Scintigraphic Evaluation of Inhalation Injury in Fire Victims / 핵의학분자영상

PURPOSE: Conventional chest X-ray and pulmonary function test cannot sensitively detect inhalation injury. Bronchoscopy is known to be the gold standard but it is invasive method. We evaluated whether lung inhalation/perfusion scans can sensitively detect inhalation injury of fire victims. MATERIALS AND METHODS: Nineteen patients (male 9, female 10, mean age 31.6 yr) of fire victims were enrolled in this study. Inhalation lung scan was performed 2 days later after inhalation injury with 99mTc-technegas. Perfusion lung scan was performed 4 days later with 99mTc-MAA (macroaggregated albumin). Follow up lung scans were performed 16 and 18 days later for each. Chest X-ray was performed in all patients and bronchoscopy was performed in 17 of 19 patients at the same period. Pulmonary function test was performed in 9 patients. RESULTS: Four of 19 patients showed inhalation and perfusion defects and one showed inhalation defect but, normal perfusion scan findings. These five patients with abnormal scan findings showed abnormal bronchoscopic findings and severe respiratory symptoms. On chest X-ray, 2 of them had pulmonary tuberculosis and one of them showed pulmonary congestion. FEV1/FVC was abnormal in 3 patients. On the follow up scan, all patients with abnormal initial scan findings showed improved findings and they had improved clinical state. CONCLUSION: Inhalation/perfusion lung scans can detect inhalation burn injury noninvasively in early stage and may be useful in therapeutic decision making and follow up of patients.

Evaluation of Human Papillomavirus Infection in Normal Women by Nested PCR / 대한임상병리학회지

BACKGROUND: The human papillomavirus (HPV) is the most common etiologic factor of cervical cancer. It was reported that the incidence of cervical intraepithelial neoplasia and cervical carcinoma was increased when normal women was infected with HPV. To date, for detection and classification of HPV, it were used by hybridization method using the DNA probe specific for HPV and in situ hybridization method for fixed paraffinized tissue, but reported that these methods were inadequate for detection of HPV DNA because of low sensitivity and complex procedure. Compared with these methods, polymerase chain reaction (PCR) was reported as a highly sensitive molecular biologic technique which could detect the HPV DNA in the cervical epithelial cell of women. Thus we used PCR for the investigation of detection rate of HPV 16 and 18, and its relationship with Pap smear class in normal women. METHODS: In 86 normal women, we had extracted the HPV DNA from cervical swab samples and then detected the presence of HPV DNA by nested PCR. RESULTS: In the cases of 86 normal women, the detection rate for HPV DNA was about 7.0%. In the cases of 26 women with Pap smear class I, the HPV DNA was not detected. And in the cases of 60 women with Pap smear class II, the detection rate for HPV DNA was about 10.0%; HPV subtype 16 about 6.7%; HPV subtype 18 about 1.7%; and the coinfection rate of HPV subtype 16 and 18 about 1.7%. CONCLUSIONS: We think that women who was previously infected with high-risk HPV should be examined for Pap smear test in regular time interval, and if the result of Pap smear was abnormal, then should be examined for the presence of the HPV DNA.

Detection of Helicobacter pylori using Polymerase Chain Reaction / 대한임상병리학회지

BACKGROUND: Helicobacter pylori(H. pylori) is an important etiologic agent for chronic active gastritis and plays a role in the pathogenesis of peptic ulcer and stomach cancer and recently lymphomas occurring in mucosa associated lymphatic tissue. At present, H. pylori infection associated gastritis was estimated about 80% among the cause of chronic gastritis. In this study, we tested Polymerase Chain Reaction (PCR) assay to detect H. pylori infection in gastric biopsy specimens. This results were compared with results obtained by other tests. METHODS: A total of 70 patients with dyspepsia were evaluated for H. pylori infection through the use of PCR, culture and serologic tests. The study population had an age of 12 to 80 years(median 46.4), there were 31 males and 39 females. We tested PCR using H. pylori detection kit(TM) (Bioneer, Korea) and anti-H. pylori anti-body EIA using GAP test IgG and IgM(TM)(BIO-RAD, USA). We used anaerobic jar without catalyst for the microaerophilic condition. RESULTS: The positive result by PCR assay for diagnosis of H. pylori infection in gastric specimens was 71.4% in total of 70 patients, which the gastritis, peptic ulcer and gastric cancer were 63.2%, 77.8% and 85.7%, respectively. Among 10 gastrectomy specimens of stomach cancers, the detection rate of H. pylori infection by culture was 50% and the PCR assay was 100%. The detection rate of If pylori IgG and IgM antibodies by commercially available GAP test IgG and IgM EIA were 64.3%, respectively, and IgG or IgM were 85.7%. CONCLUSIONS: The serologic study was sensitive but it was appeared that the high false positive (75%) and false negative (25%) rate and could not confirm current infection. The PCR assay was shown to be more sensitive, rapid and easy to treat specimen for the detection of H. pylori infection than conventional methods such as culture and serologic test in dyspeptic patients.

Detection of Helicobacter pylori using Polymerase Chain Reaction / 대한임상병리학회지

BACKGROUND: Helicobacter pylori(H. pylori) is an important etiologic agent for chronic active gastritis and plays a role in the pathogenesis of peptic ulcer and stomach cancer and recently lymphomas occurring in mucosa associated lymphatic tissue. At present, H. pylori infection associated gastritis was estimated about 80% among the cause of chronic gastritis. In this study, we tested Polymerase Chain Reaction (PCR) assay to detect H. pylori infection in gastric biopsy specimens. This results were compared with results obtained by other tests. METHODS: A total of 70 patients with dyspepsia were evaluated for H. pylori infection through the use of PCR, culture and serologic tests. The study population had an age of 12 to 80 years(median 46.4), there were 31 males and 39 females. We tested PCR using H. pylori detection kit(TM) (Bioneer, Korea) and anti-H. pylori anti-body EIA using GAP test IgG and IgM(TM)(BIO-RAD, USA). We used anaerobic jar without catalyst for the microaerophilic condition. RESULTS: The positive result by PCR assay for diagnosis of H. pylori infection in gastric specimens was 71.4% in total of 70 patients, which the gastritis, peptic ulcer and gastric cancer were 63.2%, 77.8% and 85.7%, respectively. Among 10 gastrectomy specimens of stomach cancers, the detection rate of H. pylori infection by culture was 50% and the PCR assay was 100%. The detection rate of If pylori IgG and IgM antibodies by commercially available GAP test IgG and IgM EIA were 64.3%, respectively, and IgG or IgM were 85.7%. CONCLUSIONS: The serologic study was sensitive but it was appeared that the high false positive (75%) and false negative (25%) rate and could not confirm current infection. The PCR assay was shown to be more sensitive, rapid and easy to treat specimen for the detection of H. pylori infection than conventional methods such as culture and serologic test in dyspeptic patients.

The Study of Identification of Methicillin-Resistant Staphylococcus Aureus using Polymerase Chain Reaction / 대한임상병리학회지

BACKGROUND: Rapid and accurate identification of methicillin-resistant Staphylococcus (MRSA) is very important for patients because they are one of the most common etiologic agents of hospital infection. Conventional identification methods for MRSA are influenced by various factors such as pH, concentration of salt, conditions of media. METHODS: 53 methicillin resistant staphylococcus strains identified by ATB plus system (Biomerieux, France) were preformed the polymerase chain reaction (PCR), Southern blot hybridization fort the detection of mec A gene, and subcultured in Meuller-Hinton media containing 4 microgram/mL oxacillin for the comparison. RESULTS: The correlation of detection rate of mec A gene PCR and ATB plus systems was 81.6%. The correlation of mec A gene PCR and MRSA on Mueller-Hinton media containing 4 microgram/mL oxacillin was 80%. We confirmed by Southern blot hybridization the amplified mer A gene originated from chromosome of MRSA. As the results of oxacillin sensitivity test, minimal inhibitory concentrations of MRSA were distributed between 40 microgram/mL and 320 microgram/mL. When compared with executing time, ATB plus system took 24 hours, but PCR took 5 hours for identification. CONCLUSION: We concluded that mec A gone PCR techniques were simple and rapid for detection of MRSA comparative to conventional methods.