We reported a case of histiocytic lymphoma associated with monocytic leukemia in a 55-year-old male. The patient showed numerous pruritic erythematous papules and nodules on the entire body surface, cervical and inguinal lymphadenopathy. Biopsy specimen frorn a nodule on the trunk showed widely scattered patchy infiltration of abnormal, hyperchromatic polymorphous histiocytes. The bone marrow aspirate smear revealed many atypical cells which have monocytic nuclear and cytopla,smic characteristics. Some cells are large and have serrated borders. Monoblast nuclei exhibit extreme irregularity and are folded.
Biopsy ; Bone Marrow ; Histiocytes ; Humans ; Leukemia* ; Lymphatic Diseases ; Lymphoma, Large B-Cell, Diffuse* ; Male ; Middle Aged ; Monocyte-Macrophage Precursor Cells

Aim. A neurobehavioral test for workers exposed to organic solvents in the workplace can be affected by many factors : age, education, motivation, ethnicity, etc. To apply more suitable neurobehavioral test for Korean workers, we evaluated the validity of several items of computerized and traditional neurobehavioral tests. Methods. We have applied eleven tests : four items of computerized neurobehavioral test(Swedish Performance Evaluation System) including Addition, Symbol-Digit, Digit Span, and Finger tapping speed, and seven items of traditional neurobehavioral test consisting of Addition, Digit-Symbol , Digit Span, Benton visual retention test, Pursuit aiming, Pegboard, and Tapping. These tests were performed on 96 workers exposed to solvents, and 100 reference workers. The concurrent and construct validities were evaluated by group difference, correlation with age, educational level, hippuric acid level, neurotoxic symptom, current exposure level, multitrait-multimethod matrix, factor analysis, and discriminant analysis. Results. Statistically significant differences were observed between the workers exposed to solvents and referents in computerized Symbol-Digit, Finger tapping speed, traditional Digit-Symbol and Pegboard. The computerized Symbol-Digit, traditional Digit-Symbol, Addition, Benton visual retention test, and Pegboard were found to be related to the age. The performance of computerized Symbol-Digit, Addition, and traditional Digit-Symbol were found to be related to the educational level significantly. The computerized Symbol-Digit, Finger tapping speed, and traditional Digit-Symbol were found to be related to hippuric acid, and neurotoxic symptom. The discriminability of Finger tapping speed, and Pegboard was better than the other tests. In discriminant analysis, the model with two variables, the computerized Symbol-Digit and Pegboard, classified almost 70 percent of the workers correctly. Conclusions. These results suggest that the computerized Symbol-Digit, Finger tapping speed, and Pegboard are more satisfactory for our purpose, and the Addition, Tapping, Benton visual retention test, and Pursuit aiming are less valid than other items. These may allow the reasonable selection of core neurobehavioral tests for workers exposed to solvents in Korea.
Education ; Fingers ; Korea ; Motivation ; Solvents

BACKGROUND: Determining the precise magnitude, duration, and mechanism of hypotension caused by intravenous amiodarone could potentially increase the safety of drug administration to critically ill patients. The objective of this study was to characterize the immediate cardiovascular actions of an intravenous loading dose of amiodarone administered using echocardiographic and hemodynamic measurements. METHODS: In a prospective double-blind trial, 20 patients undergoing off-pump coronary artery bypass graft surgery were randomly assigned to receive intravenous amiodarone (n = 10) or placebo (n = 10). Heart rate (HR), arterial blood pressure (systolic, diastolic, mean; SAP, DAP, MAP), pulmonary artery pressure (systolic, diastolic, mean; PSAP, PDAP, PMAP), cardiac output (CO), central venous pressure (CVP), left ventricular ejection fraction (LVEF) were measured. RESULTS: HR, SAP, DAP, MAP, PSAP, PDAP, PMAP, CO by thermodilution method, CVP, LVEF by echocardiographic measurements was not significantly different in both group. Hypotension requiring intervention occurred in 2 of 10 patients after amiodarone administration and in none of 10 patients after placebo. CONCLUSIONS: Hypotension requiring intervention occurred 20% after amiodarone administration, the cause of these hypotension were thought to be arterial dilatation but was not associated with decreased cardiac output or left ventricular ejection fraction and corrected successfully by intravenous administration of phenylephrine.
Administration, Intravenous ; Amiodarone* ; Arterial Pressure ; Cardiac Output ; Central Venous Pressure ; Coronary Artery Bypass, Off-Pump ; Critical Illness ; Dilatation ; Echocardiography* ; Heart Rate ; Hemodynamics* ; Humans ; Hypotension ; Myocardial Ischemia ; Phenylephrine ; Prospective Studies ; Pulmonary Artery ; Stroke Volume ; Thermodilution ; Transplants

Health promotion center is an area that hospitals promote and operate with priority for the early detection and prevention of disease. The quality of medical service needs to be improved by providing a quick and customized service to the patients who use the center. In the past, the examiners or hall managers took charge of the guidance and management of the patients in order, and the patients suffered from the disorder and discomfort while they are called and identified by name. In this paper, we realized automated health promotion system using PDA operation system to provide services comfortable for both patients and examiners. A comfortable and personalized system has been developed, where patients are provided with personalized guidance for the examination labs instead of being called by name and history of medical examination through the mobile terminal,
Health Promotion* ; Humans ; Medical Records Systems, Computerized

OBJECTIVES: Seoul National University Bundang Hospital, which is the first Stage 7 hospital outside of North America, has adopted and utilized an innovative and emerging information technology system to improve the efficiency and quality of patient care. The objective of this paper is to briefly introduce the major components of the SNUBH information system and to describe our progress toward a next-generation hospital information system (HIS). METHODS: SNUBH opened in 2003 as a fully digital hospital by successfully launching a new HIS named BESTCare, "Bundang hospital Electronic System for Total Care". Subsequently, the system has been continuously improved with new applications, including close-loop medication administration (CLMA), clinical data warehouse (CDW), health information exchange (HIE), and disaster recovery (DR), which have resulted in the achievement of Stage 7 status. RESULTS: The BESTCare system is an integrated system for a university hospital setting. BESTCare is mainly composed of three application domains: the core applications, an information infrastructure, and channel domains. The most critical and unique applications of the system, such as the electronic medical record (EMR), computerized physician order entry (CPOE), clinical decision support system (CDSS), CLMA, CDW, HIE, and DR applications, are described in detail. CONCLUSIONS: Beyond our achievement of Stage 7 hospital status, we are currently developing a next-generation HIS with new goals of implementing infrastructure that is flexible and innovative, implementing a patient-centered system, and strengthening the IT capability to maximize the hospital value.
Achievement ; Disasters ; Electronic Health Records ; Electronics ; Electrons ; Hospital Information Systems ; Information Systems ; North America ; Patient Care ; Patient Safety ; Quality of Health Care

OBJECTIVES: Seoul National University Bundang Hospital, which is the first Stage 7 hospital outside of North America, has adopted and utilized an innovative and emerging information technology system to improve the efficiency and quality of patient care. The objective of this paper is to briefly introduce the major components of the SNUBH information system and to describe our progress toward a next-generation hospital information system (HIS). METHODS: SNUBH opened in 2003 as a fully digital hospital by successfully launching a new HIS named BESTCare, "Bundang hospital Electronic System for Total Care". Subsequently, the system has been continuously improved with new applications, including close-loop medication administration (CLMA), clinical data warehouse (CDW), health information exchange (HIE), and disaster recovery (DR), which have resulted in the achievement of Stage 7 status. RESULTS: The BESTCare system is an integrated system for a university hospital setting. BESTCare is mainly composed of three application domains: the core applications, an information infrastructure, and channel domains. The most critical and unique applications of the system, such as the electronic medical record (EMR), computerized physician order entry (CPOE), clinical decision support system (CDSS), CLMA, CDW, HIE, and DR applications, are described in detail. CONCLUSIONS: Beyond our achievement of Stage 7 hospital status, we are currently developing a next-generation HIS with new goals of implementing infrastructure that is flexible and innovative, implementing a patient-centered system, and strengthening the IT capability to maximize the hospital value.
Achievement ; Disasters ; Electronic Health Records ; Electronics ; Electrons ; Hospital Information Systems ; Information Systems ; North America ; Patient Care ; Patient Safety ; Quality of Health Care

Isolated left ventricular noncompaction cardiomyopathy (IVNC) is a cardiomyopathy thought to be caused by arrest of normal embryogenesis of the endocardium and myocardium. This abnormality is often associated with other congenital cardiac defects. A 21-year-old man presented to the emergency department with worsening exertional dyspnea during the previous 2 months. Two-dimensional and Doppler echocardiography revealed an enlarged left atrium (LA) and a markedly dilated left ventricle (LV) with preserved LV systolic function, severe mitral valve regurgitation, and prolapse due to chordae rupture. The myocardium of the LV and right ventricle (RV) had excessively prominent trabeculations and deep intertrabecular recesses. He is the first patient in Korea who has undergone mitral valve replacement surgery because of severe mitral valve regurgitation and prolapse due to chordae rupture accompanied by IVNC.
Cardiomyopathies ; Dyspnea ; Echocardiography, Doppler ; Embryonic Development ; Emergencies ; Endocardium ; Female ; Heart Atria ; Heart Ventricles ; Humans ; Korea ; Mitral Valve ; Mitral Valve Insufficiency ; Myocardium ; Pregnancy ; Prolapse ; Rupture ; Young Adult

BACKGROUND: BRCA1 (breast-cancer gene 1) is a tumor suppressor gene that accounts for nearly all families of both early onset breast and ovarian cancer and about 45% of families with breast cancer only. Sporadic nonhereditary breast cancer is recognized as the most common form of this malignancy. However, presence of germ-line mutations in the BRCA1 gene of these tumors is an infrequent event. The BRCA1 protein includes a ring domain and an acidic domain, both of which are characteristics of certain transcription factors, as well as two putative nuclear localization signals (NLS) that interact with importin-alpha. The normal BRCA1 protein is located in the nucleus of most breast-cell types whereas the BRCA1 protein of breast cancer cells is aberrantly localized in the cytoplasm. This mislocation of the BRCA1 protein in breast cancer cells may be due to defects in the NLS receptor-mediated pathway for the nuclear import of the BRCA1 gene product. Identification of importin-alpha mutations as a cellular protein responsible for the nuclear import of BRCA1 in breast-cancer cell lines and primary breast cancers is the focus of this investigation. METHODS: A series of 15 surgical samples of breast cancer and 3 samples of breast-cancer cell lines (Hs578T, ZR75-1, MCF-7) was assayed for the presence of the deletion mutant in importin-alpha by using both RT-PCR amplification of importin-alpha transcripts and sequencing analysis. RESULTS: Three of the 15 primary breast cancers and 1 of the 3 breast-cancer cell lines showing deletions in importin-alpha transcripts produced two different truncated transcripts. 1208 bp deletions were observed in transcripts from breast cancer (T-1, T-3) and ZR75-1, which is specified by the nucleotide 251-1458 of the transcript. Another transcript encoded by primary breast cancer (T-2) included a 1312 bp deletion in the nucleotide 61-1372 of the transcript. CONCLUSIONS: The deletions eliminated part of the importin-alpha transcript segment encoding the putative NLS-binding domain but not the importin-beta binding domain, suggesting that these deletion mutants could not bind to NLS of the BRCA1 protein. These results suggest that the composite effects of mislocationof the BRCA1 protein by deletion of the NLS-binding domain in importin-alpha may contribute to tumorigenesis in sporadic breast cancer.
Active Transport, Cell Nucleus ; alpha Karyopherins* ; Alternative Splicing ; beta Karyopherins ; BRCA1 Protein ; Breast Neoplasms* ; Breast* ; Carcinogenesis ; Cell Line ; Cytoplasm ; Genes, BRCA1 ; Genes, Tumor Suppressor ; Germ-Line Mutation ; Humans ; Nuclear Localization Signals ; Ovarian Neoplasms ; Transcription Factors

Primary cardiac lymphoma (PCL) is an extranodal non-Hodgkin's lymphoma exclusively located in the heart and/or pericardium. It is rare in immunocompetent patients and represents 1.3% of primary cardiac tumors and 0.5% of extranodal lymphomas. The clinical behavior is aggressive and the early symptoms are cardiac failure, syncope, arrhythmia, or pericardial effusion. Although echocardiography, computed tomography (CT) scan, magnetic resonance image (MRI) are the mainly used imaging techniques to detect cardiac tumors, pathologic examination is always required to confirm the diagnosis. Diagnosis of PCL is difficult due to non-specific clinical manifestations and requires invasive approach to get histopathologic evidence. While surgery with systemic chemotherapy or in combination with irradiation has been attempted, the only effective treatment is chemotherapy. However, the prognosis remains poor. We report on a 42-year-old woman who is diagnosed histopathologically as PCL by cardiac catheterization assisted percutaneous endomyocardial biopsy and treated successfully by anthracycline based chemotherapy.
Adult ; Arrhythmias, Cardiac ; Biopsy ; Cardiac Catheterization ; Cardiac Catheters ; Cardiac Tamponade ; Echocardiography ; Female ; Heart ; Heart Failure ; Heart Neoplasms ; Humans ; Lymphoma ; Lymphoma, Non-Hodgkin ; Magnetic Resonance Spectroscopy ; Pericardial Effusion ; Pericardium ; Prognosis ; Syncope