• Title/Summary/Keyword: diagnostic aids

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Diagnostic Significance of TNF-$\alpha$ in Tuberculous and Non-Tuberculous Pleural Effusion (결핵성 및 비결핵성 흉막삼출액에서 TNF-$\alpha$ 농도의 진단적 의의)

  • Na, Hyun-Joo;Park, Seog-Chea;Kang, Kwang-Won;Park, Hyeong-Kwan;Kim, Young-Chul;Choi, In-Seon;Park, Kyung-Ok
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.3
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    • pp.611-620
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    • 1997
  • Objectives : The differentiation of tuberculous effusion from the other causes of exudative pleural effusion remained difficult even with aids of biochemical analyses and pleural biopsy. As the pathophysiology of tuberculous pleural effusion is an enhanced cell mediated immunity, Adenosine deaminase(ADA) and various eytokines including Inteferon-$\gamma$, tumor necrosis factor alpha(TNF-$\alpha$) are considered as useful diagnostic tools in differentiating exudative pleural effusion. The author would like to demonstrate the diagnostic usefulness of TNF-$\alpha$ in the differentiation of exudative pleural effusion, and compared the discriminating ability of TNF-$\alpha$ with ADA. Methods : Pleural fluids obtained from 80 patients (tuberculous : 39, malignant : 31, parapneumonic : 10) with exudate pleural effusions were processed for cell counts and biochemical analysis including ADA and TNF-$\alpha$. Results : Tuberculous pleural fluid showed higher levels of ADA and TNF-$\alpha$, $48.7{\pm}32.7U/L$ and $184.1{\pm}214.2pg/mL$ than that of non-tuberculous effusion $26.0{\pm}41.3U/L$ and $44.1{\pm}114.2pg/mL$, respectively (ADA, TNF-$\alpha$, p < 0.05, p < 0.01). Receiver operating characteristics(ROC) curves were generated for ADA and TNF-$\alpha$ and the best cut-off value for adenosine deaminase and TNF-$\alpha$were considered as 30U/L and 15pg/ml, respectively. Comparing the area under the ROC curves, there was no significant difference between ADA and TNF-$\alpha$. Conclusion : For the differential diagnosis of tuberculous pleural effusion from the other causes of exudative pleural effusions, TNF-$\alpha$ as well as ADA was considered as useful diagnostic method. However adding TNF-$\alpha$ to ADA has no further diagnotic benefit than ADA alone.

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Clinical study of benign and malignant fibrous-osseous lesions of the jaws

  • Lee, Ju-Min;Song, Won-Wook;Lee, Jae-Yeoul;Hwang, Dae-Seok;Kim, Yong-Deok;Shin, Sang-Hun;Chung, In-Kyo;Kim, Uk-Kyu
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.38 no.1
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    • pp.29-37
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    • 2012
  • Introduction: Fibrous-osseous lesions of the jaws are difficult to diagnose precisely until excised biopsy results are found, so they might be confused with malignant lesions. This clinical study focused on the diagnostic aids of lesions that demonstrate different clinical, radiologic, and histological findings. Materials and Methods: A total of 16 patients with benign fibrous-osseous lesions on the jaws (6 fibrous dysplasias, 6 ossifying fibromas, 3 cemental dysplasias, and one osteoblastoma) were reviewed. Nine patients with malignant fibrous-osseous lesions (8 osteosarcomas and one Ewing's sarcoma) were also retrospectively reviewed. Results: Osteosarcoma patients complained of facial swelling and tooth mobility. The radiographic findings showed the irregular resorption of cortical bone and periosteal reactions. Histological features included cellular pleomorphism and atypical mitosis. An Ewing's sarcoma patient complained of tooth mobility and facial swelling. Onion-skin appearance and irregular expansile marginal bony radiolucency were seen in the radiography. Fibrous dysplasia patients complained of facial swelling and asymmetry. The radiographic features were mostly ground-glass radiopacity. Histological findings showed a bony trabeculae pattern surrounded by fibrous ground substances. Ossifying fibroma patients complained of buccal swelling and jaw pains, showing expanded cortical radiolucent lesions with a radiopaque margin. Histological findings were revealed as cellular fibrous stroma with immature woven bones. In cemental dysplasia, most of their lesions were found in a routine dental exam. Well-circumscribed radiopaque lesions were observed in the radiography, and cementum-like ossicles with fibrous stroma were seen in the microscopy. An osteoblastoma patient complained of jaw pain and facial swelling. Radiographic findings were mottled, dense radiopacity with osteolytic margin. Trabeculae of the osteoid with a vascular network and numerous osteoblasts with woven bone were predominantly found in the microscopy. Conclusion: Our study showed similar results as other studies. We suggest the clinical parameters of diagnosis and treatment for malignant and benign fibrous-osseous lesions of the jaws.

High Resolution Melting Curve Assay for Detecting rs12979860 IL28B Polymorphisms Involved in Response of Iranian Patients to Chronic Hepatitis C Treatment

  • Fateh, Abolfazl;Aghasadeghi, Mohammad Reza;Keyvani, Hossein;Mollaie, Hamid Reza;Yari, Shamsi;Tasbiti, Ali Reza Hadizade;Ghazanfari, Morteza;Monavari, Seyed Hamid Reza
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.5
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    • pp.1873-1880
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    • 2015
  • Background: A recent genome-wide association study (GWAS) on patients with chronic hepatitis C (CHC) treated with peginterferon and ribavirin (pegIFN-${\alpha}$/RBV) identified a single nucleotide polymorphism (SNP) on chromosome 19 (rs12979860) which was strongly associated with a sustained virological response (SVR). The aim of this study was twofold: to study the relationship between IL28B rs12979860 and sustained virological response (SVR) to pegIFN-${\alpha}$/RVB therapy among CHC patients and to detect the rs12979860 polymorphism by high resolution melting curve (HRM) assay as a simple, fast, sensitive, and inexpensive method. Materials and Methods: The study examined outcomes in 100 patients with chronic hepatitis C in 2 provinces of Iran from December 2011 to June 2013. Two methods were applied to detect IL28B polymorphisms: PCR-sequencing as a gold standard method and HRM as a simple, fast, sensitive, and inexpensive method. Results: The frequencies of IL28B rs12979860 CC, CT, and TT alleles in chronic hepatitis C genotype 1a patients were 10% (10/100), 35% (35/100), and 6% (6/100) and in genotype 3a were 13% (13/100), 31% (31/100), and 5% (5/100), respectively. In genotype 3a infected patients, rs12979860 (CC and CT alleles) and in genotype 1a infected patients (CC allele) were significantly associated with a sustained virological response (SVR). The SVR rates for CC, CT and TT (IL28B rs12979860) were 18%, 34% and 4%, respectively. Multiple logistic regression analysis identified two independent factors that were significantly associated with SVR: IL-28B genotype (rs 12979860 CC vs TT and CT; odds ratio [ORs], 7.86 and 4.084, respectively), and HCV subtype 1a (OR, 7.46). In the present study, an association between SVR rates and IL28B polymorphisms was observed. Conclusions: The HRM assay described herein is rapid, inexpensive, sensitive and accurate for detecting rs12979860 alleles in CHC patients. This method can be readily adopted by any molecular diagnostic laboratory with HRM capability and will be clinically beneficial in predicting treatment response in HCV genotype 1 and 3 infected patients. In addition, it was demonstrated that CC and CT alleles in HCV-3a and the CC allele in HCV-1a were significantly associated with response to pegIFN-${\alpha}$/RBV treatment. The present results may help identify subjects for whom the therapy might be successful.

A study on the correlations between facial biotype, submentovertex cephalometric measurements and surface EMG activity in patients with facial asymmetry (안면 비대칭 환자의 수직 안모 유형과 이하두정 두부방사선 규격사진 계측치 및 표면 근전도의 상관성에 대한 연구)

  • Kim, Seong-Soo;Lee, Nam-Ki;Cha, Bong-Kuen
    • The korean journal of orthodontics
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    • v.36 no.3 s.116
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    • pp.218-227
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    • 2006
  • Although the submentovertex radiograph and surface EMG are not often used due to the difficulty of interpretation, they are accepted as useful diagnostic and analytic aids for skeletal asymmetry. There have been reports which state that they were also useful for the evaluation of vertical skeletal relations. The purpose of this study was to evaluate the correlations between EMG data, measurements from submentovertex radiographs, facial types and facial asymmetry following examination of 60 asymmetric patients. The radiographic corpus length were greater in the nonaffected sides (p<0.001), gonion to interspinosum axis were greater in the affected sides and the mandibular condyle and gonion were located more anteriorly in the non-affected sides than in the affected sides but not significant (p=0.07). The activity of the anterior temporal muscle in rest position was higher in the affected sides than in the non-affected sides (p<0.01). The activity of the masseter muscle at maximum clenching was found to be nonsignificant but it was higher in the affected sides than in the non-affected sides (p=0.09). There was positive correlation between facial index and the intercondylar axes angle (p<0.01). There was positive correlation between masseter muscle activity in maximum occlusion and facial index in the affected and non-affected sides (p<0.05). The results demonstrate that the submentovertex radiograph and EMG can provide useful information for the evaluation of horizontal and vertical skeletal relations.

Studies on the Serum Total Activities and Isoenzyme PAtterns of LDH in Non-Human Primates Reared in Korea (國內詞育 원숭이의 血淸 LDH의 總活性値와 isoenzyme에 관한 硏究)

  • 윤상보;김덕환;서지민;신남식;현병화;김명철;윤효인;박배근;송희종
    • Journal of Veterinary Clinics
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    • v.18 no.4
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    • pp.380-389
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    • 2001
  • Non-human primates have been increasing in demand as important experimental animals and companion animals, domestically and internationally. The number of non-human primates for these purposes will be much enhanced in the near future. Despite this trend, basic physiological data are scarcely available in these animal species, leading to the difficulty to diagnose diseases when necessary, due to the absence of reference values. Particularly, there is not any report on the total activity of LDH of non-human primates, let alone LDH isoenzyme patterns, in Korea. LDH isoenzymes have a high level of efficaciousness as diagnostic and prognostic aids in various diseases. In this study, total activities and isoenzyme patterns of LDH were measured to obtain their reference values in domestically reared common marmosets, crab-eating macaques and Japanese macaques. There were widespread different values of serum total LDH among the non-human primate species experimented in this study. Serum LDH values of common marmosets and crab-eating macaques were 597.5$\pm$243.1 IU/l and 605.3$\pm$312.6 IU/l, respectively, whereas those of Japanese macaque showed 1,209$\pm$473.8 IU/l. Five isoenzyme fractions of LDH were observed in all experimented non-human primates but their ranks and proportions represented different patterns one another. In common marmosets, the percent of fraction for serum LDH1, LDH$_2$, LDH$_3$, LDH$_4$, and LDH$_{5}$ was 13.7$\pm$6.4%, 23.3$\pm$3.6%, 29.2$\pm$5.0%, 9.4$\pm$1.4% and 24.4$\pm$7.5%, respectively. The rank of LDH isoenzymes was LDH$_3$>LDH$_{5}$>LDH$_2$>LDH$_1$>LDH$_4$, in the descending order. For crab-eating macaques, the fraction of serum LDH$_1$, LDH$_2$, LDH$_3$, LDH$_4$, and LDH$_{5}$ occupied 19.5$\pm$12.7%, 25.3$\pm$9.3%, 23.8$\pm$8.1%, 10.2$\pm$2.8% and 21.3$\pm$14.2%, respectively. The order of LDH isoenzymes was LDH$_2$>LDH$_3$>LDH$_{5}$>LDH$_1$>LDH$_4$, from top to down. On the while, in Japanese macaques, the fraction of serum LDH$_1$ to LDH$_{5}$ showed 23.4$\pm$11.8%, 30.5$\pm$4.1%, 17.4$\pm$3.9%, 11.3$\pm$3.7% and 13.8$\pm$5.6%, respectively. The decreasing order indicated LDH$_2$>LDH$_1$>LDH$_3$>LDH$_{5}$>LDH$_4$. In conclusion, values such as LDH and LDH isoenzyme patterns of investigated for the first time from non-human primates reaared in Korea, could be reference values for the optimal diagnosis and therapy of diseases of the corresponding animal species. Other parameters of hematology and blood biochemistry are urgently needed to study for the benefit of our intimate non-human primates.an primates.

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A Comparative Analysis on The Efficiency of Various Clinical Methods for Diagnosis of Tuberculosis (결핵 진단을 위한 검사 방법간의 효율성에 관한 비교 분석)

  • 최석철;정천환;성희경;김태운;이원재
    • Biomedical Science Letters
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    • v.5 no.2
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    • pp.191-200
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    • 1999
  • In recent years continuously increasing number of tuberculosis (TB) cases due to the emergence of strains with multidrug resistance and AIDS is a significant global health problem. Therefore, more rapid and reliable diagnosis of TB may be one of the most urgent needs in efforts to eradicate the disease. The present study was designed to compare and assess the diagnostic values and efficiencies between the conventional methods (X-ray, AFB stain and culture) and PCR for pulmonary TB on 171 cases. Chest X-ray finding and clinical features revealed that 39 (22.8%) of 171 sputum specimens were pulmonary TB cases. The statistical data were taken on the basis of the definitive diagnosis: In X-ray, overall sensitivity, specificity, efficiency and false positive and false negative incidence was respectively 69.2%, 87.1%, 83.0%, 12.9%, and 30.8%; 79.5%, 95.5%, 91.8%,4.6% and 20.5% in AFB-stain; 56.4%, 99.2%,89.5%, 0.8% and 43.6% in culture; 82.1%, 96.2%, 93.0%, 3.8% and 17.9% in PCR. PCR got a highest sensitivity and efficiency as well as a lowest false negative incidence. Culture had a highest specificity with a lowest false positive incidence. These results imply that PCR assay is fast, sensitive and efficient method for diagnosis of pulmonary TB. However, combined use of the conventional methods with thorough quality control may offer more opportunities for detecting Mycobacterium tuberculosis and diagnosting TB although they have some limits.

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The Association between Pulmonary Function Test Result and Combustible Cigarette Smoking or Electrical Cigarette Smoking in Korean Adults : Using the 2014-2019 Korean national health and nutrition examination survey data (한국 성인에서 일반담배 또는 가열 전자담배를 이용한 흡연 형태와 폐 기능 검사 결과와의 관련성: 2014-2019년도 국민건강영양조사 자료를 이용하여)

  • Il-hwan Kim;Il-Hyun Lee;Sae-Ron Shin
    • Journal of The Korean Society of Integrative Medicine
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    • v.12 no.1
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    • pp.27-39
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    • 2024
  • Purpose : Smoking is a major factor in chronic obstructive pulmonary disease (COPD), but the effect of electrical cigarette smoking on COPD development is still uncertain. This study aimed to compare the functions of airways and lungs exposed to combustible cigarettes and electrical cigarettes based on the pulmonary function test (PFT) results from the Korean National Health and Nutrition Examination Survey (NHANES). Methods : This study used data from 8,942 participants with PFT results out of 47,309 total subjects from the 6th to 8th Korean NHANES (2014-2015, 2016-2018, and 2019, respectively). Individuals with diseases such as cancer, ex-smokers, and dual tobacco users were excluded. The PFT results were analyzed according to the COPD diagnostic criteria. After adjusting for confounding variables, a complex sample generalized linear model ANOVA test was performed to investigate the association between PFT results and combustible smoker or electrical cigarette user groups. Results : In an analysis based on the obstructive ventilatory disorders (forced expiratory volume in 1 second[FEV1]/forced vital capacity[FVC]<.7), combustible cigarette smokers showed a 3.46 times higher risk of COPD compared to non-smokers, while electrical cigarette smokers exhibited no significant difference in terms of COPD-related risks compared to non-smokers. FEV1 showed a negative relation with combustible cigarette smokers as reported elsewhere (B=-.07, p<.001). FEV1/FVC was negatively related to both combustible cigarette smokers (B=-.03, p<.001) and electrical cigarette smokers (B=-.02, p<.001). Conclusion : FEV1/FVC decreases were observed in the long-term exposure to both combustible and electrical cigarettes. The lower FEV1 in the combustible cigarette group implies the worsening of the severity of COPD, suggesting more damage to the airways and lungs in the short term. Therefore, the temporary electrical cigarettes use for the transition period in order to smoking cessation potentially aids to reduce the harmful effect of combustible cigarettes in COPD development.

Ultrasonographic Features and the Diagnostic Role of Core Needle Biopsy at Metastatic Breast Cancer in the Thyroid gland: A Case Report (갑상선에 생긴 전이성 유방암의 초음파 소견 및 중심부 바늘 생검의 진단적 가치: 증례 보고)

  • Dong Hyun Lee;Ra Gyoung Yoon;Jin Kyung An;Jeong Joo Woo
    • Journal of the Korean Society of Radiology
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    • v.81 no.3
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    • pp.719-725
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    • 2020
  • Metastases to the thyroid gland have rarely been reported in clinical settings, and the thyroid gland is an uncommon site for breast carcinoma metastasis. We report a case of a 64-year-old breast cancer patient diagnosed with metastatic breast carcinoma in the thyroid gland after performing ultrasonography (US)-guided core needle biopsy (CNB) and subsequent total thyroidectomy. On US, the thyroid lesion appeared to be mildly enlarged with multiple internal hypoechoic lines and a few microcalcifications without mass formation. Under US-guidance, CNB was performed by targeting the area with microcalcifications and subsequently diagnosed as metastatic breast carcinoma. Total thyroidectomy revealed that the patient had metastatic invasive ductal carcinoma of the breast with lymphatic spread involving both lobes and the isthmus of the thyroid gland. Although the thyroid gland is an uncommon metastatic site, the unusual features of thyroid metastasis can be observed on US; thus, US-guided CNB effectively aids the diagnosis of thyroid metastasis.

Clinical Significance of PCR-Based Rapid Detection of Mycobacterium tuberculosis DNA in Peripheral Blood (결핵 환자에서 말초혈액 결핵균 중합효소 연쇄반응 양성의 임상적 의의)

  • Kim, Gyu-Won;Lee, Jae-Myung;Kang, Min-Jong;Son, Jee-Woong;Lee, Seung-Joon;Kim, Dong-Gyu;Lee, Myung-Goo;Hyun, In-Gyu;Jung, Ki-Suck;Lee, Young-Kyung;Lee, Kyung-Wha
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.5
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    • pp.599-606
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    • 2001
  • Background : Since the advent of AIDS, tuberculosis has become a major public health problem in the western society. Therefore, it is essential that pulmonary tuberculosis be rapidly diagnosed. Light microscopic detection of acid-fast organisms in sputum has traditionally been used for rapidly diagnosing tuberculosis. However positive smears are only observed in about one-half to three-quarters of cases. Studies using PCR for diagnosing pulmonary tuberculosis disclosed several shortcomings suggesting an inability to distinguish between active and treated or inactive tuberculosis. In this study, the clinical significance of a PCR-based rapid technique for detecting Mycobacterium tuberculosis DNA in peripheral blood was investigated. Materials and Methods : From July 1, 1998 through to August 30, 1999, 59 patients with presumed tuberculosis, who had no previous history of anti-tuberculosis medication use within one year prior to this study were recruited and followed up for more than 3 months. AFB stain and culture in the sputum and/or pleural fluids and biopsies when needed were performed. Blood samples from each of the 59 patients were obtained in order to identify Mycobacterium Tuberculosis DNA by a PCR test. Results : 1) Forty five out of 59 patients had a final diagnosis of tuberculosis ; Twenty eight were confirmed as having active pulmonary tuberculosis by culture or biopsy. Four were clinically diagnosed with pulmonary tuberculosis. The other 13 patients were diagnosed as having tuberculous pleurisy (9) and extrapulmonary tuberculosis (4). 2) Fourteen patients showed a positive blood PCR test. The PCR assay correctly identified active tuberculosis in 13 out of 14 patients. The overall sensitivity and specificity of this blood peR assay for diagnosing tuberculosis were 29% and 93%, respectively. The positive predictive value was 93%, the negative predictive value was 29% and the diagnostic accuracy was 44%.3) Six out of 14(43%) patients with blood PCR positive tuberculosis were immunologically compromised hosts. 4) A simple chest radiograph in blood PCR positive tuberculosis patients showed variable and inconsistent findings. Conclusion : A peripheral blood PCR assay for Mycobacterium tuberculosis is not recommended as a screening method for diagnosing active tuberculosis. However, it was suggested that the blood PCR assay could contribute to an early diagnostic rate due to its high positive predictive value.

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Risk Factors for Nosocomial Pneumonia in Patients at NS ICU (신경외과 중환자실의 병원성 폐렴 발생 위험요인)

  • Kim Nam Cho;Kim So Yeon
    • Journal of Korean Public Health Nursing
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    • v.15 no.2
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    • pp.239-248
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    • 2001
  • The purpose of this study was to analyze risk factors for nosocomial pneumonia in patients admitted to NS ICU, and to provide a basic data to decrease respiratory nosocomial infection rate engendered from medical environments in NS ICU. The study site was the NS ICU at a university hospital located in Seoul, Korea. The subjects were 31 patients diagnosed with nosocomial pneumonia, who were selected from the initial list of 300 potential subjects who had been a) admitted between September 1999 and January 2000, and September 2000 and January 2001, b) resided at the NS ICU over 72 hours. The diagnostic standard of nosocomial pneumonia was based on the nosocomial infection guides of C university hospital. The data were analyzed using frequencies and logistic regression analysis. The sputums obtained from the subjects were cultivated and causal viruses were separated. The results were as follows: 1. The nosocomial pneumonia rate was $10.3\%$. There were 7 types of causal viruses separated from the sputum. and the most prevalent type of virus was MRSA as $62.2\%$. 2. The factors significantly influencing the incidence of nosocomial pneumonia included age, the residential duration at the NS ICU, GCS scores, diabetes mellitus, insertion of tracheal tube and its duration, tracheostomy and its length of insertion, the use of artificial ventilator and the length of its use, and the insertion of naso-gastic tube. The most significant risk factor among these was the insertion of tracheal tube (odds ratio=18.684. $95\%$ CI=6.849-50.974), followed by the use of tracheostomy (odds ratio=15.419, $95\%$ CI=6.615-35.942), the insertion of naso-gastric tube (odds ratio=14.875, $95\%$ CI=6.396-34.595), and the use of artificial ventilator (odds ratio=13.000. $95\%$ CI=5.633­30.001). 3. Regarding the use of the mechanical aids, the insertion of tracheal tube resulted in 12.968 times increase of the nosocomial pneumonia rate, and the use of artificial ventilator lead 6.714 times increase of the nosocomial pneumonia rate. One point increase of the GCS score resulted in the 1.210 times increase of the nosocomial pneumonia rate. For patients who had tracheal tube, tracheostomy, and artificial ventilator, one day increase of their residential duration at NS ICU lead 1.073 times increase of the nosocomial pneumonia rate. 4. In terms of duration of the mechanical aid usage, one day increase in the use of artificial ventilator engendered 1.080 times increase in the nosocomial pneumonia rate. One day increase of the residential duration at the NS ICU lead 1.604 times increase in the nosocomial pneumonia rate. As one point of the GCS score increased, 0.876 times decrease of the nosocomial pneumonia rate was reported. These study findings show that the risk factors significantly influencing the incidence of nosocomial pneumonia include the use of tracheal tube, tracheostomy, naso-gastic tube, and artificial ventilator. It is recommended that nurses working at NS ICU should pay more attention to the patients with these factors as the risky group for the nosocomial pneumonia, and thus make more active efforts to provide nosocomial pneumonia prevention strategies for them. In further studies patients admitted to the different types of ICUs such as internal medicine or surgery unit ICU will be also included, and more wide investigation of nosocomial pneumonia risk factors will be conducted through one-year longitudinal follow up.

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