OBJECTIVE: As an electronic health record system is implementing in Korean health care sectors, concerns about key functionalities of electronic health record systems are increasing. The purpose of this study was to identify core functions and set the priority in electronic health record systems under the Korean contexts in order to assure and improve the quality of the systems. METHODS: A survey was conducted using questionnaire developed by the study team based on literature review. The subjects were medical record administrators working at medical record department in general hospitals. RESULTS: The response rate was 59.8%(55/92). The functions which more than ninety percent of subjects responded as necessary right now and/or in near future related to 'drug alert', 'clinical guideline', 'chronic disease management', 'automated real-time surveillance', 'coded data', 'result reporting', 'de-identifying data', 'disease registry', and 'provider-provider communication and connectivity'. CONCLUSION: The results showed the high prioritized functions were decision support and health information/data management.
Electronic Health Records* ; Health Care Sector ; Hospitals, General* ; Humans ; Medical Record Administrators ; Medical Records ; Needs Assessment* ; Surveys and Questionnaires

PURPOSE: Grape seed-derived polyphenols (GSPs) provide a concentrated source of polyphenols having antioxidant capacity. In this study we investigated the cytoprotective effect of GSP against oxidative stress-induced cell damage in cultured human retinal pigment epithelial (RPE) cells. METHODS: Cultured adult retinal pigment epithelium (ARPE)-19 cells were incubated with GSP from Vitis vinifera (0.1, 0.5, 1, 5 or 10 microg/mL) for 24 hours and treated with hydrogen peroxide (H2O2, 0.4 mM) for 24 hours to induce oxidative stress. Cell viability was measured using 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assay. Intracellular reactive oxygen species (ROS) was quantified using 2',7'-dichlorofluorescein diacetate (DCF-DA) fluorescence. RESULTS: The percentage of viable RPE cells was significantly lower in cultures treated with H2O2 0.4 mM than in control cultures. GSP significantly reduced H2O2-induced cell death in a dose dependent manner. GSP at 0.1, 0.5, 1, 5 and 10 microg/mL significantly reduced cell mortality due to the treatment with H2O2. Intracellular ROS production increased significantly in cultures treated with H2O2 0.4 mM compared with control. There was a significant dose-dependent decrease in intracellular ROS levels after treatment of RPE with GSP. CONCLUSIONS: GSP, a natural polyphenolic compound, can protect RPE cells from H2O2-induced oxidative stress and reduce intracellular ROS production by scavenging free radicals. This suggests potential effects of polyphenolic compounds against retinal diseases associated with oxidative stress.
Adult ; Cell Death ; Cell Survival ; Epithelial Cells* ; Fluorescence ; Free Radicals ; Grape Seed Extract ; Humans ; Hydrogen Peroxide ; Mortality ; Oxidative Stress* ; Polyphenols ; Proanthocyanidins ; Reactive Oxygen Species ; Retinal Diseases ; Retinal Pigment Epithelium ; Retinaldehyde* ; Vitis

BACKGROUND: The main source of carbohydrate in the Korean diet is rice, which is usually served in a rice bowl. This study investigated the impact of a meal plan using smaller rice bowls on dietary energy intake and macronutrient composition in overweight or obese patients with type 2 diabetes mellitus. METHODS: A total of 67 women with type 2 diabetes were enrolled in our study. We divided these participants into three groups: a normal-weight group (NW; body mass index [BMI] < 23 kg/m2; n = 17), an overweight group (OW; 23 < or = BMI < 25 kg/m2; n = 24) and an obese group (OB; BMI > or = 25 kg/m2; n = 26). Three-day dietary records were analyzed for total energy intake (TEI) and macronutrient composition both before enrollment and two weeks after patients received instruction in a dietary plan based on using a small (200 mL) rice bowl. RESULTS: After the intervention, TEI decreased in the OW and OB groups. Decreased carbohydrate (NW, -4 +/- 5%; OW, -4 +/- 5%; OB, -3 +/- 6%) and increased fat intakes were found in all three groups, which complies with Korean Diabetes Association recommendations. The protein proportion of TEI significantly increased only in the OW group. Body weight decreased both in the OW and OB groups. CONCLUSION: A short-term, small-rice-bowl-based meal plan was effective for body weight control and macronutrient balance in overweight or obese women in Korea with type 2 diabetes.
Body Mass Index ; Body Weight ; Diabetes Mellitus, Type 2 ; Diet, Diabetic ; Diet ; Diet Records ; Energy Intake ; Female ; Humans ; Korea ; Meals ; Overweight

PURPOSE: To evaluate the effects of macular ischemia and early treatment on the visual outcomes of patients with branch retinal vein occlusion (BRVO). METHODS: This study retrospectively reviewed the records of 42 patients who were treated with an intravitreal bevacizumab injection for BRVO, repeated 3 times at 6-week intervals and were whose data available for a follow-up period of at least 4 years. Best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) results before treatment and at 6, 12, 24, 36 and 48 months after the 3 serial injections, were measured. We assessed macular ischemia, time to the first treatment, and the relationship of these with BCVA. RESULTS: Mean BCVA (log MAR) was significantly improved from 0.67 +/- 0.43 at baseline to 0.30 +/- 0.30 at 48 months (p < 0.001). Four years after treatment, mean BCVA in the macular non-ischemic group was better than in the ischemic group, but this relationship did not hold for mean change in BCVA. There was a statistically significant (p < 0.05) difference between the early (< or =6 weeks) and late (>6 weeks) treatment groups in BCVA and mean change in BCVA after 48 months. There was statistically significant (p < 0.05) difference between the early (< or =6 weeks) and late (>6 weeks) treatment groups with macular ischemia in BCVA after 48 months. CONCLUSIONS: In patients with BRVO, a significant visual improvement was maintained after intravitreal bevacizumab injections, despite the presence of macular ischemia. Early treatment (within 6 weeks) is more effective for maintaining and improving visual acuity. Similar results in the macular ischemia group confirmed the importance of early treatment.
Follow-Up Studies ; Humans ; Ischemia* ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Retrospective Studies ; Tomography, Optical Coherence ; Visual Acuity ; Bevacizumab

PURPOSE: To investigate the effect of prophylactic intraocular pressure (IOP)-lowering medication after intravitreal dexamethasone implantation. METHODS: This is a retrospective analysis of 39 eyes undergoing intravitreal dexamethasone implantation for macular edema. Eyes were divided into two groups, those which had used prophylactic IOP-lowering medication and those which had not. IOP was measured preoperatively, at one week, and monthly until six months post-injection in each group. RESULTS: The mean pre-injection IOP for the group that had not used prophylactic IOP-lowering medication and the group that had was 13.95 +/- 3.32 mm Hg and 13.56 +/- 3.71 mm Hg, the mean post-injection IOP at two months was 15.81 +/- 3.75 mm Hg and 12.56 +/- 5.02 mm Hg, and that at six months was 12.90 +/- 2.95 mm Hg and 11.44 +/- 3.59 mm Hg, respectively. The difference between the two groups was statistically significant at one week, one month, two months, and three months (p = 0.001, 0.002, 0.011, 0.035, respectively). A greater than 22 mm Hg increase in IOP was seen in four eyes (19.05%) in the group that had not used IOP-lowering medication and in one eye (5.56%) in the group that had. A greater than 5 mm Hg increase in IOP from baseline was seen in eight eyes (38.10%) in the group that had not used IOP-lowering medication and in one eye (5.56%) in the group that had. CONCLUSIONS: After intravitreal dexamethasone implantation, prophylactic IOP-lowering medication will significantly prevent IOP increase and decrease the number of patients requiring additional treatment that could cause potential damage to the retina and optic nerve.
Dexamethasone* ; Humans ; Intraocular Pressure ; Macular Edema ; Optic Nerve ; Retina ; Retrospective Studies

PURPOSE: To investigate the effect of prophylactic intraocular pressure (IOP)-lowering medication after intravitreal dexamethasone implantation. METHODS: This is a retrospective analysis of 39 eyes undergoing intravitreal dexamethasone implantation for macular edema. Eyes were divided into two groups, those which had used prophylactic IOP-lowering medication and those which had not. IOP was measured preoperatively, at one week, and monthly until six months post-injection in each group. RESULTS: The mean pre-injection IOP for the group that had not used prophylactic IOP-lowering medication and the group that had was 13.95 +/- 3.32 mm Hg and 13.56 +/- 3.71 mm Hg, the mean post-injection IOP at two months was 15.81 +/- 3.75 mm Hg and 12.56 +/- 5.02 mm Hg, and that at six months was 12.90 +/- 2.95 mm Hg and 11.44 +/- 3.59 mm Hg, respectively. The difference between the two groups was statistically significant at one week, one month, two months, and three months (p = 0.001, 0.002, 0.011, 0.035, respectively). A greater than 22 mm Hg increase in IOP was seen in four eyes (19.05%) in the group that had not used IOP-lowering medication and in one eye (5.56%) in the group that had. A greater than 5 mm Hg increase in IOP from baseline was seen in eight eyes (38.10%) in the group that had not used IOP-lowering medication and in one eye (5.56%) in the group that had. CONCLUSIONS: After intravitreal dexamethasone implantation, prophylactic IOP-lowering medication will significantly prevent IOP increase and decrease the number of patients requiring additional treatment that could cause potential damage to the retina and optic nerve.
Dexamethasone* ; Humans ; Intraocular Pressure ; Macular Edema ; Optic Nerve ; Retina ; Retrospective Studies

BACKGROUND: Since April 2009, novel influenza A (H1N1) infection is spreading throughout the world. This infection might be fatal for immunocompromised patients who are at a potentially high risk of developing infectious complications. We investigated the detection rate and features of H1N1 infection in immunocompromised patients. METHODS: Between August 2009 and February 2010, we examined 8,112 subjects, including 390 immunocompromised patients, for H1N1. Swab samples were taken from the nose and throat of the participants. Real-time PCR was performed to identify H1N1 viral genes. RESULTS: Positive results were obtained in 2,953/8,112 (36.4%) subjects and 46/390 (11.8%) immunocompromised patients. H1N1 was identified in 8.7% patients with solid cancer, 12.9% patients with hematologic malignancy, 16.7% patients with chronic renal disease, and 14.5% patients with kidney transplantation. The mean cycle threshold (Ct) value of PCR was significantly lower (P<0.05) in patients with hematologic malignancy as compared to that in patients with chronic renal disease and control subjects. Four patients died due to respiratory complications. CONCLUSIONS: The detection rate of H1N1 was significantly lower in immunocompromised patients than in other patients. The Ct value of patients with hematologic malignancy was significantly lower than that of other immunocompromised patients and control subjects.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Humans ; *Immunocompromised Host ; Infant ; Influenza A Virus, H1N1 Subtype/genetics/*isolation & purification ; Influenza, Human/complications/*diagnosis/epidemiology ; Kidney Failure, Chronic/complications ; Leukemia/complications ; Male ; Middle Aged ; Neoplasms/complications ; Polymerase Chain Reaction

Exflagellation of the malaria parasite microgametocyte usually occurs in the gut cavity of Anopheles mosquitoes following an infective blood meal. Exflagellation is a very rare event in human blood. Due to its rarity, the appearance of this structure in a peripheral blood smear will easily create a diagnostic dilemma. We report a case of malaria with exflagellated microgametes in human blood that was initially mistaken for a double infection of Plasmodium and another blood flagellate. The patient was a 29-year-old Parkistani man presenting with fluctuating fever accompanied by chills and fatigue for 4 days. Initial peripheral blood smear examination showed a number of Plasmodium ring forms, trophozoites, and gametocytes. Additionally, several filamentous structures resembling blood flagellates were seen. With these features, an initial diagnostic impression of combined infection of malaria and blood flagellate was made. Later, we determined that these structures resembling blood flagellates were exflagellated microgametes of malarial parasite. Therefore, the knowledge that exflagellation may appear in human blood with Plasmodium species infection and being more familiar with differentiation of the morphologic features of other species infection can prevent further possible misinterpretation.
Anopheles ; Chills ; Culicidae ; Fatigue ; Fever ; Humans ; Malaria ; Meals ; Parasites ; Plasmodium ; Trophozoites

Endocarditis due to anaerobes is not a rare ocurrence. However, Clostridial endocarditis, most cases are caused by Clostridium perfringens, is an uncommon disease. Clostridium are gram positive spore forming obligate anaerobes that are found widely in soil, water, and foods. They naturally inhabit the respiratory, gastrointestinal, and female genital tract. We observed a case of Clostridium perfringens endocarditis in a 67 years old woman. Who experienced fever, chronic diarrhea and vegetation in the aortic valve.
Aged ; Aortic Valve ; Clostridium perfringens* ; Clostridium* ; Diarrhea ; Endocarditis* ; Female ; Fever ; Humans ; Soil ; Spores

OBJECTIVE: A recently developed facial scanning method uses three-dimensional (3D) surface imaging with a light-emitting diode. Such scanning enables surface data to be captured in high-resolution color and at relatively fast speeds. The purpose of this study was to evaluate the accuracy and precision of 3D images obtained using the Morpheus 3D(R) scanner (Morpheus Co., Seoul, Korea). METHODS: The sample comprised 30 subjects aged 24-34 years (mean 29.0 +/- 2.5 years). To test the correlation between direct and 3D image measurements, 21 landmarks were labeled on the face of each subject. Sixteen direct measurements were obtained twice using digital calipers; the same measurements were then made on two sets of 3D facial images. The mean values of measurements obtained from both methods were compared. To investigate the precision, a comparison was made between two sets of measurements taken with each method. RESULTS: When comparing the variables from both methods, five of the 16 possible anthropometric variables were found to be significantly different. However, in 12 of the 16 cases, the mean difference was under 1 mm. The average value of the differences for all variables was 0.75 mm. Precision was high in both methods, with error magnitudes under 0.5 mm. CONCLUSIONS: 3D scanning images have high levels of precision and fairly good congruence with traditional anthropometry methods, with mean differences of less than 1 mm. 3D surface imaging using the Morpheus 3D(R) scanner is therefore a clinically acceptable method of recording facial integumental data.
Anthropometry ; Seoul