Clinical Significance of Preoperative Studies in Diagnosis of Thyroid Nodule : FNAC, Ultrasonography, Computed Tomography / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: It is critical to distinguish benign from malignant thyroid nodule and to select a patient for surgery. Fine needle aspiration cytology(FNAC) and various radiologic techniques are used in the evaluation of thyroid nodule. The purpose of this study is to evaluate the diagnostic accuracy of preoperative FNAC, ultrasonography(US) and computed tomography(CT) in thyroid nodule, and to identify the reliable factors of radiologic imaging in the differential diagnosis of thyroid nodule. MATERIALS AND METHOD: Retrospectively, we reviewed 34 patients among 50 patients with thyroid nodule who were evaluated by FNAC, US and CT and operated on at our Department from June 1995 to December 1998. By comparing the preoperative FNAC results, US and CT findings with postoperative pathologic diagnosis, the results were as followed. RESULTS: Overall diagnostic accuracy of FNAC, US, and CT was 84.4%, 88.2%, 79.4%. Solid nature, ill defined margin, calcification, lymphadenopathy on US imaging indicated the possibility of malignancy. Solid nature, ill defined margin, lymphadenopathy on CT imaging indicated the possibility of malignancy. CONCLUSION: This study suggests that FNAC has a high sensitivity(75.0%) and specificity(93.8%) rate and it is therefore a valuable initial diagnostic procedure. US has higher diagnostic accuracy than computued tomography.

Detection of Bacteria in the Middle Ear Effusion and Adenoid Tissue of Chronic Otitis Media Patient Using PCR Method / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Otitis media with effusion (OME) is one of the most common reasons for children to seek doctors. Although it is closely related to bacterial infection, the pathogenesis remains unclear. The most common bacteria associated with OME include Haemophilus influenzae (H. influenzae), Streptococcus pneumoniae (S. pneumoniae), and Moraxella catarrhais (M. catarrahalis). These bacteria have consistently been reported to show colony growth on agar. Recently, the analysis using polymerase chain reaction (PCR) has been reported to be much more sensitive for bacteria detection than previous methods, such as culture. In this study, we investigate the possible relationship between bacterial infection in adenoid tissue and middle ear effusion. MATERIALS AND METHODS: Total of 52 middle ear effusion and adenoids were collected from pediatric patients during ventilation tube insertion and adenoidectomy. All the patients had gone through multiple courses of antimicrobial therapies without success. PCR was applied to detect bacteria(H. influenzae, S. pneumoniae, M. catarrha lis) in the middle ear effusion and adenoids. RESULTS: Overall detection rates of bacteria were 57.7% and 46.2% for effusion and adenoids, respectively. Bacterial detection rates of H. influenzae, S. pneumoniae, M. catarrhalis in the middle ear effusion were 30.8%, 19.2%, 11.5%, and in the adenoid were 36.5%, 15.4%, 13.5%, and in both and effusion were 13.5%, 7.7%, 3.8%, respectively. CONCLUSION: PCR is the effective method for detection of bacteria in OME and adenoid tissue. The bacteria found in the adenoid tissue of chronic OME patients did not show any correlation with those found in the OME fluid.