BACKGROUND: A fully automated enzyme-immunoassay (EIA) analyzer, Enzymun System, ES-300 (Boehringer Mannheim, Germany) uses streptavidin technology and performs single test or panels of up to 12 tests per run. We evaluated the results of ES-300 for anti-HCV by comparing the results with microplate-EIA, radioimmunoassay (RIA), and confirmatory test. METHODS: Total 79 sera (51 positive, 24 negative, 4 indeterminate results confirmed by Lucky HCD Confirm) were analysed. ES-300 with Enzymun-Test(R) Anti-HCV (Boehringer Mannheim, Germany) and microplate-EIA (Green Cross Center Innotest HCV 3.0(R)) were used. Fifty one sera were examined additionally by 2nd-generation RIA method, NANBDINE 125C(General Biologicals Corp., R.O.C.). And all results were compared to the results of Lucky HCD Confirm. RESULTS: The overall concordance rate of ES-300 and Innotest(R) was 72/79 (91.1%). The results of Lucky HCD Confirm on seven discrepant samples were five negative and two indeterminate. The results of ES-300 and NANBDINE 125C showed concordance rate of 90.2%. The sensitivity and specificity of ES-300 with regard to Lucky HCD Confirm were 94.5%, and 87.5%, respectively, and that of Innotest(R) were 98.2% and 66.7%, respectively. Clear distinction of positive and negative results by signal/cut off ratio was available in both EIAs. The positive predictive values of ES-300 and Innotest(R) were 94.5%, and 87.1%, respectively. CONCLUSIONS: ES-300 showed relatively good results in sensitivity and positive predictive value with regard to confirmatory test. In EIA-positive persons, however, follow-up study would be necessary for reliable evaluation of HCV infection.
Humans ; Radioimmunoassay ; Sensitivity and Specificity ; Streptavidin

PURPOSE: Intraductal papilloma (IDP) is a benign breast disease with malignant potential, for which complete surgical excision is usually recommended. The aim of the present study was to investigate predictive factors for upgrading patients with a benign papillary lesion (BPL). METHODS: This study was an observational study using a prospectively collected cohort. In total, 13,049 patients who underwent a core needle biopsy (CNB) for a breast lesion between January 2009 and May 2015 were enrolled. We reviewed all patients with pathologically confirmed BPL from a CNB. RESULTS: Surgical treatment was performed for 363 out of a total of 592 lesions. According to the pathological differences, the lowest upgrade rate was shown in IDP without atypia (without atypia, 6.0%; with atypia, 26.8%; papillary neoplasm, 31.5%; p<0.001). The univariate analysis showed that, in IDP without atypia, the age at diagnosis, size of BPL on ultrasonography, and density on mammography were associated with upgrading. The multivariate analysis revealed that age >54 years and lesion size >1 cm were significantly associated with upgrade to malignancy (odds ratio [OR]=4.351, p=0.005 and OR=4.236, p=0.001, respectively). CONCLUSION: The indications for surgical treatment can be defined as age >54 years and mass size >1 cm, even in IDP without atypia in the CNB results; this also includes cases of IDP with atypia or papillary neoplasm. Therefore, we suggest that close observation without surgery is sufficient for younger women with a small IDP without atypia.
Biopsy ; Biopsy, Large-Core Needle* ; Breast Diseases ; Breast Neoplasms ; Breast* ; Cohort Studies ; Diagnosis ; Female ; Humans ; Mammography ; Multivariate Analysis ; Observational Study ; Papilloma, Intraductal ; Prospective Studies ; Ultrasonography

Antigens, CD20 ; metabolism ; Breast Neoplasms ; diagnosis ; diagnostic imaging ; metabolism ; Female ; Humans ; Immunohistochemistry ; Lymphoma ; diagnosis ; diagnostic imaging ; metabolism ; Middle Aged ; Positron-Emission Tomography ; Radiography ; Ultrasonography

Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome is a maternally inherited mitochondrial disorder of which m.3243A>G is the most commonly associated mutation, resulting in an inability to meet the energy requirements of various organs. MELAS poses a diagnostic challenge owing to its multiple organ involvement and great clinical variability due to its heteroplasmic nature. We report three cases from a family who were initially misdiagnosed with myasthenia gravis or undiagnosed. Although there is no optimal consensus treatment approach for patients with MELAS because of the disease's heterogeneity, our 21-year-long therapy regimen of l-arginine, l-carnitine, and coenzyme Q10 supplementation combined with dietary management appeared to provide noticeable protection from the symptoms and complications. Prompt early diagnosis is important, as optimal multidisciplinary management and early intervention may improve outcomes.
Acidosis, Lactic ; Arginine ; Carnitine ; Consensus ; DNA, Mitochondrial ; Early Diagnosis ; Early Intervention (Education) ; Follow-Up Studies ; Humans ; MELAS Syndrome ; Mitochondrial Diseases ; Myasthenia Gravis ; Population Characteristics

PURPOSE: The purpose of this study was to prospectively evaluate the detectability and usefulness of automated whole breast ultrasound (AWUS) and to compare it with handheld breast ultrasound (HHUS) in cases with suspicious microcalcifications identified by mammography. METHODS: Forty-two patients with 43 suspicious microcalcifications (25 malignant and 18 benign) detected by mammography underwent AWUS, HHUS, and histol-ogic examination. With knowledge of the mammographic findings, HHUS was performed to assess the visibility of the microcalcifications and the presence of associated masses or ductal changes. Two radiologists reviewed the AWUS images in consensus using the same methods employed for HHUS. Detectability of AWUS was compared with that of HHUS and was correlated with histologic and mammographic findings. RESULTS: Of the 43 lesions, 32 (74.4%) were detectable by AWUS and 31 (72.1%) by HHUS. No significant differences in sensitivity were found between the two methods (p=0.998). AWUS detected 96% (24/25) of malignant microcalcifications and 44.4% (8/18) of benign microcalcifications. AWUS was more successful in the detection of malignant vs. benign lesions (96.0% vs. 44.4%, p=0.002), lesions >10 mm vs. ≤10 mm in size (86.7% [26/30] vs. 46.2% [6/13], p=0.009), lesions with a fine pleomorphic or linear shape vs. a round or amorphous or coarse heterogeneous shape (94.7% [18/19] vs. 58.3% [14/24], p=0.021), and lesions associated with a mass or architectural distortion vs. without obvious changes on mammography (100% [19/19] vs. 54.2% [13/24], p=0.022). CONCLUSION: Detectability of AWUS was comparable to that of HHUS in cases where suspicious microcalcifications were identified on mammography. Therefore, AWUS might be helpful in the performance of ultrasound-guided percutaneous procedures for highly suspicious microcalcifications.
Breast Neoplasms ; Breast* ; Calcinosis ; Consensus ; Humans ; Mammary Glands, Human ; Mammography* ; Prospective Studies ; Ultrasonography*

PURPOSE: Most of the former studies about the occlusal contact patterns during the mandibular movement focused on foreigner. The purpose of this study is analyzing the occlusal contacts of young Koreans by using T-Scan system. MATERIALS AND METHODS: The sample size was 87 and the occlusal contacts of each right and left lateral movements were measured from the maximum intercuspation to the 3mm excursive position for three times respectively. All of the occlusal contacts were double checked through the thin metal foil. The results were categorized as two; 1) considering occlusal contact patterns on working side only, 2) considering occlusal contact patterns on working and nonworking sides. RESULTS: The results showed that the nonworking side occlusal contacts play major roles in the lateral mandibular movement. In both cases of considering with and without the nonworking side occlusal contacts, the group function was the most prevalent. In the working side, the contacts were the most frequent in canine and the frequency of contacts was decreased as the distance was increased from canine to molar. In the nonworking side, the contacts were the most frequent in second molar. And the gender factor was statistically significant (alpha=.05), as females have more nonworking side occlusal contacts in this study. CONCLUSION: Among the three factors of anterior guidance, the group function was the most dominant factor. The analysis of 87 samples showed that canine contact was the most frequent in the working side and second molar contact was the most common in the nonworking side.
Emigrants and Immigrants ; Female ; Humans ; Molar ; Sample Size

No abstract available.
Paramyxoviridae Infections* ; Polymerase Chain Reaction* ; Reverse Transcription*

PURPOSE: The study was performed to identify the reality of urinary incontinence (UI) and to evaluate the risk factors developing UI for the patients with Parkinson's disease. MATERIALS AND METHODS: This was the cross-sectional study with interviews using structured questionnaires. The subjects who were 72 patients(male 20, female 52) and their mean age is 70.07+/-20.06(range 54~86) with Parkinson's disease visited the Neurology clinic, from September to November 2005, at one university hospital located in Jeju island. RESULTS: Subjects with restricted mobility were 45, and 13 were in first stage of Hoehn & Yahr stage, 31 were in second stage, 28 were in third stage. Fifty three(73.6%) subjects had experienced UI. Mixed UI was in 32 (44.4%), stress UI 12(16.7%), and urge UI 9(12.5%), respectively. As for risk factors developing UI, female had 1.62 times(OR=1.62, 95% CI=0.47~5.66) more than male, age of 80~86 had 3.20 times(OR=3.20, 95% CI=0.65~15.69) more than age of 54~69, subjects with restricted mobility had 2.75 times(OR=2.75, 95% CI=0.80~9.43) more than subjects without restricted mobility. Group without regular exercise had 2.9 times more than group with regular exercise(OR=2.90, 95% CI=0.92~9.22). Cognitive impairment group had 1.98 times more than normal mental status group(OR=1.98, 95% CI=0.39~9.97). Second stage had 4.91 times(OR=4.91, 95% CI=0.55~43.53) and third stage had 5.68 times(OR=5.68, 95% CI=00.64~50.73) more than first stage in Hoehn and Yahr stage. CONCLUSION: There is a high prevalence(73.6%) of UI in patients with Parkinson's diseases. Mixed UI was the most common type of incontinence. Risk factors developing UI were higher in female, older group, restricted mobility group, group without regular exercise, cognitive impairment group andhigher Hoehn and Yahr stage.
Cross-Sectional Studies ; Female ; Humans ; Male ; Neurology ; Parkinson Disease* ; Surveys and Questionnaires ; Risk Factors ; Urinary Incontinence*

OBJECTIVE: To determine the diagnostic performance of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and DCE ultrasound (DCE-US) for predicting response to neoadjuvant chemotherapy (NAC) in breast cancer patients. MATERIALS AND METHODS: This Institutional Review Board-approved prospective study was performed between 2014 and 2016. Thirty-nine women with breast cancer underwent DCE-US and DCE-MRI before the NAC, follow-up DCE-US after the first cycle of NAC, and follow-up DCE-MRI after the second cycle of NAC. DCE-MRI parameters (transfer constant [Ktrans], reverse constant [kep], and leakage space [Ve]) were assessed with histograms. From DCE-US, peak-enhancement, the area under the curve, wash-in rate, wash-out rate, time to peak, and rise time (RT) were obtained. After surgery, all the imaging parameters and their changes were compared with histopathologic response using the Miller-Payne Grading (MPG) system. Data from minor and good responders were compared using Wilcoxon rank sum test, chi-square test, or Fisher's exact test. Receiver operating characteristic curve analysis was used for assessing diagnostic performance to predict good response. RESULTS: Twelve patients (30.8%) showed a good response (MPG 4 or 5) and 27 (69.2%) showed a minor response (MPG 1–3). The mean, 25th, 50th, and 75th percentiles of Ktrans and Kep of post-NAC DCE-MRI differed between the two groups. These parameters showed fair to good diagnostic performance for the prediction of response to NAC (AUC 0.76–0.81, p ≤ 0.007). Among DCE-US parameters, the percentage change in RT showed fair prediction (AUC 0.71, p = 0.023). CONCLUSION: Quantitative analysis of DCE-MRI and DCE-US was helpful for early prediction of response to NAC.
Breast Neoplasms* ; Breast* ; Drug Therapy* ; Female ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging* ; Prospective Studies ; ROC Curve ; Ultrasonography*

BACKGROUND: The regression of the left ventricular hypertrophy after prosthetic valve replacement in patients with aortic valvular stenosis is an important factor to determine the appropriateness of the replaced prosthetic valvular size. Methods: To assess the regression of myocardial hypertrophy, a retrospective analysis of Doppler echocardiographic and electrocardiographic data was undertaken before, soon after (7.5+/-2.1 day), and late after (10.7+/-1.8 months) surgery in 36 patients (22 males, 14 female, mean age 54+/-12.1 years, mean BSA 1.61+/-0.15m2) with predominant aortic valvular stenosis. The patients underwent St. Jude Medical aortic valve replacement. By the size of the valves used, the patients were divided into three groups (19, 21 and 23+). RESULTS: The mean body surface area (1.48+/-0.13) in the patients with the 19 mm valve was smaller than that in the other groups (1.63+/-0.12) (p<0.05). No significant changes of ejection fraction were detected in all groups over time. Left ventricular muscle mass index (gm/m2) was reduced significantly in the 21 and 23+ groups over time (p<0.05), but there were no significant changes in the 19 mm valve group. The electric voltage height on EKG at the period of late after surgery was reduced significantly in all groups (p<0.05). CONCLUSION: Despite clinical improvement, the LVH was not reduced significantly in 19 mm valve group. Thus we suggest that more attention and additional procedures such as annular enlargement should be taken in patients who will undergo the replacement of 19 mm prosthetic valve.
Aortic Valve ; Body Surface Area ; Cardiomegaly ; Constriction, Pathologic* ; Echocardiography ; Electrocardiography ; Female ; Heart Valve Prosthesis ; Heart Ventricles ; Humans ; Hypertrophy ; Hypertrophy, Left Ventricular* ; Male ; Retrospective Studies