• 제목/요약/키워드: Discordance test

검색결과 25건 처리시간 0.029초

IgG Western Blot for Confirmatory Diagnosis of Equivocal Cases of Toxoplasmosis by EIA-IgG and Fluorescent Antibody Test

  • Khammari, Imen;Saghrouni, Fatma;Yaacoub, Alia;Meksi, Sondoss Gaied;Ach, Hinda;Garma, Lamia;Fathallah, Akila;Said, Moncef Ben
    • Parasites, Hosts and Diseases
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    • 제51권4호
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    • pp.485-488
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    • 2013
  • The performance values of available techniques used in serodiagnosis of toxoplasmosis are satisfactory but they raise problems of equivocal and discordant results for very low IgG titers. Recently marketed, LDBio-Toxo II IgG Western blot (IB) showed an excellent correlation with the dye test. We estimated the proportion of equivocal and discordant results between the enzyme immunoassay Platelia Toxo IgG (EIA-IgG) and fluorescent antibody test (FAT) and assessed the usefulness of the IB as a confirmatory test. Out of 2,136 sera collected from pregnant women, 1,644 (77.0%) tested unequivocally positive and 407 (19.0%) were negative in both EIA-IgG and FAT. The remaining 85 (4%) sera showed equivocal or discordant results. Among them, 73 (85.9%) were positive and 12 (14.1%) were negative in IB. Forty-one (89.1%) equivocal sera in EIA-IgG and 46 (86.8%) equivocal sera in FAT were positive in IB. Reducing the cut-off values of both screening techniques improved significantly their sensitivity in detecting very low IgG titers at the expense of their specificity. In conclusion, equivocal results in routine-used techniques and their discordance in determination of the immune status in pregnancy women were not uncommon. IB test appeard to be highly useful in these situations as a confirmatory technique.

인슐린 의존성 당뇨병 학생을 대상으로 실시한 영양교육의 효과 (Evaluation of Nutrition Education for Insulin Dependent Diabetic Students)

  • 이정희;박동연;윤진숙
    • Journal of Nutrition and Health
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    • 제28권10호
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    • pp.1015-1021
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    • 1995
  • This study was conducted to evaluate changes in nutritional knowledge, attitudes, behavior intention and behavior in a sample of 27 insulin dependent diabetic students participating in diabetics' camp. Nutritional knowledge related to diabetes, attitudes toward diabetes treatment and behavior intention about dietary changes were tested before and after nutrition education. Six months after nutrition education, an open ended questionnaire about their actual behavior changes was mailed to all participants and 17 of them responded. Pre-and post-testing showed that nutrition education was effective in significant changes in knowledge and in promoting positive attitudes and behavior intention. Increases of knowledge were consistently the same regardless of sex, level of education, regularity of diet, and duration of disease. Compared to male students, female students showed more positive change in knowledge, attitudes and behavior intention. It also appeared that middle school students showed more positive improvement in knowledge, attitudes and behavior than elementary and high school students. A follow-up test showed that their actual behavior changes were not squared with their behavior intention. They pointed out difficulties in having proper amount of meals and snack and the conflict with school time schedule as the major reason for discordance. These findings suggest that nutrition education for diabetics can be effective to improve their knowledge, attitudes and behavior intention and understanding about barriers to behavior change is important for better compliance to the disease.

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Application of array comparative genomic hybridization in Korean children under 6 years old with global developmental delay

  • Lee, Kyung Yeon;Shin, Eunsim
    • Clinical and Experimental Pediatrics
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    • 제60권9호
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    • pp.282-289
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    • 2017
  • Purpose: Recent advancements in molecular techniques have greatly contributed to the discovery of genetic causes of unexplained developmental delay. Here, we describe the results of array comparative genomic hybridization (CGH) and the clinical features of 27 patients with global developmental delay. Methods: We included 27 children who fulfilled the following criteria: Korean children under 6 years with global developmental delay; children who had at least one or more physical or neurological problem other than global developmental delay; and patients in whom both array CGH and G-banded karyotyping tests were performed. Results: Fifteen male and 12 female patients with a mean age of $29.3{\pm}17.6months$ were included. The most common physical and neurological abnormalities were facial dysmorphism (n=16), epilepsy (n=7), and hypotonia (n=7). Pathogenic copy number variation results were observed in 4 patients (14.8%): 18.73 Mb dup(2)(p24.2p25.3) and 1.62 Mb del(20p13) (patient 1); 22.31 Mb dup(2) (p22.3p25.1) and 4.01 Mb dup(2)(p21p22.1) (patient 2); 12.08 Mb del(4)(q22.1q24) (patient 3); and 1.19 Mb del(1)(q21.1) (patient 4). One patient (3.7%) displayed a variant of uncertain significance. Four patients (14.8%) displayed discordance between G-banded karyotyping and array CGH results. Among patients with normal array CGH results, 4 (16%) revealed brain anomalies such as schizencephaly and hydranencephaly. One patient was diagnosed with Rett syndrome and one with $M{\ddot{o}}bius$ syndrome. Conclusion: As chromosomal microarray can elucidate the cause of previously unexplained developmental delay, it should be considered as a first-tier cytogenetic diagnostic test for children with unexplained developmental delay.

Personality Traits in Cancer Patients

  • Turhal, Nazim Serdar;Demirhan, Salih;Satici, Celal;Cinar, Caner;Kinar, Abdullah
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권8호
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    • pp.4515-4518
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    • 2013
  • Background: This study was planned to investigate the personality traits of cancer patients in different treatment settings, and to correlate the demographics with the personality features. Materials and Methods: A total of 237 patients referred either to Marmara University School of Medicine (MUSM) Oncology Outpatient Unit or to the private office of the faculty between March 10th and April 22nd, 2010 were enrolled in the study. The Big Five Mini Test was used to evaluate the 40 personality traits of the patients. Results: The study group consisted of 98 males (41.35%) and 139 females (58.65%) with a mean age of 51. Out of the 237, 73.9% had an educational level beyond the junior high school, and 47.3% of all patients reported a positive family history for cancer. A significant difference in terms of reconcilability, extraversion, and responsibility was observed between patients admitting to the university outpatient clinic and the private office (p<0.05). Reconcilability and extraversion were found to differ between genders significantly (p<0.05). The description of the patients by him/herself or by relatives displayed a significant difference in terms of openness (p<0.05). Parameters such as educational level, family history of cancer, age and marital status showed no relevance to their characters. No discordance was observed between the self-analysis of the patient and the patient's relatives. Conclusions: Patients with cancer are typically highly reconcilable and responsible, moderately stable, open and extraverted.

국내 소아 결핵감염 진단에서의 결핵피부반응 검사와 Interferon-gamma Release Assay (IGRA)의 비교 연구 (Discordance between Tuberculin Skin Test and Interferon-gamma Release Assays for Diagnosis of Tuberculosis Infection in Korean Children)

  • 유리나;김준일;김서희;이진아
    • Pediatric Infection and Vaccine
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    • 제23권1호
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    • pp.18-24
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    • 2016
  • 목적: 국내와 같이 결핵의 유병률이 높은 지역에서 결핵을 정확하게 진단하는 것은 중요하다. 본 예비연구는 국내의 소아청소년에서 결핵진단 시 TST 및 2가지 IGRA 검사법 (QFT-G 및 T-SPOT.TB) 간의 일치도를 알아보고자 하였다. 방법: 2014년 1월부터 2015년 4월까지 잠복결핵감염 또는 결핵질환의 진단을 위해 서울아산병원을 방문한 20세 이하 환자 중, TST, T-SPOT.TB 및 QFT-G 검사 중 최소 2가지 이상의 검사를 동시에 시행한 경우를 연구에 포함하였다. 이들의 의무기록을 후향적으로 분석하여 각 검사 간의 일치도를 평가하였다. 결과: 연구에 포함된 총 20명의 연령의 중앙값은 13.3세(범위: 3.8-18.1세)이었고, 이 중 11명은 면역저하와 관련된 기저질환이 있었다. T-SPOT.TB와 QFT-G 결과의 일치도는 90%였으며, TST와 T-SPOT.TB의 일치도는 50%, TST와 QFT-G의 일치도는 42.9%였다. T-SPOT.TB, QFT-G 및 TST의 결핵질환에 대한 특이도는 93.3%, 86.7% 및 58.3%였다. 결론: T-SPOT.TB과 QFT-G 간의 일치도는 높으나 TST와 T-SPOT.TB 또는 QFT-G 간의 일치도는 낮았다. 추후 국내 소아청소년의 정확한 결핵의 진단을 위한 각 검사들의 일치도 및 진단적 유용성에 대한 추가적인 연구가 필요하다.

혈액배양에서 VITEK MS와 VITEK 2 System을 이용한 신속 항생제 감수성 시험의 유용성 평가 (An Evaluation of the Rapid Antimicrobial Susceptibility Test by VITEK MS and VITEK 2 Systems in Blood Culture)

  • 박강균;유영빈;육근돌;김상하;김성현;김영권
    • 대한임상검사과학회지
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    • 제49권3호
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    • pp.279-284
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    • 2017
  • 본 연구에서는 혈액배양에서 신속한 세균 동정과 항생제 감수성 시험(antibiotic susceptibility test, AST) 결과를 얻기 위해 혈액배양 양성배지에서 계대배양 없이 세균을 VITEK MS와 VITEK 2 시스템에 직접 접종하였으며, 도출된 결과를 표준방법과 비교하여, 그 신뢰도와 정확도를 평가하였다. 혈액배양 양성시료에서 직접 결과는 표준방법 AST 결과와 비교하였을 때, 97.9% (1,936/1,978)의 전체적인 일치율을 보였다. 그람양성 세균은 97.2% (1,051/1,081)의 일치율을 나타냈으며, 매우 중대한 오차율은 0.5% (5/1081), 중대한 오차율은 0.1% (1/1,081), 사소한 오차율은 2.2% (24/1,081)의 결과를 나타냈다. 두 방법 간 불일치의 주요 원인균은 Staphylococcus epidermidis이었고, 그 중 gentamicin (N=9)과 fusidic acid (N=8)에서 높은 오류를 나타냈다. 그람음성 세균 중 전체적인 일치율은 98.6%(885/897)였고, 사소한 오류는 1.4% (12/897)였다. 그람음성세균의 불일치 주요 원인균은 Escherichia coli와 Pseudomonas aeruginosa였으며, 그 중 amoxicillin/clavulanic acid(N=3)에서 높은 오류를 나타냈다. 직접법에 의한 AST 방법은 CLSI 기준을 충족하였고, 결과 보고 시간을 24시간 단축할 수 있었지만, 매우 큰 오류가 있는 항생제에 대해서는 디스크확산법으로 추가적인 검사를 시행한 후 보고해야 한다는 것을 알 수 있었다. 이러한 연구 결과들을 토대로 혈액배양 시료에서 직접 AST를 실시하는 방법은 정확하고 결과를 보고하는데 까지 소요되는 시간을 크게 감소시킬 수 있기 때문에 환자의 정확하고 효율적인 치료에 유용하게 활용될 수 있을 것으로 사료된다.

우리나라의 빈도홍수량의 추정 (Estimates of Regional Flood Frequency in Korea)

  • 김남원;원유승
    • 한국수자원학회논문집
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    • 제37권12호
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    • pp.1019-1032
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    • 2004
  • 빈도홍수량은 중ㆍ소 수공구조물의 설계에 중요한 지표로서 매우 중요하나, 자료의 부족과 설계 관습으로 인하여 홍수량을 직접해석하여 사용하지 못하고 있는 실정으로 설계호우-단위도법과 같은 간접적인 홍수량추정방법이 이용되고 있다. 따라서 본 연구에서는 수집가능한 일제시대부터 1999년까지 망라한 국내 첨두홍수량 자료를 수집하여 연 최대치 계열을 작성하고 지수홍수법에 의해서 지역홍수빈도분석을 수행하였다. 지역홍수빈도분석을 위해서 사용된 분포는 WMO(1989)가 권장한 Wakeby 분포였으며, 매개변수 추정은 Hosking(1990)의 L-모멘트를 이용하였다. 지역의 수문학적인 동질성을 위해서 Hosking과 Wallis(1993)의 불일치성, 이산성의 검정을 따랐다. 지수홍수와 상관시킨 물리적인 독립 변수는 유역면적이고, 이는 비유량이 유역면적이 커짐에 따라 작아지는 소위 멱함수 형태를 잘 따르고 있었다. 우리나라 주요유역을 4개의 유역 즉, 한강, 낙동강, 금강, 영산/섬진강으로 나누어 유역별 재현기간별 홍수량을 이러한 형태로 제시하였다. 또한 비교를 위해서 점빈도분석에 의한 지역화를 수행하여 지역빈도 분석의 결과와 비교하였다. 댐 개발전과의 비교에서는 댐의 역할이 첨두홍수량의 변화에 큰 영향이 없는 것으로 나타났다. 이 결과를 기존의 타 연구와 비교함으로써 본 연구의 타당성을 구체화할 수 있었다.

부모세대가 받은 훈육방법과 그들의 자녀 훈육방법과의 비교 -서울시 일부 지역을 중심으로- (A Study on the Disciplinary Method in Korean Family: Comparing the cases of two generations between parents and children)

  • 김희숙
    • 대한가정학회지
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    • 제26권3호
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    • pp.225-241
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    • 1988
  • The purpose of this study is to find the difference between the parents generation and that of the children in the disciplinary methods by means of parental social population variation. With these purpose in mind, the problems have been suggested like following: 1) what are the general differences of between the two generations of parents and children in disciplinary method? 2)What are the general differences of the views between those two generations according to sex? 3) What are the general differences between the parents generation and the child generation according to age? 4) What are the general differences between the parents generation and the child generation according to education level? 5) What are the general differences between the parents generation and the child generation according to income level? In order to solve these problems, questionnaries were distributed on this appendix 374parents (father: 177, mother: 197) who have the children. Questionnaires were compose on "Parents Inventory" of Radke were employs, classfied five measures. To test and verifying the above hypothes, the following five measures. were used. 1) Philosophy of authority (authoritarian vs. democratic) 2) Parental restrition (strict and stubbon vs. democratic) 3) Severity of punishment (severity vs. mildness) 4) Parent-child rapport 9desirable vs. undesirable) 5) Relative responsibility of father and mothehr towards child disciplinary (equal vs. differ) The result of this study is like follows: 1) In general comparison of two generations, tends to be more democratic in the philosophy of authority, more relaxed and easygoing in the parental restroction, more severe in the severity of punishment, and good rapport in the parent-child rapport than grandparents generation and the responsibility of father don't change but that of mother tends to augment in child disciplinary 2) In comparison of two generation according to sex, the mother showed more democratic in the philosophy of authority and closely perceive her parents in the parent-child rapport as compared with the father. 3) In comparison of two generation according to age, the younger parents showed more relaxed attitudes towards the child disciplinary, the perception better relations of their parents in the parent-child rapport. 4) In the comparison of two generations according to education level the more educated parents showed the more relaxed and easygoing attitude towards in the parental restriction. 5) In comparison of two generation according to income, as the parents of large income generally (not always) showed easygoing than their previous generation in the parental restriction, and they perceive that they have a good one in parent-child rapport. This study caused by the some difficult problem required futher investigation on the result of two generations the problems happened in the inner unitary of items. And, it proposed some problems which constitutes the problems of the proper interpretation of the results between two generations brought about discordance of items between tow generations

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자궁경부 편평상피병변에서 자궁경부질도말 세포검사의 진단정확도 : 481예의 세포-조직 상관관계 (Diagnostic Accuracy of Cervicovaginal Cytology in the Detection of Squamous Epithelial Lesions of the Uterine Cervix; Cytologic/Histologic Correlation of 481 Cases)

  • 진소영;박상모;김미선;진윤미;김동원;이동화
    • 대한세포병리학회지
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    • 제19권2호
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    • pp.111-118
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    • 2008
  • Background : Cervicovaginal cytology is a screening test of uterine cervical cancer. The sensitivity of cervicovaginal cytology is less than 50%, but studies of cytologic/histologic correlation are limited. We analyzed the diagnostic accuracy of cervicovaginal cytology in the detection of the squamous epithelial lesions of the uterine cervix and investigate the cause of diagnostic discordance. Materials and Methods : We collected a total of 481 sets of cervicovaginal cytology and biopsies over 5 years. The cytologic diagnoses were categorized based on The Bethesda System and the histologic diagnoses were classified as negative, flat condyloma, cervical intraepithelial neoplasia (CIN) I, CIN II, CIN III, or squamous cell carcinoma. Cytohistologic discrepancies were reviewed. Results: The concordance rate between the cytological and the histological diagnosis was 79.0%. The sensitivity and specificity of cervicovaginal cytology were 80.6% and 92.6%, respectively. Its positive predictive value and negative predictive value were 93.7% and 77.7%, respectively. The false negative rate was 19.4%. Among 54 false negative cytology cases, they were confirmed by histology as 50 flat condylomas, 2 CIN I, 1 CIN III, and 1 squamous cell carcinoma. The causes of false negative cytology were sampling errors in 75.6% and interpretation errors in 24.4%. The false positive rate was 7.4%. Among 15 false positive cytology cases, they were confirmed by histology as 12 atypical squamous cells of undetermined significance (ASCUS) and 3 low grade squamous intraepithelial lesions (LSIL). The cause of error was interpretation error in all cases. The overall diagnostic accuracy of cervicovaginal cytology was 85.7%. Conclusions : Cervicovaginal cytology shows high overall diagnostic accuracy and is a useful primary screen of uterine cervical cancer.

Machine Learning Model to Predict Osteoporotic Spine with Hounsfield Units on Lumbar Computed Tomography

  • Nam, Kyoung Hyup;Seo, Il;Kim, Dong Hwan;Lee, Jae Il;Choi, Byung Kwan;Han, In Ho
    • Journal of Korean Neurosurgical Society
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    • 제62권4호
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    • pp.442-449
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    • 2019
  • Objective : Bone mineral density (BMD) is an important consideration during fusion surgery. Although dual X-ray absorptiometry is considered as the gold standard for assessing BMD, quantitative computed tomography (QCT) provides more accurate data in spine osteoporosis. However, QCT has the disadvantage of additional radiation hazard and cost. The present study was to demonstrate the utility of artificial intelligence and machine learning algorithm for assessing osteoporosis using Hounsfield units (HU) of preoperative lumbar CT coupling with data of QCT. Methods : We reviewed 70 patients undergoing both QCT and conventional lumbar CT for spine surgery. The T-scores of 198 lumbar vertebra was assessed in QCT and the HU of vertebral body at the same level were measured in conventional CT by the picture archiving and communication system (PACS) system. A multiple regression algorithm was applied to predict the T-score using three independent variables (age, sex, and HU of vertebral body on conventional CT) coupling with T-score of QCT. Next, a logistic regression algorithm was applied to predict osteoporotic or non-osteoporotic vertebra. The Tensor flow and Python were used as the machine learning tools. The Tensor flow user interface developed in our institute was used for easy code generation. Results : The predictive model with multiple regression algorithm estimated similar T-scores with data of QCT. HU demonstrates the similar results as QCT without the discordance in only one non-osteoporotic vertebra that indicated osteoporosis. From the training set, the predictive model classified the lumbar vertebra into two groups (osteoporotic vs. non-osteoporotic spine) with 88.0% accuracy. In a test set of 40 vertebrae, classification accuracy was 92.5% when the learning rate was 0.0001 (precision, 0.939; recall, 0.969; F1 score, 0.954; area under the curve, 0.900). Conclusion : This study is a simple machine learning model applicable in the spine research field. The machine learning model can predict the T-score and osteoporotic vertebrae solely by measuring the HU of conventional CT, and this would help spine surgeons not to under-estimate the osteoporotic spine preoperatively. If applied to a bigger data set, we believe the predictive accuracy of our model will further increase. We propose that machine learning is an important modality of the medical research field.