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Purpose: It is useful to convert free-text diagnostic reports into structured diagnostic reports by semantic analysis for the secondary investigation of their contents. In this study, we propose a system in which description units are automatically extracted to create structured text reports and we evaluated its usefulness. Methods: We defined the rules to create description units and developed the system that can automatically extract these description units from free-text diagnostic reports. We applied this system to reports of cerebral perfusion scintigrams and obtained 5 dictionaries of description units, increasing the number of scintigrams from 100 to 500 in increments of 100. Each dictionary was used to analyze another 100 scintigrams. The results obtained using each dictionary were compared with the results of physicians' interpretation. Results: The recall rate of this system to the physicians' interpretation increased when correlated with the number of scintigrams but with 300 cases was almost saturated at 85%. Conclusion: We propose a semantic analysis system and show its usefulness in the semantic evaluation of the reports of cerebral perfusion scintigrams. [ABSTRACT FROM AUTHOR]

Gene transfer targeting interstitial fibroblasts by the artificial viral envelope-type hemagglutinating virus of Japan liposome method. Background. Tubulointerstitial inflammation and fibrosis are commonly associated with most human glomerular diseases. The degree of tubulointerstitial damage, rather than the glomerular injury, could correlate with the degree of renal functional impairment and accurately predict long-term prognosis. In an effort to understand the pathogenesis of the progressive interstitial fibrosis, we developed a new strategy of gene transfer to the interstitial fibroblasts. Methods. Either fluorescein isothiocyanate (FITC)-labeled oligodeoxynucleotides (ODNs) or pEBAct-NlacF expression vector was introduced into the kidney of normal rats retrogradely via ureter by using the artificial viral envelope (AVE)-type hemagglutinating virus of Japan (HVJ) liposome method. Results. FITC-labeled ODNs were accumulated diffusely in the nuclei of the interstitial cells in the transfected kidney 10 minutes after transfection, and the interstitial cells were identified as interstitial fibroblasts by immunostaining with ER-TR7. To examine the gene expression in the interstitium, pEBAct-NlacF gene-conjugated HVJ liposome was injected retrogradely through the ureter, and in consequence, nuclear β-galactosidase activity was continuously observed in interstitial cells at least two weeks after transfection. Conclusion. This new strategy of gene transfer to the interstitial fibroblasts is useful for the investigation of the pathophysiology of tubulointerstitial lesion, and furthermore, it may be a promising new therapeutic method for the progression of interstitial fibrosis. [ABSTRACT FROM AUTHOR]

We have developed a data archiving system for study of charged particle therapy. We required a data-relation mechanism between electronic medical record system (EMR) and database system, because it needs to ensure the information consistency. This paper presents the investigation results of these techniques. The standards in the medical informatics field that we focus on are Integrating the Healthcare Enterprise (IHE) and 2) Health Level-7 (HL7) to archive the data. As a main cooperation function, we adapt 2 integration profiles of IHE as follows, 1) Patient Administration Management (PAM) Profile of IHE-ITI domain for patient demographic information reconciliation, 2) Enterprise Schedule Integration(ESI) profile of IHE-Radiation Oncology domain for order management between EMR and treatment management system(TMS). We also use HL7 Ver2.5 messages for exchanging the follow-up data and result of laboratory test. In the future, by implementation of this system cooperation, we will be able to ensure interoperability in the event of the EMR update.

Our hospital is specialized for radiation therapy and has many information devices. Various job categories are working. When we implemented an EMR, we aimed to enforce ISMS by using IHE profiles. To solve the already existed system-related problems, we selected and use some profiles (EUA, PSA, ATNA and PAM). After implementation, we audited and then some findings were pointed out. These findings are being settled by the PDCA cycle. We also found that appropriate IHE profiles were effective in the building of ISMS.

The Patient Location Tracking Query (PLQ) is the IHE integration profile in order to find the location of patient only in a hospital, not for cross-referencing between multiple hospitals. In Japan, it is common for elderly patients to consult multiple departments in one hospital visit. To find the location of patients quickly is very important for productivity and use of resources in a hospital. We analyzed the workflow of patients and defined three actors and two transactions for PLQ integration profile. In order to collect the location of patients, multiple systems must provide the location into central management system. We proposed PLQ for the better patient care in hospitals. We believe that by using this PLQ profile hospital staffs are able to utilize the resource more efficiently.

A 65-year-old-man complained of coughing and fever. The urine showed microscopic hematuria. The level of myeloperoxidase anti-neutrophil cytoplasmic antibody (MPO-ANCA) was 167 EU. Two months later, he was admitted to our hospital with pulmonary hemorrhage and progressive renal dysfunction. He was treated with intravenous methylprednisolone followed by oral prednisolone with plasma exchanges, and his first pulmonary hemorrhage was relieved. Three weeks later, he suffered from a second diffuse pulmonary hemorrhage with central nervous system symptoms. He was treated again with intravenous methylprednisolone, plasma exchanges, and also intravenous pulse cyclophosphamide (IVCY), but he died of respiratory failure. Autopsy findings revealed microscopic polyangiitis (MPA)in the brain as well as in the lung, kidney and gastrointestinal system. The histopathological findings suggested that cerebral nervous system symptoms could have been caused by brain vasculitis in this case.

Purpose: It is useful to convert free-text diagnostic reports into structured diagnostic reports by semantic analysis for the secondary investigation of their contents. In this study, we propose a system in which description units are automatically extracted to create structured text reports and we evaluated its usefulness., Methods: We defined the rules to create description units and developed the system that can automatically extract these description units from free-text diagnostic reports. We applied this system to reports of cerebral perfusion scintigrams and obtained 5 dictionaries of description units, increasing the number of scintigrams from 100 to 500 in increments of 100. Each dictionary was used to analyze another 100 scintigrams. The results obtained using each dictionary were compared with the results of physicians' interpretation., Results: The recall rate of this system to the physicians' interpretation increased when correlated with the number of scintigrams but with 300 cases was almost saturated at 85%., Conclusion: We propose a semantic analysis system and show its usefulness in the semantic evaluation of the reports of cerebral perfusion scintigrams.