base is ready for querying of drug information so that visitors can search a list of rare diseases that is relative to specific drugs. Visitors can have access to KRDK via http://www.snubi.org/software/raredisease/.
Databases, Genetic ; Humans ; Information Storage and Retrieval ; Knowledge Bases ; Korea ; Online Systems ; Rare Diseases

Slowing the progression of chronic kidney disease is much more important in children and adolescents with a relatively longer remaining life span. A practical way to assess the rate of progression of chronic kidney disease is to measure the change of GFR estimated by formulae. To slow the progression, hypertension and proteinuria have to be controlled strictly, and hypoplastic anemia must be treated with erythropoietin. If not contraindicated, ACE inhibitor or angiotensin receptor blocker is recommended with monitoring of the side effects. Trials to slow the progression should be commenced as soon as the chronic kidney disease is confirmed and needs to be continued until renal transplantation as long as residual renal function remains. An online system, the Korean Pediatric Chronic Kidney Disease Registry (http://pedcrf.or.kr/), provides tools that are useful in evaluation and management of the children and adolescents with chronic kidney diseases.
Adolescent ; Anemia, Aplastic ; Angiotensins ; Child ; Erythropoietin ; Humans ; Hypertension ; Kidney Transplantation ; Online Systems ; Proteinuria ; Renal Insufficiency, Chronic

INTRODUCTIONProblem-based learning (PBL) embraces principles of good learning and teaching. It is student-directed, fosters intrinsic motivation, promotes active learning, encourages peer teaching, involves timely feedback, and can support student self and peer assessment. The most important function of the assessment process is to enhance student learning, to improve the curriculum and to improve teaching.

MATERIALS AND METHODSTo improve the PBL tutorial in Chung Shan Medical University, we developed an online evaluation system containing the evaluation forms for students, tutor, self and peer. The Cronbach alpha reliability coefficients were 0.9480, 0.9103, and 0.9198 for the Student, Tutor and Self and Peer Evaluation Form, respectively. The online evaluations were mandatory to both students and tutors, and the information was completely anonymous.

RESULTS AND CONCLUSIONSThe survey response rates of the online evaluations ranged from 95.6% to 100%. The online evaluations provided a documented feedback to the students on their knowledge, skills and attitudes. Correspondingly, tutors too received feedback from students in evaluating their performance on the appropriateness and effectiveness of tutoring the group. Although there was an initial lack of coordination regarding responsibilities and how to use the online system for both students and the Faculty, the system enabled us to look into how effective our PBL course had been, and it provided both process and outcome evaluations. Our strategy for evaluating the success of PBL is only at its initial stage; we are in an ongoing process of collecting outcome data for further analysis which will hopefully provide more constructive information to the PBL curricula.

Education, Medical ; standards ; Educational Measurement ; Humans ; Online Systems ; Pilot Projects ; Problem-Based Learning ; methods ; Taiwan ; Universities