Background : An immunochromatographic assay (ICT Diagnostics) which facilitates the diagnosis of tuberculosis(TB) by detecting serum antibodies mainly directed against specific 38KDa of Mycobacterium tuberculosis has come into the market. The test consists of a cardboard folding device containing nitrocellulose strip and absorbent pads. The whole procedure is completed within 15 min and does not require any additional equipment. The test has been reported to be sensitive and specific in diagnosing active TB. Thus the test had been evaluated with sera from TB patients and TB-free subjects. Method : Sera from patients with active pulmonary tuberculosis(40 sputum positives for Mycobacterium tuberculosis, 79 sputum negatives, and 3 extrapulmonary tuberculosis) were obtained from the Double-Cross Chest Clinic of the Korean National Tuberculosis Association (KNTA) in Seoul. The control group consisted of TB-free 68 subjects(21 children under 7 years old and 47 healthy staff members of KNTA). Results : Nine out of 68(13.2%) TB-free controls had positive antibody response. Total 106 of 122(86.9%) radiologically active patients had positive antibodies while 16 (13.1%) showed negative reaction. Antibody was detected in 38 of 40(95.0%) sputum positive patients and 68 of 82(82.9%) sputum negative patients who were under the antituberculosis chemotherapy. The sensitivity and specificity were all 87% and the positive predictive value was 92.2% while the negative predictive value was 78.7%, when the prevalence of TB in the sample was 64.2%. Our results clearly show that the detection of antibodies which mainly react with the 38KDa antigen of M. tuberculosis is not suitable as the first-line method of diagnosis but considered only as an adjunctive test to standard techniques of tuberculosis diagnosis. when considering its high false positivity.
Kim, Kyu Sik;Lim, Sung Chul;Ko, Young Chun;Park, Kyung Ha;Ju, Jin Young;Jo, Kae Jung;Kim, Soo Ok;Oh, In Jae;Kim, Yu Il;Kim, Young Chul;Kim, Sung Min;Song, Ho Chun;Bom, Hee Seung;Park, Kyung Ok
Tuberculosis and Respiratory Diseases
/
v.55
no.6
/
pp.589-596
/
2003
Background : The solitary pulmonary nodule(SPN) presents a diagnostic dilemma to the physician and the patients in the our nation with high incidence of tuberculoma. We could not exclude whether the SPN was benign or malignant by the change of the size at chest radiograph and findings of chest CT. Recently, positron emission tomography(PET) have been tried as the differential diagnostic method of SPN. We evaluated the efficacy of PET for differentiating malignant from benign SPN and the relationship between standardized uptake values(SUV) of PET and serum glucose. Method : Between January 2001 and July 2002, sixty-one patients with pulmonary nodule were examined by the chest CT and PET. The SPN has been finally diagnosed by the transthorasic needle aspiration and biopsy, bronchoscopic biopsy, and open lung biopsy. Results : Forty eight patients had a malignant nodule(23 squamous cell lung carcinoma, 16 adenocarcinoma, 9 small cell lung cancer) and thirteen patients had a benign nodule(3 tuberculoma, 9 inflammatory granuloma, 1 cryptococcosis). The mean size of malignant and benign nodule was 40.6 mm and 20.0 mm, respectively. All malignant nodules showed a marked increase in 18 fluorodeoxyglucose (FDG) uptake. Mean SUV of malignant was $9.52{\pm}5.20$ and benign nodule was $1.61{\pm}3.60$. There were false positive cases with an increase in 18-FDG uptake (2 tuberculoma, 1 inflammatory granuloma). The SUV of malignant nodule in diabetes patients has no difference in non diabetes patients($9.10{\pm}4.51$ vs $9.65{\pm}5.46$). The sensitivity and specificity of the PET scan for SPN were 100%, 77%, respectively. The positive and negative predictive values were 94% and 100%. Conclusion : PET scanning showed highly accurate result in differentiating the malignant and benign SPN. There were no significant differences between the SUV and serum glucose in the patients with lung cancer.
Defamation lawsuits of public figures against media have been an issue since Roh government set in. Dissension between the government and media has probably acted as the key factor on this problem. Accordingly, arguments on the defamation lawsuits of public figures occurred the political issues such as opposition between the Progressive and the Conservative Parties or between the ins and the outs and showed the limits to suggest an appropriate judgment or solution. This study will analyze how the court makes its judgement on their rights and the limits by understanding the characteristic and the problem of defamation lawsuits made by senior government officials including a politician, the government, the president, and etc. As results, the defamation lawsuits of politicians and senior government officials showed specially noteworthy matters in salvation (damage suits), the amount claimed, court costs, ratio of winning lawsuits, and etc. The result on the tendency of the court decision showed the following matters in confusion: it holds the media responsible for the burden of proof by applying the inappropriate criterion; The applied laws, especially in the inferior court decision, do not show the consistency of the burden of proof between the misconception/ intention (malice)/ accident/ purpose of slander on the legal principles of public figures. Therefore, this study suggests the court to apply an appropriate law, let alone regulating the Anti-SLAPP law, so that it curtails the rights of public figures; limits the salvation of damage suit; and protects the right only in the case of false accusation by applying the existing law of "the Protection of the Deceased's Defamation Law." In order to dissolve the confusion when applying the laws on the public figures, the study insists the court to positively apply the Constitutional Court made criterion on "people" and "content." The study also insists to distinguish "intention(malice)," "accident," and "purpose of slander" and variant sorts of the burden of proof should be applied to each.
Enzyme immunoassay to analyze specific binding activity of antibody to antigen uses horseradish peroxidase (HRP) or alkaline phosphatase (AP). Chemical methods are usually used for coupling of these enzymes to antibody, which is complicated and random cross-linking process. As results, it causes decreases or loss of functional activity of either antibody or enzyme. In addition, most enzyme assays use secondary antibody to detect antigen binding activity of primary antibody. Enzymes coupled to secondary antibody provide a binding signal by substrate-based color development, suggesting secondary antibody is required in enzyme immunoassay. Additional incubation time for binding of secondary antibody should also be necessary. More importantly, non-specific binding activity caused by secondary antibody should also be eliminated. In this study, we cloned AP isolated from Escherichia coli (E. coli) chromosome by PCR and fused to) hAY4 single-chain variable domain fragment (ScFv) specific to death receptor (DR4) which is a receptor for tumor necrosis factor ${\alpha}$ related apoptosis induced ligand (TRAIL). hAY4 ScFv-AP expressed in E. coli showed 73.8 kDa as a monomer in SDS-PAGE. However, this fusion protein shown in size-exclusion chromatography (SEC) exhibited 147.6 kDa as a dimer confirming that natural dimerization of AP by non-covalent association induced ScFv-AP dimerization. In several immunoassay such as ELISA, Western blot and immunocytochemistry, it showed antigen binding activity by color development of substrates catalyzed by AP directly fused to primary hAY4 ScFv without secondary antibody. In summary, hAY4 ScFv-AP fusion protein was successfully purified as a soluble dimeric form in E. coli and showed antigen binding activity in several immunoassays without addition of secondary antibody which sometimes causes time-consuming, expensive and non-specific false binding.
Park, Yoon-Ki;Kim, Jong-Wook;Lee, Tae-Hyung;Park, Wan-Seok;Lee, Sung-Ho;Chung, Wun-Yong
Journal of Yeungnam Medical Science
/
v.2
no.1
/
pp.221-227
/
1985
Thirty-four patients with suspected ectopic pregnancy whose serum hCG levels had been measured by beta-hCG EIA before surgery were evaluated retrospectively. The results were as follows: 1. Final diagnosis of thirty-four patients with suspected ectopic pregnancy comprised twenty- eight tubal pregnancy, five ruptures of hemorrhagic corpus luteum and, one tubo-ovarian abscess. One of the five patients with rupture of hemorrhagic corpus luteum was accompanied by missed abortion. 2. Range of serum hCG levels in twenty-eight patients with tubal pregnancy was 59-21,980 mIU/ml and that of four patients with rupture of hemorrhagic corpus luteum and one patient with tubo-ovarian abscess was 0.6-6.6mIU/ml. Serum hCG level of a patient with rupture of hemorrhagic corpus luteum who was accompanied by missed abostion was 200 mIU/ml. 3. Serum hCG levels in twenty-two of twenty-eight patients with tubal pregnancy were lower than 3,000 mIU/ml. Low serum hCG level below 100mIU/ml and high serum hCG level above 6,500 mIU/ml were noticed in four and six patients with tubal pregnancy, respectively. 4. Mean serum hCG levels (${\pm}SD$) of twelve patients with tubal pregnancy who had intra-abdominal free blood of less than 500ml and sixteen patients with tubal pregnancy who had intra-abdominal free blood of more than 500ml were 4,131 (${\pm}7,801$) mIU/ml and 3,208 (${\pm}5,081$) mIU/ml, respectively. There was no statistical difference in the mean level of serum hCG between both group (P>0.05). 5. Mean serum hCG levels (${\pm}SD$) of thirteen patients with unruptured tubal pregnancy and fifteen patients with ruptured tubal pregnancy were 2,628 (${\pm}5,448$) mIU/ml and 4,449 (${\pm}6,938$) mIU/ml, respectively. Mean level of serum hCG was statistically higher in ruptured tubal pregnancy (P<0.01). 6. Positive rate of urine pregnancy test in the diagnosis of ectopic pregnancy was 64% (16/25) and mean range of serum hCG level of nine patients with false negative result were 353 mIU/ml and 59-933 mIU/ml.
This study was carried out to investigate recognition level and practical application status of oral hygiene devices through making a survey of Seoul inhabitants. And survey was implemented in order to propose oral hygiene device for household health care activities. The following results were obtained by analyzing personal interviews of 347 commuting patients at two university hospitals and seven dental clinics. 1) The average length of toothbrush head was estimated as 22.3 mm and average changing cycle was 2.3 months. The user ratio of flat-headed brush was estimated as 51.9% and 46.7% were using fluoridated toothpaste. 2) Generally the ratio of toothpick users was higher than other device users. But the user ratio of dental floss was higher than toothpick in case of patients under orthodontic treatment. 3) The patients under orthodontic treatment were not familiar with handling orthodontic toothbrush. Though 45.8% among orthodontic patients recognized this type of toothbrush, only 25.4% of them knew how exactly to use it. 4) It was shown very low user ratio of oral hygiene devices that the patients who had periodontal problem, hypersensitive trouble, halitosis, implant or denture 5) The patients who had halitosis showed the highest user ratio of toothpick. The patients who had separation of teeth showed the highest user ratio of dental floss. The patients who're under orthodontic treatment showed the highest user ratio of interproximal brush and motorized brush. 6) In response to the most interesting dental disease, it's surveyed as follows; 60.3% of dental caries, 24.0% of periodontal disease, 14.8% of false occlusion and 0.9% of oral cancer. 7) Regarding the motivation of using those oral hygiene devices, 45% responded that it was because of recommendation by dental clinics. Among the negative answers, 38.6% responded that it was because of no selection guidance. 31.3% answered that they didn't use hygiene device because it's inconvenient. 12.0% answered that it's difficult to buy and expensive. 7.8% responded that they didn't feel significant improvement. 4.8% answered that dental hospitals and clinics didn't even introduce those hygiene devices. Therefore efficient campaign for those hygiene devices over all Korea nation should be developed and education program must be prepared for each case of patients in every dental hospitals and clinics.
Kim, Ho-Joong;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo;Kim, Keun-Youl;Han, Yong-Chol
Tuberculosis and Respiratory Diseases
/
v.39
no.6
/
pp.517-525
/
1992
Background: Since its development by Saiki et al, polymerase chain reaction (PCR) has been very useful in various fields of molecular biology. PCR can be used for the detection of a very small amount of microbial agent, and is especially useful in those patients who are difficult to diagnose microbiologically or serologically. Mycobacterium tuberculosis is a very slowly growing organism and AFB staining frequently shows false negative results, and therefore PCR would be a very rapid, easy, and sensitive diagnostic method for the diagnosis of Mycobacterium tuberculosis. Method: To compare PCR with conventional methods in diagnosing Mycobacterium tuberculosis in sputum, we used sputa of patients who visited or were admitted to Seoul National University Hospital. The amplification targets were 383 base pair DNA, a part of 2520 base pair DNA encoding 65 kD Mycobacterium tuberculosis specific protein (the primers are TB-1, -2), and 123 base pair DNA, a part of IS6110 fragment, which multiple copies are known to exsist PCR one genome (the primers are Sal I-1, -2). We also requested AFB staing and culture to the lab of Seoul National University Hospital with the same sample and compared the results. Results: 1) Using TB-1, -2 primers, PCR was positive in 73.1% (19/26) of culture positive sputa, in 12.5% (1/8) of culture negative. but clinically diagnosed tuberculous sputa, and was negative in all sputa of patients who were clinically diagnosed as non-tuberculous etiology. 2) Using Sal I-I, -2 primers, PCR was positive in 94.1% (32/34) of culture positive sputa, in 23.1% (6/26) of culture negative, but clinically diagnosed tuberculous sputa, and was negative in 87.5% (14/16) of sputa from patients who were clinically diagnosed as non-tuberculous etiology. Conclusion: PCR could be a very rapid, sensitive and specific method for the diagnosis of Mycobacterium tuberculosis in sputa, and further studies should be followed for the development of easier method.
Introduction: Transthoracic fine needle aspiration biopsy(TNAB) has shown to be a resonably safe, simple, and accurate procedure in diagnosis of intrathoracic lung lesions. We reviewed the results of 1,005 TNAB of chest lesions performed on 930 patients with 20 or 22-gauze needles over a period of 10 years. Methods: From November 1983 to June 1995, 1,005 cases in 930 patients with an undiagnosed lung lesion underwent TNAB at the Hanyang University Hospital: 66% were men and 34% were women. Most of the patients were 40~60 years old and the youngest patient was 3 years of age. Result: 540 patients had various malignant chest lesions and 322 patients had benign pulmonary lesions. The diagnostic accuracy of TNAB was 96.1 percent in malignant diseases with one false positive result and 90.1% in benign diseases. A definitive diagnosis was not obtained in the remaining 68 patients. The most common diagnoses among 519 malignancy chest lesions with TNAB were the following: squamous cell lung carcinoma, 31.7%; adenocarcinoma, 24.7%; small cell lung carcinoma, 16.7%; metastatic cancer, 14.2%; large cell lung carcinoma, 6.2% and so on. Complications included pneumothorax in 12.3% necessitating chest tube drainage in 0.6%. Minor hemoptysis occurred in 3.6%. There was no death directly attributable to the procedure. Conclusion: We concluded that TNAB permits a direct approach to all kinds of localized lung lesions with a high degree of accuracy and without major complications.
Background : Examining the biological susceptibility of Mycobacterium tuberculosis to pyrazinamide (PZA) in vitro is very difficult as PZA is inactive under normal culture conditions. The biological susceptibility test, an enzyme assay for Pzase activity, and a genetic test for pncA gene mutations, were performed in order to predict PZA resistance. Methods : 28 cultured clinical isolates of Mycobacterium tuberculosis were tested. The biological susceptibility was performed by the absolute concentration method using Lowenstein-Jensen media. The PZase activity was tested by means of Wayne's method. A 710-bp region includes the entire open reading frame of pncA was amplified and sequenced. Results : All six strains with positive PZase activity exhibited no pncA mutations with one strain showing a false resistance in the biological susceptibility test. Among the 22 strains with no PZase activity, 21 exhibited showed pncA mutations. In the biological susceptibility test, 20 strains were resistant, and one was susceptible, and the other flied to test. The mutation types varied with ten missense, one silent and one nonsense mutation 1 slipped-strand mispairing, and 6 frameshift mutations. Three strains had an adenine to guanine mutation at position -11 upstream of the start codon. Conclusion : The mutation at the pncA promotor region is frequent at -11 upstream position. Automatic sequencing of pncA is a useful tool for rapid and accurate detection of PZA resistant M. tuberculosis, and for demonstrating the epidemiological relatedness of the PZA resistant M. tuberculosis strains.
With the rapid evolution of technology, the size, number, and the type of databases has increased concomitantly, so data mining approaches face many challenging applications from databases. One such application is discovery of fraud patterns from agricultural product wholesale transaction instances. The agricultural product wholesale market in Korea is huge, and vast numbers of transactions have been made every day. The demand for agricultural products continues to grow, and the use of electronic auction systems raises the efficiency of operations of wholesale market. Certainly, the number of unusual transactions is also assumed to be increased in proportion to the trading amount, where an unusual transaction is often the first sign of fraud. However, it is very difficult to identify and detect these transactions and the corresponding fraud occurred in agricultural product wholesale market because the types of fraud are more intelligent than ever before. The fraud can be detected by verifying the overall transaction records manually, but it requires significant amount of human resources, and ultimately is not a practical approach. Frauds also can be revealed by victim's report or complaint. But there are usually no victims in the agricultural product wholesale frauds because they are committed by collusion of an auction company and an intermediary wholesaler. Nevertheless, it is required to monitor transaction records continuously and to make an effort to prevent any fraud, because the fraud not only disturbs the fair trade order of the market but also reduces the credibility of the market rapidly. Applying data mining to such an environment is very useful since it can discover unknown fraud patterns or features from a large volume of transaction data properly. The objective of this research is to empirically investigate the factors necessary to detect fraud transactions in an agricultural product wholesale market by developing a data mining based fraud detection model. One of major frauds is the phantom transaction, which is a colluding transaction by the seller(auction company or forwarder) and buyer(intermediary wholesaler) to commit the fraud transaction. They pretend to fulfill the transaction by recording false data in the online transaction processing system without actually selling products, and the seller receives money from the buyer. This leads to the overstatement of sales performance and illegal money transfers, which reduces the credibility of market. This paper reviews the environment of wholesale market such as types of transactions, roles of participants of the market, and various types and characteristics of frauds, and introduces the whole process of developing the phantom transaction detection model. The process consists of the following 4 modules: (1) Data cleaning and standardization (2) Statistical data analysis such as distribution and correlation analysis, (3) Construction of classification model using decision-tree induction approach, (4) Verification of the model in terms of hit ratio. We collected real data from 6 associations of agricultural producers in metropolitan markets. Final model with a decision-tree induction approach revealed that monthly average trading price of item offered by forwarders is a key variable in detecting the phantom transaction. The verification procedure also confirmed the suitability of the results. However, even though the performance of the results of this research is satisfactory, sensitive issues are still remained for improving classification accuracy and conciseness of rules. One such issue is the robustness of data mining model. Data mining is very much data-oriented, so data mining models tend to be very sensitive to changes of data or situations. Thus, it is evident that this non-robustness of data mining model requires continuous remodeling as data or situation changes. We hope that this paper suggest valuable guideline to organizations and companies that consider introducing or constructing a fraud detection model in the future.
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