• Title/Summary/Keyword: 의뢰율

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The Patterns of Conversion to Anti-Tuberculosis Drug Resistance in Mycobacterium tuberculosis (결핵균의 항결핵제 내성 전환 패턴)

  • Chong, Moo-Sang;Lee, Kyutaeg
    • Korean Journal of Clinical Laboratory Science
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    • v.54 no.2
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    • pp.125-132
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    • 2022
  • The prevalence of multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) are increasing. We analyzed the patterns of drug resistance and tracking period days of acquiring anti-mycobacterial resistance. From January 2010 to December 2019, drug susceptibility tests (DST) were performed by the absolute concentration method using the Löwenstein-Jensen solid medium and pyrazinamidase activity test (to assess pyrazinamide resistance) in samples from patients who were referred to the Green Cross Laboratories in Yongin. Among the cases that showed resistance to one or more anti-tuberculosis drugs, 55 patients (33.1%) were resistant to isoniazid (INH) at the time of initial referral, and the rates for the development of resistant anti-tuberculosis drugs were ethambutol (EMB) (26.6%), rifampicin (RFP) (21.9%), quinolones (QUI) (21.9%) and pyrazinamide (PZA) (10.9%), in that order. In the cases sensitive to all 10 anti-tuberculosis drugs initially, the development of resistance to INH was the most frequent, seen in 43 patients (7.2%). The average follow-up period was 435.6 days, and the resistance development was observed in the order of INH (7.2%), RFP (3.9%), SM (1.9%), QUI (0.7%), amikacin (AMK) (0.5%), and EMB (0.5%). The conversion of susceptible strains to resistant strains is an important warning sign for the patient, especially in cases of conversion to MDR or XDR. This information would be helpful for improving patient care during TB treatment.

A study of PCNA Expression in Gastric Adenoma and Adenocarcinoma (위선종 및 위선암종에 있어서 PCNA 발현 양상에 관한 연구)

  • Kim, Mi-Jin;Choi, Won-Hee;Lee, Tae-Sook
    • Journal of Yeungnam Medical Science
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    • v.12 no.1
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    • pp.1-9
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    • 1995
  • A monoclonal antibody to PCNA, which can be used on routinely processed tissue, was applied to 25 cases of gastric adenomas and 64 cases of gastric adenocarcinomas in order to diffentiate adenoma and adenocarcinoma and also to evaluate the prognostic value in adenocarcinoma. The results were summerized as follows: The peNA labelling index was $29.14{\pm}12.77%$ in control, $44.09{\pm}17.11%$ in adenoma and $80.15{\pm}10.69$ in adenocarcinoma, resulting in significant increase in adenocarcinoma compared to adenoma. In adenocarcinoma, no significant correlation was observed between PCNA labelling index and histologic grade, and there was increased tendency of PCNA labelling index in proportion to depth of invasion without statistical significance. The PCNA index was significantly increased in advanced adenocarcinoma compared to early gastric carcinoma, and also in positive nodal metastasis group than in negative group. From above results, the PCNA stain will be able to provide a helpful method for the differential diagnosis between gastric adenoma and adenocarcinoma, and could be a useful prognostic factor in adenocarcinoma if other factors are considered together.

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Radiation Therapy for Operable Breast Cancer after Conservative Surgery (유방암환자의 유방보존수술 후 방사선 치료 성적)

  • Lee, Myung-Za;Chun, Ha-Chung
    • Radiation Oncology Journal
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    • v.20 no.4
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    • pp.309-315
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    • 2002
  • Purpose : To evaluate the result of conservative management on recurrence, survival and prognostic factors of patient with operable breast cancer. Materials and Methods : Fifty three patients, treated for localized breast cancer by lumpectomy or quadrantectomy followed by radiotherapy between January 1985 and December 1996, were retrospectively studied. All patients followed up for at least five years. Their median age was 43 years $(range\;24\~72)$. The tumor stages were as follows : T1 in 30 patients, T2 in 21, Tis in 2. Thirty-eight patients had negative and 15 had positive axillary nodes. The histological types were 42 infiltrating ductal, 2 infiltrating lobular, and 2 intraductal carcinomas with 7 other histologies. The tumor locations were the outer quadrant in 38 breasts, the inner quadrant in 13 and central in 2. Radiation doses of $46\~50\;Gy$ were given to the entire breast areas with additional doses of 14-18 Gy delivered to the tumor bed areas. Results : The overall five and 10 yea actuarial and disease free survivals were $94.3\%\;and\;92.4\%,\;91.2\%\;and\;81\%$, respectively. The overall five year survivals were $100\%$ in stage I and IIa, and $66.7\%$ in stage IIb and IIIa tumors. Seven patients failed either locally or distantly. Incidence of local failure and distant metastasis for the first failure were $7.5\%\;and\;5.7\%$, respectively. Local recurrence appeared within 2 years of treatment at the primary site and after more than 8 years outside of primary lesion, whereas distant metastasis appeared between 2 and 6 years following treatment. The overall recurrences were high at a young age (< or = 35 years), with 5 out of 12 (2 local, 3 distant), and in T2 lesions with 5 out of 21 (1 local, 3 distant, and 1 in both). Distant metastasis was high in the positive axillary lymph node group with 4 out of 15 $(26.6\%)$. A high incidence in the axillary node was noted at a young age with 7 out of 12 $(58.3\%)$ and in T2 lesions with 8 out of 21 $(38.4\%)$. A young age, positive axillary node and large tumor size were all related with poor survival. Conclusion : Based on this study, lumpectomy or quadrantectomy, followed by radiation appears to be an adequate therapeutic method in operable breast cancer. A long term follow-up is necessary because a recurrence of breast can occur long time after treatment. The poor prognostic group, especially young patients with an aggressive biological behavior needs more effective treatment modalities to improve their survival.

Epidemiological Study on Acute Diarrheal Disease of Children and Adolescents in the Jeju Region Using a Multiplex-PCR (Multiplex-PCR을 이용한 제주지역 소아청소년의 급성설사질환 역학조사)

  • Lee, Kyu-taeg;Kim, Sunmi;Chong, Moo Sang
    • Korean Journal of Clinical Laboratory Science
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    • v.49 no.2
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    • pp.141-149
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    • 2017
  • To examine the cause of acute diarrheal disease in children and adolescents, 521 fecal samples underwent multiple-PCR for a period of two years, between March 2015 and February 20178, in the Jeju region of Korea. Based on the analysis of 179 positive samples, 102 samples were male (56.98%) and 77 were female (43.02%), and highest positive rates were shown in the age group of 3~4 years (51.96%) and 5~6 years (12.29%). When 209 cases (40.12%), including double infection were analyzed, there were 88 cases (16.89%) of norovirus-GII infection, 26 cases (4.99%) of Campylobacter spp. infection, 18 cases (3.45%) of rotavirus infection, 18 cases (3.45%) of Clostridium difficile Toxin B infection, 17 cases (3.26%) of adenovirus infection, 16 cases (3.07%) of Clostridium perfringens infection, 11 cases (2.11%) of astrovirus infection, 5 cases (0.96%) of Salmonella spp. infection, 3 cases (0.58%) of norovirus-GI, Yersinia spp. and Aeromonas spp. infections, and 1 case (0.19%) of verocytotoxin-producing E. coli infection. Based on a seasonal separation of early childhood, norovirus-GI and norovirus-GII mainly prevailed during the winter, when the temperature is low. Typical enteritis with an increased prevalence of rotavirus during the spring. Astrovirus prevailed between the months of April and October, when norovirus-GI, norovirus-GII, and rotavirus did not prevail. With increasing age, acute diarrheal disease was not only induced by a virus, but also by bacteria. Although a test for virus is an effective method when trying to identify the cause during early childhood by multiplex-PCR, it would be desirable to undergo tests for both virus and bacteria concurrently as age increases.

Activities to Reduce the number of No-Show Patients with Colonoscopy appointments (대장내시경 검사 부도관리를 위한 개선활동)

  • Kwon, Oh-Ryoun;Lee, Jung-Sun;Na, Eun-Shim;Kim, Hoon
    • Quality Improvement in Health Care
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    • v.15 no.1
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    • pp.89-100
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    • 2009
  • 문제: 소화기병검사실에서 대장내시경 검사의 부도건수가 최근 월 200명 정도로 예약인원의 16%에 달한다. 이는 본원 외래진료 부도율이 평균 10%인 것과 비교할 때 상당히 높은 결과이므로 대장내시경 예약환자를 대상으로 부도율 관리를 위한 활동이 필요하였다. 목적: 외래 및 입원환자의 부도건수 및 부도환자의 특성을 분석하고, 개선활동을 통하여 대장내시경 검사의 부도율을 줄인다. 의료기관: 서울 아산병원. 질 향상 활동: 부도관리를 위한 개선활동으로 SMS 횟수를 2주전, 4일전, 1일전 3회로 변경하고, 내용도 각 시기마다 차별화하였다. 대장내시경 검사 예약을 하고 기다리는 환자를 대상으로 처방일 순, 예약 날짜순서 등 필요한 항목 순으로 볼 수 있는 리스트가 필요하여 예약대기 프로그램을 개발하였고, 처방일로부터 2주 이내 자동예약을 금지하였다.(7월 10일부터 시작) 예약대기명단에 있는 환자를 대상으로 전화로 예약 변경을 하여 2주 이내에는 예약의 빈자리가 없도록 하였다. 미리 부도를 예측하여 추가로 예약하던 방법에서 정원조정을 하여 정원 외 추가 예약을 하지 않았다. 입원환자 일정관리를 위하여 일정관리 프로그램을 개발하여 타과의뢰 회신을 하는 전임의가 직접 날짜를 전산에 입력하여 회신과 동시에 검사실, 담당주치의, 담당 간호사가 모두 일정을 확인할 수 있도록 하였으나 프로그램이 늦어져 9월 12일부터 시행하였다. 개선효과: 부도건수가 개선 전 8주 동안 385건(예약인원 대비 16%) 에서 개선 후 6주의 평가기간 동안 256건(예약인원대비 14.1%)으로 129건이 감소하였으며, 검사 1-2일전 일정 변경 연락 환자 감소 및 검사 비용 수납 환자의 부도건수가 감소하였다. 대장내시경 검사 예약대기 프로그램 운영 및 예약 변경 전화 활동으로 2달씩 기다리던 환자의 예약일을 약 한 달 정도 단축하여 줄 수 있었다. 검사 정원 관리의 결과로 검사 예약 시 예약기준이 명확해지고, 부적절한 예약으로 인한 검사지연 등이 확실히 줄었다. 또한 입원환자 일정관리 프로그램 적용으로 입원환자의 검사일정과 관련된 전화업무는 확실히 줄어들 것으로 예상된다.

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Seven-year experience with inherited metabolic disorders screening by tandem mass spectrometry (Tandem Mass Spectrometry를 이용한 선천성 대사이상질환 선별검사 7년간의 경험)

  • Song, Sean-Mi;Yoon, Hye-Ran;Lee, An-Na;Lee, Kyoung-Ryul
    • Journal of Genetic Medicine
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    • v.5 no.1
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    • pp.21-25
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    • 2008
  • Purpose : In recent years, many countries have adopted newborn screening programs that use tandem mass spectrometry (MS/MS) to screen and the number of diseases screened has also increased. We began screening for inherited metabolic disorders using MS/MS in April, 2001. Our goal was to determine the overall prevalence of metabolic disorders and to assess the effectiveness of newborn screening by MS/MS in Korea. Methods : From April, 2001 to December, 2007, we screened newborns and high risk groups using MS/MS. Acylcarnitines and amino acids were extracted and butylated and were introduced into the inlet of MS/MS. Confirmatory testing including a repeat newborn screening, and urine organic acid and plasma amino acid analysis were performed on a case-by-case basis. Results : The total number of screened subjects 284,933 which comprised 251,799 neonates and 33,134 high risk subjects. The recall rate was 0.4% (1158 tests) and true positive cases were 117 (0.04%). Confirmed metabolic disorders (newborn/high risk group) were as follows; 78 (25/53) amino acid disorders, 27 (16/11) organic acid disorders, and 12 (5/7) fatty acid oxidation disorders. The estimated prevalence of inherited metabolic diseases in newborns was 1:5,000 and that in the total group was 1:2,000. Conclusion : Newborn screening by MS/MS improved the detection of many inherited metabolic disorders. We therefore propose that all newborns be screened by a MS/MS national program and followed-up using a systemic organization strategy.

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Survey on the Sulfonamide Residues in Beef, Pork and Chicken (HPLC법에 의한 식육중의 설파제 잔류량 조사)

  • Park, J.T.;Jeong, E.J.;Kim, Y.G.;Song, B.J.;Oh, K.S.;Lim, H.C.;Kim, S.C.
    • Korean Journal of Food Science and Technology
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    • v.26 no.3
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    • pp.221-225
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    • 1994
  • This survey was carried out to determine five sulfonamide(sulfamerazine, sulfamethazine, sulfadimethoxine, sulfamonomethoxine, sulfaquinoxaline) residues in beef, pork, chicken and swine kidney. For this survey, 30 samples of beef, 15 samples of chicken, 10 samples of pork and 10 samples of swine kidney were collected in Chonnam from June, 1992 to June, 1993, and were analyzed by HPLC. The recoveries of sulfamerazine, sulfamethazine, sulfamonomethoxine, sulfadimethoxine, and sulfaquinoxaline in spiked samples between $0.25{\sim}1.00$ ppm were 71.7%, 80.3%, 71.6%, 70.9%, 68.4%, respectively. None of 65 samples which were examined exceeded 0.1 ppm. Of 15 chicken muscle samples, 2 samples exceeded 0.05 ppm in sulfamerazine (0.077 ppm) and sulfamethazine (0.075 ppm), respectively. Of 10 swine kidney samples, 1 sample exceeded 0.05 ppm in sulfadimethoxine (0.052 ppm). And sulfanilamide concentration of swine kidney were higher than pork.

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Radiotherapy for Nasopharyngeal Carcinoma (비인강암의 방사선치료 성적)

  • Lee, Myung-Za;Chun, Ha-Chung
    • Radiation Oncology Journal
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    • v.21 no.4
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    • pp.269-275
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    • 2003
  • Purpose: To evaluate the results of radiation management on recurrence, survival and prognostic factors of patients with nasopharyngeal cancer Materials and Methods: Forty-nine patients, treated for nasopharyngeal cancer by radiotherapy between January 1984 and June 2000, were retrospectively studied. All patients were followed up for at least 2.5 years. Their median age was 52 years (range 17$\~$78). The histological types were 21 squamous cell carcinoma, 25 undifferentiated carcinoma, and 3 adenoid cystic carcinoma. The tumor stages were as follows: T1 in 14 patients, T2 in 24, T3 in 3, and T4 in 8, and N0 in 17 patients, Nl in 15, N2 in 4 and N3 in 13. Stages I, IIa, IIb ,III, IV and IVb were 4, 7, 12, 5, 8, and 13 patients respectively. Radiation doses of 58$\~$70 Gy (median 68.7 Gy) were given to the nasopahryngeal and involved lymphatic areas and of 46 $\~$ 50 Gy to the uninvolved neck areas. Results: The overall 5 and 10-year actuarial and disease free survival rates were 54.53$\%$ and 47$\%$ and 55.7$\%$ and 45.3$\%$, respectively The overall five-year survival rates were 100$\%$ in stage I , 80$\%$ in stage IIa, 59.5$\%$ in stage IIIb, 40$\%$ in stage III, and 42.2$\%$ in stage IV tumors. Twenty-three patients fatted either loco-regionally or distantly. Incidences of local failure, regional failure and distant metastasis for the first failure were 20.4$\%$, 8.2$\%$ and 20.4$\%$, respectively. Local recurrences were 4.3$\%$ in T1, 12.5$\%$ in T2, 0$\%$ in T3, and 62.5$\%$ in T4 lesions. Distant metastasis was seen in 41.2$\%$ of N2-3 lesions. Fifty percent of local recurrence appeared within 2 years of treatment at the primary lesion, whereas 70$\%$ of distant metastasis appeared within 2 years following treatment. Young age, female, early T stage, N0 stage; and poorly differentiated carcinoma were all related with good survival. However only stage showed statistically significance. Conclusionn: Based on the results of this study, radiation therapy to nasopharyngeal cancer showed high local recurrence in T4 and increased metastasis in N2-3 lesions. To improve local failure, further radiation doses, such as stereotactic radiation or IMRT radiation, are necessary especially in T4 lesions. The high incidence of distant metastasis in positive lymph node patients, indicates that combined radiation and effective chemotherapeutic agents with appropriated schedule are necessary.

Comparison of chemiluminescence immunoassay (CIA) and immunochromatography assay(ICA) for Detecting HBsAg and Anti-HBs (B형 간염항원 및 항체 검사를 위한 화학발광면역검사법(CIA)과 면역크로마토그래피법(ICA)의 비교분석)

  • Kim, Hye-Jeong;Kim, Eun-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.7
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    • pp.3419-3424
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    • 2013
  • Diverse immunoassays including a chemiluminescent immunoassay (CIA) are used to detect hepatitis B surface antigen (HBsAg) and antibody (anti-HBs). Recently, an increasing number of institutions have been utilizing an immunochromatography assay (ICA), which is easy to use. In this study, We evaluated ICA kits for the rapid detection of HBsAg and anti-HBs by comparing them with a CIA. A total of 120 serum hospital samples, were collected for the whole month, were assayed using ICA kit. The Concordance rate, sensitivity, specificity, positive predictive value and negative predictive value of the ICA for HBsAg based on CIA results were 97%, 97%, 100%, 100%, and 96.8%, respectively. The diagnostic performances of the ICA for Anti-HBs were 90%, 90%, 93.3%, 93.1%, and 90.3%, respectively. The ICA kit failed to detect HBsAg and anti-HBs in low reactive samples. The ICA kits for the rapid detection of HBsAg might be recommended for interpreted with caution and dual analysis in the clinical laboratory.

The Effect of Relative Humidity in the Mounting Time on the Reelability Ratio, Bave Length, and Percentage of Raw Silk (상족기 습도가 해서율, 견사장 및 생사량비율에 미치는 영향)

  • 최진래;이광길
    • Journal of Sericultural and Entomological Science
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    • v.28 no.2
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    • pp.74-78
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    • 1986
  • The experiments were carried out to investigate the effect of humidity on the cocoon quality, and 4, 000 lots of cocoon pruduced fot five years in Chin yang, Ha dong, Keo chang, San chung of Kyeong nam, and Sun san, Sang ju, Young poong, An dong of Kyeong buk were analyzed. The results were summarized as follows ; 1. The reelability ration, the bave length, and raw silk ration were decreased with increasing the humidity in mounting time, and it was remarkably observed when the relative humidity was over 80%. 2. With increasing the reelability ration, the bave length, and raw silk ration were increased, and the longer the bave lenger the bave length was the higher raw silk ration obtained. 3. The average reelability ration for five years in autumn-rearing period was higher than that in spring-rearing period, but the bave length and raw silk ratio was on the contrary from the above. 4. The reelability ration of cocoon produced in the mountainous area was higher than that in the field area but the shorter the bave length, the raw silk ration had no significant difference between those.

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