OBJECTIVES: Measurement of similarities between documents is typically influenced by the sparseness of the term-document matrix employed. Latent semantic indexing (LSI) may improve the results of this type of analysis. METHODS: In this study, LSI was utilized in an attempt to reduce the term vector space of clinical documents and newspaper editorials. RESULTS: After applying LSI, document similarities were revealed more clearly in clinical documents than editorials. Clinical documents which can be characterized with co-occurring medical terms, various expressions for the same concepts, abbreviations, and typographical errors showed increased improvement with regards to a correlation between co-occurring terms and document similarities. CONCLUSIONS: Our results showed that LSI can be used effectively to measure similarities in clinical documents. In addition, correlation between the co-occurrence of terms and similarities realized in this study is an important positive feature associated with LSI.
Abstracting and Indexing as Topic ; Cluster Analysis ; Information Storage and Retrieval ; Periodicals ; Semantics

PURPOSE: The purpose of this study was to assess the effects of a medication management program on oral chemotherapy patients. METHODS: A nonequivalent control group ppretest-posttest design was used. Participants were 60 cancer patients (intervention group: 30, control group: 30). The medication management program was provided for 6 weeks. Collected data were analyzed using the SPSS/WIN 21.0 program. RESULTS: Although there were no statistically significant differences, scores of self-efficacy (t=−0.12, p=.902), knowledge (t=0.62, p=.537), medication adherence (t=0.51, p=.610), and staff satisfaction (t=1.44, p=.156) were higher in the experimental group than in the control group. CONCLUSION: There was no significant difference in self-efficacy, knowledge, symptom experience, medication adherence and staff satisfaction. This can be explained by both groups having already received initial instruction concerning basic care when they started to receive chemotherapy. Considering the positive outcome of the medication management program, a specialist nursing effort is needed to improve symptoms and medication adherence. Furthermore, a medication counseling hotline is needed to support the medical staff.
Counseling ; Drug Therapy* ; Hotlines ; Humans ; Medical Staff ; Medication Adherence ; Medication Therapy Management ; Mouth ; Nursing ; Specialization

Septic pulmonary embolism occurs when septic material becomes detached from its origin and infiltrates into the pulmonary parenchyma causing significant clinical symptoms. It is uncommon in children and mostly related to intravascular catheterization, endocarditis, pelvic thrombophlebitis, and soft tissue infection. We report a case of a 5-year-old boy who experienced septic pulmonary embolism originating from a left shoulder abscess after traumatic injury. Magnetic resonance imaging of the shoulder revealed a multifocal subcutaneous and intramuscular abscess with septic arthritis. The initial chest radiograph showed suspicious pneumonic infiltration with nodular opacities. A percutaneous catheter was inserted to drain the shoulder abscess, and cefazedone, a first-generation cephalosporin, was administered intravenously. Two days later, a chest radiograph taken for the follow-up of the initial pneumonic infiltration with nodular opacities demonstrated aggravation of multifocal nodular lesions in bilateral lung fields, with one of the nodular cavities containing an air-fluid level. Despite the absence of significant respiratory symptoms, chest computed tomography showed multifocal necrotic nodules and cavity lesions with feeding vessel signs dominantly in the left lower lung field, which is characteristic of septic pulmonary embolism. Methicillin-susceptible Staphylococcus aureus was isolated from the shoulder abscess, whereas repeated blood and sputum cultures did not reveal any bacterial growth. With resolution of clinical symptoms as well as the finding of chest computed tomography, the patient was discharged 18 days after admission in a stable condition. Regression of the multifocal pulmonary nodular lesions was noticed on the subsequent chest imaging studies performed 45 days after the treatment.
Abscess ; Arthritis, Infectious ; Catheterization ; Catheters ; Child* ; Child, Preschool* ; Endocarditis ; Follow-Up Studies ; Humans ; Lung ; Magnetic Resonance Imaging ; Male ; Pulmonary Embolism* ; Radiography, Thoracic ; Shoulder ; Soft Tissue Infections* ; Sputum ; Staphylococcus aureus ; Thorax ; Thrombophlebitis

BACKGROUND: The aim of this study was to determine the appropriate target concentrations at the effect site of propofol and remifentanil when deep sedation was achieved by monitored anesthesia care (MAC) anesthesia and related respiratory depression during vein stripping surgery for varicose veins. METHODS: In total, 51 adult patients who were scheduled for varicose vein stripping surgery were sedated with propofol and remifentanil during the surgery, after administration of midazolam. Target concentrations at the effect site of the two drugs were changed based on the patient's status. Respiratory support was applied in the order of oxygen supply, chin lift, and assisted mask ventilation. Target concentrations at the effect site of propofol and remifentanil, the need for respiratory support, and a six-point rating scale satisfaction score were the outcome measurements. RESULTS: Only one patient did not require oxygen, eight patients needed oxygen alone, 22 patients required use of the chin lift technique, and 20 patients were assisted with mask ventilation. There was no significant difference in the target concentration of propofol or remifentanil between the patients who required mask ventilation and those who did not. Fifty of the 51 patients reported a satisfaction score of 6. CONCLUSIONS: Although MAC using low target concentrations of propofol and remifentanil during vein stripping surgery was satisfactory to patients, close observation regarding the need for respiratory assistance was necessary.
Adult ; Anesthesia* ; Chin ; Deep Sedation ; Humans ; Masks ; Midazolam ; Oxygen ; Propofol* ; Prospective Studies* ; Respiration ; Respiratory Insufficiency ; Saphenous Vein* ; Varicose Veins ; Veins ; Ventilation

Providing a protocol in the case of multiple food allergies is difficult although the demand of immunotherapy for patients with wheat anaphylaxis is increasing. This case series study aimed to report the wheat oral immunotherapy successfully achieving the maintenance dose along with immunological changes in children with multiple food anaphylaxis. In oral food immunotherapy, personalized therapeutic protocol, which sets the initial dose using the oral food provocation test and increase the dose considering the patients’ needs and compliance, for each patient is essential.

Background: Accurate diagnosis of diseases in animals is crucial for their treatment, and imaging evaluations such as radiographs, computed tomography (CT), and magnetic resonance imaging (MRI) are important tools for this purpose. However, a cross-sectional anatomical atlas of normal skeletal and internal organs of long-tailed gorals (Naemorhedus caudatus) has not yet been prepared for diagnosing their diseases. Objectives: The objective of this study was to create an anatomical atlas of gorals using CT and MRI, which are imaging techniques that have not been extensively studied in this type of wild animal in Korea. Methods: The researchers used CT and MRI to create an anatomical atlas of gorals, and selected 37 cross-sections from the head, thoracic, lumbar, and sacrum parts of gorals to produce an average cross-sectional anatomy atlas. Results: This study successfully created an anatomical atlas of gorals using CT and MRI. Conclusions The atlas provides valuable information for the diagnosis of diseases in gorals, which can improve their treatment and welfare. The study highlights the importance of developing cross-sectional anatomical atlases of gorals to diagnose and treat their diseases effectively.

BACKGROUND: Personal health records (PHRs) are web based tools that help people to access and manage their personalized medical information. Although needs for PHR are increasing, current serviced PHRs are unsatisfactory and researches on them remain limited. The purpose of this study is to show the process of developing Seoul National University Bundang Hospital (SNUBH)'s own PHR system and to analyze consumer's use pattern after providing PHR service. METHODS: Task force team was organized to decide service range and set the program. They made the system available on both mobile application and internet web page. The study enrolled PHR consumers who assessed PHR system between June 2013 and June 2014. We analyzed the total number of users on a monthly basis and the using pattern according to each component. RESULTS: The PHR service named Health4U has been provided from June 2013. Every patient who visited SNUBH could register Health4U service and view their medical data. The PHR user has been increasing, especially they tend to approach via one way of either web page or mobile application. The most frequently used service is to check laboratory test result. CONCLUSION: For paradigm shift toward patient-centered care, there is a growing interest in PHR. This study about experience of establishing and servicing the Health4U would contribute to development of interconnected PHR.
Advisory Committees ; Electronic Health Records ; Health Records, Personal* ; Humans ; Internet ; Mobile Applications ; Patient-Centered Care ; Seoul

OBJECTIVES: To design a cloud computing-based Healthcare Software-as-a-Service (SaaS) Platform (HSP) for delivering healthcare information services with low cost, high clinical value, and high usability. METHODS: We analyzed the architecture requirements of an HSP, including the interface, business services, cloud SaaS, quality attributes, privacy and security, and multi-lingual capacity. For cloud-based SaaS services, we focused on Clinical Decision Service (CDS) content services, basic functional services, and mobile services. Microsoft's Azure cloud computing for Infrastructure-as-a-Service (IaaS) and Platform-as-a-Service (PaaS) was used. RESULTS: The functional and software views of an HSP were designed in a layered architecture. External systems can be interfaced with the HSP using SOAP and REST/JSON. The multi-tenancy model of the HSP was designed as a shared database, with a separate schema for each tenant through a single application, although healthcare data can be physically located on a cloud or in a hospital, depending on regulations. The CDS services were categorized into rule-based services for medications, alert registration services, and knowledge services. CONCLUSIONS: We expect that cloud-based HSPs will allow small and mid-sized hospitals, in addition to large-sized hospitals, to adopt information infrastructures and health information technology with low system operation and maintenance costs.
Commerce ; Computer Systems ; Decision Support Systems, Clinical ; Delivery of Health Care* ; Electronic Health Records ; Information Services ; Medical Informatics ; Medical Order Entry Systems ; Privacy ; Soaps ; Social Control, Formal

OBJECTIVES: The objective of this paper is to assess which wide type monitor configurations are preferred when physicians use an Electronic Medical Record (EMR) system in an outpatient clinic setting. METHODS: We selected three kinds of monitor configurations available for adoption at outpatient clinics with reference to monitor market trends. Fifteen attending physicians of the Seoul National University Bundang Hospital used each monitor configuration in their outpatient clinics. After completing the outpatient sessions, they selected the best monitor configuration for criteria described in five questionnaire items. We counted the number of votes and reviewed opinions of participants. RESULTS: The Wide Quad High Definition (WQHD) 27-inch single monitor configuration was most preferred for all questionnaire items. All participants answered that the WQHD 27-inch single monitor configuration was the best for desk space utilization. Eleven out of fifteen participants chose the WQHD 27-inch single monitor configuration as the most suitable monitor for outpatient practice. CONCLUSIONS: This study found that physicians preferred the WQHD 27-inch single monitor configuration in outpatient clinic settings. Healthcare organizations need to consider this finding when they purchase wide type monitors for EMR systems instead of the standard type monitor.
Adenine ; Adoption ; Ambulatory Care Facilities ; Carbamates ; Computer Terminals ; Delivery of Health Care ; Deoxycytidine ; Drug Combinations ; Electronic Health Records ; Electronics ; Electrons ; Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination ; Humans ; Organophosphonates ; Organothiophosphorus Compounds ; Outpatients ; Personal Satisfaction ; Quinolones ; Thiazoles ; User-Computer Interface ; Surveys and Questionnaires

OBJECTIVE: The Ubiquitous Spaced Retrieval-based Memory Advancement and Rehabilitation Training (USMART) program was developed by transforming the spaced retrieval-based memory training which consisted of 24 face-to-face sessions into a self-administered program with an iPAD app. The objective of this study was to evaluate the feasibility and efficacy of USMART in elderly subjects with mild cognitive impairment (MCI). METHODS: Feasibility was evaluated by checking the satisfaction of the participants with a 5-point Likert scale. The efficacy of the program on cognitive functions was evaluated by the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological Assessment Battery before and after USMART. RESULTS: Among the 10 participants, 7 completed both pre- and post-USMART assessments. The overall satisfaction score was 8.0+/-1.0 out of 10. The mean Word List Memory Test (WLMT) scores significantly increased after USMART training after adjusting for age, educational levels, baseline Mini-Mental Status Examination scores, and the number of training sessions (pre-USMART, 16.0+/-4.1; post-USMART, 17.9+/-4.5; p=0.014, RM-ANOVA). The magnitude of the improvements in the WLMT scores significantly correlated with the number of training sessions during 4 weeks (r=0.793; p=0.033). CONCLUSION: USMART was effective in improving memory and was well tolerated by most participants with MCI, suggesting that it may be a convenient and cost-effective alternative for the cognitive rehabilitation of elderly subjects with cognitive impairments. Further studies with large numbers of participants are necessary to examine the relationship between the number of training sessions and the improvements in memory function.
Aged ; Alzheimer Disease ; Cognitive Therapy ; Computer User Training ; Dementia ; Education* ; Humans ; Learning ; Memory* ; Mild Cognitive Impairment ; Rehabilitation*