• Title/Summary/Keyword: 진단 일치율

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Tuberculin Skin Test and QuantiFERON-TB Gold Assay before and after Treatment for Latent Tuberculosis Infection among Health Care Workers in Local Tertiary Hospital (일개 병원의 의료인에서 투베르쿨린 검사와 QuantiFERON-TB Gold 검사를 이용한 잠복결핵의 진단과 치료 전후의 변화)

  • Lee, Seung Jun;Kim, Hyeon Sik;Ma, Jung Eun;Lee, Sang Min;Ham, HyunSeok;Cho, Yu Ji;Jeong, Yi Yeong;Kim, Ho Cheol;Lee, Jong Deok;Kim, Sun-Joo;Hwang, Young Sil
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.4
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    • pp.270-275
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    • 2007
  • The QuantiFERON-TB Gold assay and tuberculin skin test (TST) have been useful test for diagnosing latent tuberculosis infections (LTBI). However, there are few reports on the efficacy of the QuantiFERON-TB Gold assay and TST in evaluating the response after the treatment of LTBI. This study examined the changes in the TST and QuantiFERON-TB Gold assay before and after a treatment for latent tuberculosis in health care workers (HCWs) at a local tertiary hospital. Methods: A cohort of volunteers working as nurses and doctors who underwent a TST and QuantiFERON-TB Gold assay was established. The volunteers positive for the QuantiFERON-TB Gold assay had been treated with 3 months of isoniazid (INH) and rifampin (RFP). After completing treatment, the TST and QuantiFERON-TB Gold assay were repeated. Results: Of the 48 participants (14 doctors, 34 nurses, M: F=11:37, mean $age=29.9{\pm}5.5$ years, mean employment $period=74.9{\pm}64.3$ months), 19 (39.6%) tested positive to the TST (mean induration=$19.1{\pm}9.7mm$) and 8 (16.7%) were QuantiFERON-TB Gold assay. Among them, one had active pulmonary tuberculosis. Seven volunteers were consistently positive to both the TST and QuantiFERON-TB Gold assay after being medicated with INH and RFP for 3 months. Conclusion: TST and QuantiFERON-TB Gold assay are unsuitable for evaluating the treatment response of LTBI because they were consistently positive both before and after the anti-tuberculosis medication.

A Study on the Standardization of Sample Preparation for Urine Sediment Microscopic Examination (요침사 현미경검사를 위한 표본제작의 표준화 연구)

  • Hyeok Jae LEE;Dae Heon KIM;Min-Hyeok LEE
    • Korean Journal of Clinical Laboratory Science
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    • v.56 no.2
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    • pp.135-146
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    • 2024
  • Urinalysis is a fundamental diagnostic test routinely performed in clinical laboratories. We evaluated two manual microscopy methods, including a novel protocol, against the standardized chamber method. A total of 402 specimens, comprising 201 positive each for red blood cells (RBCs) and white blood cells (WBCs) by the strip test and automated urine sediment analyzer, were selected for the analysis. The correlation coefficients between the standardized chamber method and the novel protocol RBC and WBC test were both r=0.98, indicating a high degree of correlation. The pair-wise agreement rates for the same grade between these two methods were 86.1% for RBCs and 88.6% for WBCs, with rates within one grade difference of both at 99.5%. In contrast, the agreement rates between the standardized chamber method and smaller or medium-sized laboratory methods were notably lower, with the same-grade rates at 11.9% for RBCs and 13.4% for WBCs, and within one grade difference at 67.2% and 74.1%, respectively. Additional analyses using the intraclass correlation coefficient and Bland-Altman plots confirmed that the novel protocol exhibited superior agreement compared to the other three manual microscopy methods tested. Therefore, we recommend the novel protocol as a standardized procedure for urine sediment preparation, given its high correlation and agreement with the standardized chamber method.

Evaluation for detection of Cryptosporidium oocysts in diarrheal feces of calves (야외 송아지 설사변에서 작은와포자충 검출에 대한 평가)

  • Wi, Seong-Hwan;Ju, Hu-Don;Gang, Yeong-Bae
    • Parasites, Hosts and Diseases
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    • v.34 no.2
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    • pp.121-126
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    • 1996
  • For the detection of Cwptospori,mum oocysts, fecal samples were collected from 201 calves which showed diarrhea. Among the 201 samples, 29 samples (14.4%) were positive for Cwptosporinium spry. by the DMSO-modified acid-fast stain (MAFS) , 23 samples (11.4%) were positive by commercial kit (Meridian Diagnostics, Cincinnati, Ohiol and 23 by the indirect immunofluorescence antibody (IFA )assay employing the monoclonal antibody (mAb C6). When tested by both IFA and MAFS, 20 fecal samples were positive for Cwptosporinium oocysts whereas 169 fecal samples were negative. If the MAFS is considered a standard method for oocyst detection, the IFA showed 69% of sensitivity and 98% of specificity. When tested by both IFA and commercial kit, 22 fecal samples were positive for Cwptospori,mum oocysts while 177 samples were negative. One sample tested by IFA was found to be false negative, when compared with the results by commercial kit. The sensitivity of IFA was calculated as high as 96%; the specificity as 99% and the predictive value was also 99%. In the present study, IFA employing the nAb C6 revealed that 23 samples (11.4%) were positive among the 201 calves showing diarrhea. Of 23 IFA positive samples, 4 samples (5%) showed cryptosporidial oocysts more than 105 OPG Therefore. it is concluded that the calves showing cryptosporidial oocysts more than 105 OPG in the feces were highly associated with clinical cryptosporidiosis.

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Cytopathologic Diagnosis of Bile Obtained by Percutaneous Biliary Drainage (담즙의 세포병리학적 진단에 관한 연구)

  • Park, In-Ae;Ham, Eui-Keun
    • The Korean Journal of Cytopathology
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    • v.3 no.1
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    • pp.1-11
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    • 1992
  • From the one hundred forty eight patients with evidence of biliary tract obstruction, 275 bile samples were obtained from percutaneously placed biliary drainage catheters. Of the 148 patients, ova of Clonorchis sinensis were demonstrated in 17 patients (11.5%), with the epithelial cells. Among them, one case also demonstrated coexisting adenocarcinoma. In 105 patients, the medical records were available for review and the clinical diagnoses were malignancy in 99 patients and benign lesion in 6 patients. Of the 99 patients in which clinico-radiologic diagnosis were malignant, cytologic results were positive in 23.2%. Dividing the patients Into two groups, the ones with tumor of bile duct origin (group I) and the others with tumors producing extrinsic compression of bile duct, such as periampullary carcinoma, pancreas head carcinoma or metastatic carcinoma in lymph nodes from tumors of adjacent organs (group II), the cytologic results were positive in 37% and 11.6%, respectively. In patients with histologic confirmation, the positive correlation was found in 50% and 20% in group I and group II, respectively, with remarkable difference between two groups. There were no false positives in cytologic diangosis. The overall concordance rate of cytologic diagnosis with diagnosis of clinical investigation in both benign and malignant lesions was 27.6% and the diagnostic specificity was 100%.

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Diagnostic Accuracy and Evaluation of Myocardial Viability by Cardiac Magnetic Resonance Imaging in Acute Myocardial Infarction: A Comparison with Thallium-201 Myocardial SPECT (급성심근경색증에서의 심장자기공명영상술의 진단 정확도와 심근 생존력 평가: TI-201 심근관류 SPECT와의 비교)

  • Kim Hye-seon;Park Dong Woo;Kim Yongsoo;Kim Young-sun;Choi Yo Won;Jeon Seok Chul;Seo Heung Suk;Hahm Chang Kok;Kim Soon Kil;Ahn You hern;Choi Yoon Young;Park Choong-Ki
    • Investigative Magnetic Resonance Imaging
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    • v.7 no.2
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    • pp.100-107
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    • 2003
  • Purpose : To assess the usefulness of cardiac MR imaging (MRI) in the diagnosis of acute myocardial infarction and in the assessment of myocardial viability in comparision with T1-201 SPECT. Materials and Methods : We retrospectively studied 17 patients who complained of chest pain and dyspnea with cardiac MRI . The patients were evaluated for the presence or absence of high signal intensity on T2-weighted image (T2wI), abnormal wall motion on 2D-FIESTA, perfusion defect on Gd-DTPA enhanced T1WI, and delayed myocardial enhancement on 15-minutes delay Gd-DTPA enhanced T1WI. The results were correlated with the images on T1-201 SPECT, taken at rest and stress, through which reversibility of perfusion defect was assessed. Results : Both cardiac MRI and T1-201 SPECT proved to be useful methods for diagnosing acute myocardial infarction. In order of decreasing correspondence, T2WI, T1-201 SPECT, delayed enhancement study, and wall motion images all showed significant statistical correlation with the clinical diagnosis of myocardial infarction. Perfusion MRI, on the other hand, showed no significant statistical difference was found between T1-201 SPECT and cardiac MRI. The results on T2WI showed high accordance with those on Tl-201 SPECT, while delayed myocardial enhancement and wall motion studies showed no agreement with Tl-201 SPECT. Conclusion : Cardiac MRI is useful method for diagnosis of acute myocardiac infarction. With respect to the assessment of myocardial viability, the results obtained on cardiac MRI showed high agreement with those on Tl-201 SPECT. However, further study is necessary at this point for standardization and establishment of the methods for assessing myocardial viability on cardiac MRI.

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The Efficacy of Rapid Antigen Tests for Detection of Seasonal Influenza Virus (계절 인플루엔자 진단에서 신속항원검사의 유용성)

  • Lee, Jun Yeol;Lee, Sol;Kim, Han Sung;Kim, Kwang Nam
    • Pediatric Infection and Vaccine
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    • v.24 no.1
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    • pp.31-36
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    • 2017
  • Purpose: This study aimed to examine the accuracy of rapid influenza diagnostic tests (RIDT) in children with an influenza-like illness and to evaluate factors associated with greater accuracy. Methods: Pediatric patients, who visited Hallym University Sacred Heart Hospital with an influenza-like illness between June 2011 and May 2016, were enrolled in this study. We tested 798 samples using a real-time polymerase chain reaction (PCR) for respiratory viruses and compared the results with rapid influenza tests. Results: In comparison with the results of the multiplex PCR, the positive agreement rates of RIDT for influenza A and B virus were 75.7% and 60.0%, respectively. The performance of RIDT varied according to days after fever onset. The positive agreement rates of RIDT for influenza A and B tests, performed within 4 days of fever onset, were 77.6% and 73.2%, but the rates for tests performed more than 5 days after fever onset were 66.7% and 21.4%, respectively. Conclusions: The RIDT is a quick and simple aid to diagnosis, but is less sensitive than the labeled sensitivity. Moreover, test performance varied according to days after fever onset. Test specimens for RIDT should be collected as soon as possible after the onset of symptoms (less than 4 days).

Clinical Assessment of Patients with Mandibular Condyle hypoplasia (하악 과두저형성증 환자의 임상적 평가)

  • Yi, Young-Chul;Cho, Bong-Hae;Ok, Soo-Min;Heo, Jun-Young;Kim, Kyung-Hee;Ahn, Young-Woo;Ko, Myung-Yun;Jeong, Sung-Hee
    • Journal of Oral Medicine and Pain
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    • v.38 no.2
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    • pp.175-185
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    • 2013
  • Objective : Condyle hypoplasia in temporomandibular joint(TMJ) is often observed in several radiographic views. Mandibular Condyle hypoplasia is frequently confused with osteoarthritis with bony changes in TMJ. This paper investigated clinical characteristics of mandibular condyle hypoplasia as compared with TMJ osteoarthritis. Material and method : 276 patients with TMD were taken clinical and radiological examination and were divided into study group, 189 patients diagnosed with mandibular condyle hypoplasia, and control group, 87 patients diagnosed with TMJ osteoarthritis. And clinical features(Onset, Overjet, Overbite, Noise, Locking, NAS of noise, LOM, pain, MCO, and site of diagnosis and pain)of the two groups were compared. Results : 1. Mandibular condyle hypoplasia and TMJ osteoarthritis were similar in many of the clinical features. 2. Mandibular condyle hypoplasia concordance rates of the radiographic diagnosis site and the pain site was significantly lower than TMJ osteoarthritis. 3. Bilateral mandibular condyle hypoplasia group had more occlusal discomfort, and clenching habits than unilateral mandibular condyle hypoplasia group. 4. Unilateral mandibular condyle hypoplasia group had more unilateral chewing habits and LOM than unilateral TMJ osteoarthritis group. Unilateral TMJ osteoarthritis group had more morning stiffness and higher concordance rates of the radiographic diagnosis site and the click sound site than unilateral mandibular condyle hypoplasia group. 5. Bilateral mandibular condyle hypoplasia group had more usual headaches and overjet than bilateral TMJ osteoarthritis group. Conclusion : Mandibular condyle hypoplasia has somewhat distinguishing clinical characteristics as compared with TMJ osteoarthritis.

Clinical Studies about diagnostic Yields according to Variable Diagnostic Methods in Lung Cancer (폐암에서 각종 진단수기에 따른 진단율에 관한 연구)

  • Kang, Dae-Song;Cho, Jin-Ung;Kim, Sang-Gyun;Kim, Mi-Ae;Yang, Sung-Uk;Lee, Tae-Quan;Lee, Tae-Hun;Kim, Kwi-Wan
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.6
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    • pp.700-708
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    • 1993
  • Background: Lung cancer has become one of the most common cancers in Korea. It is important to determine the accurate histologic types and stages because of different therapeutic modlaity, especially in small cell carcinoma. This study was designed to evaluate diagnostic yields according to variable diagnostic methods in lung cancer. Methods: The records of 683 patients with a confirmed diagnosis of primary lung cancer during the period of 7 years, from January, 1986 until December, 1992 at Presbyterian Medical Center were analyzed retrospectively. Results: 1) Age and sex distributions Male: female sex ratio was 5.57:1 and age distributions were 7th decade 41.4%, 6th decade 30.2%, 8th decade 17.0%, 5th decade 7.9%, 4th decade 2.5%, 9th decade 1.3%, and 3rd decade 0.2% in decreasing order. 2) The frequencies according to histologic cell types were squamous cell carcinoma 44.7%, small cell carcinoma 23.9%, adenocarcinoma 22.8%, alveolar cell carcinoma 2.5%, large cell carcinoma 1.2%. mixed forms 1.2%, undifferenciated cell carcinoma 0.6% and malignant fibrous histiocytoma 0.2%(1 case) in decreasing order. 3) The most common locations of lung cancer were in left upper lobe and right lower lobe, and no differences of diagnostic methods according to locations were noted. 4) In central lesions, bronchoscopic examination was very accurate and frequently used diagnostic method, and in peripheral lesions, transthoracic lung biopsy(TTLB) was apparent1y accurate method. 5) The diagnostic yields of bronchoscopic biopsy, bronchial brushing, sputum cytology, transthoracic lung biopsy and transbronchial lung biopsy(TBLB) were 81.3%, 57.5%, 31.1%, 69.6% and 61.6%, respectively. 6) The concordance rates between the histologic diagnosis with bronchial brushing and sputum-cytology were 91.3% and 98.4%, respectively. 7) It was appropriate in lung cancer to repeat sputum cytology 3 to 5 times. Conclusion: Bronchoscopic examination is important to determine the histologic cell types in lung cancer. In addition, we should be interrested in improving diagnostic yields of sputum cytology as an easy method.

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Toxoplasma antibody titers by ELISA and indirect latex agglutination test in pregnant women (ELISA 및 간접 latex 응집반응검사에 의한 임산부의 항 톡소포자충 항체가)

  • 류재숙;민득영
    • Parasites, Hosts and Diseases
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    • v.34 no.4
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    • pp.233-238
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    • 1996
  • The seroepidemiologic studies on antral-ToxopIasma antibody titers were carried out using ELISA and indirect latex agglutination test. Among 899 sera prepared from pregnant women, 39 cases (4.3%) revealed positive reaction and 218 sera from middle school students showed 4 positive reaction (1.8%) by ELISA. By LAT (newly established by National Veterinary Research Institute, Korea), the sera of 7 pregnant women (0.8%) showed positive reaction. When 80 sera showing ≥ 1 :8 by LAT were used for comparing the results obtained from LAT and Toxotest-MT (Eikon Chemical Co., Japans, 7 cases and 8 sera were positive, respectively. All of 11 sera of proven toxoplasmosis patients showed positive reaction in both tests. Overall proportion of agreement between LAT kit and Toxotest-MT was 0.94 (K-index : 0.632, p < 0.01), and LAT was considered to be useful for the screening of toxoplasmosis.

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Comparison of the Results of Multistix$^{(R)}$SG and Comber-9-Test$^{(R)}$ RL Urine Dipstick Assay (Multistix$^{(R)}$-SG와 Comgur-9-test$^{(R)}$RL에 의한 요시험지봉검사 성적의 비교)

  • Kim, Dae-Chul;Kim, Kyung-Dong;Jung, Bo-Chan;Kim, Chung-Sook;Cho, Kil-Ho
    • Journal of Yeungnam Medical Science
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    • v.8 no.1
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    • pp.42-52
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    • 1991
  • Two types of urine dipstick assays, Multistix-SG and Combur-9-test RL, were compared for compatibility, accuracy, specificity and predictive values of a positive and negative test in 501 patients urine and artificially prepared specimen. We found that the results of semiquantitative tests of Multistix-SG and Combur-9-Test RL performed were statistically similar in patients specimen. The urinary leukocyte estrase tests of Combur-9-Test RL assays compared with urine sediment microscopy in regard to compatibility, sensitivity, specificity, and predictive values of a positive and negative test 83.7%, 48.1%, 90.3%, 47.4% and 90.1%, respectively. The urinar nitrite tests of Comber-9-Test RL assays compared with urine culture tests, in regard to compatibility, sensitivity, specificity, and predictive values of a positive and negative tests were 90.3%, 19.4%, 84.7%, 53.8% and 94.1%, respectively. For the urinary protein, the sulfosalicylic acid method was the most sensitive test for any kinds of protein, and Multistix-SG appeared more sensitive than Compur-9-Test RL for the albuminuria. For the urinary bilirubin and glusose, two dipstick assays were similar in their diganostic efficiency. Finally in the urinary occult blood tests, Combur-9-Test RL assays was more sensitive than Multistix-SG.

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