• Title/Summary/Keyword: Diagnostic Fluid

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Validity of nursing diagnosis : Fluid volume deficit (체액량 부족(Fluid volume deficit) ; 간호진단의 타당도 조사 연구)

  • Byun Young-Soon;Kim Sook-Young
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.1 no.2
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    • pp.207-218
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    • 1994
  • A validation of the nursing diagnosis 'fluid volume deficit' was completed by using the diagnostic content validity method. Articles pertaining to fluid volume depletion were reviewed to identify the signs and symptoms used to describe the nursing diagnosis. The topics addressed in the articles included hypovolemic shock, hemorrhage, trauma, fluid balance, hydration, burn injury, thirst, dehydration. A validation instruments was constructed of 52 signs and symptoms. A validation tool was examined by expert nurses group who work on intensive care unit, kidney transplantation unit, internal medicine and general surgery unit. The study sample rated the signs and symptoms on a scale from one to five, evaluating their relevance to this diagnosis. Of the 52 signs and symptoms on the validation tool, 10 were categorized as critical indicators and 34 were categorized as defining characteristics.

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Availability of Toluidine Blue Stain in Body Fluid (체액 검체에서 톨루이딘 블루 염색의 유용성)

  • Lee, Hye-Kyung;Joo, Myung-Jin;Lee, Kwang-Min;Lee, Eun-Hee;Sim, Sang-In
    • The Korean Journal of Cytopathology
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    • v.10 no.1
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    • pp.7-11
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    • 1999
  • We evaluated the availability of toluidine blue stain in body fluids, such as peritoneal and pleural fluid and urine. Nine hundreds specimens, i.e., 400 pleural and 400 peritoneal fluids and 100 urine samples, respectively, from Jan. 1995 to May 1996 were included. We obtained the result of high sensitivity and high specificity. In toluidine blue stained body fluid in comparison with Papanicolaou stained result. Additionally, we found the diagnostically important crystals in chylothorax and some urine samples, which can not be seen in routine Papanicolaou stain. We thought the toluidine blue stain in body fluid is one of very useful diagnostic methods.

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Diagnostic Utility of Pleural Fluid Soluble Triggering Receptor Expressed on Myeloid Cells 1 Protein in Patients with Exudative Pleural Effusion (삼출성흉수에서 Soluble Triggering Receptor Expressed on Myeloid Cells 1 Proteion의 진단적 유용성)

  • Sim, Yun Su;Lee, Jin Hwa;Cheun, En Mi;Chang, Jung Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.6
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    • pp.499-505
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    • 2007
  • Background: Triggering receptor expressed on myeloid cells 1 protein (TREM-1) is a cell surface molecule expressed on neutrophils and monocytes, and it plays an important role in myeloid cell-activated inflammatory response. The aim of this study was to investigate the diagnostic efficiency of soluble (s) TREM-1 in the patients who had pleural effusion from various causes. Methods: Forty-five patients with exudative pleural effusion were included in this study. The level of sTREM-1 was measured in both the serum and pleural fluids by immunoblot assay with using human-sTREM-1 antibody. Results: The pleural fluid sTREM-1 was significantly different in the three groups of exudative pleural effusion (p=0.011). Particularly, the patients with parapneumonic effusion were found to have significantly higher pleural fluid levels of sTREM-1 than patients with tuberculous (p<0.05) and malignant effusion, respectively (p<0.05). However, the serum sTREM-1 did not show a significant difference in the three groups. In order to evaluate the diagnostic utility of pleural fluid sTREM-1, the receiver operating characteristic (ROC) curve was constructed and the area under the curve (AUC) was 0.818 (p=0.001). Using a cutoff value of 103.5 pg/mL for the pleural fluid sTREM-1, the sensitivity and specificity were 73% and 81%, respectively, for differentiating parapneumonic effusion from tuberculous or malignant effusions. Conclusion: Pleural fluid sTREM-1 can be an additional marker for making the differential diagnosis of pleural effusion.

CT and US Findings of Multilocular Cystic Renal Cell Carcinoma

  • Jong Chul Kim;Kie Hwan Kim;Jun Woo Lee
    • Korean Journal of Radiology
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    • v.1 no.2
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    • pp.104-109
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    • 2000
  • Objective: Multilocular cystic renal cell carcinoma (MCRCC) is a recently described variety of renal cell carcinoma with characteristic pathologic and clinical features. The purpose of this study was to analyze the imaging findings of MCRCCs. Materials and Methods: Ten adult patients with pathologically proven unilateral MCRCC who underwent renal US and CT were included in this study. The radiologic findings were retrospectively evaluated for cystic content, wall, septum, nodularity, calcification and solid portion by three radiologists who established a consensus. Imaging and postnephrectomy pathologic findings were compared. Results: All patients were adults (six males and four females) and their ages ranged from 33 to 68 years (mean, 46). On US and CT images, all tumors appeared as well-defined multilocular cystic masses composed of serous or complicated fluid. In all patients, unenhanced CT scans revealed hypodense cystic portions, and in four tumors, due to the presence of hemorrhage or gelatinous fluid, some hyperdense areas were also noted. In no tumor was an expansile solid nodule seen in the thin septa, and in only one was there dystrophic calcification in a septum. Small areas of solid portion constituting less than 10% of the entire lesion were found in six of the ten tumors, and these areas were slightly enhanced on enhanced CT scans. In all patients, imaging and pathologic findings correlated closely. Conclusion: On US and CT images, MCRCC appeared as a well-defined multilocular cystic mass with serous, proteinaceous or hemorrhagic fluid, with no expansile solid nodules in the thin septa, and sometimes with small slightly enhanced solid areas. Where radiologic examinations demonstrate a cystic renal mass of this kind in adult males, MCRCC should be included in the differential diagnosis.

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Significance of Pleural Fluid PCR and ADA Activity in the Diagnosis of Tuberculous Pleurisy (결핵성 늑막염의 진단시 늑막액의 Tb PCR 및 ADA활성도에 관한 연구)

  • 황재준;최영호;김욱진;신재승;손영상;김학제
    • Journal of Chest Surgery
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    • v.33 no.8
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    • pp.669-675
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    • 2000
  • Background: Tuberculous pleurisy is the leading cause of pleural effusion in Korea. And differential diagnosis of tuberculous pleurisy with other cause is clinically very important. Traditional diagnostic methods such as routine analysis of pleural fluid, staining for acid-fast bacilli or pleural biopsy have major inherent limitaion. This study was designed to evaluate the significance of pleural fluid polymerase chain reaction(PCR) and adenosine deaminase (ADA) activity in early diagnosis of tuberculous pleurisy. Material and Method: Between March 1996 and July 1997, 198 patients with pleural effusion reviewed retrospectively. The study group included 112 cases with tuberculous effusion and 86 cases with non-tuberculous effusions, whose diagnoses were confirmed by pleural biopsy, microbiological methods, or cytology. We compared the results of PCR and pleural fluid levels of ADA between tuberculous and non-tuberculous effusions. Result: Mean age was 47.54$\pm$19.52 years(range 2 to 85 years). The positive rate of PCR was significantly higher in tuberculous group than non-tuberculous group(p<0.05). The sensitivty, specificity, positive predictive value(PPV), and negative predictive value(NPV) for PCR were 31.7, 90.9, 83.0, and 48.8%, respectively. Mean ADA activity was significantly higher in tuberculous group than non-tuberculous group(83.2 U/L vs 49.8 U/L)(p<0.05). With diagnostic thresholds of 40 U/L, the sensitivity, specificity, PPV, and NPV of ADA for tuberculosis were 75.9, 70.9, 77.3, and 69.3% respectively. At a level of 70 U/L, the sensitivity, specificity, PPV, and NPV of ADA for tuberculosis were 70.1, 75.9, 82.9, and 60.3% respectively. Conclusion: PCR is very highly specific, but less sensitive methods in diagnosis of tuberculous pleurisy. But ADA level of pleural fluid has acceptable sensitivity and specificity in diagnosis of tuberculous pleurisy. ADA activity is more useful test in the evaluation of pleural effusions.

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Heatstroke occurred in an American Pit Bull Terrier in Korea (국내 아메리칸 핏불테리어에서 발생한 열사병 증례 보고)

  • Lee, Seunghee;Jung, Ji-Youl;Jeong, Jae-Hoon;Lee, Hyunkyoung;Park, Jung-Won;Lee, Kyoung-Ki;Kim, Jong-Hwan;So, ByungJae;Yoon, Soon-Seek
    • Korean Journal of Veterinary Service
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    • v.41 no.3
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    • pp.211-216
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    • 2018
  • Heat stroke in a dog is a life-threatening syndrome characterized by a high body temperature over $41^{\circ}C$, by the central nervous system dysfunction, and by multiple organ dysfunction. A 11-month-old male American Pit Bull Terrier was presented to clarify the cause of death to diagnostic laboratory. This dog showed clinical signs such as high body temperature ($42^{\circ}C$), severe tachypnea, hematochezia, epistaxis and hemoptysis after transportation at hot summer time. At necropsy, there were hemorrhages in skin, serosa of stomach and small intestine, and also dark red fluid in lumen of intestine. Histopathologic examination revealed extensive hemorrhages in stomach, muscle, skin, and tongue. In microbiology, pathologic bacteria such as Pasteurella, Boedetella, Salmonella, Clostridium, and circulating virus in Korea such as CDV, CIV, CAV, CHV, CCV, CPIV were negative except CPV. There were many gross and microscopic lesions suggesting hest stroke while pathologic agents and related lesions were not detected. Therefore we diagnosed this case as heatstroke.

Clinical Utility of CT-Based Bronchial Aspirate TB-PCR for the Rapid Diagnosis of Pleural Tuberculosis

  • Lee, Jaehee;Lee, So Yeon;Choi, Keum Ju;Lim, Jae Kwang;Yoo, Seung Soo;Lee, Shin Yup;Cha, Seung Ick;Park, Jae Yong;Kim, Chang Ho
    • Tuberculosis and Respiratory Diseases
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    • v.75 no.4
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    • pp.150-156
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    • 2013
  • Background: Thoracoscopic pleural biopsy is often required for rapid and confirmative diagnosis in patients with suspected pleural tuberculosis (PL-TB). However, this method is more invasive and costly than its alternatives. Therefore, we evaluated the clinical utility of the chest computed tomography (CT)-based bronchial aspirate (BA) TB-polymerase chain reaction (PCR) test in such patients. Methods: Bronchoscopic evaluation was performed in 54 patients with presumptive PL-TB through diagnostic thoracentesis but without a positive result of sputum acid-fast bacilli (AFB) smear, pleural fluid AFB smear, or pleural fluid TB-PCR test. Diagnostic yields of BA were evaluated according to the characteristics of parenchymal lesions on chest CT. Results: Chest radiograph and CT revealed parenchymal lesions in 25 (46%) and 40 (74%) of 54 patients, respectively. In cases with an absence of parenchymal lesions on chest CT, the bronchoscopic approach had no diagnostic benefit. BA TB-PCR test was positive in 21 out of 22 (95%) patients with early-positive results. Among BA results from 20 (37%) patients with patchy consolidative CT findings, eight (40%) were AFB smear-positive, 18 (90%) were TB-PCR-positive, and 19 (95%) were culture-positive. Conclusion: The BA TB-PCR test seems to be a satisfactory diagnostic modality in patients with suspected PL-TB and patchy consolidative CT findings. For rapid and confirmative diagnosis in these patients, the bronchoscopic approach with TB-PCR may be preferable to the thoracoscopy.

Application of Spatial Modulation of Magnetization to Cervical Spinal Stenosis for Evaluation of the Hydrodynamic Changes Occurring in Cerebrospinal Fluid

  • Kwang-Hun Lee;Tae-Sub Chung;Tae Joo Jeon;Young Hwan Kim;Daisy Chien;Gerhard Laub
    • Korean Journal of Radiology
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    • v.1 no.1
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    • pp.11-18
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    • 2000
  • Objective: To evaluate the hydrodynamic changes occurring in cerebrospinal fluid (CSF) flow in cervical spinal stenosis using the spatial modulation of magnetization (SPAMM) technique. Materials and Methods: Using the SPAMM technique, 44 patients with cervical spinal stenosis and ten healthy volunteers were investigated. The degree of cervical spinal stenosis was rated as low-, intermediate-, or high-grade. Low-grade stenosis was defined as involving no effacement of the subarachnoid space, intermediate-grade as involving effacement of this space, and high-grade as involving effacement of this space, together with compressive myelopathy. The patterns of SPAMM stripes and CSF velocity were evaluated and compared between each type of spinal stenosis and normal spine. Results: Low-grade stenosis (n = 23) revealed displacement or discontinuity of stripes, while intermediate- (n = 10) and high-grade (n = 11) showed a continuous straight band at the stenotic segment. Among low-grade cases, 12 showed wave separation during the systolic phase. Peak systolic CSF velocity at C4-5 level in these cases was lower than in volunteers (p < .05), but jet-like CSF propulsion was maintained. Among intermediate-grade cases, peak systolic velocity at C1-2 level was lower than in the volunteer group, but the difference was not significant (p > .05). In high-grade stenosis, both diastolic and systolic velocities were significantly lower (p < .05). Conclusion: Various hydrodynamic changes occurring in CSF flow in cervical spinal stenosis were demonstrated by the SPAMM technique, and this may be a useful method for evaluating CSF hydrodynamic change in cervical spinal stenosis.

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