BACKGROUND: Detection of malignant effusion is important task in the routine laboratory work. However, in clinical laboratory where only Wright-Giemsa stained slides are examined it is not easy. So the author proposed a scoring system in the differential diagnosis of malignant effusion using the results of routinely tested items. METHODS: 61 samples of exudates (13 ascites, 48 pleural fluids) from 47 patients were included. The scores are summed based on the routine laboratory results. Items were as follows: protein concentration, dominancy of lymphocyte (lymphocyte count over 50%) and morphologic variety of lymphoid cells, mesothelial cell count, eosinophil count, and presence of tumor cells. Total summed full scores would be 8 points. RESULTS: The summed scores of 14 samples of malignant effusion were as follows: 7 points in 2 cases, 6 points in 1 case, 5 points in 8 cases, 4 points in 3 cases, with the mean score of 5.1 points. The 47 benign exudates showed 4 points in 1 case, 3 points in 4 cases, 2 points in 33 cases, 1 point in 9 cases, with the mean score of 1.9 points. If malignancy were postulated as summed score over 4 points, a statistically significant difference was observed between the summed score and effusion type (P<0.0001). CONCLUSIONS: Two groups of effusion can be distinguished: one group that showed more than 4 points, with malignant potential and the other group lower than 3 points with benign effusion. In case with high score, 4 points above, one should pay attention to the presence of malignant cells and even if tumor cells were not found, the possibility of malignant condition should be notified.
Ascites ; Cell Count ; Diagnosis, Differential ; Eosinophils ; Exudates and Transudates ; Humans ; Lymphocytes

BACKGROUND: Because laboratory tests are important elements of medical practice and many new tests using new technologies are being developed, the effective use of laboratory tests and services is clearly the joint responsibility of clinicians and clinical laboratory. Clinical laboratory is needed to adopt more active approach to advocating test strategy and interpreting results. We evaluated the reflex testing algorithms, consequently ordering the secondary tests by clinical pathologists. METHODS: We decided 36 test items, which can be odered consequently by clinical pathologists, working with communication between the laboratory and the clinic. In our laboratory, clinical pathologists consequently ordered the secondary tests after interpreting the primary screening test results, analyzed them with the same samples, and reported on the same day. We applied this consequently ordering system to the hospitalized patients. RESULTS: Consequently ordered secondary tests were 5,060 (17.8%) among 28,494 tests performed on 36 items during 6 months, which comprised 0.5% of total laboratory tests. Consequently ordering system was a successful attempt to improve the effectiveness of test utilization, in which we generated laboratory informations sequentially, reduced the turn-around time and played an active role in assuring effective utilization of the laboratory tests. CONCLUSIONS: Laboratory information including optimal test selection, development of methods to insure that the resulting data are utilized properly, and interpretation of test results, which can be provided more actively by clinical pathologists, should be used in assuring superior patient care. Consequently ordering system by clinical pathologists may be considered to be a means of providing patient services more efficiently.
Humans ; Joints ; Mass Screening ; Patient Care ; Reflex

BACKGROUND: Quantitative experiment and analysis of the result with statistical techniques are an essential part of the medical article for acquiring objective confidence. But errors on application, calculation, and interpretation of statistics and insufficient explanation of the used statistical technique deprive the reader of reliance on the article. We identified the statistical errors that were commonly encountered and which researchers and readers should recognize in the Korean Journal of Clinical Pathology (KJCP) in order to improve the quality of the statistics in the article. METHODS: We identified the frequency of the statistical errors from the 193 articles in the 1995 - 1996 editions of the KJCP. There were seven kinds of statistical errors that were most frequently observed. Each different kind of error in the same article were counted separately, but two or more of the same kind of error in an article were counted as one. RESULTS: Seventy-five statistical errors were identified. Seven kind of the most common errors and the observed numbers of the every kind of error were as follow : 1. Using P value without the statistical name (12), 2. Performing t test instead of the analysis of variance (ANOVA) test in comparing the means of three or more groups (11), 3. Omitting the F test on the unpaired t test in small different sized samples (10), 4. Mentioning the statistical technique without using it (9), 5. Mentioning the predictive value without prevalence (7), 6. Not performing multiple comparison after the significant ANOVA test (5), 7. Not using the P value with the correlation coefficient (r) (5). CONCLUSIONS: There were 75 statistical errors in the 1995-1996 editions of the KJCP. Not mentioning the name of the statistical technique used was the most frequently observed error. The authors' careful application of the basic statistics would be the real solution of the problem.
Pathology, Clinical* ; Prevalence

Turner syndrome is a genetic disorder that affects about 1/2,000-1/5,000 females born. The typical female with Turner syndrome has only one X chromosome in each of her cells. There are several variations on this theme as other similar chromosome anomalies occur in females with Turner syndrome. We observed a patient with short stature, abscent vagina and chromosomal abnormality. Chromosomal analysis of the patient showed 45,X/46,X, +mar. The marker chromosome was revealed as X chromosome in fluorescent in situ hybridization (FISH). We report a case of mos 45,X/46,X,+mar.ish der(X)(wcp X+) in Turner syndrome with a brief review of literature.
Chromosome Aberrations ; Female ; Humans ; In Situ Hybridization, Fluorescence ; Mosaicism ; Turner Syndrome* ; Vagina ; X Chromosome

BACKGROUND: Platelet antibody test has been used in the diagnosis and management of immunological platelet disorders and platelet crossmatch. Mixed passive hemagglutination (MPHA) test is a cost-effective, reproducible, easy to perform and convenient method. Anti-IgG coated indicator red cells used for MPHA test have not been made in Korea and those cells have been exclusively donated by Dr. Shibata in Japan. This study was designed to produce domestic indicator cells and to determine its acceptability by comparing to the results obtained with Dr. Shibata's indicator cells. We produced homemade indicator cells by coating human RhD-positive O RBC with human IgG anti-D (check cell) and then coated with rabbit anti-human IgG. METHODS: Sixty three sera from healthy male donors, 58 sera tested positive in platelet suspension immunofluorescence test (PSIFT), and 61 sera tested negative in PSIFT were evaluated by MPHA employing both homemade and Dr. Shibata's indicator cells. RESULTS: The concordance rate between PSIFT and homemade MPHA was 74%. Test results of MPHA with homemade indicator cell showed excellent correlation with Shibata's indicator cell (P=0.002). All of 63 sera from healthy volunteer male blood donors without history of transfusion were tested negative with homemade MPHA method. Test results of MPHA employing homemade indicator cells showed excellent correlation with those of PSIFT (P=2.67x10-8). CONCLUSIONS: Homemade indicator cells we developed in this study were able to replace Dr. Shibata's indicator cells for the MPHA test.
Blood Donors ; Blood Platelets* ; Diagnosis ; Fluorescent Antibody Technique ; Healthy Volunteers ; Hemagglutination* ; Humans ; Immunoglobulin G ; Japan ; Korea ; Male ; Tissue Donors

BACKGROUND: The opportunistic imperfect fungus Candida albicans causing life-threatening infections in immunocompromised patients is recognized to be one of important nosocomial pathogens. Recently, an outbreak of septicemia caused by C. albicans was occured in neonatal intensive care unit (NICU) of Chungbuk university hospital. To investigate the molecular epidemiology of these infections, we analyzed genotypes of C. albicans isolates from NICU and non-NICU. METHODS: Fourteen isolates of C. albicans were used for intraspecies genotyping, which were composed of 9 isolates from NICU and 5 isolates from non-NICU from January to April 1998. Each three isolates of C. albicans, C. parapsilosis and C. tropicalis were used for interspecies genotyping. The genotyping were analyzed by RAPD with four random primers. RESULTS: The genotypes of C. albicans isolates from immature neonates in NICU were identical with those from medical persons in NICU but different with those from patients in non-NICU. Interspecies RAPD profiles were more distinctive than intraspecies RAPD profiles. The reproducibility of RAPD showed good result. CONCLUSION: These results show that C. albicans isolated from NICU disclose the same RAPD genotype, which suggests the clonal origin, and RAPD can be the useful method for the epidemiological study of nosocomial infection caused by C.albicans.
Candida albicans* ; Candida* ; Chungcheongbuk-do ; Cross Infection ; DNA* ; Epidemiologic Studies* ; Fungi ; Genotype ; Humans ; Immunocompromised Host ; Infant, Newborn ; Intensive Care Units, Neonatal* ; Intensive Care, Neonatal* ; Molecular Epidemiology ; Sepsis*

BACKGROUND: Studies on the incidence and seasonality of respiratory viruses that are the main cause of lower respiratory tract disease in children are insufficient in Korea. In the present study, the epidemiology of respiratory viruses in children was studied during the last 2 years and, the indirect immunofluorescent (IF) method was compared with the direct IF method. METHODS: A total of 814 pediatric inpatients hospitalized for lower respiratory tract infection at Hanyang University Hospital were studied from April, 1996 to July, 1998. Nasopharyngeal aspirates were obtained from these patients and indirect IF (Respiratory Panel I Viral Screening & Identification Kit, Light Diagnostics, Chemicon, Temecula, CA, USA) was performed for the following viruses : respiratory syncytial virus (RSV), parainfluenza virus type I, II and III, influenza virus A, B, and adenovirus. Sixty-nine of these samples were tested by direct IF (IMAGENTM, DAKO, UK) and indirect IF, simultaneously. RESULTS: 1) Viral pathogens were detected in 30.5% of nasopharyngeal aspirates. Among the positive cases, RSV was 60.6%, influenza A 35.3%, adenovirus 5.2%, influenza B 4.0%, and parainfluenza II 0.8%. 2) The occurrence rate of RSV in spring, summer, fall and winter was 7.3%, 13.6%, 31.45%, 33.45%, respectively, and showed a unique pattern in that the incidence rate in the summer of 1997 was 22.2%. A unique pattern was also observed for influenza A, which was continuously detected from December 1997 to July 1998. 3) The positive rate of indirect IF was statistically higher than that of direct IF. Excluding the results of the influenza A, there was no statistically significant difference between the two methods. CONCLUSION: RSV was the most frequently detected virus in viral respiratory infections in children. Infection usually began in the fall and most frequently detected in the winter and lasted until spring. High incidence of RSV in summer 1997 and continuous detection of influenza A till summer 1997 suggest some change of epidemic pattern. The discordance between direct and indirect IF was probably due to the difference in quality of the anti-influenza A reagent rather than a real difference in the two methods.
Adenoviridae ; Child* ; Epidemiologic Studies* ; Epidemiology ; Humans ; Incidence ; Influenza, Human ; Inpatients ; Korea ; Mass Screening ; Orthomyxoviridae ; Paramyxoviridae Infections ; Respiratory Syncytial Viruses ; Respiratory Tract Diseases ; Respiratory Tract Infections ; Seasons

BACKGROUND: Self-monitoring blood glucose devices are widely used for self-monitoring and point-of-care testing (POCT) in the management of diabetic patients. We performed the present study to evaluate the performance of Precision Q.I.DR Blood Glucose Testing System using electochemical detection techique. METHODS: Precision Q.I.DR was evaluated for linearity, precision, comparison of method, and the effect of sample volume, hematocrit concentration, reapplication, operator, and application methods. RESULTS: Precision Q.I.DR revealed good linearity in glucose concentration ranging from 40 mg/dL to 550 mg/dL (r2=0.9874). In the precision study, within-run and total-run CVs were within 10%. Excellent correlation was found between Precision Q.I.DR and Hitachi 7070 (y = 1.0332 x, r = 0.9195). Sample volume, reapplication, operator, and application method did not produce significant effect on the test result. Over- or underestimation of glucose values was found with the change of hematocrit concentration. CONCLUSIONS: Precision Q.I.DR showed good linearity, precision, and correlation with reference method. No significant effect of testing procedure or operator was found. Precision Q.I.DR provided rapid and reliable result of blood glucose and seems appropriate for clinical use in the management of diabetic patients.
Blood Glucose ; Diabetes Mellitus ; Glucose* ; Hematocrit ; Humans

BACKGROUND: Recent studies have implicated paraoxonase (PON), an HDL-associated enzyme, in providing protection against LDL oxidation, thus affecting the risk of coronary heart disease in general population. Serum PON activity is affected by PON gene polymorphism. We investigated the correlation between the PON2 codon 311 polymorphism (Cys-->Ser) and coronary heart disease in Koreans. METHODS: The subjects consisted of 145 healthy controls and 72 patients with coronary heart disease who were diagnosed by coronary angiography in Soonchunhyang University Hospital. The polymorphism at 311 codon in the PON2 gene was assessed by PCR-RFLP (restriction fragment length polymorphism) in their blood leukocyte DNA. RESULTS: PON2 genotype frequencies among 145 healthy controls were 7.6% CC, 37.2% CS and 55.2% SS (C:S = 0.250:0.750). PON2 genotype frequencies among 72 patients with coronary heart disease were 4.2% CC, 41.7% CS and 54.1% SS (C:S = 0.262:0.738). There was no significant difference between the two groups in genotype frequency or the allele frequency. There was no correlation between the PON2 polymorphism and HDL cholesterol level. CONCLUSIONS: The polymorphism at codon 311 in the PON2 gene are not associated with coronary heart disease in Koreans.
Aryldialkylphosphatase* ; Cholesterol, HDL ; Codon ; Coronary Angiography ; Coronary Disease* ; DNA ; Gene Frequency* ; Genotype ; Humans ; Leukocytes

BACKGROUND: Hypertriglyceridemia (HTG) has been considered a characteristic plasma lipid abnormality in hemodialysis patients with chronic renal failure, but is actually shown in only some of them (30-50%). Also renal dyslipidemia may contribute to atherosclerosis in hemodialysis patients. METHODS: Study population consisted of 34 patients with normotriglyceridemia (NTG), 11 patients with HTG and 47 controls. We measured total cholesterol (TC), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C), apolipoprotein (apo) A-I, apoB, apoC-III and apoE. RESULTS: Compared with controls, the NTG patients had significantly decreased levels of TC, HDL-C, and low density lipoprotein-cholesterol (LDL-C). But HTG patients had significantly increased TG, and TC/HDL-C ratio which were considered to represent the atherogenic indicator and had decreased HDL-C and LDL-C (P <0.001), with significant increase of TG and TC/HDL-C ratio compared with those of NTG patients. In the apolipoprotein profiles, all patients showed decreased levels of apoA-I, apoB, and apoA-I/apoC-III ratio and increased levels of apoC-III and apoC-III/apoE ratio compared with those of controls (P <0.001). Especially, HTG patients had significantly increased levels of apoC-III compared with NTG patients. CONCLUSIONS: So these results indicated that abnormalities of those potentially atherogenic lipid and lipoproteins may contribute to the high incidence of cardiovascular diseases and progression of renal disease in the HTG patients than NTG patients on maintenance hemodialysis.
Apolipoprotein A-I ; Apolipoprotein C-III ; Apolipoproteins B ; Apolipoproteins E ; Apolipoproteins* ; Atherosclerosis ; Cardiovascular Diseases ; Cholesterol ; Dyslipidemias ; Humans ; Hypertriglyceridemia ; Incidence ; Kidney Failure, Chronic* ; Lipoproteins* ; Plasma ; Renal Dialysis* ; Triglycerides