OBJECTIVE: To measure the performance of a hospital enterprise resource planning (ERP) system and suggest various system improvements. METHODS: A survey based on a 5-point Likert scale questionnaire and an exclusive interview was administered to 102 employees with a one-year experience of using an ERP system at one university hospital. In order to analyze the factors affecting the ERP system performance, multiple regression analysis and Chi-square test were conducted. RESULTS: All three examined variables-system quality, information quality and integration of hospital information resources-affected the ERP system performance positively. However, the system quality variable had the lowest mean score indicating that the ERP system was difficult to understand for many users. User characteristics were not significantly associated with information quality satisfaction. CONCLUSION: On the basis of the study results, we recommended some suggestions to improve the ERP system performance. In order to reduce users' dissatisfaction with the new system, hospitals should publicize the needs of the ERP system for the employees, design more effective training programs, and provide more decision-supporting information for managers.
Education ; Surveys and Questionnaires

No abstract available.
Lymphangioma* ; Mediastinal Cyst*

BACKGROUND AND OBJECTIVES: The nasal epithelium is the first barrier encountered by airborne allergens and an active participant in airway inflammation. Fungi have been increasingly recognized as important pathogens in sinusitis and consists of several allergenic proteins. We hypothesized that fungi induce the release of inflammatory mediators, and tried to find out the mechanism of epithelial cell activation. SUBJECTS AND METHOD: The epithelial cells of nasal polyp were obtained from patients and stimulated with Alternaria, Aspergillus, and Cladosporium. Interleukin-8 (IL-8), granulocyte-macrophage colony stimulating factor (GM-CSF), regulated on activation and normal T expressed and secreted (RANTES) were measured to determine the activation of epithelial cells. Nasal epithelial cell activation was inhibited with serine and cystein protease inhibitors. Reverse transcriptase-polymerase chain reaction (RT-PCR) test for protease-activated receptors (PARs) mRNA expression in nasal epithelial cells were performed. RESULTS: Fungi enhanced the production of chemical mediators from nasal epithelial cells. Serine protease inhibitors inhibited the activation of nasal epithelial cells. When nasal epithelial cells were activated, PAR2 and PAR3 mRNAs were more strongly expressed than non-activated cells. CONCLUSION: Serine proteases in fungi interact with nasal epithelial cells and enhance the production of inflammatory cytokines. PARs might play a role in the process of epithelial cell activation.
Allergens ; Alternaria ; Aspergillus ; Cladosporium ; Colony-Stimulating Factors ; Cytokines ; Epithelial Cells* ; Fungi* ; Humans ; Inflammation ; Interleukin-8 ; Nasal Mucosa ; Nasal Polyps ; Protease Inhibitors ; Receptors, Proteinase-Activated ; RNA, Messenger ; Serine ; Serine Proteases ; Serine Proteinase Inhibitors ; Sinusitis

PURPOSE: To analyze the ridge profile of the anterior maxilla using cone-beam computed tomography and to assess the clinical significance of the ridge profile by performing virtual implant placement. METHODS: Thirty-two cone-beam computed tomography scans of anterior maxillae were included. For each tooth, a vertical line was made along the longitudinal axis, and 3 horizontal lines at 1-, 3-, and 5-mm levels below the labial bone crest were drawn perpendicularly to the vertical reference. At these levels, the thickness of the alveolar ridge (RT), and the labial (LT) and palatal bone plate (PT) were measured. Then, virtual implant placement using standard and tapered implants was performed. A generalized linear mixed model was used for statistical analysis. RESULTS: The teeth were located labially based on the proportion of LT and PT with respect to RT. At the 1-mm level, the value of LT was between 1.0±0.4 mm for central incisors and 1.3±0.6 mm for canines. A large number of teeth had area(s) with less than 1-mm-thick labial bone between the 1- and 5-mm levels below the crest. The mean PT was generally thicker than the LT in all tooth types. The greatest mean value of labial concavity was observed for canines, compared to other tooth types. Men had a greater RT than did women, but had a comparable LT. Less apical fenestration was observed when tapered implants were used. CONCLUSIONS: Most teeth in the anterior maxilla had a thin labial bone plate, with no significant difference between sexes. Tapered implants may be advantageous for the anterior maxilla.
Alveolar Process ; Bone Plates ; Cone-Beam Computed Tomography ; Dental Implants ; Female ; Humans ; Incisor ; Male ; Maxilla ; Tooth

PURPOSE: To compare concentration of cytokines in the vitreous of rabbit eyes after photocoagulation using a short-pulse pattern scanning laser (PASCAL) or a conventional laser. METHODS: Laser photocoagulation was performed using PASCAL (duration 0.02 seconds) in the right eyes and a conventional laser (duration 0.1 seconds) in the left eyes of 13 pigmented rabbits. To obtain ophthalmoscopically similar mild burns, power was adjusted during the photocoagulation. The rabbits were sacrificed at 1, 3 or 7 days after photocoagulation to investigate histological changes. Levels of interleukins (IL)-1beta, IL-6, IL-8 and tumor necrosis factor (TNF)-alpha in the vitreous humors of ten rabbits were measured using enzyme-linked immunosorbent assay before treatment and at 1, 3 and 7 days after photocoagulation. RESULTS: Histological changes were comparable between the two groups. IL-1beta and TNF-alpha were not detectable. IL-6 did not change significantly. IL-8 increased at day 3 and day 7, but no significant difference was observed between the two groups (p>0.05). CONCLUSIONS: When ophthalmoscopically similar mild burn intensity was achieved, conventional and PASCAL treatments of rabbit eyes caused no difference in intravitreal concentration of inflammatory cytokines.
Burns ; Cytokines* ; Enzyme-Linked Immunosorbent Assay ; Interleukin-6 ; Interleukin-8 ; Interleukins ; Light Coagulation* ; Rabbits* ; Tumor Necrosis Factor-alpha ; Vitreous Body

Blue rubber bleb nevus syndrome (BRBNS) is a rare congenital disorder characterized by multiple venous malformations in the skin, soft tissues and gastrointestinal (GI) tract. Patients with this syndrome may develop iron deficiency anemia from chronic GI hemorrhage and require lifelong treatment with iron and blood transfusions. In addition, GI lesions can be treated using endoscopic techniques such as sclerotherapy, band ligation, coagulation, and polypectomy. We describe here the anesthetic management of a 12-year-old male patient with BRBNS for endoscopic polypectomy under general anesthesia.
Anemia, Iron-Deficiency ; Anesthesia ; Blister ; Blood Transfusion ; Child ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Gastrointestinal Neoplasms ; Hemorrhage ; Humans ; Iron ; Ligation ; Male ; Nevus ; Nevus, Blue ; Rubber ; Sclerotherapy ; Skin ; Skin Neoplasms

Livedo vasculitis is a chronic dermatosis characterized by recurrent painful ulceration of the lower limbs, which heals to leave atrophie blanche. The precise pathophysiology is not known. Antiplatelet, anticoagulant, fibrinolytic therapies and anabolic steroids have been reported to be helpful in this syndrome. However, no consistent benefit has been demonstrated with any treatment modality. Recently, pulsed intravenous immunoglobulin therapy has been reported to be effective in some refractory cases. We herein report two cases of recalcitrant livedo vasculitis which were effectively treated with pulsed intravenous immunoglobulin therapy. These were the first trials carried out in Korea.
Immunization, Passive* ; Immunoglobulins* ; Korea ; Lower Extremity ; Skin Diseases ; Steroids ; Thrombolytic Therapy ; Ulcer ; Vasculitis*

BACKGROUND: In cardiac surgery with cardiopulmonary bypass (CPB), hyperlactatemia (HL) is common and is associated with postoperative morbidity and mortality. At present, the cause of HL during CPB is proposed to be tissue hypoxia. Tissue perfusion and oxygen delivery can be impaired to varying degrees during CPB. Although surgery involving CPB apparatus is associated with increased pro-inflammatory mediators, such as TNF-alpha and IL-6, tissue hypoxia that occurs during CPB may be an additionally potent stimulus to inflammation. We hypothesized that hypoxic patients during CPB that experience elevated serum lactate levels, may be related to higher serum cytokine level after CPB than normoxic patients during CPB with normal serum lactate levels. METHODS: Levels of TNF-alpha and IL-6 were measured by ELISA in a) Time 1; before initiation of CPB, b) Time 2; 30 min after aortic de-clamping, c) Time 3; 24 hrs after aortic de-clamping. Levels of lactate was measured at a) Time A; before initiation of CPB, b) Time B; 30 min after aortic de-clamping. Postoperative ICU stay, intubation time and oxygen index were evaluated as postoperative morbidity scale. RESULTS: There were no statistical differences between HL (n = 43, lactate > or =3 mMol/L at time B) and normal lactate group (NL) (n = 63, lactate <3 mMol/L at time B) in demographic data, preoperative left ventricular ejection fraction, CPB time, and aortic cross-clamp time. Level of IL-6 in HL at time 3 was higher than that of NL. The ICU stay and intubation time were longer in HL. The oxygen index on 1st postoperative day was lower in HL. CONCLUSIONS: Our results suggest that hyperlactatemia after weaning from CPB may be related to IL-6 hypercytokinemia, and therefore related to postoperative morbidity.
Anoxia ; Cardiopulmonary Bypass ; Enzyme-Linked Immunosorbent Assay ; Humans ; Inflammation ; Interleukin-6 ; Intubation ; Lactic Acid ; Oxygen ; Perfusion ; Stroke Volume ; Thoracic Surgery ; Tumor Necrosis Factor-alpha ; Weaning

PURPOSE: We investigated structural changes in the retina by using optical coherence tomography (OCT) in a feline model of retinal degeneration using iodoacetic acid (IAA).METHODS: We examined 22 eyes of 11 felines over 2 years of age. The felines had fasted for 12 hours and were intravenously injected with IAA 20 mg/kg of body weight. OCT (Spectralis OCT) was performed at the point where the ends of the retinal vessels collected in the lateral direction from the optic nerve head and area centralis. Similarly, OCT was performed four times at 1-week intervals following injections, at which point the felines were sacrificed and histologic examinations were performed. Using OCT, the thickness of each layer of the retina was measured.RESULTS: The average body weight of the three male and eight female felines investigated in this study was 1.61 ± 0.19 kg. The mean total retinal thickness of the felines before injection was 221.32 ± 9.82 µm, with a significant decrease in the retinal thickness at 2, 3, and 4 weeks following injections of 186.41 ± 35.42, 174.56 ± 31.94, and 175.35 ± 33.84 µm, respectively (p = 0.028, 0.027, and 0.027, respectively). The thickness of the outer nuclear layer was 57.49 ± 8.03 µm before injection and 29.26 ± 17.87, 25.62 ± 13.88, and 31.60 ± 18.38 µm at 2, 3, and 4 weeks, respectively, after injection (p = 0.028, 0.028, 0.046, respectively).CONCLUSIONS: In a feline model of retinal degeneration using IAA, the total retinal thickness and the thickness of the outer nuclear layer were shown to decrease significantly on OCT.
Angiography ; Body Weight ; Female ; Humans ; Iodoacetic Acid ; Male ; Optic Disk ; Photoreceptor Cells, Vertebrate ; Retina ; Retinal Degeneration ; Retinal Vessels ; Retinaldehyde ; Tomography, Optical Coherence

Pancreatic acinar cell carcinoma (ACC) is a rare neoplasm accounting less than 1% of malignant pancreatic tumors. A 47-year-old male patient visited the emergency room with epigastric pain. Computed tomography or magnetic resonance imaging revealed a 4.7-cm heterogeneously enhanced solid and cystic mass with internal necrosis located in the head of the pancreas. Radiological diagnosis was borderline malignancy such as neuroendocrine tumor or solid pseudopapillary neoplasm. Two months later, the necrotic mass in the pancreas head had grown up to 11 cm, compressing the duodenum, superior mesenteric vein, and proximal transverse colon. Pylorus preserving pancreatoduodenectomy with segmental resection of transverse colon was performed. Histopathological examination revealed that the tumor was pancreatic ACC. The patient recovered without any complication and was doing well without recurrence for 12 months after surgery.