Acute Vulvar Ulcer (Lipschutz Ulcer) in a Sexually Inactive 11-Yearold Girl / 이화의대지

Non-sexually acquired genital ulceration, also known as Lipschutz ulcer, is a rare condition that typically occurs in prepubertal and pubertal girls. It can be misdiagnosed as a sexually transmitted disease or even a sign of child abuse, causing great anxiety for patients and their families. It is often accompanied by systemic symptoms such as fever, myalgia, or lymphadenopathy. Several viruses such as Epstein-Barr virus, cytomegalovirus, and mumps virus have been associated with this entity. Furthermore, Mycoplasma pneumonia has rarely been linked to such ulcers in the literature. We present a case of Lipschutz ulcer in a sexually inactive 11-year-old girl.

Acute Vulvar Ulcer (Lipschutz Ulcer) in a Sexually Inactive 11-Yearold Girl / 이화의대지

Non-sexually acquired genital ulceration, also known as Lipschutz ulcer, is a rare condition that typically occurs in prepubertal and pubertal girls. It can be misdiagnosed as a sexually transmitted disease or even a sign of child abuse, causing great anxiety for patients and their families. It is often accompanied by systemic symptoms such as fever, myalgia, or lymphadenopathy. Several viruses such as Epstein-Barr virus, cytomegalovirus, and mumps virus have been associated with this entity. Furthermore, Mycoplasma pneumonia has rarely been linked to such ulcers in the literature. We present a case of Lipschutz ulcer in a sexually inactive 11-year-old girl.

Interaction Between Smoking Cigarettes and Alcohol Consumption on Sexual Experience in High School Students

OBJECTIVES: This study aimed to analyze nationwide representative data from the 11(th) Korean Youth Health Risk Behavior Web-Based Survey to determine whether factors including socio-demographics, smoking and alcohol consumption, were factors related to high school students that had experienced sexual intercourse. METHODS: A total of 33,744 students (17,346 boys and 16,398 girls) in 1(st), 2(nd), and 3(rd) grade at high school were analyzed. SPSS complex samples methods were used for analyses. Socio-demographic and health risk behaviors (type of region of residence, family structure, and economic status, student academic achievement, gender, high school grade, pocket money, student smoking, alcohol consumption, and having engaged in sexual intercourse) were considered as independent variables. RESULTS: There were 3.6% of girls and 9.9% of boys in high school that were sexually active. This behavior and the average number of cigarettes smoked daily, and alcohol consumed weekly, represented a dose-response relationship, after considering confounding factors. Compared with students that did not smoke or consume alcohol, smoking 1–9 cigarettes per day and consuming 1–6 cups of alcohol and group “smoking more than 10 cigarettes per day and consuming more than 7 cups of alcohol, had a 5.94 and 22.25 higher risk of having had sexual intercourse, respectively. CONCLUSION: Cigarette smoking and alcohol consumption were associated with an increased likelihood of high school students engaging in sexual intercourse.

Analysis of Women's Health Online News Articles Using Topic Modeling

OBJECTIVES: This research aimed to understand the popularity of topics in the field of women's health through analysis of online news articles which were chronologically classified and examined to determine how women's health and diseases had changed over time. METHODS: Women's health and disease news articles were collated from a popular news website between 1993 to 2015 and preprocessed using gynecological medical terminology, Korean words and nouns (excluding general nouns not related to women's healthcare topics). The resultant articles (N = 7,710) were analyzed using the Latent Dirichlet Allocation algorithm and major topics were extracted. Topic trends were analyzed by year and period for women's health. RESULTS: It was observed that most of the women's health articles were focused on “Healthcare”, and 9 other topics were identified that represented a relatively small proportion in 1993–2000. In 2001–2005, most of the articles were focused on “Medical Services” and “Dietary Supplements” with some specific topics that peaked people's interest, as compared to those focused on “Healthcare” in the 1990s. It was also observed that differences in the proportion of each topic was small after 2011. CONCLUSION: Changes in topics related to women's disease were not clearly distinguished in the 1990s but this changed from 2001where articles related to “women disease” appeared as articles on the topics of various diseases.

Effects of Anti-Smoking Public Service Announcements on the Attitudes of Korean College Students toward Smoking

OBJECTIVES: This study aimed to identify the effects of anti-smoking public service announcements on the attitudes of Korean college students toward smoking. METHODS: This study involved students via convenience sampling from seven universities who were randomly assigned to four groups. All groups completed a preliminary questionnaire, before being shown a public service announcement twice, and then completed a post viewing questionnaire. RESULTS: For announcements with positive messages, the proportion of changes in beliefs and attitudes were 39.1% and 19.8%, respectively, whereas those with negative messages showed a greater proportion of changes in the beliefs (59.7%) and attitudes (40.3%). After adjusting for sex and change in belief, the message types and smoking status were identified as factors affecting the change in the participants attitudes. A negative message resulted in a greater change in attitudes (odds ratio [OR], 3.047; 95% confidence interval [CI], 1.847–5.053). Ever-smokers including current smokers showed a greater positive change in attitude than never-smokers (OR, 6.965; 95% CI, 4.107–11.812). CONCLUSION: This study found that positive anti-smoking public service announcements were more effective on attitude change than negative messages. Additionally these announcements were more effective among viewers who were current smokers or had a prior smoking experience.

Application of Queueing Theory to the Analysis of Changes in Outpatients' Waiting Times in Hospitals Introducing EMR / 대한의료정보학회지

OBJECTIVES: This research used queueing theory to analyze changes in outpatients' waiting times before and after the introduction of Electronic Medical Record (EMR) systems. METHODS: We focused on the exact drawing of two fundamental parameters for queueing analysis, arrival rate (λ) and service rate (µ), from digital data to apply queueing theory to the analysis of outpatients' waiting times. We used outpatients' reception times and consultation finish times to calculate the arrival and service rates, respectively. RESULTS: Using queueing theory, we could calculate waiting time excluding distorted values from the digital data and distortion factors, such as arrival before the hospital open time, which occurs frequently in the initial stage of a queueing system. We analyzed changes in outpatients' waiting times before and after the introduction of EMR using the methodology proposed in this paper, and found that the outpatients' waiting time decreases after the introduction of EMR. More specifically, the outpatients' waiting times in the target public hospitals have decreased by rates in the range between 44% and 78%. CONCLUSIONS: It is possible to analyze waiting times while minimizing input errors and limitations influencing consultation procedures if we use digital data and apply the queueing theory. Our results verify that the introduction of EMR contributes to the improvement of patient services by decreasing outpatients' waiting time, or by increasing efficiency. It is also expected that our methodology or its expansion could contribute to the improvement of hospital service by assisting the identification and resolution of bottlenecks in the outpatient consultation process.

Performance Evaluation of Public Hospital Information Systems by the Information System Success Model / 대한의료정보학회지

OBJECTIVES: This study was to evaluate the performance of the newly developed information system (IS) implemented on July 1, 2014 at three public hospitals in Korea. METHODS: User satisfaction scores of twelve key performance indicators of six IS success factors based on the DeLone and McLean IS Success Model were utilized to evaluate IS performance before and after the newly developed system was introduced. RESULTS: All scores increased after system introduction except for the completeness of medical records and impact on the clinical environment. The relationships among six IS factors were also analyzed to identify the important factors influencing three IS success factors (Intention to Use, User Satisfaction, and Net Benefits). All relationships were significant except for the relationships among Service Quality, Intention to Use, and Net Benefits. CONCLUSIONS: The results suggest that hospitals should not only focus on systems and information quality; rather, they should also continuously improve service quality to improve user satisfaction and eventually reach full the potential of IS performance.

Diffusion of Electronic Medical Record Based Public Hospital Information Systems / 대한의료정보학회지

OBJECTIVES: This study was conducted to evaluate the adoption behavior of a newly developed Electronic Medical Record (EMR)-based information system (IS) at three public hospitals in Korea with a focus on doctors and nurses. METHODS: User satisfaction scores from four performance layers were analyzed before and two times after the newly develop system was introduced to evaluate the adoption process of the IS with Rogers' diffusion theory. RESULTS: The 'intention to use' scores, the most important indicator for determining whether or not to adopt the IS in Rogers' confirmation stage for doctors, were very high in the third survey (4.21). In addition, the scores for 'reduced medication errors', which is the key indicator for evaluating the success of the IS, increased in the third survey for both doctors and nurses. The factors influencing 'intention to use' with a high odds ratio (>1.5) were the 'frequency of attendance of user training sessions', 'mandatory use of system', 'reduced medication errors', and 'reduced medical record documentation time' for both doctors and nurses. CONCLUSIONS: These findings show that the new EMR-based IS was well accepted by doctors. Both doctors and nurses also positively considered the effects of the new IS on their clinical environments.

The Role of Microtubule in the Regulation of Endochondral Bone Formation in the Developing Mouse Cranial Base / 체질인류학회지

Endochondral bone formation of the developing cranial base is a complex process. This mechanism requires precise orchestration of many cellular events and cartilage matrix metabolism, such as proliferation, becoming round in shape, termination of proliferation, hypertrophic size-increase, and finally programmed cell death. Active formation and degradation of cartilage matrix take place, in which microtubules are involved for intracellular events; bone apposition follows these events. However, the involvement of microtubules during these changes in the developing cranial base has not been identified yet. Thus, we investigated the involvement of microtubules in the regulation of endochondral bone formation during cranial base development. Using tubulin-binding drug nocodazole, we examined the effects of altering the structure and function of microtubules during in vivo organ culture of the mouse cranial base. Cultured specimens were analyzed with HE staining, immunohistochemistry, and cell counting in order to study the morphological and molecular changes that occurred in the tissues. Disruption of the microtubular array by nocodazole reduced cells expressing proliferation marker Ki67, osteogenic marker BSP, and BMP4 within the sphenooccipital synchondrosis region; chondrocyte hypertrophy was ceased in the hypertrophic zone; degeneration of cartilage matrix and bone matrix apposition was inhibited in the ossification center of the basooccipital cranial base. Our data demonstrated that disruption of microtubules by nocodazole have multiple inhibitory effects on the sequential changes that occur during endochondral bone formation, suggesting the importance of normal microtubule-polymerization in cranial base development.

Point Mutation of Hoxd12 in Mice

PURPOSE: Genes of the HoxD cluster play a major role in vertebrate limb development, and changes that modify the Hoxd12 locus affect other genes also, suggesting that HoxD function is coordinated by a control mechanism involving multiple genes during limb morphogenesis. In this study, mutant phenotypes were produced by treatment of mice with a chemical mutagen, N-ethyl-N-nitrosourea (ENU). We analyzed mutant mice exhibiting the specific microdactyly phenotype and examined the genes affected. MATERIALS AND METHODS: We focused on phenotype characteristics including size, bone formation, and digit morphology of ENU-induced microdactyly mice. The expressions of several molecules were analyzed by genome-wide screening and quantitative real-time PCR to define the affected genes. RESULTS: We report on limb phenotypes of an ENU-induced A-to-C mutation in the Hoxd12 gene, resulting in alanine-to-serine conversion. Microdactyly mice exhibited growth defects in the zeugopod and autopod, shortening of digits, a missing tip of digit I, limb growth affected, and dramatic increases in the expressions of Fgf4 and Lmx1b. However, the expression level of Shh was not changed in Hoxd12 point mutated mice. CONCLUSION: These results suggest that point mutation rather than the entire deletion of Hoxd12, such as in knockout and transgenic mice, causes the abnormal limb phenotype in microdactyly mice. The precise nature of the spectrum of differences requires further investigation.

Data Mining Application for Knowledge Management in Medical Field / 대한의료정보학회지

The purpose of this study are to find useful knowledge through discovering relations and patterns of unknown facts from large data using data mining technique and to introduce a scheme of knowledge management concept in medical field. The application areas of data mining in medical fields include the medical utilization review analysis, disease pattern analysis, analysis related with health promotion and hospital management analysis. Among those areas, we selected the disease pattern analysis and studied on prediction of the diagnosis of hypertension patients. Three data mining techniques of the statistical analysis, decision tree analysis and C4.5 were performed on the health examination data from Korea Medical Insurance Corporation. From the experiments, the levels of importance of factors to hypertension were inferred and the specifications between hypertensive group and normotensive group was classified and identified. These results can be applied not only to the prediction of the diagnosis of hypertension patients but also to the medical decision support system for the management of hypertension. From now on, the data mining techniques that reproduce valuable information to help decision support will provide and be applied to various areas; clinical epidemiological study, useful information of health promotion project, health care policy support information. And the technique will also give the additional efficiency of national projects related health and the realization of scientific health social management resulting the much more national welfare service.