• Title/Summary/Keyword: Clinical Feature

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Multiple Myeloma: a Retrospective Analysis of 61 Patients from a Tertiary Care Center

  • Sultan, Sadia;Irfan, Syed Mohammed;Parveen, Saira;Ali, Hamza;Basharat, Maria
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.1833-1835
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    • 2016
  • Background: Multiple myeloma (MM) is an acquired clonal B-cell malignancy which primarily affects elderly individuals with an annual incidence of approximately 1% of all malignancies. Our aim is to study demographic and clinicopathological features of adult Pakistani MM patients at presentation. Materials and Methods: This single centre retrospective study extended from January 2010 to December 2014. Data were retrieved from the patients' maintained records on predetermined performa. Results: Overall, 61 patients were diagnosed at our institution with MM during the study period. There were 43 males and 18 females. Age ranged between 34 and 81 years with a mean of $56.1{\pm}12.8$ and a median of 57 years. The male to female ratio was ~2:1. Common presenting complaints included fatigue (81.9%), backache (80.3%) and bone pain (67.2%). Physical findings revealed pallor (44.2%) as a presenting clinical feature. The mean hemoglobin value was $8.9{\pm}1.7g/dl$ with a mean MCV of $85.3{\pm}11.0fl$. Severe anemia with hemoglobin <8.5 gm/dl was seen in 40.9%. The mean total leukocyte count was $8.9{\pm}8.2{\times}10^9/l$, the ANC was $5.0{\pm}3.1{\times}10^9/l$ and the mean platelet count was $188.4{\pm}150.6{\times}10^9/l$. Conclusions: MM in Pakistani patients is seen in a relatively young population with male preponderance. The majority of patients present with symptomatic anemia and backache to seek medical attention. However, clinico-pathological features appear comparable to the published literature.

Role of CD10 Immunohistochemical Expression in Predicting Aggressive Behavior of Phylloides Tumors

  • Tariq, Muhammad Usman;Haroon, Saroona;Kayani, Naila
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.8
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    • pp.3147-3152
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    • 2015
  • Background: Phylloides tumors are rare breast neoplasms with a variable clinical course depending on the tumor category. Along with histologic features, the role of immunohistochemical staining has been studied in predicting their behavior. Objectives: Our aim was to evaluate the role of CD 10 immunohistochemical staining in predicting survival, recurrence and metastasis in phylloides tumor. We also evaluated correlations of other clinicopathological features with overall and disease-free survival. Materials and Methods: CD10 expression was studied in 82 phylloides tumors divided into recurrent/metastatic and non-recurrent/non-metastatic cohorts. The Chi-square test was applied to determine the significance of differences in CD10 expression between outcome cohorts. Uni and multivariate survival analyses were also performed using log-rank test and Cox regression hazard models. Results: All 3 metastatic cases, 5 out of 6 (83.3%) recurrent cases and 37out of 73 (50.7%) non-recurrent and non-metastatic cases expressed significant (2+ or 3+) staining for CD10. This expression significantly varied between outcome cohorts (p<0.03). Tumor category and histological features including mitotic count and necrosis correlated significantly with recurrence and metastasis. A significant decrease in overall and disease free survival was seen with CD10 positivity, malignant category, increased mitoses and necrosis. Neither CD10 expression nor any other clinicopathologic feature proved to be an independent prognostic indicator in multivariate analysis. Conclusions: CD10 immunohistochemical staining can be used as a predictive tool for phylloides tumor but this expression should be interpreted in conjunction with tumor category.

A Case of Moyamoya Disease in a Child with Alagille Syndrome (Alagille 증후군 환아에서 발생한 Moyamoya병 1례)

  • Lim, Mi Rang;Lee, So Yaun;Kim, Deok Soo;Kim, Kyung Mo;Ko, Tae Sung
    • Clinical and Experimental Pediatrics
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    • v.46 no.1
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    • pp.86-90
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    • 2003
  • Alagille syndrome is a autosomal dominant disorder characterized by intrahepatic bile duct paucity and resultant chronic cholestasis in combination with cardiac(mainly peripheral pulmonary stenosis), skeletal, ocular, and facial abnormalities. In addition to the pulmonary stenosis, in large series, anecdotal reports of vascular lesions have concerned the renal artery, aorta, hepatic artery, carotid artery, celiac artery or subclavian artery. Theses diffuse vascular abnormalities, which appear to be a feature of Alagille syndrome, suggest Notch signaling pathway defects affect angiogenesis. The associations of Alagille syndrome with moyamoya disease, the chronic cerebrovascular occlusive disease, were reported and suggested as additional evidence of vasculopathy of Alagille syndrome. We report another 25 month-old Alagille syndrome girl who presented with acute left hemiparesis and was diagnosed with moyamoya disease through the cerebral angiographic study.

Interstitial deletion of 5q33.3q35.1 in a boy with severe mental retardation

  • Lee, Jin Hwan;Kim, Hyo Jeong;Yoon, Jung Min;Cheon, Eun Jung;Lim, Jae Woo;Ko, Kyong Og;Lee, Gyung Min
    • Clinical and Experimental Pediatrics
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    • v.59 no.sup1
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    • pp.19-24
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    • 2016
  • Constitutional interstitial deletions of the long arm of chromosome 5 (5q) are quite rare, and the corresponding phenotype is not yet clearly delineated. Severe mental retardation has been described in most patients who present 5q deletions. Specifically, the interstitial deletion of chromosome 5q33.3q35.1, an extremely rare chromosomal aberration, is characterized by mental retardation, developmental delay, and facial dysmorphism. Although the severity of mental retardation varies across cases, it is the most common feature described in patients who present the 5q33.3q35.1 deletion. Here, we report a case of a de novo deletion of 5q33.3q35.1, 46,XY,del(5)(q33.3q35.1) in an 11-year-old boy with mental retardation; to the best of our knowledge this is the first case in Korea to be reported. He was diagnosed with severe mental retardation, developmental delay, facial dysmorphisms, dental anomalies, and epilepsy. Chromosomal microarray analysis using the comparative genomic hybridization array method revealed a 16-Mb-long deletion of 5q33. 3q35.1(156,409,412-172,584,708)x1. Understanding this deletion may help draw a rough phenotypic map of 5q and correlate the phenotypes with specific chromosomal regions. The 5q33.3q35.1 deletion is a rare condition; however, accurate diagnosis of the associated mental retardation is important to ensure proper genetic counseling and to guide patients as part of long-term management.

Review of Randomized Controlled Trials on Pharmacopuneture Treatment for Musculoskeletal Diseases (무작위대조군연구(RCT)를 중심으로 한 근.골격계 질환의 약침 치료에 관한 고찰)

  • Jang, Min-Ki;Yoon, Eun-Hye;Jung, Chan-Yung;Kim, Eun-Jung;Lee, Seung-Deok;Hwang, Min-Seop;Kim, Kap-Sung
    • Journal of Acupuncture Research
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    • v.26 no.3
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    • pp.149-163
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    • 2009
  • Objectives : The purpose of this study is to review RCTs on pharmacopuncture treatment for musculoskeletal diseases and to establish standards of pharmacopuncture treatment model. Methods : We searched articles up to date of March 2009 via computerized databases of Pubmed, The Journal of Korean Acupuncture & Moxibustion, Journal of Korean institute of Herbal Acupuncture, Journal of Oriental Rehabilitation and Journal of Korean Oriental Medicine. Only Randomized Controlled Trials (RCT) concerning the effects of pharmacopuncture on musculoskeletal diseases. The pharmacopuncture treatment methods were assessed based on STRICTA and items considering the feature of pharmacopuncture. And the methodological quality of the trials was assessed by FEAS and modified Jadad score. Results : Eighteen trials of pharmacopuncture on musculoskeletal diseases were analyzed. Except for 4 trials comparing the effect of SBV and BV, positive outcome was reported in ten trials. Among eighteen trials; most of the trials were about Bee Venom acupuncture, and most of the trials used about five acupuncture points, mainly local acupuncture points. But, the amount of injection to each point and total injection were various. And most of trials were lack in the information about method of stimulation. The adjusted FEAS score ranged from 0 to 12, and modified Jadad scoreranged from 1 to 5. Conclusions: To standardize pharmacopuncture treatment, we need more well-designed, high quality clinical trials. And methodological assessment tools designed for pharmacopuncture treatment are also needed.

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Multiscale Clustering and Profile Visualization of Malocclusion in Korean Orthodontic Patients : Cluster Analysis of Malocclusion

  • Jeong, Seo-Rin;Kim, Sehyun;Kim, Soo Yong;Lim, Sung-Hoon
    • International Journal of Oral Biology
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    • v.43 no.2
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    • pp.101-111
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    • 2018
  • Understanding the classification of malocclusion is a crucial issue in Orthodontics. It can also help us to diagnose, treat, and understand malocclusion to establish a standard for definite class of patients. Principal component analysis (PCA) and k-means algorithms have been emerging as data analytic methods for cephalometric measurements, due to their intuitive concepts and application potentials. This study analyzed the macro- and meso-scale classification structure and feature basis vectors of 1020 (415 male, 605 female; mean age, 25 years) orthodontic patients using statistical preprocessing, PCA, random matrix theory (RMT) and k-means algorithms. RMT results show that 7 principal components (PCs) are significant standard in the extraction of features. Using k-means algorithms, 3 and 6 clusters were identified and the axes of PC1~3 were determined to be significant for patient classification. Macro-scale classification denotes skeletal Class I, II, III and PC1 means anteroposterior discrepancy of the maxilla and mandible and mandibular position. PC2 and PC3 means vertical pattern and maxillary position respectively; they played significant roles in the meso-scale classification. In conclusion, the typical patient profile (TPP) of each class showed that the data-based classification corresponds with the clinical classification of orthodontic patients. This data-based study can provide insight into the development of new diagnostic classifications.

Computer-Aided Diagnosis for Pulmonary Tuberculosis using Texture Features Analysis in Digital Chest Radiography (질감분석을 이용한 폐결핵의 자동진단)

  • Kim, Dae-Hun;Ko, Seong-Jin;Kang, Se-Sik;Kim, Jung-Hoon;Kim, Chang-Soo
    • The Journal of the Korea Contents Association
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    • v.11 no.11
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    • pp.185-193
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    • 2011
  • There is no exact standard of detecting pulmonary tuberculosis(TB) in digital image of simple chest radiography. In this study, I experimented on the principal components analysis(PCA) algorithm in the past and suggested six other parameters as identification of TB lesions. The purpose of this study was to develop and test computer aided diagnosis(detection) method for the detection and measurement of pulmonary abnormalities on digital chest radiography. It showed comparatively low recognition diagnosis rate using PCA method, however, six kinds of texture features parameters algorithm showed similar or higher diagnosis rates of pulmonary disease than that of the clinical radiologists. Proposed algorithms using computer-aided of texture analysis can distinguish between areas of abnormality in the chest digital images, differentiate lesions having pulmonary disease. The method could be useful tool for classifying and measuring chest lesions, it would play a major role in radiologist's diagnosis of disease so as to help in pre-reading diagnosis and prevention of pulmonary tuberculosis.

The effects of Oriental medicine treatment and the characteristics of MMPI profile on Vertigo Patients (어지럼증 환자(患者)의 MMPI 프로파일 특성과 한의학적(韓醫學的) 치료효과(治療效果))

  • Kim, Jin-Woo;Lee, Soon-E;Kim, Ja-Young;Kim, Tae-Heon;Lyu, Yeong-Su;Kang, Hyung-Won
    • Journal of Oriental Neuropsychiatry
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    • v.17 no.3
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    • pp.67-75
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    • 2006
  • This Study is attempted to analyze Minnesota Multiphasic Personality Inventory responses to Vertigo patients and remedial value of Oriental medicine treatment. Methods: 24 Vertigo patients and 28 control group were tested by MMPI and QSCCII. It is analyzed by cluster analysis, one-way ANOVA, chi-square test, t-test, Duncan method is used as ex-post test. Results and Conclusions: 1. The MMPI scores of Vertigo patients were elevated in Hs, Hy clinical scales, 1-3 profile type, it is profile of conversional neurosis. In this case body condition where the psychological problem will get conversion is a notable feature. 2. All of the profiles can be classified three types of profile. Group 1(33.3%) showed 1-3-2 profile type and elevated Pt. scale, suggesting mainly depressive neurosis in the department of neuropsychiatry. Group 2 (37.5%) showed a normal profile. Group 3(29.2%) showed 1-3 profile type it is profile of conversional neurosis. With this result it is indicated that 62.5% Vertigo patients are related to emotional difficulties. 3. There was to a remedial value for the Vertigo patients, before treating from VAS score 10.00 after treating at VAS score 4.13. From this study, we know the possibility the Oriental medicine register remedial value for the Vertigo patients.

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Chondrasarcoma of the Head and Neck - 4 Cases Report - (두경부에 발생한 연골육종 4 예)

  • Lee C.G.;Park K.R.;Kim S.K.;Suh C.O.;Kim G.E.;Loh J.K.;Koh E.H.;Kim B.S.;Hong W.P.
    • Korean Journal of Head & Neck Oncology
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    • v.3 no.1
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    • pp.97-105
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    • 1987
  • Chondrosarcoma of the head and neck is very rare tumor and this incidence was reported to be about 10% of all chondrosarcomas. Maxilla is the most common site of involvement and mandible, paransal sinus, nasal cavity and base of skull in that order. In general, chondrosarcoma has been known to be radioresistant, however since the Princess Margaret Hospital reported that it was radioresponsive tumor in 1980, the role of radiotherapy has been emphasized in terms of local control, especially in head and neck regions where complete excion is often difficult to achieve. The authors experienced 4 cases of chondrosarcoma of head and neck among all 29 chondrosarcoma patients from 1971 to 1985. The clinical and pathologic feature of this disease, it's treatment and prognosis were reviewed along with the literatures.

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Two cases of Antley-Bixler syndrome caused by mutations in different genes, FGFR2 and POR

  • Woo, Hyewon;Ko, Jung Min;Shin, Choong Ho;Yang, Sei Won
    • Journal of Genetic Medicine
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    • v.13 no.1
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    • pp.31-35
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    • 2016
  • Antley-Bixler syndrome (ABS) is a rare form of syndromic craniosynostosis with additional systemic synostosis, including radiohumeral or radioulnar synostosis. Another characteristic feature of ABS is mid-facial hypoplasia that leads to airway narrowing after birth. ABS is associated with mutations in the FGFR2 and POR genes. Patients with POR mutations present with either skeletal manifestations or congenital adrenal hyperplasia with ambiguous genitalia. We report here two cases of ABS caused by mutations in FGFR2 and POR. Although the patients had craniosynostosis and radiohumeral synostosis in common and cranioplasty was performed in both cases, the male with POR mutations showed an elevated level of $17{\alpha}$-hydroxyprogesterone during newborn screening and was diagnosed with congenital adrenal hyperplasia by adrenocorticotropic hormone stimulation. This patient has been treated with hydrocortisone and fludrocortisone. He had no ambiguous genitalia but had bilateral cryptorchidism. On the other hand, the female with the FGFR2 mutation showed severe clinical manifestations: upper airway narrowing leading to tracheostomy, kyphosis of the cervical spine, and coccyx deformity. ABS shows locus heterogeneity, and mutations in two different genes can cause similar craniofacial and skeletal phenotypes. Because the long-term outcomes and inheritance patterns of the disease differ markedly, depending on the causative mutation, early molecular genetic testing is helpful.