Pleural masses may be caused by various conditions, including benign and malignant neoplasms and non-neoplastic tumorlike conditions. Primary pleural neoplasms include solitary fibrous tumor, malignant mesothelioma, and primary pleural non-Hodgkin's lymphoma. Metastatic disease is the most common neoplasm of the pleura and may uncommonly occur in patients with hematologic malignancy, including lymphoma, leukemia, and multiple myeloma. Pleural effusion is usually associated with pleural malignancy. Rarely, pleural malignancy may arise from chronic empyema, and the most common cell type is non-Hodgkin's lymphoma (pyothorax-associated lymphoma). Non-neoplastic pleural masses may be observed in several benign conditions, including tuberculosis, pleural plaques caused by asbestos exposure, and pleural loose body. Herein, we present a review of benign and malignant pleural neoplasms and tumorlike conditions with illustrations of their computed tomographic images.

OBJECTIVES: This research aimed to understand the popularity of topics in the field of women's health through analysis of online news articles which were chronologically classified and examined to determine how women's health and diseases had changed over time. METHODS: Women's health and disease news articles were collated from a popular news website between 1993 to 2015 and preprocessed using gynecological medical terminology, Korean words and nouns (excluding general nouns not related to women's healthcare topics). The resultant articles (N = 7,710) were analyzed using the Latent Dirichlet Allocation algorithm and major topics were extracted. Topic trends were analyzed by year and period for women's health. RESULTS: It was observed that most of the women's health articles were focused on “Healthcare”, and 9 other topics were identified that represented a relatively small proportion in 1993–2000. In 2001–2005, most of the articles were focused on “Medical Services” and “Dietary Supplements” with some specific topics that peaked people's interest, as compared to those focused on “Healthcare” in the 1990s. It was also observed that differences in the proportion of each topic was small after 2011. CONCLUSION: Changes in topics related to women's disease were not clearly distinguished in the 1990s but this changed from 2001where articles related to “women disease” appeared as articles on the topics of various diseases.
Data Mining ; Delivery of Health Care ; Women's Health

BACKGROUND: Tuberculosis is globally the most important cause of death from single pathogen. Rapid and accurate identification of mycobacteria is essential for the control of tuberculosis. We evaluated a fluorescence in situ hybridization (FISH) method using peptide nucleic acid (PNA) probes for the differentiation of Mycobacterium tuberculosis complex (MTB) and nontuberculous mycobacteria (NTM) in direct smears of sputum specimens. METHODS: The cross-reactivity of MTB- and NTM-specific PNA probes was examined with reference strains of M. tuberculosis ATCC 13950, Mycobacterium kansasii ATCC 12479, Mycobacterium fortuitum ATCC 6841, several clinical isolates of mycobacteria (Mycobacterium abscessus, Mycobacterium avium, Mycobacterium intracellulare, Mycobacterium gordonae and Mycobacterium chelonae), and 11 frequently isolated respiratory bacterial species other than mycobacteria. A series of 128 sputa (89 MTB culture positive, 29 NTM culture positive, and 10 under treatment culture negative) with grades of trace to 4+ were used to evaluate the performance of the method. RESULTS: The MTB- and NTM-specific PNA probes showed specific reactions with the reference strains of MTB and M. kansasii and clinical isolates of mycobacteria except M. fortuitum ATCC 6841, and no cross-reactivity with other tested bacteria. The PNA probe-based FISH assay for detection of MTB had a sensitivity and specificity of 100%, respectively. The sensitivity and specificity of the NTM-specific PNA probe was 100%. The smear grades of the PNA FISH test were same as with those of the fluorescence AFB stain in 2+ or higher grade. CONCLUSION: Detection and differentiation based on PNA FISH is sensitive and accurate for detecting mycobacteria and for differentiating MTB from NTM in clinical sputum smears.
Bacteria ; Cause of Death ; Fluorescence* ; In Situ Hybridization* ; Mycobacterium ; Mycobacterium avium ; Mycobacterium avium Complex ; Mycobacterium fortuitum ; Mycobacterium kansasii ; Mycobacterium tuberculosis* ; Nontuberculous Mycobacteria* ; Peptide Nucleic Acids ; Sputum ; Tuberculosis

We evaluated the incidence, clinical characteristics, and prognostic impact of calreticulin (CALR) mutations in essential thrombocythemia (ET) and primary myelofibrosis (PMF) patients. In all, 48 ET and 14 PMF patients were enrolled, and the presence of CALR mutations was analyzed by direct sequencing. Patients were classified into three subgroups according to Janus kinase 2 (JAK2) V617F and CALR mutation status, and their clinical features and prognosis were compared. CALR mutations were detected in 15 (24.2%) patients, and the incidence increased to 50.0% in 30 JAK2 V617F mutation-negative cases. These included 11 patients with three known mutations (c.1092_1143del [seven cases], c.1154_1155insTTGTC [three cases], and c.1102_1135del [one case]) and 4 patients with novel mutations. ET patients carrying CALR mutation were younger, had lower white blood cell counts, and experienced less thrombosis during follow-up than those carrying JAK2 V617F mutation, while both patient groups showed similar clinical features and prognosis. In ET patients without JAK2 V617F mutation, CALR mutation did not significantly affect clinical manifestation and prognosis. In conclusion, CALR mutation analysis could be a useful diagnostic tool for ET and PMF in 50% of the cases without JAK2 V617F mutations. The prognostic impact of CALR mutations needs further investigation.
Adult ; Aged ; Calreticulin/*genetics ; DNA Mutational Analysis ; Exons ; Female ; Genotype ; Humans ; INDEL Mutation ; Janus Kinase 2/genetics ; Male ; Middle Aged ; Primary Myelofibrosis/diagnosis/epidemiology/*genetics ; Prognosis ; Republic of Korea ; Tertiary Care Centers ; Thrombocythemia, Essential/diagnosis/epidemiology/*genetics ; Young Adult

We report three patients with normal karyotype (NK) ALL, who showed genetic aberrations as determined by high-resolution single nucleotide polymorphism array (SNP-A) analysis at both diagnosis and relapse. We evaluated the clinical relevance of the SNP-A assay for the detection of subtle changes in the size of affected genetic lesions at relapse as well as the prognostic value of the assay. In our patients, application of the SNP-A assay enabled sensitive detection of cryptic changes affecting clinically important genes in NK ALL. Therefore, this assay seems to be more advantageous compared to other conventional methods such as FISH assay, HemaVision (DNA Technology, Denmark), and conventional karyotyping for the detection of an "unstable genotype" at relapse, which may be associated with microscopic clonal evolution and poor prognosis. Further comprehensive studies are required to confirm the issues presented by our case patients in this report.
Adult ; Cyclin-Dependent Kinase Inhibitor p16/genetics ; Female ; Genotype ; Humans ; In Situ Hybridization, Fluorescence ; Karyotype ; Karyotyping ; Loss of Heterozygosity ; Male ; Middle Aged ; Oligonucleotide Array Sequence Analysis ; Polymorphism, Single Nucleotide ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/*diagnosis/genetics ; Recurrence ; Retinoblastoma Protein/genetics

We performed customer satisfaction surveys for physicians and nurses regarding clinical laboratory services, and for outpatients who used phlebotomy services at a tertiary care unit level to evaluate our clinical laboratory and phlebotomy services. Thus, we wish to share our experiences with the customer satisfaction survey for clinical laboratory and phlebotomy services. Board members of our laboratory designed a study procedure and study population, and developed two types of questionnaire. A satisfaction survey for clinical laboratory services was conducted with 370 physicians and 125 nurses by using an online or paper questionnaire. The satisfaction survey for phlebotomy services was performed with 347 outpatients who received phlebotomy services by using computer-aided interviews. Mean satisfaction scores of physicians and nurses was 58.1, while outpatients' satisfaction score was 70.5. We identified several dissatisfactions with our clinical laboratory and phlebotomy services. First, physicians and nurses were most dissatisfied with the specimen collection and delivery process. Second, physicians and nurses were dissatisfied with phlebotomy services. Third, molecular genetic and cytogenetic tests were found more expensive than other tests. This study is significant in that it describes the first reference survey that offers a survey procedure and questionnaire to assess customer satisfaction with clinical laboratory and phlebotomy services at a tertiary care unit level.
Humans ; Internet ; Interviews as Topic ; Laboratories ; *Personal Satisfaction ; *Phlebotomy ; Questionnaires ; Tertiary Healthcare ; User-Computer Interface

BACKGROUND: Early laboratory detection of Mycobacterium tuberculosis is crucial for controlling tuberculosis. We developed a hydrogel mycobacterial culture method that retains the advantages of both solid and liquid methods in terms of speed, cost, and efficiency. METHODS: Mycobacterium bovis bacillus Calmette-Guerin (BCG) suspensions and 200 acid-fast bacilli (AFB)-positive clinical specimens were inoculated in Middlebrook 7H9 liquid media (Becton-Dickinson and Company, USA) and mixed with 75 microL of 9-fluorenylmethoxycarbonyl (Fmoc)-Phe-Phe-OH hydrogel stock solution in an Eppendorf tube just before culture incubation. The mixtures were cultured at 37degrees C for as long as 14 days to monitor culture status. RESULTS: The number of M. bovis BCG increased with time. For 200 AFB smear-positive specimens, 155 of 158 conventional culture-positive specimens and 4 culture-negative or contaminated specimens yielded positive cultures within 14 days. For 128 specimens positive with the liquid culture method, the time to positive culture using the hydrogel method (mean, 12.6 days; range, 7 to 14 days) was significantly shorter than that for conventional liquid culture (mean, 16.2 days; range, 6 to 31 days; P<0.0001). CONCLUSIONS: The hydrogel scaffold culture system is useful for timely, economical, and efficient detection of mycobacteria in clinical specimens.
Bacteriological Techniques/*methods ; Culture Media/chemistry ; Early Diagnosis ; Humans ; Hydrogel/*chemistry ; Mycobacterium tuberculosis/*isolation & purification ; Tuberculosis/diagnosis/*microbiology

Aggregatibacter aphrophilus, a normal component of oral cavity flora, mostly causes infective endocarditis and only rarely causes spondylitis; no spondylitis cases have been previously reported in Korea. We report a case of pyogenic spondylitis due to A. aphrophilus without endocarditis. A 64-year-old man was admitted for back pain lasting 3 weeks. There was severe tenderness on lumbar spines but no fever. Laboratory evaluation showed leukocytosis and elevated C-reactive protein. Blood cultures were negative. Magnetic resonance imaging showed psoas abscess and vertebral inflammation. Pus was obtained by computerized tomography-guided aspiration from the psoas abscess and inoculated into blood culture bottles. After 5 days of incubation, growth was detected: the isolate was a Gram-negative short rod bacteria identified as A. aphrophilus by the automated system; this was confirmed by 16S ribosomal RNA sequencing. There was no evidence of endocarditis in echocardiography and retinal examination. Back pain persisted despite 8 weeks of antibiotic treatment, so vertebral corpectomy was performed. A. aphrophilus, a rare cause of pyogenic spondylitis, can induce spondylitis without endocarditis. If a patient with pyogenic spondylitis shows negative routine bacterial cultures, fastidious organisms such as A. aphrophilus should be suspected and the blood culture bottles could be used.
Aggregatibacter aphrophilus* ; Back Pain ; Bacteria ; C-Reactive Protein ; Echocardiography ; Endocarditis ; Fever ; Humans ; Inflammation ; Korea ; Leukocytosis ; Magnetic Resonance Imaging ; Middle Aged ; Mouth ; Psoas Abscess ; Retinaldehyde ; RNA, Ribosomal, 16S ; Spine ; Spondylitis* ; Suppuration

No abstract available.
Base Sequence ; Carnobacteriaceae/genetics/*isolation & purification ; Databases, Genetic ; Gram-Positive Bacterial Infections/blood/*microbiology ; Humans ; Male ; Middle Aged ; Polymerase Chain Reaction ; RNA, Ribosomal, 16S/chemistry/genetics ; Sequence Analysis, RNA

OBJECTIVE: To evaluate the reliability of virtual non-contrast (VNC) images reconstructed from contrast-enhanced, dual-energy scans compared with true non-contrast (TNC) images in the assessment of high CT attenuation or calcification of mediastinal lymph nodes. MATERIALS AND METHODS: A total of 112 mediastinal nodes from 45 patients who underwent non-contrast and dual-energy contrast-enhanced scans were analyzed. Node attenuation in TNC and VNC images was compared both objectively, using computed tomography (CT) attenuation, and subjectively, via visual scoring (0, attenuation < or = the aorta; 1, > the aorta; 2, calcification). The relationship among attenuation difference between TNC and VNC images, CT attenuation in TNC images, and net contrast enhancement (NCE) was analyzed. RESULTS: CT attenuation in TNC and VNC images showed moderate agreement (intraclass correlation coefficient, 0.612). The mean absolute difference was 7.8 +/- 7.6 Hounsfield unit (HU) (range, 0-36 HU), and the absolute difference was equal to or less than 10 HU in 65.2% of cases (73/112). Visual scores in TNC and VNC images showed fair agreement (kappa value, 0.335). Five of 16 nodes (31.3%) which showed score 1 (n = 15) or 2 (n = 1) in TNC images demonstrated score 1 in VNC images. The TNC-VNC attenuation difference showed a moderate positive correlation with CT attenuation in TNC images (partial correlation coefficient [PCC] adjusted by NCE: 0.455) and a weak negative correlation with NCE (PCC adjusted by CT attenuation in TNC: -0.245). CONCLUSION: VNC images may be useful in the evaluation of mediastinal lymph nodes by providing additional information of high CT attenuation of nodes, although it is underestimated compared with TNC images.
Adult ; Aged ; Aged, 80 and over ; Calcinosis/*radiography ; Contrast Media/diagnostic use ; Female ; Humans ; Image Processing, Computer-Assisted ; Lymph Nodes/*radiography ; Male ; Mediastinum/*radiography ; Middle Aged ; Reproducibility of Results ; Sensitivity and Specificity ; Tomography, X-Ray Computed/*methods