Acta Med Okayama
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Since clinical document architecture (CDA) became an American National Standards Institute (ANSI)-approved health level seven (HL7) Standard, many countries have begun making an effort to make local standards conform to CDA. In order to make CDA compatible with the many different local standards existing in different countries, we designed a prototype model using HL7 CDA R2 with medical markup language (MML), a Japanese medical data exchange standard. ⋯ We share herein the experience gathered in designing and implementing a referral letter system based on HL7 CDA, Release 2 (CDA R2). We also outline the challenges encountered in our project and the opportunities to widen the scope of this approach to other clinical documents.
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The induction of both long-term potentiation (LTP) and long-term depression (LTD) in the hippocampal CA1 region is triggered by the activation of N-methyl-D-aspartate (NMDA) receptors and the subsequent postsynaptic intracellular Ca2+ increase. However, how NMDA receptor activation differs between LTP and LTD induction is unclear. In the present study, we examined the effects of the magnitude and duration of NMDA receptor activation on the induction of LTP and LTD. ⋯ Finally, LTD induced by prolonged activation of NMDA receptors was not affected by inhibition of the desensitization of alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA) receptors. These results suggest that critical differences exist between the induction of LTP and that of LTD in terms of both the magnitude and the duration of NMDA receptor activation. The duration of the increase in intracellular Ca2+ concentration may be critical for determining whether LTP or LTD induction occurs.