• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• v.61 no.11
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• pp.600-604
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• 2018

Background and Objectives This study aimed to identify a reliable preoperative predictive factor for the development of thyroid cancer in patients with atypia of undetermined significance (AUS) identified by fine needle aspiration biopsy (FNAB). Subjects and Method This was a retrospective cohort study. Two hundred and ninety-nine patients diagnosed with AUS by preoperative FNAB who underwent curative thyroid surgery at our institution between September 2005 and February 2014 were analyzed. Clinical, radiological and molecular features were investigated as preoperative predictors for postoperative permanent malignant pathology. Results The final pathologic results revealed 36 benign tumors including nodular hyperplasia, follicular adenoma, adenomatous goiter, nontoxic goiter, and lymphocytic thyroiditis, as well as 263 malignant tumors including 1 follicular carcinoma and 1 invasive follicular carcinoma; the rest were papillary thyroid carcinomas. The malignancy rate was 87.9%. The following were identified as risk factors for malignancy by univariate analysis: $BRAF^{V600E}$ gene mutation, specific ultrasonographic findings including smaller nodule size, low echogenicity of the nodule, and irregular or spiculated margin (p<0.05). Multivariate analysis revealed that only $BRAF^{V600E}$ mutation was a statistically significant risk factor for malignancy (p<0.05). When $BRAF^{V600E}$ mutation was positive, 98.5% of enrolled patients developed malignant tumors. In addition, the diagnostic rate of malignancy in these cases was approximately 16-fold higher than BRAF-negative cases. Conclusion Patients with AUS thyroid nodules should undergo $BRAF^{V600E}$ gene mutation analysis to improve diagnostic accuracy and if the mutation is confirmed, surgery is recommended due to the high risk of malignancy.

• Journal of Yeungnam Medical Science
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• v.4 no.1
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• pp.97-103
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• 1987

A Study to evaluate the diagnostic significance of M. pneumoniae infection by measurements of cold agglutinin and antimycoplasma antibody titers is performed with 191 pediatric patients who have visited Yeungnam University Hospital during the period through January to July, 1987. Forty eight of 191 cases made follow up tests feasible. The results obtained are as follows : 1. It is necessary to perform routine combined measurements of cold agglutinin and antimycoplasma antibody titers for the all pediatric pneumoniae caser since a large proportion of pneumonia in children is caused by M. pneumoniae. 2. For the diagnosis of M. pneumoniae infection, measurements of cold agglutinin titers alone seems to be les significant than to check both cold agglutinin and antimycoplasma antibody titers. 3. The measurement of antimycoplasma antibody titer appeared to be more specific than cold agglutinin test in the diagnosis of M. pneumoniae infection. 4. The present study urges the necessity of follow up study of cold agglutinin and antimycoplasma antibody titers for those who initially presented with normal titers in both tests, but are clinically suspected for M. pneumoniae infection.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.6
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• pp.2745-2748
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• 2012

Aims: To study KIT (CD117) expression in thymic epithelial tumors in China, and investigate diagnostic and clinical significance. Material and Methods: Thymic epithelial tumors (TETs) from 102 patients (3 type A, 29 type AB, 5 type B1, 22 type B2, 29 typeB3 and 16 thymic carcinomas) were examined. Immunohistochemical staining with an antic-kit monoclonal antibody was performed on a tissue microarray. Relationships between KIT positive expression and the TET clinical characteristics (WHO histologic classification and Masaoka stage system) were analysed. Results: The KIT positive expression rate was significantly higher in thymic carcinoma (60%, 9/16) than in thymoma (8%, 7/86), a strong correlation being found with the WHO classification, but not the Masaoka tumor stage. The overall survival for patients with KIT positive lesions was significantly worse. Conclusions: KIT is a good molecule marker to differentially diagnose thymic carcinoma from thymoma, while also serving as a predictor of prognosis for TETs. Further research into KIT mutations in Chinese TETs should be conducted to assess the efficacy of targeted therapy.

• Journal of Korean Neurosurgical Society
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• v.54 no.1
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• pp.30-33
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• 2013

Objective : To suggest a new useful diagnostic technique, principles of the selective excitation technique-magnetic resonance images (Proset-MRI), and to know the precise radiologic findings that can prove symptomatic foraminal and extraforaminal stenosis at L5-S1. Methods : Nineteen patients with symptomatic L5-S1 stenosis were checked by Proset-MRI. Four patients were performed decompressive surgery and 15 patients were performed selective nerve root block (SNRB) at L5. The pain scale of patients was checked by Visual Analogue Scale (VAS) scores at the pre- and post-treatment state. Results : Proset-MRI findings of patients with symptomatic stenosis are root swelling (RS) and indentation. The comparisons with VAS scores had a meaningful statistical result at each RS (p<0.01) and indentation (p<0.01). However, the findings of RS combined with indentation lacked statistical significance (p=0.0249). In addition, according to a comparison with the treatment modalities, reducing of VAS scores had statistical meaningful significance in decompressive surgery cases (p<0.01), and also in SNRB cases (p<0.01) after a 3-month follow-up period. Conclusion : The three dimensional Proset-MRI is very useful and sensitive technique to diagnose the symptomatic foraminal and extraforaminal stenosis at L5-S1.

• Journal of Chest Surgery
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• v.33 no.8
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• pp.669-675
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• 2000

Background: Tuberculous pleurisy is the leading cause of pleural effusion in Korea. And differential diagnosis of tuberculous pleurisy with other cause is clinically very important. Traditional diagnostic methods such as routine analysis of pleural fluid, staining for acid-fast bacilli or pleural biopsy have major inherent limitaion. This study was designed to evaluate the significance of pleural fluid polymerase chain reaction(PCR) and adenosine deaminase (ADA) activity in early diagnosis of tuberculous pleurisy. Material and Method: Between March 1996 and July 1997, 198 patients with pleural effusion reviewed retrospectively. The study group included 112 cases with tuberculous effusion and 86 cases with non-tuberculous effusions, whose diagnoses were confirmed by pleural biopsy, microbiological methods, or cytology. We compared the results of PCR and pleural fluid levels of ADA between tuberculous and non-tuberculous effusions. Result: Mean age was 47.54$\pm$19.52 years(range 2 to 85 years). The positive rate of PCR was significantly higher in tuberculous group than non-tuberculous group(p<0.05). The sensitivty, specificity, positive predictive value(PPV), and negative predictive value(NPV) for PCR were 31.7, 90.9, 83.0, and 48.8%, respectively. Mean ADA activity was significantly higher in tuberculous group than non-tuberculous group(83.2 U/L vs 49.8 U/L)(p<0.05). With diagnostic thresholds of 40 U/L, the sensitivity, specificity, PPV, and NPV of ADA for tuberculosis were 75.9, 70.9, 77.3, and 69.3% respectively. At a level of 70 U/L, the sensitivity, specificity, PPV, and NPV of ADA for tuberculosis were 70.1, 75.9, 82.9, and 60.3% respectively. Conclusion: PCR is very highly specific, but less sensitive methods in diagnosis of tuberculous pleurisy. But ADA level of pleural fluid has acceptable sensitivity and specificity in diagnosis of tuberculous pleurisy. ADA activity is more useful test in the evaluation of pleural effusions.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.4
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• pp.369-376
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• 2019

Purpose: The aim of this study was to evaluate the clinical significance of inflammatory biomarkers in acute infectious diarrhea among children. Methods: Clinical parameters including fever, bacterial and viral etiology based on stool culture and multiplex polymerase chain reaction, and nine biomarkers including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and leukocytes in blood and calprotectin, lactoferrin, myeloperoxidase, polymorphonuclear elastase, leukocytes, and occult blood in feces were evaluated in children who were hospitalized due to acute diarrhea without underlying disease. Results: A total of 62 patients were included. Among these patients, 33 had fever, 18 showed bacterial infections, and 40 patients were infected with 43 viruses. Of all the biomarkers, CRP was significantly correlated with fever (p<0.001). CRP, ESR, calprotectin, lactoferrin, myeloperoxidase, fecal leukocytes, and occult blood were significantly associated with infection with bacterial pathogens (p<0.001, p=0.04, p=0.03, p=0.003, p=0.02, p=0.03, p=0.002, respectively). The combination of CRP and fecal lactoferrin at their best cut-off values (13.7 mg/L and $22.8{\mu}g/mL$, respectively) yielded a sensitivity of 72.2%, and a specificity of 95.5% for bacterial etiology compared with their individual use. Conclusion: Blood CRP is a useful diagnostic marker for both fever and bacterial etiology in acute pediatric diarrhea. The combination of CRP and fecal lactoferrin yields better diagnostic capability for bacterial etiology than their use alone for acute diarrhea in children without underlying gastrointestinal disease.

• Korean Journal of Head & Neck Oncology
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• v.40 no.1
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• pp.1-5
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• 2024

The Bethesda System for Reporting Thyroid Cytopathology (TBSRCT) is crucial for cytopathologists to use a standardized, category-based reporting system for thyroid fine needle aspirations and is effective for clear communication with the referring physicians. The new Bethesda System for Reporting Thyroid Cytopathology, the third edition in 2023, provides several key updates. The most important update is the assignment of only single name for each of the six diagnostic categories: (I) nondiagnostic; (II) benign; (III) atypia of undetermined significance; (IV) follicular neoplasm; (V) suspicious for malignancy; and (VI) malignant. An implied risk of malignancy (ROM) for each of six categories has been updated based on extensively published data since the second edition of TBSRTC in 2017 and offers both an average ROM for each category and the expected range of cancer risk. Estimated final ROM after excluding "Noninvasive Follicular Thyroid Neoplasm with Papillary Like Nuclear Features (NIFTP)" for each of six categories has been updated based on the reported mean decreases in the ROM if excluding NIFTP. For atypia of undetermined significance (AUS) category, the subcategorization is simplified and more formalized into 2 subgroups, AUS-nuclear atypia or AUS-other, based on the implied ROM and molecular profiling. For the pediatric thyroid disease, pediatric ROMs and management algorithms are newly added for the same six reporting categories for this age group. New or revised disease nomenclatures including high-grade follicular-derived carcinoma has been updated according to the recently published 2022 World Health Organization Classification of Thyroid Neoplasms. Brand new two chapters are added including clinical perspectives and imaging studies (Chap. 13) and the use of molecular and other ancillary tests (Chap. 14). The atlas is updated with new images to illustrate more effectively for new disease entity and diagnostic criteria.

• The Korean Journal of Cytopathology
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• v.15 no.1
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• pp.33-39
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• 2004

We compared the diagnostic accuracy of liquid-based cervicovaginal cytology using $MonoPrep2^{TM}$ system (Monogen, Herndon, Virginia, USA), a manual system based on membrane filtration method, with conventional Pap smear. Study population included 92 patients visiting the gynecologic department under the suspicion of uterine cervical disease. In thirty of them, surgical biopsy was performed. $MonoPrep2^{TM}$ system provided well-preserved monolayer specimen with good nuclear morphology. However, about 19% of specimens were inadequate to interpret due to low cellularity. The detection rate of abnormal cells more than ASCUS (atypical squamous cells of unknown significance) was 23.9% and higher than 19.4 % of conventional Pap smear. Diagnostic concordance rate with conventional Pap smear was 81%, and severe discordance rate influencing on the management of patient was 7.6 %. Among these seven cases, $MonoPrep2^{TM}$ system was more diagnostic only in four. In comparison with histology, the sensitivity of diagnosis of $MonoPrep2^{TM}$ system was 78.9% and slightly higher than 73.5% of conventional Pap smear. However, the specificity was 81.1% and lower than 90.9% of Pap smear. In conclusion, $MonoPrep2^{TM}$ system provided diagnostic accuracies similar to the conventional Pap smear. The inexpertness of slide preparation and the low cellularity were considered to endow a limitation in more accurate evaluation.

• Journal of Biomedical Engineering Research
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• v.29 no.2
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• pp.151-158
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• 2008

To evaluate aortic wall stiffness without influence of different background blood pressure, a new technique was developed and verified. At eight swine descending aortae, volume-pressure measurement was performed using custom-made system. Based on averaged pressure-volume curve, aortic distensibility index was formulated to evaluate aortic wall stiffness regardless of variable blood pressure and aortic size. The variability of aortic distensibility index by pressure change was compared with other parameters for wall stiffness evaluation. Subsequently, the aortic distensibility index was calculated at 100 contrast-enhanced EBCT data sets of normal volunteers in regular health screening program. The measured aortic distensibility index was compared with age, coronary calcium score, and aortic calcium score. Between 50 and 360 mmHg of blood pressure, the coefficient of variance of aortic distensibility index was 22.00% as comparing with 88.99% of classical compliance. Based on age, aortic distensibility index showed correlation coefficient of 0.55, whereas classical compliance showed 0.26. The correlation coefficient with modified aortic calcification was 0.43. Linear regression study revealed statistical significance of correlation coefficients. The aortic distensibility index, the method to evaluate aortic wall stiffness free from variable blood pressure and aortic size, was developed and verified with significant practical feasibility.

• Journal of Acupuncture Research
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• v.25 no.1
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• pp.15-23
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• 2008

Objectives : The aim of our study was to demonstrate the clinical application of a diagnosis relating the 7-zone-diagnostic system and heart rate variability. Materials and Methods : Subjects were divided into two groups according to the factor AA form of the 7-zone-diagnostic system(VEGA-DFM722, VEGA, Germany). Subjects in group A showed a factor-AA red bar graph in which zone 2 was higher than the normal range, and zone 6 was lower than the normal range. Subjects in group B showed a factor-AA red bar graph in which zone 2 was lower than the normal range, and zone 6 was higher than the normal range. We investigated how to differentiate the index of heart-rate variability(HRV, LX-3202, LAXTHA, Korea) for each group. We did independent sample t-tests and evaluated the results of the HRV at the 5% significance level using SPSS 10.0 for Windows. Results : The differences of the MeanRR, MeanHRV, SDNN, complexity, HRV-index, RMSSD, SDSD, and pNN50 values between the groups was not significant. The differences of the Ln(TP), Ln(VLF), Ln(HF), LF/(LF+HF), LF/HF, norm LF, and norm HF values between the groups was also not significant. The differences were not significant, but generally the values of SDNN, complexity, RMSSD, SDSD, Ln(VLF), Ln(HF) and norm LF for group B were higher than those for group A, and the values of pNN50 and norm HF for group B were lower than those for group A. Conclusions : This study suggests that differences in the HRV values between the groups was not significant, but group B has a tendency to be healthier than group A because of stress. Accordingly, further study will be required.