Electronic health records (EHR) hold promise in improving the quality and efficiency of health care, yet the health care system remains years behind other industries with respect to the adoption of information technology (IT). Stakeholders in the medical community, including government and tertiary hospitals, have emphasized the urgent need to adopt IT systems. This paper reviews the current research and development efforts related to EHR in Korea, which have been supported by the government since December 2005, on the basis of the following core EHR components: EHR architectures that incorporate an external, implementation-independent view of a complete EHR; EHR functionality for defining tasks that an EHR system should perform; semantic ontology for developing standard vocabularies at the national level; EHR messaging standards for exchanging data; and clinical decision support systems for improving patient safety. Recent international work on EHR systems and the underlying trends are described, and suitable directions for research and development are suggested under relevant subtopics. Advances in the relevant areas will greatly facilitate our ability to achieve interoperability and promote patient safety. However, EHR systems will perform optimally only if we improve our understanding of the political, structural, and technical foundations for EHR, and reach consensus via collaborations between all the stakeholders in the health care system.
Consensus ; Cooperative Behavior ; Decision Support Systems, Clinical ; Delivery of Health Care ; Electronic Health Records* ; Foundations ; Health Level Seven ; Humans ; Korea ; Patient Safety* ; Semantics ; Tertiary Care Centers ; Vocabulary

Objective: Intractable massive oronasal bleeding can become a life-threatening condition. The success rate of conventional bleeding control methods other than transarterial embolization (TAE) is not expected to be high. We investigated the efficacy of Sengstaken-Blakemore tube (SBT) balloon tamponade in patients with sustained and intractable oronasal bleeding secondary to facial injury. Methods: This study is a retrospective chart review from traumatic patients with sustained and intractable oronasal bleeding who were admitted to the emergency center of Ajou University Hospital and Soonchunhyang University Bucheon Hospital from January 2014 to December 2016. Results: Twelve patients were included in the study, of whom nine (75%) were male. The median age was 31 years (range, 20–73 years). Bleeding was controlled in 11 of the 12 patients (91.7%) either temporarily or definitively. One patient without hemostasis underwent TAE. TAE was performed in an additional three patients out of the 11 patients with hemostasis who experienced continued nasal bleeding after the removal of SBTs. There were no complications from performing the procedure. Conclusion Using SBTs as a hemostatic tool will aid patients with life-threatening intractable oronasal bleeding. Furthermore, this method may be used in patients with continual and intractable oronasal bleeding after facial trauma as a bridging procedure from the emergency department or the intensive care unit to the interventional radiology.

Objective: Intractable massive oronasal bleeding can become a life-threatening condition. The success rate of conventional bleeding control methods other than transarterial embolization (TAE) is not expected to be high. We investigated the efficacy of Sengstaken-Blakemore tube (SBT) balloon tamponade in patients with sustained and intractable oronasal bleeding secondary to facial injury. Methods: This study is a retrospective chart review from traumatic patients with sustained and intractable oronasal bleeding who were admitted to the emergency center of Ajou University Hospital and Soonchunhyang University Bucheon Hospital from January 2014 to December 2016. Results: Twelve patients were included in the study, of whom nine (75%) were male. The median age was 31 years (range, 20–73 years). Bleeding was controlled in 11 of the 12 patients (91.7%) either temporarily or definitively. One patient without hemostasis underwent TAE. TAE was performed in an additional three patients out of the 11 patients with hemostasis who experienced continued nasal bleeding after the removal of SBTs. There were no complications from performing the procedure. Conclusion Using SBTs as a hemostatic tool will aid patients with life-threatening intractable oronasal bleeding. Furthermore, this method may be used in patients with continual and intractable oronasal bleeding after facial trauma as a bridging procedure from the emergency department or the intensive care unit to the interventional radiology.

Purpose: The aim of study is to analyze the associations between menopause symptoms, including sleep quality and depressive symptoms, and body composition, physical fitness, and physical activity indices in middle-aged women. Methods: This cross-sectional study included 91 women aged 45 to 55 years. The study employed the Menopause Rating Scale to assess menopausal symptoms, the Pittsburgh Sleep Quality Index to evaluate sleep quality, and the Center for Epidemiologic Studies Depression scale to measure depressive symptoms. Cardiorespiratory fitness was assessed by breath-by-breath respiratory exchange during an incremental cycle ergometer, while muscle fitness was assessed by hand grip strength measurement. Physical activity was assessed using both the Global Physical Activity Questionnaire and Fitbit devices. Results: According to correlation analysis, indicators of obesity such as body fat and waist circumference were positively associated with menopausal symptoms. Conversely, muscle fitness and engaging in light physical activity were negatively associated with these symptoms. Conclusion This study identified physical indicators in Korean middle-aged women linked to menopausal symptoms.This study suggests that exercise programs for middle-aged women should include resistance training and promote physical activity to improve obesity markers and manage menopausal symptoms for healthy aging.

Purpose: The aim of study is to analyze the associations between menopause symptoms, including sleep quality and depressive symptoms, and body composition, physical fitness, and physical activity indices in middle-aged women. Methods: This cross-sectional study included 91 women aged 45 to 55 years. The study employed the Menopause Rating Scale to assess menopausal symptoms, the Pittsburgh Sleep Quality Index to evaluate sleep quality, and the Center for Epidemiologic Studies Depression scale to measure depressive symptoms. Cardiorespiratory fitness was assessed by breath-by-breath respiratory exchange during an incremental cycle ergometer, while muscle fitness was assessed by hand grip strength measurement. Physical activity was assessed using both the Global Physical Activity Questionnaire and Fitbit devices. Results: According to correlation analysis, indicators of obesity such as body fat and waist circumference were positively associated with menopausal symptoms. Conversely, muscle fitness and engaging in light physical activity were negatively associated with these symptoms. Conclusion This study identified physical indicators in Korean middle-aged women linked to menopausal symptoms.This study suggests that exercise programs for middle-aged women should include resistance training and promote physical activity to improve obesity markers and manage menopausal symptoms for healthy aging.

Purpose: The aim of study is to analyze the associations between menopause symptoms, including sleep quality and depressive symptoms, and body composition, physical fitness, and physical activity indices in middle-aged women. Methods: This cross-sectional study included 91 women aged 45 to 55 years. The study employed the Menopause Rating Scale to assess menopausal symptoms, the Pittsburgh Sleep Quality Index to evaluate sleep quality, and the Center for Epidemiologic Studies Depression scale to measure depressive symptoms. Cardiorespiratory fitness was assessed by breath-by-breath respiratory exchange during an incremental cycle ergometer, while muscle fitness was assessed by hand grip strength measurement. Physical activity was assessed using both the Global Physical Activity Questionnaire and Fitbit devices. Results: According to correlation analysis, indicators of obesity such as body fat and waist circumference were positively associated with menopausal symptoms. Conversely, muscle fitness and engaging in light physical activity were negatively associated with these symptoms. Conclusion This study identified physical indicators in Korean middle-aged women linked to menopausal symptoms.This study suggests that exercise programs for middle-aged women should include resistance training and promote physical activity to improve obesity markers and manage menopausal symptoms for healthy aging.

Purpose: The aim of study is to analyze the associations between menopause symptoms, including sleep quality and depressive symptoms, and body composition, physical fitness, and physical activity indices in middle-aged women. Methods: This cross-sectional study included 91 women aged 45 to 55 years. The study employed the Menopause Rating Scale to assess menopausal symptoms, the Pittsburgh Sleep Quality Index to evaluate sleep quality, and the Center for Epidemiologic Studies Depression scale to measure depressive symptoms. Cardiorespiratory fitness was assessed by breath-by-breath respiratory exchange during an incremental cycle ergometer, while muscle fitness was assessed by hand grip strength measurement. Physical activity was assessed using both the Global Physical Activity Questionnaire and Fitbit devices. Results: According to correlation analysis, indicators of obesity such as body fat and waist circumference were positively associated with menopausal symptoms. Conversely, muscle fitness and engaging in light physical activity were negatively associated with these symptoms. Conclusion This study identified physical indicators in Korean middle-aged women linked to menopausal symptoms.This study suggests that exercise programs for middle-aged women should include resistance training and promote physical activity to improve obesity markers and manage menopausal symptoms for healthy aging.

A new blood bank system was established in our trauma bay, which allowed immediate utilization of uncross-matched type O packed red blood cells (UORBCs). We investigated the efficacy of UORBC compared to that of the ABO type-specific packed red blood cells (ABO RBCs) from before the bank was installed. From March 2016 to February 2017, data from trauma patients who received UORBCs in the trauma bay were compared with those of trauma patients who received ABO RBCs from January 2013 to December 2015. Propensity matching was used to overcome retrospective bias. The primary outcome was 24-hour mortality, while the secondary outcomes were in-hospital mortality and intensive care unit (ICU) length of stay (LOS). Data from 252 patients were reviewed and UORBCs were administered to 64 patients. The time to transfusion from emergency room admission was shorter in the UORBC group (11 [7–16] minutes vs. 44 [29–72] minutes, P < 0.001). After propensity matching, 47 patients were included in each group. The 24-hour mortality (4 [8.5%] vs. 9 [13.8%], P = 0.135), in-hospital mortality (14 [29.8%] vs. 18 [38.3%], P = 0.384), and ICU LOS (9 [4–19] days vs. 5 [0–19] days, P = 0.155) did not differ significantly between groups. The utilization of UORBCs resulted in a faster transfusion but did not significantly improve the clinical outcomes in traumatic shock patients in this study. However, the tendency for lower mortality in the UORBC group suggested the need for a large study.
Bays ; Bias (Epidemiology) ; Blood Banks ; Emergency Service, Hospital ; Erythrocyte Transfusion* ; Erythrocytes* ; Hospital Mortality ; Humans ; Intensive Care Units ; Length of Stay ; Mortality ; Propensity Score* ; Retrospective Studies ; Shock* ; Shock, Traumatic ; Trauma Centers ; Wounds and Injuries

Keratoacanthomas (KAs) are epithelial skin tumors characterized by rapid growth and spontaneous regression, with histopathologic features similar to those of cutaneous squamous cell carcinoma (SCC). KA arising after the use of anti-programmed cell death protein 1 (PD1) and anti-transforming growth factor beta (TGF-β) antibody have been reported. The patient in the present case was administered a new anti-cancer drug under clinical trial, which comprised anti-PD-ligand 1 (PD-L1) and anti-TGF-β antibodies. Nine months after the drug was used, a hyperkeratotic nodular lesion appeared on the patient's left arm. As a result of histopathologic examination by excision of the corresponding lesion, it was diagnosed as KA.