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A novel approch of usage of Gram staining to indentify Mycobacterium tuberculosis from tissues
Jin Mok Kim(Jin Mok Kim),Ji Eun Oh(Ji Eun Oh),Reye Kim(Reye Kim),Yeong-Jin Heo(Yeong-Jin Heo),Jae-Hyeon Cho(Jae-Hyeon Cho) 한국예방수의학회 2023 예방수의학회지 Vol.47 No.1
Tuberculosis is a potentially deadly infectious disease caused by the Mycobacterium tuberculosis (M. tuberculosis). Tuberculosis is diagnosed by proving the M. tuberculosis in sputum samples based on the results of acid-resistant staining, culture, and nucleic acid amplification tests. However, there is a report that the detection rate of M. tuberculosis is low in acid-resistant staining using tissue specimens. It has been suspected that the cause is a potential loss of acid resistance by the organic solvents used for tissue specimen preparation. Therefore, this study was pursued to find out if Gram staining and fluorescent staining in addition to acid-resistant staining would be helpful in diagnosing tuberculosis. We used four tissue (lung, small intestine, large intestine, and lymph node) samples with chronic granulomatous inflammation observed in HE staining and positive results in real-time PCR. These detection rates and staining properties were investigated through microscopic examination using the Ziehl-Neelsen, Gram, and Auramin rhodamine staining. In this studies, M. tuberculosis were observed by Ziehl-Neelsen, Gram, and Auramin rhodamine staining in all four samples. In the evaluation of clinical microbiology proficiency testing (CMPT), the Ziehl-Neelsen and Gram staining were the same result, but the Auramin rhodamine staining was relatively low. These data indicated that Gram staining is useful for detecting M. tuberculosis in formalin-fixed tissue specimens. Therefore, if the Ziehl-Neelsen and Gram staining are combined as the M. tuberculosis staining method in tissue specimens, a better direction may be provided for tuberculosis diagnosis.
Kim, Hyun-Mok,Shin, Sang-Wook,Yoon, Ji-Young,Lee, Hyeon-Jeong,Kim, Kyung-Hoon,Baik, Seong-Wan The Korean Society of Anesthesiologists 2012 Korean Journal of Anesthesiology Vol.62 No.3
<P><B>Background</B></P><P>Etomidate frequently induces myoclonus, so it may affect electromyographics (EMG). And EMG commonly has an effect on the bispectral index scale (BIS) and spectral entropy. This study was performed to compare the effect of etomidate on BIS, response entropy (RE) and state entropy (SE) during induction of anesthesia.</P><P><B>Methods</B></P><P>Fifty patients (ASA I or II) scheduled for elective surgery were included in this study. Anesthesia was induced with etomidate (0.3 mg/kg) and rocuronium (0.6 mg/kg). Patients also inhaled 4 vol% sevoflurane and 100% oxygen and, then intubated. BIS, RE, SE and Modified Observer's Assessment of Alertness/Sedation Scale (MOAA/S) were measured 4 times (before injection of etomidate [T0], at loss of eyelash reflex [T1], 90 seconds after rocuronium injection [T2], and after intubation [T3]). We also checked whether myoclonus occurred.</P><P><B>Results</B></P><P>Baseline values (T0) were 93.1 ± 4.7 for BIS, 95.8 ± 3.7 for RE and, 87.3 ± 3.5 for SE. In comparison with T0, there were significantly differences in BIS (50.2 ± 16.3), RE (76.8 ± 18.5) and SE (66.3 ± 17.4) at T1 (all P < 0.05). There were no significant differences at T2 and T3. Thirty one patients had myoclonus. At the occurrence of myoclonus, RE and SE values significantly increased but not BIS (P < 0.05).</P><P><B>Conclusions</B></P><P>In patients with myoclonus, at the loss of consciousness, spectral entropy did not decrease where as BIS did, suggesting that BIS may evaluate hypnotic levels better than spectral entropy during induction of anesthesia with etomidate.</P>
Kim Hoyoung,Kim Jihoon,Choe Yeon Hyeon,Kim Sung Mok 대한의학회 2023 Journal of Korean medical science Vol.38 No.45
Background: There is a strong correlation between risk factors for coronary artery disease (CAD) and aortic aneurysm (AA). We aimed to investigate the prevalence and prognostic impact of CAD and AA in patients who underwent coronary aorta computed tomography (CACT) protocol, which allowed simultaneous evaluation of coronary artery and aorta. Methods: Between 2010 and 2021, 1,553 patients who underwent CACT were enrolled from a tertiary center. The presence and location of AA and the presence of CAD were identified from CT. The primary outcome was a composite of cardiovascular death, acute coronary syndrome requiring urgent revascularization, and stroke at 3 years after the index CT scan. Results: Out of 1,553 enrolled patients, 179 (11.5%) had AA. The prevalence of CAD was significantly higher in patients with AA than those without (47.5% vs. 18.3%, P < 0.001). Among patients with AA, the prevalence of comorbid CAD was higher in those with abdominal AA than thoracic AA (57.3% vs. 37.8%, P = 0.014), respectively. In multivariable analysis, the presence of CAD was an independent predictor of primary outcome at 3 years (hazard ratio [HR], 2.58; 95% CI, 1.47–4.51; P = 0.001), while AA was not (HR, 1.00; 95% CI, 0.48–2.07; P = 0.993). Conclusion: In this cohort of patients undergoing simultaneous evaluation of coronary artery and aorta using CACT protocol, patients with AA had an increased risk of comorbid CAD compared to those without AA. CAD was independently associated with adverse clinical outcomes at 3 years.
Kim Hae Jin,Choe Yeon Hyeon,Kim Sung Mok,Kim Eun Kyung,Lee Mirae,Park Sung-Ji,Ahn Joonghyun,Carriere Keumhee C. 대한영상의학회 2021 Korean Journal of Radiology Vol.22 No.8
Objective: We aimed to compare the aortic valve area (AVA) calculated using fast high-resolution three-dimensional (3D) magnetic resonance (MR) image acquisition with that of the conventional two-dimensional (2D) cine MR technique. Materials and Methods: We included 139 consecutive patients (mean age ± standard deviation [SD], 68.5 ± 9.4 years) with aortic valvular stenosis (AS) and 21 asymptomatic controls (52.3 ± 14.2 years). High-resolution T2-prepared 3D steady-state free precession (SSFP) images (2.0 mm slice thickness, 10 contiguous slices) for 3D planimetry (3DP) were acquired with a single breath hold during mid-systole. 2D SSFP cine MR images (6.0 mm slice thickness) for 2D planimetry (2DP) were also obtained at three aortic valve levels. The calculations for the effective AVA based on the MR images were compared with the transthoracic echocardiographic (TTE) measurements using the continuity equation. Results: The mean AVA ± SD derived by 3DP, 2DP, and TTE in the AS group were 0.81 ± 0.26 cm2, 0.82 ± 0.34 cm2, and 0.80 ± 0.26 cm2, respectively (p = 0.366). The intra-observer agreement was higher for 3DP than 2DP in one observer: intraclass correlation coefficient (ICC) of 0.95 (95% confidence interval [CI], 0.94–0.97) and 0.87 (95% CI, 0.82–0.91), respectively, for observer 1 and 0.97 (95% CI, 0.96–0.98) and 0.98 (95% CI, 0.97–0.99), respectively, for observer 2. Inter-observer agreement was similar between 3DP and 2DP, with the ICC of 0.92 (95% CI, 0.89–0.94) and 0.91 (95% CI, 0.88–0.93), respectively. 3DP-derived AVA showed a slightly higher agreement with AVA measured by TTE than the 2DP-derived AVA, with the ICC of 0.87 (95% CI, 0.82–0.91) vs. 0.85 (95% CI, 0.79–0.89). Conclusion: High-resolution 3D MR image acquisition, with single-breath-hold SSFP sequences, gave AVA measurement with low observer variability that correlated highly with those obtained by TTE.
( Junghyun Kim ),( Woo Jin Kim ),( Bom Kim ),( So Hyeon Bak ),( Yeon-mok Oh ) 대한결핵 및 호흡기학회 2020 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.128 No.-
Purpose The clinical and radiological presentation of chronic obstructive pulmonary disease (COPD) has proposed heterogeneity according to the sources of inflammation characterized in COPD. This study tried to evaluate COPD phenotypes for specific dust exposure. Method This study was designed to compare characteristics and clinical outcomes with radiological findings between the two prospective COPD cohorts representing a distinguishing region in the Korea; COPD in Dusty Area (CODA) and the Korean Obstructive Lung Disease (KOLD) cohort. A total of 733 participants (n=186 for CODA, and n=547 for KOLD, for each) were included in the final analysis. Multivariate analysis for the comparison of lung function and CT measurements of both study groups after adjusting for age, gender, education, body mass index, smoking status, pack-year, charlson comorbity index, and the frequency of exacerbation were done entering the level of FEV1(%), biomass exposure and COPD medication into the model in stepwise. Result There was no differences in mean wall area (70.2±1.26 in CODA vs. 67.07±0.90 in KOLD, p=0.121). KOLD, where the COPD subjects from urban and metropolitan area, showed higher emphysema index (6.07±3.06 in CODA vs. 20.0±2.21 in KOLD, p<0.001, respectively). This significance in emphysema index was consistent even after further adjustment for FEV1 (6.12±2.88 in CODA vs. 17.3±2.10 in KOLD, p=0.002, respectively). Mean wall area was also found to be significantly lower in KOLD (70.2±1.21 in CODA vs. 66.8±0.88 in KOLD, p=0.028) after including FEV1 into the model. However, there was no difference in lung density between the two groups (p=0.077). Additional adjustment for biomass parameter and medication for COPD did not alter the statistical significance after entering into the analysis with COPD medication. Conclusion Higher mean wall area and lower emphysema index were observed in dust exposure region. These Results suggest that imaging phenotype of COPD is influenced by the environmental exposure.