The performance values of available techniques used in serodiagnosis of toxoplasmosis are satisfactory but they raise problems of equivocal and discordant results for very low IgG titers. Recently marketed, LDBio-Toxo II IgG Western blot (IB) showed an excellent correlation with the dye test. We estimated the proportion of equivocal and discordant results between the enzyme immunoassay Platelia Toxo IgG (EIA-IgG) and fluorescent antibody test (FAT) and assessed the usefulness of the IB as a confirmatory test. Out of 2,136 sera collected from pregnant women, 1,644 (77.0%) tested unequivocally positive and 407 (19.0%) were negative in both EIA-IgG and FAT. The remaining 85 (4%) sera showed equivocal or discordant results. Among them, 73 (85.9%) were positive and 12 (14.1%) were negative in IB. Forty-one (89.1%) equivocal sera in EIA-IgG and 46 (86.8%) equivocal sera in FAT were positive in IB. Reducing the cut-off values of both screening techniques improved significantly their sensitivity in detecting very low IgG titers at the expense of their specificity. In conclusion, equivocal results in routine-used techniques and their discordance in determination of the immune status in pregnancy women were not uncommon. IB test appeard to be highly useful in these situations as a confirmatory technique.
This study was conducted to evaluate changes in nutritional knowledge, attitudes, behavior intention and behavior in a sample of 27 insulin dependent diabetic students participating in diabetics' camp. Nutritional knowledge related to diabetes, attitudes toward diabetes treatment and behavior intention about dietary changes were tested before and after nutrition education. Six months after nutrition education, an open ended questionnaire about their actual behavior changes was mailed to all participants and 17 of them responded. Pre-and post-testing showed that nutrition education was effective in significant changes in knowledge and in promoting positive attitudes and behavior intention. Increases of knowledge were consistently the same regardless of sex, level of education, regularity of diet, and duration of disease. Compared to male students, female students showed more positive change in knowledge, attitudes and behavior intention. It also appeared that middle school students showed more positive improvement in knowledge, attitudes and behavior than elementary and high school students. A follow-up test showed that their actual behavior changes were not squared with their behavior intention. They pointed out difficulties in having proper amount of meals and snack and the conflict with school time schedule as the major reason for discordance. These findings suggest that nutrition education for diabetics can be effective to improve their knowledge, attitudes and behavior intention and understanding about barriers to behavior change is important for better compliance to the disease.
Purpose: Recent advancements in molecular techniques have greatly contributed to the discovery of genetic causes of unexplained developmental delay. Here, we describe the results of array comparative genomic hybridization (CGH) and the clinical features of 27 patients with global developmental delay. Methods: We included 27 children who fulfilled the following criteria: Korean children under 6 years with global developmental delay; children who had at least one or more physical or neurological problem other than global developmental delay; and patients in whom both array CGH and G-banded karyotyping tests were performed. Results: Fifteen male and 12 female patients with a mean age of $29.3{\pm}17.6months$ were included. The most common physical and neurological abnormalities were facial dysmorphism (n=16), epilepsy (n=7), and hypotonia (n=7). Pathogenic copy number variation results were observed in 4 patients (14.8%): 18.73 Mb dup(2)(p24.2p25.3) and 1.62 Mb del(20p13) (patient 1); 22.31 Mb dup(2) (p22.3p25.1) and 4.01 Mb dup(2)(p21p22.1) (patient 2); 12.08 Mb del(4)(q22.1q24) (patient 3); and 1.19 Mb del(1)(q21.1) (patient 4). One patient (3.7%) displayed a variant of uncertain significance. Four patients (14.8%) displayed discordance between G-banded karyotyping and array CGH results. Among patients with normal array CGH results, 4 (16%) revealed brain anomalies such as schizencephaly and hydranencephaly. One patient was diagnosed with Rett syndrome and one with $M{\ddot{o}}bius$ syndrome. Conclusion: As chromosomal microarray can elucidate the cause of previously unexplained developmental delay, it should be considered as a first-tier cytogenetic diagnostic test for children with unexplained developmental delay.
Turhal, Nazim Serdar;Demirhan, Salih;Satici, Celal;Cinar, Caner;Kinar, Abdullah
Asian Pacific Journal of Cancer Prevention
/
v.14
no.8
/
pp.4515-4518
/
2013
Background: This study was planned to investigate the personality traits of cancer patients in different treatment settings, and to correlate the demographics with the personality features. Materials and Methods: A total of 237 patients referred either to Marmara University School of Medicine (MUSM) Oncology Outpatient Unit or to the private office of the faculty between March 10th and April 22nd, 2010 were enrolled in the study. The Big Five Mini Test was used to evaluate the 40 personality traits of the patients. Results: The study group consisted of 98 males (41.35%) and 139 females (58.65%) with a mean age of 51. Out of the 237, 73.9% had an educational level beyond the junior high school, and 47.3% of all patients reported a positive family history for cancer. A significant difference in terms of reconcilability, extraversion, and responsibility was observed between patients admitting to the university outpatient clinic and the private office (p<0.05). Reconcilability and extraversion were found to differ between genders significantly (p<0.05). The description of the patients by him/herself or by relatives displayed a significant difference in terms of openness (p<0.05). Parameters such as educational level, family history of cancer, age and marital status showed no relevance to their characters. No discordance was observed between the self-analysis of the patient and the patient's relatives. Conclusions: Patients with cancer are typically highly reconcilable and responsible, moderately stable, open and extraverted.
Purpose: There is a the great diagnostic challenge in pediatric tuberculosis especially in high burden setting. The purpose of this preliminary study is to evaluate the agreement between tuberculin skin test (TST) and interferon-gamma release assay (IGRA) including T-SPOT$^{(R)}$.TB and QuantiFERON$^{(R)}$-TB Gold (QFT-G) in Korean children. Method: This retrospective study included children and adolescents who visited to Asan Medical Center to evaluate tuberculosis infection using at least two assays of TST, T-SPOT.TB and QFT-G, from January 2014 to April 2015. Results: A total of 20 patients were included, whose median age was 13.3 years (range, 3.8-18.1 years), and all of them had history of BCG vaccination. Eleven patients had underlying diseases including 7 patients with immunosuppressant medication. The concordance rate between T-SPOT.TB and QFT-G was 90%. However, the concordance rate between TST and T-SPOT.TB was 50%, and between TST and QFT-G was 42.9%. Specificity for the diagnosis of tuberculosis infection of T-SPOT.TB, QFT-G, and TST was 93.3%, 86.7%, and 58.3%, respectively. Conclusions: Although there was a discrepancy between TST and IGRA to diagnose tuberculosis, agreement between T-SPOT.TB and QFT-G was relatively high. Further prospective study to validate the clinical usefulness of each assay for immunologic evidence of tuberculosis infection in Korean children will be mandatory.
Park, Kang-Gyun;Yu, Young-Bin;Yook, Keundol;Kim, Sang-Ha;Kim, Sunghyun;Kim, Young Kwon
Korean Journal of Clinical Laboratory Science
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v.49
no.3
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pp.279-284
/
2017
The results of rapid antimicrobial susceptibility test (AST) in blood cultures were obtained by inoculating the bacteria directly into the VITEK MS and the VITEK 2 systems without subculturing in the blood culture positive medium. The obtained results were compared with the results using a standard method to evaluate their reliability and accuracy. The direct AST results in blood culture positive specimens were 97.9% (1,936/1,978), consistent with the standard AST results. Gram-positive bacteria showed a concordance rate of 97.2% (1,051/1,081), a very major error rate of 0.5% (5/1,081), a major error rate of 0.1% (1/1,081), and a minor error rate of 2.2% (24/1,081). Staphylococcus epidermidis was the main cause of discordance, and gentamicin (N=9) and fusidic acid (N=8) showed high errors. The overall concordance rate and minor error among the Gram-negative bacteria were 98.6% (885/897) and 1.4% (12/897), respectively. Escherichia coli and Pseudomonas aeruginosa were the major causative bacteria of Gram-negative bacteria. Among them, amoxicillin/clavulanic acid (N=3) showed high error. Direct AST met the CLSI criteria and shortened the reporting time by 24 hours; however, we found that there was a need to perform an addition test via disk diffusion for antimicrobials with very large errors. These results suggest that the method of direct AST in blood culture positive medium may be very useful in efficiently treating patients.
Flood frequency estimate is an essential index for determining the scale of small and middle hydraulic structure. However, this flood quantity could not be estimated directly for practical design purpose due to the lack of available flood data, and indirect method like design rainfall-runoff method have been used for the estimation of design flood. To give the good explain for design flood estimates, regional flood frequency analysis was performed by flood index method in this study. First, annual maximum series were constructed by using the collected data which covers from Japanese imperialism period to 1999. Wakeby distribution recommended by WMO(1989) was used for regional flood frequency analysis and L-moment method by Hosking (1990) was used for parameter estimation. For the homogeneity of region, the discordance and heterogeneity test by Hosking and Wallis(1993) was carried for 4 major watersheds in Korea. Physical independent variable correlated with index flood was watershed area. The relationship between specific discharge and watershed area showed a type of power function, i.e. the specific discharge decreases as watershed area increases. So flood quantity according to watershed area and return period was presented for each watershed(Han rivet, Nakdong river, Geum river and Youngsan/Seomjin river) by using this relation type. This result was also compared with the result of point frequency analysis and its regionalization. It was shown that the dam construction couldn't largely affect the variation of peak flood. The property of this study was also examined by comparison with previous studies.
The purpose of this study is to find the difference between the parents generation and that of the children in the disciplinary methods by means of parental social population variation. With these purpose in mind, the problems have been suggested like following: 1) what are the general differences of between the two generations of parents and children in disciplinary method? 2)What are the general differences of the views between those two generations according to sex? 3) What are the general differences between the parents generation and the child generation according to age? 4) What are the general differences between the parents generation and the child generation according to education level? 5) What are the general differences between the parents generation and the child generation according to income level? In order to solve these problems, questionnaries were distributed on this appendix 374parents (father: 177, mother: 197) who have the children. Questionnaires were compose on "Parents Inventory" of Radke were employs, classfied five measures. To test and verifying the above hypothes, the following five measures. were used. 1) Philosophy of authority (authoritarian vs. democratic) 2) Parental restrition (strict and stubbon vs. democratic) 3) Severity of punishment (severity vs. mildness) 4) Parent-child rapport 9desirable vs. undesirable) 5) Relative responsibility of father and mothehr towards child disciplinary (equal vs. differ) The result of this study is like follows: 1) In general comparison of two generations, tends to be more democratic in the philosophy of authority, more relaxed and easygoing in the parental restroction, more severe in the severity of punishment, and good rapport in the parent-child rapport than grandparents generation and the responsibility of father don't change but that of mother tends to augment in child disciplinary 2) In comparison of two generation according to sex, the mother showed more democratic in the philosophy of authority and closely perceive her parents in the parent-child rapport as compared with the father. 3) In comparison of two generation according to age, the younger parents showed more relaxed attitudes towards the child disciplinary, the perception better relations of their parents in the parent-child rapport. 4) In the comparison of two generations according to education level the more educated parents showed the more relaxed and easygoing attitude towards in the parental restriction. 5) In comparison of two generation according to income, as the parents of large income generally (not always) showed easygoing than their previous generation in the parental restriction, and they perceive that they have a good one in parent-child rapport. This study caused by the some difficult problem required futher investigation on the result of two generations the problems happened in the inner unitary of items. And, it proposed some problems which constitutes the problems of the proper interpretation of the results between two generations brought about discordance of items between tow generations
Background : Cervicovaginal cytology is a screening test of uterine cervical cancer. The sensitivity of cervicovaginal cytology is less than 50%, but studies of cytologic/histologic correlation are limited. We analyzed the diagnostic accuracy of cervicovaginal cytology in the detection of the squamous epithelial lesions of the uterine cervix and investigate the cause of diagnostic discordance. Materials and Methods : We collected a total of 481 sets of cervicovaginal cytology and biopsies over 5 years. The cytologic diagnoses were categorized based on The Bethesda System and the histologic diagnoses were classified as negative, flat condyloma, cervical intraepithelial neoplasia (CIN) I, CIN II, CIN III, or squamous cell carcinoma. Cytohistologic discrepancies were reviewed. Results: The concordance rate between the cytological and the histological diagnosis was 79.0%. The sensitivity and specificity of cervicovaginal cytology were 80.6% and 92.6%, respectively. Its positive predictive value and negative predictive value were 93.7% and 77.7%, respectively. The false negative rate was 19.4%. Among 54 false negative cytology cases, they were confirmed by histology as 50 flat condylomas, 2 CIN I, 1 CIN III, and 1 squamous cell carcinoma. The causes of false negative cytology were sampling errors in 75.6% and interpretation errors in 24.4%. The false positive rate was 7.4%. Among 15 false positive cytology cases, they were confirmed by histology as 12 atypical squamous cells of undetermined significance (ASCUS) and 3 low grade squamous intraepithelial lesions (LSIL). The cause of error was interpretation error in all cases. The overall diagnostic accuracy of cervicovaginal cytology was 85.7%. Conclusions : Cervicovaginal cytology shows high overall diagnostic accuracy and is a useful primary screen of uterine cervical cancer.
Nam, Kyoung Hyup;Seo, Il;Kim, Dong Hwan;Lee, Jae Il;Choi, Byung Kwan;Han, In Ho
Journal of Korean Neurosurgical Society
/
v.62
no.4
/
pp.442-449
/
2019
Objective : Bone mineral density (BMD) is an important consideration during fusion surgery. Although dual X-ray absorptiometry is considered as the gold standard for assessing BMD, quantitative computed tomography (QCT) provides more accurate data in spine osteoporosis. However, QCT has the disadvantage of additional radiation hazard and cost. The present study was to demonstrate the utility of artificial intelligence and machine learning algorithm for assessing osteoporosis using Hounsfield units (HU) of preoperative lumbar CT coupling with data of QCT. Methods : We reviewed 70 patients undergoing both QCT and conventional lumbar CT for spine surgery. The T-scores of 198 lumbar vertebra was assessed in QCT and the HU of vertebral body at the same level were measured in conventional CT by the picture archiving and communication system (PACS) system. A multiple regression algorithm was applied to predict the T-score using three independent variables (age, sex, and HU of vertebral body on conventional CT) coupling with T-score of QCT. Next, a logistic regression algorithm was applied to predict osteoporotic or non-osteoporotic vertebra. The Tensor flow and Python were used as the machine learning tools. The Tensor flow user interface developed in our institute was used for easy code generation. Results : The predictive model with multiple regression algorithm estimated similar T-scores with data of QCT. HU demonstrates the similar results as QCT without the discordance in only one non-osteoporotic vertebra that indicated osteoporosis. From the training set, the predictive model classified the lumbar vertebra into two groups (osteoporotic vs. non-osteoporotic spine) with 88.0% accuracy. In a test set of 40 vertebrae, classification accuracy was 92.5% when the learning rate was 0.0001 (precision, 0.939; recall, 0.969; F1 score, 0.954; area under the curve, 0.900). Conclusion : This study is a simple machine learning model applicable in the spine research field. The machine learning model can predict the T-score and osteoporotic vertebrae solely by measuring the HU of conventional CT, and this would help spine surgeons not to under-estimate the osteoporotic spine preoperatively. If applied to a bigger data set, we believe the predictive accuracy of our model will further increase. We propose that machine learning is an important modality of the medical research field.
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