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Objective To compare the clinical diagnosis effect of high and common iodine concentration of contrast agent to patients with liver cirrhosis hepatocarcinoma in 64-MDCT.Methods Ninety patients who diagnosed with cirrhosis and hepatoma by biopsy in our hospital from January 2015 to December 2016 were randomly divided into observation group(n =45) and control group(n =45).The observation group and the control group separately accepted 350 mgI/mL and 300 mgI/mL Lohexol enhancement.The CT values of different enhanced parts,detection rate of lesions and the incidence of adverse reactions were chosen as clinical diagnosis indexes.Results The CT value of liver parenchyma,aorta and portal vein in observation group were particularly or very particularly higher than those of control group (P ＜ 0.05).145 and 110 lesions were respectively detected in observation group and control group.It showed higher diagnostic sensitivity of observation group in three phases (P ＜ 0.05) and good safety in 64-MDCT.Conclusion High concentration iodine contrast agent can remarkably improve the detection CT value and detection rate of liver cancer patients with liver cirrhosis in 64-MDCT,with less adverse reactions.
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BACKGROUND AND PURPOSE: The various tests that are routinely used to diagnose generalized myasthenia gravis, such as the edrophonium test, serum anti-acetylcholine-receptor antibodies (AChR-Ab), and repetitive nerve stimulation (RNS) tests, have lower diagnostic sensitivity in ocular myasthenia gravis (OMG). Diagnosing OMG becomes even more difficult when the clinical symptoms are subtle. There is no gold-standard diagnostic test available for OMG patients, and so this study compared the diagnostic sensitivity of gaze photographs with conventional tests in OMG. METHODS: Records of gaze photographs were available for 25 of 31 consecutive patients diagnosed with OMG. Each patient underwent a neuro-ophthalmologic examination, serum AChR-Ab, RNS, edrophonium test, ice tests, and the acquisition of gaze photographs. The margin reflex distance 1 (MRD1) was measured on each of the gaze photographs, with MRD1 < 2 mm or an interlid MRD1 difference of ≥2 mm on any of the gaze photographs defined as a positive sign of OMG. The diagnostic sensitivities of the tests were assessed. RESULTS: The mean age at onset was 38.5 years (range, 2–76 years), and 13 patients (52%) were men. The diagnostic sensitivities of the RNS test, AChR-Ab test, gaze photographs, and ice test were 56%, 64%, 80%, and 73%, respectively. CONCLUSIONS: The diagnostic sensitivity was higher for gaze photographs than for the other tests applied to OMG patients.
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Humans , Male , Age of Onset , Antibodies , Diagnosis , Diagnostic Tests, Routine , Edrophonium , Ice , Myasthenia Gravis , ReflexABSTRACT
La tosferina es una enfermedad infecciosa causada por Bordetella pertussis, que se diagnostica mediante el cultivo como técnica de referencia, la cual tiene como limitante una baja sensibilidad. Es debido a esto, que el presente trabajo se centró en evaluar a la técnica de PCR a punto final amplificando las secuencias IS481 y PT, como una metodología alternativa diagnóstica a partir de 100 muestras pareadas de hisopado nasofaríngeo de pacientes provenientes de distintas regiones de Venezuela. Dichas muestras pareadas constaron de un hisopado para realizar el cultivo bacteriano y el otro para la detección de ADN específico. La identificación microbiológica de B. pertussis incluyó el aislamiento del microorganismo en agar Regan-Lowe, identificación bioquímica y la confirmación por coaglutinación. El análisis de los resultados fue realizado empleando el programa SPSS 21.0.0., usando como herramienta estadística el test de McNemar. La sensibilidad obtenida por el protocolo de PCR a punto final fue 50%, en concordancia con reportes previos. De acuerdo al valor de p=0,002 obtenido, la detección de B. pertussis mediante los dos métodos presentó una diferencia para el diagnóstico de tosferina estadísticamente significativa, por lo que no es indiferente emplear ambas técnicas diagnósticas. Sin embargo, se recomienda emplear en forma combinada ambas metodologías para incrementar la probabilidad de realizar el diagnóstico.
Whooping cough is an infectious disease caused by Bordetella pertussis, diagnosed by culture as a reference technique, which has low sensitivity as limiting. It is because of this that the present work focused on evaluating the PCR technique endpoint amplifying IS481 and PT sequences, as an alternative methodology diagnostic from 100 paired samples of nasopharyngeal swabs from patients from different regions of Venezuela. Such paired samples comprised a swab for bacterial culture and the other for detection of specific DNA. Microbiological identification of B. pertussis included the isolation of the microorganism in agar Regan-Lowe, biochemical identification and confirmation by Coagglutination. The analysis of the results was performed using the SPSS program 21.0.0., as a statistical tool using the McNemar test. The sensitivity obtained by the PCR protocol endpoint was 50%, consistent with previous reports. According to the value of p = 0.002 obtained, detection of B. pertussis by the two methods showed a difference for the diagnosis of pertussis statistically significant, so it is not indifferent both diagnostic techniques employed. However, it is recommended to use both methods in combination to increase the likelihood of diagnosis.
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Humans , Male , Female , Bordetella pertussis , Whooping Cough , Polymerase Chain Reaction/methods , Public Health , Communicable Diseases/pathologyABSTRACT
Background: Suppurative keratitis is a common ophthalmic condition mostly caused by fungi. Apart from fungal culture, wet preparation using 10% Potassium hydroxide (KOH) for microscopic detection of fungal elements is a rapid and accurate method of laboratory diagnosis. Purpose: This prospective and cross sectional study was undertaken in order to evaluate the diagnostic sensitivity of wet preparation microscopy using KOH for detection of fungal agents from suppurative corneal ulcer patients. Methodology: Fifty six (56) consecutive clinically suspected patients of suppurative corneal ulcer attending Rajshahi Medical College Hospital (RMCH) during the period from July, 06 to June, 07 were included. Corneal swabs were taken aseptically for detection of bacteria in gram-stained smear and culture. Conventional mechanical corneal scrapings were collected under topical anesthesia and utilized for microscopic detection of fungal agents in KOH wet preparation and fungal cultures in the department of Microbiology of Rajshahi Medical College. Results: Culture yielded microbial growths in 47(83.93%) out of 56 samples of corneal ulcer that included 24 (42.86%) pure fungal growths, 14 (25.0%) pure bacterial growths and 09 (16.07%) mixed microbial growths (both bacteria and fungi). Direct microscopical examination using 10% KOH wet preparation detected 28 fungal agents out of total 33 fungal cases (combining both pure and mixed fungal growths in culture). Diagnostic sensitivity of wet preparation microscopy was found to be 84.85% by comparing its performance to fungal culture yields, which is the ‘gold standard’ for laboratory diagnosis. Conclusion: This limited study has revealed that wet preparation can be a tentative diagnosis of fungal keratitis and can be accurately relied upon for initiating prompt anti-fungal therapy and also recommended as a cost-effective method for laboratory diagnosis especially where culture facility is not available.
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PURPOSE: To compare the sensitivity of various diagnostic tests, and to assess the efficacy of therapy in the management of myasthenia gravis (MG). METHODS: Thirty-two patients with ocular findings with MG were examined by Stimulated Single Fiber Electromyograhy (SFEMG), Repetitive Nerve Stimulation (RNS) test, Edrophonium (Tensilon) test, anti-acethylcholine receptor antibody titer. We also studied retrospectively clinical characteristics and efficacy RESULTS: Mean age of patients was 32 years (range 1 to 63 years). Twenty (62.5%) were females and 12 (37.5%) were males. Mean duration of symptoms was 17 months (range 5 months to 10 years). Associated ocular findings were ptosis 31 eyes (97%), diplopia 20 eyes (63%), and ocular limitation 19 eyes (59%). The value of diagnostic sensitivity was 97% in SFEMG, 94% in tensilon test, 75% in RNS test, and 69% in anti-acetylcholine receptor antibody assay. Nine of 10 cases who were treated with thymectomy and pyridostigmine were markedly improved. Eight cases (25%) subsequently developed generalized type of myasthenia gravis. CONCLUSIONS: Ptosis and diplopia were most frequently associated with ocular myasthenia gravis. For diagnosis of ocular myasthenia gravis, SFEMG or tensilon test was the most sensitive test. Thymectomy combined with pyridostigmine bromide seemed to be an effective therapeutic modality.
Subject(s)
Female , Humans , Male , Diagnosis , Diagnostic Tests, Routine , Diplopia , Edrophonium , Myasthenia Gravis , Pyridostigmine Bromide , Retrospective Studies , ThymectomyABSTRACT
The possibility of whether minimal F-wave latency and a simple ratio between the sural and superficial radial sensory response amplitudes may provide a useful electrodiagnostic test in diabetic patients was investigated in this report. To evaluate the diagnostic sensitivity of minimal F-wave latency, the Z-scores of the minimal F-wave latency, motor nerve conduction velocity (MCV), amplitude of compound muscle action potentials (CMAP), and distal latency (DL) of the median, ulnar, tibial, and peroneal nerve were compared in 37 diabetic patients. For the median, ulnar, and tibial nerves, the Z scores of the minimal F-wave latency were significantly larger than those of the MCV. In addition for all four motor nerves, the Z scores of the minimal F-wave latency were significantly larger than those for the CMAP amplitude. Furthermore, 19 subjects showing abnormal results in the standard sensory nerve conduction study had a significantly lower sural/radial amplitude ratio (SRAR), and 84% of them had an SRAR of less than 0.5. In conclusion, minimal F-wave latency and the ratio between the amplitudes of the sural and superficial radial sensory nerve action potential are sensitive measures for the detection of nerve pathology and should be considered in electrophysiologic studies of diabetic polyneuropathy.
Subject(s)
Aged , Female , Humans , Male , Diabetic Neuropathies/physiopathology , Diabetic Neuropathies/diagnosis , Electrodiagnosis , Middle Aged , Polyneuropathies/physiopathology , Polyneuropathies/diagnosis , Radial Nerve/physiopathology , Reaction Time , Sural Nerve/physiopathologyABSTRACT
BACKGROUND: Early diagnosis of tuberculosis is critical, especially in Korea, an area where tuberculosis is endemic. Because antibody responses to some membrane proteins of Mycobacterium tuberculosis are not comparable, and the policy of BCG vaccination and the prevalence of tuberculosis are different from country to country, the usefulness of the serological diagnostic tests is questionable in Korea, even though they have been confirmed to be useful in other countries. In the specific context of Korea, we tried to evaluate the validity of the ICT Tuberculosis Test (ICT), a membrane-based antibody kit that purports to detect the 5 M. tuberculosis complex-specific antigens including 38-kDa protein. METHOD: 68 patients with tuberculosis were tested: 37 had no history of previous tuberculosis, and 31 were reactivated cases. The control group comprised 77 subjects: 25 healthy adults, 35 hospital workers with frequent contact with tuberculosis patients, and 17 in-patients with non-tuberculous respiratory diseases. RESULTS: The diagnostic sensitivities of the ICT were 87% and 73% in patients with versus without previous history of tuberculosis, respectively. The sensitivities of smear-positive and smear-negative patient groups were 81% and 73%, respectively. Both of the two patients with extrapulmonary tuberculosis tested positive through the ICT. The specificities of the ICT were 88%, 94%, and 94% in healthy adults, hospital workers, and non-tuberculous patients, respectively, with an overall specificity of 92%. Conclusion: It is suggested that when combined with traditional techniques, the ICT is an useful tool for the diagnosis of pulmonary tuberculosis. The procedure is simple, easy to perform, rapid, and needs no equipment. It shows 73% sensitivity and 92% specificity for the diagnosis of tuberculosis.
Subject(s)
Adult , Humans , Antibody Formation , Diagnosis , Diagnostic Tests, Routine , Early Diagnosis , Korea , Membrane Proteins , Mycobacterium bovis , Mycobacterium tuberculosis , Prevalence , Tuberculosis , Tuberculosis, Pulmonary , VaccinationABSTRACT
BACKGROUND: Early diagnosis of tuberculosis is critical, especially in Korea, an area where tuberculosis is endemic. Because antibody responses to some membrane proteins of Mycobacterium tuberculosis are not comparable, and the policy of BCG vaccination and the prevalence of tuberculosis are different from country to country, the usefulness of the serological diagnostic tests is questionable in Korea, even though they have been confirmed to be useful in other countries. In the specific context of Korea, we tried to evaluate the validity of the ICT Tuberculosis Test (ICT), a membrane-based antibody kit that purports to detect the 5 M. tuberculosis complex-specific antigens including 38-kDa protein. METHOD: 68 patients with tuberculosis were tested: 37 had no history of previous tuberculosis, and 31 were reactivated cases. The control group comprised 77 subjects: 25 healthy adults, 35 hospital workers with frequent contact with tuberculosis patients, and 17 in-patients with non-tuberculous respiratory diseases. RESULTS: The diagnostic sensitivities of the ICT were 87% and 73% in patients with versus without previous history of tuberculosis, respectively. The sensitivities of smear-positive and smear-negative patient groups were 81% and 73%, respectively. Both of the two patients with extrapulmonary tuberculosis tested positive through the ICT. The specificities of the ICT were 88%, 94%, and 94% in healthy adults, hospital workers, and non-tuberculous patients, respectively, with an overall specificity of 92%. Conclusion: It is suggested that when combined with traditional techniques, the ICT is an useful tool for the diagnosis of pulmonary tuberculosis. The procedure is simple, easy to perform, rapid, and needs no equipment. It shows 73% sensitivity and 92% specificity for the diagnosis of tuberculosis.
Subject(s)
Adult , Humans , Antibody Formation , Diagnosis , Diagnostic Tests, Routine , Early Diagnosis , Korea , Membrane Proteins , Mycobacterium bovis , Mycobacterium tuberculosis , Prevalence , Tuberculosis , Tuberculosis, Pulmonary , VaccinationABSTRACT
Transbronchial fine needle aspiration(TBNA) is one of the cytologic methods in diagnosing lung cancers. TBNA can be used in cases of hilar, mediastinal or lung masses adjacent to the bronchi. We analyzed and compaired the findings of 27 cases of TBNA and bronchial washing and brushing(BW/BB) in lung cancers confirmed by either biopsy or surgical resection between Jun, 1996 and May, 1997 in Asan Medical Center. They were 18 cases of non-small cell carcinomas(eight squamous cell carcinomas, nine adenocarcinomas, and one large cell undifferentiated carcinoma), eight cases of small cell carcinomas, and one case of metastatic hepatocellular carcinoma. The sensitivity of TBNA was 37%(10/27) and false negative was 63%(17/27). Although the sensitivity of BW/BB was 56%(15/27), it was not different statistically from that of TBNA(Chi square, p=0.38). Overall sensitivity of TBNA and BW/BB in this series was 70%(19/27). Forty-seven percent of false negative TBNA(8/17) were positive in BW/BB. The findings suggest that the addition of TBNA to the standard BW/BB increases diagnostic yield in cytologic diagnosis of lung cancer.