Reducing nurses'. Workload using a computerized nursing support system linked to the hospital information system

A computerised nursing support system (CNSS) linked to the hospital information system (HIS) was developed and has been in use for one year, in order to reduce the workload of nurses. CNSS consists of (1) a hand held computer for each nurse (2) desk-top computers in the nurses' station and doctors' rooms (3) a data server (4) an interface with the main hospital information system. Nurses enter vital signs, food intake and other information about the patients into the hand held computer at the bed-side. The information is then sent automatically to the CNSS data server, which also receives patients' details (prescribed medicines etc.) from the HIS. Nurses and doctors can see all the information on the desk-top and hand held computers. This system was introduced in May 1995 into a university hospital ward with 40 beds. A questionnaire was completed by 23 nurses before and after the introduction of CNSS. The mean time required to post vital data was significantly reduced from 121 seconds to 54 seconds (p < 0.01). After three months 30% of nurses felt CNSS had reduced their workload, while 30% felt it had complicated their work; after five months 70% noted a reduction and 0% reported that CNSS had made their work more complex. The study therefore concludes that the interface between a computerised nursing support system and the hospital information system reduced the workload of nurses.

Epidermoid cyst in the temporomandibular joint after a dermal graft

A very rare case of epidermoid cyst of the left temporomandibular join (TMJ) after a dermal graft inserted as the interposing material in the surgical correction of TMJ ankylosis is presented. Two years after the surgery, a cystic lesion the size of a walnut was observed in the TMJ region. The cyst contained an odorless, straw-coloured mucoid fluid and a wall lined by stratified squamous epithelium containing orthokeratin. It contained no hair follicles or sweat glands.

Pycnodysostosis. Report of a case and review of the Japanese literature, with emphasis on oral and maxillofacial findings

We report a case of pycnodysostosis and review 54 cases of this syndrome in the Japanese literature, with special emphasis on oral and maxillofacial findings. Common findings were as follows: hypoplasia of maxilla and mandible, hypopneumatization of the maxillary sinuses, loss of mandibular angle, a grooved palate, and malpositioned teeth.

Pathological calcification of the cervico-facial region

Two rare cases of pathological calcification affecting the face and neck are reported. The first case, a 32-year-old male, developed massive calcification of the lymphoid tissues in the preauricular, submandibular and cervical regions. In the second case, a 56-year-old male, a radiographic diagnosis of bilateral multiple miliary osteomas of the cheeks was made. Although dystrophic calcification of lymph nodes and salivary glands is common, it is important to establish any underlying disease.

[Treatment of a refractory chronic osteomyelitis of the jaw]

Two cases of refractory chronic osteomyelitis of the jaw were presented, the first in a patient with pycnodysostosis, the second that had been receiving radiotherapy. Both cases were primary chronic osteomyelitis with a markedly protracted course of recovery, in spite of the antibiotic and local irrigation therapy. However the lesion was cured by the removal of sequesters and granulation tissues without radical treatment such as a decorticotomy. Radical surgery, decortication, is an effective procedure in the treatment of chronic osteomyelitis of the jaw, but treatment with the surgical procedures which remove only the necrotic bones and granulation tissues followed by antibiotic therapy is also possible.