• Tuberculosis and Respiratory Diseases
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• v.47 no.1
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• pp.66-76
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• 1999

Background : To assess the utility of HRCT in the evaluation of visceral pleural invasion and to determine whether visceral pleural invasion and bronchovascular bundle thickening on the same lobe could be related to the recurrence and survival in non-small cell lung cancer (NSCLC) Method: Eighty one patients, which were fulfilled long-term follow-up at least 18 months (maximum 103 months) among which 434 patients had underwent curative surgical resection for NSCLC from 1986 to 1995, were studied. They were analyzed to evaluate whether the prognostic factors such as the recurrence and survival depend on visceral pleural invasion and bronchovascular bundle thickening to the same lobe. Thirty two patients adjacent to a chest wall or a fissure were evaluated for visceral pleural invasion by HRCT. CT criteria included abutting pleura along the chest wall, abutting and/or compressing fissure, croosing fissure, and pleural tail. Results: The positive predictive value and the negative predictive value of crossing fissure were 100% and 100%, respectively. Two patients showing spiculated interface between a mass and abutting fissure were confirmed to have visceral pleural invasion at surgery. Visceral pleural invasion confirmed at surgery was significant to local recurrence and survival (p<.05. p<.05, respectively). Brochovascular bundle thickening to the same lobe on CT scan was significant to survival (p<.05) but was not significant to local and distant recurrence (p>.05). Conclusion : Visceral pleural invasion and bronchovascular bundle thickening to the same lobe have a role in predicting prognosis such as recurrence and survival in NSCLC. Therefore, the analysis of visceral pleural invasion on CT scan and the pathological analysis of bronchovascular bundle thickening to the same lobe may be necessary to predict the prognosis in NSCLC.

• Tuberculosis and Respiratory Diseases
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• v.40 no.5
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• pp.509-518
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• 1993

Background: By amplifying small amount of DNA, polymerase chain reaction (PCR) can be used for the detection of very small amount of microbial agent, and may be especially useful in certain cases which are difficult to be diagnosed microbiologically or serologically. Tuberculous pleurisy is a disease that can be diagnosed in only 70% of cases by conventional diagnostic tools, and PCR would be a very rapid, easy, and sensitive diagnostic method. Method: The specificity and sensitivity of PCR to detect Mycobacterium tuberculosis DNA were evaluated using various strains of Mycobacteria. To evaluate the diagnostic usefulness of PCR in tuberculous pleurisy, we used PCR to detect Mycobacterium tuberculosis DNA in pleural fluid. The amplification target was 123 base pair DNA, a part of IS6110 fragment, 10~16 copies of which are known to exist per genome. The diagnostic yield of PCR was compared with conventional methods, including pleural fluid adenosine deaminase (ADA) activity. Also, the significance of PCR in undiagnosed pleural effusion was evaluated prospectively with antituberculosis treatment. Results: 1) Using cultured Mycobacterium tuberculosis and other strains, PCR could detect upto 1 fg DNA and specific for only Mycobacterium tuberculosis and Mycobacterium bovis. 2) Using pleural effusions of proven tuberculosis cases, the sensitivity of PCR was 80.0% (16/20), and the specificity 95.0% (19/20). 3) Among 13 undiagnosed, but suspected tuberculous effusion, the positive rate was 60% in 10 improved cases after antituberculosis medications, and 0% in 3 cases of proven malignancy later. 4) Adenosine deaminase level of proven and clinically diagnosed tuberculous pleurisy patients was significantly higher than that of excluded patients, and correlated well with PCR results. Conclusion: We can conclude that PCR detection of Mycobacterium tuberculosis in pleural effusion has acceptable sensitivity and specificity, and could be an additional diagnostic tool for the diagnosis of tuberculous pleurisy.

• Investigative Magnetic Resonance Imaging
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• v.9 no.1
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• pp.16-23
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• 2005

Purpose : In order to investigate the functional brain anatomy associated with mental calculation, functional magnetic resonance imaging was performed. Materials and Methods : In six normal right handed subjects, functional MR images were obtained using a 1.57 MR scanner and the EPI BOLD technique. The study included experiment I and experiment II. Each experiment consisted of five resting and four activation periods with each period of 30 seconds. During the activation period of both experiment I and II, calculation equations[an example: $(4+5)\times8=72$] were presented and the subjects were instructed to decide true or false of them. During the resting period of experiment I, the subjects were instructed to visually fixate on a crosshair. During the resting period of experiment II, two diagrams (an example: $(\bullet,\;\blacksquare)$)were presented and the subjects were instructed to decide they are same or not. For the post-processing of images, the SPM program was used, with the threshold of significance set at p<0.00001. The activated areas during the tasks were assessed. Results : In experiment 1, the inferior frontal gyrus, prefrontal cortex, promoter area, supplementary motor area, and intraparietal sulcus including superior parietal cortex were activated bilaterally. Although these areas were also activated in experiment II, the activated signals in the right frontal and parietal lobes were lessened. Conclusion : The left inferior frontal gyrus and prefrontal cortex and bilateral intraparietal sulci were activated during mental calculation. The right frontal and parietal lobes might be related to attention and decision making.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.24 no.1
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• pp.4-12
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• 2015

Purpose: Due to the presence of various muscles around lips, variety of facial expression can be made and changes from aging process such as wrinkles can develop on the facial skin by the action of multiple muscles. In animals, skin and muscles are developed in the entire body. On contrast, they are well developed only in the face and just one is present in the neck and the palm. Alar band was defined as outer wrinkle formed by zygomaticus minor muscle, which is common in Koreans. This study aimed to investigate clinical prevalence of alar band. Materials & Methods: Subjects were chosen from 780 new patients who visited private clinic in Gyeonggi province for orthodontic treatment. Presence of alar band was examined from the smile extraoral photos. Correlation among skeletal form, lip protrusion, gender, and age were evaluated. Results: Prevalence of alar band was higher in women (27.9%) than in men (18.5%) with statistical significance (p<0.05). With respect to age, prevalence of alar band was 19.4% in age 0-9 y, 16.9% in age 10-19 y, 31.2% in age 20-29 y, 39.5% in age 30-39, 56.5% in age 40-49. Prevalence was gradually increased from patients in their 20s to patients in their 40s and statistical significance was found (p<0.001). Concerning SN_NP, prevalence was 26.2% in normodivergent facial type, 22.0% in hyperdivergent facial type, and 32.2% in hypodivergent facial type. Hypodivergent facial group had higher prevalence but statistical significance was not observed. Statistically significant difference was not found regarding upper lip. However, prevalence of the alar band was 26% in patients with normal lower lip, 14.7% in patients with pretruded lower lip, and 33.3% in retruded lower lip. The prevalence was higher in patients with retruded lower lip with statistical significance (p<0.05). Conclusions: 27.8% on previous anatomical study and this study showed 27.8% prevalence of alar band in clinical smile photographs. Clinical photograph study showed that alar band was more prominent in women, older people, and people with retruded lips with statistical significance. This will provide valuable diagnostic information for esthetic consideration.

• Journal of the Korean Society of Radiology
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• v.5 no.3
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• pp.111-120
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• 2011

A purpose of study is to develop optimization and radiation dose exposure reference level by measuring actual radiation dose in condition of quality control of mammography equipment for 39 clinics. The result were as follows. First, we measured T-test separating radiology from general clinic. According to the test, mAs was measured at average 78.58 mAs; radiology at 80.16 mAs and general clinic at 77.22 mAs. And, kerma rate was measured at average 7.71 mGy/mR; radiology at 8.94 mGy/mR and general clinic at 6.66 mGy/mR. HVL was measured at average 0.42 mmAl; radiology at 0.40 mmAl and general clinic at 0.43 mmAl. Average glandular dose was measured at average 1.14 mGy; radiology at 1.09 mGy and general clinic at 1.19 mGy. Second, we measured value of mAs, HVL, processing method and so on dividing two groups. And, we compared and analyzed average value measured using T-test. As a result, there was significance level in SID(P<0.05). There was significance level in mAs(P<0.05). Because processor was measured at 1.00 mGy and CR at 1.17 mGy according to the processing method of radiology. Third, according to the correlation analysis, radiology had significance level between average glandular dose and mAs and general clinic had significance level between average glandular dose and SID(P<0.05). Forth, as a result of regression analysis, mAs affected 22.7%t of average glandular dose and SID affected 21.7% of average glandular dose, which had significance level(P<0.05). And, mAs affected 29.0% of average glandular dose in radiology and SID affected 29.1% of average glandular dose in general clinic, which was most influential.

• Nuclear Medicine and Molecular Imaging
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• v.41 no.1
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• pp.22-29
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• 2007

Purpose: Metastatic thyroid cancers with I-131 uptake have been known to show no increase of FDG uptake whereas those without I-131 uptake tend to demonstrate increased uptake on PET. In this study, we evaluated the degree of FDG uptake in primary thyroid cancers of papillary histology before surgery. Material & Methods: Forty FDG PET studies were performed on the patients who had papillary cancer proven by fine needle aspiration. The degree of FDG uptake was visually categorized as positive or negative (positive if the tumor showed discernible FDG; negative if the tumor didn't) and the peak standard uptake value (peak SUV) of the papillary thyroid cancer (PTC) were compared with the size of PTC. Results: The mean size of 26 PTC with positive FDG uptake was $1.9{\pm}1.4\;cm(0.5{\sim}5\;cm)$. In 13 PTC with negative FDG uptake, the mean size of those was $0.5{\pm}0.2\;cm\;(0.2{\sim}0.9\;cm)$. All PTC larger than 1cm ($2.5{\pm}1.4\;cm,\;1{\sim}5\;cm$) have positive FDG uptake (peak $SUV=6.4{\pm}5.7,\;1.7{\sim}22.7$). Among the micropapillary thyroid cancer (microPTC; PTC smaller than 1cm), 8 microPTC show positive FDG uptake(peak $SUV=2.9{\pm}1.3,\;1.7{\sim}5.5$), while 13 microPTC show negative finding(peak $SUV=1.3{\pm}0.2,\;1.1{\sim}1.7$). The size of microPTC with positive FDG uptake is significantly larger than that of microPTC with negative FDG uptake ($0.7{\pm}0.1\;cm$ vs $0.4{\pm}0.2\;cm$, p=0.01). Conclusion: All PTCs larger than 1cm show positive FDG uptake in our study. In other words, thyroid lesions larger than 1cm with negative FDG uptake are unlikely to be PTC. So far, only poorly differentiated thyroid cancers are known to show increased FDG uptake. Our results seem to be contradictory to what is known in the literature. Further study is needed to understand better the significance of increased FDG uptake in PTC in relation to expression of NIS and GLUT.

• Tuberculosis and Respiratory Diseases
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• v.66 no.6
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• pp.437-443
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• 2009

Background: The aim of this study was to consider the significance of pleural fluid adenosine deaminase (ADA) activity combined with lymphocyte/neutrophil (L/N) ratio in the diagnosis of tuberculous pleurisy (TBpl) in a region of intermediate prevalence of tuberculosis (TB). Methods: We collected data from 388 patients with exudative pleural effusions. The final diagnoses were compared to the results from our diagnostic method using pleural fluid ADA and L/N ratio. Results: 108 patients had a final diagnosis of TBpl; 102 cases had high levels of ADA ($\geq$40 IU/L). When we considered ADA $\geq$40 IU/L as a diagnostic criterion, the sensitivity was 94.4%, specificity 87.5%, and posttest posttest probability 74.5%. However, when we considered ADA $\geq$40 IU/L combined with the L/N ratio $\geq$0.75 as a diagnostic criterion, the specificity and post-test probability were rose to 97.5% and 93%, respectively. The other causes of high ADA and L/N ratios were lymphoma and metastatic carcinoma, but mass-like lesions were found on the chest radiographs or CT scans. Conclusion: To evaluate the causes of exudative pleural effusions in a region of intermediate prevalence of tuberculosis, we recommend measuring the pleural fluid ADA and L/N ratio first. If the result is high and malignancies are not suspected, it may be diagnostic of TBpl.

• Tuberculosis and Respiratory Diseases
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• v.49 no.5
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• pp.558-567
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• 2000

Background : Recently, serologic techniques for tuberculosis have been developed and some of them, which are focusing on detection of serum antibodies mainly directed against specific 38-kDa Mycobacterium tuberculosis, have already been introduced into the markel. In this study, diagnostic significance of a new serologic test(ELISA kit) for pulmonary tuberculosis was evaluated. Method : Serologic test with newly developed ELISA kit was performed upon 474 individuals, who include 333 active pulmonary tuberculosis patients, 80 healthy cases, and 61 tuberculosis contact cases. This serologic test was based on the ELISA technique and designed to detect antibodies to mixed complex antigens including 38-kDa, which were developed by Erume Biotech Co., Seoul. Active pulmonary tuberculosis was diagnosed by sputum AFB smear and culture methods. Results : The seropositivities using this ELISA kit were 82.1% and 73.6% in smear-positive and negative groups among active pulmonary tuberculosis, respectively. And, it also showed that seronegativities were 97.5% and 85.2% in healthy and contact groups, respectively. As a whole, the results of our study using the ELISA kit as a diagnostic method for pulmonary tuberculosis showed 80.0% sensitivity for active pulmonary tuberculosis, 97.5% specificity, 96.1% positive predictive value, and 65.0% negative predictive value when the prevalence of tuberuclosis in the samples was 60.1%. Conclusion : Our results reveal that the detection of antibody its reaction with 38-kDa antigen of M. tuberculosis is not sufficient to be accepted as single diagnostic method for pulmonary tuberculosis. However, they suggest that ELISA kit may be considered as an adjunctive test to standard diagnostic techniques of pulmonary tuberculosis.

• Tuberculosis and Respiratory Diseases
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• v.44 no.3
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• pp.611-620
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• 1997

Objectives : The differentiation of tuberculous effusion from the other causes of exudative pleural effusion remained difficult even with aids of biochemical analyses and pleural biopsy. As the pathophysiology of tuberculous pleural effusion is an enhanced cell mediated immunity, Adenosine deaminase(ADA) and various eytokines including Inteferon-$\gamma$, tumor necrosis factor alpha(TNF-$\alpha$) are considered as useful diagnostic tools in differentiating exudative pleural effusion. The author would like to demonstrate the diagnostic usefulness of TNF-$\alpha$ in the differentiation of exudative pleural effusion, and compared the discriminating ability of TNF-$\alpha$ with ADA. Methods : Pleural fluids obtained from 80 patients (tuberculous : 39, malignant : 31, parapneumonic : 10) with exudate pleural effusions were processed for cell counts and biochemical analysis including ADA and TNF-$\alpha$. Results : Tuberculous pleural fluid showed higher levels of ADA and TNF-$\alpha$, $48.7{\pm}32.7U/L$ and $184.1{\pm}214.2pg/mL$ than that of non-tuberculous effusion $26.0{\pm}41.3U/L$ and $44.1{\pm}114.2pg/mL$, respectively (ADA, TNF-$\alpha$, p < 0.05, p < 0.01). Receiver operating characteristics(ROC) curves were generated for ADA and TNF-$\alpha$ and the best cut-off value for adenosine deaminase and TNF-$\alpha$were considered as 30U/L and 15pg/ml, respectively. Comparing the area under the ROC curves, there was no significant difference between ADA and TNF-$\alpha$. Conclusion : For the differential diagnosis of tuberculous pleural effusion from the other causes of exudative pleural effusions, TNF-$\alpha$ as well as ADA was considered as useful diagnostic method. However adding TNF-$\alpha$ to ADA has no further diagnotic benefit than ADA alone.

• Korean Journal of Clinical Laboratory Science
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• v.52 no.2
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• pp.158-163
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• 2020

This study examines and presents reasonable improvement measures for the operation and revision of the relative value scoring system, and the basis for performance of a medical technologist. Seven hospitals were enrolled in the study, and included 5 resident laboratory medicine specialists and 53 medical technologists, giving a ratio of 10.6 technologists per laboratory medicine specialist. The average of professional manpower scores was 18, and the average of each medical institution's total score was 78. Ratings and additional rates were in the range 2~3%, and quality-added ratios were 2~3%, with no significance. Excluding pathological testing and assessing physiological functions, the average number of diagnostic tests for health insurance claims were 9,618,062, including 4,378,146 points for 5% of the total relative value scores. According to the DEA, the appropriate number of medical technologist is one person per 49,974 points of relative value. In conclusion, our study results indicate that it would be desirable to set the appropriate workforce for medical technologist to one person per 50,000 points of relative value. Our data could be used as a basis for enhancing productivity of the workforce and balancing health care resources.