BACKGROUND: Recently malaria infection became one of the most important parasitic diseases in Korea. After the re-emergence of malaria in a young soldier in 1993 near the De-Militarized Zone (DMZ), three to four thousand people have been infected per year in the last few years and the cases of infection have been increasing threefold each year. Microscopic examination of a thick blood smear is a conventional and confirmatory method for diagnosis. However, it requires labor-intensive procedures and its interpretation is quite subjective. Faster and more reliable methods are needed for the diagnosis of malaria. METHODS: We evaluated 155 patients who were diagnosed as malaria. We performed point-of-care rapid diagnostic methods recently introduced: two antibody detection tests manufactured by Korean companies and one antigen (Plasmodium lactate dehydrogenase, pLDH) detection test. The results were compared with those of microscopic examinations of thick blood smears. RESULTS: Sensitivities of two antibody detection assays and one antigen detection assay in acute attacks of malaria were 64.7%, 72.5%, and 96.1%; and, specificities were 88.5%, 89.4%, and 95.1%, respectively. Overall accuracy for all samples were 80.6%, 83.9%, and 95.5%, respectively. CONCLUSIONS: Antibody detection tests for malaria have limitations in sensitivity and accuracy to replace microscopic examination of blood film. Antigen tests detecting pLDH could replace conventional microscopic examinations of blood film, especially in emergency situations in cases that require prompt medication.
Diagnosis* ; Emergencies ; Humans ; Korea* ; L-Lactate Dehydrogenase ; Malaria* ; Military Personnel ; Parasitic Diseases ; Plasmodium

Malaria is one of the most important parasitic diseases especially in tropical areas. Over 300 million people are affected and the condition causes 1-3 million deaths each year. It is transmitted by the bite of infected Anopheles mosquitoes. Although Korea was declared to be free of Malaria by the WHO in 1979, malaria re-emergence has been apparent since 1993 amongst soldiers located near the De-Militarized Zone (DMZ) in the northern part of the country. Conventional microscopic examination of thin and thick blood films demonstrates the presence of the parasite and thus this method has been used to confirm the diagnosis of malaria, but it is a labor-intensive procedure and relies upon subjective interpretation. To overcome these limitations, fast and reliable methods for malaria detection have been recently introduced. In this study, we compared three kinds of antibody detection kits and one biochemical test kit that determines the presence of Plasmodium lactate dehydrogenase (pLDH) with conventional peripheral blood smears. The antibody detection methods examined were, two rapid test pack format methods and a single microplate format enzyme-linked immunosorbent assay (ELISA) kit, as manufactured by Korean companies. The sensitivities of the three commercial antibody detection kits in the early stage of malaria were 70.8%, 77.4%, and 63.6%, their corresponding specificities 90.5%, 91.8%, and 80.9%, and their accuracies 87.6%, 87.0%, and 76.7%. The sensitivity and specificity of the pLDH assay were 100% apiece and the results were in 100% concordance with the microscopy of thick blood films. Thus, the pLDH assay may be used as an alternative for conventional microscopic blood film examination, especially in emergency situations when prompt treatment is necessary.
Adult ; Aged ; Animal ; Antibodies, Protozoan/blood ; Enzyme-Linked Immunosorbent Assay ; Female ; Human ; Lactate Dehydrogenase/blood ; Malaria/diagnosis* ; Male ; Middle Age ; Plasmodium/enzymology ; Sensitivity and Specificity

The main goal of transfusion medicine is safe and appropriate blood transfusion in all situations. To accomplish this, it is essential to have a high level quality management system for the entire process from blood donation to transfusion. Regulations regarding blood management have been adopted and strictly managed in Korea since 2007. Blood center's blood management tasks should establish appropriate quality management systems to ensure the safe supply of blood, as well as the basic resources of personnel, facilities and equipment in accordance with laws and regulations governed by the Ministry of Health and Welfare in Korea. The purpose of this review is to examine the contents and processes for quality control of clinical chemistry tests in Korean blood centers.
Blood Donors ; Blood Transfusion ; Chemistry, Clinical* ; Clinical Chemistry Tests* ; Humans ; Jurisprudence ; Korea ; Quality Control ; Social Control, Formal ; Transfusion Medicine

We reviewed MR angiograms to evaluate its efficacy for visualizing the renal arteries and detecting renovascular disease. 41 renal arteries in 19 patients were examined by MR angiography. 3-D time-of-flight technique was used as routine examination method for MR angiography and 2-D time-of-flight technique was added in some particular cases to visualize venous flow. Within two weeks after MR angiography was performed, 23 renal arteries in 10 patients were additionally examined by conventional angiography or intraarterial DSA. The success rates of vessel visualization on MR angiography in normal renal arteries were 100% in main 67.7% in segmental, and 11.8% in intrarenal arteries. As a result of comparative study in normal main renal arteries with MR angiograms and conventional angiograms, overall correspondence in the number and the shape was noted and the caliber discrepancy between two examination did not exceed 3.0 mm. one arteriovenous fistula with aneurysm, one stenotic artery and two occluded arteries were well evaluated One arteriovenous fistula with aneurysm, and two occluded arteries were well evaluated by MR angiography. However three stenotic lesions were misdiagnosed as occlusions on MR angiography. and the overall accuracy was 87%. We conclude that MR angiography has the potential to be a noninvasive and useful screening method for determining the number of renal arteries and for detection of abnormalities of main renal arteries.
Aneurysm ; Angiography* ; Arteries ; Arteriovenous Fistula ; Humans ; Mass Screening ; Methods ; Renal Artery*

No abstract available.
Cardiotocography* ; Meconium* ; Pregnancy*

BACKGROUND: Transfusion is a choice of treatment and should be used in order to maintain patients' lives and health. In order to supply safe blood, the quality improvements of hospital blood collection centers should be periodically monitored. To establish systematic surveillance of blood management system, we would like to suggest proper program. METHODS: Twenty-nine hospital small scale blood centers, collects less than 100 units of blood collection per year, were evaluated. Qualified were selected among blood bank specialists who were eligible to simultaneously perform inspections and consultations, and who had attended inspectors' workshop. RESULTS: Among twenty-five blood collection centers, four blood collection centers were closed prior to inspections. Among them, two blood collection centers were evaluated as inadequate. Among adequate centers, some questionnaires were evaluated as "not applicable" mainly for reasons pertaining to personnel and facilities, such as blood component preparation rooms and/or center administrators. CONCLUSION: A checklist for an inspection program should be reviewed continuously. Additionally, detailed guidelines for inspection should be standardized prior to commencing of subsequent year's inspection program. Finally, guidelines for inspection should be established for every questionnaire.
Blood Banks ; Checklist ; Quality Improvement ; Referral and Consultation ; Specialization ; Surveys and Questionnaires

Korean Society of Clinical Pathologists' Information Network(KSCPIN) began its service as a Closed User Group (CUG) In HiTEL. one of the major information providers in Korea, on March 2nd, 1995. The KSCPIN is the first and the only society which has its own information network among the Regular Member Society of Korean Medical Association. As the name CUG implies. this network is opened only for the members of the society. The main concept of KSCPCIN is to offer various informations and opinion exchange sites only to the society members. For providing various laboratory related informations to every one, we accepted non-society members as KSCPIN members to make KSCPIN as an opened CUG. KSCPIN now offers various bulletins and library not only for the society members, except for some limitations. KSCPIN consists of 115 clinical pathologists, 60 clinical pathology residents, 34 business men, 26 physicians, and 15 others making the total members of 262 at present. With new definition of members and new menu, KSCPIN was self-estimated as a successful CUG, and we recommend the utilization of CUG for all academic societies. In near future, we are going to move the CUG on the internet. which is our finalgoal.
Commerce ; Humans ; Information Services* ; Internet ; Korea ; Male ; Pathology, Clinical ; Running*

BACKGROUND: Hypobetalipoproteinemia (HBL) is characterized by plasma concentration of lowdensity lipoprotein cholesterol below the fifth percentile in a healthy population. It has been suggested that HBL may be associated with apolipoprotein E (apoE) and apoB polymorphisms, such as apoB 8344 and apoB EcoRI. METHODS: Patients with HBL (n=51) and age-and- sex-matched healthy controls (n=136) were compared for apoE genotyping, apoB 8344 polymorphism and apoB EcoRI polymorphism. ApoE genotyping and apoB EcoRI polymorphism were determined by polymerase chain reaction (PCR) restriction fragment-length polymorphism. ApoB 8344 polymorphism was determined by the PCR-amplification refractory mutation system. We also Search truncated apoB with ECL western blotting in 23 HBL subjects. RESULTS: We could not find any truncated form of apoB. We found significant elevation of the apoE epsilon2 allele frequency of 0.147 in HBL cases compared with 0.063 in healthy controls (P=0.018). The ApoB 8344 polymorphism showed no significant difference between the HBL and the normal control groups. There were no significant apoB EcoRI allele frequency differences between the HBL and the normal groups. There were no significant apoB EcoRI allele frequency differences between the HBL and the normal groups. CONCLUSIONS: We could not find any relationship between HBL either with apoB 8344 or apoB EcoRI polymorphisms, but apoE epsilon2 allele seemed to be associated with HBL in Koreans.
Alleles ; Apolipoprotein E2 ; Apolipoproteins B ; Apolipoproteins E ; Apolipoproteins* ; Blotting, Western ; Cholesterol ; Gene Frequency ; Humans ; Hypobetalipoproteinemias ; Lipoproteins ; Plasma ; Polymerase Chain Reaction

PURPOSE:We report the results of image-guided percutaneous biopsies with a biopsy gun and evaluate the clinical usefullness. MATERIALS AND METHODS: One hundred and five biopsies under ultrasonographic or fiuoroscopic guidance were performed. Various anatomic sites were targeted (liver;50, chest;22, kidney;12, pancreas;8, intraperitoneum;7, retroperitoneum; ). RESULTS:Obtained tissue was diagnostic in 98 of the 105 biopsies(93%). In each instance, representative core tissue specimens were obtained. Evaluation of the core tissue by pathologist revealed consistent, uniform specimens that contained significant crush artifact in no case. Five biopsies yielded inadeguate tissues which were too small for histopathologic interpretation or were composed of necrotic debris. Two biopsies yielded adequate tissues, but tissues were not of the target. The diagnoses were malignancy in 77 biopsies and benign disease in 21 biopsies. No complications other than mild, localized discomfort were encountered except a transient hemoptysis and pneumothorax which was observed in two patients. CONCLUSION:Cutting biopsy with a biopsy gun provided sufficient amount of target tissue for an accurate diagnosis of malignant and benign disease. It was a safe and useful procedure for percutaneous biopsy.
Artifacts ; Biopsy* ; Diagnosis ; Hemoptysis ; Humans ; Pneumothorax

BACKGROUND: Due to the westernization of living environments in Korea, a number of allergy patients are greatly increasing. External quality control assessments are difficult for allergy tests due to the lack of reference methods. We surveyed the current status of allergy tests performed in medical laboratories in Korea to prepare for an external quality control assessment in the near future. METHODS: We conducted a survey on internal and external quality control trials, calibrations and its intervals, medical staffs, analyzers in use, an average number of tests per months, and report formats. RESULTS: Among the 85 laboratories surveyed, 61 were doing allergy tests including 6 reference laboratories. There were two different types of analyzers (1) qualitative or semi-quantitative and (2) quantitative. These analyzers use either chemiluminescent or immunoblot method. Fifty-five laboratories were using 'qualitative or semi-quantitative' analyzers as a screening test and 31 laboratories were using quantitative analyzers. Most of the laboratories were only doing an internal quality control assessment included in the test kits. Excepting a few laboratories, calibrations were not done. About 34 laboratories reported numerical values with interpretative reports prepared by laboratory medical doctors. CONCLUSIONS: The necessity of external quality control assessment has become an issue for improving the quality of allergy tests. But due to the lack of standardization, it is difficult to carry out external quality control assessments. By grouping the laboratories in terms of the type of analyzers, we could overcome the problem of analyzer variations and launch an external quality control assessment program in the near future.
Allergens/*immunology ; Chemiluminescent Measurements/standards ; Humans ; Immunoassay/instrumentation/*standards ; Immunoblotting/standards ; Immunoglobulin E/*blood/immunology ; Korea ; Quality Control