• Title/Summary/Keyword: Classification of Disease

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A Clinicopathological Study of Rapidly Progressive Glomerulonephritis in Children (소아 급속 진행성 사구체 신염의 임상-병리학적 고찰)

  • Cho Hee-Yeon;Chung Dae-Lim;Kang Ju-Hyung;Ha Il-Soo;Choi Yong;Cheong Hae-Il
    • Childhood Kidney Diseases
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    • v.8 no.2
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    • pp.176-185
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    • 2004
  • Purpose: Rapidly progressive glomerulonephritis (RPGN) is a clinicopathologic entity characterized by extensive crescent formation and rapid deterioration of renal function within few months. For better understanding of its clinical course and designing better treatment strategies, a clinicopathological study of childhood RPGN was performed. Methods: The clinical manifestations and pathological findings were reviewed retrospectively in 12 children who were diagnosed as having RPGN by clinical manifestations and renal biopsy during a period from 1991 to 2003. Several clinicopathological parameters were analyzed as prognostic factors. Results: Among a total of 12 patients, 4 were male and 8 were female. The median onset age was 11.5 years(range 5.5-14.6 years), and the median period of follow-up was 25 months(range 7 months-6.6 years). According to the pathological classification, 10 patients (83%) were type II RPGN(immune-complex mediated glomerulonephritis), 2 patients were type III RPGN(pauci-immune glomerulonephritis), and none was type I RPGN(anti-glomerular basement membrane nephritis). All patients were treated with oral steroid in various combinations with methylprednisolone pulse therapy(10 patients, 83%), cyclophosphamide(8 patients, 67%), or plasmapheresis(4 patients, 33%). Clinical outcomes of 12 patients were complete remission in 1(8%), end-stage renal disease in 2(17%), chronic renal insufficiency with persistent proteinuria in 2(17%), and normal renal function with persistent proteinuria in 7(58%) at the last follow-up. Poor prognosis is associated with increased serum creatinine level, severe anemia and younger age at the time of diagnosis. Conclusion: Immune-complex mediated glomerulonephritis is the major cause RPGN in children and most cases showed improvement of renal function with aggressive management. For better understanding of this rare disease, a prospective multicenter study should be done.

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A 15-year clinical retrospective study of Br${\aa}$nemark implants (Br${\aa}$nemark 임플란트의 15년 임상적 후향 연구)

  • Park, Hyo-Jin;Cho, Young-Ye;Kim, Jong-Eun;Choi, Yong-Geun;Lee, Jeong-Yol;Shin, Sang-Wan
    • The Journal of Korean Academy of Prosthodontics
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    • v.50 no.1
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    • pp.61-66
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    • 2012
  • Purpose: This study was to compare the cumulative survival rate (CSR) of Br${\aa}$nemark machined surface implants and TiUnite$^{TM}$ imlants and to analyze association between risk factors and the CSR of the implants. Materials and methods: A retrospective study design was used to collect long-term follow-up clinical data from dental records of 156 patients treated with 541 Br${\aa}$nemark machined and TiUnite$^{TM}$ implants at Korea University Guro hospital in South Korea from 1993 through 2008. Machined implant and TiUnite$^{TM}$ implant were compared by CSR. Exposure variables such as gender, systemic disease, location, implant length, diameter, prosthesis type, opposing occlusion type, date of implant placement, type of edentulous space, abutment type, existence of splinting with natural teeth, and existence of cantilever were collected. Life table analysis was undertaken to examine the CSR. Cox regression method was conducted to assess the association between potential risk factors and overall CSR (${\alpha}$=.05). Results: Patient ages ranged from 16 to 75 years old (mean age, 51 years old). Implants were more frequently placed in men than women (94 men versus 63 women). Since 1993, 264 Br${\aa}$nemark machined implants were inserted in 79 patients and since 2001, 277 TiUnite$^{TM}$ implants were inserted in 77 patients. A total survival rate of 86.07% was observed in Br${\aa}$nemark and Nobel Biocare TiUnite$^{TM}$ during 15 years. A survival rate of machined implant during 15 years was 82.89% and that of TiUnite$^{TM}$ implant during 5 years was 98.74%. The implant CSR revealed lower rates association with several risk factors such as, systemic disease, other accompanied surgery, implant location, and Kennedy classification. Conclusion: Clinical performance of Br${\aa}$nemark machined and TiUnite$^{TM}$ implant demonstrated a high level of predictability. In this study, TiUnite$^{TM}$ implant was more successful than machined implant. The implant CSR was associated with several risk factors.

Alexithymia in Patients with Ulcerative Colitis and Irritable Bowel Syndrome (궤양성대장염 환자와 과민성대장증후군 환자의 감정표현불능증 비교 연구)

  • Lee, Sang-Bin;Lee, Seong-Yong;Kim, Sang-Heon;Rim, Hyo-Deog
    • Korean Journal of Psychosomatic Medicine
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    • v.11 no.1
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    • pp.69-76
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    • 2003
  • Objectives: Many researches have been done to compare psychopathology of functional gastrointestinal disorder and inflammatory bowel disease which involves structural change. Recently, many studies focused on the topic of alexithymia. The results from these studies were questionable for lack of valid measures of alexithymia and valid diagnostic criteria of functional gastrointestinal disorders. Therefore, we tried to overcome these two problems and to assess alexithymia, personality characteristics, and other psychopathology. Methods: The subjects consisted of ulcerative colitis group(N=28) who were diagnosed by colonoscopy and biopsy, irritable bowel syndrome group(N=27) who were diagnosed by Rome II criteria and normal control group(N=22). All patients were diagnosed at outpatient department of Kyungpook National University Hospital. All these groups completed three psychological tests, including MMPI, Rorschach test, and well validated TAS-20K(The Korean Version of the 20-Item Toronto Alexithymia Scale). Results: Twenty-five percent of the ulcerative colitis group and 22% of the irritable bowel syndrome group scored in the alexithymia range, compared with 0% of the normal group. In Rorschach test, irritable bowel syndrome group showed high levels of weighted Sum C and EA. Most of clinical scales of MMPI were higher in two gastrointestinal groups than the normal control group. And two gastrointestinal groups showed low ego strength level, but there was no statistical significant difference between them. Conclusion: Two gastrointestinal groups showed high rate of alexithymia, other psychopathological profiles, and low ego strength but there was no significant difference between two groups.

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Comparison of the Result of Radiation Alone and Chemoradiation in Cervical Cancer (자궁 경부암에서 방사선 단독치료와 방사선 및 화학요법 병행치료의 비교)

  • Kim, Jae-Cheol;Park, In-Kyu
    • Radiation Oncology Journal
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    • v.13 no.2
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    • pp.191-198
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    • 1995
  • Purpose: This analysis was to compare the result of radiation alone and chemoradiation in cervical cancer in terms of response, survival, failure, and complication. Materials and Methods: A retrospective analysis of 135 cervical cancer patients treated with definitive radiotherapy from November 1985 to December 1991 was performed. Fifty-six patients were treated with radiation alone and 79 patients were treated with cisplatin-based chemotherapy plus radiation. Follow-up period ranged from 5 to 105 months with a median 47 months. According to the FIGO classification, the patients were subdivided into 18 $(13.3\%)$ stage IB, 7 $(5.2\%)$ stage IIA, 97 $(71.9\%)$ stage IIB, and 9 $(6.7\%)$ stage IIIB. Results: A complete response was noted in 51 patients $(91.1\%)$ of the radiation alone group, and 68 patients $(86.1\%)$ of the chemoradiation group. There was no statistical difference in complete response rate between the two groups. Overall survival rate at 5 years was $73.3\%$. According to stage, overall survival rates at 5 years were $88.9\%$ in stage IB, $85.7\%$ in stage IIA, $73.8\%$ in stage IIB, and $37.5\%$ in stage IIIB, respectively. According to treatment modality, overall survival rates at 5 years were $81.9\%$ in the radiation alone group, $67.0\%$ in the chemoradiation group (p=0.22). Disease-free survival rate at 5 years were $70.4\%$ in the radiation alone group. $68.5\%$ in the chemoradiation group (p=0.85) Locoregional control rates at 5 years were $76.1\%$ in the radiation alone group, $73.8\%$ In the chemoradiation group (p=0.70). Distant disease-free survival rates at 5 years were $83.9\%$ in the radiation alone group, $90.3\%$ in the chemoradiation group (p=0.59). Treatment-related bone marrow suppressions were noted in 3 $(5.4\%)$ patients of the radiation alone group, 14 patients $(17.7\%)$ of the chemoradiation group (p(0.05). Grade 2 vesical complications were noted in 14 patients of the radiation alone group. and 10 Patients of the chemoradiation group. Grade 2 rectal complications were noted in 2 patients of the radiation alone group, and 3 Patients of the chemoradiation group. One case of rectal perforation was noted in the chemoradiation group, and grade 2 small bowel obstructions were noted in 2 patients of the radiation alone group. There were no statistical differences in the incidence of vesicar, rectal, and small bowel complicaions between the two groups. Conclusion: No statistical difference was found between the radiation alone group and the chemoradiation group in terms of response, survival, and failure. but the incidence of bone marrow suppression was higher in the chemoradiation group.

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Relationships of Obesity, Total-Cholesterol, Hypertension and Hyperglycemia in Health Examinees with Disabilities (장애인 건강검진 수검자들의 비만, 콜레스테롤, 고혈압, 고혈당의 관련성)

  • Hong, Min-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.10
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    • pp.591-599
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    • 2016
  • Among the employer-supported subscribers to the National Health Insurance Service, 6,797 people with mild disabilities with western ages of 20 and up and who received health checkups were investigated. Of these 6,797 people, 3,186 and 3,611 received health checkups in 2009 and 2013, respectively. Those people who were diagnosed with physical handicaps, brain lesions, visual impairment, hearing impairment, intellectual disabilities, mental disorders, kidney disorders or other disorders according to the classification standard for people with disabilities were classified into disability groups of the 3rd through 6th degrees. The purpose of this study was to examine the dangerous influence of obesity of people with mild disabilities on their hyperglycemia, hypertension and high cholesterol. The items measured in this study were abdominal obesity, body mass index, fasting glucose, total cholesterol, systolic blood pressure and diastolic blood pressure. To look for connections between the obesity level and at-risk groups for each disease, cross tabulation and multinomial logistic regression analyses were utilized. Higher levels of abdominal obesity and BMI were found among those who were male, were younger and had higher incomes. The risks of abdominal obesity and BMI were higher in the abnormal groups for each disease. In 2009, the obesity group whose BMI was higher had a 1.51-fold higher risk of hypertension than the normal group. The abdominal obesity group had a 1.59-fold higher risk of high cholesterol, a 1.26-fold higher risk of hypertension and a 1.54-fold higher risk of hyperglycemia than the normal group. In 2013, the obesity group whose BMI was higher had a 1.72-fold higher risk of high cholesterol and a 1.43-fold higher risk of hypertension than the normal group. Those with abdominal obesity had a 1.59-fold higher risk of hyperglycemia than the normal subjects. As the risk of obesity was higher in those with disabilities than in those without disabilities, the former should be encouraged to undergo health checkups on a regular basis, and the coverage of the health checkups should be extended to keep track of their illness. In addition, appropriate education and concern are both required to prevent obesity.

Needs Assessment for the Beneficiaries of Home-Based Cancer Patients Management Project (보건소 재가암환자관리사업 대상자의 서비스 요구도 분석)

  • Lee, Ju-Hyung;Park, Jung-Im;Kang, Ji-Hoon;Youm, Jung-Ho;Koh, Dai-Ha;Kwon, Keun-Sang
    • Journal of agricultural medicine and community health
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    • v.36 no.4
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    • pp.238-250
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    • 2011
  • Objectives: This study was performed to investigate the service needs of the beneficiaries who had enrolled in home-based management programs for cancer patients. Methods: From March to May 2009, 676 cancer patients who were registered in home-based cancer patient management programs were selected as subjects for this study. The data were collected using a questionnaire along with a face-to-face interview performed by officers in charge of the home-based care programs of 47 regional health centers. Fifteen patients were excluded due to incomplete data, leaving 661 subjects who were ultimately enrolled in the study. Results: The mean age of subjects was $64.0{\pm}2.5$ years, and males comprised 45.1% (298/661) of the sample. The results of factor analysis for service needs showed that there were five main categories and Cronbach's alpha ranged from 0.593 to 0.890 for each factor. The service needs categories in order of importance were social support, information and education, psychological problems, physical symptoms and household chores. The service needs scores were significantly different when subjects were stratified by age, habitation, religion and disease classification. When we divided the subjects into complete remission, under treatment and terminally ill groups, the needs scores of the terminally ill patient group were significantly higher than those of the other groups (p<0.001). Conclusions: Service provision based on patient and beneficiary needs could be an effective intervention to reduce the economic burden of cancer management and to improve the quality of life of cancer patients receiving home-based care. Therefore, it is recommended that individual cancer patient care programs be developed and administered according to patient age, habitation and disease severity.

The First Report on the Acanthocephalan Infection of the Dybowskii's Brown Frogs (Rana dybowskii) Collected Inside and Outside the Commercial Frog Farms in Korea (국내 개구리 양식장 내·외에서 채집된 북방산개구리(Rana dybowskii)의 구두충 감염 최초보고)

  • Kim, Jong-Sun;Koo, Kyo-Soung;Park, Jae-Jin;Kwon, Sera;Choia, Woo-Jin;Cho, Han-Na;Park, Daesik
    • Korean Journal of Environment and Ecology
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    • v.30 no.4
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    • pp.694-704
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    • 2016
  • Various infectious and parasitic diseases are known to be the main factors that cause decline in the global amphibian population. In Korea, commercial frog farms have been running since 2005. However, until now, studies on diseases including studies on parasitic diseases that occur in farm frogs have not been conducted. In this study, we studied and compared the acanthocephalan infection rates and the number of parasites in the body cavity, stomach, and small and large intestines of the Dybowskii's brown frogs collected from inside and outside the frog farms in Inje, Goesan, Gongju and Boryeong. In addition, we classified the acanthocephalan parasites into genera by analyzing their nuclear 18S rRNA genes. On an average, 51.7% of the investigated frogs were infected by acanthocephalans, which belong to the Centrorhynchus genus. The infection rate of the frogs collected in the Inje farm was 15%, significantly lower than those from the Goesan, Gongju and Boryeong farms. The rate in Goesan was 55%, which is lower than Gongju (80%) and Boryeong (90%) although it is not statistically significant. No difference was found in the infection rate and in the number of parasites in male and female frogs and between the groups collected from inside and outside of the farms. The number of infected parasites negatively correlated with the body condition of the frogs. The most parasites were found in the stomach followed by the small and large intestines and the body cavity. This study is the first report on the Centrorhynchus acanthocephalan infection of amphibians in Korea and it suggests the necessity for acanthocephalan parasite management and for conducting further disease-related studies in commercial frog farms.

Cis-acting Replication Element Variation of the Foot-and-mouth Disease Virus is Associated with the Determination of Host Susceptibility (구제역바이러스의 숙주 특이성 결정에 연관되어있는 구제역바이러스 cis-acting replication element 변이 분석 연구)

  • Kang, Hyo Rin;Seong, Mi So;Ku, Bok Kyung;Cheong, JaeHun
    • Journal of Life Science
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    • v.30 no.11
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    • pp.947-955
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    • 2020
  • The foot-and-mouth disease virus (FMDV), a member of the Aphthovirus genus in the Picornaviridae family, affects wild and domesticated ruminants and pigs. During replication of the FMDV RNA (ribonucleic acid) genome, FMDV-encoding RNA polymerase 3D acts in a highly location-specific manner. This suggests that specific RNA structures recognized by 3D polymerase within non-coding regions of the FMDV genome assist with binding during replication. One such region is the cis-acting replication element (CRE), which functions as a template for RNA replication. The FMDV CRE adopts a stem-loop conformation with an extended duplex stem, supporting a novel 15-17 nucleotide loop that derives stability from base-stacking interactions, with the exact RNA nucleotide sequence of the CRE producing different RNA secondary structures. Here, we show that CRE sequences of FMDVs isolated in Korea from 2010 to 2017 exhibit A and O genotypes. Interestingly, variations in the RNA secondary structure of the Korean FMDVs are consistent with the phylogenetic relationships between these viruses and reveal the specificity of FMDV infections for particular host species. Therefore, we conclude that each genetic clade of Korean FMDV is characterized by a unique functional CRE and that the evolutionary success of new genetic lineages may be associated with the invention of a novel CRE motif. Therefore, we propose that the specific RNA structure of a CRE is an additional criterion for FMDV classification dependent on the host species. These findings will help correctly analyze CRE sequences and indicate the specificity of host species for future FMDV epidemics.

Treatment of Squamous Cell Carcinoma in Extremity & Trunk (사지와 체부에 발생한 편평상피 세포암의 치료)

  • Shin, Duk-Seop;Kim, Beom-Jung
    • The Journal of the Korean bone and joint tumor society
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    • v.18 no.1
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    • pp.7-13
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    • 2012
  • Purpose: The purpose of this study is to compare general survival rate and survival rate according to expectable prognostic factors by analyzing the result of treating a patient of squamous cell carcinoma. Materials and Methods: From Mar. 1999 to Feb. 2011, 151 patients were pathologically confirmed as squamous cell carcinoma of limbs and body in our hospital, and among those patients, 51 patients underwent the surgical treatment. This study included 41 patients who underwent the surgical treatment and were followed-up for more than 12 months. The mean age of population was 64.4 years. 31 males and 10 females were included. Wide excision with following skin grafts or flaps for reconstruction (29 cases) was mostly performed, but amputation (12 cases) was also performed for cases with extremities where resection margin was difficult to obtain and cases with neural or vascular invasion. 8 patients underwent chemotherapy or radiotherapy after resection, and 33 underwent the operation only. Stages were classified by AJCC Classification, survival rate was calculated by Kaplan-Meier method and survival rate of groups was compared by Log-rank test. For the expectable prognostic factors related to survival rate, location of primary lesion, cause of disease, pathologic grade, staging, surgical method, additional anticancer therapy were examined and each survival rate was compared. Results: The average follow-up period was 65.2 (12-132) months. Thirty patients survived out of 41 patients till last follow up. The overall survival rate in 5 years was 77%. Three cases (7.3%) had local recurrence, and 7 cases (17.0%) had metastasis. The average period of recurrence from operation was 27 (18-43) months. Possible prognostic factors such as location of primary lesion, cause of disease, pathologic grade, staging, additional anticancer therapy showed no significant difference in survival rates. However, patients with amputation showed significantly lower survival rate than those with wide excision. Conclusion: In analysis the results of treating 41 cases of squamous cell carcinoma, the overall 5-year survival rate was 77%. And, among the several prognostic factors, only the surgical method was significant statistically.

Evaluation of Etiological Factors for Injuries at Oral and Maxillofacial Area (구강악안면부 외상발생의 역학적 평가)

  • Bae, Sung-Suk;Hwang, Soon-Jung
    • Journal of dental hygiene science
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    • v.12 no.4
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    • pp.310-319
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    • 2012
  • In this study, 1,495 cases of computerized data collected as disease entities of oral and maxillofacial injuries among patient visiting S university hospital located in Seoul in 2009 were analyzed and following results were obtained. It was found that the injury incidence in male was greater than in female (1.49:1), it occurred most frequently in the age of 7~14 years old (19.6%), and its most frequent cause was falling down (25.9%). Injuries occurred in other place including beach and open-air (24.7%) most frequently, often developed in anterior teeth (43.2%) and posterior teeth (43.1%), their incidence was relatively higher between 15:00~17:00 (10.4%) and 19:00~23:00 (7.1%) O'clock. In the relationship between causes of the injury and the diagnosis based on the international classification of disease), falling, fall, impingement, violence, traffic accident, sports and own making accident caused most frequently lip and oral open injuries (S01.5), open fracture of tooth (S02.51), close fracture of tooth (S02.50), close fracture of mandible (S02.60), close fracture of tooth (S02.50), respectively. From the above results, it is necessary to understand general characteristics of oral and maxillofacial injuries and to consider their trends for the establishment of systematic complement policies and for the performing safety training and public relations activities.