• 대한의생명과학회지
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• 제19권2호
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• pp.90-97
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• 2013

The tuberculin skin test (TST) and interferon gamma (IFN-${\gamma}$) release assay (IGRA) have been widely used for diagnosis of latent tuberculosis infection (LTBI). In order to overcome limitations of current LTBI diagnostic methods, the development of a novel molecular assay which is able to measure the IFN-${\gamma}$ messenger RNA (mRNA) expression level after stimulation with Mycobacterium tuberculosis (MTB) specific antigen was recently developed. The ability of a molecular assay to detect MTB infection was similar to commercial IGRA however, the optimal incubation time for stimulating IFN-${\gamma}$ was not yet established. Therefore, in this study the direct comparisons of MTB Ag stimulation times (4 and 24 hrs) were performed for diagnosis of MTB infection. Data showed that the coincident rate between QFT-GIT IFN-${\gamma}$ ELISA and IFN-${\gamma}$ RT-PCR (4 hrs) was 88.35% and that of QFT-GIT and IFN-${\gamma}$ RT-PCR (24 hrs) was 70.85%. Based on a receiver operating characteristic (ROC) curve, the 4 hrs-MTB specific Ag stimulation time for IFN-${\gamma}$ RT-PCR had the significant P value, 95% CI value, and AUC (P < 0.0001, 95% CI=0.82 to 1.02, and AUC=0.9214) in comparison with 24 hrs-MTB specific Ag stimulation time (P = 0.009, 95% CI=0.06 to 0.94, and AUC=0.7711). These results show that 4-hr was the most optimal MTB Ag stimulation time for performing IFN-${\gamma}$ RT-PCR. Although semi-quantitative RT-PCR had a few analytical limitations, it might be useful as an alternative molecular diagnostic method for detecting MTB infection.

• 대한의생명과학회지
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• 제25권4호
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• pp.426-430
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• 2019

Currently, molecular diagnostic assays based on nucleic acid amplification tests have been shown to effectively detect mycobacterial infections in various types of specimen, however, variable sensitivity was shown in FFPE samples according to the kind of commercial kit used. The present study therefore used automated PCR-reverse blot hybridization assay (REBA) system, REBA Myco-ID HybREAD 480^®, for the rapid identification of Mycobacterium species in various types of human tissue and compared the conventional one-tube nested-PCR assay for detecting Mycobacterium tuberculosis (MTB). In conventional nested-PCR tests, 25 samples (48%) were MTB positive and 27 samples (52%) were negative. In contrast, when conducted PCR-REBA assay, 11 samples (21%) were MTB positive, 20 samples (39%) were NTM positive, 8 samples (15%) were MTB-NTM double positive, and 13 samples (25%) were negative. To determine the accuracy and reliability of the two molecular diagnostic tests, the one-tube nested-PCR and PCR-REBA assays, were compared with histopathological diagnosis in discordant samples. When conducted nested-PCR assay, 10 samples (59%) were MTB positive and seven samples (41%) were negative. In contrast, when conducted PCR-REBA test, three samples (17%) were MTB positive, 10 samples (59%) were NTM positive and four samples (24%) were negative. In conclusion, the automated PCR-REBA system proved useful to identify Mycobacterium species more rapidly and with higher sensitivity and specificity than the conventional molecular assay, one-tube nested-PCR; it might therefore be the most suitable tool for identifying Mycobacterium species in various types of human tissue for precise and accurate diagnosis of mycobacterial infection.

• Annals of Clinical Microbiology
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• 제21권4호
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• pp.69-74
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• 2018

진단검사의학은 신속하고 정확한 체외검사 결과를 제공함으로써 임상의사가 환자를 진료하는 데 도움을 주는 전문 분야이다. 정확한 검사 결과를 제공하기 위해서는 검사에 관련된 모든 요소의 표준화가 필요하다. Clinical and Laboratory Standards Institute (CLSI)는 1968년에 표준화를 하는 데에 모두가 동의할 수 있는 공식적인 절차를 마련하기 위해 만들어졌고, 현재까지 임상검사실, 연구용 검사실을 포함한 많은 종류의 검사실 전 분야에 대해서 표준과 지침을 출판하여, 전 세계의 많은 검사실들이 표준화를 위해 이를 이용하고 있다. CLSI의 항생제 감수성 검사 소위원회(AST SC)는 6개의 상설 부서와 필요에 따라 만들어지는 많은 특설 부서로 구성되어 있다. AST SC의 구성원들은 소위원회에 제안된 내용을 검토하여 연 2차례 열리는 회의에서 제안 내용을 반영할지 여부를 결정함으로써 문서의 개정이 이루어진다. 이 회의는 등록한 사람은 누구나 참여할 수 있으므로, 우리 학회원들도 회의에 참여하여 표준 혹은 지침 문서의 생산에 능동적인 역할을 하기를 기대한다.

• 대한의생명과학회지
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• 제24권2호
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• pp.138-142
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• 2018

The incidence of tuberculosis (TB) in the Republic of Korea remains high when compared to the incidence in other Organization for Economic Cooperation and Development (OECD) countries. The prompt diagnosis and effective treatment of latent TB infection (LTBI) are very important in terms of controlling the burden of TB. The tuberculin skin test (TST) has long been the "gold standard" assay for the diagnosis of LTBI. However, it can show false positive results due to Bacille Calmette-$Gu{\acute{e}}rin$ (BCG) vaccination and infection with many environmental nontuberculous mycobacteria (NTM). The interferon gamma release assay (IGRA) using Mycobacterium tuberculosis (MTB)-specific antigens, was developed for the detection of LTBI. The QuantiFERON-TB Gold In-Tube assay is one of the most commonly used forms of the IGRA. In order to compare the diagnostic efficacy of the TST and IGRA in relation to LTBI among BCG-vaccinated healthy donors, whole blood samples were collected from 51 participants, and the results of the TST and IGRA were compared. Of the 51 cases, 18 cases (35.3%) were positive and 33 cases (64.7%) were negative when using the TST, while four cases (7.8%) were positive and 47 cases (92.2%) negative when using the IGRA. There was no correlation between the size of the induration in the TST and the $IFN-{\gamma}$ protein level. In conclusion, the TST showed higher cross-reactivity among the BCG-vaccinated healthy participants, therefore, the IGRA might be the most suitable assay for the rapid screening of LTBI in BCG-vaccinated healthy population, or for TB contact investigation.

• 대한임상검사과학회지
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• 제43권1호
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• pp.1-5
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• 2011

The infection rate of syphilis is still increasing in the world especially in developing countries and the infection is often seen in large amounts of clinical specimens. For the diagnosis of this disease, Rapid Plasma Reagin (RPR)/Venereal Disease Research Laboratory (VDRL) has still been used as one of major primary methods to diagnose syphilis even though the test readings are somewhat subjective with high false positive rates. Recently, the automatic ARCHITECT Syphilis TP, which is based on the detection of the TP-specific antibodies, has been introduced in many laboratories. Therefore, the clinical assessment of the method is needed to provide primary diagnosis of syphilis at the moment. We evaluated 3 different manual rapid kits and ARCHITECT Syphilis TP comparing with RPR/FTA-ABS and analysed their diagnostic properties. From February 2006 to April 2008, 203 positive and 250 negative specimens, obtained from Chungbuk National University Hospital were used for the evaluation. In the evaluation between manual rapid kits, their specificities were as high as 99.2 ~ 99.6% while their sensitivities were observed with little differences; 98.0% (199/203) for Kit A, 96.6% (196/203) for Kit B, and 97.4% (197/203) for Kit S. In the case of ARCHITECT Syphilis TP test, it showed 100% specificity (250/250) and 98.5% sensitivity (249/250). Kappa values comparing with RPR/FTA-ABS were 0.978 for Kit A, 0.964 for Kit B and Kit S, and 0.987 for ARCHITECT Syphilis TP. From our evaluation, we found out that manual rapid tests and ARCHITECT Syphilis TP have very good clinical accuracies and high kappa agreements with RPR/FTA-ABS. Due to its automation and quick simultaneous diagnosis with another serological markers, we suggest that the ARCHITECT Syphilis TP is one of best suitable method for the primary diagnosis of syphilis and that it might be able to replace RPR method in the laboratories.

• Parasites, Hosts and Diseases
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• 제59권2호
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• pp.113-119
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• 2021

The computer vision diagnostic approach currently generates several malaria diagnostic tools. It enhances the accessible and straightforward diagnostics that necessary for clinics and health centers in malaria-endemic areas. A new computer malaria diagnostics tool called the malaria scanner was used to investigate living malaria parasites with easy sample preparation, fast and user-friendly. The cultured Plasmodium parasites were used to confirm the sensitivity of this technique then compared to fluorescence-activated cell sorting (FACS) analysis and light microscopic examination. The measured percentage of parasitemia by the malaria scanner revealed higher precision than microscopy and was similar to FACS. The coefficients of variation of this technique were 1.2-6.7% for Plasmodium knowlesi and 0.3-4.8% for P. falciparum. It allowed determining parasitemia levels of 0.1% or higher, with coefficient of variation smaller than 10%. In terms of the precision range of parasitemia, both high and low ranges showed similar precision results. Pearson's correlation test was used to evaluate the correlation data coming from all methods. A strong correlation of measured parasitemia (r²=0.99, P<0.05) was observed between each method. The parasitemia analysis using this new diagnostic tool needs technical improvement, particularly in the differentiation of malaria species.

• 한방재활의학과학회지
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• 제23권3호
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• pp.149-157
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• 2013

Objectives This study was designed to: (1) investigate the clinical feature of tongue diagnosis, (2) make an observation of significant changes in tongue diagnosis according to the patient's physical condition and laboratory result and (3) identify clinical efficacy of tongue diagnosis. Methods 300 patients' tongue diagnosis results were analyzed and the patients were divided to each group according to the physical condition and laboratory result. Then, chi-square test was performed to assess statistical significance between tongue diagnosis results of each group. Results As a result of analyzing the spread of tongue diagnosis according to the patient's physical condition and laboratory result, 18 groups had statistical significance related to specific tongue color and tongue coating. Conclusions Even if there would be possible misinterpretations in one-to-one match between the tongue diagnosis and certain diseases, we identified that tongue diagnosis results were changed somewhat related to patient's physical condition with some tendency and tongue diagnosis could be used for meaningful clinical diagnostic tool.

• 대한의생명과학회지
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• 제18권4호
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• pp.428-434
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• 2012

Epilepsy is a chronic neurological disease showing a symptom of repeated seizures without any other physical disorders. Among the diagnostic examination for epilepsy, the electroencephalogram (EEG) has been known as an important test. This study aimed to investigate the EEG with photic stimulation in the pediatric epilepsy patients. They underwent digital sleep and waking EEGs or waking EEGs with photic stimulation. Epilepsy type, seizure history, and season of occurring seizure were analyzed. Epilepsy patients showed more response during the period of photic-on and eye close at the frequency of 10~20 Hz during the EEG activation procedure. Photoparoxysmal response (PPR) was shown in 206 patients out of total 1,551 epilepsy patients. PPR was appeared more frequently during summer and winter seasons, and especially in the patients who had a history of seizure. During the PPR, EEG pattern showed spike (77.18%), theta (9.71%), and spike + theta (13.11%). On the other hand, beta and theta waves were not significantly changed by photic stimulation. However, alpha wave was decreased and delta wave was increased by photic stimulation (P<0.05). These changes may be due to temporarily altered electrophysiological function of the epileptic patient's brain by the photic stimulation. There was no difference in the EEG pattern between the left and right side in the brain. In conclusion, condition of photic-on with closed eyes and frequency of 10~20 Hz during the procedure of EEG activation could be appropriate for obtaining a definite photoparoxysmal response in the electroencephalogram of the pediatric epilepsy patients.

• 대한임상검사과학회지
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• 제45권3호
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• pp.91-95
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• 2013

It is important to check the types of drugs when treating acute drug intoxication. This study researches the clinical characteristics and types of patients hospitalized in emergency medical center for drug addiction in 2009 and 2010. By applying a drug addiction selecting kit, it studied the flexibility and clinical efficiency during diagnosis and treatment. The study result shows, among the drugs causing addiction, Sedative accounts for 34.4%, Herdicide 23.5%, Analgesic 17.2%, Insectide 7.8% and else 17.2%. Sedative showed the highest proportion both in 2009 and 2010. Among the drug addicted patients, 39 cases did not know that the drugs are poisonous and among them, the drug addiction selecting kit was positive in 32 cases (82.0%). In 42 cases where addiction was suspicious, 25 cases (59.5%) were positive in the drug addiction selecting kit. In 57 cases of using drug addiction selecting kits, the cases in which benzodiazepine was positive, were 30 and the most frequently cases were as follows; Tricyclic Antidepressants (TCA) 13 cases, Amphetamines 3 cases, barbiturate 3 cases, and piate 3 cases. In the district using drug addiction kit meaningfully had Flumazenil injection much greater impact than the one not using the kit. This proves the efficiency of the kit (p<0.05). The uses of drug addiction selecting kits are for acute drug intoxicated patients and for providing objective and scientific information when emergency medical doctor are checking unchecked poisoning drugs. It is considered that drug addiction selecting kits would give help when treating the early stage of drug addicted patients in emergency medical treatment.

• Parasites, Hosts and Diseases
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• 제52권5호
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• pp.479-485
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• 2014

Cryptosporidium diarrhea represents a relevant clinical problem in developing countries. In Al-Taif, a city of Saudi Arabia that lies at an altitude of an around 2 km above the sea level, Cryptosporidium infection seems to be undiagnosed in nearly all clinical laboratories. Furthermore, nothing was published regarding Cryptosporidium-associated diarrhea in this area. The objectives of this research were to (1) determine the Cryptosporidium prevalence among patients with diarrhea and (2) to estimate the performances of 3 different diagnostic methods. Total 180 diarrheal fecal samples, 1 sample per patient, were collected between January and August 2013. Samples were screened for Cryptosporidium with modified Zeihl Neelsen (ZN) microscopy, $RIDA^{(R)}$ Quick lateral flow (LF) immunotest, and a previously published PCR. The Cryptosporidium prevalence rate was 9.4% (17/180), 10% (18/180), and 11.6% (21/180) by microscopy, LF, and PCR test, respectively. Infection was significantly (P=0.004) predominant among children <5 years (22%) followed by children 5-9 years (11.1%). Although infection was higher in males than in females (16.2% males and 8.5% females), the difference was not statistically significant (P=0.11). Compared to PCR, the sensitivity of microscopy and the LF test were 80.9%, 85.7%, respectively. To conclude, high Cryptosporidium-associated diarrhea was found in this area especially in children ${\leq}9$ years. The PCR test showed the best performance followed by the LF test and ZN staining microscopy. The primary health care providers in Al-Taif need to be aware of and do testing for this protozoon, particularly for children seen with diarrhea.