Methylenetetrahydrofolate Reductase Gene C677T Mutation and Apolipoprotein E Gene Mutation in Recurrent Aphthous Stomatitis / 대한피부과학회지

BACKGROUND: Recurrent aphthous stomatitis (RAS) is usually the earliest sign of Behcet's disease. Hyperhomocysteinemia can damage endothelial cells and progress to obstructive vascular disease. It has been reported that hyperhomocysteinemia is a marker of activation in Behcet's disease. Enzyme 5,10-methylenetetrahydrofolate reductase may be one of the main factors that regulates plasma homocysteine levels. Homozygosity for the C677T (MTHFR C677T) mutation is associated with reduced activity of this enzyme and considered the most common genetic cause of elevated serum homocyteine levels. However its relationship to vascular injury in Behcet's disease remains controversial, and its relationship to RAS is unknown. Apolipoprotein E (Apo E) has both immunoregulatory and anti-infective features. Search for Apo E polymorphism and lipid composition in RAS patients might be a clue to pathogenesis of RAS. OBJECTIVE: To analyze the relationship of MTHFR gene C677T polymorphism, several epidemiologic factors such as age and sex, smoking, lipid composition and Apo E polymorphism to vasculitis in RAS, we assessed the MTHFR gene C677T polymorphism, Apo E polymorphism and lipid composition in RAS and normal population. METHODS: We analyzed data from the General Health survey conducted on 1,243 participants (M:F=281:962) over a 20 year-old in Incheon city. Medical interview and laboratory test for methylenetetrahydrofolate reductase (MTHFR) C677T gene polymorphism, apolipoprotein E polymorphism were completed. Statistical significance was analyzed by chi-square test and multistep logistic regression analysis. RESULTS: Among normal population over the age of twenty, a total of 34.2% (426/1,243) had RAS. Female predominance (4.5:1, p=0.003) was noted. The incidence of RAS in age group 20 to 39 year old is higher than the over 40 age group. The incidence is higher in smoking group compared to the nonsmoking group in multistepwise logistic regression analysis. Frequency of the MTHFR C677T genotypes was highest at CT compared to CC and TT homozygous genotype in normal and RAS patients group. There was no significant statistical differences in MTHFR genotypes in RAS patients compared to the control group. Similarly, Apo E genotype analysis revealed no significant statistical differences either. Apo E genotype and total cholesterol, HDL-cholesterol, triglyceride level didn't show any associations. CONCLUSION: This study revealed insignificant association between the MTHFR C677T mutation and RAS. Apo E genotype didn't show a significant statistical difference in RAS patients compared to normal controls.

Predictors of Cardiopulmonary Resuscitation Education for Layperson

PURPOSE: Few data exist regarding cardiopulmonary resuscitation (CPR) education status in relationship to characteristics of socio-economic status and health and medical conditions in Korea. The purpose of this study is to describe the characteristics associated with the CPR educated populationand to develop and analyze a simple predictive model of the CPR education status. METHODS: Based on a health survey of Incheon Metropolitan City adults (5,114), differences between a CPR-educated group (n=220) and a CPR non-educated group (n=4,894) were analyzed and a logistic regression analysis of the two groups was performed to evaluate socio-economic status-gender, age, marital status, education level, number of family members, and monthly household income-and health-medical conditions-disease, accidental history, EMS (emergency medical service) experience, and health status. RESULTS: The participation rate in CPR education in Korea is only 4.3% which is vastly lower than in other developed countries, and there are statistically significant differences between the CPR-educated and CPR not-educated in gender (0.000), age (0.000), marital status (0.000), education level (0.000), and diseases (0.003). Similarly, gender (OR: 0.247, 0.000), age (OR: 0.964, 0.000), marital status (OR: 0.463, 0.000), education level (OR: 1.797, 0.000), numbers of family members (OR: 1.231, 0.004), and health status (OR: 0.894, 0.009) are statistically significant predictors of participation in CPR education. CONCLUSION: Monthly household income, accident history, and EMS experience are not statistically significant factors for participation in CPR education in Korea. It may be necessary to determine the optimal fees of CPR education based on social characteristics and economic conditions, Certain subgroups of lay persons such as high-risk patients and family members need targeted outreach programs.

The Construction and the Evaluation of Web Sites on Epilepsy Information / 대한의료정보학회지

We aimed to construct web sites providing information on epilepsy and to evaluate its practical use. To estimate the demand for such information, a questionnaire was administrated to 106 patients, their 54 families, and 78 nurses, who consented to be interviewed. After using the data collected from the survey to build a epilepsy information web site, data on the level of satisfaction for the website were collected by e-mails and direct surveys from subjects who used this web site; the collected data were analyzed. The results of this study were as follows: The educational level demanded by nurses was slightly higher than those of patients and their families. Patients, their families, and nurses wanted more information on how to handle patients during seizures, especially, and. families wanted to know about drug therapy. The content of the web site was configured based on the educational level of perceived users. Photoshop 6.0, Flash MX and FrontPage 2000 were used to build the web site. Images available on the internet that are shared served as the source of images. The program's URL is www.multimoon.com/black. Regarding user satisfaction with the web site, users found that the Information on the Prognosis of Epilepsy, the Pharmacological Treatment of Epilepsy, Occupation and Marriage Status in Daily Life, and the How to Manage Epileptic Attacks sections were quite helpful. Generally, the reactions to the website were positive. To construct an effective web site to provide information about epilepsy to patients, their families and nurses, educational data and information that meet the demands of users should be added. Its contents should be continuously updated, and its environment should be kept user-friendly so that the information can be accessed with ease.

Development and Experimental Application of an Emergency Patient Information Delivery System Using a PDA / 대한의료정보학회지

This study developed, and applied, a portable emergency medical information system, enabling patient-related information to be efficiently shared with the hospital information system, via a PDA, while an emergency patient was being taken to the emergency room. The system consisted of an emergency patient`s server for monitoring the condition of the emergency patients registered in an emergency room, in real time, and a PDA terminal that delivers patient and emergency ac tivity information to a se rver through a wireless connection. Within the emergency room of G hospital a DB server was in charge of the stored information to de liver information the patients' conditions, emergency treatments, and activities, with 119 emergency medical system personnel being responsible for the information storage space, via a PDA. In addition, the member of personnel in charge of an emergency room can check the registrations of the 119 EMS personnel through a user's application, that enablings real-time checks of the fir st-aid patients being registerted in the information storage space. In conclusion, the development and experimental application of the emergency patient information delivery system demonstrated that a PDA can be used in an emergency medical environment. Modification to the interface, for a convenient input into a PDA, and an increase in its usability, through the training and continuous studies of the users, will help to make qualitative improvements to this emergency medical service.

Construction And Evaluation Of A Point Of Care Computer System (Pccs) To Improve The Efficiency Of A Nursing Information System / 대한의료정보학회지

The purpose of this study was to construct an effective point of care computer system (PCCS) to improve bedside nursing care and integrate it into a nursing information system. The study was based on the System Development Life Cycle. We preliminarily investigated user demands of a Nursing information system (NIS) and then proceeded on to the PCCS Design and Development. At the analysis stage, the nursing units of four general hospitals in the Seoul and the Kyongin areas were compared with G hospital. Sub-programs of the PCCS were customized for G hospital's system. At the PCCS Design stage, a nursing information flowchart was constructed and contents to be used by each PCCS sub-program were selected. At the PCCS Development stage, PCCS sub-programs were developed using the Visual Basic. Fifty-three nurses of six nursing units who used PCCS (on a wireless notebook computer) responded to the questionnaire 3 months after they started using the system. The results of the evaluation were positive. It is believed that this study helped to improve patient service and the efficiency of nursing units in providing bedside nursing care.

Factors Affecting the Participation Rate in the Health Screening Program of Medical Insurance / 예방의학회지

OBJECTIVE: To analyze the factors affecting the participation rate in the health screening program of medical insurance. METHOD: We investigated the factors associated with the participation rate in the health screening program in Korea. Data were collected at the aggregate level from 145 employee health insurance societies and 227 self-employed health insurance societies from 1995 to 1997. Data were also collected at the individual level from four health insurance societies. This study hypothesized that the participation rate of the health screening program was related to 1) the characteristics of its members and the size of the health insurance society; 2) the specifications of the health screening program; 3) the venue of the health screening institution and the interests of individuals in the health screening program; and 4) the activities of the health insurance society. We used bivariate and multiple regression models to examine the factors on the participation rate of the health screening program. RESULTS: First, in the case of dependents of on employee health insurance society, the ratio of dependents 40 years old and over, the average monthly contribution per household, the interest and satisfaction level of individuals in health screening, and the level of refunds for over-payment were all associated with the participation rate in the health screening program, accounting for 54.4% of the participation rate. Second, in case of those insured by the self-employed health insurance society, the interest and satisfaction level of individuals in health screening, the level of refunds for over-payment, and the performance level of on-the-spot health screening were statistically significant, accounting for 40.1% of the participation rate. CONCLUSION: The factors concerning the participation rate in the health screening program of medical insurance, in both a health insurance society and for individuals, were closely related to the age and gender of individuals and household contributions.