• Journal of Gastric Cancer
• /
• v.9 no.4
• /
• pp.172-176
• /
• 2009

Purpose: The rapid urease test is a rapid and reliable method for diagnosing Helicobacter pylori infection. However it requires gastric mucosal biopsies during endoscopy, and the test is not covered by national health insurance for patients with gastric cancer. So, we introduced an alternative method for a rapid urease test using back-table gastric mucosal biopsies from gastrectomy specimen. Materials and Methods: Ninety gastric cancer patients underwent an anti H. pylori IgG ELISA test and gastrectomy. Just after gastrectomy, two gastric mucosal biopsies from the prepyloric antrum and lower body of the gastrectomy specimen were taken from the back table in the operative room, and these were fixed immediately with the rapid urease test kit, and the color change was monitored for up to 24 hours. In this study, H. pylori infection was defined as positive when the serology or rapid urease test showed positive results. Results: The positive rate of the rapid urease test and serology was 91.1% and 77.8%, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of the rapid urease test and serology were 94.3 and 80.5%, 100 and 100%, 100 and 100%, and 37.5 and 15%, respectively. The accuracy of the rapid urease test was higher than that of serology (94.4 vs. 81.1%, respectively). The rapid urease test showed a higher rate of detecting H. pylori infection than that of serology (McNemar's test, P=0.019). Conclusion: The result of the rapid urease test using back-table gastric mucosal biopsies from a gastrectomy specimen is comparable to the reference data of the conventional rapid urease test using gastric mucosal endoscopic biopsies. Therefore, it can be an alternative diagnostic method for H. pylori infection.

• The Korean Journal of Nuclear Medicine
• /
• v.33 no.1
• /
• pp.49-56
• /
• 1999

Purpose: Heart to liver ratio on T1-201 per rectal scintigraphy (shunt index) is known to be useful in the assessment of portal systemic shunt. We assessed T1-201 uptake pattern and early liver/heart uptake rate of T1-201 and correlated with shunt index in patients with chronic active hepatitis (CAH) and liver cirrhosis (LC). Materials and Methods: Fifty eight patients with biopsy-proven chronic liver disease (35 with CAH, 23 with LC) underwent T1-201 per rectum scintigraphy after instillation of 18.5 MBq of T1-201 into the upper rectum. We evaluated hepatic uptake (type 1 : homogeneous, 2: inhomogeneous segmental, 3: inhomogeneous nonsegmental) and extrahepatic uptake of spleen, heart and kidney (grade 0: no uptake, 1: less than liver, 2: equal to liver, 3: greater than liver). We measured the early liver/heart uptake rate (the slope of the liver to heart uptake ratio for 10 min) and shunt index (heart to liver uptake ratio). T1-201 uptake pattern and early liver/heart uptake rate of T1-201 was correlated with the pathologic diagnosis and shunt index. Results: Hepatic uptake patterns of type 1 and 2 were dominant in CAH (CAH: 27/35, LC. 8/23), and type 3 in LC (CAH: 8/35, LC: 15/23)(p<0.005). The grades of extrahepatic uptake were higher in LC than in CAH (spleen: p<0.001, other soft tissue: p<0.005). The early liver/heart uptake rate of CAH ($0.110{\pm}0.111$) was significantly higher than that of LC ($0.014{\pm}0.090$)(p<0.001). The sensitivity and specificity of the early liver/heart uptake rate were 77.7% and 67.7% in differentiating LC from CAH. There was negative correlation between early liver/heart uptake rate and shunt index (r=-0.3347, p<0.01). Conclusion: Hepatic and extrahepatic uptake pattern and early liver/heart uptake rate on T1-201 per rectum scintigraphy are useful in the assessment of portal systemic shunt in patients with chronic liver disease.

• The Korean Journal of Nuclear Medicine
• /
• v.39 no.1
• /
• pp.21-25
• /
• 2005

Purpose: $^{14}C$-urea breath test (UBT) is a non-invasive and reliable method for the diagnosis of Helicobacter pylori (HP) infection. In this study, we evaluated the diagnostic performance of a new and rapid $^{14}C$-UBT (Heliprobe method), which was equipped with $Geiger-M\ddot{u}ller$ counter and compared the results with those obtained by using the conventional method. Materials and Methods: Forty-nine patients with dyspepsia underwent gastroduodenoscopy and $^{14}C$-UBT. A 37 KBq $^{14}C$-urea capsule was administered to patients and breath samples were collected. In Heliprobe method, patients exhaled into a Hellprobe BreathCard for 10 min. And then the activities of the BreathCard were countered using Heliprobe analyzer. In the conventional method, results were countered using liquid scintillation counter. During gastroduodenoscopy, 18 of 49 patients were underwent biopsies. According to these histologic results, we evaluated the diagnostic performance of two different methods and compared them. Also we evaluated the concordant and disconcordant rates between them. Results: In all 49 patients, concordant rate of both conventional and Heliprobe methods was 98% (48/49) and the discordant rate was 2% (1/49). Thirteen of 18 patients to whom biopsies were applied, were found to be HP positive on histologic results. And both Heliprobe method and conventional method classified 13 of 13 HP-positive patients and 5 of 5 HP-negative patients correctly (sensitivity 100%, specificity 100%, accuracy 100%). Conclusion: The Heliprobe method demonstrated the same diagnostic performance compared with the conventional method and was a simpler and more rapid technique.

• The Korean Journal of Blood Transfusion
• /
• v.23 no.2
• /
• pp.127-135
• /
• 2012

Background: Despite modern advances in laboratory automated medicine, work-process in the blood bank is still handled manually. Several automated immunohematological instruments have been developed and are available in the market. The IH-1000 (Bio-Rad Laboratories, Hercules, CA, USA), a fully automated instrument for immunohematology, was recently introduced. In this study, we evaluated the performance of the IH-1000 for ABO/Rh typing and irregular antibody screening. Methods: In October 2011, a total of 373 blood samples for ABO/Rh typing and 303 cases for unexpected antibody screening were collected. The IH-1000 was compared to the manual tube and slide methods for ABO/Rh typing and to the microcolumn agglutination method (DiaMed-ID system) for antibody screening. Results: For ABO/Rh typing, concordance rate was 100%. For unexpected antibody screening, positive results for both column agglutination and IH-1000 were observed in 10 cases (four cases of anti-E and c, three of anti-E, one of anti-D, one of anti-M, and one of anti-Xg) and negative results for both were observed in 289 cases. The concordance rate between IH-1000 and column agglutination was 98.7%. Sensitivity and specificity were 90.9% and 99.3%, respectively. Conclusion: The automated IH-1000 showed good correlation with the manual tube and slide methods and the microcolumn agglutination method for ABO-RhD typing and irregular antibody screening. The IH-1000 can be used for routine pre-transfusion testing in the blood bank.

• Tuberculosis and Respiratory Diseases
• /
• v.62 no.6
• /
• pp.479-485
• /
• 2007

Background: The purpose of this study was to evaluate the differences in CT findings according to sputum smear-positive or -negative results in patients with active pulmonary tuberculosis having a single cavity. Methods: A total of 32 patients with active pulmonary tuberculosis having a single cavity on CT were classified into two groups: smear-positive (n=19) and smear-negative (n=13). The CT findings were reviewed retrospectively. The presence of consolidation, the number of lobes showing consolidation, ground-glass opacity, micronodules and nodule, the maximum diameter of the cavity, and the shape and maximum thickness of the cavity wall were assessed. Result: The maximum diameter of the cavity was $33.84{\pm}13.65mm$ and $27.08{\pm}9.04mm $ in the smear-positive and -negative groups, respectively (p>0.05). The amount of consolidation and the number of lobes with consolidation were found to be 89.5% and 30.8% (p=0.01) and $1.37{\pm}0.90$ and $0.31{\pm}0.48$ (p=0.0002) in the smear-positive and -negative groups, respectively. Consolidations in two or more lobes were only noted in 31.6% of in the sputum smear- positive group (p< 0.05). There were no other significant differences between the two groups. The sensitivity, specificity, positive and negative predictive values for the presence of consolidation were 89.5%, 69.2%, 73.9%, and 81.8%, respectively. Conclusion: While the absence of consolidation on CT may be associated with sputum smear-negative results in patients with active pulmonary tuberculosis having a single cavity, the presence of consolidation in two or more lobes on CT may be associated with spear-positive results in these patients.

• Clinical and Experimental Pediatrics
• /
• v.45 no.11
• /
• pp.1381-1388
• /
• 2002

Purpose : Magnetic resonance cholangiopancreatography(MRCP) is a noninvasive method for imaging the pancreaticobiliary tree. The aim of this study was to evalute the usefulness of MRCP for the diagnosis of pancreaticobiliary diseases in children. Methods : From October 1996 to May 2001, 67 patients with obstructive jaundice and three patients with chronic recurrent pancreatitis were evaluated with abdominal ultrasonography and MRCP. The final diagnosis was based on the operative and pathologic findings with biopsy specimen including clinical and laboratory findings. Results : A total of 70 patients, consisting of 31 males and 39 females, with a mean age of $2.6{\pm}3.3$ years were studied. The final diagnosis was biliary atresia in 25, neonatal cholestasis in 18, choledochal cyst without anomalous pancreatobiliary duct union(APBDU) in nine, choledochal cyst with APBDU in seven, cholestatic hepatitis in five, chronic recurrent pancreatitis in three, sclerosing cholangitis in two, and secondary biliary cirrhosis in one case. The overall diagnostic accuracy of abdominal ultrasonography was 75.7% and that of MRCP was 97.1%. The sensitivity and specificity of MRCP were 100% and 98% for biliary atresia, 87.5% and 100% for choledochal cyst with APBDU, 100% and 100% for choledochal cyst without APBDU, sclerosing cholangitis and chronic recurrent pancreatitis, respectively. Conclusion : MRCP is a fast, non-invasive and reliable method for diagnosing pancreaticobiliary diseases in children and will be the standard diagnostic procedure in the future.

• Clinical and Experimental Pediatrics
• /
• v.51 no.12
• /
• pp.1329-1335
• /
• 2008

Purpose : This study aimed to determine the best cutoff line for insulin-like growth factor (IGF)-I and insulin-like growth factor binding protein (IGFBP)-3 to discriminate between growth hormone deficiency (GHD) patients and the control group. Methods : Two hundred thirty subjects with normal controls (129 boys and 101 girls, aged 7-15 years), 14 patients with complete GHD (12 boys and 2 girls), and 17 patients with partial GHD (9 boys and 8 girls) were studied. IGF-I serum concentrations were measured by radioimmunoassay (RI), and IGFBP-3 concentrations were measured by immunoradiometric assay (IRMA). Results : The receiver operating characteristic (ROC) plot analysis showed that the best IGF-I and IGFBP-3 cutoff line was at -1 standard deviation (SD). By comparing IGF-I serum levels of GHD children within 1 SD of normal control, we determined the sensitivity (S) (87.5-100%) and specificity (Sp) (80-84.6%) according to the age group. For IGFBP-3, we determined the following values: S (58.7-85.7%) and Sp (79.2-85.5%). Eleven of 14 patients with complete GHD (78.5%) and 16 of 17 patients with partial GHD (94.1%) had IGF-I concentrations equal to or below -1 SD of the control group mean. Ten of 12 complete GHD children (83.3%) and 13 of 17 partial GHD children (76.5%) had IGFBP-3 concentrations equal or below -1 SD of the control group mean. Conclusion : We conclude that the measurement of IGF-I and IGFBP-3 concentrations might provide essential supplementary data in the diagnostic evaluation of patients with GHD. Our results support the need to use cutoff lines based on below -1 SD of the control.

• The Korean Journal of Nuclear Medicine
• /
• v.34 no.6
• /
• pp.478-486
• /
• 2000

Purpose: The sentinel lymph node is defined as the first draining node from a primary tumor and reflects the histologic feature of the remainder of the lymphatic basin status. The aim of this study was to evaluate the usefulness of lymphoscintigraphy and intraoperative radioguided gamma probe for identification and removal of sentinel lymph node in breast cancer. Materials and Methods: Lymphoscintigraphy was performed preoperatively in 15 patients with biopsy proven primary breast cancer. Tc-99m antimony sulfide colloid was injected intradermally at four points around the tumor. Imaging acquisition included dynamic imaging, followed by early and late static images at 2 hours. The sentinel lymph node criteria on lymphoscintigraphy is the first node of the highest uptake in early and late static images. We tagged the node emitting the highest activity both in vivo and ex vivo. Histologic study for sentinel and axillary lymph node investigation was done by Hematoxylin-Eosin staining. Results: On lymphoscintigraphy, three of 15 patients had clear lymphatic vessels in dynamic images, and 11 of 15 patients showed sentinel lymph node in early static image and three in late static 2 hours image. Mean detection time of sentinel lymph node on lymphoscintigraphy was $33.5{\pm}48.4$ minutes. The sentinel lymph node localization and removal by lymphoscintigraphy and intraoperative gamma probe were successful in 14 of 15 patients (detection rate: 93.3%). On lymphoscintigraphy, 14 of 15 patients showed $2.47{\pm}2.00$ sentinel lymph nodes. On intraoperative gamma probe, $2.36{\pm}1.96$ sentinel lymph nodes were detected. In 7 patients with positive results of sentinel lymph node metastasis, 5 patients showed positive results of axillary lymph node (sensitivity: 72%) but two did not. In 7 patients with negative results of sentinel lymph node metastasis, all axillary nodes were free of disease (specificity: 100%). Conclusion: Sentinel lymph node biopsy with lymphoscintigraphy and intraoperative gamma probe is a reliable method to predict axillary lymph node metastasis in breast cancer, and unnecessary axillary lymph node dissection can be avoided.

• Journal of Nutrition and Health
• /
• v.42 no.1
• /
• pp.38-47
• /
• 2009

The purpose of the study was to develop an eating habit checklist for screening elementary school children at risk of inadequate micronutrient intake. Eating habits, food intake, and anthropometric data were collected from 142 children (80 boys and 62 girls) in the $4^{th}$ to $6^{th}$ grades of elementary schools. Percentage of Recommended Intakes (RI) and Mean Adequacy Ratio (MAR) of six micronutrients; vitamin A, riboflavin, vitamin C, calcium, iron, zinc, and the number of nutrients the children consumed below EAR among the six nutrients were used as indices to detect the risk of inadequate micronutrient intake. Pearson correlation coefficients were calculated between eating habit scores and inadequate micronutrient intake indices in order to select questions included in the checklist. Meal frequency, enough time for breakfast, regularity of dinner, appetite, eating frequencies of Kimchi, milk, fruits and beans showed significant correlations with indices of inadequate micronutrient intake. Stepwise regression analysis was performed to give each item a different weight by prediction strength. To determine the cut-off point of the test score, sensitivity, specificity, and positive predictive values were calculated. The 8-item checklist with test results from 0 to 12 points was developed, and those with equal or higher than 6 points were diagnosed as high-risk group of inadequate micronutrient intake, and those with 4 or 5 points were diagnosed as moderate-risk group. Among our subjects 14.1% was diagnosed as high-risk group, and 30.3% as moderate-risk group. The proportions of the subjects who consumed below EAR of all micronutrients but vitamin C were highest in the high-risk group, and there were significant differences in the proportions of the subjects with intake below EAR of all micronutrients except vitamin B6 among the three groups. This checklist will provide a useful screening tool to identify children at risk of inadequate micronutrient intake.

• Korean Journal of Poultry Science
• /
• v.37 no.2
• /
• pp.167-172
• /
• 2010

An immunochromatograhy (IC) based infectious bursal disease virus (IBDV) detection kit, which employed two anti-IBDV VP2 monoclonal antibodies, was evaluated for rapid diagnosis of infectious bursal disease virus (IBD). The detection limit of the IC kit for IBDV was $10^{3.1}$ to $10^{3.9}$ $EID_{50}$/mL, indicating that the IC kit detected IBDV sensitively as same as double antigen capture ELISA but less than a RT-PCR assay. The IC kit did not detect other viral pathogens such as Newcastle disease virus, infectious bronchitis, avian influenza virus, and infectious larynotracheitis virus. When applied to tissue samples of experimental chickens died 3 or 4 days post infection after very virulent IBDV (strain Kr/D62) infection, the IC kit detected IBDV in all samples of the bursa of Fabricius, spleen, kidney, cecal tonsil and in 87.5%, 37.5% and 0% of liver, thymus and proventriculus samples. In particular, BF tissue samples showed stronger signal bands than other tissues. Positive signal was observed. All except for one thymus sample of samples having negative results by the IC kit showed the same result with DAS-ELISA but RT-PCR assay detected IBDV in some of IC kit negative samples of thymus and proventriculus. When swab samples from the bursa of Fabricius of dead chickens (n=231) on field farms were tested, the sensitivity and specificity of the IC assay relative to RT-PCR was 100% (109/109) and 97.5% (119/122), respectively and kappa value between both assay was 0.97. The kit can provide a useful aid for rapid detection of IBDV in chickens under field circumstances.