OBJECTIVE: CDA (Clinical Document Architecture) is a markup standard for clinical document exchange. In order to increase the semantic interoperability of documents exchange, the clinical statements in the narrative blocks should be encoded with code values. Natural language processing (NLP) is required in order to transform the narrative blocks into the coded elements in the level 3 CDA documents. In this paper, we evaluate the accuracy of text mapping methods which are based on NLP. METHODS: We analyzed about one thousand discharge summaries to know their characteristics and focused the syntactic patterns of the diagnostic sections in the discharge summaries. According to the patterns, different rules were applied for matching code values of Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT). RESULTS: The accuracy of matching was evaluated using five-hundred discharge summaries. The precision was as follows: 86.5% for diagnosis, 61.8% for chief complaint, 62.7%, for problem list, and 64.8% for discharge medication. CONCLUSION: The text processing method based on the pattern analysis of a clinical statement can be effectively used for generating CDA entries.
Diagnosis ; Natural Language Processing ; Semantics ; Systematized Nomenclature of Medicine

Although the incidence is not high in the general surgical population, pulmonary aspiration of gastric contents can result in serious long-term morbidity and mortality. We report a case of early use of extracorporeal membrane oxygenation (ECMO) to correct severe hypoxemia refractory to conventional mechanical ventilation in a patient with massive aspiration of gastric contents immediately followed by acute lung injury during general anesthesia induction. A 64-year-old woman diagnosed with stomach cancer was scheduled for elective diagnostic laparoscopy. Although there was no sign of gastrointestinal tract obstruction and midnight Nil per Os (NPO) was performed before the operation, pulmonary aspiration occurred during the induction of anesthesia. Despite the endotracheal intubation with mechanical ventilation, severe hypoxemia with hypercapnea persisted. Medical team agreed with applying veno-venous (VV) ECMO, and her blood gas analysis results became stable. ECMO was weaned successfully 9 days after the first aspiration event had occurred. Based on this case, early application of extracorporeal life support can have survival benefits.
Acute Lung Injury ; Anesthesia* ; Anesthesia, General ; Anoxia ; Blood Gas Analysis ; Extracorporeal Membrane Oxygenation* ; Female ; Gastrointestinal Tract ; Humans ; Incidence ; Intubation, Intratracheal ; Laparoscopy ; Middle Aged ; Mortality ; Pneumonia, Aspiration ; Respiration, Artificial ; Stomach Neoplasms

OBJECT: To evaluate how the therapeutic factors affect post-discharge course of patients with schizophrenia, we analyzed relationship between each therapeutic factor and outcome of inpatients with schizophrenia in Hanyang University Hospital. METHODS: This study is a retrospective report. Subjects were schizophrenic inpatients who were discharged from Hanyang University Hospital from January 1, 2003 through December 31, 2004. We obtained demographic and clinical data from review of inpatient and outpatient charts. RESULTS: We analyzed the records of 104 patients with schizophrenia(44 males and 60 females). Patients who had longer first admission days have fewer number of readmission. There were no significant correlation between psychiatric rehabilitation and course of schizophrenia. Courses, such as duration of outpatient department follow-up and number and duration of rehospitalization, did not differ according to the existence of extrapyramidal symptoms or types of antipsychotics prescribed. CONCLUSION: Among the therapeutic factors, longer duration of the first admission only affected better post-discharge course of patients with schizophrenia.
Antipsychotic Agents ; Follow-Up Studies ; Humans ; Inpatients ; Male ; Outpatients ; Rehabilitation ; Retrospective Studies ; Schizophrenia*

Objective: Although the safety and efficacy of desvenlafaxine have been demonstrated, long-term evidence in Asians is lacking. We examined the safety and effectiveness of desvenlafaxine for up to 6 months in routine clinical practice in Korea. Methods: This multicenter, open-label, prospective observational study was conducted from February 2014 to February 2020 as a postmarketing surveillance study of desvenlafaxine (ClinicalTrials.gov identifier: NCT02548949). Adult patients with major depressive disorder (MDD) were observed from the initiation of treatment for 8 weeks (acute treatment phase) and then up to 6 months (continuation treatment phase) in a subsample. Safety was evaluated by incidence of adverse events (AE) and adverse drug reactions. Treatment response was assessed using the Clinical Global ImpressionImprovement (CGI-I) scale. Results: We included 700 and 236 study subjects in the analysis of acute and continuation treatment phase, respectively. In acute treatment phase, AE incidence was 9.86%, with nausea being most common (2.00%). In continuation treatment phase, AE incidence was 2.97%, with tremor occurring most frequently. After acute treatment (n = 464), the treatment response rate according to the CGI-I score at week 8 was 28.9%. In long-term users (n = 213), the response rate at month 6 was 45.5%. During the study period, no clinically relevant changes in BP were found regardless of concomitant use of antihypertensive drugs. Conclusion This study provides evidence on the safety and effectiveness of desvenlafaxine in adults with MDD, with a low incidence of AE, consistent AE profile with previous studies, and improved response after long-term treatment.

Objective: This study evaluated the health behavior level of urological cancer survivors after surgery.Understand the experience of change and identify the factors that affect it for health. Selection of the best intervention steps and effective intervention adopt a lifestyle. It is intended to contribute to the creation of basic data for development of guidelines. Methods: The study was conducted with patients diagnosed with urological cancer at a hospital in Seoul.Study data were obtained by having 100 patients who agreed to the study self-fill out a questionnaire through interviews, and the 2018 World Cancer Research Fund and American Institute for Cancer Research Score (2018 WCRF/AICR SCORE) was used to estimate the level of health behavior. Results: The study examines health behavior among urolgical cancer survivors based on the 2018 WCRF/AICR SCORE. Higher household income and younger age were associated with better health behavior scores, with those under 60 and earning over 3 million won being more likely to have higher scores. Conclusion Based on these results, this study requires comprehensive data collection considering the missing variables, suggesting that high household income and young age can positively affect healthy behavior. In addition, we conclude that education for cancer survivors and development of strategies to bridge the health gap for low-income and elderly populations are necessary.

Objective: This study evaluated the health behavior level of urological cancer survivors after surgery.Understand the experience of change and identify the factors that affect it for health. Selection of the best intervention steps and effective intervention adopt a lifestyle. It is intended to contribute to the creation of basic data for development of guidelines. Methods: The study was conducted with patients diagnosed with urological cancer at a hospital in Seoul.Study data were obtained by having 100 patients who agreed to the study self-fill out a questionnaire through interviews, and the 2018 World Cancer Research Fund and American Institute for Cancer Research Score (2018 WCRF/AICR SCORE) was used to estimate the level of health behavior. Results: The study examines health behavior among urolgical cancer survivors based on the 2018 WCRF/AICR SCORE. Higher household income and younger age were associated with better health behavior scores, with those under 60 and earning over 3 million won being more likely to have higher scores. Conclusion Based on these results, this study requires comprehensive data collection considering the missing variables, suggesting that high household income and young age can positively affect healthy behavior. In addition, we conclude that education for cancer survivors and development of strategies to bridge the health gap for low-income and elderly populations are necessary.

Objective: This study evaluated the health behavior level of urological cancer survivors after surgery.Understand the experience of change and identify the factors that affect it for health. Selection of the best intervention steps and effective intervention adopt a lifestyle. It is intended to contribute to the creation of basic data for development of guidelines. Methods: The study was conducted with patients diagnosed with urological cancer at a hospital in Seoul.Study data were obtained by having 100 patients who agreed to the study self-fill out a questionnaire through interviews, and the 2018 World Cancer Research Fund and American Institute for Cancer Research Score (2018 WCRF/AICR SCORE) was used to estimate the level of health behavior. Results: The study examines health behavior among urolgical cancer survivors based on the 2018 WCRF/AICR SCORE. Higher household income and younger age were associated with better health behavior scores, with those under 60 and earning over 3 million won being more likely to have higher scores. Conclusion Based on these results, this study requires comprehensive data collection considering the missing variables, suggesting that high household income and young age can positively affect healthy behavior. In addition, we conclude that education for cancer survivors and development of strategies to bridge the health gap for low-income and elderly populations are necessary.

BACKGROUND/AIMS: As a result of the rapid development of medical diagnostic tools, physicians require concrete evidence to evaluate the effectiveness of the tools. We aimed to investigate the effectiveness and additional diagnostic benefits of capsule endoscopy (CE) in patients with small bowel Crohn’s disease (CD). METHODS: We performed a systematic search of databases, including MEDLINE, EMBASE, and the Cochrane Library, as well as eight domestic databases. Two reviewers independently screened all references. Diagnostic data from the studies were collected, and a meta-analysis was performed. RESULTS: Twenty-four studies were included. In cases of suspected CD, CE demonstrated a superior diagnostic yield compared with small bowel follow-through (SBFT) and enteroclysis (EC); however, there was no difference compared with computed tomography enterography or magnetic resonance enterography. In cases with established CD, CE demonstrated a higher diagnostic yield only compared with EC. In the detection of terminal ileum lesions, CE exhibited a significantly increased detection rate compared with ileoscopy. CONCLUSIONS: The findings of our meta-analysis indicate that CE is superior to SBFT and EC in the evaluation of suspected CD cases. CE is also a more effective diagnostic modality in patients with established CD compared with EC.
Capsule Endoscopy* ; Crohn Disease ; Humans ; Ileum ; Intestines

OBJECTIVES: The aim of this study was to investigate medium- and long-term developmental directions of mental hospitals. METHODS: The preliminary investigation is composed of unstructured interviews with 10 psychiatrists, literature and case investigations, and development of models for medium- and long-term developmental model. The qualitative investigation consisted of constructed interviews with seven professionals. The quantitative investigation was conducted using questionnaires, which were sent to members of the Korean Neuropsychiatric Association, etc. Data were analyzed using frequency analysis. RESULTS: Through the preliminary investigation we were able to make three models : community model emphasizing linkage between mental hospitals and community, specialization model stressing specializations of mental hospitals, and extension model highlighting extensions of the roles of the mental hospital. In the qualitative investigation, two of the seven professionals gave a special preference for the community model, one for the specialization model, and two for the extension model. In the quantitative investigation, the community model and the specialization model were the most favorite models, and the extension model was the least favorite model. CONCLUSION: Three developmental models could be used in planning of the medium- and long-term developmental directions of mental hospitals, although each model needs to be embodied in order to work in practice.
Hospitals, Psychiatric* ; Psychiatry ; Surveys and Questionnaires

OBJECTIVES: The traditional roles of psychiatrists are being threatened according to the changes of requests from society. Psychiatrists need to rapidly adapt to new upcoming circumstances, improve leadership skills, and prepare for emerging ethical problems. The aim of this study is to predict and suggest what will happen in the future in the area of mental health, what role models might be required, what we should do and how we can prepare. METHODS: The authors interviewed seven mental health professionals on topics of leadership, participating roles of psychiatrists. Three models for psychiatrists were suggested : clinical model, community leader model, and mental health promoting model. Afterwards, a questionnaire on each role model was distributed to members of the Korean Neuropsychiatric Association via email and results were analyzed. RESULTS: Experts and stakeholders suggested that the following components from the interview will be fostered in the future : leadership in collaboration with other communities, introduction of leadership programs for young psychiatrists, strategies for sensitization of ethical issues, active communication with community partners, training professionals in legislation and administration. Regarding the questionnaire, 32 members responded. The most preferred role model was the Community leader model (46.9%, n=15), followed by the mental health promoting model (34.4%, n=11) and clinical model (15.6%, n=5). Most responders recognized that these issues are emerging and answered affirmatively on the developmental potential of each role model. A question about primary agents who are supposed to take charge of development of a suitable model was answered as follows : university professors for the clinical model (37.5%, n=12), psychiatrists working for public hospitals both for community leader (28.1%, n=9), and mental health promoting model (43.8%, n=14). Various opinions on leadership and strategies for fulfilling the role model were proposed. CONCLUSION: This study investigated leadership, ethics, social roles, and future directions of psychiatrists in order to provide suggestions on how to properly respond to changes of environment. It is expected that this study will be helpful in establishment of guidelines for leadership development and improving ethical orientation of psychiatrists, and will provide an opportunity for Korean NeuroPsychiatric Association members to have deep consideration and radical debate on our transforming roles.
Cooperative Behavior ; Electronic Mail ; Ethics ; Ethics, Medical ; Ethics, Professional* ; Hospitals, Public ; Leadership* ; Mental Health ; Professional Role ; Psychiatry* ; Surveys and Questionnaires