PURPOSE: The purpose of this study was to develop a home care nursing network system for operating home care effectively and efficiently by utilizing a wire-wireless network and mobile computing in order to record and send patients' data in real time, and by combining the headquarter office and the local offices with home care nurses over the Internet. It complements the preceding research from1999 by adding home care nursing standard guidelines and upgrading the PDA program. METHOD: Method/1 and Prototyping were adopted to develop the main network system. RESULT: The detailed research process is as follows : 1)home care nursing standard guidelines for Diabetes, cancer and peritoneal-dialysis were added in 12 domains of nursing problem fields with nursing assessment/intervention algorithms. 2) complementing the PDA program was done by omitting and integrating the home care nursing algorhythm path which is unnecessary and duplicated. Also, upgrading the PDA system was done by utilizing the machinery and tools where the PDA and the data transmission modem are integrated, CDMX-1X base construction, in order to reduce a transmission error or transmission failure.
*Computer Communication Networks ; *Home Care Services ; Humans ; *Information Systems ; *Nursing Care

This study was to develop the home care nursing network system for low income and vulnerable health people by utilizing wire- wireless network and mobile computing in order to record and send patients' data in real time, and connect the headquarter office and four local community health centers. The methods were the Method/1 and Prototyping were adopted to develop the main network system. Results were: 1) home care nursing standard guidelines for Diabetes, cancer and peritoneal-dialysis, dementia/mental disorder, and chronic arthritis were added in 12 domains of nursing problem field with nursing assessment/intervention algorithms. 2) upgrading PDA system by utilizing the machinery and tools where the PDA and the data transmission modem are integrated, CDMX - 1X base construction in order to reduce a transmission hour and the transmission failure.
Arthritis ; Community Health Centers ; Home Care Services* ; Modems ; Nursing*

Nocardiosis is uncommon in healthy people, but occurs as an opportunistic infection in patients with connective tissue disease, solid organ transplantation, lung disease, malignancies, and the acquired immune deficiency syndrome (AIDS). Nocardia is a gram positive, variably acid-fast aerobic bacterium of the family Nocardiaceae characterized by branching and filamentous growth, with distinctive aerial hyphae. In systemic lupus erythematosus (SLE) patients, immunosuppressiion with cytotoxic drugs or corticosteroids, proteinuria, renal insufficiency, and active SLE itself are known as risk factors for serious bacterial infections and opportunistic infections. We report a case of pulmonary Nocardiosis in patient with lupus nephritis treated with cyclophosphamide and high dose corticosteroid.
Acquired Immunodeficiency Syndrome ; Adrenal Cortex Hormones ; Bacterial Infections ; Connective Tissue Diseases ; Cyclophosphamide ; Humans ; Hyphae ; Lung Diseases ; Lupus Erythematosus, Systemic ; Lupus Nephritis* ; Nocardia ; Nocardia Infections* ; Nocardiaceae ; Opportunistic Infections ; Organ Transplantation ; Proteinuria ; Renal Insufficiency ; Risk Factors ; Transplants

OBJECTIVE: To evaluate the technical feasibility, performance, and interobserver agreement of a computer-aided classification (CAC) system for regional ventilation at two-phase xenon-enhanced CT in patients with chronic obstructive pulmonary disease (COPD). MATERIALS AND METHODS: Thirty-eight patients with COPD underwent two-phase xenon ventilation CT with resulting wash-in (WI) and wash-out (WO) xenon images. The regional ventilation in structural abnormalities was visually categorized into four patterns by consensus of two experienced radiologists who compared the xenon attenuation of structural abnormalities with that of adjacent normal parenchyma in the WI and WO images, and it served as the reference. Two series of image datasets of structural abnormalities were randomly extracted for optimization and validation. The proportion of agreement on a per-lesion basis and receiver operating characteristics on a per-pixel basis between CAC and reference were analyzed for optimization. Thereafter, six readers independently categorized the regional ventilation in structural abnormalities in the validation set without and with a CAC map. Interobserver agreement was also compared between assessments without and with CAC maps using multirater kappa statistics. RESULTS: Computer-aided classification maps were successfully generated in 31 patients (81.5%). The proportion of agreement and the average area under the curve of optimized CAC maps were 94% (75/80) and 0.994, respectively. Multirater kappa value was improved from moderate (kappa = 0.59; 95% confidence interval [CI], 0.56-0.62) at the initial assessment to excellent (kappa = 0.82; 95% CI, 0.79-0.85) with the CAC map. CONCLUSION: Our proposed CAC system demonstrated the potential for regional ventilation pattern analysis and enhanced interobserver agreement on visual classification of regional ventilation.
Aged ; Area Under Curve ; Feasibility Studies ; Female ; Humans ; Male ; Middle Aged ; Observer Variation ; Pulmonary Disease, Chronic Obstructive/physiopathology/*radiography ; Pulmonary Emphysema/physiopathology/radiography ; *Respiration ; Retrospective Studies ; Tomography, X-Ray Computed/*methods ; Xenon/*diagnostic use