• Clinical and Experimental Pediatrics
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• v.45 no.4
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• pp.489-497
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• 2002

Purpose : The objectives of this study were to investigate the causes of chronic cough and to establish the appropriate diagnostic approach to chronic cough in children. Methods : One hundred and thirty two cases of chronic cough were prospectively evaluated. They visitors to pediatric chronic cough clinics at Kang-nam saint Mary's Hospital of Catholic University from August 2000 to July 2001 for 12 months. Careful history taking by questionnaire, physical examination, radiologic studies of chest and sinus, hematologic and immunologic studies, allergic skin tests, and methacholine challenge tests were performed. Color doppler(CD) ultrasonography were performed and compared with simultaneous 24 Hr. esophageal pH monitoring to diagnose gastroesophageal reflux disease(GERD). Results : Age distributions were demonstrated that nine in infants, 82 in early childhood, 38 in late childhood, and three in adolescence. Common causes of chronic cough were bronchial asthma in 40 cases, chronic sinusitis in 22 cases, GERD in seven cases, bronchial asthma combined with sinusitis in 28 cases, bronchial asthma combined with GERD in 14 cases, psychogenic cough in two. cases, foreign body in one case, chronic bronchitis in one case, and bronchiolitis in one case. Comparing with 24 Hr. pH monitoring, sensitivity, specificity, positive predictive value and negative predictive values of CD ultrasonography were 88%, 69%, 85 %, and 73% respectively. Conclusion : The most common causes of chronic cough in children were bronchial asthma, sinusitis and GERD in order. We suggest that CD ultrasonography can be used as a good, convenient screening method for patients with suspected GERD in outpatient settings.

• Pediatric Infection and Vaccine
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• v.6 no.1
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• pp.93-100
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• 1999

Purpose : For evaluation of acute Mycoplasma pneumoniae(M. pneumoniae) pneumonia in children, we have studied the Mycoplasma indirect particle agglutination test, cold hemagglutinin test, ESR, CRP, and total white blood cell counts and it's differential count retrospectively. Methods : The total numbers of patients whom compatible with diagnostic criteria of acute M. pneumoniae peumonia were 56 cases from Jan. to Dec. 1997. The diagnostic criteria were 1) onset of fever(${\geq}38.0^{\circ}C$) and coughing were within 7 days, 2) rhonchi and/or role was audible on chest, 3) pneumonic infiltration on chest X-ray, and 4) M. pneumoniae indirect particle agglutination test titer was higher than 1:640, or initial titer was less than 1:640 but increased more than 4 folds after week. We classified the enrolled patients according to initial antibody titer, such as soup A(${\leq}1:640$) and group B(${\geq}1:320$). We compared group A and B by demographic findings, clinical symptoms and signs, and laboratory findings. Results : 1) The male and female sex ratio was 1:1.4, and average onset age was $5.8{\pm}2.96$ years. 2) The average body temperature on admission was $38.5{\pm}0.1^{\circ}C$ and productive coughing was noticed in 52 cases(93%). 3) The average total white cell counts were $10,470{\pm}877.0/mm^3$ in group B patients, which was significantly higher compared to $7,761{\pm}508.5/mm^3$ in group A(p<0.014). 4) The average value of ESR and CRP were within normal range in both group. 5) The most common site of pneumonic infiltration was right lower lobe of lung in both groups. 6) There were no correlation between antibody titer and cold hemagglutinine titer in patients and cold hemagglutination titer were less than 1:64 in 25 cases(45%). Conclusion : The clinical manifestations of pneumonia, findings of chest x-ray, and indirect particle agglutination test were useful on diagnosis of M. pneumoniae pnumonia onset within 7 days, but cold hemagglutinin test was a little diagnostic meaning.

• Progress in Medical Physics
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• v.18 no.2
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• pp.98-106
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• 2007

In June 2005, Yonsei University Medical Center, Severance Hospital upgraded a full-PACS system by adding twenty (5 mega pixels) Totoku ME511L flat panel LCD display devices for diagnostic interpretation purposes. Here we report upon the quantitative (or visual) acceptance testing of the twenty Totoku ME511L display devices for reflection, luminance response, luminance spatial dependency, resolution, noise, veiling glare, and display chromaticity based on AAPM TG 18 report. The tools used in the tests included a telescopic photometer, which was used as a colorimeter, illuminance meter, light sources for reflection assessment, light-blocking devices, and digital TG18 test patterns. For selected 8 flat panel displays, mean diffuse reflection coefficient ($R_d$) was $0.019{\pm}0.02sr^{-1}$. In the luminance response test, luminance ratio (LR), maximum luminance difference ($L_{max}$), and deviation of contrast response were $550{\pm}100,\;2.0{\pm}1.9%\;and\;5.8{\pm}1.8%$, respectively. In the luminance uniformity test, maximum luminance deviation was $14.3{\pm}5.5%$ for the 10% luminance of the TG18-UNL10 test pattern. In the resolution test with luminance measurement method, percent luminance (${\Dalta}L$) at the center was $0.94{\pm}0.64%$. In all cases of noise testing, rectangular target In every square in the three quadrants was visible and all 15 targets except the smallest one in the every corner pattern and the center pattern. The glare ratio (GR) was $12,346{\pm}1,995$. The color uniformity, (u',v'), was $0.0025{\pm}0.0008$. Also, the research results of qualify control guideline of primary disply devices suitable for domestic circumstance are presented All test results are in-line with the criteria recommended by AAPM TG18 report and are thus fully acceptable for diagnostic image interpretation. As a result, the acceptance testing schedule described provides not only an acceptance standard but also guidelines for quality control, optimized viewing conditions, and a means for determining the upgrading time of LCD display devices for diagnostic interpretation.

• Tuberculosis and Respiratory Diseases
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• v.46 no.4
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• pp.473-480
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• 1999

Background: Early diagnosis of tuberculosis is critical, especially in Korea, an area where tuberculosis is endemic. Because antibody responses to some membrane proteins of Mycobacterium tuberculosis are not comparable, and the policy of BCG vaccination and the prevalence of tuberculosis are different from country to country, the usefulness of the serological diagnostic tests is questionable in Korea, even though they have been confirmed to be useful in other countries. In the specific context of Korea, we tried to evaluate the validity of the ICT Tuberculosis Test (ICT), a membrane-based antibody kit that purports to detect the 5 M. tuberculosis complex-specific antigens including 38-kDa protein. Method: 68 patients with tuberculosis were tested : 37 had no history of previous tuberculosis, and 31 were reactivated cases. The control group comprised 77 subjects : 25 healthy adults, 35 hospital workers with frequent contact with tuberculosis patients, and 17 in-patients with non-tuberculous respiratory diseases. Results: The diagnostic sensitivities of the ICT were 87% and 73% in patients with versus without previous history of tuberculosis, respectively. The sensitivities of smear-positive and smear-negative patient groups were 81% and 73%, respectively. Both of the two patients with extrapulmonary tuberculosis tested positive through the ICT. The specificities of the ICT were 88%, 94%, and 94% in healthy adults, hospital workers, and non-tuberculous patients, respectively, with an overall specificity of 92%. Conclusion: It is suggested that when combined with traditional techniques, the ICT is an useful tool for the diagnosis of pulmonary tuberculosis. The procedure is simple, easy to perform, rapid, and needs no equipment. It shows 73% sensitivity and 92% specificity for the diagnosis of tuberculosis.

• Tuberculosis and Respiratory Diseases
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• v.47 no.6
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• pp.735-746
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• 1999

Background: As the prevalence of nontuberculous mycobacteriosis has been increasing rapidly, there has been recent advance in diagnostic methods and drug therapies for disease. Although the incidence of pulmonary disease caused by nontuberculous mycobacteria(NTM) has been increasing in Korea since 1990, detailed clinical description about the disease were very few. In this study we described the clinical manifestations, radiologic findings, and therapeutic outcomes of nontuberculous mycobacterial pulmonary disease. Methods: Medical records and radiologic findings were retrospectively reviewed in 27 patients who were fulfilled the diagnostic criteria of ATS guideline for NTM pulmonary disease between January of 1990 and August of 1998 in Seoul National University Hospital(SNUH). Results: Of the 27 patients, 15 were male. The mean age was 51.5 yr($\pm$11.9). Twenty patients(74.1%) had preexisting pulmonary diseases. Among them, 19 patients had previous pulmonary tuberculosis. Sixteen patients(59.2%) had cavitary lesions and the majority showed slow progression over 1 yr during follow up period on radiography. Susceptibility test to standard antituberculous drugs showed 100% resistance to INH, 72.2% to RMP, 81.5% to EMB, 92.6% to PZA. The average resistance rate to 2nd-line antituberculous drugs was 66.1%. Among twenty-one patients(77.8%) who received drug therapy over 6 months, 11 subjects were improved and 10 subjects were aggravated. Of six subjects(22.2%) without therapy, 5 patients were aggravated. Presence of cavity and less than 3 sensitive drugs in the regimen were indicators for adverse outcome. Conclusion : The nontuberculous mycobacterial pulmonary diseases in our hospital developed predominantly in older patients with preexistent pulmonary disease. The results of antituberculous drug therapy has been frustrating and disappointing. To improve treatment response, different susceptibility tests and drug regimens for different species of NTM should be performed. Also, diagnostic and therapeutic guidelines of Korea should be made in the recent future.

• Tuberculosis and Respiratory Diseases
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• v.45 no.2
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• pp.280-289
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• 1998

Background: It is sometimes difficult to differentiate tuberculous pleural effusion from malignant pleural effusion by clinical symptoms, signs, by routine tests of pleural fluid, and by pathologic studies. And recently, it was discovered that cytokines such as IL-2, IFN-$\gamma$, TNF-$\alpha$ are elevated in tuberculous pleural fluid, and there have been several attempts to diagnose tuberculous pleural effusion by using these immunological mediators. There are several studies regarding the diagnostic value of IFN-$\gamma$, and there are two studies in Korea. But the diagnostic values of IFN-$\gamma$ in these studies were slightly lower than those in other countries. To compare the diagnostic value of IFN-$\gamma$ with those of CEA and ADA, and to determine the sensitivity and specificity of IFN-$\gamma$ in Korean, we mesured IFN-$\gamma$, CEA level and ADA activity in pleural effusions. Methods: ADA activity, IFN-$\gamma$ level and CEA level as well as cell count, differential count, and biochemical assays such as protein content and lactate dehydrogenase were measured in 40 cases of tuberculous pleuritis and 42 cases of malignant pleural effusion. Results: Tuberculous pleural fluid showed higher levels of IFN-$\gamma$ and ADA ($832.6{\pm}357.2$ pg/ml and $82.5{\pm}25.9$ U/L, respectively) than those of malignant pleural effusion ($2.6{\pm}8.0$ pg/ml and $19.2{\pm}10.9$ U/L, respectively) (p<0.01). Malignant pleural effusions showed higher median value (102.2 ng/ml) than tubercalous pleural effusions (1.8 ng/ml) (p<0.01). The sensitivities of IFN-$\gamma$, ADA, CEA were 0.97, 0.87, 0.67 and the specificities of IFN-$\gamma$, ADA, CEA were 1.0, 0.97, 1.0, respectively. There was no significant correlation between ADA activity and IFN-$\gamma$ level. Conclusion: This study showed that IFN-$\gamma$ test would be a very useful clinical test for differential diagnosis of tuberculous pleuritis and malignant pleural effusion because it is very sensitive and specific, although it is an expensive test.

• Journal of radiological science and technology
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• v.35 no.2
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• pp.93-102
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• 2012

Thanks to the rapid increase of the interest in the quality control of the General X-ray systems, this research proposes the direction of the quality control through comparing and inspecting the actual condition of the respective quality control in the Clinic, the educational institution and the hospital. The subjects of the investigation are diagnostic radiation equipment's in the clinic, the educational institution and the hospital around the capital. A test of kVp, mR/mAs out put test and reproducibility of the exposure dose, half value layer, an accordance between the light field and the beam alignment test, and lastly reproducibility of the exposure time. Then the mean difference of the percentage, the CV (Coefficient of Variation, CV) and the attenuated curve which are respectively resulted from the above tests are computed. After that we have evaluated the values according to the regulations on the Diagnostic Radiation Equipment Safety Administration regulations. In the case of the clinic and the educational institution, there were 22 general X-ray devices. And 18.2% of the kVp test, 13.6% of the reproducibility of exposure dose test, 9.1% of the mR/mAs out put test, and 13.6% of the HVL (Half Value Layer) test appeared to be improper. In the case of the hospital, however, there were 28 devices. And 7.1% of the reproducibility of exposure dose, 7.1% of the difference in the light field/ beam alignment, and 7.1% of the reproducibility of the exposure time appeared to be improper. According to the investigation, the hospital's quality control condition is better than the condition in the clinic and the educational institution. The quality control condition of the general X-ray devices in the clinic is unsatisfactory compared to the hospital. Thus, it is considered that realizing the importance of the quality control is necessary.

• The Korean Journal of Nuclear Medicine
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• v.36 no.4
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• pp.232-243
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• 2002

Purpose: We studied whether brain perfusion SPECT is useful in the psychiatric disability evaluation of patients with chronic traumatic brain injury (TBI). Materials and Methods: Sixty-nine patients (M:F=58:11, age $39{\pm}14$ years) who underwent Tc-99m HMPAO brain SPECT, brain MRI and neuropsychological (NP) tests during hospitalization in psychiatric wards for the psychiatric disability evaluation were included; the severity of injury was mild in 31, moderate in 17 and severe in 21. SPECT, MRI, NP tests were peformed $6{\sim}61$ months (mean 23 months) post-injury. Diagnostic accuracy of SPECT and MRI to show hypoperfusion or abnormal signal intensity in patients with cognitive impairment represented by NP test results were compared. Results: Forty-two patients were considered to have cognitive impairment on NP tests and 27 not. Brain SPECT showed 71% sensitivity and 85% specificity, while brain MRI showed 62% sensitivity and 93% specificity (p>0.05, McNemar test). SPECT found more cortical lesions and MRI was superior in detecting white matter lesions. Sensitivity and specificity of 31 mild TBI patients were 45%, 90% for SPECT and 27%, 100% for MRI (p>0.05, McNemar test). Among 41 patients with normal brain MRI, SPECT showed 63% sensitivity (50% for mild TBI) and 88% specificity (85% for malingerers). Conclusion: Brain SPECT has a supplementary role to neuropsychological tests in the psychiatric disability evaluation of chronic TBI patients by detecting more cortical lesions than MRI.

• Pediatric Infection and Vaccine
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• v.30 no.3
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• pp.121-128
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• 2023

Purpose: This study aimed to investigate the recent age distribution of Mycoplasma pneumoniae in patients with respiratory infections and the differences in diagnostic usefulness according to the methods used in these patients. Methods: We retrospectively reviewed the medical records of patients aged ≤18 years with respiratory infectious diseases who underwent polymerase chain reaction (PCR) or a specific immunoglobulin M (IgM) test between July 2016 and February 2019. The diagnosis of M. pneumoniae infection was confirmed by a positive result in the PCR or IgM test. Results: Of the 2,721 patients tested for M. pneumoniae, 2,197 underwent IgM, and 1,144 underwent PCR, with positivity rates of 17% and 20%, respectively. Among the 620 patients tested for both IgM and PCR tests simultaneously, 35% had M. pneumoniae infection, with 14% under 1 year old and 13% under 1-2 years old. The positive rate increased with age in both tests. Higher positive rates were observed in the IgM test before 3 years of age and in the PCR test after 3 years of age. The agreement rate between the two tests was 77.9% (Cohen's kappa 0.402). Conclusions: As age increased, the rates of M. pneumoniae infection also increased. In patients under 2 years of age, 4¬-14% of infections were confirmed depending on the method used. The moderate agreement between the PCR and IgM tests suggests that the simultaneous use of PCR and the IgM test for the early diagnosis should be approached with caution.

• The Korean Journal of Nuclear Medicine
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• v.12 no.1
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• pp.17-28
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• 1978

A simplified photoelectric apparatus producing graphic records of the free Achilles tendon reflex allowed us to study the reflex quantitatively in subjects with normal and abnormal thyroid function. In this study Achilles tendon reflex times were tested in 340 normal Korean persons, 89 hyperthyroid patients, 19 hypothyroid patients and 85 other thyroid disease patients who were euthyroid in thyroid function tests. In normal Korean persons, the Achilles tendon reflex time was delayed with increasing age and slower in female than in male. They showed good correlationship with various thyroid function tests which included ETR, $T_3RU,\;^{131}I$ thyroid uptake and serum TSH. Diagnostic accuracy of them was 71% in hyperthyroidism and 90% in hypothyroidism. Finally the serial measurements of them were very useful tests in evaluating the clinical coures of hyperthyroidism and hypothyroidism once treatment was begun.