• Title/Summary/Keyword: test specificity

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The Relationship between the Anterior Cruciate Ligament Tear and the Posterior Cruciate Ligament Index on MRI Findings (자기공명영상 상 전방십자인대 파열과 후방십자인대 곡선값의 연관성)

  • Kang Jae Do;Kim Kwang Yul;Kim Hyung Cheon;Lee Sung Chun
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.109-114
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    • 2002
  • Propose : The purpose of this retrospective study was to test the posterior cruciate ligament (PCL index) for diagnosis of a tear of the anterior cruciate ligament (ACL) by means of MR imaging. Materials and Methods : From Mar. 1997 to Feb. 2001, concomitant magnetic resonance imaging (MRI) and knee joint arthroscopy were performed in 56 patients of either pain or instability of the knee. The shortest distance between the femoral and tibial attachment of PCL (X) and the distance from that line to the tip of the arc marked by the PCL (Y) on the sagittal plane images were measured. The quotient of these two parameters (Y/X) defined the PCL index. Results : Using MRI diagnosis, there were 35 patients diagnosed with ACL rupture and 21 patients were ruled out of ACL injury. Using arthroscopy, 32 of the 35 patients diagnosed by MRI showed ACL rupture, and 20 of the 21 patients were ruled out of ACL injury. The mean PCL index was 0.40 in the 33 patients diagnosed with ACL rupture through arthroscopy. The mean PCL index was 0.23 in 23 patients with an uninjured ACL through arthroscopy. In 33 patients with ruptured ACL, this value exceeds 0.31. The index value was 0.31 in 3 patients with uninjured ACL. The value of the index was not above 0.31 with an uninjured ACL. PCL index on MRI had a sensitivity of $91\%$ and a specificity of $94\%$ for determining the status of the anterior cruciate ligament. Conclusion : Injury to the ACL changes the PCL index markedly. In diagnostically unreliable MR images, amelioration of the PCL index could help in the diagnosis of ACL injury.

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Usefulness of serum procalcitonin test for the diagnosis of upper urinary tract infection in children (소아 상부 요로감염의 진단을 위한 혈청 procalcitonin 검사의 유용성)

  • Kim, Dong Wook;Chung, Ju Young;Koo, Ja Wook;Kim, Sang Woo;Han, Tae Hee
    • Clinical and Experimental Pediatrics
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    • v.49 no.1
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    • pp.87-92
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    • 2006
  • Purpose : It is difficult to make a distinction between lower urinary tract infection(UTI) and acute pyelonephritis(APN) during the acute phase of febrile UTI due to nonspecific clinical symptoms and laboratory findings, especially among young children. We measured the serum procalcitonin(PCT) in children with UTI to distinguish between acute pyelonephritis and lower UTI, and to determine the accuracy of PCT measurement compared with other inflammatory markers. Methods : Serum samples were taken from children who admitted with unexplained fever or were suspected of having UTI. 51 children(mean $12.2{\pm}11.4$ months) were enrolled in this study. Leukocyte counts, erythrocyte sedimentation rates(ESR) and C-reactive protein(CRP) were also measured. Renal parenchymal involvement was assessed by $^{99m}Tc$ DMSA scintigraphy in the first 7 days after admission. PCT was measured by immunoluminometric assay. Results : PCT values were significantly correlated with the presence of renal defects in children with UTI(n=16)($5.06{\pm}12.97{\mu}g/L$, P<0.05). However, PCT values were not significantly different between children with UTI without renal damage(n=18) and children without UTI(n=17). Using a cutoff of $0.5{\mu}g/L$ for PCT and 20 mm/hr for ESR, 20 mg/L for CRP, sensitivity and specificity in distinguishing between UTI with and without renal involvement were 81.3 percent and 88.9 percent for PCT 87.5 percent and 72.2 percent for ESR, and 87.5 percent and 55.6 percent for CRP, respectively. Positive and negative predictive values were 86.7 percent and 84.2 percent for PCT and 60.9 percent and 81.8 percent for CRP, respectively. Conclusion : In febrile UTI, PCT values were more specific than CRP, ESR and leukocyte count for the identification of patients who might develop renal defects.

A STUDY ON 4 TYPE CONSTITUTION AND SIFE CHARACTER OF OBESE PATIENTS (비만인의 생활특성과 사상체질에 관한 연구)

  • KIM, DAL RAE
    • Journal of Sasang Constitutional Medicine
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    • v.9 no.1
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    • pp.303-313
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    • 1997
  • Disease depends on the three factors, agent, host and environment. According to history of disease, by early 1900s the case of deaths is infectious disease, in late 1900s care of infectious diseases and tremendous scale of chronic disease, i.e., heart disease, diabetes, cancers and etc, makes care of chronic diseases be a most important theme. Now, life-style of diet is being westernized and in high industry-oriented society, obesity makes attack fate remarkably increase and life-expectancy become short, so that it causes severe problem of health. Chronic disease, such as obesity, is not affected by specific agent, but depends of interaction between host and environmental factors. There is the theory of constitutional medicine in Korean Medicine. According to it, all the people have constitutional specificity and disease. Because obesity is a kind of disease, there is the corresponding constituent being apt to be fat. Oriental Medicine utilizes herb-medication, acupuncture, and massage-therapy in treating obesity. Therefore study on relationship between constituent and obesity for OPD patients of Sangji-Oriental Medicine Hospital is carried out. The results are summarized as followings. 1. 70.2% of obesity patients are Taeumin(太陰人), 26.9% of those are Soyangin(少陽人), 2.9% of thoese are Soeumin(少陰人). 2. Most cases, high value of Free Fat Acid and Triglyceride not that of Total Cholesterol and Low Density Lipoprptein is meaningful in obesity patient blood. The corelationship between lipid test and Constitution is meaningful in Triglyceride and Free Fatty Acid. 3. Obesity is not related with gene. 4. Obesity is not related with Boyak(Herb-Med : 補藥). 5. Obesity mostly happens after delivery, contraception and operation. 6. Obese Patients are apt to eat between meals, especially food of wheat flour such as a snack. 7. The aim of treating obesity is not persuit of beauty but of keeping healthy. 8. 2.2Kg of body weight is lost after 4 week-treatment. 9. Common cause of obesity is overeating of carbohydrate and lipid than meat.

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The Development of Theoretical Model for Relaxation Mechanism of Sup erparamagnetic Nano Particles (초상자성 나노 입자의 자기이완 특성에 관한 이론적 연구)

  • 장용민;황문정
    • Investigative Magnetic Resonance Imaging
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    • v.7 no.1
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    • pp.39-46
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    • 2003
  • Purpose : To develop a theoretical model for magnetic relaxation behavior of the superparamagnetic nano-particle agent, which demonstrates multi-functionality such as liver- and lymp node-specificity. Based on the developed model, the computer simulation was performed to clarify the relationship between relaxation time and the applied magnetic field strength. Materials and Methods : The ultrasmall superparamagnetic iron oxide (USPIO) was encapsulated with biocompatiable polymer, to develop a relaxation model based on outsphere mechanism, which was resulting from diffusion and/or electron spin fluctuation. In addition, Brillouin function was introduced to describe the full magnetization by considering the fact that the low-field approximation, which was adapted in paramagnetic case, is no longer valid. The developed model describes therefore the T1 and T2 relaxation behavior of superparamagnetic iron oxide both in low-field and in high-field. Based on our model, the computer simulation was performed to test the relaxation behavior of superparamagnetic contrast agent over various magnetic fields using MathCad (MathCad, U.S.A.), a symbolic computation software. Results : For T1 and T2 magnetic relaxation characteristics of ultrasmall superparamagnetic iron oxide, the theoretical model showed that at low field (<1.0 Mhz), $\tau_{S1}(\tau_{S2}$, in case of T2), which is a correlation time in spectral density function, plays a major role. This suggests that realignment of nano-magnetic particles is most important at low magnetic field. On the other hand, at high field, $\tau$, which is another correlation time in spectral density function, plays a major role. Since $\tau$ is closely related to particle size, this suggests that the difference in R1 and R2 over particle sizes, at high field, is resulting not from the realignment of particles but from the particle size itself. Within normal body temperature region, the temperature dependence of T1 and T2 relaxation time showed that there is no change in T1 and T2 relaxation times at high field. Especially, T1 showed less temperature dependence compared to T2. Conclusion : We developed a theoretical model of r magnetic relaxation behavior of ultrasmall superparamagnetic iron oxide (USPIO), which was reported to show clinical multi-functionality by utilizing physical properties of nano-magnetic particle. In addition, based on the developed model, the computer simulation was performed to investigate the relationship between relaxation time of USPIO and the applied magnetic field strength.

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Comparison of Ultrasound-guided Suprapubic Aspiration with Urethral Catheterization in Infants (영유아에서 초음파 감시하 치골상부 방광천자와 도뇨관 채뇨의 비교)

  • Lee, Jung-Won;Lee, Seung-Joo
    • Childhood Kidney Diseases
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    • v.11 no.1
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    • pp.59-64
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    • 2007
  • Purpose : Suprapubic aspiration(SPA) has been considered the "gold standard" for obtaining urine in non-toilet trained infants. Ultrasound(US)-guided SPA improves the success rate of the procedure and reduces the complications. However, many physicians perceive SPA as invasive and prefer the use of urethral catheterization (Ucat). We compared the success rate, complications and accuracy of US-guided SPA and Ucat. Methods : 121 infants who visited Ewha Womans University Mokdong Hospital with suspected urinary tract infection(UTI) were investigated. For the first study, the study infants were randomly assigned to either the US-guided SPA(n=32) or Ucat(n=32) groups. The success rate and complications of both procedures were compared. For the second study, US-guided SPA and Ucat were performed simultaneously(n=57). The accuracy of urethral catheterization was subsequently analyzed. The criteria for success was defined as the collection of more than 0.5 mL of urine. UTI was diagnosed by the presence of uropathogens over 105 colony-forming units (CFU)/mL. Results : The overall success rate of the US-guided SPA was 96.9%(71.9% in first attempts, 25.0% in second attempts) which was not significantly different compared to 96.9%(90.6% in first attempts, 6.3% in second attempts) in the Ucat(P>0.05) group. The aspirated urine volume was $7.4{\pm}3.7mL$ in the US-guided SPA group, which was not significantly different to $4.5{\pm}2.6mL$ in the Ucat(P>0.05) group. The accuracy of Ucat in comparison to the US guided SPA was low with sensitivity 59.5%, specificity 86.6%, false-positive rate 13.3% and false-negative rate 40.5%. Conclusion : US-guided SPA should be encouraged as the best method to collect the urine in non-toilet trained infants with UTI.

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Diagnosis of Malignant Pleural Effusion by using Aberrant Methylation of p16 and RARB2 (p16과 RARB2 유전자의 비정상적인 메틸화 검사를 이용한 악성 흉수의 진단)

  • Rha, Seo Hee;Lee, Su Mi;Koo, Tae Hyoung;Shin,, Bong Chul;Huh, Jung Hun;Um, Soo Jung;Yang, Doo Kyung;Lee, Soo-Keol;Son, Choonhee;Roh, Mee Sook;Bae, Ho-Jeong;Kim, Ki Nam;Lee, Ki Nam;Choi, Pil Jo
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.4
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    • pp.285-292
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    • 2008
  • Background: A diagnosis of malignant pleural effusion is clinically important, as the prognosis of lung cancer patients with malignant pleural effusion is poor. The diagnosis will be difficult if a cytological test is negative. This study was performed to investigate whether the detection of hypermethylation of the p16 (CDKN2A) and retinoic acid receptor b2 (RARB2) genes in pleural fluid is useful for a diagnosis of malignant pleural effusion. Methods: Pleural effusion was collected from 43 patients and was investigated for the aberrant promoter methylation of the RARB2 and CDKN2A genes by use of methylation-specific PCR. Results were compared with findings from a pleural biopsy and from pleural fluid cytology. Results: Of 43 cases, 17 cases of pleural effusion were due to benign diseases, and 26 cases were from lung cancer patients with malignant pleural effusion. Hypermethylation of the RARB2 and CDKN2A genes was not detected in the case of benign diseases, independent of whether or not the patients had ever smoked. In 26 cases of malignant pleural effusion, hypermethylation of RARB2, CDKN2A or either of these genes was detected in 14, 5 and 15 cases, respectively. The sensitivities of a pleural biopsy, pleural fluid cytology, hypermethylation of RARB2, hypermethylation of CDKN2A, or hypermethylation of either of the genes were 73.1%, 53.8%, 53.8%, 19.2%, and 57.7%, respectively; negative predictive values were 70.8%, 58.6%, 58.6%, 44.7%, and 60.7%, respectively. If both genes are considered together, the sensitivity and negative predictive value was lower than that for a pleural biopsy, but higher than that for pleural fluid cytology. The sensitivity of hypermethylation of the RARB2 gene for malignant pleural effusion was lower in small cell lung cancers than in non-small cell lung cancers. Conclusion: These results demonstrate that detection of hypermethylation of the RARB2 and CDKN2A genes showed a high specificity, and sensitivity was higher than for pleural fluid cytology. With a better understanding of the pathogenesis of lung cancer according to histological types at the molecular level, and if appropriate genes are selected for hypermethylation testing, more precise results may be obtained.

Usefulness of Prone Position on PET-CT in Breast Cancer (유방암 PET-CT 검사에서 Prone(복와위)자세의 유용성 평가)

  • Park, Hoon-Hee;Kim, Sei-Yung;Kim, Jung-Yul;Park, Min-Soo;Lim, Han-Snag;Jung, Suk;Kang, Chun-Goo;Kim, Jae-Sam;Lee, Chang-Ho;Lee, Yung-Joo
    • The Korean Journal of Nuclear Medicine Technology
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    • v.12 no.1
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    • pp.44-48
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    • 2008
  • Purpose: In FDG-PET/CT of breast cancer, a sensitivity was 80~96% and a specificity was 75~95% commonly. It was valuable to identify a cancer in early stage been difficult in Mammography. Most of the PET/CT scans have been examined on supine position, so, the image of breast has been acquired by reconstructed whole body scan image. However, using prone position with a compensator, a shape of breast was reassembly shown to be real by gravity. Therefore, the purpose of this study was to evaluate diagnostic value of prone position in FDG PET-CT of breast cancer. Materials and Methods: 30 female patients with doubtful or positive breast cancer were examined. The PET-CT whole body scan was acquired at 60 minutes after $^{18}F$-FDG injection on Supine position. Then, regional breast spot scan was progressed on prone position using a compensator. Each image was evaluated by physicians blinded to patient's data, and statistical analysis did through SUVs measured in PET-CT images. Results: In 27 of 30 patients, prone position was shown accurate discrimination and diagnostic value, but in another 3 patients had a lesion 1cm below, PET-CT couldn't detect it, unlike MRI. Consequently, prone position distinguished a lesion better than Supine position, because of low degree of metamorphosis by gravity. The SUVs analysis of each position was significant (p value=0.004). Conclusion: In PET-CT of breast cancer, prone position could detect micrometastasis as well as primary lesion, better than supine position. Therefore, this study proposes that any technical change considered morphological feature like prone position can offer adequate and useful diagnostic information, together with complementary quantitative analysis.

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Development of Rapid Analytical Method of Forbidden Medicines in Dietary Supplements Using LC-ESI-Tandem MS (LC-ESI-tandem MS를 이용한 기능성표방식품 중 부정유해물질 신속검사체계 개발)

  • Kim, Hee-Yun;Jang, Young-Mi;Joo, Hyun-Jin;Jung, Young-Hyun;Lee, Myoung-Sook;Park, Jong-Seok;Lee, Kwang-Ho;Lee, Hwa-Mi
    • Korean Journal of Food Science and Technology
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    • v.39 no.4
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    • pp.372-379
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    • 2007
  • A high-performance liquid chromatography-electrospray ionization (HPLC-ESI) tandem MS was developed for the rapid and simultaneous determination of forbidden medicines in dietary supplements. Thirteen medicinal components such as PDE-5 inhibitors and their analogues, and the newly identified dimethylsildenafil and xanthoanthrafil, were included in this study. After tentative standardization of molecular ions in both polarities using thirteen references on the mass spectrometer, with ESI-continuous infusion via the syringe pump method, the relative intensity of the ions present in the resulting spectra was quantitatively compared. From the results, the ion mode was selected depending on each reference's characteristics. A HPLC method coupled with the ESI mode was developed considering the matrix effect and interference depending on the type of sample. The validation test of the developed method was followed by carrying out precision, accuracy, recovery, sensitivity and linearity, etc. The method showed sufficiently high sensitivity, reproducibility, and specificity, and produced 4 times faster results when compared with the existing HPLC/UV method for the determination of forbidden compounds in dietary supplements.

B-type Natriuretic Peptide (BNP) as a Predictive Marker after Heart Transplantation (심장이식 후 예측인자로서 B-type Natriuretic Peptide (BNP)의 역할)

  • Shin, Hong-Ju;Kim, Hee-Jung;Choo, Suk-Jung;Kim, Jae-Joong;Song, Meong-Gun
    • Journal of Chest Surgery
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    • v.40 no.8
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    • pp.552-557
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    • 2007
  • Background: B-type natriuretic peptide (BNP) is a cardiac hormone that is primarily synthesized by the ventricular cardiac myocytes. Increased plasma BNP levels have been observed in patients suffering with congestive heart failure, ventricular hypertrophy and myocaridits and also during heart transplantation rejection. We investigated the serum BNP level as a predictive marker for rejection after heart transplantation. Material and Method: To test the usefulness of measuring the BNP level in cardiac transplant patients, consecutive blood samplings for BNP, right ventricular endomyocardial biopsies, hemodynamic measurements and transthoracic echocardiogram were all done in 10 such patients between January 2004 and August 2005 at the Department of Thoracic and Cardiovascular Surgery in Asan Medical Center. Two groups were identified with using the median value: the low BNP group (n=28, BNP: ${\le}290$ pg/mL) and the high BNP group (n=29, BNP: >290 pg/mL). We retrospectively analyzed rejection, the ejection fraction, tricuspid regurgitation, left ventricular hypertrophy, the pulmonary capillary wedge pressure and the right atrial pressure between the 2 groups. Result: There were no differences in age, gender, rejection, the ejection fraction, tricuspid regurgitation, left ventricular hypertrophy and the right atrial pressure between the 2 groups (p>0.05). However, a higher pulmonary capillary wedge pressure and a higher mean pulmonary atrial pressure were observed in the high BNP group (p<0.05). Further, BNP has linear correlation with the pulmonary capillary wedge pressure (r=0.590, p<0.001). Using the cut-off value of 620 pg/mL, the BNP predicted a high PCWP (>12 mmHg) with a sensitivity of 83.3% and a specificity of 91.1% (AUC: $0.900{\pm}0.045$, p<0.001). Conclusion: The BNP level after heart transplantation does not show any significant correlation with rejection, yet it might be a predictive marker of ventricular diastolic dysfunction.

Development and Validation of Real-time PCR to Determine Branchiostegus japonicus and B. albus Species Based on Mitochondrial DNA (Real-time PCR 분석법을 이용한 옥돔과 옥두어의 종 판별법 개발)

  • Chung, In Young;Seo, Yong Bae;Yang, Ji-Young;Kim, Gun-Do
    • Journal of Life Science
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    • v.27 no.11
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    • pp.1331-1339
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    • 2017
  • DNA barcoding is the identification of a species based on the DNA sequence of a fragment of the cytochrome C oxidase subunit I (COI) gene in the mitochondrial genome. It is widely applied to assist with the sustainable development of fishery-product resources and the protection of fish biodiversity. This study attempted to verify horse-head fish (Branchiostegus japonicus) and fake horse-head fish (Branchiostegus albus) species, which are commonly consumed in Korea. For the validation of the two species, a real-time PCR method was developed based on the species' mitochondrial DNA genome. Inter-species variations in mitochondrial DNA were observed in a bioinformatics analysis of the mitochondrial genomic DNA sequences of the two species. Some highly conserved regions and a few other regions were identified in the mitochondrial COI of the species. In order to test whether variations in the sequences were definitive, primers that targeted the varied regions of COI were designed and applied to amplify the DNA using the real-time PCR system. Threshold-cycle (Ct) range results confirmed that the Ct ranges of the real-time PCR were identical to the expected species of origin. Efficiency, specificity and cross-reactivity assays showed statistically significant differences between the average Ct of B. japonicus DNA ($21.85{\pm}3.599$) and the average Ct of B. albus DNA ($33.49{\pm}1.183$) for confirming B. japonicus. The assays also showed statistically significant differences between the average Ct of B. albus DNA ($22.49{\pm}0.908$) and the average Ct of B. japonicus DNA ($33.93{\pm}0.479$) for confirming B. albus. The methodology was validated by using ten commercial samples. The genomic DNA-based molecular technique that used the real-time PCR was a reliable method for the taxonomic classification of animal tissues.