ERP System Performance in a Hospital / 대한의료정보학회지

OBJECTIVE: To measure the performance of a hospital enterprise resource planning (ERP) system and suggest various system improvements. METHODS: A survey based on a 5-point Likert scale questionnaire and an exclusive interview was administered to 102 employees with a one-year experience of using an ERP system at one university hospital. In order to analyze the factors affecting the ERP system performance, multiple regression analysis and Chi-square test were conducted. RESULTS: All three examined variables-system quality, information quality and integration of hospital information resources-affected the ERP system performance positively. However, the system quality variable had the lowest mean score indicating that the ERP system was difficult to understand for many users. User characteristics were not significantly associated with information quality satisfaction. CONCLUSION: On the basis of the study results, we recommended some suggestions to improve the ERP system performance. In order to reduce users' dissatisfaction with the new system, hospitals should publicize the needs of the ERP system for the employees, design more effective training programs, and provide more decision-supporting information for managers.

The Clinical Significance of VEGF and TGF-beta Expression in Osteosarcoma / 대한정형외과학회잡지

INTRODUCTION: The transforming growth factor-beta (TGF-beta ) is a multipotent glycoprotein that has been implicated in tumor development. The vascular endothelial growth factor (VEGF), which is an endothelial-specific mitogen that is overexpressed in various malignancies, is believed to be a potent regulator of angiogenesis. Osteosarcoma was examined to determine firstly, if VEGF and the TGF-beta isoform were overexpressed in this sarcoma, and secondly, if the degree of expression might represent a significant biologic predictor for disease-specific survival. MATERIALS AND METHODS: Selected paraffin-embedded tissues of surgical specimens from 25 patients of prechemotherapy case with osteosarcoma, who were treated between 1995 and 2001 were stained with rabbit polyclonal anti-VEGF and TGF-beta isoform antibodies. RESULTS: The majority of high-grade osteosarcomas in this study had a high intensity TGF-beta 2, - 3 and VEGF expression levels. The three in 5 patients who died of the disease had a high VEGF expression level. However VEGF expression was only independent predictor of overall survival. CONCLUSION: Further studies about TGF-beta and VEGF may provide useful information for understanding of pathophysiology of osteosarcoma.

The Results of Spinous Process-splitting Laminoplasty Using Heterograft Spinous Process Spacer / 대한정형외과학회잡지

PURPOSE: To assess the effectiveness and safety of heterograft spacer (Lubboc) as a substitute for autograft in cervical laminoplasty. MATERIALS AND METHODS: 21 patients with cervical myelopathy were treated by spinous process splitting laminoplasty using heterograft intraspinous spacers. The clinical and the radiographic evaluations were checked pre- and postoperatively. RESULTS: The average JOA score was increased from 8.7 preoperatively to 12.9 at the final follow-up with a average recovery rate of 60.6%. Preoperative spinal canal diameter, 14.7 +/- 1.4 mm were improved to 20.1 +/- 1.8 mm postoperatively and canal to body ratio, 0.75 +/- 0.10 to 1.02 +/- 0.11 in average. The intraspinous spacer, heterograft demonstrated fragmentation and partial resorption mainly at the level of C3, 4, 5 from postoperative 2 months, but showed no clinical deterioration in spite of radiographic changes of heterograft. CONCLUSION: We think that heterograft spacer is one of the safe and effective substitutes for autograft in maintaining the improved postoperative radiographic indeces.

The Results of Anterior Screw Fixation in Odontoid Fractures: Comparison of the Results on the Number of Screws / 대한척추외과학회지

STUDY DESIGN: A retrospective study was performed in 22 cases undergoing anterior screw fixation for type II odontoid process fracture. OBJECTIVES: To determine the utility of anterior screw fixation for type II odontoid process fracture and assess the influence of several factors including the number of screw on results. SUMMARY OF BACKGROUND DATA: There are few data on the surgical results of type II odontoid process fracture in Korea. MATERIALS AND METHODS: Between Jan. 1987 and Jan. 1997, 24 patients were operated by anterior screw fixation for the type II odontoid process fracture, but 2 patients were lost to follow-up and we analyzed 22 patients with average 68 month followup(range: 24~142 months). Nine patients were operated by anterior fusion using one screw(group I) and 13 patients using two screws(group II). There were 19 fresh odontoid fractures, 3 delayed union preoperatively. The amount of correction of initial displacement and angulation, bone union and perioperative complications were selected as assessment criteria. Eric and James' functional outcome scale was used for the functional results. The statistical analysis using the two-way ANOVA and chisquare test was performed. RESULTS: In clinical results, excellent functional outcome were obtained in 6 cases of group I and 10 cases of group II, while good functional outcome in 3 cases of group I and 3 cases of group II according to Erric and James' criteria(p=0.477). There was no case with fair or poor results in both groups including nonunited case. In radiological results, union rate was 86.4%(19 patients) totally, 67%(6 patients) in group I and 100%(13 patients) in group II retrospectively(p=0.045). The mean time to fusion was 11.3 weeks in all cases and there was no difference between both groups(p=0.521). In all cases, reduction rate was 4.0mm(displacement in lateral view), 1 . 5degree(angulation in lateral view), 1.5degree(angulation in open mouth view) postoperatively, being 5.7mm, 2.5degree, 2.8degreein group I and 3.6mm, 3 . 8degree, 0.6degreein group II. There was no significant differences between both groups(p=0.164, p=0.794, p=0.235). SUMMARY: Anterior screw fixation was clinically and radiologically reliable surgical treatment option for type II odontoid process fracture. Speaking of the number of screw used in anterior screw fixation, two screw group showed better results in union rate.

Prevalence of Cerebral Palsy in Neonates with Risk Factors

The purpose of this study was to investigate the prevalence of cerebral palsy among neonates with risk factors and the relationship between cerebral palsy and risk factors. Among 6,220 neonates who were born in Yonsei University Hospital between January 1, 1990 and December 31, 1992; 699 neonates had more than one risk factors which were prematurity, low birth weight, perinatal asphyxia, and hyperbilirubinemia. This study comprised 361 neonates with risk factors who could be followed up to 1 year of age. The prevalence of cerebral palsy was 4.7% and the prevalence of delayed development was 2.5%. Among 264 cases with a prematurity, 15(5.7%) cases were diagnosed as cerebral palsy. Among 239 cases with a low birth weight, 12(5.0%) cases were diagnosed as cerebral palsy. Among 228 neonates with an APGAR score below 7 point in 1 minute, 16(7.0%) cases were diagnosed as cerebral palsy and among 79 neonates with an APGAR score below 7 point in 5 minute, 9(11.4%) cases were diagnosed as cerebral palsy.