Comparison of Isolation rate of the Pathogenic Microorganisms According to Stool Culture Methods / 대한임상미생물학회지

BACKGROUND: In developed countries, food-born diseases have decreased and hospital laboratory have taken more simple method rather than complex enrichment-selective methods. But detection rate of pathogenic bacteria in stool culture was not so high. METHODS: We mixed 4 pathogenic bacteria (S. typhi, S. flexneri, V. cholerae and Y. enterocolitica) with 3 stool specimens from healthy persons (for Y. enterocolitica, 5 specimens) and innoculated directly or after enrichment (105 bacteria/plate). After proper incubation, we counted suspected colonies and calculated true positive rate after identification of each colonies. RESULTS: For S. typhi, in the case of direct innoculation on the MacConkey, XLD and SS agar, positive rate of selected colonies were below 36.6%. After enrichment in SF broth for 8 hours, the rate were 80.0%, 83.0% and 70.0% respectively. For S. flexneri, the rates were 86.7%, 100%, 93.3% in direct innoculation, and were highest after enrichment in GN broth for two hours (93.3% in MacConkey and 100.0% in both XLD and SS agar). For V. cholerae, inspite of screening by catalase and oxidase tests, positive rate of selected colonies were 0% (0/7 colonies) in direct innoculation on the MacConkey. After enrichment in APW about 1 day and on TCBS agar, the rate were 100%. For Y. enterocolitica, after incubation at room temperature for 2 days, most selected colonies were Y. enterocolitica on CIN media. CONCLUSION: For more efficient detection of pathogenic bacteria in stool culture, combination of direct innoculation on MacConkey agar and on one or two selective media after proper enrichment process, should be considered.

Laboratory Information System using One Combined Request Slip: Specimen Requisition and Order Input System / 대한의료정보학회지

Usually LIS(Laboratory Information System) depend on OCS(Order Communication System) of HIS(Hospital Information System). So, both systems are constructed simultaneously. But it needs high cost and has potential of failure. So, we designed one combined laboratory request slip and isolated LIS(sever: Power Mac 7200, eight clients: LC 475, connected by Ethernet) operating with own order input system before HIS construction. we analyzed the efficiency during early 9 weeks (from Aug. 17 to Oct. 17 in 1995) and later 4 weeks (March in 1996). Daily input amount of request changed stably in the later period(maximum: 552. mean: 410.0) than the early period(maximum: 604. mean: 341.6). Peak time was between 9 a.m. and 10 a.m.(maximum: 127. slip/hour). In the later period, 64.2% the requests for in-patients were completed until 10 a.m. and the request for out-patients distributed more evenly. Majority of problems occurred, were delayed(25.5% in the early, 61.1% in the later period) or missed specimen(31.9% in the early, 22.9% in the later). Total number (26,309) of used requests was less than half of the calculated number(57,621) of previous laboratory slips.

Sea Blue Histiocytosis Associated with Hyperlipoproteinemia Type IIb

Sea-blue or ceroid histiocytosis is a storage phenomena associated with a variety of conditions especially abnormal lipid metabolism and particularly hyperlipoproteinemia. It is characterized by histiocytic proliferation in the bone marrow and spleen, contain-ing sea-blue inclusions by Romanovsky stain. The present case is a 1 1/2 year-old Korean boy who had marked enlargement of the spleen which was eventually removed. Aspirates of the bone marrow and histology of the spleen disclosed an enormous proliferation of histiocytes containing numerous cytoplasmic inclusions which stained sea-blue with Wright stain, was strongly positive to PAS and weakly positive to oil red-O and Sudan black B in frozen and in paraffin embedded section. Ultrastructually histiocytes were marked1y hypertrophic and contained numerous cytoplasmic inclusions which showed three distinct types and conglomeration of all three types, presumably representing age or maturation steps of the inclusions. The ear1y type consisted of a high electron dense core or deposits within a low electron dense matrix, evolving into homogeneous moderately electron dense inclusion and finally a well developed finger print-like internal structure. Analysis of the plasma lipid disclosed type IIb hyperlipoproteinemia. Types of hyperlipoproteinemia previously reported in association with sea-blue histiocytosis were type-I, III, IV and V, and this is the first case of type IIb hyperlipoproteinemia.