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PubMed2006

Standardization of Korean nursing terminology.

Korean nursing terminology was standardized to improve sharing and exchange of nursing data and information. English nursing terms were collected from existing nursing terminology, journal articles, nursing records, text books, and nursing/medical dictionaries, translated into Korean and were tested for their validity. More than 9000 terms were standardized and published on a website for further feedback from the users. This study will contribute to communication within the nursing community and with other health care professionals.

Humans↗
PubMed2000

Calixarenes in analytical and separation chemistry.

Discovered in the 1940's, [1n]metacyclophanes with the common name calix[n]arenes which is derived from for the molecule's shape enjoyed a remarkable interest in almost all fields of chemistry since the 1980's, which is highlighted by several books [1-8]. Over 50 reviews concerning their synthesis, properties and applicabilities were published, many of those with emphasis on organic synthesis and structural properties are cited in [P. 5-6 in 2]. Of interest for analytical chemists are reviews on calixarenes and the structurally related resorcin[n]arenes (or calix[n]resorcarenes) and calixpyrroles concerning potentiometric sensors [9-12], chromo- and fluorophores [13, 14], molecular switches [15], metal ion binding in solution [16-19], redox properties [20] and anion binding [21-24]. Other recent reviews deal with thermodynamic aspects [25], organometallic compounds [26], P-containing calixarenes [27-29], as well as molecular dynamics modeling [30-33]. It is a vital field with over 200 publications per year. Therefore, this article presents only selected results on complexation, solvent extraction and membrane transport with the emphasis on ion and molecular recognition which can be used for analytical purposes, without attempting to cover all available references.

Journal Article↗
PubMed1994

A new method for practicing exploration, dissection, and simulation with a complete computerized three-dimensional model of the brain and skull.

In current practice, anatomical atlases are based on a collection of planar images presented in a book or, recently, stored on digital media. We present a new kind of interactive true three-dimensional (3D) anatomical atlases based on a volume model derived from MRI and CT. The model has a two-layer structure. The lower level is a volume model with a set of semantic attributes connected to each voxel. The semantic attributes are assigned by an anatomist using a volume editor. THe upper level represents a set of relations between these attributes. Interactive visualization tools such as multiple surface display, preparation of transparent material and cutting are provided. It is shown that the combination of this model with advanced tools for volume visualization provides the 'look and feel' of real dissection. The system therefore represents a bridge between real dissection of a cadaver and textbooks and classical atlases of anatomy. First tests have shown that the atlas system may be used successfully for teaching anatomy, but also as a reference for radiologists or surgeons. The powerful underlying data structure potentially includes all classical visual teaching aids. As a replacement of classical atlases, however, spatial resolution has still to be improved.

Anatomy↗
PubMed1998

Leptin levels in pregnancy: marker for fat accumulation and mobilization?

BACKGROUND: Leptin, an adipose tissue-derived signalling factor encoded by the obese gene has been shown to be present as a 16-kDa protein in the blood of mice and humans. Resistance to leptin occurs in human obesity. Leptin has also been shown to associate with plasma insulin concentrations and there is currently considerable debate about the potential link between insulin resistance and resistance to leptin. In non-pregnant individuals, circulating leptin concentrations associate strongly with both total body fat mass and body mass index (BMI). In normal human pregnancy, the maternal fat stores increase to a peak in the late second trimester, before declining towards term as fat stores are mobilized to support the rapidly growing fetus. Insulin resistance increases during late pregnancy and is believed to be further enhanced in pregnancies complicated by pre-eclampsia. The aim of this study was to examine if leptin levels were altered in pregnancy and, if so, whether the pattern of change in circulating leptin related to previously established changes in fasting insulin concentrations or fat mass. METHODS: We measured third trimester plasma leptin concentrations in 12 uncomplicated pregnant women, nine women with pre-eclampsia matched for age and booking BMI, and 18 non-pregnant women similarly matched. We also examined the longitudinal course of leptin concentrations occurring throughout gestation (from 10 weeks gestation and at five week intervals thereafter), in five normal pregnancies and two women with gestational-onset diabetes. RESULTS: Leptin concentrations were significantly higher in the normal pregnant women (37.1 microg/L, [15.4-117.0], geometric mean, [range]; p=0.049), and women with pre-eclampsia (45.3 microg/L, [21.3-98.4]; p=0.001), than in non-pregnant controls (17.85 microg/L, [1.3-36.5]), however, there was no significant difference between uncomplicated and pre-eclamptic pregnancies (p=0.22). On examination of the longitudinal course of leptin concentrations occurring throughout gestation, in all seven women plasma leptin concentrations initially increased relative to booking (10 weeks) concentrations, but did so by varying amounts (ranging between 30-233%). Significantly, however, in all seven women plasma leptin concentrations peaked at around 20-30 weeks of gestation before declining towards term. CONCLUSION: On the basis of these observations, we postulate that plasma leptin levels increase significantly in human pregnancies and that the pattern of change in circulating leptin parallels the process of fat accumulation and mobilization.

Adult↗
PubMed1998

The vital few meet the trivial many: unexpected use patterns in a monographs collection.

PURPOSE: To test three related hypotheses about monographs circulation at academic health sciences libraries: (1) Juran's "Vital Few" Principle, sometimes incorrectly referred to as the "Pareto Principle"; (2) most (> 30%) new monographs will not circulate within four years; and, (3) Trueswell's 20/80 rule concerning intensity of monographs circulation. METHODS: Retrospective circulation study conducted at a major academic health sciences library in November 1997 on monographs acquired during 1993, utilizing an online review file. RESULTS: Unexpectedly, most monographs (84%) had circulated at least once in the four years following acquisition. Combining circulation and in-house data revealed that 90.7% of the monographs acquired in 1993 had been used at least once. Small percentages of these monographs produced disproportionately high circulation levels. CONCLUSION: Monographs circulation rates confirm Juran's Vital Few principle. Most monographs circulated at least once in contrast to results reported by the Pittsburgh Study or other studies reported by Hardesty and Fenske. The results do not comply with Trueswell's 20/80 ratio rule. Further research needs to investigate the effects of low students to books ratios and problem-based learning (PBL) curricula upon monographs utilization.

Books↗
PubMed1996

[Establishing a clinical information system for surgical ophthalmology and orthopedics specialties with reference to GSG '93].

BACKGROUND: As a result of new health care guidelines (Gesundheitsstrukturgesetz) and the federal hospital and nursing ordinance, there has been a large increase in the documentation required for diagnoses (ICD-9) and service ("Operationenschlüssel nach section 301 SGB V" = ICPM), all of which is done in the form of a numeric code. The method of coding diagnoses is supposed to make possible data entry and statistical evaluation of plausibility controls, as well as conspicuous and random testing of economic feasibility. Our data processing system is designed to assist in the planning and organization of clinical activities, while at the same time making documentation in accordance with health care guidelines easier and providing scientific documentation and evaluation. METHOD: The application MedAccess was developed by clinicians on the basis of a relational client-server database. The application has been in use since June 1992 and has been further developed during operation according to the requirements and wishes of clinic and administrative staff. In cooperation with the Institute for Medical Information Technology, a computer interface with the patient check-in system was created, making possible the importing of patient data. The application is continuously updated according to the current needs of the clinic and administration. The primary functions of MedAccess include managing patient data, planning of in-patient admissions, surgical planning, organization, documentation (surgery book, reports with follow-up treatment records), administration of the tissue bank, clinic communications, clinic work processing, and management of the staff duty roster. RESULTS: Clinical data are entered into a computer and processed on site, and the user is assisted by practical applications which do not require special knowledge of data processing or encoding systems. The data is entered only once, but can be further used for other purposes, such as evaluations or selective transfer, for example, to clinical documents. Through an integrated flow of data, information entered one time remains readily available, while, at the same time, preventing duplicate entries. The integration of hardware and software via a mainframe computer (clinic system WING) has proven to be well-suited for the exchange of data. CONCLUSION: The use of this thesaurus-supported and graphics-oriented system required no special knowledge of the ICD code and makes documentation much easier to produce. The advantages of computer-supported encoding not only include a savings in time, but also an improvement in the quality of the encoding from which clinical and scientific reports can be derived. The relational client-server, operating in a graphics-supported programming environment, makes it possible for the clinic's doctors to further develop and improve the system. Through the installation and support of a Macintosh network, and training of doctors, medical personnel and clerical staff, cost as well as investment of time have been kept to a minimum in comparison to other LAN servers.

Data Collection↗
PubMed1992

LIPIDAT: a database of lipid phase transition temperatures and enthalpy changes. DMPC data subset analysis.

The systematic study of the mesomorphic phase properties of synthetic and biologically derived lipids began some 30 years ago. In the past decade, interest in this area has grown enormously. As a result, there exists a wealth of information on lipid phase behavior, but unfortunately these data have until now been scattered throughout the literature in a variety of books, proceedings and journals. The data have recently been compiled in a centralized database, LIPIDAT, with a view to providing ready access to the data and to the appropriate literature. LIPIDAT consists of a tabulation of all known mesomorphic and polymorphic phase transition temperatures and enthalpy changes for synthetic and biologically-derived lipids in the dry and in the partially and fully hydrated states. Also included is the effect of pH, and of salt and metal ion concentration and other additives such as proteins, drugs, etc., on the thermodynamic values. The methods used in making the measurements and the experimental conditions are reported. Bibliographic information includes comprehensive literature referencing and list of authors, but does not at the present time include article titles. As of this writing, the database is current through June, 1990 and is approaching 10,000 records in length. Each record contains 28 fields. In this paper we report the contents and present an analysis of LIPIDAT as it refers to fully hydrated 1,2-dimyristoyl-sn-glycero-3-phosphocholine (DMPC). This database subset represents about 7% of all LIPIDAT records. It includes data collected over a 23-year period from 1967 to 1989 and consists of 702 records obtained from 336 articles in 55 different journals. The number of records per year rises steadily beginning in 1971, reaches a maximum of 89 records/year in 1977 and remains relatively constant at 60-70 records/year in the succeeding period. Journals making the greatest contribution to the DMPC subset include Biochimica et Biophysica Acta, Biochemistry, Chemistry and Physics of Lipids and the Biophysical Journal. These four journals account for 71% of the total records in the database subset. The analysis shows that differential scanning calorimetry, electron spin resonance, fluorescence, nuclear magnetic resonance and Raman spectroscopy are the methods most commonly used for DMPC transition temperature determination. An interesting pattern emerges as to the place in time the different methods assume or loose popularity.(ABSTRACT TRUNCATED AT 400 WORDS)

Calorimetry, Differential Scanning↗
PubMed1996

Reduction of false-positive diagnosis of fetal growth restriction by application of customized fetal growth standards.

OBJECTIVE: To evaluate the clinical performance of fetal growth charts adjusted for individual maternal characteristics. METHODS: The study group consisted of 267 low-risk singleton pregnancies with normal clinical outcome. Mothers were recruited prospectively after the booking visit, then underwent three to five ultrasound examinations for fetal weight estimation. Individual growth curves were generated from these data and the birth weight, based on logpolynomial growth model. Computer software was written to calculate the number of fetal growth curves that cross the tenth percentile limit, based on an unadjusted, average ultrasound standard for our population, compared with the number that cross this limit if it is customized for known pregnancy characteristics such as maternal height, booking weight, parity, and ethnic group. RESULTS: Individual growth trajectories of this group of pregnancies with normal outcome were significantly less likely to cross below the tenth percentile for fetal weight when using customized growth charts than when the unadjusted standard was used (McNemar's test, P < .001). CONCLUSION: The relationship between maternal characteristics and fetal size needs to be considered in the assessment of fetal growth. The use of a customized standard reduces the false-positive rate for the diagnosis of growth restriction in a normal population.

Adult↗
PubMed1998

[Clarification of Amae as a concept--response to the criticism by K. Nagayama].

Nagayama wrote a lengthy paper in order to demonstrate that the amae theory which I propounded is all confused. I should say on the contrary that the confusion is his own because he dose not realize that he and I may mean different things by the same word amae. Apparently he means those phenomena that indicate the fulfilment of amae, while I take amae as a verbnoun of amaeru meaning the operation of amaeru in one way or another irrespective of the outcome, its prototype being that of an infant seeking its mother. In short, for Nagayama amae is a characteristic of certain Japanese phenomena and for me a concept. It may refer, in psychoanalytic thinking, to that primordial urge for object relations. It makes no sense therefore to censure my wording of amae like 'narcissistic amae' as not measuring up to the true state of amae as Nagayama defines it, because my usage of the word amae is entirely different from his. In this connection I may point out a curious resemblance between the dismissive manner of his criticism and the behavior of a small group embodying amae which he characterizes as distinctly exclusive of outsiders. There is a good reason to believe that the resemblance is not accidental. I must say that Nagayama is most confused in his critical appraisal of the amae theory against Balint's theory. He completely ignores the fact that these two theories developed independently though there is a definite parallel between them. He then takes me to task that I did not properly incorporate Balint's late ideas into my thinking, even though those ideas became known only in the books published after that book of mine which is the butt of his criticism. Nagayama attempts to trace the amae phenomena back to some racial unconscious underlying Japanese culture. He may believe so, but it sharply contrasts with my view that the very availability of such a concept like amae is indicative of the tenor of Japanese culture. It is interesting to note here that all critics of the amae theory including Nagayama stumble on amae as a concept. They just cannot imagine that one can fetch a Japanese word and make it a universal concept. It must be their unspoken belief that all the valid concepts in whatever field of study come from abroad, notably the West.

Cultural Characteristics↗
PubMed1997

[The sphygmograph in England (1860-1900). How a physiological instrument entered medicine].

Stuart Blume, in his 1992 book Insight and industry. On the dynamics of technological change in medicine, designed his model for the development of twentieth century imaging devices. The development of instruments, according to Blume, is divided into four stages: exploration; development; diffusion, evaluation and assessment; and feedback. The central question in this article is whether Blume's model can be applied to the nineteenth century context of the increasing use of diagnostic instruments, related to the 'scientification' of medicine. A case study of the sphygmograph shows that in the nineteenth century a considerable overlap in time can be found between the different stages. Nevertheless, most of the characteristics of these stages do correspond to the nineteenth century situation. Therefore it is suggested to replace the stages model with a spiraled model, in which four elements of development play a part: new ideas, experiments, construction of prototypes and publication of the results. Besides, the different whirls should not be subdivided according to the disciplines in which the technique was used, but with reference to the amount of specialisation occuring around the instrument. The development would then be described from an amateur's workshop to respectively an experimental physiological laboratory, an instrumentmaker's workshop, and an experimental medical practitioner. Subsequently the level changes to that of an established laboratory, a commercial producer and a more or less specialised medical practice. Through these stages other long-term constituent processes take place. Advantage of this model is that its basic categories--ideas, experiments, construction of prototypes, publication of results--can be extended with subcategories at any level if the social situation demands this.

Equipment and Supplies↗
PubMed1995

[Image data bases and multimedia works on server and CD-ROM in medical imaging. A French experience].

The CD-ROM technology allows the production of multimedia works which costs far less than books do. The creation of Internet and the servers World Wide Web has the advantage of distributing those works world wide, without the difficulties and the delays related to books and magazines distribution. The Teachers' Council of Radiology of France (CERF) and the French Society of Radiology (SFR) have opted to use these new media and these information highways to spread a part of their radiology teaching work. Iconocerf is a software program which allows to create, store, read and to exchange digitized radiological cases. It's available free of charge, within the CERF and SFR. The CD-ROMs Iconocerf-Medimag contain 3,500 radiological files with 15,000 images, previously on the videodisc Medimag. The Server of the French Radiology is a W3 server which includes: the CERF directory, a guide for the teachers, the research workers and the students in Radiology and Medical Imaging. It also contains the teaching works on Radiology, and some Iconocerf clinical cases translated onto HTML. The aim of this project is to create an evaluation system for radiology. By using key words, this system allows to consult: radiological clinical cases, located on the server or on CD-ROMs; reference texts; and to have access to the experts' addresses to be able to send them eventually a difficult case through electronic mail.

CD-ROM↗
PubMed2004

Extemporaneously compounded sterile medications: relevance of new United States pharmacopeial standards to pain clinicians.

The United States Pharmacopeia (USP) is the United States' congressionally authorized book of standards for pharmaceutical manufacturing in the United States. The most current edition of the USP includes a new chapter entitled Pharmaceutical Compounding-Sterile Preparations that sets standards for all health care professionals who prepare, store or dispense sterile preparations. Extemporaneously compounded sterile formulations are sometimes needed for symptom control in pain and palliative practice. The implications and relevance of this new USP chapter to pain and palliative care clinicians-and the importance of all clinicians understanding the implications of how their patient's compounded sterile products are prepared-are discussed.

Drug Compounding↗
PubMedDate not supplied

A death with dignity in Oregon.

PURPOSE/OBJECTIVES: To inform readers about the Oregon Death With Dignity Act and present a compilation and summary of major arguments in debates regarding physician assistance in dying for the terminally ill. DATA SOURCES: Experience, medical records, the patient's physician and family, books, periodicals, legislative documents, and publications. DATA SYNTHESIS: The Oregon Death With Dignity Act became a legal option for terminally ill Oregon residents in October 1997. Persuasive psychological, theological, philosophical, and pragmatic arguments protest the Act as being irrational, immoral, contrary to medical ethics, and dangerous. Equally persuasive arguments advocate the Act as rational, moral, consistent with the practice of healing, and safe. CONCLUSIONS: Physician assistance in dying is a legal option for terminally ill patients in the State of Oregon. For such a practice to be "out of the closet," as well as legal, is novel. The debate about the appropriateness of this Act revolves around values and beliefs that are seasoned and cherished. IMPLICATIONS FOR NURSING PRACTICE: As the practice of the terminally ill requesting physician assistance to die moves into the realm of a rational patient choice and legal physician action, nurses increasingly will be faced with having to deal with their own beliefs, attitudes, and emotions regarding this issue. Nurses cannot hide behind glib responses, quick referals, institutional policies, or organizational standards to cover their own discomfort or confusion. They must discuss and formulate an understanding of healing and caring in situations that may challenge their core values.

Aged↗
PubMed1998

Electroencephalographic and psychometric differences between boys with and without attention-deficit/Hyperactivity disorder (ADHD): a pilot study.

Attention-Deficit/Hyperactivity Disorder (ADHD) is reported to have an incidence of 3-5%, and is associated with a variety of interpersonal, academic, and social problem behaviors. There is controversy as to whether ADHD is a learned behavioral or brain dysfunction. Research has explored a variety of measures to assess behavioral and brain dysfunctions in this population, with no consistent and clearly diagnostic results. We investigated whether a new psychometric and a new electroencephalographic procedure would clearly differentiate ADHD. The psychometric was based on DSM-IV criteria and the EEG measure was based on the assumption that ADHD interferes with cognitive transition from one discrete task to another. Parents of four ADHD boys (ages 8-12) and four age- and interest-matched non-ADHD boys completed the ADHD Symptom Inventory, while their sons' EEG was monitored during viewing of a video and reading of a book. For the ADHD boys, this was repeated a second time, 3 months later, to assess test-retest reliability. Both the psychometric and the EEG measures clearly differentiated the two samples (p's < .01) with no overlap in scores, were reliable over 3 months (r = .87), and were significantly correlated with one another (r = .85). While a small sample size, these robust, related and reliable findings suggest that both the psychometric and the psychophysiological EEG measures deserve further replication and exploration.

Attention Deficit Disorder with Hyperactivity↗
PubMed2003

Customizing fetal biometric charts.

OBJECTIVE: To study the effects of maternal and pregnancy characteristics on fetal biometric size using longitudinal ultrasound measurements and to construct customized models for fetal biometric size charts. METHODS: A cohort of 533 healthy pregnant women with normal singleton pregnancies were recruited for regular ultrasound examination for fetal biometry between 24 and 40 weeks' gestation. Multilevel modeling was used to construct models of fetal head size, femur length and abdominal circumference. Variables of maternal and pregnancy characteristics including booking weight and height, age, parity and fetal sex were included in the construction of the customized fetal biometric size charts. RESULTS: Increased fetal head size and abdominal circumference were significantly associated with extremes of maternal age. Maternal height had a statistically significant influence on biparietal diameter. Maternal booking weight had an influence on fetal abdominal circumference and femur length. Fetal sex was found to have a statistically significant influence on the final regression models of biparietal diameter, head circumference and femur length. Parity had an influence on fetal head circumference and abdominal circumference. CONCLUSIONS: Maternal and pregnancy characteristics have a significant influence on in-utero fetal biometry. We produced models to construct customized fetal biometric size charts. Further validation studies are necessary to evaluate the clinical usefulness of such customized fetal biometric size charts.

Adult↗
PubMed1995

Intrauterine growth retardation.

IUGR puts the fetus at risk of stillbirth, perinatal morbidity and neonatal handicap, yet most instances of IUGR are not recognized. Progress has been made in recent years to monitor the high-risk fetus with intensive biometric and biophysical tests and to determine the appropriate time for intervention. These methods of surveillance are ineffective and inappropriate for population screening, and the main problem remains how to identify the at-risk fetus. Improvement of current performance requires the establishment of appropriate standards by which intrauterine growth can be assessed, and their introduction as part of well-organized screening programmes. We describe a computerized method of predicting the optimal weight for each pregnancy, which is individually adjusted for non-pathological variables such as maternal height, booking weight, ethnic group and parity. The optimal birthweight determines the expected slope or velocity of fetal weight gain. This individualized prediction improves the distinction between constitutional and pathological smallness. Furthermore, preterm weights are measured against a fetal weight norm rather than a birthweight standard that is derived from non-physiological preterm deliveries. The customized growth chart allows screening for growth retardation by determining the growth velocity through serial measurement and plotting of fundal height, backed up as necessary by ultrasound estimation of fetal weight and referral for more intensive surveillance as indicated.

Anthropometry↗
PubMed2000

[In vivo test for endocrine disruptors].

The Endocrine Disruptor Issue has been brought up widely to the public by a book titled "Our stolen future"(Theo Colborn et al., 1996), in which the reproductive impairment of a variety of wild life was documented in relation to chemical exposures. The fear that the similar adverse effects could have been observed in humans is based on the understandings that estrogens and androgens are highly conserved signaling molecules among species. In addition, the estrogen receptors are known to have abilities to bind a variety of chemicals. Although such chemicals bind weakly to the receptor, it is also known that, at least in some assay systems, high concentration of these chemicals can elicit effects that are quite similar to those of the natural hormones. Thus, such "hermonally active agents, HAAs" can be ligands to the hormone receptors in an organism, and may cause adverse effects, namely the "receptor-mediated toxicity", which is a relatively new concept in the field of toxicology. This new aspects of toxicology is briefly discussed in relation to the reversible/irreversible effects in developing organisms and the shape of dose-response curves, both especially in the low-dose ranges, now often referred to as "low-dose effects".

Animals↗
PubMed2000

Development of a customised birthweight standard for ethnic Chinese subjects.

A model to establish customised birthweight standards for the Chinese population was developed, using data from a cohort of 1564 Chinese women with normal singleton pregnancies. Multiple regression analysis was performed using maternal height, weight, parity, gestation at delivery and fetal sex as independent (predictor) variables. From this, a customised ideal birthweight for each baby can be estimated, and the normality of the actual birthweight can be evaluated according to this, rather than from population standards. The results of this study show that birthweights are strongly influenced by maternal characteristics, confirming conclusions from similar studies in other ethnic populations. The overall mean birthweight at 280 days of gestation was 3252 g, which was smaller than that of the Caucasian population. Birthweight increased with maternal height (5.1 g/cm), maternal booking weight (10.2 g/kg) and gestation at delivery (18.3 g/day from 280 days). Babies from women who had two previous deliveries weighed 145.2 g more than the nulliparous. Male babies were 84.8 g heavier than females. Adjustment using these results produces a customised ideal birthweight for each baby. When compared with population based standards, customised birthweight standards identified significantly fewer small for gestational age (SGA - birthweight below 10th centile, McNemar Chi square = 19.1, p < 0.01) and fewer large for gestational age (LGA - birthweight above 90th centile, McNemar Chi square = 23.7, p < 0.01) cases.

Asian People↗

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