• Title/Summary/Keyword: diagnostic approach

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Antiserum Preparation of Recombinant Sweet Potato Latent Virus-Lotus (SPLV-Lotus) Coat Protein and Application for Virus-Infected Lotus Plant Detection

  • He, Zhen;Dong, Tingting;Chen, Wen;Wang, Tielin;Gan, Haifeng;Li, LiangJun
    • The Plant Pathology Journal
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    • v.36 no.6
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    • pp.651-657
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    • 2020
  • Lotus is one of the most important aquatic vegetables in China. Previously, we detected sweet potato latent virus from lotus (SPLV-lotus) and found that it has highly significant sequence diversity with SPLV-sweet potato isolates (SPLV-sp). Here, we developed serological methods for the detection of SPLV-lotus in Chinese lotus cultivation areas. Based on the high sensitivity of SPLV-lotus coat protein antiserum, rapid, sensitive and large-scale diagnosis methods of enzyme-linked immunosorbent assay (ELISA) and dot blot in lotus planting area were developed. The established ELISA and dot blot diagnostic methods can be used to detect SPLV-lotus from samples successfully. And our results also showed that the SPLV-lotus and sweet potato isolates appeared clearly distinction in serology. Our study provides a high-throughput, sensitive, and rapid diagnostic method based on serology that can detect SPLV on lotus, which is suggested to be included in viral disease management approach due to its good detection level.

Status of Pathology Services and Molecular Pathology in Sub-Saharan Africa: Implications for Combating Breast Cancer

  • Wajana Lako LABISSO
    • Korean Journal of Clinical Laboratory Science
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    • v.55 no.3
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    • pp.121-131
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    • 2023
  • African breast cancer patients benefit less from classical pathology services owing to the complex molecular and clinicopathological nature of the disease, poor quality of laboratory supplies, and shortage of experts in the field. This review presents evidence and confirms the need for improving anatomic pathology services in Africa. Peer-reviewed international journal articles available in Medline, Scopus, PubMed, and Google scholars, describing the status of pathology services in Africa, were included. Besides the late presentation of patients, anatomic pathology laboratories are accountable for the escalated mortality of breast cancer patients in several parts of Africa. Conversely, molecular diversity and biological heterogeneity of breast cancers, which disprove the one-size-fits-all therapeutic approach, have been reported from different parts of the continent. Irrespective of the geographical background, the choice of therapeutic options and predicting disease outcome depends on the right identification of the molecular signature of the cancer type. In conclusion, we propose that upgrading and integrating anatomic pathology with molecular diagnostic pathology is essential in order to provide better diagnostic results that will profoundly impact curbing mortality from breast cancers.

RENE LAENNEC'S SYNDROME-BASED CLINICAL REASONING

  • Berezutskyi Volodymyr
    • CELLMED
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    • v.14 no.2
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    • pp.4.1-4.4
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    • 2024
  • The development of clinical reasoning, which is the basis of medical education, is of great importance in medical universities. One of the founders of modern structural clinical reasoning, based on the knowledge of pathological physiology, is the inventor of the stethoscope Rene Laennec (1781-1826). He described the pioneering experience of clinical reasoning in the pages of his treatise A Treatise on the Diseases of the Chest and on Mediate Auscultation, which is of lasting value, since every rookie physicians in his professional development goes through the path of Laennec. Laennec's practice is of great importance for novice physicians since Laennec's treatise contains a diagnostic analysis of the most common clinical cases. Each such analysis demonstrates the algorithm of clinical reasoning. The purpose of this study was to analyze the approaches of clinical reasoning by René Laennec, which made it possible to identify two basic principles. Laennec's diagnostic reasoning involved two principles: pathogenetic analysis of clinical manifestations and a syndrome-based approach to differential diagnosis. These principles help distinguish between diseases with similar symptoms and physical findings are used to demonstrate the practical application of syndrome-based differential diagnosis. These principles can be easily mastered by understanding the pathogenesis of clinical manifestations. Thanks to the pathogenetic basis, the principles of clinical reasoning of Rene Laennec are universal and applicable to the analysis of any signs of the disease: not only physical but also laboratory and instrumental.

State-of-the-art update for diagnosing diabetic foot osteomyelitis: a narrative review

  • Inha Woo;Seung Jae Cho;Chul Hyun Park
    • Journal of Yeungnam Medical Science
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    • v.40 no.4
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    • pp.321-327
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    • 2023
  • Recently, the International Working Group on the Diabetic Foot and the Infectious Diseases Society of America divided diabetic foot disease into diabetic foot infection (DFI) and diabetic foot osteomyelitis (DFO). DFI is usually diagnosed clinically, while numerous methods exist to diagnose DFO. In this narrative review, the authors aim to summarize the updated data on the diagnosis of DFO. An extensive literature search using "diabetic foot [MeSH]" and "osteomyelitis [MeSH]" or "diagnosis" was performed using PubMed and Google Scholar in July 2023. The possibility of DFO is based on inflammatory clinical signs, including the probe-to-bone (PTB) test. Elevated inflammatory biochemical markers, especially erythrocyte sedimentation rate, are beneficial. Distinguishing abnormal findings of plain radiographs is also a first-line approach. Moreover, sophisticated modalities, including magnetic resonance imaging and nuclear medicine imaging, are helpful if doubt remains after a first-line diagnosis. Transcutaneous bone biopsy, which does not pass through the wound, is necessary to avoid contaminating the sample. This review focuses on the current diagnostic techniques for DFOs with an emphasis on the updates. To obtain the correct therapeutic results, selecting a proper option is necessary. Based on these numerous diagnosis modalities and indications, the proper choice of diagnostic tool can have favorable treatment outcomes.

Watch Out for the Early Killers: Imaging Diagnosis of Thoracic Trauma

  • Yon-Cheong Wong;Li-Jen Wang;Rathachai Kaewlai;Cheng-Hsien Wu
    • Korean Journal of Radiology
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    • v.24 no.8
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    • pp.752-760
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    • 2023
  • Radiologists and trauma surgeons should monitor for early killers among patients with thoracic trauma, such as tension pneumothorax, tracheobronchial injuries, flail chest, aortic injury, mediastinal hematomas, and severe pulmonary parenchymal injury. With the advent of cutting-edge technology, rapid volumetric computed tomography of the chest has become the most definitive diagnostic tool for establishing or excluding thoracic trauma. With the notion of "time is life" at emergency settings, radiologists must find ways to shorten the turnaround time of reports. One way to interpret chest findings is to use a systemic approach, as advocated in this study. Our interpretation of chest findings for thoracic trauma follows the acronym "ABC-Please" in which "A" stands for abnormal air, "B" stands for abnormal bones, "C" stands for abnormal cardiovascular system, and "P" in "Please" stands for abnormal pulmonary parenchyma and vessels. In the future, utilizing an artificial intelligence software can be an alternative, which can highlight significant findings as "warm zones" on the heatmap and can re-prioritize important examinations at the top of the reading list for radiologists to expedite the final reports.

Transvaginal Ultrasound-Guided Biopsy (경질 초음파 유도생검)

  • Su Hyeok Lim;Jung Jae Park;Chan Kyo Kim
    • Journal of the Korean Society of Radiology
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    • v.84 no.6
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    • pp.1233-1243
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    • 2023
  • Percutaneous ultrasound-guided biopsy is useful for the pathologic confirmation of variable body lesions to establish diagnostic and therapeutic approaches. However, deep pelvic lesions are a challenge for pathologic diagnoses because of the presence of the bowel, bladder, major vessels, and pelvic bones which make a percutaneous approach difficult and dangerous. In female, the vagina is elastic and near the pelvic internal organs. Therefore, transvaginal ultrasound may serve as an effective and safe guide for the pathologic diagnosis of pelvis lesions. This review aimed to introduce the indications for, and the method of transvaginal ultrasoundguided biopsy, and to describe the reported diagnostic accuracy and safety.

Comparison of Thallium-201, Tc-99m MIBI and I-131 Scan in the Follow-up Assessment after I-131 Ablative Therapy in Differentiated Thyroid Cancer (방사성 옥소 치료 후 분화된 갑상선암 추적관찰에서 Thallium-201 스캔, Tc-99m MIBI 스캔과 I-131 스캔 검사 결과의 비교)

  • Kwon, Jae-Sung;Lee, Sung-Keun;Kim, Doe-Min;Park, Sae-Jong;Jang, Kyong-Sun;Kim, Eun-Sil;Kim, Chong-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.6
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    • pp.493-501
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    • 1999
  • Purpose: We conducted a comparative study to evaluate the diagnostic values of T1-201, Tc-99m MIBI and I-131 scans in the follow-up assessment after ablative I-131 therapy in differentiated thyroid cancer. Materials and Methods: The study population consisted of 20 patients who underwent surgical removal of thyroid cancer and ablative radioactive iodine therapy, and followed by one or mote times of I-131 retreatments (33 cases). In all patients, T1-201, Tc-99m MIBI, diagnostic and therapeutic I-131 scans were performed and the results were analyzed retrospectively. Also serum thyroglobulin levels were measured in all patients. The final diagnosis of recurrent or metastatic thyroid cancer was determined by clinical, biochemical, radiologic and/or biopsy findings. Results: Positive rates (PR) of Tc-99m MIBI, T1-201, diagnostic and therapeutic I-131 scans in detecting malignant thyroid tissue lesions were 70% (19/27), 54% (15/28), 35% (17/48) and 63% (30/48), respectively. The PR in the group of 20 cases (28 lesions) who underwent concomitant T1-201 and I-131 scans were in the order of therapeutic 131 scan 71%, T1-201 scan 54% and diagnostic I-131 scan 36%. There was no statistically significant difference between T1-201 and diagnostic I-131 scans (p>0.05). In the group of 20 cases (27 lesions) who underwent concomitant Tc-99m MIBI and I-131 scans, the PR were in the order of Tc-99m MIBI scan 70%, I-131 therapeutic scan 52% and I-131 diagnostic scan 33%. The PR of Tc-99m MIBI was significantly higher than that of diagnostic I-131 scan (p<0.05). Conclusion: Tc-99m MIBI scan is superior to diagnostic I-131 scan in detecting recurrent or metastatic thyroid cancer following ablation therapy in patients with differentiated thyroid cancer. T1-201 scan did not showed significantly higher positive rate than diagnostic I-131 scan. Instead of diagnostic I-131 scan before the I-131 retreatment, Tc-99m MIBI scan without discontinuing thyroid hormone replacement would be a prudent and effective approach in the management of these patients.

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Diagnostic Accuracy of Fine Needle Aspiration Cytology in Thyroid Lesions - Analysis of Histologically Confirmed 153 Cases - (갑상선 질환의 진단에 있어서 세침흡인세포학적 검사의 중요성 - 조직학적으로 확진된 153예에 대한 연구 -)

  • Park, Kyeong-Mee;Ko, Ill-Hyang
    • The Korean Journal of Cytopathology
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    • v.7 no.2
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    • pp.122-133
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    • 1996
  • This is a retrospective review of fine-needle aspiration cytology(FNAC) smears of 153 cases of thyroid disease performed during August 1989 to July 1995, which were confirmed histologically following surgical operations. FNAC results showed 63 cases(41.2%) of adenomatous goiter, 45 cases(29.4%) of papillary carcinoma, 29 cases(19.0%) of follicular neoplasm, 4 cases(2.6%) of follicular variant of papillary carcinoma, 4 cases(2.6%) of Hashimoto's thyroiditis, 4 cases(2.6%) of $H\ddot{u}rthle$ cell neoplasm, 2 cases(1.3%) of medullary carcinoma and one case(0.7%) each of subacute thyroiditis and of anaplastic carcinoma. The overall accuracy of cytological diagnosis was 83.7%. These data strongly suggest thyroid FNAC is a reliable preoperative diagnostic tool, but FNAC has been less valuable in the diagnosis of follicular lesions than any other disease of the thyroid. Adenomatous goiter was not infrequently interpreted as follicular neoplasia that requires surgery for diagnostic conformation and vice versa. The following findings are considered to be compatible with follicular neoplasm: 1) microfollicles, 2) nuclear grooving, 3) irregularity of nuclear membrane, and 4) irregular arrangement or crowding of follicular cells in groups. The FNAC criteria of adenomatous goiter are as follows: 1) atrophic follicular cells, 2) presence of macrophages, 3) abundant colloid, and 4) large follicles. It is recommended that aspiration of thyroid lesions in order to analyse with critical clinico-pathological approach and surgery is considered only for nodules that are clinically suspicious or unresponsive to hormone therapy or when a diagnosis of follicular neoplasm is made.

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Changes of Plasma Lidocaine Concentrations after Stellate Ganglion Block according to Volume-changes of 1% Lidocaine (성상신경절차단시 주입된 1% Lidocaine 양에 따른 혈중 Lidocaine 농도 변화)

  • Song, Sun-Ok;Suh, Yung-Ho
    • The Korean Journal of Pain
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    • v.14 no.1
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    • pp.26-31
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    • 2001
  • Background: Sympathetic blocks with local anesthetics are used to differentiate sympathetically- maintained pain (SMP) from sympathetically-independent pain (SIP). However, systemic lidocaine is also used in the management of neuropathic pain. Therefore, there may be possibility of a false positive response in relieving their pain by systemic absorption of lidocaine following a diagnostic sympathetic block in patients with SIP. In this study, we measured the plasma lidocaine concentrations after a stellate ganglion block (SGB) using three volumes of 1% lidocaine. Methods: This prospective, crossover study was performed in 3 patients who experience sudden hearing loss and in 4 volunteers. Each person received SGB three times using three different volumes (6 ml, 12 ml and 16 ml) of 1% lidocaine at one week intervals. SGB was performed using a 23 G butterfly needle via a paratracheal approach by two persons. Two ml of venous blood was obtained from a prepared contra-lateral sided venous route at 1, 3, 5, 7, 10, 20 and 60 min after SGB. Plasma lidocaine level was analyzed by immunoassay. Results: Mean plasma lidocaine concentrations correlated well with the volumes of 1% lidocaine used in SGB; larger volumes showed higher concentrations (P < 0.01). Mean peak plasma concentrations were $1.08{\pm}0.18$ in 6 ml, $1.90{\pm}0.47$ in the 12 ml and $2.74{\pm}0.67{\mu}g/ml$ in the 16 ml groups (P < 0.01). The mean time to reach peak plasma concentration was not significantly different between the three groups. Conclusions: The peak plasma lidocaine concentrations in SGB using large volume were found to be similar to that of IV lidocaine infusion in the management of neuropathic pain. These data suggest that diagnostic sympathetic block may result in many false positive responses for SMP. Part of its effect may be related to systemic local anesthetic absorption and not to a sympathetic block. Therefore, physicians may be required to use optimal volumes and minimal concentration of local anesthetic in diagnostic sympathetic block procedures and also make a careful assessment of the performance of a permanent sympathetic block.

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Diagnostic Usefulness of Quantitative Sensory Test Comparison with Photoplethysmography (광용적맥파와 정량적 감각검사의 비교를 통한 진단적 유용성)

  • LEE, Sang-Bong;SEO, Jeong-Hyeok
    • Journal of the Korean Society of Radiology
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    • v.9 no.5
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    • pp.315-322
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    • 2015
  • The purposes of this study were to compare the sensitivities of two tests, QST(quantitative sensory test)and PPG(photoplethysmography) in normal adults. We evaluated the sensory thresholds of QST and PPG and diabetes mellitus test in 17 normal adults. The finding of this study can be summarized as follow :The diagnostic sensitivities of QST was similar to PPG. There is a direct correlation between the amount of Blood sugar and parasympathetic nerve in ANS. Concluded that the QST might be complement to NCS for early of diabetic polyneuropathy. A new diagnostic approach, QST was introduced and exploited for diagnosis. This study provides support for PPG performed a ANS analysis.