OBJECTIVES: Adoption of hospital information systems offers distinctive advantages in healthcare delivery. First, implementation of consolidated hospital information system in Seoul National University Hospital led to significant improvements in quality of healthcare and efficiency of hospital management. METHODS: The hospital information system in Seoul National University Hospital consists of component applications: clinical information systems, clinical research support systems, administrative information systems, management information systems, education support systems, and referral systems that operate to generate utmost performance when delivering healthcare services. RESULTS: Clinical information systems, which consist of such applications as electronic medical records, picture archiving and communication systems, primarily support clinical activities. Clinical research support system provides valuable resources supporting various aspects of clinical activities, ranging from management of clinical laboratory tests to establishing care-giving procedures. CONCLUSIONS: Seoul National University Hospital strives to move its hospital information system to a whole new level, which enables customized healthcare service and fulfills individual requirements. The current information strategy is being formulated as an initial step of development, promoting the establishment of next-generation hospital information system.
Adoption ; Confidentiality ; Delivery of Health Care ; Electronic Health Records ; Hospital Information Systems ; Information Systems ; Management Information Systems ; Quality of Health Care ; Radiology Information Systems ; Referral and Consultation

BACKGROUND: Smoking prevention and anti-smoking education in schools must be designed and planned according to age and sex as well as the type of schools and their smoking status. But the current education programs do not consider these factors. This study, therefore, aims to evaluate the actual status of the smoking prevention and anti-smoking education in Korea and to find present recommendations for an effective and, systematic education. METHODS: We surveyed 15,310 teen-age students attending middle schools and high schools in such cities as Seoul, Incheon, Bucheon, Mokpo, and Pohang and smaller areas in the vicinity of these cities from June 1 to 15, 2005. Self-survey was done by the health education teacher of each school. It contained questions about the general disposition of respondents, their smoking habits, and awareness programs on prevention and cessation of smoking. We used SPSS 12.0 for chi-square-test to analyze the collected data. RESULTS: The most prevailing form of anti-smoking education was "video". Most of the students surveyed said that the fourth or fifth grade of elementary school will be a good starting point for anti-smoking education. Only 39.6% of students who were educated by the current smoking prevention and anti-smoking program answered that it was "helpful" and 29.6% was "satisfied". Higher percentage of middle school students said that they either tried to quit smoking ('pre-contemplation') or had no intention of doing it ('termination-fail') after having been involved in the anti-smoking education program, while high school students turned out to be more oriented towards 'contemplation' and 'termination-success'. CONCLUSION: Some students were found to begin smoking even at an early grade in elementary school. Most adolescents knew about the danger of smoking, but current smokers had a low educational satisfaction. The real target of such education programs, however, should be focused on higher grade students in elementary schools and middle school students, because data show that smoking rate increases explosively among these students.
Adolescent ; Surveys and Questionnaires ; Education* ; Gyeonggi-do ; Gyeongsangbuk-do ; Health Education ; Humans ; Incheon ; Intention ; Jeollanam-do ; Korea ; Seoul ; Smoke* ; Smoking Cessation ; Smoking*

Isolated deficiency of 3-methylcrotonyl CoA carboxylase is a rare disorder of the catabolic pathway for leucine and many patients have mild symptoms or no symptom. However, the introduction of tandem mass spectrometry in newborn screening has revealed an unexpectedly high incidence of this disorder. We report an asymptomatic premature infant with isolated 3-methylcrotonyl CoA carboxylase deficiency detected by newborn screening program using tandem mass spectrometry. She was born at preterm, 36 weeks of gestation and her birth weight was 1,912 gm. She was delivered by Cesarian section due to maternal preeclampsia and oligohydramnios. An elevation of 3-hydroxyisovalerylcarnitine in a blood sample obtained at Seven days was detected by tandem mass screening. Massively elevated excretion of 3-hydroxyisovalerate and 3-methylcrotonylglycine was detected in the urine collected at 15 days. L-carnitine(100 mg/kg/day) was administrated orally to correct sencondary carnitine deficiency. Carnitine is conjugated with metabolites, to decrease the potential toxic effects. She is asymptomatic to date, and her growth and development are within normal limits.
Birth Weight ; Carnitine ; Female ; Growth and Development ; Humans ; Incidence ; Infant, Newborn* ; Infant, Premature ; Leucine ; Mass Screening* ; Oligohydramnios ; Pre-Eclampsia ; Pregnancy ; Tandem Mass Spectrometry*

PURPOSE: We wished to develop the web based Picture Archiving and Communication System in the emergency room for early decision making in emergency treatment planning at a full PACS Hospital. MATERIALS AND METHODS: The program tools were Microsoft Visual Studio 6.0 - Visual C++ 6.0, and the Microsoft SQL 7.0 under the Microsoft Windows 2000 server(R) operation system. The achievement of images was performed by an auto transport program installed in the ER and the radiology department. RESULTS: The average compression rates were 5:1 for CT and MR, and 20:1 for CR with JPEG 2000 lossy compression. All the images were stored on hard disk for 3 months. The patients' information was displayed for 2 weeks for reducing the security risk. For interdepartmental consultation, patient query by patient hospital number was available. CONCLUSION: Our Web based ER PACS could be useful system for early decision making for treatment planning in the emergency room because it reduces the risk factors for the security of the Web PACS by using a system independent from PACS in the hospital and minimizing the information patients.
Decision Making ; Emergencies* ; Emergency Service, Hospital* ; Emergency Treatment ; Humans ; Risk Factors

Human chorionic gonadotropin (HCG) is one of the glycoproteins families synthesized by the placenta, and consists of 2 noncovalently joined subunits, namely, alpha and beta. The alpha and beta-subunits have a structural homology with the alpha and beta-subunits of TSH and LH. The thyrotropic action of HCG results from its structural similarity to TSH, so beta-HCG can bind to the TSH receptor in the thyroid gland. A high level of HCG, accompanied by an increased thyroid hormone level, can be observed in gestational trophoblastic diseases (GTD), such as a hydatidiform mole or a choriocarcinoma. However, the clinical symptoms of hyperthyroidism in GTD are rarely observed. A 27-years-old woman, admitted due to an amenorrhea of 11 weeks duration, with thyrotoxic symptoms, such as weight loss, palpitation, sweating, tremor, heat intolerance and anxiety, was evaluated. Her serum free T4 level was 8 times higher than normal, and her serum beta-HCG level was over 1,000,000IU/L. She had a curettage operation, with the pathological findings of a complete hydatidiform mole. These thyrotoxic symptoms developed due to a hydatidiform mole, and were accompanied with a highly increased serum beta-HCG level. After evacuation of the molar tissue, the thyroid hormone and thyrotoxic symptoms normalized. Here, this case is reported, with brief review of the literature.
Amenorrhea ; Anxiety ; Choriocarcinoma ; Chorionic Gonadotropin ; Curettage ; Female ; Gestational Trophoblastic Disease ; Glycoproteins ; Hot Temperature ; Humans ; Hydatidiform Mole* ; Hyperthyroidism ; Molar ; Placenta ; Pregnancy ; Receptors, Thyrotropin ; Sweat ; Sweating ; Thyroid Gland ; Thyrotoxicosis* ; Tremor ; Weight Loss

PURPOSE: Acute lower respiratory tract infections (ALRI) are one of the most common causes of morbidity in children. Most infections are known to be caused by virus and bacteria, greater percentage caused by virus than bacteria. This study was aimed to define the viral etiologic agents, age distribution, clinical manifestations, and seasonal occurrences of viral ALRI in Korean children, during 1996 and 2002. METHODS: A total of 4, 311 patients who had been hospitalized for ALRI at Samsung Medical Center, from March 1996 to September 2002, were studied. Nasopharyngeal aspirates were obtained for virus culture. Respiratory viruses were identified by indirect immunofluorescent staining. RESULTS: One or more viral agents were isolated in 14.8% (639 cases). The pathogens identified were RSV (21.8%), influenza virus type A (21.3%), adenovirus (20.7%), parainfluenza virus type 3 and 1 (17.4%, 8.3%), influenza virus type B (7.4%). The clinical patterns of viral ALRI were pneumonia (49%), bronchiolitis (22%), tracheobronchitis (15%) and croup (14%). The occurrence of viral ALRI was highest in the 1st year of life. Pneumonia was developed mostly by adenovirus. The most frequent cause of bronchiolitis was RSV. Croup was frequently caused by parainfluenza and influenza virus. Infections with influenza virus type A, B, parainfluenza virus type 1, 3, and RSV occurred in epidemics, whereas adenovirus was isolated throughout the study period. CONCLUSION: These data expand our understanding of the etiology of ALRI among pediatric inpatients in Seoul, Korea and may contribute to the prevention and control of viral respiratory tract infection.
Adenoviridae ; Age Distribution ; Bacteria ; Bronchiolitis ; Child ; Child, Hospitalized* ; Croup ; Epidemiologic Studies* ; Humans ; Inpatients ; Korea* ; Orthomyxoviridae ; Parainfluenza Virus 1, Human ; Parainfluenza Virus 3, Human ; Paramyxoviridae Infections ; Pneumonia ; Respiratory System* ; Respiratory Tract Infections* ; Seasons ; Seoul*

Primary thyroid lymphomas constitute of up to 5% of all thyroid malignancies. Recently, mucosa-associated lymphoid tissue (MALT) lymphoma are relatively recognized as a B cell subset of non-Hodgkin's lymphoma. MALT-lymphomas are thought to develop from acquired lymphocytic tissue during the course of a chronic inflammatory or autoimmune process. In the thyroid , which is normally devoid of lymphocytic tissue, chronic autoimmune thyroiditis (Hashimoto's disease) has been associated with an increased risk of lymphoma, including MALT type. The clinical presentations include the enlarging of the neck mass, dysphagia, hoarsenes and choking or cold thyroid nodule. We report a case of MALToma of the thyroid accompanied by Hashimoto's thyroiditis with a review of the literature.
Airway Obstruction ; Deglutition Disorders ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone* ; Lymphoma, Non-Hodgkin ; Neck ; Thyroid Gland* ; Thyroid Nodule ; Thyroiditis* ; Thyroiditis, Autoimmune

Carcinoembriogenic antigen (CEA) was widely used as a marker for staging and detection of recurrence and metastases, and evaluation of response of radical opertion or chemotherapy in colorectal cancer patients. METHODS: We examined 50 patients with sigmoid colon and rectal cancer patients who had a radical operation between 1994 May and 1995 April. We checked the level of CEA of peripheral blood preoperatively and postoperatively, and inferior mesenteric vein, bile of gall bladder and peritoneal fluid during surgery. We review clinical characters of the patients, and analyzed the importance of CEA level. RESULTS: The mean CEA levels of peripheral blood (postoperation), inferior mesenteric vein, bile, peritoneal fluid were 5.35+/-2.65, 13.23+/-2.13, 9.23+/-1.65, 7.42+/-2.34 ng/ml respectlively. The mean CEA level of inferior mesentiric vein (13.23+/-2.13 ng/ml) was significantly higher than that of preoperative peripheral blood (8.13+/-2.34 ng/ml) (p<0.05). Falling of postoperative peripheral blood CEA level was also significantly lower than that of preoperative level (p<0.05). CONCLUSIONS: Level of postoperative peripheral blood was related to recurrence rate and survival rate, but tumor size, tumor location, tumor differentiation, Dukes' stage were not related to the CEA level. Bile and peritoneal fluid CEA levels were related with the liver metastasis or local recurrence respectively. We suggest that CEA was useful indicator for evaluation, management, and prognosis of colorectal cancer not only preoperatively but also postoperatively.
Ascitic Fluid* ; Bile* ; Colon, Sigmoid* ; Colorectal Neoplasms ; Drug Therapy ; Humans ; Liver ; Mesenteric Veins* ; Neoplasm Metastasis ; Prognosis ; Rectal Neoplasms* ; Recurrence ; Survival Rate ; Urinary Bladder ; Veins*

Over Past years people have known rich medical information and knowledge through mass-media. It is needed to develop medical database, which makes people get proper medical information, So we made an effort to analysis health and medical consultation data. People easily access internet hospital of Gachon Medial School Gil Medical Center, coorperated with MIDAS Dongailbo. 4020 cases of "Questions and Answers "were conducted to access from March 25th, 1997 to March 25th, 1998. Using Java Servlet, Sybase, and Apache Web Server, we classified data. Those data present over 4000 databases, such as text (3644 cases), image (212 cases), moving picture (21 cases), and medical dictionary (416 dases). People can search symptome, or disease, what they want to know. Our database as a medical service is enhance people know about medical knowledge and information, so that they can take care of their health and prevent illness in advance.
APACHE ; Dictionaries, Medical ; Humans ; Indonesia ; Internet* ; Multimedia*

Condyloma acuminata, an uncommon disease in the pediatric patients, is being reported with increasing frequency in both adults and children. During the last 10 years, we had the opportunity to treat 11 children with condyloma acuminata in anogenital area. Patient age at presentation varied from 9 months to 11 years, and boys were outnumbered girls by a ratio of 2 : 1. The lesions were found in the perianal area in 9 patients, while the remaining had lesions localized to the genitalia. No history of sexual contact or abuse could be elicited. Although the exact mode of transmission of human papillomavirus (HPV) couldn't be defined, maternal-infant transmission at birth and close nonsexual family contact were the main possible causes of HPV infection in our patients. Our experience suggest that fulguration of the warts and concomitant scissors excision for the larger ones are the satisfactory method of treatment in children. However, based on our data we feel that condyloma acuminata has a high recurrence rate despite treatment. Viral typing and careful epidemiological investigation on a larger series of patients may further clarify the causal factors and effective modalities of treatment in childhood anogenital condyloma acuminata.
Adult ; Child* ; Female ; Genitalia ; Humans ; Parturition ; Recurrence ; Warts