• 제목/요약/키워드: Clinical laboratory data

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프로칼시토닌의 수준에 따른 C-반응성단백과 혈구산정검사의 변화 (Changes in C-Reactive Protein and Complete Blood Cell Count According to Procalcitonin Levels)

  • 김진산;박창은
    • 대한임상검사과학회지
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    • 제54권1호
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    • pp.15-22
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    • 2022
  • 프로칼시토닌(procalcitonin, PCT)은 세균성과 바이러스성의 감염을 구별하기 위한 과학적 근거와 진단상의 중요한 단서를 제공한다. 프로칼시토닌이 높은 환자의 임상적 특성과 예후를 조사하고 임상적 진단을 향상시키고자 한다. 프로칼시토닌이 일반적인 집단에서 패혈증의 유병률과 연관성이 있는지를 결정한다. 이에 본 연구는 1년 동안 프로칼시토닌을 검사한 외래 환자(127명)의 C-반응성단백과 혈구산정검사의 결과를 기반으로 후향적 조사연구이다. 분석에 사용된 데이터는 프로칼시토닌, C-반응 단백 그리고 혈구산정검사이다. PCT의 결과가 높은 군의 CRP와 WBC의 양성율은 정상군보다 높게 나타났다(P<0.05). 프로칼시토닌 수준의 특이성과 민감도는 C-반응단백과 백혈구 수준보다 높게 나타났다(P<0.05). 또한. 프로칼시토닌의 결과값을 삼분위한 그룹의 분석에서는 낮은 군과 중간군의 값에 비해 높은 군의 값이 평균보다 높은 것으로 나타났다(P<.001). 상관분석에서는 프로칼시토닌은 C-반응단백, 백혈구(호중구, 림프구 포함)에서 양의 상관성을 보였다(P<.001). 이 연구의 주된 발견은 높은 프로칼시토닌은 C-반응성단백, 백혈구들의 수준에서 높은 연관성을 보이며 진단적 가치를 확인하였다. 따라서 이러한 관련 인자들은 환자의 감염진단과 항생제 치료에 중요한 진단적 및 치료적 영향을 미칠 것으로 사료된다.

소아 일차성 신증후군의 치료반응과 재발빈도에 관련된 인자 (Predictive Clinical Factors for the Treatment Response and Relapse Rate in Childhood Idiopathic Nephrotic Syndrome)

  • 전학수;안병훈;하태선
    • Childhood Kidney Diseases
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    • 제10권2호
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    • pp.132-141
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    • 2006
  • Purpose : This study was aimed to determine the predictive risk factors for the treatment response and relapse rate in children diagnosed with idiopathic nephrotic syndrome. Methods : We analyzed the medical records of children who were diagnosed and treated for childhood idiopathic nephrotic syndrome from November 1991 to May 2005. Variables selected in this study were age at onset, sex, laboratory data, concomitant bacterial infections, days to remission, and interval to first relapse. Results : There were 46 males and 11 females, giving a male:female ratio of 4.2:1. The age($mean{\pm}SD$) of patients was $5.8{\pm}4.1$ years old. Of all patients who were initially given corticosteroids, complete remission(CR) was observed in 54(94.7%). Of the 54 patients who showed CR with initial treatment, 40(70.2%) showed CR within 2 weeks and 14(24.6%) showed CR after 2 weeks. The levels of serum IgG were lower in the latter group who showed CR after 2 weeks(P=0.036). Of the 54 patients who showed CR with initial treatment, 47(82.5%) relapsed. Of these patients, 35.1% were frequent relapsers and 43.9% were infrequent relapsers. There was no significant correlation between the frequency of relapse and the following variables : sex, days to remission, and laboratory data. However, age at onset and interval to first relapse had a negative correlation with the frequency of relapse(Pearson's coefficient=-0.337, -0.433, P<0.012, P<0.01). Conclusion : The age at onset and the interval to first relapse were found to be predictive clinical parameters for the relapse rate, while the levels of serum IgG at initial presentation were a predictive laboratory factor for treatment response in childhood idiopathic nephrotic syndrome.

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Safe Discharge Criteria After Curative Gastrectomy for Gastric Cancer

  • Guner, Ali;Kim, Ki Yoon;Park, Sung Hyun;Cho, Minah;Kim, Yoo Min;Hyung, Woo Jin;Kim, Hyoung-Il
    • Journal of Gastric Cancer
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    • 제22권4호
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    • pp.395-407
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    • 2022
  • Purpose: This study aimed to investigate the relationship between clinical and laboratory parameters and complication status to predict which patients can be safely discharged from the hospital on the third postoperative day (POD). Materials and Methods: Data from a prospectively maintained database of 2,110 consecutive patients with gastric adenocarcinoma who underwent curative surgery were reviewed. The third POD vital signs, laboratory data, and details of the course after surgery were collected. Patients with grade II or higher complications after the third POD were considered unsuitable for early discharge. The performance metrics were calculated for all algorithm parameters. The proposed algorithm was tested using a validation dataset of consecutive patients from the same center. Results: Of 1,438 patients in the study cohort, 142 (9.9%) were considered unsuitable for early discharge. C-reactive protein level, body temperature, pulse rate, and neutrophil count had good performance metrics and were determined to be independent prognostic factors. An algorithm consisting of these 4 parameters had a negative predictive value (NPV) of 95.9% (95% confidence interval [CI], 94.2-97.3), sensitivity of 80.3% (95% CI, 72.8-86.5), and specificity of 51.1% (95% CI, 48.3-53.8). Only 28 (1.9%) patients in the study cohort were classified as false negatives. In the validation dataset, the NPV was 93.7%, sensitivity was 66%, and 3.3% (17/512) of patients were classified as false negatives. Conclusions: Simple clinical and laboratory parameters obtained on the third POD can be used when making decisions regarding the safe early discharge of patients who underwent gastrectomy.

복부비만 고령여성의 대사증후군 위험요인과 고감도 C-반응성 단백의 관련성 (The Relationship between Metabolic Syndrome Risk Factors and High Sensitive C-reactive Protein in Abdominal Obesity Elderly Women)

  • 신경아
    • 대한임상검사과학회지
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    • 제49권2호
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    • pp.121-127
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    • 2017
  • 이 연구에서는 복부비만을 가진 고령여성을 대상으로 대사증후군 동반 유무에 따른 대사증후군 위험요인과 hs-CRP와의 관련성에 대해 알아보고자 하였다. 대사증후군 진단은 AHA/NHLBI (American Heart Association/National Heart, Lung and Blood Institute) 2005년 기준에 따라 5가지 기준 중 3개 이상 해당되는 경우 대사증후군 진단군(MetS, N=77), 2개이하의 위험요인에 해당하는 경우 대조군(Absent, N=97)으로 분류하였다. hs-CRP 농도는 대사증후군 위험요인과 밀접한 관련이 있으며, 특히 복부비만(r=0.190, p=0.014), 공복혈당(r=0.240, p=0.002), HDL-콜레스테롤(r=-0.164, p=0.035)과 연관이 있음을 확인할 수 있었다. 또한 대조군보다 대사증후군 진단군에서 hs-CRP가 높게 나타났으며(p=0.007), 복부비만 상태일지라도 높은 혈당(p=0.006)과 낮은 HDL-콜레스테롤혈증(p=0.010)의 위험요인이 있는군에서 hs-CRP가 높았다. 결론적으로 복부비만이 있더라도 대사증후군 위험요인의 동반 유무에 따라 염증관련 위험도가 달라짐을 알 수 있었다.

Molecular Detection and Subtyping of Human Blastocystis and the Clinical Implications: Comparisons between Diarrheal and Non-diarrheal Groups in Korean Populations

  • Kim, Moon-Ju;Won, Eun Jeong;Kim, Soo Hyun;Shin, Jong Hee;Chai, Jong-Yil
    • Parasites, Hosts and Diseases
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    • 제58권3호
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    • pp.321-326
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    • 2020
  • Blastocystis has recently been recognized as the most common eukaryotic microbe of the human gut. We investigated the prevalence of Blastocystis and their subtypes in diarrheal and non-diarrheal groups and the associated clinical parameters. A total of 324 stool samples were obtained from 196 diarrheal and 128 non-diarrheal subjects. Blastocystis subtypes were determined by sequencing the small subunit ribosomal DNA (SSU rRNA) gene. Demographic, clinical and laboratory data were collected and analyzed by diarrhea and Blastocystis status. The overall rate of Blastocystis positivity was 9.0% (29/324) but was significantly higher in the non-diarrheal group (18.0% vs. 3.1%, P<0.0001). Of the 6 Blastocystis-positive diarrheal patients, 3 (50.0%), none (0.0%), 2 (33.3%), and 1 (16.7%) were infected with subtypes ST1, ST2, ST3, and multiple subtypes, respectively. Of the 23 Blastocystis-positive non-diarrheal patients, 4 (17.4%), 1 (4.3%), and 18 (78.3%) were infected with subtypes ST1, ST2, and ST3, respectively. Blastocystis was less common in the diarrheal than the non-diarrheal group (odds ratio, 0.144; 95% confidence interval, 0.057-0.365, P<0.001). Of the 3 subtypes, ST3 was more frequently observed in the non-diarrheal than diarrheal group (78.3% vs. 33.3%, P=0.0341). Collectively, Blastocystis was found in both the diarrheal and non-diarrheal groups and ST3 was the most common subtype in Korea.

Cytomegalovirus Infection among Pregnant Women in Beijing: Seroepidemiological Survey and Intrauterine Transmissions

  • Jin, Qing'e;Su, Jianrong;Wu, Shanna
    • Journal of Microbiology and Biotechnology
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    • 제27권5호
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    • pp.1005-1009
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    • 2017
  • Primary cytomegalovirus (CMV) infection during pregnancy can cause congenital defects. Available data for CMV infection during pregnancy in north China are inadequate. The aim of this study was to evaluate the epidemiology of maternal CMV infection and explore the incidence of congenital infection. In this prospective study, serum CMV IgG and IgM antibodies were measured in 2,887 pregnant women using ELISA, and the IgG avidity test was performed on all IgM-positive subjects. The seroprevalence of anti-CMV IgG was 94.70%, and of anti-CMV IgM was 1.28%. CMV IgG prevalence increased significantly with age (p < 0.01). Women living in downtown areas showed higher IgG prevalence than those residing in urban areas (p = 0.023). CMV-IgM seroprevalence was highest in autumn (p = 0.021). There was no difference in IgM seroprevalence by age, socioeconomic status, geographical area, or gravida. The rate of primary CMV infection was 0.45% (13/2,887) at the first trimester. The seroconversion rate during pregnancy was 0.76% (22/2,887). One woman underwent seroconversion during pregnancy and gave birth to an infant with asymptomatic CMV infection. Congenital CMV infection was diagnosed in five of the 14 infants from 14 mothers with active infection, for a vertical transmission rate of 35.71% (5/14). Three infants were asymptomatic, whereas two infants presented symptomatic infection with hearing deficits. Although CMV IgG prevalence is relatively high in north China, significant attention to primary CMV infection during pregnancy is still needed.

Gene Expression of CYP1A1 and its Possible Clinical Application in Thyroid Cancer Cases

  • Gallegos-Vargas, JA;Sanchez-Roldan, J;Ronquillo-Sanchez, MD;Carmona-Aparicio, L;Floriano-Sanchez, E;Cardenas-Rodriguez, N
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권7호
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    • pp.3477-3482
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    • 2016
  • Background: Thyroid cancer is the most common endocrine malignancy, and exact causes remain unknown. The role of CYP450 1A1 (CYP1A1) in cancer initiation and progression has been investigated. The aim of this work was to analyze, for the first time, CYP1A1 gene expression and its relationship with several clinicopathological factors in Mexican patients diagnosed with thyroid cancer. Materials and Methods: Real-time PCR analysis was conducted on 32 sets of thyroid tumors and benign pathologies. Expression levels were tested for correlations with clinical and pathological data. All statistical analysis were performed using GraphPad Prism version 3.0 software. Results: We found that female gender was associated with thyroid cancer risk (P<0.05). A positive relationship was identified between CYP1A1 mRNA levels and the presence of chronic disease, alcohol use, tumor size, metastasis and an advanced clinical stage (P<0.05). Conclusions: The results suggest that CYP1A1 gene expression could be used as a marker for thyroid cancer.

Mice에서 Calcein 표지를 이용한 골 변화 관찰 (Bone Changes in Femoral Bone of Mice Using Calcein Labeling)

  • 심문정
    • 대한임상검사과학회지
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    • 제48권2호
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    • pp.114-117
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    • 2016
  • 골은 일생에 걸쳐 지속적인 재형성과장을 거치면서 유지되고 이러한 기전에 대한 연구는 골다공증을 비롯한 골대사 질환의 병태생리와 치료에 있어 큰 진전을 이루고 있다. 특히 생체 내 골형성 및 재생과정을 연구하는데 있어 형광표지자를 이용하는 방법이 널리 알려져 있는데, 그 중 calcein은 칼슘 킬레이터로 골이 새롭게 형성하는 부위에 녹색을 띔으로써 유용한 마커로 사용된다. 그러나 대부분의 골형성 연구에서 실험동물의 경우 표본제작을 할 때 크기가 작고 뼈가 부숴지기 쉬워 rat이나 rabbit을 이용하였으며, mice의 femur를 cross-section해서 관찰한 연구는 거의 없는 실정이다. 그래서 본 연구에서는 어린 mice를 실험동물로 이용하였으며, 생체 내 calcein을 4주간, 8주간 투여한 후 골 형성 변화를 형광현미경으로 관찰한 결과 8주차 쥐에서 4주차보다 진하고 골 형성 간격도 넓게 관찰된 것을 확인 할 수 있었다. Mice는 빠른 시일 내에 결과를 얻을 수 있고 부작용이 적은 장점이 있어서 앞으로 knock-out mice를 이용한 생체 내 실험에 활용하기 적합하다고 생각되며, 골형성 속도 평가 등 다양한 분야에서의 골 형성과 재생연구에 있어 기초 정보를 제공할 것으로 기대한다.

약물검사 키트의 분석 민감도에 대한 연구 (A Study of Analytical Sensitivity on TDM Test Kit in Clinical Chemistry)

  • 장상우;김남용;이희경;김현정;이윤정;진옥배;김미경
    • 대한임상검사과학회지
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    • 제36권2호
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    • pp.127-130
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    • 2004
  • Analytical sensitivity on TDM test is the lowest concentration that can be distinguished from background noise. The aim of study was to evaluate analytical sensitivity that is also referred to as the lower limit of detection(LLD) about difference between zero calibrator and isotonic saline sample. We tested for 10 days with zero calibrators and 0.85% saline samples while running trilevel control samples under control. Raw data divided by two groups calculated mean and standard deviation from two sample populations and analytical sensitivity by ${\bar{X}}+2SD$. In comparison with isotonic saline samples and zero calibrators, there were significant differences in phenytoin, phenobarbital and vancomycin, etc. Especially analytical sensitivity on phenytoin is at the same level as the upper limit of analytical measurement range with $40{\mu}g/mL$. We think the cause of this is matrix interference. In conclusion, we were sure that standard protocol for analytical sensitivity as lower limit of analytical measurement range on TDM test must be measured with zero standard rather than an isotonic saline sample and type 1 reagent DW for reducing matrix effects within interactions between different materials in a mixture.

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Predictive value of C-reactive protein in response to macrolides in children with macrolide-resistant Mycoplasma pneumoniae pneumonia

  • Seo, Young Ho;Kim, Jang Su;Seo, Sung Chul;Seo, Won Hee;Yoo, Young;Song, Dae Jin;Choung, Ji Tae
    • Clinical and Experimental Pediatrics
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    • 제57권4호
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    • pp.186-192
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    • 2014
  • Purpose: The prevalence of macrolide-resistant Mycoplasma pneumoniae (MRMP) has increased worldwide. The aim of this study was to estimate the proportion of MRMP in a tertiary hospital in Korea, and to find potential laboratory markers that could be used to predict the efficacy of macrolides in children with MRMP pneumonia. Methods: A total of 95 patients with M. pneumoniae pneumonia were enrolled in this study. Detection of MRMP was based on the results of specific point mutations in domain V of the 23S rRNA gene. The medical records of these patients were reviewed retrospectively and the clinical course and laboratory data were compared. Results: The proportion of patients with MRMP was 51.6% and all MRMP isolates had the A2063G point mutation. The MRMP group had longer hospital stay and febrile period after initiation of macrolides. The levels of serum C-reactive protein (CRP) and interleukin-18 in nasopharyngeal aspirate were significantly higher in patients who did not respond to macrolide treatment. CRP was the only significant factor in predicting the efficacy of macrolides in patients with MRMP pneumonia. The area under the curve for CRP was 0.69 in receiver operating characteristic curve analysis, indicating reasonable discriminative power, and the optimal cutoff value was 40.7 mg/L. Conclusion: The proportion of patients with MRMP was high, suggesting that the prevalence of MRMP is rising rapidly in Korea. Serum CRP could be a useful marker for predicting the efficacy of macrolides and helping clinicians make better clinical decisions in children with MRMP pneumonia.