Journal of Yeungnam Medical Science

Original article

Diagnostic value of serum procalcitonin and C-reactive protein in discriminating between bacterial and nonbacterial colitis: a retrospective study: Jae Yong Lee, So Yeon Lee, Yoo Jin Lee, Jin Wook Lee, Jeong Seok Kim, Ju Yup Lee, Byoung Kuk Jang, Woo Jin Chung, Kwang Bum Cho, Jae Seok Hwang; J Yeungnam Med Sci. 2023;40(4):388-393. Published online April 3, 2023; DOI: https://doi.org/10.12701/jyms.2023.00059

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Abstract PDF: Background
Differentiating between bacterial and nonbacterial colitis remains a challenge. We aimed to evaluate the value of serum procalcitonin (PCT) and C-reactive protein (CRP) in differentiating between bacterial and nonbacterial colitis.
Methods
Adult patients with three or more episodes of watery diarrhea and colitis symptoms within 14 days of a hospital visit were eligible for this study. The patients’ stool pathogen polymerase chain reaction (PCR) testing results, serum PCT levels, and serum CRP levels were analyzed retrospectively. Patients were divided into bacterial and nonbacterial colitis groups according to their PCR. The laboratory data were compared between the two groups. The area under the receiver operating characteristic curve (AUC) was used to evaluate diagnostic accuracy.
Results
In total, 636 patients were included; 186 in the bacterial colitis group and 450 in the nonbacterial colitis group. In the bacterial colitis group, Clostridium perfringens was the commonest pathogen (n=70), followed by Clostridium difficile toxin B (n=60). The AUC for PCT and CRP was 0.557 and 0.567, respectively, indicating poor discrimination. The sensitivity and specificity for diagnosing bacterial colitis were 54.8% and 52.6% for PCT, and 52.2% and 54.2% for CRP, respectively. Combining PCT and CRP measurements did not increase the discrimination performance (AUC, 0.522; 95% confidence interval, 0.474–0.571).
Conclusion
Neither PCT nor CRP helped discriminate bacterial colitis from nonbacterial colitis.

Case Report

Double primary lung adenocarcinoma diagnosed by epidermal growth factor receptor mutation status: Oh Jung Kwon, Min Hyeok Lee, Sung Ju Kang, Seul Gi Kim, In Beom Jeong, Ji Yun Jeong, Eun Jung Cha, Do Yeun Cho, Young Jin Kim, Ji Woong Son; Yeungnam Univ J Med. 2017;34(2):270-274. Published online December 31, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.2.270

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Abstract PDF: A nodular density was detected on a chest radiograph taken from a 57-year-old Korean woman who was visiting a hospital for a routine check. Chest computed tomography revealed a 4.8 cm lobulated mass in the right lung and another focal nodular lesion in the left lung; biopsies of both lungs revealed adenocarcinoma. We conducted DNA sequencing and peptide nucleic acid clamping to investigate the potential double primary lung cancer. The results verified that the mass in the right lung had a mutation in the epidermal growth factor receptor, whereas the nodule in the left lung had a wild-type sequence, showing that these two were genetically different cancers from one another. Thus, we demonstrate that genetic testing is useful in determining double primary lung cancer, and we herein report on this case.

Original Article

The Role of Dynamic CT for the Differential Diagnosis of Solitary Pulmonary Nodule.: Jin Hong Chung, Won Jong Park, Ihn Ho Cho; Yeungnam Univ J Med. 2008;25(2):102-107. Published online December 31, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.2.102

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Abstract PDF: BACKGROUND
Malignant pulmonary nodules account for 30 to 40 percent of all solitary pulmonary nodules (SPNs). Therefore, characterization of SPNs is very important for treatment. Recently, dynamic CT has been widely used for tissue characterization and formation of differential diagnoses. The purpose of this study was to evaluate the ability of dynamic CT to formulate the differential diagnosis of SPNs. MATERIALS AND METHODS: Nineteen patients with SPNs underwent dynamic CT (unenhanced scans, followed by a series of images at 20, 40, 60, 80, 100, 120, 140, 160, and 180 sec after intravenous injection of contrast medium). Diagnosis of SPN was performed based on pathologic findings in needle biopsy samples. Peak enhancement, net enhancement, slope of enhancement, and maximum relative enhancement ratio of the SPN were measured on dynamic CT, and Levene's test was performed to assess benignancy and malignancy. RESULTS: Twelve SPNs were confirmed to have malignant pathology. There were no significant differences between benign and malignant nodules with respect to peak enhancement (p=0.787), net enhancement (p=0.135), or slope of enhancement (p=0.698). The maximal enhancement ratio was increased in malignancy compared to benignancy, but the difference was not statistically significant (p=0.094). CONCLUSION: In our study, the hemodynamic characteristics of dynamic CT were not significantly different between benign and malignant nodules. Therefore, long-term studies of larger patient samples are required to confirm our findings.

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