• Title/Summary/Keyword: 임상 경과

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Non-hemolytic, Mucinous, Coagulase Negative MRSA Isolated from Urine (소변에서 분리된 비용혈성, 점액성, 응고효소 음성 MRSA)

  • Kim, Jae Soo;Choi, Qute;Jung, Bo Kyeung;Kim, Jong Wan;Kim, Ga Yeon
    • Korean Journal of Clinical Laboratory Science
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    • v.51 no.2
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    • pp.260-264
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    • 2019
  • An 84-year-old woman presented to the emergency department with a chief complaint of pressure sores of the anus. She had a urine catheter when she showed pyuria three times but had no fever. A microscopic examination revealed many grapevine-like Gram positive strains and neutrophils. After 24 hours of urine culture on blood agar, non-hemolytic mucous colonies were found and further enlarged after 48 hours of culture. The capsules were identified after India ink stain. The catalase was positive, but the tube coagulase and latex coagulase were both negative. The S. aureus was identified by Vitek-2 and mass spectrometer Vitek MS V-3 IVD. The strain was confirmed by 16S rRNA gene sequencing and multilocus sequence typing (MLST). The phenotypically atypical MRSA found in the tube coagulase and latex coagulase were both negative. MRSA often show no beta hemolysis as in this case but are rarely latex coagulase-negative. We report a woman whose urine culture showed non-hemolytic, tube coagulase-negative, and latex coagulase-negative MRSA.

Characteristics of Clinical Trials in Korea for Atopic Dermatitis - Focus on ClinicalTrials.gov Registered Clinical Trials - (식약처 승인 아토피 피부염 의약품 국내 임상 시험의 특성 - ClinicalTrials.gov 등록 임상시험을 중심으로-)

  • Hwang, Mi-Lee;Ahn, Jae-Hyun;Jea, Ha-Kyung;Kim, Soo-Young;Jung, Hyun-A
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.32 no.2
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    • pp.68-93
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    • 2019
  • Objective : This study summarized the characteristics of clinical trials for atopic dermatitis medicines approved by the Ministry of Food and Drug Safety(MFDS). This study may be a reference for the design of clinical trials of atopic dermatitis herbal medicine treatment which may be carried out later. Method : The characteristics of the clinical trial were analyzed for clinical trials registered with ClinicalTrials.gov, CRIS, and the Korea Health Industry Development Institute among the clinical trial approval statuses posted on the website of the MFDS. Result : 1. Clinical trial drugs were developed in various formulations such as oral medicines, injections, dermatologic agents, and similar proportions. Relatively little clinical trials were found for herbal medicine. 2. In the control evaluation test, most of the treatments for the control group were performed with placebo using Vehicle. 3. In most clinical trials, one intervention group was in the form of a parallel assignment with only one treatment. 4. The age of the subjects was 11 out of 28 studies including minors, and clinical trials targeting minors were also found to be significant. 5. In the case of atopic dermatitis, the cases of subacute chronic or atopic dermatitis more than 6 months or more than 1 year were often used. 6. Most clinical trials were divided into mild to moderate atopic dermatitis or moderate to severe atopic dermatitis. The SCORAD index, EASI, IGA, BSA, and NRS were used as the evaluation criteria. 7. Regulations for the drugs used prior to the trial period for the treatment of atopic dermatitis vary somewhat from one clinical trial to another. 8. IGA was used most often as a primary efficacy tool, and SCORAD index, EASI, and NRS were also used.

Complete denture made with closed-mouth impression technique on severely atrophied edentulous jaw (하악 치조골이 심하게 위축된 무치악 환자에서 폐구인상법을 이용한 총의치 수복 증례)

  • Lee, Suk-Hwan;Leesungbok, Richard;Lee, Suk-Won
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.2
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    • pp.195-202
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    • 2019
  • At the department of prosthodontics, the elderly patients with severely atrophied alveolar ridge who have been wearing complete dentures for a long period frequently visit the clinic. In general, the open-mouth impression technique for manufacturing a mandibular complete denture to secure primary support on buccal shelf area has been prevalent. In addition, for securing retention and stability of mandibular denture, we should consider diagnosis, oral function, denture border, occlusal plane, teeth arrangement, and patient training, etc.. But in edentulous patients with severe alveolar bone atrophy, it may hardly secure retention and stability of mandibular complete denture. To promote these, some of clinicians are making an attempt manufacturing the mandibular complete dentures using closed-mouth impression technique based on several reports that compare various impression techniques including open-mouth and closed-mouth impression technique. This case report suggests closed-mouth impression technique may promote retention and stability of mandibular complete denture and compares between the two impression techniques clinically.

Neutrophil-to-lymphocyte Ratio as A Predictor of Aspiration Pneumonia in Drug Intoxication Patients (약물중독 환자에서 Neutrophil Lymphocyte Ratio의 흡인성폐렴 발생 예측인자로서의 고찰)

  • Lee, Jeong Beom;Lee, Sun Hwa;Yun, Seong Jong;Ryu, Seokyong;Choi, Seung Woon;Kim, Hye Jin;Kang, Tae Kyung;Oh, Sung Chan;Cho, Suk Jin;Seo, Beom Sok
    • Journal of The Korean Society of Clinical Toxicology
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    • v.16 no.2
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    • pp.61-67
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    • 2018
  • Purpose: To evaluate the association between neutrophil-to-lymphocyte ratio (NLR) and occurrence of aspiration pneumonia in drug intoxication (DI) patients in the emergency department (ED) and to evaluate the relationship between NLR and length of hospital admission/intensive care unit (ICU) admission Methods: A total of 466 patients diagnosed with DI in the ED from January 2016 to December 2017 were included in the analysis. The clinical and laboratory results, including NLR, were evaluated as variables. NLR was calculated as the absolute neutrophil count/absolute lymphocyte count. To evaluate the prognosis of DI, data on the development of aspiration pneumonia were obtained. Also, we evaluated the relationship between NLR and length of hospital admission and between NLR and length of ICU admission. Statistically, multivariate logistic regression analyses, receiver-operating characteristic (ROC) curve analysis, and Pearson's correlation (${\rho}$) were performed. Results: Among the 466 DI patients, 86 (18.5%) developed aspiration pneumonia. Multivariate logistic regression analysis revealed NLR as an independent factor in predicting aspiration pneumonia (odds ratio, 1.7; p=0.001). NLR showed excellent predictive performance for aspiration pneumonia (areas under the ROC curves, 0.815; cut-off value, 3.47; p<0.001) with a sensitivity of 86.0% and a specificity of 72.6%. No correlations between NLR and length of hospital admission (${\rho}=0.195$) and between NLR and length of ICU admission (${\rho}=0.092$) were observed. Conclusion: The NLR is a simple and effective marker for predicting the occurrence of aspiration pneumonia in DI patients. Emergency physicians should be alert for aspiration pneumonia in DI patients with high NLR value (>3.47).

Improved Anatomical Landmark Detection Using Attention Modules and Geometric Data Augmentation in X-ray Images (어텐션 모듈과 기하학적 데이터 증강을 통한 X-ray 영상 내 해부학적 랜드마크 검출 성능 향상)

  • Lee, Hyo-Jeong;Ma, Se-Rie;Choi, Jang-Hwan
    • Journal of the Korea Computer Graphics Society
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    • v.28 no.3
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    • pp.55-65
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    • 2022
  • Recently, deep learning-based automated systems for identifying and detecting landmarks have been proposed. In order to train such a deep learning-based model without overfitting, a large amount of image and labeling data is required. Conventionally, an experienced reader manually identifies and labels landmarks in a patient's image. However, such measurement is not only expensive, but also has poor reproducibility, so the need for an automated labeling method has been raised. In addition, in the X-ray image, since various human tissues on the path through which the photons pass are displayed, it is difficult to identify the landmark compared to a general natural image or a 3D image modality image. In this study, we propose a geometric data augmentation technique that enables the generation of a large amount of labeling data in X-ray images. In addition, the optimal attention mechanism for landmark detection was presented through the implementation and application of various attention techniques to improve the detection performance of 16 major landmarks in the skull. Finally, among the major cranial landmarks, markers that ensure stable detection are derived, and these markers are expected to have high clinical application potential.

The Efficacy of Detecting a Sentinel Lymph Node through Positron Emission Tomography/Computed Tomography (근골격계 악성 종양 환자의 림프절 전이 발견을 위한 양전자 방출 컴퓨터 단층 촬영기(Positron Emission Tomography/Computed Tomography)의 유용성)

  • Shin, Duk-Seop;Na, Ho Dong;Park, Jae Woo
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.6
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    • pp.509-518
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    • 2019
  • Purpose: Lymph node metastasis is a very important prognostic factor for all skin cancers and some sarcomas. A sentinel lymph node (SLN) biopsy is the most useful technique for identifying SLNs. Recently, a new generation of diagnostic tools, such as single photon emission computed tomography/computed tomography (SPECT/CT) and positron emission tomography/CT (PET/CT) enabled the detection of SLNs. This study compared the efficacy of PET/CT for detecting lymph node metastases with a SLN biopsy in a single medical center. Materials and Methods: From 2008 to 2018, 72 skin cancers of sarcoma patients diagnosed with some lymph node involvement in a whole body PET/CT reading were assessed. Patients suspected of lymph node metastasis were sent to biopsy and those suspected to be reactive lesions were observed. The analysis was performed retrospectively using the medical records, clinical information, PET/CT readings, and pathology results. Results: The age of patients ranged from 14 to 88 years and the mean follow-up period was 2.4 years. Twenty-two patients were suspected of a lymph node metastasis and confirmed. The sensitivity, specificity, positive predictive value and negative predictive value of PET/CT images in sarcoma and non-sarcoma tumors were increased significantly when the expert's findings were considered together. Conclusion: PET/CT is effective in detecting lymph node metastases.

Anti-inflammatory Effect of Conditioned Medium From an Immortalized Adipose-derived Stem Cell Line by SV40 T Antigen (SV40의 T항원으로 불사화한 지방줄기세포주로부터 생산한 배양액의 항염증 효능)

  • Ye Jin Lee;So Yeong Lee;Min Gyeong Jeong;Seong Moon Park;Dong Wan Kim
    • Journal of Life Science
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    • v.34 no.3
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    • pp.170-178
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    • 2024
  • Adipose-derived stem cells (ADSCs) are capable of differentiation into multiple lineages of cells, which has attracted attention for clinical therapy. However, ADSCs have poor proliferation capacity and a short life span in culture, which is an impediment in the application to clinical use. Previously, to overcome growth disadvantages, we had established an immortalized ADSC line (ADSC-T) by introducing the SV40 T antigen coding gene into primary human ADSC. In the present study, we evaluated the differentiation potential of this cell line and assessed the anti-inflammatory effect of its conditioned medium (CM). ADSC-T appeared to maintain the differentiation potential into adipocyte and chondrocyte. The CM of ADSC-T suppressed the NF-κB activity and its target gene expression of COX-2 and iNOS. Furthermore, the phosphorylations of MAPKs, including ERK, JNK and p38, were suppressed by the ADSC-T CM. The expressions of pro-inflammatory cytokines such as TGF-β, TNF-α, IL-6, and IL-13 were also suppressed by the CM of ADSC-T. In the Nc/Nga atopic model mice, the CM showed therapeutic effect on DNCB-induced atopic dermatitis. These results indicate that the immortalized ADSC-T maintains the beneficial properties of primary ADSC and could be a versatile cell source for not only research into ADSC but also for production of CM suitable for clinical application.

Multicentric Epithelioid Angiosarcoma of Bones Showing Angiotropic Spread: A Case Report (뼈에 발생한 혈관성 파종 양상을 보이는 다발성 상피상 혈관육종: 증례 보고)

  • Woo Suk Choi;Seul Ki Lee;Jee-Young Kim;Jun-Ho Kim
    • Journal of the Korean Society of Radiology
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    • v.85 no.1
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    • pp.240-246
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    • 2024
  • Epithelioid angiosarcoma is a rare variant of angiosarcoma characterized by an epithelioid morphology that mimics carcinoma. Therefore, multicentric epithelioid angiosarcoma is easily misdiagnosed as bone metastasis from carcinoma and has an aggressive clinical course. Here, we present a rare case of a 61-year-old male with multicentric epithelioid angiosarcoma of the bone. Plain radiography, CT, and MRI revealed multiple osteolytic lesions in both femurs; some lesions showed soft tissue extension with cortical bone destruction. Interestingly, PET-CT revealed that the lesions were only distributed along the bones of the lower extremities, including the pelvic bones, femurs, and tibiae. Despite histological analysis initially suggesting metastatic carcinoma, after additional immunohistological staining, including that for vascular markers (CD31 and ERG), the final diagnosis was epithelioid angiosarcoma. A better understanding of the clinicoradiological features of this disease may help eliminate diagnostic confusion and provide better management.

A Case of Glycogen Storage Disease Type Ia Confirmed by Biopsy and Enzyme Assay (제Ia형 당원병 1례 (Glycogen Storage Disease , Type Ia))

  • Meen Sang-Ae;Rho Kwang-Sik;Kim Pyung-Kil;Jeong Hyeon-Joo;Park Young-Nyeon;Kim Myung-Joon;Kim Ji-Hong
    • Childhood Kidney Diseases
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    • v.2 no.1
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    • pp.77-81
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    • 1998
  • The author exprienced a case of glycogen storage disease type Ia(GSD-I) in an 18-year-old male patient who was admitted to our hospital due to proteinuria and hypertension. he was suspected to have GSD when 12 years old because of his family history of short stature and hepatomegaly. On admission, physical examination revealed short stature, heparomegaly, and The diagnosis of GSD-I was confirmed by compatible liver biopsy finding and enzyme assay which erealeddeficiency of glcose-6-phosphatase if hepatocyte. Sympromatic treatment was done using antihypertensive drugs and allopurinol with diet control. The authors report a case of glycogen storage disease type Ia completely confirmed by typical clinical manifestation, pathologic findings of the liver and the kidney, and the result of enzyme assay which revealed deficiency of glucose-6-phosphatase in hepatocytes with brief review fo related literatures.

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Clinical Spectra of Auto-amputated Polyps: Comparison of Juvenile Polyps and Meckel's Diverticula (자동절제 대장 용종의 임상 양상: 연소성 용종 및 멕켈 게실과의 비교)

  • Kim, Jae-Young;Park, Jae-Hong;Choi, Gwang-Hae;Choe, Byung-Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.1
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    • pp.10-15
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    • 2009
  • Purpose: The manner of rectal bleeding of auto-amputated polyps (AP) is similar to juvenile polyps (JP) or Meckel's diverticula (MD). We conducted this study to characterize the clinical spectrum of AP. Methods: Fourteen patients were enrolled this study who were diagnosed AP due to painless rectal bleeding. The clinical data of AP was assessed and then compared with the clinical data of JP and MD retrospectively. Results: The prevalence of AP was 10.4% (14/135) and high in younger patients compared with that of JP (p=0.042 below 2 years). Whereas JP was more common in patients aged 2 to 5 years (p=0.005). Male was predominant in AP (p=0.008 AP vs JP). The manner of rectal bleeding in AP group was sudden and transient. There was no significant difference in time interval between onset of rectal bleeding and diagnosis between the 3 groups. However AP was diagnosed in 9 patients (64.3%) within 7 days after onset of rectal bleeding, but JP was diagnosed in 5 patients (4.1%) in the same period (p<0.001). All of AP were located in the rectum and the sigmoid colon. The mean hemoglobin was 11.3${\pm}$1.5 g/dL in AP, 11.8${\pm}$1.3 g/dL in JP, and 8.4${\pm}$1.2 g/dL in MD (p<0.001, only significant in MD). Conclusion: AP may be considered in male older than 1 year with transient and sudden onset or increase of painless rectal bleeding without drop of hemoglobin level.

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