This study was performed to find a more efficient analytic method for medical record delivery process between using data collected from HIS and using data collected manually. And how to apply the Statistical Process Control technique to the quality measurement of work process. The results were as follows: 1. The method of using data collected from Hospital Information System was more efficient ( 99.2% ) than using data collected manually in time consumption. 2. The amount of analyzed data collected from HIS was amount about 3 times (279%) of those collected manually. 3. The application of Statistical Process Control technique for evaluating medical record delivery process was very effective to identify the problems in delivery process We identified the possibility that this statistical analytic technique of using data collected from HIS could be adopted to evaluate other process of healthcare management.
Delivery of Health Care ; Hospital Information Systems ; Medical Records*

BACKGROUND: Alveolar soft part sarcoma (ASPS) accounts for 0.5-1% of soft tissue sarcomas, and often metastasizes to the lung. Cases of pulmonary ASPS of unknown primary site have rarely been reported in literature. METHODS: Here, we report three cases of metastatic pulmonary ASPS and three cases of presumably primary ASPS using immunohistochemistry and clinicoradiologic findings. RESULTS: All of the cases occurred in young females. Two of the cases had metastasized from soft tissue ASPS of the lower extremities, and one case had metastasized from one of the patient? femur bones. Immunohistochemical stains were applied to four cases that had available paraffin blocks. The tumor cells of all cases on which immunohistochemical stains were done were positive for vimentin (4/4, 100%). None of the tumors were positive for myoglobin, desmin, smooth muscle actin, progesterone receptor, estrogen receptor, thyroid transcription factor-1, S-100 protein, pancytokeratin, and HMB-45 antibodies. CONCLUSION: The present study revealed that the rare pulmonary ASPS has nonspecific clinicoradiologic findings. In the immunohistochemical results, no differences existed between the presumably primary ASPS and the metastatic ASPS except for a higher Ki-67 labeling index in the latter (less than 0.1% vs. 30%). The higher index was not dissimilar to those of the extrapulmonary ASPS which showed a tumor with a low proliferation index, signifying a better prognosis and have a low potential to metastasize.
Actins ; Antibodies ; Coloring Agents ; Desmin ; Estrogens ; Female ; Femur ; Humans ; Immunohistochemistry ; Lower Extremity ; Lung* ; Muscle, Smooth ; Myoglobin ; Paraffin ; Prognosis ; Receptors, Progesterone ; S100 Proteins ; Sarcoma ; Sarcoma, Alveolar Soft Part* ; Thyroid Gland ; Vimentin ; Viperidae

Primary hyperoxaluria is a rare autosomal recessive inherited metabolic disease which results from endogenous overproduction of oxalic acid. It causes variant phenotypes from renal failure in infancy to mere urolithiasis in late adulthood. We report a case of primary hyperoxaluria in a 11-year-old boy. He presented with recurrent multiple renal stones since 3 years of age. He had renal failure and markedly increased hyperoxaluria (568.26 microgram/mg of creatinine (normal: 0.04-0.15)) and his stones consisted of a mixture of calcium oxalate (30%) and calcium phosphate (10%) in contrast to pure calcium oxalate monohydrate in the other primary hyperoxaluria type 1 patients. A renal biopsy showed interstitial cellular infiltration with crystals which are birefringent under polarized light within the tubules. His general conditions were improved after hemodialysis treatment. For definite cure of disease, combined liver-kidney transplantation is considered.
Biopsy ; Calcium ; Calcium Oxalate ; Child ; Creatinine ; Humans ; Hyperoxaluria ; Hyperoxaluria, Primary* ; Kidney Failure, Chronic* ; Male ; Metabolic Diseases ; Nephrolithiasis ; Oxalic Acid ; Phenotype ; Renal Dialysis ; Renal Insufficiency ; Urolithiasis

No abstract available.
Asian Continental Ancestry Group* ; Humans

No abstract available.
Asian Continental Ancestry Group* ; Humans

BACKGROUND: Emergence of pneumococcal resistance became a global issue since 1990s. According to the ANSORP studies with clinical isolates and carriage isolates between 1996 and 1999, some Asian countries showed alarmingly high prevalence of resistance to penicillin and other antimicrobial agents. To investigate the changing trends of pneumococcal resistance, ANSORP study group has performed a multinational surveillance study with invasive pneumococcal isolates from Asian countries. METHODS: All isolates from various invasive pneumococcal diseases were prospectively collected from 14 centers in 12 countries between November 1999 to August 2001. Broth microdilution tests with 16 antimicrobial agents were performed according to the NCCLS procedures. Serotyping was performed by means of Quelling reaction with use of group-specific antisera. RESULTS: A total of 685 isolates were collected. Overall, 52.4% of invasive isolates from Asian countries were not susceptible to penicillin (intermediate (I), 22.9%; Resistant (R), 29.5%). Vietnam showed the highest prevalence of penicillin non-susceptibility (I 20.6%, R 71.4%) followed by Sri Lanka (I 71.4%, R 14.3%), Hong Kong (I 24.1%, R 76%) and Korea (I 9.7%, R 54.8%). China (I 19.8%, R 23.4%) and Malaysia (I 9.1%, R 29.5%) also showed remarkable increase in penicillin resistance compared with previous ANSORP data, which were less than 10%. Vietnam (92.1%), Taiwan (87.7%), Korea (80.6%), and Hong Kong (76.8%) showed high prevalence of erythromycin resistance. MIC90s for ciprofloxacin were 4 microgram/mL (Hong Kong) and 2 microgram/mL (11 Asian countries except Hong Kong), respectively. CONCLUSION: Compared with previous data from ANSORP studies, antimicrobial resistance among invasive pneumococcal isolates has markedly increased in Vietnam, Sri Lanka, Taiwan, China, and Malaysia. Continuous surveillance of pneumococcal resistance in Asia is strongly warranted.
Anti-Infective Agents ; Asia ; Asian Continental Ancestry Group* ; China ; Ciprofloxacin ; Erythromycin ; Hong Kong ; Humans ; Immune Sera ; Korea ; Malaysia ; Penicillin Resistance ; Penicillins ; Prevalence ; Prospective Studies ; Serotyping ; Sri Lanka ; Streptococcus pneumoniae ; Taiwan ; Vietnam

BACKGROUND: Emergence of pneumococcal resistance became a global issue since 1990s. According to the ANSORP studies with clinical isolates and carriage isolates between 1996 and 1999, some Asian countries showed alarmingly high prevalence of resistance to penicillin and other antimicrobial agents. To investigate the changing trends of pneumococcal resistance, ANSORP study group has performed a multinational surveillance study with invasive pneumococcal isolates from Asian countries. METHODS: All isolates from various invasive pneumococcal diseases were prospectively collected from 14 centers in 12 countries between November 1999 to August 2001. Broth microdilution tests with 16 antimicrobial agents were performed according to the NCCLS procedures. Serotyping was performed by means of Quelling reaction with use of group-specific antisera. RESULTS: A total of 685 isolates were collected. Overall, 52.4% of invasive isolates from Asian countries were not susceptible to penicillin (intermediate (I), 22.9%; Resistant (R), 29.5%). Vietnam showed the highest prevalence of penicillin non-susceptibility (I 20.6%, R 71.4%) followed by Sri Lanka (I 71.4%, R 14.3%), Hong Kong (I 24.1%, R 76%) and Korea (I 9.7%, R 54.8%). China (I 19.8%, R 23.4%) and Malaysia (I 9.1%, R 29.5%) also showed remarkable increase in penicillin resistance compared with previous ANSORP data, which were less than 10%. Vietnam (92.1%), Taiwan (87.7%), Korea (80.6%), and Hong Kong (76.8%) showed high prevalence of erythromycin resistance. MIC90s for ciprofloxacin were 4 microgram/mL (Hong Kong) and 2 microgram/mL (11 Asian countries except Hong Kong), respectively. CONCLUSION: Compared with previous data from ANSORP studies, antimicrobial resistance among invasive pneumococcal isolates has markedly increased in Vietnam, Sri Lanka, Taiwan, China, and Malaysia. Continuous surveillance of pneumococcal resistance in Asia is strongly warranted.
Anti-Infective Agents ; Asia ; Asian Continental Ancestry Group* ; China ; Ciprofloxacin ; Erythromycin ; Hong Kong ; Humans ; Immune Sera ; Korea ; Malaysia ; Penicillin Resistance ; Penicillins ; Prevalence ; Prospective Studies ; Serotyping ; Sri Lanka ; Streptococcus pneumoniae ; Taiwan ; Vietnam

Purpose: The association of serum lipids with gastric cancer is controversial. We clarified the role of serum lipids in the development, progression, and prognosis of gastric cancer. Materials and Methods: In total, 412 patients diagnosed with gastric cancer were prospectively recruited, and 2,934 control subjects who underwent screening endoscopy were enrolled from December 2013 to March 2017 to conduct a case-control study in a tertiary center. Serum lipid profiles, including total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), apolipoprotein A-I (apoA-I), and apolipoprotein B, and clinicopathologic characteristics were analyzed. Results: The gastric cancer group showed significantly lower HDL-C, higher LDL-C, and lower apoA-I level than the control group. In multivariate analysis, old age (odds ratio [OR], 1.051; p < 0.001), smoking (OR, 1.337; p < 0.001), a family history of gastric cancer (OR, 2.038; p < 0.001), Helicobacter pylori seropositivity (OR, 4.240; p < 0.001), lower HDL-C (OR, 0.712; p=0.020), and higher LDL-C (p=0.002) were significant risk factors for gastric cancer. Lower HDL-C and higher LDL-C remained significant after adjustments for covariates, including age and sex. In a subgroup analysis of the gastric cancer group, lower TG levels were associated with undifferentiated histology. No serum lipids were associated with overall survival. Conclusion Lower HDL-C and higher LDL-C were associated with the risk of gastric cancer, even after adjusting for age, sex, and other factors. In the gastric cancer group, undifferentiated histology was associated with lower TG levels.

Poststreptococcal reactive arthritis (PSRA) is associated with recent streptococcal infections. However, PSRA is distinct from acute rheumatic fever by its clinical manifestations: non-migrating arthritis, erythema nodosum or erythema multiforme, and transient elevation of serum transaminases. We experienced a 33-year-old man who presented with fever, arthritis of both knees and ankles, and erythema nodosums on extensor surfaces of lower legs which developed 6 days after the onset of pharyngitis symptoms. Blood and urine cultures were negative. Throat culture was negative for group A beta-hemolytic streptococcus. The ASO titers increased up to 2080 IU/mL in sequential monitoring. The result of bone scan was compatible to arthritis of both knees and ankles. There were no signs or symptom of carditis. He showed clinical improvement with anti-inflammatory drugs (naproxen 1,000 mg/day and prednisolone 7.5 mg/d). PSRA should be included in the differential diagnosis of patients presenting with arthritis combined with fever.
Adult ; Ankle ; Arthritis ; Arthritis, Reactive* ; Diagnosis, Differential ; Erythema Multiforme ; Erythema Nodosum ; Fever ; Humans ; Knee ; Leg ; Myocarditis ; Pharyngitis ; Pharynx ; Prednisolone ; Rheumatic Fever ; Streptococcal Infections ; Streptococcus ; Transaminases

Poststreptococcal reactive arthritis (PSRA) is associated with recent streptococcal infections. However, PSRA is distinct from acute rheumatic fever by its clinical manifestations: non-migrating arthritis, erythema nodosum or erythema multiforme, and transient elevation of serum transaminases. We experienced a 33-year-old man who presented with fever, arthritis of both knees and ankles, and erythema nodosums on extensor surfaces of lower legs which developed 6 days after the onset of pharyngitis symptoms. Blood and urine cultures were negative. Throat culture was negative for group A beta-hemolytic streptococcus. The ASO titers increased up to 2080 IU/mL in sequential monitoring. The result of bone scan was compatible to arthritis of both knees and ankles. There were no signs or symptom of carditis. He showed clinical improvement with anti-inflammatory drugs (naproxen 1,000 mg/day and prednisolone 7.5 mg/d). PSRA should be included in the differential diagnosis of patients presenting with arthritis combined with fever.
Adult ; Ankle ; Arthritis ; Arthritis, Reactive* ; Diagnosis, Differential ; Erythema Multiforme ; Erythema Nodosum ; Fever ; Humans ; Knee ; Leg ; Myocarditis ; Pharyngitis ; Pharynx ; Prednisolone ; Rheumatic Fever ; Streptococcal Infections ; Streptococcus ; Transaminases