• Title/Summary/Keyword: 간질 환자

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Evaluation of Anti-AFP Monoclonal Antibodies as Immunodiagnostic Reagents for Hepatocellular Carcinoma (항-AFP 단일클론 항체를 이용한 간암진단 효과의 검토)

  • 현광자;강희갑;강신성
    • The Korean Journal of Zoology
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    • v.38 no.3
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    • pp.382-387
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    • 1995
  • To check the possible application of our anti-AFP monocional antibodies (MAbs) as immunodiagnostic reagents for hepatocellular carcinoma, ELISA and immunohistochemical assay were performed on the sera and liver biopsy specimens from the patients of hepatocellular carcinoma and other non-malignant hepatic disease. By non-competitive ELISA using anti-AFP MAbs, the highest incidence of AFP value was found only in the sera of hepatocellular carcinoma patients, i.e., more than 54% of patients had serum AFP levels of more than 500 ng/mi. By immunoperoxidase and indirect immunofluorescence techniques, anti-AFP MAbs were found to react with cytoplasm of hepatoceliular carcinoma cells. However immunohistochemical reactIvity to AFP in hepatocellular carcinoma cells was lower than that in non-neoplastic liver cells adjacent to the hepatocellular carcinoma. From these results with the similar findings from other studies, we suggest that AFP antigen is appropriate in the diagnosis assay (ELISA) but is not by immunohistochemical detection.

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The Correlation of TUNEL Apoptotic Index with Clinicoradiologicopathologic Scores in Interstitial Lung Disease (간질성 폐질환에서 TUNEL 아포프토시스 지수와 임상적, 방사선학적, 및 병리학적 지표와의 상관관계)

  • Kim, Youn-Seup;Myung, Na-Hye;Park, Jae-Seuk;Jee, Young-Koo;Lee, Kye-Young
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.2
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    • pp.136-147
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    • 2002
  • Background : Interstitial lung disease has various manifestations that are differentiated by their pathology, progress and treatment. However, all manifestations eventually progresses to pulmonary fibrosis. Recent studies have shown that apoptosis of pulmonary epithelial cells might be related to pulmonary fibrosis. The correlation of the apoptotic index with the clinical manifestations, pathological findings, HRCT findings and the response to treatment were examined. Materials and Methods : Twenty subjects (14 men, 16 women), who had been diagnosed with interstitial lung disease through an open lung biopsy, were enrolled in this study. The subtypes were one AIP, two NIP, eight BOOP, and seven UIP cases. The apoptotic index was scaled from 0-2 depending on the fraction of positive staining cells by TUNEL method. The clinical severity was assessed by a modification of a previously developed CRP scoring system. The pathologic scores were based on 4 components: fibrosis, cellularity, desquamation, and granulation. In the HRCT study, each lobe was scored by the radiologists on a scale for both fibrosis and ground-glass attenuation. The treatment response was assessed by an increase in more than 10% of the CRP score, and comparing the results 3 months before and after treatment. Results : The apoptotic index showed no correlation with the CRP and HRCT scoring system. The apoptotic index correlated with the pathologic elements including fibrosis, cellularity and the desquamation score (p<0.05). Of the 16 patients who received corticosteroid therapy, 9 patients (56.3%) responded to therapy. There was no correlation between the response to corticosteroid and the apoptotic index. In the case of patients with acute and subacute ILD, the apoptotic index showed a correlation with the cellularity, desquamation, and the total histological score (p<0.05). In the case of patients with chronic ILD, the apoptotic index correlated with the fibrosis and cellularity score (p<0.05). Conclusion : Apoptosis of the pulmonary epithelial cells is implicated in the pathogenesis of interstitial lung disease particularly on a pathological basis.

Ictal Hyperperfusion of Cerebellum and Basal Ganglia in Temporal Lobe Epilepsy: SPECT Subtraction (측두엽 간질에서 발작기 소뇌와 기저핵의 뇌혈류 변화: SPECT 감영영상)

  • Shin, Won-Chul;Hong, Seung-Bong;Tae, Woo-Suk;Seo, Dae-Won;Kim, Sang-Eun
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.1
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    • pp.12-22
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    • 2001
  • Purpose: The ictal perfusion patterns of cerebellum and basal ganglia have not been systematically investigated in patients with temporal lobe epilepsy (TLE). Their ictal perfusion patterns were analyzed in relation with temporal lobe and frontal lobe hyperperfusion during TLE seizures using SPECT subtraction. Materials and Methods: Thirty-three TLE patients had interictal and ictal SPECT, video-EEG monitoring, SPGR MRI, and SPECT subtraction with MRI co-registration. Results: The vermian cerebellar hyperperfusion (CH) was observed in 26 patients (78.8%) and hemispheric CH in 25 (75.8%). Compared to the side of epileptogenic temporal lobe, there were seven ipsilateral hemispheric CH (28.0%), fifteen contralateral hemispheric CH (60.0%) and three bilateral hemispheric CH (12.0%). CH was more frequently observed in patients with additional frontal hyperperfusion (14/15, 93.3%) than in patients without frontal hyperperfusion (11/18, 61.1%). The basal ganglia hyperperfusion (BGH) was seen in 11 of the 15 patients with frontotemporal hyperperfusion (73.3%) and 11 of the 18 with temporal hyperperfusion only (61.1%). In 17 patients with unilateral BGH, contralateral CH to the BGH was observed in 14 (82.5%) and ipsilateral CH to BGH in 2 (11.8%) and bilateral CH in 1 (5.9%). Conclusion: The cerebellar hyperperfusion and basal ganglia hyperperfusion during seizures of TLE can be contralateral, ipsilateral or bilateral to the seizure focus. The presence of additional frontal or basal ganglia hyperperfusion was more frequently associated with contralateral hemispheric CH to their sides. However, temporal lobe hyperperfusion appears to be related with both ipsilateral and contralateral hemispheric CH.

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Update in Diagnosis of Idiopathic Pulmonary Fibrosis and Interstitial Lung Abnormality (특발폐섬유증 진단의 최신 지견과 간질성폐이상)

  • Bo Da Nam;Jung Hwa Hwang
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.770-790
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    • 2021
  • Idiopathic pulmonary fibrosis (IPF), based on the 2018 international clinical practice guidelines, can be diagnosed with a usual interstitial pneumonia (UIP) pattern on high-resolution computed tomography (HRCT) and compatible clinical findings. Given that imaging is pivotal for IPF evaluation and diagnosis, more emphasis should be placed on the integration of clinical, radiological, and pathologic findings for multidisciplinary diagnosis. Interstitial lung abnormality (ILA), on the other hand, has a purely radiological definition based on the incidental identification of CT abnormalities. Taken together, differentiation between ILA and clinically significant interstitial lung disease (ILD) must be based on proper clinical evaluation. With this review, the recent updates in IPF diagnosis and the radiologic considerations for ILA can be well understood, which can be helpful for the proper diagnosis and management of patients with diffuse interstitial pulmonary fibrosis.

Thoracic Surgeon's Role in Differential Diagnosis of the Interstitial Lung Disease (간질성 폐질환의 확진을 위한 흉부외과의 역할)

  • Kim Sung-Whan;Yahang Jun-Ho;Kim Jong-Woo;Choi Jun-Young;Rhie Sang-Ho;Jang In-Seok
    • Journal of Chest Surgery
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    • v.39 no.5 s.262
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    • pp.382-386
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    • 2006
  • Background: Pathologic confirmation is needed to diagnose various forms of interstitial lung diseases. We wanted to find out how much the thoracic surgical lung biopsies will be needed for definite diagnosis of interstitial lung diseases. Material and Method: 17 patients underwent surgical lung biopsy in the department of thoracic and cardiovascular surgery, Gyeongsang National University Hospital from June 1995 to November 2002. Chart review and telephone questionnaire were done for retrospective study. Result: Mean age was $49{\pm}22$ years. Age ranged from 1 to 70 years. Dyspnea was the most common complaint. They were referred for definite differential diagnosis from pediatrics and internal medicine. Biopsy methods were thoracotomy in 11 cases, and thoracoscopy in 6 cases. Pathologic confirmation was possible in 11 cases (65%). According to the pathologic reports, treatment plans were changed in 13 cases (76%). Conclusion: Surgical lung biopsy was effective method in differentiating diagnosis of the interstitial lung disease, There was no mortality during operation. It is important that undiagnosed fibrous lung disease should be recommanded the lung biopsy for planning patient's treatment.

Comparative Study of the Clinicopathologic Characteristics between Gastrointestinal Stromal Tumors Arising from the Stomach and Small Bowel (위와 소장에 생긴 위장관 간질종양의 임상병리학적 비교)

  • Heo, Geon-Woong;Shin, Dong-Woo;Paik, So-Ya;Kim, Il-Dong;Kim, Ki-Ho;Suh, Byung-Sun;Park, Jin-Soo;Kim, Sang-Wook
    • Journal of Gastric Cancer
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    • v.7 no.4
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    • pp.254-260
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    • 2007
  • Purpose: The purpose of this study is to compare the clinicopathological characteristics of stomach and small bowel gastrointestinal stromal tumors and to determine the risk factors and treatment guidelines. Materials and Methods: Among 38 patients who were diagnosed with a gastrointestinal stromal tumor from August 1998 to May 2006, 29 patients at the Pundang Jesaeng General Hospital, Daejin Medical Center were evaluated. The clinicopathological characteristics of gastrointestinal stromal tumors arising from stomach and small bowel were compared. Immunohistochemical staining for CD117, CD34, smooth muscle actin, desmin, and S-100 protein was performed and classified according to NIH criteria. Prognosis between groups was analyzed according to NIH criteria. Results: There was no significant difference in the clinicopathological characteristics and prognosis between gastrointestinal stromal tumors arising from the stomach and small bowel. Recurrence of the disease occurred in four (13.8%) patients. Classification of gastrointestinal stromal tumors according to NIH criteria was predictive of recurrence (P=0.030). Conclusion: NIH criteria were predictive of recurrence, but the location of the primary site was not predictive of recurrence. A further study involving multi center data and a long-term follow-up will be needed for formulating diagnostic and therapeutic guidelines.

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3D Shape Analysis for the Hippocampus Using ICP Registration and Neural Networks (ICP 정합과 신경망을 이용한 해마의 3차원 형상 분석)

  • Kim, Jeong-Sik;Choi, Soo-Mi;Kim, Yong-Guk;Kim, Myoung-Hee
    • Journal of the Korea Computer Graphics Society
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    • v.10 no.4
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    • pp.27-36
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    • 2004
  • 본 논문에서는 뇌의 하부구조인 해마를 정확하게 분석하기 위한 형상 정규화 방법과 정상인과 간질 환자의 해마를 분류하기 위한 방법을 제시한다. 해마에 대한 형상 분석 과정은 크게 형상 표현을 구축하는 과정, 형상의 유사도를 측정하는 과정, 정상인 집단과 환자 집단을 분류하는 과정으로 이루어진다. 본 연구에서는 해마의 형상 표현으로 메쉬, 골격, 복셀로 이루어진 하이브리드 옥트리 자료구조를 구축하였다. 또한 Iterative Closest Point (ICP) 알고리즘을 사용하여 해마 골격을 기반으로 한 정규화를 수행하였다. 그리고 정규화된 해마 형상을 전역적, 국부적으로 분석하여 최종적으로 입력된 해마가 정상인 또는 간질 환자에 속하는지를 학습된 데이터를 이용하여 분류하였다. 본 논문에서 제시한 ICP 기반의 정규화 방법은 3차원 해마 형상을 정확하게 분석하게 해주고, 골격의 정점 수를 조절함으로써 정규화 시간을 감소시킬 수 있다. 뿐만 아니라 3차원 해마 모델의 형상을 신경망을 통하여 학습시킴으로써 해마의 형상이 변형된 환자 집단과 정상인 집단을 분류하는데 이용할 수 있다.

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Asymmetry of Medial and Lateral Temporal Regional Glucose Metabolism in Temporal Lobe Epilepsy by F-18-FDG PET (측두엽 간질에서 F-18-FDG PET에 나타난 측두엽 내외측 부위별 대사의 차이)

  • Lee, Dong-Soo;Yeo, Jeong-Seok;Song, Ho-Cheon;Lee, Sang-Kun;Kim, Hyun-Jip;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.1
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    • pp.28-39
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    • 1999
  • Purpose: We investigated the difference of glucose metabolism of medial and lateral temporal lobes of patients with temporal lobe epilepsy (TLE) utilizing quantitative comparison of regional metabolic activities using asymmetric index. Materials and Methods: We studied 19 pathologically proven mesial TLE and 25 lateral TLE patients. Lateral TLE patients were either normal on magnetic resonance imaging (cryptogenic: n=14) or had structural lesions (lesional: n= 11). Asymmetric index (ASI) was calculated as [(ipsilateral-contralateral)/(ipsilateral+contralateral)]${\times}200$. Results: ASI of medial and lateral lobes of mesial TLE was decreased ($-16.4{\pm}8.3$ and $-12.1{\pm}5.5$, respectively). In cryptogenic lateral TLE, ASI of lateral temporal lobe was decreased ($-11.8{\pm}4.7$), whereas that of medial temporal lobe was not decreased ($-4.6{\pm}6.3$). ASI of medial lobe of lesional lateral TLE was $-7.3{\pm}9.1$, which was significantly different from that of mesial TLE (p<0.05). Patients with lesional lateral TLE had evident metabolic defects or decrease (ASI: $-22{\pm}10.5$) in lateral temporal lobe. While we could not find the difference of metabolic activity in lateral temporal lobes between cryptogenic lateral TLE and mesial TLE patients, the difference of metabolic activity was significant in medial temporal lobes which was revealed by ASI quantitation. Conclusion: Asymmetric decrease of metabolic activity in both medial and lateral temporal lobes indicates medial temporal epilepsy. Symmetry of metabolic activity in medial temporal lobe combined with asymmetry of that in lateral temporal lobe may give hints that the epileptogenic zone is lateral.

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VRML을 이용하는 3 차원 융합 영상의 가시화와 위치 측정 구현 : 간질 환자의 적용 예

  • 이상호;유선국;정해조;강원석;성민모;이재훈;김새롬;김희중
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2003.09a
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    • pp.50-50
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    • 2003
  • World Wide Web (WWW)에서 Virtual Reality Modeling Language (VRML)를 이용하는 3 차원 (3D) 디스플레이는 사용자에게 직관적인 정보를 더 효과적으로 제공해 준다. 웹을 기반으로 하는 해부학적 영상과 융합되는 기능적 영상의 3D 가시화는 아직까지 체계적인 방식으로 연구가 활발히 진행되지 않았다. 이 연구의 목적은 2D 영상들과 함께 웹에서 VRML을 이용하여 구현되는 3D 해부학적 표면 영상들과 기능적 표면 영상들을 동시적으로 관찰할 수 있게 하고 VRML을 통해 만들어진 거리 측정 도구를 가지고 관심영역의 공간적인 위치 정보를 제공하는 것이다. 본 연구에서는 한 명의 간질 환자로부터 Magnetic Resonance (MR) 축면 영상과 발작기 및 발작간기 Single Photon Emission Computed Tomo graphy (SPECT) 축면 영상들을 각각 획득하였다. 발작 진원지의 확인을 향상시키기 위해서 subtraction ictal SPECT co registered to MRI (SISCOM) 을 수행하였다. SISCOM 결과로 나타난 각 2D 영상들은 모든 voxel 들의 평균 값 위로 1 표준편차와 2 표준편차에 해당하는 문턱 이상의 영상 값을 갖도록 하였다. SISCOM으로 나타나는 간질 발작 진원지들과 MRI 영상에서 회색질, 백색질 및 뇌척수액의 경계들을 각각 분할하고 marching cube 알고리즘에 의해 VRML 표면 영상들로 나타내었다. 축면 영상에서 실제 거리를 나타내는 x, y 축의 길이를 측정하고 z 축선의 길이를 계산하였다. VRML을 이용한 거리 측정 도구를 만들어 이전의 VRML 표면 영상들과 융합하였다. MRI 영상을 이용하여 3D 표면 영상들의 단면을 나타내고 3D 표면 영상들의 투명도를 설정하기 위해 Java Script 루틴을 사용자 인터페이스 도구로서 삽입하였다. 웹 페이지에서 구현되는 3D 표면 영상들의 투명도와 관찰 위치를 조절함에 따라 모델들 사이의 공간적인 정보를 직관적으로 알 수 있었다. 간질 발작 진원지에 대응하는 해부학적 구조를 3D 표면 영상들을 가로지르는 MRI 평면 영상들을 통해서 확인하였다. 결론적으로 본 연구에서 제시하는 웹에 근거한 3D 융합 영상의 가시화와 위치 측정은 진단 및 치료 방사선학과 외과학 등의 분야에서 온라인 방식의 연구와 교육에 있어 많은 도움을 줄 것이다.

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Synchronous Occurrence of a Gastric Adenocarcinoma and a GIST (Gastrointestinal Stromal Tumor): A Case Report (위에 동시성으로 발생한 조기위암 및 위장관간질종양)

  • Jee, Sung-Bae;Seo, Kyung-Jin;Heo, Hun;Jeon, Hae-Myung
    • Journal of Gastric Cancer
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    • v.7 no.4
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    • pp.261-264
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    • 2007
  • A gastric adenocarcinoma is the second most common cause of cancer deaths worldwide, but there are some geographical differences in its incidence. A gastrointestinal tumor is an uncommon disease with a wide spectrum of aggressive behavior. These two tumors have a distinct pathogenesis, and synchronous occurrence of an adenocarcinoma and a GIST (gastrointestinal stromal tumor) in the stomach is very rare. We report a case of synchronous occurrence of a gastric adenocarcinoma and GIST in a 64-year-old man. We performed the following tests: barium swallowing test, gastroduodenoscopy, and CT scanning. We performed a total gastrectomy, and a 9 em-sized GIST at the fundus and a small early gastric cancer at the antrum were confirmed pathologically. Some explanations for this rare case exist, but in our opinion, the synchronous occurrence is a rare but probable event that can happen in an endemic area. We describe a case of synchronous occurrence of a gastric adenocarcinoma and GIST in the stomach, with a review of the literature.

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