• Title/Summary/Keyword: Atypical

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Comparison of Thinprep (Liquid-Based Cytology) and Conventional Cytology : Abnormal Lesion on Bronchoscopy (기관기내시경상 이상병변을 보이는 환자에게 있어 Thinprep검사법과 기존세포검사법의 효율성 및 유용성에 대한 비교)

  • Lee, Jung Ho;Yang, Jung Kyung;Jung, In Bum;Lee, Jung Hea;Sul, Hae Jung;Kim, Yoon Mi;Kim, Bum Kyeng;Choi, Yue Jin;Na, Moon Joon;Son, Ji Woong
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.6
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    • pp.547-553
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    • 2006
  • Background: Liquid-based cytology is currently known as an effective method, and cervical cytology has been shown to be especially effective from of malignancy detection. In our study, the cytological detection rates of the Thinprep (Liquid-based cytology) and conventional cytology (bronchial washing & brushing) for endobronchial lesions were compared. Methods: Between July 2005 and September 2005, the data from 30 patients with respiration symptom, who had shown abnormal lesion on bronchoscopy, were collected. Results: The bronchoscopic biopsy group was consisted of 30 cytodiagnosis specimens, 24 of which were confirmed to be malignant. The others were tuberculosis (4), bronchiectasis and bronchopulmonary fistula (1 each). Of the 24 malignant case, cancer or atypical cells were detected in 19, 17 and 12 of the Thinprep, brushing cytology and washing cytology cases, respectively. None one of the methods detected cancer cells in the non-malignant specimens. Washing cytology has shown sensitivity, specificity, and positive and negative predictive values of 50, 100, 100 and 33.3% respectively. Brushing cytology has shown sensitivity, specificity, and positive and negative predictive values of 70.8, 100, 100 and 46.2%, respectively. Thinprep has shown sensitivity, specificity, and positive and negative predictive values of 79.2, 100, 100 and 54%, respectively. Conclusions: Thinprep (liquid-based cytology) showed better sensitivity and negative predictive values for the evaluation of lung cancer than conventional cytology. However a large-scale study will be needed in the future.

Usefulness of Tuberculin Test in Adult Patients with Suspected Pulmonary Tuberculosis (폐결핵이 의심되는 성인 환자에서 투베르쿨린 검사의 유용성)

  • Kang, Eun Hae;Koh, Won-Jung;Kwon, O Jung;Kim, Kyung Chan;Lee, Byoung-Hoon;Hwang, Jung Hye;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Lee, Kyung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.3
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    • pp.268-279
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    • 2004
  • Background : The tuberculin skin test has been used to diagnose latent tuberculosis infection, but is not widely used to diagnose or exclude pulmonary tuberculosis. The objective of this study was to evaluate the diagnostic utility of the tuberculin test in diagnosing and excluding pulmonary tuberculosis, and differentiating pulmonary tuberculosis from nontuberculous mycobacteria (NTM) pulmonary disease, when a sputum acid-fast bacilli (AFB) smear was positive. Material and Methods : From October 2002 to August 2003, among all the inpatients of the Division of Pulmonary and Critical Care Medicine at Samsung Medical Center, 258 patients with clinical suspicion of pulmonary tuberculosis were enrolled and underwent a tuberculin test. Results : 156 males and 102 females were included, with a mean age of 57.5 years. The final diagnoses included lung cancer in 89 cases (34.5%), pulmonary tuberculosis in 59 cases (22.9%), bacterial pneumonia in 33 cases (12.8%) and NTM pulmonary disease in 24 cases (9.3%). The positive tuberculin test rate was higher in the tuberculosis than non-tuberculosis group; 81.4 (48/59) vs. 42.4% (81/199). (p<0.001). In 208 patients with a negative sputum AFB smear, the result of the tuberculin test was positive in 69.4% (25/36) of the tuberculosis group and in 44.8% (77/172) of the non-tuberculosis group (p=0.007), so a positive result of the tuberculin test could predict pulmonary tuberculosis with 69.4% sensitivity, 55.2% specificity, a 24.5% positive predictive value and a 89.6% negative predictive value. In 50 patients with a positive sputum AFB smear, the positive rates of the tuberculin test were 83.9% (26/31) in tuberculosis group and 21.1% (4/19) in NTM pulmonary disease group (p<0.001), so a positive result of the tuberculin skin test could predict pulmonary tuberculosis with 83.9% sensitivity, 78.9% specificity, a 86.7% positive predictive value and a 75.0% negative predictive value. Conclusion : The tuberculin test could be useful in excluding pulmonary tuberculosis when the sputum AFB smear is negative, and to differentiate pulmonary tuberculosis from NTM pulmonary disease when the sputum AFB smear is positive.

Abnormal Perfusion on Myocardial Perfusion SPECT in Patients with Wolff-Parkinson-White Syndrome (Wolff-Parkinson-White 증후군 환자의 심근 관류 이상)

  • Kang, Do-Young;Cha, Kwang-Soo;Han, Seung-Ho;Park, Tae-Ho;Kim, Moo-Hyun;Kim, Young-Dae
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.1
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    • pp.9-14
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    • 2005
  • Purpose: Abnormal myocardial perfusion may be caused by ventricular preexcitation, but its location, extent, severity and correlation with accessory pathway (AP) are not established. We evaluated perfusion patterns on myocardial perfusion SPECT and location of AP in patients with WPW (Wolff-Parkinson-White) syndrome. Materials and Methods: Adenosine Tc-99m MIBI or Tl-201 myocardial perfusion SPECT was performed in 11 patients with WPW syndrome. Perfusion defects (PD) were compared to AP location based on ECG with Fitzpatrick's algorithm or electrophysiologic study and radiofrequency catheter ablation. Results: Patients had atypical chest discomfort or no symptom. Risk of coronary artery disease (CAD) was below 0.1 in 11 patients using the nomogram to estimate the probability of CAD. Coronary angiography was performed in 4 patients (mid-LAD 50% in one, normal in others). In 4 patients, AP localization was done by electrophysiologic study and radiofrequency catheter ablation (RFCA). Small to large extent ($11.0{\pm}8.5%$, range:$3{\sim}35%$) and mild to moderate severity ($-71{\pm}42.7%$, range:$-2l7{\sim}-39%$) of reversible (n=9) or fixed (n=1) perfusion defects were noted. One patient with right free wall (right lateral) AP showed normal. PD locations were variable following the location of AP. One patient with left lateral wall AP was followed 6 weeks after RFCA and showed significantly decreased PD on SPECT with successful ablation. Conclusion: Myocardial perfusion defect showed variable extent, severity and location in patients with WPW syndrome. Abnormal perfusion defect showed in most of all patients, but it did not seem to be correlated specifically with location of accessory pathway and coronary artery disease. Therefore myocardial perfusion SPECT should be interpreted carefully in patients with WPW syndrome.

A. Artaud or the Prisoner of Language (앙토냉 아르토 혹은 언어의 수형자)

  • Park, Hyung-Sub
    • Cross-Cultural Studies
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    • v.45
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    • pp.219-243
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    • 2016
  • The life of Antonin Artaud exactly reproduces a very cruel drama. He lived in constant anguish and suffered from severe mental pain. This research will trace his thoughts in his writings while he was a prisoner of language. Artaud was a poet filled with anxiety about language, things, being, and thought. Whenever he tried to explain the mystery of being by means of mundane language, he experienced psychological agony. His poetic thoughts began to break down, because of his identity loss. Nevertheless, he was destined to grasp the world through language. Artaud had suffered from mental illness during his youth. His mental illness was associated with his difficulty in creating poetry. In this research, the letter, Correspondance avec Jacques $Rivi{\grave{e}}re$, is analyzed. The poet refers to "the collapse of the spirit's core, and the erosion of the fundamental thought that slips away" to convey his linguistic incompetence. Hereafter, he constantly demonstrated anxious mental symptoms. Even though he became mentally deranged, he maintained his consciousness, as is apparent in his writings. Also, his spiritual belief is reflected in his mental uneasiness. While he was traveling through the Tarahumaras area in Mexico, he was obsessed with its primitive belief in the Peyote rituals, and he immersed himself in performing them. His unchristian belief was the product of his mystical personality. Until his last breath, he did not give up writing. Artaud's mental derangement does not mean lunacy, but if one insists in calling it so, that is a metaphor. His derangement comes from his refusal to accept his limitations and from his aspiring to regard his body in the same light as his intellectual perceptions. His intellect could manifest more easily when his mind was elevated to the extreme. Artaud's lunacy is no different from that of a profound philosopher. The lives of poets who suffer from mental derangement are more poetic than the lives of those who do not. Artaud's atypical emotions provide a way of to measure our own limitations, helplessness, and resignation. His scream is nonsegmental but different from that of a mental patient. That difference is why people are interested in his works and wish to delve into his writings.

The success and failure of non-regular workers' struggles and their effects on organizational strength (비정규직 노동자 투쟁의 승패와 조직력 변화)

  • Ch, Donmoon
    • Korean Journal of Labor Studies
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    • v.17 no.1
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    • pp.139-176
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    • 2011
  • Non-regular workers came to the fore while working class formation was in retreat along with the democratic labor movement of regular workers. The formation of principal agents, however, is yet to occur. Then, why non-regular workers' struggles could not yield a consequence in that regard? What kind of factors are to determine the outcome of the struggles and how do they do it? It is the aim of this study to answer those questions. In contrast with regular workers' struggles, non-regular workers' struggles tend to break out in response to capitalist offensives, rely on atypical and, often, extreme measures of struggle rather than strike in the form of work stoppage, drag out for too long, and appeal for social solidarity outside when the solidarity of regular workers is not available. Non-regular workers' struggles tend to end up with failure rather than success, and with weakening rather than strengthening of their organizational strength. So as to overcome the tendency to fail, non-regular workers' struggles need regular workers' solidarity in addition to their own strong mobilization power, while social solidarity or positional power could substitute for regular workers' solidarity in some cases. So as to build up their organizational strength, non-regular workers' struggles should win victories in the struggles, while a victory could turn into a trap in the case of conversion. Both regular workers' solidarity and the internal integration of the struggles are two foremost important factors in achieving the victory of struggles and the building-up of organizational strength. Those who have got involved in struggles are from the best organized sector among all the non-regular workers. As they have gone through weakening of organizational strength, it becomes more difficult for non-regular workers to form principal agents. Without non-regular workers' struggles, however, the capitalist offensives must have carried the day. In that sense, non-regular workers' struggles did a role in at least detaining capitalist offensives, if not stopping them. The practical implication of non-regular workers' struggles is that, if non-regular workers redefine the ultimate goal of their struggles as the formation of their principal agents for working class formation, it would be a strategically rational choice to identify the strategic objective of struggles with the maintaining and strengthening of their organizational strength rather than the achievement of their immediate demands.

Etiology and Risk Factors of Community-Acquired Pneumonia in Hospitalized Children During the COVID-19 Pandemic in South Korea (국내 코로나19 판데믹 기간 발생한 입원을 요하는 소아청소년 지역사회폐렴의 원인과 위험 인자)

  • Hae Min Kang;Seung Ha Song;Bin Ahn;Ji Young Park;Hyunmi Kang;Byung Ok Kwak;Dong Hyun Kim;Joon Kee Lee;Soo-Han Choi ;Jae Hong Choi;Eun Hwa Choi;Ki Wook Yun
    • Pediatric Infection and Vaccine
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    • v.30 no.1
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    • pp.20-32
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    • 2023
  • Purpose: This study aimed to identify the etiology and risk factors of community-acquired pneumonia (CAP) requiring hospitalization in Korean children during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Clinical information of children admitted with CAP to Seoul National University Children's Hospital (SNUCH) between January 1, 2021, and February 28, 2022, was retrospectively collected and analyzed. In addition, the etiologic diagnosis and demographic data of children with CAP who were discharged at the other seven hospitals between January and February 2022 were collected. Pneumonia was diagnosed using strict criteria comprising clinical symptoms, physical examination findings, and chest radiographic findings. Results: Among 91 children hospitalized with CAP at SNUCH during the 14-month period, 68.4% were aged <5 years and 79.1% had underlying diseases. Among the 95 CAP cases, respiratory assistance was required in 70.5%, and the use of a ventilator was required in 20.0%. A total of five patients expired, all of whom were either immunocompromised or had underlying neurological diseases. Neurological diseases and immunosuppression were significantly correlated with respiratory assistance (P=0.003) and death (P=0.014). A total of 55% of the detected respiratory pathogens were viruses, the most common of which was rhinovirus at 35.9%. Among the 169 children hospitalized for CAP at the eight institutions, ≥1 respiratory virus was detected in 92.3%, among which respiratory syncytial virus (79.8%) was the most prevalent. Conclusions: Even during the COVID-19 pandemic, Korean children were hospitalized with CAP caused by seasonal respiratory viral pathogens. Although atypical and pyogenic bacteria were not detected, continuous clinical monitoring and further prospective studies should be conducted.

Clinical Presentation of the Patients with Non-traumatic Chest Pain in Emergency Department (응급의료센터에 내원한 비외상성 흉통환자의 임상 양상)

  • Chung, Jun-Young;Lee, Sam-Beom;Do, Byung-Soo;Park, Jong-Seon;Shin, Dong-Gu;Kim, Young-Jo
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.283-295
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    • 1999
  • Background: Patients with acute non-traumatic chest pain are among the most challenging patients for care by emergency physicians, so the correct diagnosis and triage of patients with chest pain in the emergency department(ED) becomes important. To avoid discharging patients with acute myocardial infarction(AMI) without medical care, most emergency physicians attempt to admit almost all patients with acute chest pain and order many laboratory tests for the patients. But in practice, many patients with non-cardiac pain can be discharged with simple tests and treatment. These patients occupy expensive intensive care beds, substantially increasing financial cost and time of stay at ED for the diagnosis and treatment of myocardial ischemia and AMI. Despite vigorous efforts to identify patients with ischemic heart disease, approximately 2% to 5% of patients presented to the ED with AMI and chest pain are inadvertently discharged. If the cause for the chest pain is known, rapid and accurate diagnosis can be implemented, preventing wastes in time and money and inadvertent discharge. Methods and Results: The medical records of 488 patients from Jan. 1 to Dec. 31, 1997 were reviewed. There were 320(angina pectoris 140, AMI 128) cases of cardiac diseases, and 168(atypical chest pain 56, pneumothorax 47) cases of non-cardiac diseases. The number of associated symptoms were $1.1{\pm}0.9$ in non-cardiac diseases, $1.4{\pm}1.1$ in cardiac diseases and $1.7{\pm}1.1$ in AMI(p<0.05). In laboratory finding the sensitivity of electrocardiography(EKG) was 96.1%, while the sensitivity of myoglobin test ranked 45.1%. Admission rate was 71.6% in for cardiac diseases and 50.6% for non-cardiac diseases(p<0.01). Mortality rate was 8.8% in all cases, 13.8% in cardiac diseases, 0.6% in non-cardiac diseases, and 28.1% especially in AMI. Conclusion: In conclusion, all emergency physicians should have thorough knowledge of the clinical characteristics of the diseases which cause non-traumatic chest pain, because a patient with any of these life-threatening diseases would require immediate treatment. Detailed history on the patient should be taken and physical examination performed. Then, the most simple diagnostic approach should be used to make an early diagnosis and to provide treatment.

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Clinical Characteristics of the Patients with Mycobacterium avium Complex Pulmonary Disease (Mycobacterium avium complex 폐질환 환자의 임상적 특징)

  • Koh, Won-Jung;Kwon, O Jung;Kang, Eun Hae;Jeon, Ik Soo;Pyun, Yu Jang;Ham, Hyoung Suk;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Han, Daehee;Kim, Tae Sung;Lee, Kyung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.1
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    • pp.33-44
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    • 2003
  • Background : Mycobacterium avium complex(MAC) is the most common respiratory pathogen in nontuberculous mycobacterial pulmonary disease. This study described the clinical characteristics of the patients with pulmonary disease caused by MAC. Materials and Methods : The clinical characteristics of 24 patients with pulmonary disease caused by the MAC, who fulfilled the 1997 American Thoracic Society diagnostic criteria for nontuberculous mycobacterial pulmonary disease, were retrospectively analyzed. Results : Fourteen patients(58%) were male and the median age at diagnosis was 61 years(range 46-75). Of the 24 patients, 16(67%) had a M. intracellulare infection, 7(29%) had a M. avium infection and one patient was not identified. Coughing (92%) and sputum (88%) were most frequently observed symptoms. The sputum smear for acid-fast bacilli was positive in 17(71%) patients. Fourteen(58%) patients had the upper lobe cavitary form and 10(42%) patients had the nodular bronchiectatic form. In a comparison between the patients with the upper lobe cavitary form and those with the nodular bronchiectatic form, significant differences were found according to sex(male 86% vs. 20%, p=0.003), smoking history(79% vs. 10%, p=0.008), the presence of an underlying disease(64% vs. 20%, p=0.036), the pulmonary function(% forced vital capacity, median 71% vs. 88%, p=0.022; % forced expiratory volume in one second, median 69% vs. 89%, p=0.051) and bilateral disease at chest radiography(29% vs. 90%, p=0.005). The time from the onset of symptoms to diagnosis was longer in those with the nodular bronchiectatic form(median 72 months, range 8-132) than those with the upper lobe cavitary form(median 22 months, range 6-60) Conclusions : MAC pulmonary disease occurs in two distinct populations with two distinct clinical presentations. For a correct diagnosis of MAC pulmonary disease, knowledge of the diverse clinical and radiological findings is essential.

Transferrin Receptors in the Liver Cell Membrane of Carcinogen (3-methyl-4-dimethyl-arninoazobenzene) Treated Rat (Carcinogen (3-methyl-4-dimethyl-aminoazo benzene) 처리후 간세포막에서의 Transferrin Receptor 변동에 관한 연구)

  • Lee, Jae-Heun;Ro, Eu-Sun;Hur, Gang-Min;Lee, Choong-Sik;Seok, Jeong-Ho
    • The Korean Journal of Pharmacology
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    • v.29 no.1
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    • pp.85-96
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    • 1993
  • To investigate the alteration of transferrin receptor (TfR) in the proliferating or transformed liver cells, $^{125}I-transferrin$ binding experiment was carried out in the isolated parenchymal cells (PC) or nonparenchymal cells (NPC) from normal regenerated rat liver after partial hepatectomy and from the liver of 3-methyl-4-dimethyl-aminoazobenzene (3-Me-DAB) treated rat. With the administration of 3-Me-DAB for 8 weeks, the liver tissue showed marked morphologic changes of oval cell proliferation, regenerations of hepatocytes, and atypical proliferations of bile ducts, but these changes were little affected by partial hepatectomy. Transferrin binding values in PC or NPC homogenate from the regenerated liver of normal rat, were increased by 3rd day and diminished to control level at 7th day after partial hepatectomy. With the treatement of 3-Me-DAB for 8 weeks, transferrin binding sites in homogenates were higher than those of normal rat liver and increased by 7th day after partial hepatectomy. Transferrin binding sites (Bmax) in the cell membrane of NPC were higher than those of PC of normal rat liver, but there was no significant difference in Kd values between both groups (5.05, 6.3 nM). In the normal resenerated rat liver, transferrin binding sites in the PC or NPC plasma membrane, were increased by 3rd day and diminished to control level at 7th day after partial hepatectomy. With 3-Me-DAB tratment, transferrin binding sites in both liver NPC and PC plasma membrane were increased about 3 folds, compared to those in each plasma membrane of normal rat liver. And after partial hepatectomy of 3-Me-DAB trated rat, transferrin binding sites were increased by the 3rd day in the NPC plasma membrane but increased by the 7th day in the PC plasma membrane. In the transferrin binding sites of the PC or NPC plasma membrane of 3-Me-DAB treated liver, two kinds of Kd values $(3.1{\sim}4.7\;nM,\;25.4{\sim}54.1\;nM)$ were detected. The present results suggest that 1) TfRs are distributed in the liver PC as well as NPC; 2) Increased TfRs in PC or NPC plasma membrane of normal regenerated liver after partial hepatectomy and 3-Me-DAB treated rat liver, may be due to increased intracellular synthesis; 3) Increased TfRs in normal regenerated liver after partial hepatectomy might be related to the expression of a single type of high affinity site $(Kd,\;3.1{\sim}7.5\;nM)$, but in 3-Me-DAB treated rat liver might be related to the expression of high and low affinity types of receptors $(Kd,\;25.4{\sim}54.1\;nm)$.

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Stock-Index Invest Model Using News Big Data Opinion Mining (뉴스와 주가 : 빅데이터 감성분석을 통한 지능형 투자의사결정모형)

  • Kim, Yoo-Sin;Kim, Nam-Gyu;Jeong, Seung-Ryul
    • Journal of Intelligence and Information Systems
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    • v.18 no.2
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    • pp.143-156
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    • 2012
  • People easily believe that news and stock index are closely related. They think that securing news before anyone else can help them forecast the stock prices and enjoy great profit, or perhaps capture the investment opportunity. However, it is no easy feat to determine to what extent the two are related, come up with the investment decision based on news, or find out such investment information is valid. If the significance of news and its impact on the stock market are analyzed, it will be possible to extract the information that can assist the investment decisions. The reality however is that the world is inundated with a massive wave of news in real time. And news is not patterned text. This study suggests the stock-index invest model based on "News Big Data" opinion mining that systematically collects, categorizes and analyzes the news and creates investment information. To verify the validity of the model, the relationship between the result of news opinion mining and stock-index was empirically analyzed by using statistics. Steps in the mining that converts news into information for investment decision making, are as follows. First, it is indexing information of news after getting a supply of news from news provider that collects news on real-time basis. Not only contents of news but also various information such as media, time, and news type and so on are collected and classified, and then are reworked as variable from which investment decision making can be inferred. Next step is to derive word that can judge polarity by separating text of news contents into morpheme, and to tag positive/negative polarity of each word by comparing this with sentimental dictionary. Third, positive/negative polarity of news is judged by using indexed classification information and scoring rule, and then final investment decision making information is derived according to daily scoring criteria. For this study, KOSPI index and its fluctuation range has been collected for 63 days that stock market was open during 3 months from July 2011 to September in Korea Exchange, and news data was collected by parsing 766 articles of economic news media M company on web page among article carried on stock information>news>main news of portal site Naver.com. In change of the price index of stocks during 3 months, it rose on 33 days and fell on 30 days, and news contents included 197 news articles before opening of stock market, 385 news articles during the session, 184 news articles after closing of market. Results of mining of collected news contents and of comparison with stock price showed that positive/negative opinion of news contents had significant relation with stock price, and change of the price index of stocks could be better explained in case of applying news opinion by deriving in positive/negative ratio instead of judging between simplified positive and negative opinion. And in order to check whether news had an effect on fluctuation of stock price, or at least went ahead of fluctuation of stock price, in the results that change of stock price was compared only with news happening before opening of stock market, it was verified to be statistically significant as well. In addition, because news contained various type and information such as social, economic, and overseas news, and corporate earnings, the present condition of type of industry, market outlook, the present condition of market and so on, it was expected that influence on stock market or significance of the relation would be different according to the type of news, and therefore each type of news was compared with fluctuation of stock price, and the results showed that market condition, outlook, and overseas news was the most useful to explain fluctuation of news. On the contrary, news about individual company was not statistically significant, but opinion mining value showed tendency opposite to stock price, and the reason can be thought to be the appearance of promotional and planned news for preventing stock price from falling. Finally, multiple regression analysis and logistic regression analysis was carried out in order to derive function of investment decision making on the basis of relation between positive/negative opinion of news and stock price, and the results showed that regression equation using variable of market conditions, outlook, and overseas news before opening of stock market was statistically significant, and classification accuracy of logistic regression accuracy results was shown to be 70.0% in rise of stock price, 78.8% in fall of stock price, and 74.6% on average. This study first analyzed relation between news and stock price through analyzing and quantifying sensitivity of atypical news contents by using opinion mining among big data analysis techniques, and furthermore, proposed and verified smart investment decision making model that could systematically carry out opinion mining and derive and support investment information. This shows that news can be used as variable to predict the price index of stocks for investment, and it is expected the model can be used as real investment support system if it is implemented as system and verified in the future.