• Title/Summary/Keyword: False Negative

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Development of a Duplex RT-PCR Assay for the Simultaneous Detection and Discrimination of Avirulent and Virulent Newcastle Disease Virus (NDV) (뉴캣슬병 바이러스 검출 및 병원성 감별을 위한 Duplex RT-PCR법 개발)

  • Kim, Ji-Ye;Lee, Hyun-Jeong;Jang, Il;Lee, Hee-Soo;Yoon, Seung-Jun;Park, Ji-Sung;Seol, Jae-Goo;Kim, Seung-Han;Hong, Ji-Mu;Wang, Zillian;Liu, Hualei;Choi, Kang-Seuk
    • Korean Journal of Poultry Science
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    • v.44 no.2
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    • pp.93-102
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    • 2017
  • A duplex RT-PCR (dRT-PCR) assay was developed for the simultaneous detection and discrimination of non-virulent and virulent Newcastle disease virus (NDV) in a single PCR tube. Primers targeting the large polymerase protein (L) gene and the fusion protein (F) gene of NDV were designed to detect all NDVs (by common type PCR primers) and virulent NDVs (by pathotype PCR primers), respectively and evaluated experimentally with reference NDV strains and other poultry viral pathogens. PCR products of the expected size of 386 bp were amplified from all NDV samples whereas PCR products of the expected size of 229 bp were amplified from virulent NDV samples alone. Cross reaction was not observed with other avian viral pathogens. The detection limit of NDV by the dRT-PCR was estimated to be $10^3$ 50% egg infectious dose/0.1 mL. In the dRT-PCR using field isolates of NDV, the pathotype PCR primers detected specifically all of virulent field isolates of NDV from Malaysia, Pakistan and China whereas common type PCR primers detected 94.4% (51/54) of field isolates of NDV from China. Three Chinese NDV isolates with false negative result were non-virulent viruses. Our results indicate that the dRT-PCR might provide a rapid and simple tool for rapid simultaneous detection and discrimination of non-virulent and virulent NDVs. Therefore the developed dRT-PCR assay provides a powerful novel means for the rapid diagnosis of Newcastle disease.

Outcomes of the Initial Surgical Treatment without Neoadjuvant Therapy in Patients with Unexpected N2 Non-small Cell Lung Cancer (선행요법 없이 초기치료로서 수술을 시행했던 예측되지 않은 N2 비소세포폐암의 치료 성적)

  • Shim, Man-Shik;Kim, Jhin-Gook;Yoon, Yoo-Sang;Chang, Sung-Wook;Kim, Hong-Kwan;Choi, Yong-Soo;Kim, Kwhan-Mien;Shim, Young-Mog
    • Journal of Chest Surgery
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    • v.43 no.1
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    • pp.39-46
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    • 2010
  • Background: Preoperative chemotherapy has been adopted in our hospital as a standard treatment for non-small cell lung cancer patients with N2 disease. However, there have been cases of pathologic N2 disease that have been detected after curative-intent surgical resection. We retrospectively studied the outcomes of initial surgical treatment without neoadjuvant therapy in patients with unexpected N2 non-small cell lung cancer. Material and Method: Between January 1995 and June 2007, 225 patients were diagnosed with pathologic N2 disease after they underwent initial pulmonary resection without neoadjuvant therapy. Among them, 170 patients were preoperatively diagnosed with lymph node stage N0 or N1. We retrospectively reviewed their medical record and analyzed the outcomes. Result: The overall 5-year survival rate was 35.4%. The prognostic factors that were significantly associated with survival were no adjuvant therapy, histologic cell types other than adenocarcinoma or squamous cell carcinoma, a pathologic T stage more than T1, old age (${\geq}$70 years) and no mediastinoscopic biopsy. During the follow-up, 79 patients (46.5%) experienced tumor recurrence, including loco-regional recurrence in 20 patients (25.3%) and distant metastasis in 56 (70.9%). The 5-year recurrence-free survival rate was 33.7%. Conclusion: Based on our findings, the survival was good for patients with unexpected N2 non-small cell lung cancer and who underwent initial pulmonary resection without neoadjuvant therapy. A prospective comparative analysis is needed to obtain more conclusive and persuasive results.

A Study of the Change of Breast Uptake in Menstrual Cycle on $^{18}F$-FDG PET/CT (월경 주기에 따른 $^{18}F$-FDG PET/CT에서의 유방 섭취 변화에 관한 고찰)

  • Park, Min-Soo;Park, Hoon-Hee;Kim, Jung-Yul;Lim, Han-Sang;Kim, Jae-Sam;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.1
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    • pp.39-44
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    • 2011
  • Purpose: $^{18}F$-FDG PET/CT has been known a useful modality to diagnose high-glucose-using cells such as cancer cells by glucose metabolism of FDG. Mainly, FDG takes on cancer and inflammatory cells; However, There have been FDG uptakes on normal tissues by individual physiological characteristics, occasionally. Especially, in fertile females, unusual FDG uptake of breast changes as the menstrual cycle, and disturb diagnosis. Therefore, the study aimed to evaluate the change of breast FDG uptake in menstrual cycle on $^{18}F$-FDG PET/CT. Materials and Methods: 160 females ($34{\pm}3.5$ years old) who do not undergo a gynecologic anamnesis and have regular menstrual cycle over the previous 6 months were examined, from March 2009 to February 2010. They were divided 4 groups (each 40 patients) as flow phase, proliferative phase, ovulatory phase and secretory phase using Pregnancy Calculator 0.14. and history taking. Discovery Ste (GE Healthcare, Milwaukee, Mi, USA) was used as PET/CT. We analyzed SUVs on accumulated region on breast, and 3 nuclear medicine specialists did the Blind test. Results: SUVs on the Breast were flow phase ($1.64{\pm}0.25$), proliferative phase ($0.93{\pm}0.28$), ovulatory phase ($1.66{\pm}0.26$) and secretory phase ($1.77{\pm}0.28$). It showed high uptake value in secretory, flow phase and ovulatory phase (p<0.05). In gross analysis, the accumulation of breast was divided into 3 grades as comparing with lung and liver. The breast's uptake was equal to lung (Grade I); between lung and liver (Grade II); equal to or greater than liver (Grade III). The results showed high uptake value in secretory, flow phase and ovulatory phase (p<0.05). Conclusion: In fertile females, FDG uptake of breast changed as menstrual cycle, and it available to diagnose breast disease. Therefore, we consider reducing false-negative finding of breast disease, by doing examination on appropriate period through history taking about individual menstrual cycle.

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Utility of FDG-PET in Solitary Pulmonary Nodules and the Relationship Between Standardized Uptake Values of PET and Serum Glucose (폐 결절에서 FDG-PET의 유용성과 표준섭취계수와 혈당농도의 상관관계)

  • Kim, Kyu Sik;Lim, Sung Chul;Ko, Young Chun;Park, Kyung Ha;Ju, Jin Young;Jo, Kae Jung;Kim, Soo Ok;Oh, In Jae;Kim, Yu Il;Kim, Young Chul;Kim, Sung Min;Song, Ho Chun;Bom, Hee Seung;Park, Kyung Ok
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.6
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    • pp.589-596
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    • 2003
  • Background : The solitary pulmonary nodule(SPN) presents a diagnostic dilemma to the physician and the patients in the our nation with high incidence of tuberculoma. We could not exclude whether the SPN was benign or malignant by the change of the size at chest radiograph and findings of chest CT. Recently, positron emission tomography(PET) have been tried as the differential diagnostic method of SPN. We evaluated the efficacy of PET for differentiating malignant from benign SPN and the relationship between standardized uptake values(SUV) of PET and serum glucose. Method : Between January 2001 and July 2002, sixty-one patients with pulmonary nodule were examined by the chest CT and PET. The SPN has been finally diagnosed by the transthorasic needle aspiration and biopsy, bronchoscopic biopsy, and open lung biopsy. Results : Forty eight patients had a malignant nodule(23 squamous cell lung carcinoma, 16 adenocarcinoma, 9 small cell lung cancer) and thirteen patients had a benign nodule(3 tuberculoma, 9 inflammatory granuloma, 1 cryptococcosis). The mean size of malignant and benign nodule was 40.6 mm and 20.0 mm, respectively. All malignant nodules showed a marked increase in 18 fluorodeoxyglucose (FDG) uptake. Mean SUV of malignant was $9.52{\pm}5.20$ and benign nodule was $1.61{\pm}3.60$. There were false positive cases with an increase in 18-FDG uptake (2 tuberculoma, 1 inflammatory granuloma). The SUV of malignant nodule in diabetes patients has no difference in non diabetes patients($9.10{\pm}4.51$ vs $9.65{\pm}5.46$). The sensitivity and specificity of the PET scan for SPN were 100%, 77%, respectively. The positive and negative predictive values were 94% and 100%. Conclusion : PET scanning showed highly accurate result in differentiating the malignant and benign SPN. There were no significant differences between the SUV and serum glucose in the patients with lung cancer.

Diagnostic Value of Serum Beta-hCG Measured by EIA in Suspected Ectopic Pregnancy (EIA로 측정한 혈청 ${\beta}$-hCG치의 자궁외 임신에 대한 진단적 가치)

  • Park, Yoon-Ki;Kim, Jong-Wook;Lee, Tae-Hyung;Park, Wan-Seok;Lee, Sung-Ho;Chung, Wun-Yong
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.221-227
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    • 1985
  • Thirty-four patients with suspected ectopic pregnancy whose serum hCG levels had been measured by beta-hCG EIA before surgery were evaluated retrospectively. The results were as follows: 1. Final diagnosis of thirty-four patients with suspected ectopic pregnancy comprised twenty- eight tubal pregnancy, five ruptures of hemorrhagic corpus luteum and, one tubo-ovarian abscess. One of the five patients with rupture of hemorrhagic corpus luteum was accompanied by missed abortion. 2. Range of serum hCG levels in twenty-eight patients with tubal pregnancy was 59-21,980 mIU/ml and that of four patients with rupture of hemorrhagic corpus luteum and one patient with tubo-ovarian abscess was 0.6-6.6mIU/ml. Serum hCG level of a patient with rupture of hemorrhagic corpus luteum who was accompanied by missed abostion was 200 mIU/ml. 3. Serum hCG levels in twenty-two of twenty-eight patients with tubal pregnancy were lower than 3,000 mIU/ml. Low serum hCG level below 100mIU/ml and high serum hCG level above 6,500 mIU/ml were noticed in four and six patients with tubal pregnancy, respectively. 4. Mean serum hCG levels (${\pm}SD$) of twelve patients with tubal pregnancy who had intra-abdominal free blood of less than 500ml and sixteen patients with tubal pregnancy who had intra-abdominal free blood of more than 500ml were 4,131 (${\pm}7,801$) mIU/ml and 3,208 (${\pm}5,081$) mIU/ml, respectively. There was no statistical difference in the mean level of serum hCG between both group (P>0.05). 5. Mean serum hCG levels (${\pm}SD$) of thirteen patients with unruptured tubal pregnancy and fifteen patients with ruptured tubal pregnancy were 2,628 (${\pm}5,448$) mIU/ml and 4,449 (${\pm}6,938$) mIU/ml, respectively. Mean level of serum hCG was statistically higher in ruptured tubal pregnancy (P<0.01). 6. Positive rate of urine pregnancy test in the diagnosis of ectopic pregnancy was 64% (16/25) and mean range of serum hCG level of nine patients with false negative result were 353 mIU/ml and 59-933 mIU/ml.

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A Study on the Status of Recognition and Practical Application of Oral Hygiene Devices : with outpatient as the central figure (치과병·의원 내원환자의 구강위생용품에 대한 인지도 및 사용실태에 관한 연구)

  • Kim, Soo-Kyung
    • Journal of dental hygiene science
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    • v.2 no.2
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    • pp.95-103
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    • 2002
  • This study was carried out to investigate recognition level and practical application status of oral hygiene devices through making a survey of Seoul inhabitants. And survey was implemented in order to propose oral hygiene device for household health care activities. The following results were obtained by analyzing personal interviews of 347 commuting patients at two university hospitals and seven dental clinics. 1) The average length of toothbrush head was estimated as 22.3 mm and average changing cycle was 2.3 months. The user ratio of flat-headed brush was estimated as 51.9% and 46.7% were using fluoridated toothpaste. 2) Generally the ratio of toothpick users was higher than other device users. But the user ratio of dental floss was higher than toothpick in case of patients under orthodontic treatment. 3) The patients under orthodontic treatment were not familiar with handling orthodontic toothbrush. Though 45.8% among orthodontic patients recognized this type of toothbrush, only 25.4% of them knew how exactly to use it. 4) It was shown very low user ratio of oral hygiene devices that the patients who had periodontal problem, hypersensitive trouble, halitosis, implant or denture 5) The patients who had halitosis showed the highest user ratio of toothpick. The patients who had separation of teeth showed the highest user ratio of dental floss. The patients who're under orthodontic treatment showed the highest user ratio of interproximal brush and motorized brush. 6) In response to the most interesting dental disease, it's surveyed as follows; 60.3% of dental caries, 24.0% of periodontal disease, 14.8% of false occlusion and 0.9% of oral cancer. 7) Regarding the motivation of using those oral hygiene devices, 45% responded that it was because of recommendation by dental clinics. Among the negative answers, 38.6% responded that it was because of no selection guidance. 31.3% answered that they didn't use hygiene device because it's inconvenient. 12.0% answered that it's difficult to buy and expensive. 7.8% responded that they didn't feel significant improvement. 4.8% answered that dental hospitals and clinics didn't even introduce those hygiene devices. Therefore efficient campaign for those hygiene devices over all Korea nation should be developed and education program must be prepared for each case of patients in every dental hospitals and clinics.

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Development and Evaluation of Multiplex PCR for the Detection of Carbapenemase-Producing Enterobacteriaceae (카바페넴분해효소 생성 장내세균 검출을 위한 Multiplex PCR의 개발 및 평가)

  • Kim, Si Hyun;Bae, Il Kwon;Kim, Na Young;Song, Sae Am;Kim, Sunjoo;Jeong, Joseph;Shin, Jeong Hwan
    • Annals of Clinical Microbiology
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    • v.22 no.1
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    • pp.9-13
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    • 2019
  • Background: The isolation of carbapenemase-producing Enterobacteriaceae (CPE) has become increasingly common. Continuous surveillance for these organisms is essential because their infections are closely related to outbreaks of illness and are associated with high mortality rates. The aim of this study was to develop and evaluate multiplex PCR as a means of detecting several important CPE genes simultaneously. Methods: We aimed to develop a multiplex PCR that could detect seven CPE genes simultaneously. The multiplex PCR was composed of seven primer sets for the detection of KPC, IMP, VIM, NDM-1, GES, OXA-23, and OXA-48. We designed different PCR product sizes of at least 100 bp. We evaluated the performance of this new test using 69 CPE-positive clinical isolates. Also, we confirmed the specificity to rule out false-positive reactions by using 71 carbapenem-susceptible clinical strains. Results: A total of 69 CPE clinical isolates showed positive results and were correctly identified as KPC (N=14), IMP (N=13), OXA-23 (N=12), OXA-48 (N=11), VIM (N=9), GES (N=5), and NDM (N=5) by the multiplex PCR. All 71 carbapenem-susceptible clinical isolates, including Enterococcus faecalis, Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa, showed negative results. Conclusion: This multiplex PCR can detect seven CPE genes at a time and will be useful in clinical laboratories.

Digital Breast Tomosynthesis as a Breast Cancer Screening Tool for Women with Gynecologic Cancer (부인암을 가진 여성에서 유방암의 선별검사로서의 디지털 유방단층 촬영술)

  • Da-hoon Kim;Jin Chung;Eun-Suk Cha;Jee Eun Lee;Jeoung Hyun Kim
    • Journal of the Korean Society of Radiology
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    • v.81 no.4
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    • pp.886-898
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    • 2020
  • Purpose The purpose of our study was to evaluate digital breast tomosynthesis as a breast cancer screening modality for women with gynecologic cancer. Materials and Methods This retrospective study included patients with underlying gynecologic malignancies who underwent screening digital breast tomosynthesis for breast cancer. The cancer detection rate, recall rate, sensitivity, specificity, and positive predictive value (PPV) were calculated. PPV1 was defined as the percentage of all positive screening exams that have a tissue diagnosis of cancer within a year. PPV2 was defined as the percentage of all diagnostic exams (and Breast Imaging Reporting and Data System category 4, 5 from screening setting) with a recommendation for tissue diagnosis that have cancer within a year. PPV3 was defined as the percentage of all known biopsies actually performed that resulted in a tissue diagnosis of cancer within the year. For each case of screen-detected cancer, we analyzed the age, type of underlying gynecologic malignancy, breast density, imaging features, final Breast Imaging Reporting and Data System assessment, histologic type, T and N stages, molecular subtype, and Ki-67 index. Results Among 508 patients, 7 with breast cancer were identified after a positive result. The cancer detection rate was 13.8 per 1000 screening exams, and the recall rate was 17.9%. The sensitivity was 100%, and the specificity was 83.2%. The false negative rate was 0 per 1000 exams. The PPV1, PPV2, and PPV3 were 7.7, 31.8, and 31.8, respectively. Conclusion Digital breast tomosynthesis may be a promising breast cancer screening modality for women with gynecologic cancer, based on the high cancer detection rate, high sensitivity, high PPV, and high detection rate of early-stage cancer observed in our study.

A Discovery of the Creative Healing Properties in the Unconscious of Alcoholics: From the Perspective of Analytical Psychology (알코올 중독에서 발견되는 무의식의 창조적 치유 활동: 분석심리학의 관점에서)

  • Kihong Baek
    • Sim-seong Yeon-gu
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    • v.39 no.1
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    • pp.129-183
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    • 2024
  • This study is an attempt to get closer to the psychological truth of alcohol addiction. After reviewing previous related studies, the experiences of Korean alcoholics were examined, encompassing both the conscious and unconscious aspects. In order to approach the unconscious, the researcher paid attention to the series of dreams that the patients reported, from the perspective of Jungian dream analysis. Working with dreams brought considerable benefits in increasing patient's involvement in the therapeutic process and fostering therapist-patient alliance. It also helped to understand patients' conscious and unconscious aspects further. The results were as follows. On the conscious level, patients showed a long-standing alienation from their true emotional needs, a lack of sufficient experience in genuinely expressing and being accepted with one's own emotion, resulting in the need for emotional re-experience, along with the intense longing for maternal affection. This also meant that they were in need for maternal re-experience, and at the same time, for the associated paternal re-experience. Furthermore, the researcher identified that certain powerful archetypal complexes had been activated in the patient's unconscious in response to their conscious situations, triggering the destructive shadows to emerge and exert a strong influence on their conscious lives. The series of reported dreams shows how the unconscious always properly and diligently compensates, modifying the perspective and attitude of the conscious and gradually opening the doors to healing, even for alcoholic patients. This indicates that the unconscious carries out a specific and consistent guidance role so the conscious can realize and adequately respond to it, and that it also provides the creative force for transforming the conscious life. These findings suggest that alcohol addiction is a psychological condition that can jeopardize one's life by allowing the powerful energy of the unconscious to penetrate the conscious, but at the same time, have the purpose and direction to urge the creative transformation of one's conscious life. From these results, it can be concluded that the first step towards true recovery is for the individual to turn their attention towards the psychological truth occurring within themselves. In this regard, the therapist's role is crucial. This also suggests that various attempts in the field of addiction treatment will blossom their real values when they contribute, directly or indirectly, to the development of one's self-awareness since as long as one continues to turn away from the psychological truth and persist in craving for false objects, their creative healing properties in the unconscious could rather have negative and destructive impacts on their life.

Usefulness of LIFE in diagnosis of bronchogenic carcinoma (기관지 암의 진단에서 형광기관지 내시경검사의 유용성)

  • Lee, Sang Hwa;Shim, Jae Jeong;Lee, So Ra;Lee, Sang Youb;Suh, Jung Kyung;Cho, Jae Yun;Kim, Han Gyum;In, Kwang Ho;Choi, Young Ho;Kim, Hark Jei;Yoo, Se Hwa;Kang, Kyung Ho
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.1
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    • pp.69-84
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    • 1997
  • Background : Although the overall prognosis of patients with lung cancer is poor, highly effective treatment exists for the small subset of patients with early lung cancer(carcinoma in situ/micro- invasive cancer). But very few patients have benefit from them because these lesions are difficult to detect and localize with conventional white-light bronchoscopy. To overcome this problem, a Lung Imaging Fluorescence Endoscopic device(LIFE) was developed to detect and clearly delineate the exact location and extent of premalignant and early lung cancer lesions using differences in tissue autofluorescence. Purpose : The purpose of this study was to determine the difference of sensitivity and specificity in detecting dysplasia and carcinoma between fluorescence imaging and conventional white light bronchoscopy. Material and Methods : 35 patients (16 with abnormal chest X-ray, 2 with positive sputum study, 2 with undiagnosed pleural effusion, 15 with respiratory symptom) have been examined by LIFE imaging system. After a white light bronchoscopy, the patients were submitted to fluorescence bronchoscopy and the findings of both examinations have been classified in 3 categories(class I, II, III). From of all class n and III sites, 79 biopsy specimens have been collected for histologic examination: a comparison between histologic results and white light or fluorescence bronchoscopy has been performed for assessing sensitivity and specificity of the two methods. Results : 1) Total 79 sires in 35 patients were examined. Histology demonstrated 8 normal mucosa, 21 hyperplasia, 23 dysplasia, and 27 microinvasive and invasive carcinoma. 2) The sensitivity of white light or fluorescence bronchoscopy in detecting dysplasia was 60.9% and 82.6%, respectively. 3) The results of this study showed 70.3 % sensitivity for microinvasive or invasive carcinoma with LIFE system, versus 100% sensitivity for white light in 27 cases of carcinoma. The false negative study of LIFE system was 8 cases(3 adenocarcinoma and 5 small cell carcinoma), which were infiltrated in submucosal area and had normal epithelium. Conclusion : To improve the ability 10 diagnose and stage more accurately, fluorescence imaging may become an important adjunct to conventional bronchoscopic examination because of its high detection rate of premalignant and malignant epithelial lesion. But. it has limitation to detect in submucosal infiltrating carcinoma.

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