Design and Realization of Integrated Management System for Data Interoperability between Point-of-Care Testing Equipment and Hospital Information System / 대한의료정보학회지

OBJECTIVES: The purpose of this study was to design an integrated data management system based on the POCT1-A2, LIS2-A, LIS2-A2, and HL7 standard to ensure data interoperability between mobile equipment, such as point-of-care testing equipment and the existing hospital data system, its efficiency was also evaluated. METHODS: The method of this study was intended to design and realize a data management system which would provide a solution for the problems that occur when point-of-care testing equipment is introduced to existing hospital data, after classifying such problems into connectivity, integration, and interoperability. This study also checked if the data management system plays a sufficient role as a bridge between the point-of-care testing equipment and the hospital information system through connection persistence and reliability testing, as well as data integration and interoperability testing. RESULTS: In comparison with the existing system, the data management system facilitated integration by improving the result receiving time, improving the collection rate, and by enabling the integration of disparate types of data into a single system. And it was found out that we can solve the problems related to connectivity, integration and interoperability through generating the message in standardized types. CONCLUSIONS: It is expected that the proposed data management system, which is designed to improve the integration point-of-care testing equipment with existing systems, will establish a solid foundation on which better medical service may be provided by hospitals by improving the quality of patient service.

A case of pineal germioma presenting with diabetes insipidus / 대한내과학회지

Central diabetes insipidus caused by pineal gland neoplasm is rare. Here, we describe a case of central diabetes insipidus and pineal germinoma with seeding to pituitary stalk along CSF pathway. A 27 year-old male patient was admitted due to polyuria, polydipsia, headache, vomiting, diplopia, and decreased visual acuity for recent two months. Urine osmolality measured after water deprivation was below 100mOsm/kg. However, urine osmolality increasd above 300 mOsm/kg with pitressin administration. Brain MRI showed a 2cm sized mass with seeding into pituitary stalk along CSF in pineal region. Surgical biopsy revealed pineal germinoma. Two cycles of chemotherapy with etoposide and cis-platin were done followed by brain irradiation(2,500cGy). Follow up brain MRI after second chemotherapy showed complete remission. The patient had no neurologic and endocrinologic deficit after the treatment.

A Case of Parathyroid Carcinoma Invading Thyroid Gland as Solitary Nodular Form / 대한내분비학회지

Parathyroid carcinoma is a rare cause of primary hyperparathyroidism and commonly metastasize to lymph node, lung, liver, and bone. In Korea, there has been no report of distant metastasis in parathyroid carcinoma except for one case of pulmonary metastasis. A 58-year-old man presenting with weakness, nausea, and a palpable thyroid nodule visited our hospital. Elevated serum calcium and parathyroid hormone (PTH) concentration allowed the diagnosis of hyperparathyroidism. Two discrete masses were identified by neck ultrasound scan, computed tomography (CI') and Tc-Sestamibi scan in the left lobe of thyroid gland and ipsilateral parathyroid gland. So multiple endocrine neoplasia (MEN) type 2A" was suspected initially, but postoperative histological diagnosis was left parathyroid carcinoma with solitary nodular lesion invading left thyroid gland. He was successfully treated with left parathyroidectomy and left thyroid lobectomy.

Serum Lipoprotein(a) Concentration in patients with Diabetic Microangiopathy & Neuropathy / 대한내과학회지

BACKGROUND: Several epidemiological studies have shown that high plasma concentration of lipoprotein(a) [Lp(a)] is associated with an increased risk for atherosclerotic cardiovascular disease and works as an independent risk factor for atherosclerosis. But, the significance of Lp(a) in diabetic microangiopathy & neuropathy is unclear essentially due to a paucity of relevant studies. This study was designed to evaluate whether Lp(a) concentration may be increased in patients with diabetic microangiopathy & neuropathy. METHODS:We studied 96 patients who visited the department of internal medicine in Pusan National University Hospital from May 1995 to May 1996. The patients were grouped according to the presence of diabetic complications(microangiopathy and neuropathy, microangiopathy included retinopathy and nephropathy) and therapeutic modalities(diet, insulin, insulin with oral hypoglycemic agent, and oral hypoglycemic agent). RESULTS: 1) Concentration of Lp(a) was significantly higher(p or = 50 mg/dl was significantly correlated with diabetic retinopathy & nephropathy, but was not significantly correlated with diabetic neuropathy. Duration of diabetes(> or =7 years) and total cholesterol(> or =240 mg/dl) were significantly correlated with diabetic retinopathy, nephropathy and neuropathy. CONCLUSIONS: Lp(a) concentration is increased in patients with diabetic microangiopathy and neuropathy compared with patients without these complications. So, Lp(a) may works as risk factor for diabetic microangiopathy and neuropathy, and further study to evaluate the role of Lp(a) as a risk factor of such complications would be necessary in large number of patients.

Two Cases of Cerebral Toxoplasmosis in AIDS Patients / 대한내과학회지

Toxoplasmosis of the central nervous system occurs in 3 to 40 percent of all patients with the acquired immunodeficiency syndrome (AIDS), and it is the most common opportunistic infection to cause encephalitis or focal intracerebral lesions. We experienced two cases of cerebral toxoplasmosis in AIDS patients presenting as high fever, seizure and general weakness.