Utility of D-dimer Assay for Diagnosing Pulmonary Embolism: Single Institute Study / 대한진단검사의학회지

BACKGROUND: Pulmonary embolism (PE) presents with diverse non-specific signs and symptoms and its diagnosis mainly depends on diagnostic imaging tests which are laborious and not cost-effective, and only a small proportion of patients with suspected PE actually have the disease. The aim of this study was to analyze the utility of D-dimer test for diagnosing PE by categorizing patients into 'PE likely' and 'PE unlikely' groups using Wells score for clinical probability. METHODS: One hundred forty consecutive patients with clinically suspected PE, in whom D-dimer and imaging tests were performed were enrolled. Dignosis of PE was made when the imaging tests were positive. Wells scores were retrospectively assigned and the dignostic utility of D-dimer test was analyzed. RESULTS: Of the 140 patients studied, D-dimer test was positive in 97 and diagnostic imaging tests revealed PE, deep vein thrombosis (DVT), and PE+DVT in 24, 3, and 7 patients, respectively. For the diagnosis of PE, D-dimer test with cutoff value of > or =230 ng/mL showed sensitivity, specificity, and negative predictive value of 96.8%, 39.6%, and 97.7%, respectively. These values were 96.3%, 37.9%, and 91.7% in 'PE likely' group (n=56), and 100%, 38.8%, and 100% in 'PE unlikely' group (n=84). Among 43 patients with D-dimer values of <230 ng/mL, only one patient was diagnosed with PE, who belonged to the 'PE likely' group. CONCLUSIONS: D-dimer test cannot be used as a stand-alone test to diagnose PE, but it can be helpful for exclusion of PE especially in 'PE unlikely' group according to Wells score.

Effects of Ethanol Extract of Onion on the Lipid Profiles in Patients with Hypercholesterolemia

It is known that onion increases antioxidative and antibiotic capacity, and decreases blood pressure and cholesterol levels. The study was carried out to investigate whether ethanol extract of onion can enhance blood lipid profiles in hypercho-lesterolemic patients. Fourty three hypercholesterolemic patients were randomly divided into 2 groups ;25 in controls and 18 in experimental group. The control group was offered to take placebo for 4 weeks (200 ml/day ), and experimental group was offered to consume ethanol extract of onion for 8 weeks (200 ml/day that corresponds to 500 g of onion ). There were no differences in sex, age, body mass index (BMI )and educational levels between groups before treatment. After 8 weeks of onion extract consumption, plasma triglycerides level was significantly decreased in experimental group com-pared to control (p < 0.05 ). Total cholesterol level was tended to decrease in experimental group, but there was no sig-nificant difference of change between control and experimental group. The levels of plasma glucose and LDL-cholesterol were not changed significantly after onion extract consumption. In summary, alcohol extract of onion may have a positive effect on the lipid profiles of hypercholesterolemia patients through decreasing plasma triglyceride concentration.