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

No abstract available.
Lung*

OBJECTIVE: The purpose of this study was to understand the differences in masseter muscle (MM) between the shifted and non-shifted sides in facial asymmetry patients, and the changes shown by MM after mandibular surgery. METHODS: Pre- and post-operative CT scans were performed on 12 Class III patients with facial asymmetry who were treated by intraoral vertical ramus osteotomy and 10 subjects with normal occlusion. Using the V-works 4.0 program (Cybermed, Seoul, Korea), 3-dimensional images of the mandible, and MM were reconstructed, and evaluated. RESULTS: In the asymmetry group, the MM angle between the shifted and non-shifted sides was only significantly different (p < 0.05). Compared with normal occlusion, the asymmetry group showed a significantly smaller volume and maximum cross-sectional area in both sides of MM (p < 0.05). After mandibular surgery, the angle of MM (p < 0.01) and differences in angle between the shifted and non-shifted sides of MM (p < 0.05) were significantly decreased. The thickness in the maximum cross-sectional area was significantly increased (p < 0.01). After surgery, MM in facial asymmetry patients was similarly changed to those in the normal occlusion group except for widths. CONCLUSIONS: MM in facial asymmetry was definitely different from those in normal occlusion. However, this study suggests that MM changed symmetrically in conjunction with the mandible after proper mandibular surgery.
Facial Asymmetry ; Humans ; Mandible ; Masseter Muscle ; Orthognathic Surgery ; Osteotomy

The aim of the present study was to examine the effect of provinol, which is a mixture of polyphenolic compounds from red wine, on the secretion of catecholamines (CA) from isolated perfused rat adrenal medulla, and to elucidate its mechanism of action. Provinol (0.3~3 microgram/ml) perfused into an adrenal vein for 90 min dose- and time-dependently inhibited the CA secretory responses evoked by ACh (5.32 mM), high K+ (a direct membrane-depolarizer, 56 mM), DMPP (a selective neuronal nicotinic NN receptor agonist, 100 micrometer) and McN-A-343 (a selective muscarinic M1 receptor agonist, 100 micrometer). Provinol itself did not affect basal CA secretion. Also, in the presence of provinol (1 microgram/ml), the secretory responses of CA evoked by Bay-K-8644 (a voltage-dependent L-type dihydropyridine Ca2+ channel activator, 10 microgram), cyclopiazonic acid (a cytoplasmic Ca2+-ATPase inhibitor, 10 microgram) and veratridine (an activator of voltage-dependent Na+ channels, 10 microgram) were significantly reduced. Interestingly, in the simultaneous presence of provinol (1 microgram/ml) plus L-NAME (a selective inhibitor of NO synthase, 30 micrometer), the CA secretory responses evoked by ACh, high K+, DMPP, McN-A-343, Bay-K-8644 and cyclpiazonic acid recovered to the considerable extent of the corresponding control secretion in comparison with the inhibition of provinol-treatment alone. Under the same condition, the level of NO released from adrenal medulla after the treatment of provinol (3 microgram/ml) was greatly elevated in comparison to its basal release. Taken together, these data demonstrate that provinol inhibits the CA secretory responses evoked by stimulation of cholinergic (both muscarinic and nicotinic) receptors as well as by direct membrane-depolarization from the perfused rat adrenal medulla. This inhibitory effect of provinol seems to be exerted by inhibiting the influx of both calcium and sodium into the rat adrenal medullary cells along with the blockade of Ca2+ release from the cytoplasmic calcium store at least partly through the increased NO production due to the activation of nitric oxide synthase.
(4-(m-Chlorophenylcarbamoyloxy)-2-butynyl)trimethylammonium Chloride ; 3-Pyridinecarboxylic acid, 1,4-dihydro-2,6-dimethyl-5-nitro-4-(2-(trifluoromethyl)phenyl)-, Methyl ester ; Adrenal Medulla ; Animals ; Calcium ; Catecholamines ; Cytoplasm ; Dihydropyridines ; Dimethylphenylpiperazinium Iodide ; Indoles ; Neurons ; NG-Nitroarginine Methyl Ester ; Nitric Oxide ; Nitric Oxide Synthase ; Rats ; Receptor, Muscarinic M1 ; Receptors, Cholinergic ; Sodium ; Veins ; Veratridine ; Wine

No abstract available.
Humans

A 36-year-old female patient with aplastic anemia developed massive hemoptysis and was placed on ventilator support. However, airway obstruction by blood clots triggered desaturation and ventilator malfunction. Manual ventilation was initiated to improve oxy-genation, and emergency flexible bronchoscopy was performed to clear the airway. Nevertheless, the patient developed extensive subcutaneous emphysema, pneumothorax, and pneumomediastinum.
Adult ; Airway Obstruction ; Anemia, Aplastic ; Barotrauma* ; Bronchoscopy ; Emergencies ; Female ; Hemoptysis* ; Humans ; Mediastinal Emphysema ; Pneumothorax ; Subcutaneous Emphysema ; Ventilation* ; Ventilators, Mechanical

PURPOSE: To analyze the ability of serum prostate specific antigen (s-PSA) to predict the prostate volume by characterizing the relationship between the prostate volume and serum PSA in men with benign prostate hyperplasia. MATERIALS AND METHODS: We evaluated 1,254 patients, with lower urinary tract symptoms, who had visited our hospital between Jan. 2002 and Aug. 2004. All patients with prostate cancer, prostatitis, and a history of prostatic surgery and alpha-blocker or 5-alpha reductase inhibitor medication were excluded from the study. The baseline s-PSA and prostate volume were determined using standard techniques. Pearson's correlation coefficient was used to analyze the relationship between the s-PSA and prostate volume, and a linear regression model to estimate the prostate volume. Receiver operating characteristics (ROC) curves were constructed to evaluate the ability of the s-PSA to predict cut-off values for assessing prostate enlargement. RESULTS: The analyses included 959 patients, with mean age, baseline s-PSA and prostate volume of 68.2 years, 3.4ng/ml and 34.4ml, respectively. The s-PSA and prostate volume increased with age. The prostate volume correlated positively with s-PSA (r=0.292, p<0.01). The linear regression analyses showed that the s-PSA and prostate volume had an age-dependent linear relationship. According to the ROC curves, the optimal s-PSA cut-off values for the entire study population were 1.5ng/ml to detect a prostate volume>30ml and 2.0ng/ml to detect a prostate volume>40ml. CONCLUSIONS: The prostate volume is strongly related to the s-PSA and age in men with benign prostatic hyperplasia (BPH). Since treatment outcomes and the risk of long-term complications depend on the prostate volume, the serum PSA may sufficiently estimate prostate enlargement to be useful in therapeutic decision making in men with BPH.
Age Factors ; Decision Making ; Humans ; Hyperplasia ; Linear Models ; Lower Urinary Tract Symptoms ; Male ; Oxidoreductases ; Prostate* ; Prostate-Specific Antigen ; Prostatic Hyperplasia* ; Prostatic Neoplasms ; Prostatitis ; ROC Curve

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

OBJECTIVE: HL7(Health Level 7) develops standards for the representation of clinical documents like discharge and consultation notes. The goal of the present study is to develop XML(eXtensible Markup Language)-based communication standard for discharge note. METHODS: This paper presents the use of XML for electronic communication in a document-based EMR, first, as a format for the exchange of structured message, and second, as a comprehensible way to represent patient document. A retrospective analysis of 1165 discharge notes, from the department Seoul National University Hospital, were extracted by querying OCS(Order Communication System) and taking every discharge note of main disease issued over one year period (2003.01.01~2003.12.31). RESULTS: An XML-based prototype for discharge note has been put into place representing the required "section" and "specific instance". In addition, a subset of the CDA(Clinical Document Architecture) Level One details has been described and integrated. CONCLUSION: Through the introduction of definitions for sections and specific instances, progress in the development of CDA Level Two and Three might be realized. An XML-based prototype was implemented, allowing a special view on XML data to generate this document type.
Electronic Health Records ; Health Level Seven ; Humans ; Retrospective Studies ; Seoul

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