• Pediatric Infection and Vaccine
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• 제3권2호
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• pp.123-127
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• 1996

Purpose : The most patients with acute streptococcal pharyngitis lack of classic clinical manifestations, therefore diagnostic laboratory test such as the throat culture or a rapid antigen detection test are frequently employed in primary practices of developed countries. We'd like to know the accuracy of the throat swab culture as gold standard for diagnosis of streptococcal infection with studying the discordant and concordant rate of duplicate culture. Methods : The study included 89 normal school children (boys:50, girls:39) who were attending Uljin primary school in Uljin, Kyong Sang Buk Do on March 1996. We obtained simultaneous 2 times of throat swab from each subject, and plating and streaking on 5-7% of sheep blood agar separately. We counted the characteristic beta-hemolytic colonies after overnight incubation. Results : 1) The carrier rate of beta-hemolytic streptococci at first culture is 25.1% and second one is 29.2%. 2) Ten out of 89(11.2%) is discordant in duplicate culture. 3) Culture containing less than 50 colonies of beta-hemolytic streptococci (+2) in first culture is 70.4%, second one is 85.7%. 4) Number of colonies is less than 50 in all ten discordant children. Conclusions : The discordant rate of duplicate throat swab cullture for beta-hemolytic streptococci is 11.2%, even if the subjects are normal school children. About 5% of individuals harboring beta-hemolytic streptococci in the pharynx may be missed by a single throat culture. If we are trying to examine the patients with pharyngitis, the discordant rate will be much lower than this results.

• Journal of Chest Surgery
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• 제20권4호
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• pp.786-792
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• 1987

Congenitally corrected transposition of the great arteries is a congenital cardiac anomaly with ventriculoarterial discordant connection and atrioventricular discordant connection. This report describes a 17 year old male patient who had congenitally corrected transposition of the great arteries associated with ventricular septal defect and patent ductus arteriosus, underwent patch closure of the ventricular septal defect and suture closure of patent ductus arteriosus, and was discharged on 9th day after surgery with good condition.

• Journal of Chest Surgery
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• 제23권4호
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• pp.764-768
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• 1990

Congenitally corrected transposition of great arteries is a congenital cardiac anomaly with ventriculoarterial discordant connection and atrioventricular discordant connection. A 8-year-old girl had congenitally corrected transposition of the great arteries with ventricular septal defect and pulmonary valvular stenosis. By transaortic approach, ventricular septal defect was closed and pulmonary valvotomy was performed by transpulmonary approach. No heart block or aortic insufficiency developed postoperatively.

• 임상간호연구
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• 제26권1호
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• pp.107-116
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• 2020

Purpose: This study was a prospective survey to evaluate the Korean Triage and Acuity Scale (KTAS) inter-rater reliability and to identify discordant areas in the KTAS classification between nurses and paramedics in emergency department (ED). Methods: Inter-rater reliability were evaluated using triage deta from January 11 to May 31, 2019. A convinience sample of a total of 800 patients who visited an emergnecy medical center in Incheon (400 adult and 400 pediatric patients in this study) were selected. The triages of this study a pair of one nurse and one paramedic performed triage at the same time, using the KTAS, Inter-rater reliability for the KTAS was evaluated with the weighted kappa. Results: The inter-rater reliability of the KTAS evaluated by weighted Kappa between nurse-paramedic KTAS score of adult patients was .71, and .66 for pediatric patients. Both were in the level considered as substantial. Among causes of triage discordance, the most frequently identified discordant item in triaging adults was the difference in the measurement of pain intensity (28.0%). For both adult and pediatric patients, multiple chief complaint was identified as the major discordant factor. In triaging pediatric patients the body temperature assessment by subjective judgments was the highest discordant item (50.7%). Conclusion: The study result suggested that the KTAS demonstrated a reasonable level of inter-rater reliability and functioned as a standardized triage tool for emergency medical services. In order to improve the inter-rater reliability and classification competence, it is necessary to revise the current all-integrated KTAS provider course to be differentiated for each job group.

• Pediatric Infection and Vaccine
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• 제24권1호
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• pp.65-70
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• 2017

거대세포바이러스 감염은 선천감염의 가장 흔한 원인 중의 하나이다. 본 증례는 쌍생아에서 다른 임상 양상을 보인 선천 거대세포바이러스 감염 증례에 대한 국내 첫 보고이다. 31세 초산부가 쌍생아(2 융모막, 2 양막)를 임신하였다. 임신 34주 산전 초음파에서 한쪽 태아의 크기가 작고 양측 뇌실 확장증이 발견되었으며 임신 37주경에 제왕절개로 분만하였다. 첫 번째 신생아는 남자로 출생 체중 2,410 g, 아프가 점수 8/9점으로 출생하였으며 두 번째 신생아는 여자로 출생 체중 1,380 g, 아프가점수 5/8점으로 출생하였다. 두 번째 신생아는 자궁 내 성장지연, 소두증, 소하악증, 사지 관절의 강직을 보였다. 불일치 쌍생아에 대한 원인을 찾기 위한 검사를 진행하였으며 두 번째 신생아의 혈액검사에서 거대세포바이러스 immunoglobulin M이 양성반응을 보였으며 소변과, 혈액, 뇌척수액에서 거대세포바이러스 중합효소연쇄반응이 양성소견을 보였다. 반면에 정상으로 출생한 남아의 거대세포바이러스에 대한 검사는 모두 음성이었다. 감염된 환자의 안과적 검진에서 거대세포바이러스 망막염이 관찰되었고, 후에 실시한 청력검사에서 양측의 감음 난청이 확인되었다. 환자는 ganciclovir 치료를 받았으며 현재 여아는 심한 발달지연이 있으며 침대에서 누워서 생활하는 중이다. 이와 같이 쌍생아에서의 선천 거대세포 바이러스 감염증이 한 명에게만 발생하는 경우의 원인은 현재까지 명확하지 않다. 하지만 이 증례를 통하여 심한 불일치 쌍생아의 경우에 선천 거대세포바이러스 감염의 가능성을 고려해 보아야 한다.

• 자원환경지질
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• 제19권spc호
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• pp.151-162
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• 1986

The older granitic rocks of the study area are composed of mainly orthogneiss and foliated granite. These rocks shows mostly mortar or fiaser structure by strong mylonitization and thermal metamorphism during several orogenies. $^{40}Ar-^{39}Ar$ incremental·release ages of these rocks have been determined for 6 hornblende. 7 muscovite and 4 biotite concentrates separated from rocks collected across the Ryeongnam massif. Most $^{40}Ar-^{39}Ar$ age are discordant with Rb-Sr whole rock age of the same area. These ages range from 1998 to 172Ma. This discordant age is interpreted to indicate that samples were in contact with Daebo granite body that was characterized by large and variable $^{40}Ar-^{39}Ar$ ratios. Such ratios most likely resulted from widespread diffusion of the argon liberated from older granitic rocks during several metamorphic overprint. The general trend of the chemical composition of these rocks suggest that most of them are some series of differentiated products by fractional crystallization.

• Asian-Australasian Journal of Animal Sciences
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• 제29권7호
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• pp.938-943
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• 2016

Development of body hair is an important physiological and cellular process that leads to better adaption in tropical environments for dairy cattle. Various studies suggested a major gene and, more recently, associated genes for hairy locus in dairy cattle. Main aim of this study was to i) employ a variant of the discordant sib pair model, in which half sibs from the same sires are randomly sampled using their affection statues, ii) use various single marker regression approaches, and iii) use whole genome regression approaches to dissect genetic architecture of the hairy gene in the cattle. Whole and single genome regression approaches detected strong genomic signals from Chromosome 23. Although there is a major gene effect on hairy phenotype sourced from chromosome 23: whole genome regression approach also suggested polygenic component related with other parts of the genome. Such a result could not be obtained by any of the single marker approaches.

• 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.

• Asian Pacific Journal of Cancer Prevention
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• 제16권10호
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• pp.4317-4321
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• 2015

Background: Prognostic biomarkers in breast cancer are routinely investigated in the primary tumors to guide further management. However, it is proposed that the expression may change during the disease progression, and may result in a different immune profile in the metastatic nodes. This work aimed to investigate the expression of breast prognostic biomarkers in primary tumors and in its axillary nodal metastasis, to estimate the possible discordant expression. Materials and Methods: 60 paired primary and axillary nodal metastasis samples were collected from patients with primary breast cancer with positive nodal deposits, diagnosed at the Maadi Military Hospital, Cairo, Egypt, during the year 2013. ER, PR and HER2 expression was assessed by immunohistochemistry in all samples Results: 48.3% of the included cases showed concordant results for both ER and PR receptors between the primary tumor and its nodal metastasis while 51.7% showed discordant results and the discordance level was statistically significant. On the other hand, 70% of the cases showed concordant Her2 results between the primary tumors and the nodal deposits, 30% showed discordant results and the difference was significant. Conclusions: The study indicated that the discordance in ER and PR receptor expression between the primary breast tumor and their nodal metastasis may be significant. The possible switch in the biomarker status during the disease progression is worth noting and may change the patient therapeutic planning. So, whether the treatment selection should be based on biomarkers in the lymph node is a topic for further studies and future clinical trials.

• Journal of Genetic Medicine
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• 제15권2호
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• pp.79-86
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• 2018

Purpose: This study aimed to evaluate the clinical usefulness of non-invasive prenatal testing (NIPT) as an alternative testing of invasive diagnostic testing in pregnancies with ultrasound abnormalities. Materials and Methods: This was a retrospective study of pregnant women with abnormal ultrasound findings before 24 weeks of gestation between April 2016 and March 2017. Abnormal ultrasound findings included isolated increased nuchal translucency, structural anomalies, and soft markers. The NIPT or diagnostic test was conducted and NIPT detected trisomy 21 (T21), T18, T13 and sex chromosomal abnormalities. We analyzed the false positive and residual risks of NIPT based on the ultrasound findings. Results: During the study period, 824 pregnant women had abnormal ultrasound findings. Among the study population, 139 patients (16.9%) underwent NIPT. When NIPT was solely performed in the patients with abnormal ultrasound findings, overall false positive risk was 2.2% and this study found residual risks of NIPT. However, the discordant results of NIPT differed according to the type of abnormal ultrasound findings. Discordant results were significant in the group with structural anomalies with 4.4% false positive rate. However, no discordant results were found in the group with single soft markers. Conclusion: This study found different efficacy of NIPT according to the ultrasound findings. The results emphasize the importance of individualized counseling for prenatal screening or diagnostic test based on the type of abnormal ultrasound.