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ABSTRACT: Renal relapse in patients with lupus nephritis (LN) is a risk factor for poor renal function. Therefore, there is a need to identify clinical and serological risk factors for renal relapse. A total of 108 patients with LN were enrolled in this study. All the subjects had achieved complete remission or partial remission following six months of induction therapy. We retrospectively analyzed their clinical and laboratory indices, final renal function, and kidney biopsy findings. The median follow-up period after LN diagnosis was 81 months. Renal relapse had occurred in 36 patients; it occurred in 38% and 46% of patients within five and 10 years after achievement of renal remission, respectively. There was no difference between the relapsed rate in patients with complete remission and that in those with partial remission. Clinical variables at LN onset and renal biopsy findings in the patients with sustained remission and relapsed patients were also not different. The probability of renal relapse was significantly higher in patients with an earlier age of onset of systemic lupus erythematosus (SLE) (≤ 28 years versus >28 years; HR 7.308, P = 0.001), seronegativity for anti-Ro antibody (seronegativity versus seropositivity; HR 3.514, P = 0.007), and seropositivity for anti-dsDNA antibody at six months after initiation of induction therapy (HR 8.269, P = 0.001). Our study demonstrated that early onset of SLE, seronegativity for anti-Ro antibody and increased anti-dsDNA antibody following six months of induction therapy independently predict renal relapse among the LN patients.
Lupus 02/2013; · 2.34 Impact Factor
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ABSTRACT: To evaluate the occurrence of idiopathic intracranial hypertension (IIH) in patients with systemic lupus erythematosus (SLE) and to describe the manifestations, treatments and outcomes in these patients.
We reviewed the medical records of 1084 patients with SLE followed up from January 1997 to June 2011 in our unit. We identified patients with IIH and analyzed the demographic, clinical and laboratory characteristics of these patients.
Among the 1084 SLE patients, 47 underwent cerebrospinal fluid studies because of their intractable headache and eight (17%) of these were diagnosed as IIH. All were females aged 14 to 32 years. Nobody belonged to the obesity group. Headache, nausea, vomiting and blurred vision were the most common presenting symptoms. All patients had active SLE at the time of admission (SLE disease activity index ≥6). Five patients had lupus nephritis. In eight patients, there were two with antiphospholipid antibodies, two with anti-ribosomal P antibodies and six with anti-Ro antibodies. All subjects recovered without any complication after high dose steroid therapy.
IIH accounts for a considerable part of the causes of intractable headache in SLE patients and steroids should be considered as a first-line treatment.
Lupus 02/2012; 21(5):542-7. · 2.34 Impact Factor
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ABSTRACT: This paper aims to investigate the efficacy and feasibility of Template-based Electronic Medical Record System (TEMRS) and factors for its successful implementation. A TEMRS was designed and implemented in one core clinic of a Hong Kong professional multi-disciplinary medical services provider with four core clinics located in different parts of Hong Kong. Eight doctors participated in the study. Surveys and interviews were conducted to acquire the users' feedback and satisfaction level. The design, development, and the factors related to the success of the implementation of TEMRS were analyzed. In the study period, 3,032 cases were collected. The most encountered diagnosis were upper respiratory tract infection (50.59%), gastroenteritis (10.19%), dermatitis (5.87%), dyspepsia (5.28%) and rhinitis (4.82%). The system gained an overall satisfaction by the users and the most satisfied areas were rapid retrieving the necessary information of patient (75%) and fasten the diagnostic selection (75%). TEMRS is an enabling system which can reduce the user resistance in new technology with its flexibility. The consideration of cost, security, human, technical, data migration and standardization issues are essential in the implementation of the TEMRS and further research should be conducted to expand the TEMRS's implementation in health care system.
Journal of Medical Systems 12/2011; 35(6):1605-15. · 1.13 Impact Factor
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ABSTRACT: Healthcare services are complex and life-critical. One mistake in any procedure may lead to irremediable consequences; numerous researchers, thus, introduce information and communication technology to improve quality of services and enhance patient safety by reducing the medical errors. Radio frequency identification (RFID) is considered as one of the emerging tool assist in meeting the challenges of the present situation. In recent years, RFID has been applied in medical organizations for the purpose of managing and tracking medical equipment, monitoring and identifying patients, ensuring that the right medication is given to the right patient, and preventing the use of counterfeit medicine. However, most of the existing literature focuses on demonstrating how RFID can benefit the healthcare industry, whereas little attention has been given to the management issues involved in constructing an RFID project in medical organizations. In this paper, an exploratory case study is conducted in a medical organization to illustrate the development framework and critical issues that should be taken into consideration in the preparation, implementation and maintenance stage of constructing such a project. All the experiences and results discussed in this paper offer valuable and useful insights to steer those who would like to start their journey using RFID in medical organizations.
Journal of Medical Systems 08/2011; 35(4):657-69. · 1.13 Impact Factor
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ABSTRACT: We investigated the causes of death and analyzed the prognostic factors in Korean systemic lupus erythematosus (SLE) patients. We evaluated 1010 patients with SLE who visited Seoul Saint Mary's Hospital from 1997-2007. Changing patterns in the causes of death were analyzed. Survival rate was calculated by the Kaplan-Meier method and the log-rank test. The risk factors for death were analyzed by multivariate logistic regression analysis. The 5-year survival rate was 97.8%. Over the period of the study, 59 deaths were observed. Among 44 patients who died in our hospital, the most common cause of death was infection (37.3%), with SLE-related death as the next most frequent cause (22.0%). In comparison with earlier data, the proportion of SLE-related deaths has fallen and the proportion of infections has risen. SLE-related death was the most frequent cause of early death, while infection was the most common cause of death in the overall population. In univariate analysis, damage related to SLE, cumulative glucocorticoid dose, mean glucocorticoid dose for 1 month before death, intravenous methylprednisolone therapy and cyclophosphamide treatment were associated with death (p < 0.001 each). The late onset of SLE and renal involvement were predictive factors of poor outcome (p = 0.03 and p < 0.001). In multivariate analysis, the risk factors for death were irreversible damage related to SLE, cyclophosphamide therapy and mean glucocorticoid dose for 1 month before death. The most common cause of death in Korean SLE patients was infection. The judicious use of immunosuppressive agents may be important to decrease infection and to improve survival in SLE patients.
Lupus 06/2011; 20(9):989-97. · 2.34 Impact Factor
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Computers in Industry. 01/2011; 62:32-41.
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J. Medical Systems. 01/2011; 35:1605-1615.
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Knowl.-Based Syst. 01/2011; 24:444-456.
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J. Medical Systems. 01/2011; 35:657-669.
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ABSTRACT: This study was undertaken to investigate clinical characteristics of diffuse alveolar hemorrhage (DAH) in patients with systemic lupus erythematosus (SLE) and to determine risk factors and clinical outcomes of DAH in SLE patients. Among the 1521 patients with SLE admitted between January 1993 and June 2009 to affiliated hospitals of Catholic University of Korea, 21 SLE were admitted for DAH. The inclusion criteria for DAH was defined as new infiltrates on chest radiographs, an acute hemoglobin drop of at least 1.5 g/dl in the absence of an obvious source of bleeding, and one or more of the following signs: hemoptysis, hypoxemia, bronchoscopic or biopsy evidence of DAH. Included as disease controls were 83 SLE patients, matched for age and sex, who were admitted for other manifestations. Data based on medical records were analyzed retrospectively. There were no significantly differing demographic characteristics between SLE patients with DAH and those with other manifestations. Multivariate analysis demonstrated coexisting neuropsychiatric lupus (p = 0.002) and high SLE disease activity index scores (SLEDAI > 10) as independent risk factors in the development of DAH (p = 0.029). Among the 21 SLE patients with DAH, 13 died during the admission period (in-hospital mortality rate: 61.9%). Mortality was associated with infection and requirements of mechanical ventilation. Collectively, SLE patients who have neuropsychiatric manifestations or are in the active stage of the disease have an increased risk for developing DAH. Due to the high mortality of SLE patients with DAH, early recognition of risk factors and appropriate intervention is essential.
Lupus 10/2010; 20(1):102-7. · 2.34 Impact Factor
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ABSTRACT: Purpose – The purpose of this paper is to focus on the design of a counterfeit network analyzer (CNA) for aggregating all the problematic product flows in order to discover any counterfeit distribution source, and to control the spread of counterfeit goods. The analyzer leverages radio frequency identification (RFID) information stored within the electronic product code (EPC) network. Design/methodology/approach – The system architecture of the proposed CNA is first discussed. A case study of the system application in a Hong Kong pharmaceutical manufacturing company then presents the adoption process and the challenges encountered in such technologies. Findings – Compared with traditional approaches, the results show that the proposed RFID solution is reliable and is capable of discovering counterfeit distributions, as well as reducing the detection costs by means of higher product movement visibility within the supply chain. Practical implications – A prototype system has been constructed and trial implemented in a pharmaceutical manufacturing company. It proved to be of benefit to the manufacturer who is able to deter product counterfeiting effectively and visualize real-time supply chain data automatically. Originality/value – The proposed CNA is designed to overcome issues of information invisibility, which is considered a huge cost lost in the identification of counterfeit products, loss of sales and reputation associated with the counterfeiting, and ineffective product authentication in the manufacturing industry. This paper contributes to the RFID research in the counterfeiting area by studying the feasibility and practicality of shifting the focus of product identification from the traditional package redesign solutions to the visualization of the movement of the product (i.e. product supply chain) via the use of RFID and EPC. Furthermore, a pharmaceutical manufacturing site provided a case study for discussing the advantages, critical issues for implementation of the RFID system, and lessons learned.
Industrial Management & Data Systems 08/2010; 110(7):1018-1037. · 1.47 Impact Factor
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Expert Syst. Appl. 01/2010; 37:5336-5346.
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Expert Syst. Appl. 01/2010; 37:8079-8089.
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Industrial Management and Data Systems. 01/2010; 110:1018-1037.
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Computers in Industry. 01/2010; 61:624-635.
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JSEA. 01/2009; 2:150-159.
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ABSTRACT: The use of radio frequency identification (RFID) in manufacturing process automation is becoming increasingly popular in various industries. However, the integration of RFID with various manufacturing systems is still a challenge. This paper presents the development of a framework for an RFID-based manufacturing process automation system (MPAS) for use in manufacturing industries. The MPAS is characterised by its ability to capture and harness real-time production and process data of semi-finished products and components during the manufacturing and assembly processes. It supports rapid logistics decision-making for the re-allocation of production resources and rectification of bottleneck problems to meet tight delivery schedules. A prototype system has been built and the potential benefit of the system has been realised through a series of implementations in selected reference sites.
International Journal of Logistics Economics and Globalisation 01/2009; 2(1):1-22.
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ABSTRACT: Macrophage migration inhibitory factor (MIF) is a proinflammatory cytokine that has been demonstrated to regulate the apoptosis of several cell types. Dysregulated apoptosis of fibroblasts has been implicated in a variety of fibrotic diseases, including systemic sclerosis (SSc). In this study, we investigated the role of MIF in the apoptosis of dermal fibroblasts. The concentrations of MIF were measured in sera and in culture supernatants of peripheral blood mononuclear cells (PBMCs) and dermal fibroblasts by enzyme-linked immunosorbent assay. The degree of apoptosis was determined by colorimetric assay, and signalling pathways were examined by Western blot. The results showed that serum levels of MIF were significantly higher in patients with SSc (n = 47) than in healthy controls (n = 56). Stimulation of PBMCs by anti-CD3 and anti-CD28 increased the production of MIF by fourfold over the constitutive levels. SSc dermal fibroblasts produced higher amounts of MIF than normal dermal fibroblasts. When treated with sodium nitroprusside (SNP), SSc dermal fibroblasts showed a lower degree of apoptosis compared with normal dermal fibroblasts. Exogenous MIF (1-100 ng/ml) inhibited SNP-induced apoptosis of dermal fibroblasts dose-dependently. Both extracellular regulated kinase (ERK) inhibitor (PD98059) and protein kinase B (Akt) inhibitor (LY294002) almost completely blocked the inhibitory effect of MIF on apoptosis. Furthermore, MIF increased the expression of Bcl-2, phospho-ERK and phospho-Akt activity in dermal fibroblasts. Taken together, our data suggest that MIF released by activated T cells and dermal fibroblasts decreases the apoptosis of dermal fibroblasts through activation of ERK, Akt and Bcl-2 signalling pathways, which might be associated with excessive fibrosis in SSc.
Clinical & Experimental Immunology 06/2008; 152(2):328-35. · 3.36 Impact Factor
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ICEIS 2008 - Proceedings of the Tenth International Conference on Enterprise Information Systems, Volume AIDSS, Barcelona, Spain, June 12-16, 2008; 01/2008
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ABSTRACT: Due to the increasing integration of animals into family lifestyles, animal care management becomes an important issue as animals have a direct impact on human psychological and physical health. Even though there are a lot of solutions, maltreatment of animals and risks in animal health are increasing as indicated in the newspapers and statistics. In addition, many identification methods are not efficient and user-friendly. In this paper, an RFID-based mobile monitoring system (RFID-MMS) is designed in helping users to better manage the animals in dynamic information retrieving, location tracking, and behavior analyzing over a wireless network. The proposed system, which is suitable for using in all animals unities, enhances the companionship between humans and animals.
Wireless Communications, Networking and Mobile Computing, 2007. WiCom 2007. International Conference on; 10/2007
