• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.25 no.4
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• pp.312-320
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• 2022

Purpose: Screening serologic tests are important tools for the diagnosis of celiac disease (CD). Immunoglobulin (Ig)G anti-deamidated gliadin peptide (anti-DGP) is a relatively new autoantibody thought to have good diagnostic accuracy, comparable to that of anti-tissue transglutaminase (anti-tTG) antibody. Methods: Pediatric patients (n=86) with a clinical suspicion of CD were included. Duodenal biopsy, anti-tTG, and IgG anti-DGP antibody tests were performed. The patients were divided into CD and control groups based on the pathological evaluation of duodenal biopsies. The diagnostic accuracy of serological tests was determined. Results: IgA anti-tTG and IgG anti-DGP antibodies were positive in 86.3% and 95.4% of patients, respectively. The sensitivity, specificity, and diagnostic accuracy of the IgA anti-tTG test were 86.3%, 50.0%, and 68.6%, respectively, and those of the IgG anti-DGP test were 95.4%, 85.7%, and 90.7%, respectively. The area under the receiver operating characteristic (ROC) curve was 0.84 (95% confidence interval [CI], 0.74-0.91) for IgA anti-tTG test and 0.93 (95% CI, 0.86-0.97) for IgG anti-DGP test. The comparison of IgA anti-tTG and IgG anti-DGP ROC curves showed a higher sensitivity and specificity of the IgG anti-DGP test. Conclusion: IgG anti-DGP is a reliable serological test for CD diagnosis in children. High tTG and DGP titers in the serum are suggestive of severe duodenal atrophy. The combined use of IgA anti-tTG and IgG anti-DGP tests for the initial screening of CD can improve diagnostic sensitivity.

• Tuberculosis and Respiratory Diseases
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• v.42 no.2
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• pp.175-183
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• 1995

Background: The incidence of mycoplasmal pneumonia is predominantly at childhood and early adulthood, but in adults, its incidence is low and its symptoms and physical findings are nonspecific. The definite diagnosis of M. pneumoniae pneumonia can be made by sputum culture, but requires several weeks for positive results, and the early diagnosis must initially be based on the serologic tests and appropriate clinical findings. Thus, we evaluated the clinical aspects of M. pneumoniae pneumonia in the adults patients. Method: Among the admitted patients due to pneumonia, the definite diagnosis is anti-M. pneumoniae antibody titer of $\geq$ 1:40 and a single cold agglutinin titer of $\geq$ 1:64. The presumptive diagnosis is anti-M. pneumoniae antibody titer of $\geq$ 1:40 or a single cold agglutinin titer of $\geq$ 1:64 and the clinical characteristics or chest X-ray findings are compatible with M. pneumoniae pneumonia. We studied the age and sex distribution, seasonal distribution, clinical symptoms, physical findings, serologic test, chest X-ray findings, treatment and its progression. Results: 1) The age distribution was even and the ratio of male to female was 1:1. 2) The monthly distribution was most common in January(16.7%) and the seasonal distribution in autumn and winter(autumn: 30%, winter: 33.3%). 3) The cold agglutinin titers were higher than 1:64 in 12 cases(40%), and reached the peak level around 2 weeks from onset and antimycoplasma antibody titers were higher than 1:160 in 5 cases(16.7%). 4) On the chest X-ray, pulmonary infiltration was noted in 28 cases(93.3%) among 30 cases and right lower lobe involvement was the most common(33.3%) and both lower lobe involvement was noted in 7 cases(23.3%). 5) The mean treatment duration was most common(33.3%) in 1 week to 2 weeks after admission and 26 cases(86.7%) were improved within 4 weeks. 6) On admission, there was fever(${\geq}38.9^{\circ}C$) in 17 cases(56.7%), and the fever subsided in 12 cases(70%) within 3 days after treatment using erythromycin. Conclusion: The mycoplasmal pneumonia in adults shows milder clinical patterns than that in childhood and can be completely recovered without complication by early diagnosis and treatment.

• Tuberculosis and Respiratory Diseases
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• v.45 no.2
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• pp.271-279
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• 1998

Background: Diagnosis by direct microscopy and/or by culture of the Mycobacterium tuberculosis from body fluids or biopsy specimens is "Gold standard". However, the sensitivity of direct microscopy after Ziehl-Neelsen staining is relatively low and culture of mycobacteria is time consuming. Detection of mycobacterial DNA in clinical samples by the polymerase chain reaction is highly sensitive but laborious and expensive. Therefore, rapid, sensitive and readily applicable new tests need to be developed. So we had evaluated the clinical significance of serologic detection of antibody to 38 kDa antigen, which is known as the most specific to the M. tuberculosis complex, and culture filtrate antigen by ELISA in sputum AFB smear negative patients. Method: In this study, culture tests for acid fast bacilli with sputa or bronchial washing fluids of 183 consecutive patients who were negative of sputum AFB smear were performed. Simultaneously serum antibodies to 38 kDa antigen and unheated culture filtrate of M. tuberculosis were detected by an ELISA method. Results: The optical densities of ELISA test with 38 kDa and culture filtrate antigen were significantly higher in active pulmonary tuberculosis cases than in non tuberculous pulmonary diseases (p<0.05), but in patients with active pulmonary tuberculosis, those of the sputum culture positive patients for M. tuberculosis were not significantly different from those of the sputum culture negative cases(p>0.05). In the smear-negative active pulmonary tuberculosis patients, the sensitivity of the ELISA using 38 kDa antigen and culture filtrate was 20.0% and 31.4%. respectively. The specificity was 95.3% and 93.9%. respectively. Conclusion : In active pulmonary tuberculosis but smear negative, the serologic detection of antibody to 38 kDa antigen and culture filtrate by ELISA cannot substitute traditional diagnostic tests and does not have clinically significant role to differenciate the patient with active pulmonary tuberculosis from other with non-tuberculous pulmonary diseases.

• Tuberculosis and Respiratory Diseases
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• v.51 no.3
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• pp.275-280
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• 2001

Background : A 18 year-old man presented with dyspnea and a swelling of the neck. On physical examination, maculopapular rashes were noted on the face and the whole body and crepitus was noted at the thorax and upper arms. His chest X -ray showed bilateral interstitial infiltrates of the lung, pneumomediastinum and subcutaneous emphysema. On serologic examination, measles IgM was positive. Under the diagnosis of measles pneumonia, the patient was treated with oral ribavirin, which resulted in a complete resolution of the pneumomediastinum, subcutaneous emphysema, pneumonic infiltrate, and subjective symptoms of dyspnea and swelling of the neck in 7 days. Here we report this case with a brief review of the relevant literature.

• Pediatric Infection and Vaccine
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• v.4 no.1
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• pp.167-173
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• 1997

Acute infectious mononucleosis, caused by Epstein-Barr virus(EBV), is a self limited lymphoproliferative illness that is common in adolescents and young adults. It shows many complications in multiple organ systems, but the hepatobiliary and the respiratory complication is uncommon. We report a case with thickened gallbladder wall and pneumonia as complications of acute infectious mononucleosis in a child. Also the related literature were reviewed. A 4 year old boy presented with a history of high fever, cough, and abdominal distension for 20days. Physical Examination revealed audible crackles in whole lung field and gross hepatomegaly. Chest X-ray showed pneumonia and liver function tests were abnormal. Ultrasonography and computed tomography revealed a thickened gallbladder wall and hepatosplenomegaly. The diagnosis of primary Epstein-Barr viral infection was eventually made by specific serologic tests. The patients's fever subsided 6 weeks later and pneumonia was recovered around this time. Liver function tests returned near normal 2 months later and ultrasonography of gallbladder was normal at this time.

• Parasites, Hosts and Diseases
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• v.46 no.2
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• pp.71-75
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• 2008

The diagnosis of cryptosporidiosis has been carried out using coprologic techniques in the Republic of Korea. However, antibody responses to Cryptosporidium have rarely been studied. Serum antibodies from HIV-positive/oocyst-positive Korean patients recognized significantly 31 and 27 kDa antigens, and HIV-negative/oocyst-positive individuals clearly reacted to 15/17 kDa antigens. Compared with oocyst-positive cases, 18.7% and 75.8% of sera from HIV-positive patients reacted to 31 and 27 kDa antigens. Only 11.1% of HIV-negative individuals reacted to 15/17 kDa. Based on these findings, serum antibody responses were different between HIV-positive and HIV-negative individuals infected with Cryptosporidium, and it is suggested that HIV-positive patients are more frequently exposed to C. parvum compared to HIV-negative individuals.

• The Korean Journal of Cytopathology
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• v.6 no.2
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• pp.204-208
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• 1995

The cytologic findings of endodermal sinus tumor of the ovary are reported. The cytologic preperations were obtained from ascitic specimens. The findings on Papanicolaou-stained smears included a clean background and poorly preserved atypical cells loosely arranged in irregular or papillary groups. At high magnification, the cells had ill-defined and microvacuolated cytoplasms, with an increased nuclear-cytoplasmic ratio and prominent nucleoli. Hyaline globules characteristic of the alpha-fetoprotein (AFP)-synthesizing cells of endodermal sinus tumor were observed within the cells with periodic-acid-Schiff(PAS) stain. The presence of PAS-positive hyaline globules can be regarded, therefore, as a diagnostic clue to endodermal sinus tumor in an appropriate clinical setting and in the presence of AFP production. The cytologic findings in a cell block is important, in addition to smears, to obtain more diagnostic clues. A preliminary cytomorphologic diagnosis of this highly malignant tumor is valuable as a guide in planning further immunocytochemical and serologic studies.

• Archives of Plastic Surgery
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• v.33 no.3
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• pp.392-397
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• 2006

Orbital pseudotumor, also known as idiopathic orbital inflammatory syndrome(IOIS), may have protean clinical manifestations. IOIS should be determined with a diagnosis of exclusion, with evaluation directed toward eliminating other causes of orbital disease. Orbital MRI and CT are the important diagnostic tests, but serologic studies are necessary to exclude a systemic causes. Biopsy is usually not performed currently, as the risk of producing damage to vital structures within the orbital outweighs the benefits. Patients with multiple recurrences, or those unresponsive to therapy, should be treated of biopsy sample extraction. Corticosteroids are the mainstay of therapy and administered for several months to ensure remission. Radiotherapy may be used in patients who fail to respond to steroids or who have a rapidly progressive course. We analysed the data of two patients. There were no specific complications related to this treatment. We discussed the radiologic findings, treatment procedures, and other orbital diseases.

• The Journal of Korean Medicine
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• v.15 no.2 s.28
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• pp.373-396
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• 1994

The studies look at the causes, pathology, symptom, diagnosis, treatment of rheumatoid arthritis in the sight of east-western medicine. Following are the results : 1. Rheumatoid arthritis korean-medically belongs to symptom such as Bi(痺), Poung Bi(風痺), Tong Poung(痛風), Youk Jeol Poung(歷節風), Bak Hoe Poung(白虎風), Bak Hoe Youk Jeol Poung(白虎歷節風), etc. 2. The causes of Rheumatoid arthritis are endopathic and exopathic : endopathically it tis related to Chil Jeong(七情) and visceral imbalance, and exopathically it is related to Euk Eum (六淫) and environmental factors. 3. To figure out rheumatoid arthritis, we need to diagnose first the joint symptom and the general body condition, we need about 6 weeks to get the exact decision after the serologic test, the immune and inheritance test, the synovium test. 4. There are four kinds of treatments for rheumatoid arthritis : medicin, acupucture and moxibustion, suction cup and purging away the blood, physical therapy. Cheong Eol So Bi(淸熱消痺) can be used for the acute stage and Jang Bu Seong Shai(臟腑盛衰) is to be considered for the chronic stage. 5. Rheumatoid arthritis should be constantly treated to prevent the patient from the deformity of joint complication.

• Journal of Veterinary Clinics
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• v.29 no.1
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• pp.98-102
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• 2012

A 1.5-year-old male Golden Retriever was presented with worsening lameness of two month duration. Abnomral findings of blood works and serum chemistry included anemia, thrombocytopenia, hypercalcemia and hyperglobulinemia. Radiography revealed osteolysis of polyostotic regions including right femur and tibia, bilateral ilium, and spinous processes from the 13th thoracic vertebra to 5th lumbar vertebra. Enlarged multiple lymph nodes and mixed echo pattern of muscular region ventral to vertebra were observed with ultrasonography. Because concentrations of both parathyroid hormone and parathyroid hormone related peptide were all within reference ranges, humoral hypercalcemia by tumor was ruled out and extensive osteolysis was considered as the cause of hypercalcemia. Based on radiographic and ultrasonographic study, lymphoma, multiple myeloma and osteomyelitis were included in differential diagnosis. Fungal serologic test was negative. Monoclonal gammopathy was not found on serum protein electrophoresis. Cytological and histopathological examinations of the lytic lesions revealed neoplastic lymphoid proliferation, and B cell type clonal expansion was detected by polymerase chain reaction for the antigen receptor gene rearrangement. The case was diagnosed as B cell lymphoma involving polyostotic regions.