Using Medical Health IC Card in Maternal-Child and School Health Care: Maternal-Child School Medical Health IC Card / 대한의료정보학회지

Medical Health IC card is a smart card built-in a microprocessor and a memory that stores individual health care information. The card is carried by the individual and presented to the medical doctor whin needed. Being connected with the existing networks, the card enables full automation of hospital management and formation of complete medical databases. Futhermore, the card links hospitals with nation-wide medical networks. The focus of this study is on what data should actually be stored in the card, and how the card to be used effectively in maternal-child and school health service. In this paper, existing literatures about prenatal care using medical health IC card were reviewed. and standardization efforts of medical IC card conducted by the ISO and Japanese Department of Health and Welfare were analyzed. This allowed us to pick the most suitable items based on the actual situation in Korea and how to systematically collect and record such data. As a result. we were able to present a standard that follows international standards and includes all additional information from maternal-child health care in major Korean hospitals, child health record published by the Korean pediatric society, and physical examinations done in elementary, middle and high schools in Korea. Also, The terminology of each item was standardized conforming to the Korean standard medical terminology.

Etiology of Invasive Bacterial Infections in Apparently Healthy Children / 감염

BACKGROUND: Invasive bacterial infection is a considerable cause of morbidity and mortality in children. An overall view of the spectrum of invasive bacterial diseases is essential to the establishment of public health priorities. Information regarding the causative bacteria with respect to the age of affected patients and the site of infection, and case-fatality rate is invaluable in the empirical selection of antimicrobial agents. METHODS: One-hundred-and-fifteen episodes of invasive infections in presumably immunocompetent children at ages from 2 months to 15 years at the Seoul National University Children's Hospital, were reviewed retrospectively. Cases with nosocomial infection or underlying conditions that predispose to infection were excluded. RESULTS: The most common clinical entities were bacteremia without an identified focus (37%), followed by meningitis (28%), bacteremic pneumonia or empyema (18%) and bone and joint infection (15%). Staphylococcus aureus (24%), Streptococcus pneumoniae (24%), Salmonella species (23%), Haemophilus influenzae (14 %) and Streptococcus species (4%) together accounted for 90% of all cases. S. aureus was the most common pathogen in bacteremic pneumonia or empyema and bone and joint infection. S. pneumoniae together with H. influenzae were the most common causes of meningitis. The most common organism responsible for bacteremia without an identifiable focus was Salmonella species. The case-fatality rate was 4.8% for all cases of invasive infection. CONCLUSION: We reviewed the relative frequency of bacteria as etiological agents of invasive infections in children. The data may be useful in the establishment of public health priorities and serve as a reference for selection of antibiotics in the empirical therapy of suspected invasive bacterial infections.

A Method for the Application of Emergency Medical Information System in Health IC Card / 대한의료정보학회지

Recent developments in computer and communication technology were studied in relation to medical information network systems, using computers and IC cards, to solve problems in community health. Trial use of health IC card systems for personal health data management are already in existence in some countries. The health IC card system provides good quality information to the doctors, the hospital, the patients, and the insurance organizations. Emergency medical information card systems that take advantage of advanced information-related technologies such as computers and communication systems, in order to improve their emergency medical care systems may have many advantages. Emergency medical information card can provide a way to protect people during medical emergencies by providing physicians with their vital medical information during the critical seconds of emergency care if being unable to provide your vital medical information. Before introducing these systems, recognition that an important problems such as standardization of the data and code for the medical information systems, defining the access and usage rights by user profiles and the types of data for the security and data protection must be considered. We studied the emergency medical information card systems to clarify their purpose, analyse their present status, standardize the data and codes and define the access and usage rights and present the ideal system, in view of community health care requirements. Here the results of the research are examined, and there is a discussion of what is needed to use the emergency medical card system in the future.

On Study of the Standardization for Medical Information in Health IC Card / 대한의료정보학회지

Using IC cards with powerful information processing capabilities, high level of security, and multi media capabilities to create health IC cards has the following merits: comprehensive management of individual medical information, highly secure access to information that may be stored in separate location and/or institutes, increasing the compatability of difference used by various institutes. In this research ,we have categorized the information stored in the health IC card into the following main categories: basic personal information, emergency medical information, medical informatics, nursing information, welfare information. This was based on international ISO standards and specifics of Japan and south eastern Asia. These main categories are further divided into sub-categories and care was taken to ensure that the format of each sub-category is compatible with international standards while being suitable for Koran conditions of actual use. So, these categories conform to international standards and we will continue our efforts update the international standard to include additional categories needed in Korea and update the Korea standard to conform more closely with the international standards.

Mucormycosis in Leukemic Children

PURPOSE: Mucormycosis is an opportunistic fungal infection caused by one of the ubiquitous fungi of the order Mucorales, occurring almost exclusively in immunocompromised hosts such as patients with diabetes, leukemia and lymphoma. Recently the incidence of mucormycosis is rising associated with the increasing predisposing factors such as cytotoxic drugs and immunosuppressive agents. Though mucormycosis is frequently fatal, there has been a dramatic improvement in outcome by early diagnosis and aggressive treatment. The aim of this study is to investigate the clinical characteristics of mucormycosis developed in leukemic children. METHODS: Clinical characteristics of mucormycosis was analyzed by retrospective review of 6 patients diagnosed as mucormycosis during chemotherapy of acute leukemia at the Seoul National University Children's Hospital from May 1990 to May 1995. Diagnosis was confirmed by the pathologic examination of the biopsy specimens from the involved site. RESULTS: 1) The age distribution ranged from 7 to 15 years. Three patients were male and 3 were female. 2) At the onset of mucormycosis all six patients were under the cytotoxic chemotherapy with resultant neutropenia. Four of 6 patients received large doses of corticosteroids and 2 of 6 patients were receiving broad-spectrum antibiotics intravenously. 3) Of the 6 cases of mucormycosis, 5 cases were of the type involving a particular body site(rhinocerebral in 3 patients, gastrointestinal in 1 and laryngeal in 1) and 1 case was of the disseminated type. In a case of rhinocerebral type, the orbit as well as paranasal sinuses were involved and in the case of disseminated type, the lung, skin and muscle were invaded by the fungi. 4) Except one case(gastrointestinal type) in which complete resection of lesion was possible, amphotericin B was administrated for at least two months in combination with rifampin. Surgical resection was done in 4 cases. In a case who expired during medical treatment and the other one who was almost cured with medical treatment alone, surgery was not done. 5) Of the 6 cases, mucormycosis was cured in 3 cases and recurred in 1 case despite initial improvement. Two cases expired -one who showed almost complete improvement but expired due to bacterial sepsis during the following chemotherapy, and the other who showed little improvement with persistent neutropenia and expired due to septic shock. CONCLUSIONS: In the immunocompromised patients including acute leukemia, mucormycosis should be considered as a possible complicating condition, and early diagnosis and aggressive treatment may improve the survival and outcome.