• Tuberculosis and Respiratory Diseases
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• v.39 no.3
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• pp.248-254
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• 1992

Background: Pleural effusion is one of the most common clinical problems in pulmonology because of high prevalence of pulmonary tuberculosis and bronchogenic carcinoma in Korea. The differential diagnosis between pleural transudate and exudate is very important, but it is very difficult in some cases. Methods: In order to assess the clinical usefulness of cholesterol levels for the differential diagnosis of pleural transudate and exudate, we measured pleural fluid cholesterol levels by enzymatic method in 45 patients who were admitted due to pleural effusion. Results: The mean cholesterol level of transudate was $33.1{\pm}12.9\;mg%$, tuberculous exudate was $97.3{\pm}28.2\;mg%$ and malignant exudate was $97.3{\pm}28.2mg%$. When the cut-off value of pleural cholesterol level was 60 mg%, one case (6.7%) of tuberculous exudate and two cases (13.3%) of malignant exudate were incorrectly classified, but all cases of transudate were classified correctly. When the cut-off value of pleural/serum cholesterol ratio was 0.3, one case (6.7%) of transudate and two cases (13.3%) of malignant exudate were incorrectly classified, but all cases of tuberculous exudate were classified correctly. When the cut-off value of pleural cholesterol level to differentiate pleural transudate from exudate was 60 mg%, sensitivity was 90% and specificity was 100%. When the cut-off value of pleural/serum cholesterol level to differentiate pleural transudate form exuidate was 0.3, sensitivity was 93% and specifiity was 93%. Conclusions: From the above results, it can be concluded that measurement of pleural fluid cholesterol levels is useful for the differential diagnosis between pleural transudate and exudate.

• Tuberculosis and Respiratory Diseases
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• v.39 no.3
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• pp.236-241
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• 1992

Background: As well as fiberoptic bronchoscopy, chest computerized tomographic scan can now differentiate the benign from malignant causes and the obstructive from non-obstructive causes of lung collapse. This study was designed to evaluate the usefulness of chest CT scan and fiberoptic bronchoscopy in the diagnosis of middle lobe syndrome. Method: We reviewed the clinical features, roentgenographic changes, pathologic findings and bronchoscopic findings in 16 patients with middle lobe syndrome who were admitted to Severance Hospital during period of January, 1987 through January, 1992. Results: The male to female ratio was 1:1. The most common symptoms were cough and sputums. Crackle was the most common physical finding. Underlying disease was lung cancer, pulmonary tuberculosis and endobronchial tuberculosis in 3 each other, benign stenosis in 2, lung abscess, broncholithiasis, bronchial chondroma, pneumonia and nonspecific inflammation in 1 each other. Conclusion: We conclude that the combination of chest computerized tomogram and fiberoptic bronchoscopy was most desirable for the diagnosis of middle lobe syndrome.

• The Journal of the Korean bone and joint tumor society
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• v.7 no.1
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• pp.28-35
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• 2001

Purpose : Authors investigated the efficiency of preoperative MRI in suspicious glomus tumor and the clinical outcomes after marginal excision. Materials and Methods : In 10 cases of glomus tumors in the fingers, authors retrospectively analyzed the clinical data, including previous trauma, treatment history, preoperative symptoms, physical examination, plain radiography, MRI (9 cases), pathological findings and postoperative complications. Results : The patients had pain in 10 cases, tenderness in 9 cases, cold sensitivity in 3 cases and edema in one case. MRI showed low signal (3 cases) or iso-signal (5) intensity on T1 weighted image, high signal intensity (8) on T2 weighted image, and all the lesions were enhanced in gadolinium enhancement images. The exact locations of glomus tumors were median in 6 cases, lateral in 5, lateral fold in 2 and pulp in 3 in transverse section and nail bed in 5 cases and nail matrix in 5 in sagittal section. Marginal excision was performed by lateral approach in one case and transungual in 9 cases. Histologically, all 10 cases were composed of solid sheets of round cells interrupted by thin-walled blood vessels. Most of clinical symptoms were disappeared in all cases after operation. Nail deformity was found in one case, which was originated from nail matrix, however, there was no recurrence. Summary : Clinical symptom was the most impotant factor in diagnosis of glomus tumor in the fingers. However, preoperative MRIs were helpful in patients, who had obscure pain or prolonged clinical symptoms with suspicious glomus tumors. Preoperative MRI might be one of the most useful tools for establishing the exact diagnosis and detecting the location of glomus tumors, in spite of the relatively high expenses.

• Journal of Gastric Cancer
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• v.5 no.4 s.20
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• pp.222-227
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• 2005

Purpose: There are several reports suggested the usefulness of serum tumor markers, AFP, CEA and CA19-9 as prognostic factors or indicators for recurrence in gastric cancer. This clinical study was peformed to evaluate positive rate of tumor markers according to site of recurrence in gastric cancer. Materials and Methods: From the database of patients who underwent radical gastrectomy for gastric cancer between January 1999 and January 2004, 52 patients who showed recurrence were included in this retrospective study. Serum levels of tumor markers were measured at the time of preoperative diagnosis of the gastric cancer and at the time of postoperative recurrence during follow up, respectively. Results: The overall positivity of tumor markers at the time of recurrence was found to be significantly higher than that of prior to surgery in the recurred group for the single test as well as the combination tests. For the peritoneum, the most common recurrent site, the positivity of CA19-9 was higher at the time of recurrence. And the significant positivity of CEA at the time of recurrence was detected in the liver cases. Conclusion: Having a preoperative positive tumor marker may identify the patient as having an increased chance of a recurrence. Although tumor markers continue to have limited diagnostic significance in gastric cancer, CA19-9 may be useful as a predictor for peritoneal recurrence of the gastric cancer, and CEA for recurrence to liver.

• Tuberculosis and Respiratory Diseases
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• v.40 no.1
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• pp.35-42
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• 1993

Background: In order to establish the etiology of the pleural effusion, routine analysis of the fluid, bacteriologic studies, cytologic tests and pleural biopsies are currently being employed. However, even with the above mentioned tests, the exact causes cannot be determined in approximately 10-20% of cases. The purpose of our study is to determine the diagnostic value of measuring ADA activity and CEA simultaneously in various pleural fluids which their etiologies have confirmed Methods: We have studied 61 cases of tuberculous pleural effusions, 17 cases of suspected tuberculous pleural effusions, 17 cases of malignant pleural effusions, 22 cases of suspected malignant pleural effusions, and 7 cases of parapneumonic pleural effusions. We have measured the ADA activity and CEA level simultaneously in pleural fluid samples in each cases. Results: 1) The ADA activity in tuberculous pleural effusion was significantly higher than that in malignant effusion. 2) The CEA level in malignant pleural effusion was significantly higher than that in tuberculous effusion. 3) With the cut-off values of the pleural fluid ADA activity more than 40 U/L and the CEA level less than 12 ng/mL, the sensitivity was 86.9%, and the specificity was 100% in the diagnosis of tuberculous effusion. With the cut-off values of the pleural fluid CEA level more than 12 g/mL and the ADA activity less than 40 U/L, the sensitivity was 76.5%, and the specificity was 100% in the diagnosis of malignant effusion. Conclusion: It is suggested that the combined assay of pleural fluid ADA activity and CEA level is very useful in the differential diagnosis of tuberculous and malignant pleural effusion.

• Tuberculosis and Respiratory Diseases
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• v.42 no.2
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• pp.142-148
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• 1995

Background: Despite modern diagnostic, staging, and therapeutic advances, esp. with molecular biologic techniques, the 5-year survival rate of all cases of lung cancer does not exceed 15%. Also, the incidence of lung cancer of both sex in Korea is increasing year by year and the lung cancer is one of the leading causes of cancer death. Therefore, it is strongly needed to develop the new combination of treatment modalities including neoadjuvant chemotherapy and to identify tumor specific characteristics with staging or prognostic markers. Here we present the clinical significance of several biologic tumor markers to use as a prognostic markers in patients with non-small cell lung cancers. Method: The survival has correlated with the expressibility of proliferative cell nuclear antigen (PCNA), epidermal growth factor receptor(EGFR), p53 and/or blood group antigen A(BGAA) using immunohistochemistry in 46 patients with non-small cell lung cancers. Results: 1) The expression rates of PCNA, EGFR, p53 and BGAA were 80.6%, 61.3%, 45.9% and 64.3%, respectively and those were not correlated to cell types or clinical stges. 2) The expression of BGAA was correlated with better survival in median survival and in 2-year survival rate and that of PCNA was correlated with worse survival in median survival and 2-year survival rate. 3) The expression of EGFR or p53 was not valuable to predict prognosis in non-small cell lung cancers. 4) With simultaneous applications of PCNA, EGFR and p53 immunostain, the patients with 2 or more negative expressions showed better prognosis than the patients with 2 or more positive expressions. Conclusion: It is suggested that the expression of blood group antigen may be a positive prognostic factor and that of PCNA may be a negative prognostic factor. Also, the combination of expressions of PCNA, EGFR and p53 may be used as a negative prognostic factor.

• Tuberculosis and Respiratory Diseases
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• v.66 no.6
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• pp.444-450
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• 2009

Background: Biomarkers for cancer have several potential clinical uses, including the following: early cancer detection, monitoring for recurrence prognostication, and risk stratification. However, no biomarker has been shown to have adequate sensitivity and specificity. Many investigators have tried to validate biomarkers for the early detection and recurrence of lung cancer. To evaluate plasma G-CSF as such a biomarker, protein levels were measured and were found to correlate with the clinicopathological features of primary lung tumors. Methods: Between December 2006 and May 2008, 100 patients with histologically-validated primary lung cancer were enrolled into this study. To serve as controls, 127 healthy volunteers were enrolled into this study. Plasma G-CSF levels were measured in lung cancer patients using the sandwich ELISA system (R & D inc.) prior to treatment. Results: The mean plasma G-CSF levels were 12.2$\pm$0.3 pg/mL and 46.0$\pm$3.8 pg/mL (mean$\pm$SE) in the normal and in the cancer groups, respectively. In addition, plasma G-CSF levels were higher in patients with early lung cancer than in healthy volunteers (p<.001). Plasma G-CSF levels were higher in patients who were under 65 years old or smokers. Within the cancer group, plasma G-CSF levels were higher in patients with non small cell lung cancer than in patients with small cell lung cancer (p<.05). Overall, plasma G-CSF levels were shown to increase dependent upon the type of lung cancer diagnsosed. In the order from highest to lowest, the levels of plasma G-CSF tended to decrease in the following order: large cell carcinoma, squamous cell carcinoma, adenocarcinoma, and bronchioloalveolar carcinoma. Plasma G-CSF levels tended to be higher in patients with advanced TNM stage than in localized TNM stage (I, II

• The Journal of Internal Korean Medicine
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• v.19 no.2
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• pp.37-49
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• 1998

To make a objective diagnosis of the syndrome of cold-limbs, We investigated the 20 patients with cold limbs and GI trouble and 20 normal people as a control group. And we compared the thermal difference between Chon-jung(CV17) and Chung-wan(CV12 中脘), Chon-jung(CV17) and Ki-hae(氣海 CV6) and we compared the thermal differences of No-gung(PE8 勞宮) and Yong-chon(湧泉 KI1), too. The results were as follows. 1. All 20 patients had GI trouble and cold limbs. They had the symptom-Indigestion(16 cases-80%) with heart burn, tympanites, abdominal distention, hiccup, belching. Beside that symptom they also had constipation(6 cases-30%), diarrhea(3 cases-15%), headache & dizziness(6 cases-30%). And some had the menstrual syndrome, chronic fatigue, palpitation, insomnia, edema, arthralgia. 2. The thermal difference of the palms between the patients group and the control group were $25.70^{\circ}C,\;25.82^{\circ}C$, but they were not significant. 3. The thermal difference of the soles between the patients group and the control group were $23.58^{\circ}C,\;24.42^{\circ}C$ and the significancy was P=0.020 so it was significant(P<0.05). 4. The thermal difference of the palms and Chon-jung(CV17) between the patients group and the control group were $1.08^{\circ}C,\;0.76^{\circ}C$, but they were not significant. 5. The thermal difference of the sales and Chon-jung(CV17) between the patients group and the control group were $3.01^{\circ}C,\;1.90^{\circ}C$ and the significancy was P=0.003 so it was significant(P<0.05). 6. The thermal difference of Chon-jung(CV17) and Chung-wan(CV12 中脘) between the patients group and the control group was $0.30^{\circ}C,\;0.62^{\circ}C$ and the significancy was P=0.793 so it was significant(P<0.05). 7. The thermal difference of Chon-jung(CV17) and Ki-hae(CV6 氣海) between the patients group and the control group was $0.53^{\circ}C,\;0.68^{\circ}C$, but they were not significant. From the above, I could find the significance of D.I.T.I to diagnose the cold-feet not the cold-hands and the thermal difference between the trunk and limbs was more significant on cold-feet than on cold-hand, either.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.12 no.2
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• pp.256-262
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• 2001

Objective：The enlargement of the lateral ventricle is well established finding in adult-onset schizophrenia, but in the patients with early-onset psychotic disorder(EOPD) is still controversal. To identify structural abnormalities of the lateral ventricle in patients with EOPD and difference of the brain developmental course in EOPD group, planimetrical assessment of the lateral ventricle was conducted by means of retrospective quantitative neuroimaging. Methods：The brain MR images of 14 patients with EOPD(mean age $14.0{\pm}2.1$ years) who met the DSM-III-R diagnostic criteria for schizophrenia and bipolar disorder and 24 control subjects with simple headache(mean age $10.0{\pm}2.1$ years) were collected. Single best view for the lateral ventricle, one axial slice was selected for analysis. MR images were redigitalized with flatbed scanner and data were analyzed with NIH IMAGE software. Results：In the patients with EOPD, there were significant correlations between aging and lateral ventricular sizes and between aging and ventricular brain ratio(VBR). The statistical significance of normal asymmetry of the lateral ventricle was not observed for the EOPD group. The EOPD group had larger lateral ventricular sizes and VBR than control group, but these results were not statistically significant. Conclusion：These findings suggest that the brain abnormalities in patients with EOPD progress from the earlier course of the disorders and the course of brain development in EOPD group is different from control group.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.2
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• pp.139-148
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• 2012

Purpose : Since standard solution is the one that knows its exact concentration, the curve of the dissolution has been determined according to the amount of the solution, compared to the amount of the unknown sample. Therefore, the antigen that makes up standard materials should be made in a pure form. The configuration of the standard substance solution in the kit we use is a freeze-dried material, or made and comes as a liquid. Lyophilized reference material is used after dissolving in usually D.W. (Distilled Water), and if the antigen to use is too sensitive, reagents should be freeze-dried. Furthermore, when freeze-dried reference has to be frozen again after being dissolved, it should be kept under $-20^{\circ}C$ until the expiration date according to the reports. Since it is not expressed in the experiment if it is safe or stable to reuse the solution which was dissolved a few times, thus, this time it is tested and evaluated that the changes of the standard solution by freezing and melting several times, and its results and the effectiveness of it were compared to the solution which was kept in a fridge. Materials and Methods : Among Vitro diagnostic kits on the market made by radioimmunoassay, parathyroid hormone (PTH), adrenocorticotropic hormone (ACTH), luteinizing hormone (LH) are made of freeze-dried standard solution and all composed of the same Lot.NO. These hormones melted in D.W. and were separated into three groups. In the first group, melting and freezing were repeated, and in the second group, The solution only for one time use was put into a test tube after melting and freeze it. The third group was kept in the refrigerator. This experiment has been conducted from January to February in 2012. January to 2012. PH test was employed because ph is prone to changing depending on the change of protein. Each group of the standard solution, cpm (counter per minute), and the patient relative concentration values were compared by date, and Through the correlation coefficient and Paired t-test, the significant level of each group was analyzed. Results : ACTH, PTH, LH pH values were too subtle denaturation rather than numerical changes in the protein. In addition, when the standard solution of ACTH, PTH, LH was refrigerated, after 3 days and 7 days, there was a significant difference observed between the solution being kept in a refrigerator and a freezer within a significance level. Conclusion : Standard solution should be kept in a freezer, and being kept in a fridge, it is recommended to use the solution as soon as possible.