There is still lack of a convinient system that connect referring physicians to the information system of referral hospitals, We proposed to develop the laboratory-information-accessing system(LISA) for physicians referred to AMC referral center with Web-based internet technology. We constructed the menu of AMC Referral Center as a part of Asan Medical Center(AMC) homepage. The information of the referred patients wee collected in the separate internal server and then transferred to the external network sever by a batch. Referring physicians was able to connect to AMC Referral Center via AMC homepage and then browse the list of their patients by putting their identification number and password. At the next, the physicians chose the patients and the test item to be displayed. In order that the referral system is established tin the medical part, the LISA world be more needed, in the society, which internet is getting popular. This LISA was introduced successfully now, and it could be a model of national standard for hospital information system.
Chungcheongnam-do ; Clinical Laboratory Information Systems ; Hospital Information Systems ; Humans ; Information Systems ; Internet ; Referral and Consultation ; Tin

BACKGROUND: Alteration in plasma lipid levels during malaria attacks was studied to evaluate the diagnstic values in vivax malaria. METHODS: The plasma levels of total cholesterol, triglycerides, HDL-cholesterol (HDL-c), and LDL-cholesterol (LDL-c) were analyzed and compared in 32 patients with vivax malaria at presentation, in 10 patients after 17-days of treatment with anti-malaria drug, and in 40 control individuals. Interrelation of lipid profile with other parameters including parasitemia level, platelet count, hemoglobin and WBC counts were analysed. RESULTS: In patients with malaria, serum total cholesterol, triglycerides, HDL-c and LDL-c concentrations were significantly lower than those of control subjects. None of lipid profile showed any correlation with the parasitemia level. After treatment, HDL-c was significantly elevated. CONCLUSION: These results suggest that lipid profile, especially decreased of HDL-c, may be a valuable information in the diagnosis of the malaria.
Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Diagnosis ; Humans ; Malaria ; Malaria, Vivax ; Parasitemia ; Plasma ; Plasmodium vivax* ; Plasmodium* ; Platelet Count ; Triglycerides

BACKGROUND: Alteration in plasma lipid levels during malaria attacks was studied to evaluate the diagnstic values in vivax malaria. METHODS: The plasma levels of total cholesterol, triglycerides, HDL-cholesterol (HDL-c), and LDL-cholesterol (LDL-c) were analyzed and compared in 32 patients with vivax malaria at presentation, in 10 patients after 17-days of treatment with anti-malaria drug, and in 40 control individuals. Interrelation of lipid profile with other parameters including parasitemia level, platelet count, hemoglobin and WBC counts were analysed. RESULTS: In patients with malaria, serum total cholesterol, triglycerides, HDL-c and LDL-c concentrations were significantly lower than those of control subjects. None of lipid profile showed any correlation with the parasitemia level. After treatment, HDL-c was significantly elevated. CONCLUSION: These results suggest that lipid profile, especially decreased of HDL-c, may be a valuable information in the diagnosis of the malaria.
Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Diagnosis ; Humans ; Malaria ; Malaria, Vivax ; Parasitemia ; Plasma ; Plasmodium vivax* ; Plasmodium* ; Platelet Count ; Triglycerides

Multifocal papillary thyroid carcinoma (mPTC) comprises about 20-30% of PTC. In mPTC, individual tumor foci can be identical or frequently composed of different histological types including follicular, solid, tall-cell or conventional patterns. We report a case of mPTC consisting of one encapsulated follicular variant of papillary thyroid carcinoma (FVPTC) and three conventional PTCs in a 44-year-old woman. This case genetically demonstrates unique features including the simultaneous presence of the BRAF V600E (T1799A) mutation and the BRAF K601E (A1801G) mutation in conventional PTC and FVPTC, respectively.
Carcinoma ; Carcinoma, Papillary ; Factor IX ; Female ; Humans ; Thyroid Gland ; Thyroid Neoplasms

BACKGROUND: Baker's asthma is a common occupational respiratory disease and its prevalence rate varies from 15% to 30% of the workers in foreign countries. It has been reported mainly in bakers and millers due to sensitization to wheat, rye, storage mites, and several enzymes etc. But, the main allergen of baker's asthma is wheat. As there is an increase of consumption of food made of wheat due to westernized life style, it is expected that the prevalence of baker's asthma is increasing or already increased. But, there has been no study to investigate the prevalence of baker's asthma in this country. OBJECTIVE: The purpose of this study was to investigate the prevalence of baker's asthma due to wheat sensitization in baking factory workers. METHOD: A total of 147 bakers (age 32.6+/-8.2 years, male 63%) were enrolled in this study. They responded to a modified ISSAC questionnaire and underwent methacholine bronchial challenge test, and skin prick test with common inhalant allergens and work-related allergens including commercial wheat antigen, bread flour, and cake flour antigen prepared in our laboratory. And specific bronchial challenge test with wheat extract was performed to volunteers. RESULTS: The atopic prevalence based on skin prick test was 43% (63/147), and wheat sensitization rate (including commercial wheat, bread flour and cake flour antigen) was 15% (22/147). The risk factors for wheat sensitization were atopy, long duration occupied in baking process, and current or past work history in mixing and/or measuring part where wheat flour exposure was relatively high (p<0.05). Wheat sensitization was highly associated with bronchial hyperresponsiveness, work related symptoms such as asthma, rhinitis, conjunctivitis, and dermatitis (p<0.05) respectively. The prevalence of current asthma based on questionnaire and methacholine bronchial challenge test was 8% (11/147 bakers). Of these, 8 bakers were sensitized to wheat antigen, and all of them except one baker complained of work-related symptoms. These seven bakers were highly suspected of baker's asthma due to wheat sensitization. Two of these seven bakers showed early asthmatic response on specific broncho-provocation test. CONCLUSION: Wheat sensitization rate was 15%, The prevalence of baker's asthma due to wheat sensitization was 5% in baking factory workers and it's risk factors were atopy, long duration occupied in baking process, and current or past work history in mixing and/or measuring part of baking process.
Acaridae ; Allergens ; Asthma* ; Bread ; Bronchial Provocation Tests ; Conjunctivitis ; Dermatitis ; Flour ; Humans ; Life Style ; Male ; Methacholine Chloride ; Prevalence* ; Rhinitis ; Risk Factors ; Secale ; Skin ; Triticum* ; Volunteers ; Surveys and Questionnaires

BACKGROUND: Programmed death-1 (PD-1) is physiologically expressed by germinal center-associated helper T-cells and has an inhibitory effect on T-cell activity. METHODS: We examined 63 cases of diffuse large B-cell lymphoma (DLBCL) and determined the number of PD-1-positive helper T-cells in a representative tumor area after immunohistochemical staining using a monoclonal antibody against PD-1. The PD-1-positive cells were counted in 3 high-power fields (HPFs; 400x). RESULTS: Patients were divided into 2 groups: one with a high number of PD-1-positive cells (>20/HPF, n=33) and one with a low number of PD-1-positive cells (< or =20/HPF, n=30). The former group showed decreased overall survival, but at a statistically non-significant level (p=0.073). A high number of PD-1-positive cells was more common in patients at an advanced clinical stage and with high international prognostic index score (p=0.025 and p=0.026, respectively). The number of extranodal sites also somewhat correlated with the PD-1 staining status (p=0.071). However, the number of PD-1-positive cells was not associated with patient age, serum lactate dehydrogenase level, and Eastern Cooperative Oncology Group performance score. CONCLUSIONS: The high number of PD-1-positive cells might be associated with an unfavorable outcome in DLBCL patients.
B-Lymphocytes ; Humans ; L-Lactate Dehydrogenase ; Lymphocytes, Tumor-Infiltrating ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, Large B-Cell, Diffuse ; T-Lymphocytes ; T-Lymphocytes, Helper-Inducer

BACKGROUND: Recently, liquid-based cytology (LBC) has been introduced as an alternative to the conventional smear (CS) technique in thyroid fine needle aspiration, due to its diagnostic convenience. METHODS: We assessed 77 cases of thyroid fine needle aspiration using the SurePath(TM) method (SP) as LBC and CS via split-sample techniques. BRAF mutation tests were carried out via polymerase chain reaction and pyrosequencing immediately after diagnosis or a delay of more than one year. RESULTS: In a comparison between SP and CS, the rate of concordance between SP and CS was as high as 84.4% (kappa value, 0.754). In comparison with histologic diagnosis, the overall sensitivity was 100% for both. The specificity was 62.5% for SP and 56.3% for CS. Relative to CS, papillary carcinomas on SP slides revealed more accentuated nuclear irregularities, nucleoli, and reduced nuclear size. In contrast to CS, the delayed BRAFV600E mutation test using SP slides after 1-2 years failed. The use of new primers amplifying shorter product size could help the delayed test achieve success. CONCLUSIONS: Differences in the diagnostic efficacy of SP and CS were negligible. The failure of the delayed BRAF mutation test on the SP slides might be associated with DNA degradation.
Biopsy, Fine-Needle ; Carcinoma, Papillary ; DNA ; Needles ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Thyroid Gland

Thrombotic thrombocytopenic purpura (TTP) and the related hemolytic uremic syndrome (HUS) are disorders characterized by thrombocytopenia, microangiopathic hemolytic anemia, a variable degree of impairment of renal function and fluctuating neurological symptoms, which are thought to be due to platelet activation and subsequent formation of thrombi in the microcirculation. The fact that there was no clear-cut clinical and laboratory features that differentiate HUS from TTP has lead to view these two syndromes as a clinical continuum. Microvascular thrombosis is the typical lesion and closely related with endothelial injury and platelet activation. Pathologic alterations of the brain parenchyma are mainly manifested by small multiple infarcts. Numerous cases of CNS complications of these syndromes have been evaluated by using CT, but few reports have mentioned the MR findings. We experienced a case of TTP-HUS that had clinical features of cortical blindness and the brain lesion was confirmed by MRI showing cerebral infarct at the occipital area but it was reversible course. So we report this case with a brief review of literature.
Anemia, Hemolytic ; Blindness, Cortical* ; Brain ; Hemolytic-Uremic Syndrome* ; Magnetic Resonance Imaging* ; Microcirculation ; Platelet Activation ; Purpura, Thrombotic Thrombocytopenic* ; Thrombocytopenia ; Thrombosis

Sheehan's syndrome has been attributed to ischemic damage of the pituitary gland or hypothalamic-pituitary stalk during the peripartum period. Well-described clinical features of Sheehan`s syndrome include hypothyroidism, growth hormone deficiency, hypogonadism, hypoprolactinemia, adrenal insufficiency, and different sodium and water disturbance. The occurrence of sodium and water disturbances associated with Sheehan`s syndrome depends on the degree of pituitary damage, time of onset since the initial pituitary insult, and concurrent medical conditions that also may play a role in sodium and water balance. Chronic hyponatremia is the most common presentation of altered sodium levels in patients with Sheehan`s syndrome. The chronic nature of the presenting hyponatremia suggests more subtle changes of panhypopituitarism or better adaptive mechanism. Although controversial, another mechanism proposed for hyponatremia in the chronic setting involves alternation in the renin-angiotensin/aldosterone system with resulting sodium wasting. We presented a patient with Sheehan`s syndrome associated with hyporeninemic hypoaldosteronism and hyponatremia 53 years old women, who had 4th baby delivery with severe blood loss about 25 years ago, was admitted to hospital because of general weakness. The patient was diagnosis Sheehan`s syndrome with hyponatremia. In addition, we performed hormonal study to find cause of hyponatremia. The results were hypopituitarism and hyporeninemic hypoaldosteronism. Hyponatremia was corrected by hormonal therapy (glucocorticoid,synthyroid,estrogen). The patient felt well-being sensation and was followed up the out-patient department.
Adrenal Insufficiency ; Diagnosis ; Female ; Growth Hormone ; Humans ; Hypoaldosteronism ; Hypogonadism ; Hyponatremia* ; Hypopituitarism* ; Hypothyroidism ; Middle Aged ; Outpatients ; Peripartum Period ; Pituitary Gland ; Sensation ; Sodium

BACKGROUND/AIMS: The symptoms of inflammatory bowel disease (IBD) fluctuate considerably over time. However, it has not been determined whether these symptoms are affected by the menstrual cycle in female IBD patients. This study analyzed the effects of the menstrual cycle on IBD symptom variation. METHODS: This was a prospective study of 91 study subjects (47 IBD patients and 44 healthy controls) who reported daily symptoms and signs throughout their menstrual cycles. RESULTS: IBD patients had significantly more frequent gastrointestinal symptoms, such as nausea (30% vs 7%, p=0.006), flatulence (53% vs 22%, p=0.003), and abdominal pain as compared to controls (68% vs 38%, p=0.006). The IBD patients also experienced more frequent systemic premenstrual symptoms than the controls (79% vs 50%, p=0.003). More severe abdominal pain (p=0.002) and lower mean general condition scores (p=0.001) were noted during the menstrual phase as compared to the pre- or post-menstrual phase in both groups. IBD patients experienced more frequent premenstrual gastrointestinal symptoms than controls, but their IBD symptoms did not change significantly during the menstrual cycle. CONCLUSIONS: Knowledge of the cyclic alterations in gastrointestinal and systemic symptoms may be helpful in determining the true exacerbation of disease in female IBD patients.
Abdominal Pain ; Female ; Flatulence ; Humans ; Inflammatory Bowel Diseases ; Menstrual Cycle ; Nausea ; Prospective Studies