Impact of the automatic rounding-off function of the computerized physician order entry system on the ordering time and dose dispersion of chemotherapeutic drugs in regimens for hematologic malignancies.

INTRODUCTION: EGMAIN-GX is the computerized physician order entry system used in Japan. The automatic rounding-off of the calculated dose of chemotherapeutic drugs is an update in version 4, compared to version 2. We conducted a comparative study between EGMAIN-GX versions 2 and 4 to estimate the effect of the automatic rounding-off function on ordering time and dose dispersion. METHODS: Twelve hematologists ordered 5 predefined chemotherapeutic regimens most commonly used in treating hematologic malignancies, twice for each regimen. RESULTS: EGMAIN-GX version 4 significantly reduced ordering times compared to version 2 (635s vs. 259s, p<0.01). EGMAIN-GX version 4 also yielded a significantly higher ratio of actual to ideal doses of chemotherapeutic drugs than did version 2 (1.0097 and 0.9997, respectively; p<0.01) and a lower standard deviation (0.0275 and 0.0290, respectively). CONCLUSIONS: The automatic rounding-off function could decrease the ordering time and dose dispersion of chemotherapeutic drugs.

Nuclear and chloroplast microsatellite analysis of Abies sachalinensis regeneration on fallen logs in a subboreal forest in Hokkaido, Japan.

Fallen logs are the main regeneration sites for Abies sachalinensis (Sachalin fir) in subboreal forests in Japan. We surveyed the spatial genetic structure of different demographic stages in a 4.29-ha natural population of A. sachalinensis. Genetic structure was significant at short distances throughout all stages in this wind-dispersed conifer. To evaluate the effects of fallen-log-dependent recruitment on demography and spatial genetic structure, we conducted parentage analysis of offspring with highly polymorphic nuclear simple sequence repeat and chloroplast simple sequence repeat markers, and developed a new hierarchical Bayesian model to estimate the effects of mother trees and fallen logs on seed dispersal and offspring recruitment. Combined application of nuclear and chloroplast simple sequence repeat markers allowed us to unambiguously identify mother trees of most offspring (> 90%). Female reproductive success was extremely skewed; a few adults produced most of the offspring on fallen logs. Limited distance of effective dispersal and recruitment was seen in the parentage analysis and modelling estimation. These recruitment characters of A. sachalinensis, with a fallen-log-dependent recruitment process, may result in significant genetic structure in early demographic stages.

Prediction of the ablated area by the spread of microbubbles during radiofrequency ablation of hepatocellular carcinoma.

BACKGROUND/AIM: Radiofrequency ablation (RFA) is effective for the treatment of hepatocellular carcinoma (HCC). To prevent the ablation of adjacent organs and vessels, the spread of microbubbles generated by heating during RFA was observed by ultrasonography (US) and used to predict the ablated area; however, several reports documented that discrepancies existed between the spread of microbubbles and the ablated area. PATIENTS AND METHODS: The spread of microbubbles during RFA was observed by US in 24 patients with HCC and the areas were compared with the defect of enhancement in contrast enhanced (CE)-US, using Levovist in the same plane. RESULTS: During the ablation, the posterior margin was obscure but the border could be visualized 5 min after the ablation. The size of the area of hyperechogenicity 5 min after ablation and that of the defect observed by CE-US was found to correlate (r(2)=0.91, P<0.0001). The shape of the hyperechogenicity corresponded well to the defect area, even in cases showing irregular spread of the microbubbles. CONCLUSION: The observation of microbubbles during RFA can predict the ablated area and might be useful to prevent the unfavorable ablation of adjacent organs and vessels.