• The Korean Journal of Blood Transfusion
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• v.23 no.2
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• pp.173-179
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• 2012

We report on two cases of anti-$Jk^a$, whose reactivity disappeared on an antibody identification test using enzyme-treated red cells. One of two patients was a 72-year-old female with cirrhosis of the liver and colon cancer, and the other was a 55-year-old female with known MDS and incomplete Behcet's disease. Results of an antibody identification test using a LISS/Coombs gel card (DiaMed AG) showed negative to one positive with red cells having the $Jk^a$ antigen; however, all reactions using the enzyme-treated cells showed negative results, which was unexpected. The patients' RBC phenotype was Jk(a-b+). We obtained positive results in reactions of enzyme-treated $Jk^a+$ cells and EDTA using a patient's serum and proved that the cause of the negative reaction might be complement-related.

• Tuberculosis and Respiratory Diseases
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• v.53 no.4
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• pp.401-408
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• 2002

Background : Tuberculin skin test is a method to examine M. tuberculosis infection and has been used all over the world. But various factors make it difficult to understand testing results. In 2000, the American Thoracic Society recommended that skin test results should be decided by considering risk factors of the tested. In Korea, high tuberculosis infection rate and BCG vaccination rate make it difficult to differentiate current infection, past infection, and no infection by the skin test. This study was attempted to examine a negative predictive value of the skin test to understand how the skin test acts on deciding administration of anti-tuberculosis drug. Methods : From Mar. 1 to Jul. 31 in 2001, the test was performed for patients hospitalized in Department of Internal Medicine, Hallym University College of Medicine, Chunchon, Korea by administering Tuberculin PPD RT23 2 TU (0.1 ml)to them that has been currently used in Korea based on Mantoux method. They were decided to be infected with tuberculosis bacilli by following diagnostic standard: 1) tuberculosis bacilli was cultured in sputum by microbiological diagnostic standard or Acid-fast bacilli was proven on a microscopic examination or 2) tuberculosis bacilli was not proven in the aforesaid microbiological test by clinical diagnostic standard, while there was opinion or symptom suitable for tuberculosis by radiographic or histological standard so the doctor decided to apply the tuberculosis treatment. Results : In this study, total 210 patients except 20 patients (8.7%) among 230 hospitalized patients were evaluated. Their average age was 60±16.8 years, and male-female rate was 1.28 : 1 (male: 118, female: 92). Number of patient, who was diagnosed and decided as tuberculosis, was 53(25.2%). Pulmonary tuberculosis was found in 45 patients (84.9%); 22 patients were decided to be positive in the Acid-fast bacilli smear test by microbiological examination (culture positive: 13, culture negative: 9), and 23 patients were decided to be tuberculosis patients by clinical diagnosis standard. Tuberculosis pleuritis was found in 8 patients (15.1%); 4 patients were diagnosed and decided by histological standard, and 4 patients were decided and treated by clinical standard. In differentiating patients into 'Negative' and 'Positive' by the skin test standard of the American Thoracic Society, negative predictive value 92.3%, positive predictive value 47.3%, sensitivity and specificity were 83%, 68.8%, respectively. Conclusion : In hospitalized respiratory patients, there was high negative predictive vlaue 92.3% by tuberculin skin test, therefore skin test would be a important factor for deciding administration of anti-tuberculosis drug on negative skin test patient.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.1
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• pp.12-20
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• 2005

Purpose: Helicobacter pylori infection is known to be associated with acute or chronic abdominal pain and upper gastrointestinal bleeding in children. This study was performed to analyze the gastroduodenoscopic findings and the efficacy of triple therapy with omeprazole, amoxicillin and clarithromycin between one and two weeks of duration in children with H. pylori infection. Methods: We have assessed retrospectively 60 patients presented with acute or chronic abdominal pain or upper gastrointestinal bleeding. H. pylori infection was confirmed by endoscopic biopsy and rapid urease test. Out of 60 patients, 30 patients were treated with a combination of omeprazole, amoxicillin, and clarithromycin for one week, and the other 30 patients were treated for two weeks with the same medication. Efficacy of treatment was assessed 4 weeks after the termination of treatment by using the $^{13}C$ urea breath test. Results: The 60 patients with the complaint of diffuse abdominal pain, epigastric pain, vomiting or hematemesis were included in this study. One-week treatment group (group I) consisted of 30 patients (14 male, 16 female) with mean age of $11.6{\pm}2.67years$. Two-week treatment group (group II) consisted of 30 patients (11 male, 19 female) with mean age of $10.7{\pm}4.17years$. In group I, H pylori were eradicated in 26 out of 30 patients (86.7%). In group II, H. pylori were eradicated in 26 out of 30 children (86.7%). Both groups did $^{13}C$ urea breath test after 4 weeks after termination of the triple therapy. The eradication rates were same in both groups as 86.7%, 26 out of 30 patients in each group. The results of endoscopy were nodular gastritis 26 (43.3%), erosive gastritis 10 (16.7%), hemorrhagic gastritis 7 (11.7%), gastric ulcer 2 (3.3%) and normal finding 15 (25.0%). Conclusion: In this study, the nodular gastritis was most common endoscopic findings with H. pylori positive patients. The eradication rate of H. pylori with omeprazole, amoxicillin and clarithromycin was 86.7% and it would be highly effective as primary treatment with no significant differences in the eradication rate between one-week and two-week treatment groups. However, we should need more long-term follow-up data.

• Childhood Kidney Diseases
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• v.2 no.1
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• pp.1-8
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• 1998

Purpose : To evaluate the diagnostic value of dipstick urinalysis($Multistix^{(R)}$) as a screening test for urinary tract infection(UTI) in acute febrile children. Methods : We compared dipstick uinalysis (leukocyte estease(LE) and nitrite) with microscopic urinalysis (WBC and bacteria) and urine culture in 80 children with UTI and 605 children without UTI, who were admitted due to acute fever at EWHA Womans University Hospital between Oct. 1994 and Feb. 1996. Results : 1) In dipstick urinalysis, LE and nitrite were positive in 38.7%, and 13.8% of 80 children with UTI and in 2.1%. and 1.2% of 605 children without UTI. 2) In microscopic urinalysis, WBC and bacteria were positive in 31.2%, and 17.5% of 80 children with UTI and in 4.1%, and 0.6% of 605 children without UTI. 3) Positive rate of LE on dipstick urinalysis was 38.7%, which was significantly higher than 31.5% of WBC on microscopic urinalysis (P<0.05). Positive rate of nitrite was not significantly different to that of bacteria. 4) Sensitivity, specificity, positive predictive value, negative predictive value of dipstick urinalysis were 43.7%, 98.3%, 63.6%, 92.9% which were not significant different to 40.0%, 99.0%, 54.0%, 92.3% of microscopic urinalysis. The sensitivity of combined dipstick and microscopic urinalysis were still low(50%). 5) Additional positive rate of microscopic urinalysis to negative dipstick urinalysis was 6.3%(5/80) in 80 children with UTI. Conclusion : The sensitivity of dipstick urinalysis was low and additional value of microscopic urinalysis was minimal in febrile UTI. So urine culture is mandatory in acute febrile children even though dipstick and microscopic urinalysis are negative.

• Tuberculosis and Respiratory Diseases
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• v.43 no.2
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• pp.128-137
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• 1996

Background : We can diagnose pulmonary tuberculosis with sputum AFB smear and culture, but sputum AFB smear has low sensitivity and culture needs long period, and they are not available in the patients who can not expectorate effectively. Recently developed, PCR is a fast diagnostic tool in tuberculosis, but false positive and false negative are important problems. So, we studied the diagnostic value of bronchoalveolar lavage fluid AFB smear, culture, PCR through the bronchoscopy. Methods : The 67 pulmonary tuberculosis patients and 43 non-pulmonary tuberculosis patients were analyzed with their sputum specimen AFB smear and culture. Also, bronchoscopy and bronchoalveolar lavage were done, and bronchoalveolar lavage fluid AFB smear, culture and PCR were done. Results: 1) In the cases of pulmonary tuberculosis, the sensitivity of sputum AFB smear and culture were 32.8% and 57.4%, respectively. And the sensitivity of bronchoalveolar lavage fluid AFB smear and culture were 47.8% and 80.6%. respectively. 2) In the cases of pulmonary tuberculosis, the sensitivity and the positive predictive value(for predicting a positive culture) of PCR were 80.6% and 81.5%, respectively. 3) In the cases of sputum AFB smear-negative and culture-negative pulmonary tuberculosis, the sensitivity of bronchoalveolar lavage fluid AFB smear, culture, PCR, and the positive predictive value(for predicting a positive culture) of PCR were 23.1%, 100%, 88.5%, and 82.4%, respectively. 4) The specificity of bronchoalveolar lavage fluid PCR was 77.0%. 5) The median number of days between obtaining a specimen and starting therapy was 5 days for sputum AFB smear, 9 days for bronchoalveolar lavage fluid AFB smear, 26 days for bronchoalveolar lavage fluid PCR, 32 days for sputum culture, 56 days for bronchoalveolar lavage fluid culture. Conclusion : The sensitivity of bronchoalveolar lavage fluid AFB smear and culture are higher than sputum AFB smear and culture. So, the bronchoscopy must be considered for evaluating suspected cases of pulmonary tuberculosis in patients from whom smears of expectorated sputum do not reveal mycobacteria or from whom no sputum can be obtained. Especially, combined with PCR, it is expected that pulmonary tuberculosis can be diagnosed more rapidly and more accurately, so bronchoalveolar lavage fluid APB smear and PCR can be helpful in the early treatment of pulmonary tuberculosis.

• The Journal of the Korea Contents Association
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• v.17 no.11
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• pp.50-59
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• 2017

To evaluate the capability of integrated PET-MRI, which has recently been utilized in the clinical practices, on the diagnosis of liver cancer, its utility was assessed by $2{\times}2$ decision matrix. The numbers of abnormal and normal decisions on the liver cancer were 98 and 51 cases, respectively, upon PET-MRI scan results of the subjects, and the numbers of positive and negative decisions were 103 and 62, respectively, upon cytopathologic results. Out of the two tests, 95 cases were shown as true-positive and 3 were false positive, while 62 were true negative and 5 were false negative. Upon the results of PET-MRI test, its sensitivity, specificity, false negative rate, and false positive rate were 95.00%, 95.38%, 0.05%, and 95.15%, respectively. Therefore, it is considered to have the high potential to use the determination of the stage before the surgery, detections of recurrence and remote metastasis, assessment of uncertain remote lymph node metastasis, and so on in the diagnosis of the liver cancer, and also for the clinical utility of PET-MRI to be sufficient by integrated diagnosis and follow up scan with pathological studies.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.14 no.1
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• pp.16-25
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• 2003

Background and Objectives : Electroglottography(EGG) is a non-invasive method of monitoring the vocal cord vibration by measuring the variation of physiological impedance across the vocal folds through the neck skin. It reveals especially the vocal fold contact area and is widely used for basic laryngeal researches, voice analysis and synthesis. The purpose of this study is to investigate the effectiveness of EGG parameters in differential diagnosis of laryngeal cancer. Materials and Methods : The author investigated 10 laryngeal cancer and 25 benign laryngeal disease patients who visited at the Department of Otolaryngology, Pusan National University Hospital. The EGG equipment was devised in the author's Department. Among various parameters of EGG, closed quotient(CQ), speed quotient(SQ), speed index(SI), Jitter, Shimmer, Fo were determined by an analysis program made with MATLAB 6.5$^{\circledR}$(Mathwork, Inc.). In order to differentiate various laryngeal diseases from pathologic voice signals, the author has used the electroglottographic parameters using the neural network of multilayer perceptron structure. Results : SQ, SI, Jitter and Shimmer values except those of CQ and Fo showed remarkable differences between benign and malignant laryngeal disease groups. From the artificial neural network, the percentage of differentiating the laryngeal cancer was over 80% in SQ, SI, Jitter, Shimmer except for CQ and Fo. These results indicated that it is possible to discriminate the benign and malignant laryngeal diseases by EGG parameters using the artificial neural network. Conclusion : If parameters of EGG which can reveal for the pathology of laryngeal diseases are additionally developed and the current classification algorithm is improved, the discrimination of laryngeal cancer will become much more accurate.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1982.05a
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• pp.10.1-10
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• 1982

The use of phonosurgery in the recent development of laryngomicrosurgery has enabled the restoration of a normal voice in respect to functional laryngeal surgery which in Korea in the past limited to simple removal of benign laryngeal tumor such as laryngeal polyp or nodules and cordal injection of $Teflon^{{\circledR}}$ for the treatment of recurrent nerve paralysis under the vision of suspension laryngoscopy. Performance of phonosurgery for the treatment of cord paralysis, mutational dysphonia, vocal cord atrophy, hyperkinetic dysphonia and sulcus vocalis is a happy event in the view point of development of phonosurgery in Korea. In this aspect thyroplasty to change the position and physical characteristics of the cord outside the glottis instead of the direct handling of the vocal cord through direct endoscopy is popular. Among the 4 types of thyroplasty, classified by Insshiki(1974), type I thyroplasty(1ateral compression of vocal cord) and type IV thyroplasty(lengthening of vocal cord) were effective in the treatment of unilateral vocal cord paralysis. Advantages of this operation are the fine adjustment of the degree of lateral compression under local anesthesia according to the phonation of the patient during operation and avoidance of dyspnea and intralaryngeal hemorrhage due to the manipulation outside the internal perichondrium of the thyroid cartilage. We did 7 cases of thyroplasty for the treatment of unilateral vocal cord paralysis in the 7 months from September 1981 to March 1982. Before the operation aerodynamic study, psychoacoustical evaluation, stroboscopy and sound spectrographic analysis were done. Two months after the operation the above procedures were performed again. Results of preoperative and postoperative examination were compared and the following results were obtained. 1) In the aerodynamic study, maximum phonation time increased to 158% of the preoperative value and the phonation quotient and the mean flow rate decreased to 58% and 54% of preoperative values. 2) The degree of hoarseness improved in the psychoacoustical evaluation and the glottic chink during phonation was decreased in the stroboscopic examiantion. 3) In the sound spectrographic analysis, periodicity was much restored and noise distribution decreased especially in the high frequency area.

• Tuberculosis and Respiratory Diseases
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• v.45 no.3
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• pp.519-528
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• 1998

Background: Diagnosis of pulmonary tuberculosis is not easy when the sputum smear for Mycobacterium tuberculosis(M. Tb) is negative. We evaluated the clinical utility of polymerase chain reaction(PCR) for detecting M. Tb in bronchoalveolar lavage(BAL) samples. Methods: We recruited 84 patients whose sputum smear for M. Tb were negative or not available due to no production of sputum. We performed bronchoalveolar lavage for acid-fast stain, culture of mycobacteria, and PCR assay of BAL fluid. We analyzed the results of microbiologic examination. Results: The sensitivity of BAL fluid smear, culture, and PCR were 20%, 38%, and 40%, respectively. The specificity of BAL fluid PCR was 95%. The positive predictive value of PCR was 89%. The smear of BAL fluid was positive in 17%. The PCR of BAL fluid was the only diagnostic test in 17%. Therefore, the BAL fluid analysis including smear and PCR was diagnostic in 34 % within 24 hours. The BAL fluid analysis including smear, PCR, and culture was diagnostic in 55% within 2 month. Conclusion: The BAL fluid PCR was valuable method in the diagnosis of pulmonary tuberculosis in patients whose sputa were not available or reveal negative smear.

• Tuberculosis and Respiratory Diseases
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• v.61 no.6
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• pp.547-553
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• 2006

Background: Liquid-based cytology is currently known as an effective method, and cervical cytology has been shown to be especially effective from of malignancy detection. In our study, the cytological detection rates of the Thinprep (Liquid-based cytology) and conventional cytology (bronchial washing & brushing) for endobronchial lesions were compared. Methods: Between July 2005 and September 2005, the data from 30 patients with respiration symptom, who had shown abnormal lesion on bronchoscopy, were collected. Results: The bronchoscopic biopsy group was consisted of 30 cytodiagnosis specimens, 24 of which were confirmed to be malignant. The others were tuberculosis (4), bronchiectasis and bronchopulmonary fistula (1 each). Of the 24 malignant case, cancer or atypical cells were detected in 19, 17 and 12 of the Thinprep, brushing cytology and washing cytology cases, respectively. None one of the methods detected cancer cells in the non-malignant specimens. Washing cytology has shown sensitivity, specificity, and positive and negative predictive values of 50, 100, 100 and 33.3% respectively. Brushing cytology has shown sensitivity, specificity, and positive and negative predictive values of 70.8, 100, 100 and 46.2%, respectively. Thinprep has shown sensitivity, specificity, and positive and negative predictive values of 79.2, 100, 100 and 54%, respectively. Conclusions: Thinprep (liquid-based cytology) showed better sensitivity and negative predictive values for the evaluation of lung cancer than conventional cytology. However a large-scale study will be needed in the future.