Application of Middleware to Automated Hematology Analyzers / 임상검사와정도관리

BACKGROUND: Test results in a laboratory are simply relayed to the laboratory information system through the interface. Middleware facilitates and manages the interaction between applications across heterogeneous computing platforms. We applied middleware to automated hematology analyzers in a clinical laboratory. METHODS: We used HemLink (Beckman Coulter Korea, Korea) as middleware between the laboratory information system and hematology analyzers. It provides quality control programs including the Westgard multirule chart and moving averages. RESULTS: Unlike the previous system, middleware does not require manual input of the quality control results. Amendment of quality control, if necessary, could be done without the help of hospital information teams. Identification of abnormal results with patient information could be achieved with moving averages. Morphology flags and system flags are checked at remote computers. CONCLUSIONS: Management of quality control results of hematology analyzers was easy via middleware. Thus, middleware could be useful to connect proficiency testing programs with HemLink and to compare results from laboratories using the same middleware.

Changes in Protein Expression in Breast Cancer after Anthracycline-Based Chemotherapy

Background : Anthracyclines are the standard agents used to treat patients with advanced breast carcinoma. Some molecules are reportedly associated with anthracycline resistance; however, there has been some controversy surrounding these claims. The gain or loss of certain molecules after chemotherapy can explain the discrepancies in the results. Methods : We evaluated the expression levels of the estrogen receptor (ER), p53, and bcl-2 in specimens obtained from twenty patients with advanced breast cancer before and after anthracyclinebased chemotherapy using immunohistochemistry (IHC). We also examined HER2/neu expression in these specimens using IHC and fluorescence in situ hybridization (FISH) analysis. Results : After chemotherapy, one of the twenty cases (5%) showed decreased ER expression, one (5%) showed decreased p53 expression, and one (5%) showed increased bcl-2 expression. IHC and FISH analysis in pre- and post-chemotherapy specimens showed that the expression of HER2/neu changed from equivocal to negative in one case (5%). Conclusion : Our results showed that the expression levels of HER2/neu, ER, p53 and bcl-2 remained stable after chemotherapy, although the statistical significance of these results may not be validated due to the small number of cases. We also suggested that the resistance to anthracycline-based chemotherapy might not be associated with the modification of these molecules.

The Development of Viewer of Electronic Medical Vocabulary based on MED: The Viewer of Electronic Medical Vocabulary / 대한의료정보학회지

OBJECTIVE: To Implement Effective Vocabulary Viewer for Electronic Medical Vocabulary Database Such as MED. DESIGN: A few Medical Vocabulary Database access method are reviewed. Some of their disadvantage of acquiring specific medical concepts are identified. MED has chosen as an example Medical Vocabulary System. We studied AccessMED, a vocabulary browser that supports lexical matching and the traversal of hierarchical and semantic links, and enhanced methodology of medical vocabulary browsing and acquiring medical vocabulary. RESULTS: The paper suggests platform independent client-server architecture Medical Vocabulary Viewer, MEDUSA. Additional support for Medical Vocabulary Browsing options such as display all ancestor, multiple concepts displaying, and bookmarking workspaces are implemented. CONCLUSION: Since MEDUSA uses client-server architecture along with scripting language such as TCL/TK as implementation language, it runs multiple platform. We claim MEDUSA can be easily integrated with other Medical Vocabulary such as UMLS. Using bookmark and annotation function of MEDUSA enables many vocabulary developers from multiple sites to communicate and discuss new concepts better.

Serum IgG and IgG subclass in bronchial asthma / 천식및알레르기

BACKGROUND AND OBJECTIVE: IgG subclass deficiency has been reported in patients with bronchial asthma and is associated with recurrent respiratory tract infections. This study was done to identify prevalence of IgG subclass deficiency and to evaluate the possible difference between atopic and non-atopic asthmatics. Subjects and METHODS: We measured serum levels of IgG and IgG subclass in 35 asthmatic patients and 50 healthy controls using nephelometry. Reference values of each IgG subclass was defined as cumulative percentile between 2.5% to 97.5% of controls. RESULTS: Total IgG, IgG1 and IgG2 of asthmatics were significantly lower than for those of controls(p<0.05, respectively). In atopic asthmatics, compared with non-atopic asthmatics, IgG4 level was significantly higher (p<0.05). The frequency of IgG subclass levels below the reference value was eight (22.9%) of 35 asthmatics. CONCLUSION: IgG, IgG1 and IgG2 were significantly lower in asthmatic patients. Some patients had IgG subclass levels below reference value. Further studies will be needed to evaluate their clinical significance.

The Analysis of Mass Physical Screening Using the Concept of Data Warehousing Short subject: Data Warehousing and Mass Screening / 대한의료정보학회지

Vast quantities of data are generated through the health care process. While many studies to analyze the multiple database are being tried in the business area, a few studies have been done in medical area. We tried to study the seasonal variation of tests using two hospital data on mass screening. We received 79772 data from Seoul Joongang Hospital and 12330 data from Ajou University Hospital, and changed from text file to DBF. Inpromptu and Powerplay were used as the tools of data warehousing. The modeling and analysis was done effectively through the tools. The tests of seasonal variation were 6 items.

A Telemedicine System Using B-ISDN / 대한의료정보학회지

The telemedicine is emerging as a new way of medical practice. It will provide more cooperative activity between hospitals and more comfortable access for disabled patients home. We developed a telemedicine system which is aimed to be run on the broadband-intergrated services digital network (B-ISDN). The multimedia database is adjusted to those information about patients that is directly relevant to a doctor's diagnosis. The user interface is designed to help doctors to communicate easily. The key elements of telemedicine systems were designed for user friendly interface and We implemented the pilot system to confirm the usefulness of the system.

The Central and Peripheral Corneal Thickness in Normal Korean According to Age and Sex

In order to study the age and sex variations in central corneal thickness and to investigate the peripheral corneal thickness according to measured sites, the authors measured the central and peripheral corneal thickness of 380 normal Korean eyes aged 10 to 69 years (190 males and 190 females). Measurements of corneal thickness were taken with a newly developed ultrasonic pachymeter, Vida-55. Central corneal thickness was measured at four different limbal areas(upper nasal of 45 degrees, upper temporal of 135 degrees, lower temporal of 225 degrees and lower nasal of 315 degrees) immediately central to the limbal vessel loops. The results obtained were as follows; 1. The mean central corneal thickness in normal 380 Korean eyes was 0.507 +/- 0.036mm(standard deviation). The average thickness in the group of males(0.515 +/- 0.035mm) is significantly higher than in the group of females(0.501 +/- 0.035mm)(p<0.001). 2. According to the site of peripheral cornea, the average thickness was 0.716 +/- 0.038mm in male and 0.721 +/- 0.055mm in female at upper nasal, 0.724 +/- 0.041 mm in male and 0.731 +/- 0.047mm in female at upper temporal, 0.744 +/- 0.028mm in male and 0.747 +/- 0.041mm in female at lower nasal and 0.747 +/- 0.028mm in male and 0.753 +/- 0.042mm in female at lower temporal respectively. 3. The central corneal thickness has a tendency to decrease in older age groups, and after 40 years of age this decrease statistically significant(p<0.05). 4. The thinnest site of peripheral cornea is upper nasal limbal area while the thickest is lower temporal in any age or sex group. The difference between these two sites is statistically significant(p<0.05) except females aged 50 to 69 years.

Follow-up Study of Refractive Errors in School Children

The refractive state of 261 children (136 boys and 122 girls) of a primary school of Seoul City between the age of 8, 12 were examined under the cycloplegic condition with Mydrin-P(Tropicamide) for 2 years. To evaluate the effect of poor illumination we selected the children who will spend one year of their school life in the relatively poorly illuminated classrooms and follow-up study was done after one year interval. The results were as follows: 1. The incidence of refractive errors was 59.7% in 1978 and then increased up to 63.5% in 1979. 2. As to the distribution of refractive errors, in 1978 the incidene of hyperopic eyes was the grea test as 19.5%; and in 1979 the incidence of myopic eyes was the greatest as 20.5%. 3. Theare was a tendency of gradual increase in the incidence of myopic refractive errors as the age increased both in 1978 and 1979 and gradual decrease in the incidence of hyperopic refractive error as the age increased both in 1978 and 1979. 4. The majority of refractive power was in between +0.37 and +3.0D in 1978 as 53.5%; and between -0.37 and -3.0D in 1979 as 55.0%. 5. Among changes in refractive state which was discovered by follow-up study for the same children on the following year, the incidence of change to the direction of myopic refractive state was greatest in all age group. The overall incidence of the direction of myopic refractive state was greatest as 48.9% than 27.6% of unchanged refractive state.

A Statistical Study of Pterygium and Postoperatic Complication of pterygium

The authors observed 352 cases of pterygia among 34,031 out patients of St, Mary's eye clinic from Jan 1978 to Oct. 1979. A comparative study was made of 352 pterygia patients as to sex, age, the affected side, degree of corneal involvement and recurrent rate. The following results were obtained. 1) All 352 cases consist of 118 cases (33.5%) in male and 234 cases (66.5%) in female. 2) There was no significant difference in the site of the pterygium. Rt eye was involved in 121 cases (34.4%). Lt eye was involved in 118 cases (33.5%) and both eyes were involved in 113 cases (32.1%) 3) In our series. only 4 cases had temporal pterygium and 4 cases of pseudopterygium were observed. 4) We divide the types of pterygia into grades based on the corneal area covered by the lesion; 180 eyes (40.4%) were Grade I, 227 eyes(50.9%) were Gread II. 37 eyes (8.3%) were Grade III, and 2 eyes (0.4%) were Grade IV. 5) The greatest numper of patients were between 31 and 40 year old. (123 patients, 34.9%) 6) Among III cases which was operated with bare sclera and received Strontium irradiation, incidence of recurrence was 5,4% (6 cases) and mean duration of recurrence was 30 days after operation. 7) Scleromalacia, Corneal perforation and Descemetocele were observed as postoperative complication of pterygium after several years.

Intralegional Triamcinolone Acetonide Therapy of Chalazia

Chronic inflammation of the meibonliarl glands (chalazia) frequently become troublesome because of recurrences, cosmetic blemish and distortion of vision when it is large enough. Medical treatment with hot compress, topically administered antibiotics and corncosteroids often fail to cure, so leads to chalazia with trial intralesional injection of triamcinolone acetonide. Ten chalazia reso1ved within one week after only one injection, two chalazia after two injections, one chalazion after three injections and one lesion failed to respond to three injections which was removed by surgery. We observed that intralesional injection of triamcinolone acetonide for chalaza is a good procedure, which appear to be a safe, convinient and effective alternative to chalazion surgery.