• Title/Summary/Keyword: Clinical and pathologic findings

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Development of System Dynamics Model for the Variation of Plasma Glucose Levels in Patients with Type 2 Diabetes (당뇨병 환자의 혈당 변동에 대한 시스템다이내믹스 모델 개발)

  • Choi, Eun-Ok;Kwak, Chan-Yeong
    • Korean System Dynamics Review
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    • v.9 no.1
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    • pp.155-170
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    • 2008
  • The purpose of this study was to develop a system dynamics model for management of glucose metabolism disorders that demonstrated dynamic relationships between insulin and plasma glucose levels over the time. The model was developed to 1) represent the physiology of glucose metabolism for an normal adult subject, 2) to draw causal loop diagram that demonstrate feedback systems of glucose regulation in normal condition and pathologic condition of the type 2 diabetes, 3) to develop an interactive computer simulation model for management of glucose metabolism disorders. The simulation results showed the plasma glucose level for normal persons varied from 75 to 140 which was consistent with clinical findings. As an example for patients we selected a case which varied from 110 to 310. Two types of interventions were chosen to review the model; meal control and insulin administration. The simulation results for those cases also matched well with clinical findings. The developed model can be used as an effective educational tool for patients to develop healthy lifestyle choices. The results also provide a blueprint for health providers to maintain normal blood glucose levels in diabetes patients.

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CEPHALOMETRIC STUDY IN PATIENTS WITH FUNCTIONAL ALTERATIONS OF THE TEMPOROMANDIBULAR JOINT (측두 하악관절의 기능적 변화가 있는 환자의 측모두부방사선 계측학적 연구)

  • Kwon, Byung-In;Baik, Hyoung-Seon
    • The korean journal of orthodontics
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    • v.22 no.3 s.38
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    • pp.703-713
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    • 1992
  • Researches in pathologic entities and syndromes that describe temporomandibular joint (TMJ) or TMJ-related pain and dysfunction, have been hampered by confusion and conflict over the pathogenesis of myofascial and joint pain, the character and causes of joint noises, and the lack of scientific methods. Investigators have more recently correlated clinical diagnosis and arthrographic and surgical findings to demonstrate 'internal derangements' of the TMJ. It is thought that the structural and functional changes characteristic of internal derangements constitute the principal pathologic entity of the TMJ. Cephalometric data from a group of 34 subjects with documented functional changes in the TMJ were compared with those of a group of 35 subjects from a control sample. The results were as follows: 1. Comparison of a group which shows Class I relationship, there was a tendency to show clock-wise rotation of mandible and linguoversion of upper and lower anterior teeth in the experimental sample. 2. Excluding the vertical relationship, there was a tendency to show low values of the lingual surface slope of the upper central incisor and high values of the interincisor angle in the experimental sample.

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Immunohistochemical detection of viral antigen and pathological lesion in piglets experimentally infected with encephalomyocarditis virus (뇌심근염 바이러스의 실험적 감염자돈에 대한 병리학적 소견과 바이러스 항원의 면역조직화학적 검출)

  • Cho, Sung-hwna;Joo, Han-soo;Kim, Hyun-soo
    • Korean Journal of Veterinary Research
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    • v.33 no.2
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    • pp.301-308
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    • 1993
  • Three or 7day old piglets were infected experimentally with different encephalomyocarditis virus isolates to detect the viral antigen by the immunoperoxidase technique and to observe strain difference in their pathogenecity in newborn pigs by comparing clinical signs and pathologic lesions. Clinical signs of the infected pigs were different depending on the virus strain, pig age and infection route. Encephalomyocarditis virus(EMCV) NVSL-PR isolate was more pathogenic than MN-25 and MN-30 isolate. Three day old piglets showed more severe illness than 7 day old piglets. Predominant clinical signs were sudden death without noticeable clinical signs and dyspnea manifested as heavy abdominal breathing. Contact-infection from infected piglets to controls was observed in the oro-nasally infected group but not the intramuscular group. Common necropsy findings of dead piglets in both age groups infected with MN-25 and NVSL-PR were accumulation of excessive fluid in the body cavities and mild to diffuse necrotic areas observed in the hearts and occasionally in the livers. Microscopically, myocarditis with inflammatory cell infiltration, necrosis of the myocardial muscle fibers and occasional mineralization were observed along with interstitial pneumonia and centrolobular necrosis in the liver. Using an immunoperoxidase technique, viral antigen was detected in myocardial muscle fibers of piglets infected with EMCV.

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Analysis of Clostridium Difficile Toxin Value in Diarrhea Patients (설사증 환자에서 Clostridium Difficile Toxin Value 분석)

  • Kwon, Se-Young;Yoon, In-Sook
    • The Journal of the Korea Contents Association
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    • v.10 no.5
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    • pp.259-266
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    • 2010
  • Clostridium difficile-associated disease (CDAD) is an important nosocomial infectious diarrhea and is associated with antibiotic use. Recently, incidence of C. difficile has been increasing in hospitals. A total of 1,329 stool specimens were examined from January, 2005 to December, 2008. This study analyzed the incidence and clinical characteristics of C. difficile infections on them. Out of 1,329 stool specimens, 283 specimens showed toxin A/B positive, using EIA. The positive rate was 21.2%; with the highest incidence among and above the 70years old. On endoscopy, psedo membranous colitis was found in 57.7%, and 19.5% of patients were normal. Pathologic finding showed PMC in 26.8% of patients, AAC in 52.2%. C. difficile was associated with PMC, however, endoscopic and pathologic findings tests showed normal to PMC.

Artificial Intelligence in the Pathology of Gastric Cancer

  • Sangjoon Choi;Seokhwi Kim
    • Journal of Gastric Cancer
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    • v.23 no.3
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    • pp.410-427
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    • 2023
  • Recent advances in artificial intelligence (AI) have provided novel tools for rapid and precise pathologic diagnosis. The introduction of digital pathology has enabled the acquisition of scanned slide images that are essential for the application of AI. The application of AI for improved pathologic diagnosis includes the error-free detection of potentially negligible lesions, such as a minute focus of metastatic tumor cells in lymph nodes, the accurate diagnosis of potentially controversial histologic findings, such as very well-differentiated carcinomas mimicking normal epithelial tissues, and the pathological subtyping of the cancers. Additionally, the utilization of AI algorithms enables the precise decision of the score of immunohistochemical markers for targeted therapies, such as human epidermal growth factor receptor 2 and programmed death-ligand 1. Studies have revealed that AI assistance can reduce the discordance of interpretation between pathologists and more accurately predict clinical outcomes. Several approaches have been employed to develop novel biomarkers from histologic images using AI. Moreover, AI-assisted analysis of the cancer microenvironment showed that the distribution of tumor-infiltrating lymphocytes was related to the response to the immune checkpoint inhibitor therapy, emphasizing its value as a biomarker. As numerous studies have demonstrated the significance of AI-assisted interpretation and biomarker development, the AI-based approach will advance diagnostic pathology.

Different Clinical Features and Lower Scores in Clinical Scoring Systems for Appendicitis in Preschool Children: Comparison with School Age Onset

  • Song, Chun Woo;Kang, Joon Won;Kim, Jae Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.1
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    • pp.51-58
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    • 2018
  • Purpose: To clarify the clinical features of appendicitis in preschool children and to explore clinical appendicitis scoring systems in this age group. Methods: We retrospectively collected data on 142 children, aged 10 years or younger, with confirmed diagnosis of appendicitis based on surgical and pathologic findings. Enrolled subjects were divided into two groups: Group 1 (preschool children aged ${\leq}5$ years, n=41) and Group 2 (school children aged >5 to ${\leq}10$ years, n=101). Data analyzed included clinical presentation, laboratory findings, the pediatric appendicitis score (PAS), and the modified Alvarado score (MAS). Results: The most common presenting symptom was abdominal pain in both groups (92.7% vs. 97.0%). Other presenting symptoms were as follows: fever (65.9%), vomiting (68.3%), right lower quadrant (RLQ) localization (24.4%), anorexia (14.6%), and diarrhea (7.3%) in Group 1, and RLQ localization (74.3%), vomiting (71.3%), anorexia (52.5%), fever (47.5%), and diarrhea (11.9%) in Group 2. Perforation and abscess occurred more frequently in Group 1 than in Group 2 (43.9% vs. 12.9%, p<0.001; 34.1% vs. 5.0%, p<0.001; respectively). PAS and MAS were lower in Group 1 than in Group 2 ($4.09{\pm}1.97$ vs. $6.91{\pm}1.61$, p=0.048; $4.65{\pm}1.79$ vs. $6.51{\pm}1.39$, p=0.012; respectively). Conclusion: In preschool children, appendicitis often presents with atypical features, more rapid progression, and higher incidence of complications. This age group is more likely to have lower PAS and MAS than those of school children.

Clinical Course of IgA Nephropathy in Children (소아 IgA 신병증의 추적 관찰)

  • Hong In-Hee;Lee Jun-Hwa;Go Cheol-Woo;Kwak Jung-Sik;Koo Ja-Hoon
    • Childhood Kidney Diseases
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    • v.3 no.2
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    • pp.153-160
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    • 1999
  • Purpose : Present study was undertaken to find out significance of clinical presentation, initial laboratory data and renal biopsy findings on subsequent clinical course of IgA nephropathy in children. Methods : Clinical and laboratory data were analysed retrospectively from 60 children who have been admitted to the Pediatric Department of Kyungpook National University Hospital for the past 11 years and diagnosed as IgA nephropathy. Renal biopsy findings were graded according to the pathologic subclass proposed by Haas. Results : Pathologic grading according to Haas subclassification showed 10 cases in subclass I, 36 in II, 12 in IV and 2 in V and none in subclass II. Sex distribution showed male predominance (male to female ratio = 3 : 1) and mean age at onset of disease was $10.4{\pm}2.8$ years. Episodes of gross hematuria was seen in 71.7% and IgA level increased in 28.3% of children and these were not associated with pathologic grading nor clinical outcomes. With increasing subclass grading, serum protein and albumin decreased and 24 hours urinary protein excretion increased. Normalization of urinalysis (disappearance of hematuria) was seen in 14% at 1-2 years and 37.1% at 3-4 years of follow up period. In 3 cases, renal function deteriorated progressively and they belonged one each to the Haas subclass III, IV and V. Conclusion : In children with IgA nephropathy, progression to chronic renal failure appears to be quite high and pathologic grading according to Haas' subclassification seems to predict patient's outcome faily well. However, firm conclusion cannot be drawn from present study due to the small numbers of patients and short follow-up period. Therefore further multicenter study involving larger numbers of patients and longer periods of follow-up over 10 years was to be undertaken.

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Features of the Filum Terminale in Tethered Cord Syndrome with Focus on Pathology

  • Sim, Jungbo;Shim, Youngbo;Kim, Kyung Hyun;Kim, Seung-Ki;Lee, Ji Yeoun
    • Journal of Korean Neurosurgical Society
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    • v.64 no.4
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    • pp.585-591
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    • 2021
  • Objective : Filum transection is one of the most commonly performed operative procedure in pediatric neurosurgery. However, the clinical and pathological features as well as the surgical indication are not well-established. This study aimed to analyze the characteristics of patients who underwent transection of the filum during the last 10 years in a single institute. Methods : A total of 82 patients underwent transection of the filum during the period. As a general rule, we performed the transection in patients who are symptomatic or have abnormality in the urologic or neuromuscular evaluations. There were exceptions as asymptomatic patients who only fit the definition of thickened filum (width greater than 2.0 mm or conus level below L3 vertebral body) were operated by parent's wish or surgeon's preference according to radiological findings, etc. Results : Seventy-six out of 82 patients had fibrous tissue in the pathologic specimen of filum. Interestingly, patients who had glial cells were more correlated with no preoperative syrinx, and no progression of syrinx even for those who did have syrinx initially. Also, larger percentage of symptomatic patients had peripheral nerve twigs than asymptomatic patients. No difference in conus level or thickness of filum was found between patients with or without preoperative syrinx. Significantly more patients with syrinx (56%) were chosen to be operated without any symptom or abnormality in study i.e., solely based on radiological findings than those without syrinx (21%). The surgical outcome for syrinx was favorable, as all but one patient had either improved or static syrinx. The exceptional case had increase in size due to the upward displacement of the proximal end of the cut filum. Conclusion : This study evaluated the pathological, clinical, radiological features of patients who underwent transection of the filum. Interesting correlations between pathological findings and clinical features were found. Excellent outcome regarding preoperative syrinx was also shown.

Aspergillosis of Central Nervous System (중추신경계의 Aspergillosis)

  • You, Seung-Hoon;Lee, Jung-Il;Nam, Do-Hyun;Kim, Jong-Soo;Hong, Seung-Chyul;Shin, Hyung-Jin;Park, Kwan;Eoh, Whan;Kim, Jong-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.30 no.7
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    • pp.896-902
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    • 2001
  • Objectives : Aspergillosis of central nervous system(CNS) is a rare pathologic condition and it has been known to be difficult to diagnose and treat. We analyzed seven cases of central nervous system aspergillosis. The clinical characteristics, and the problems in diagnosis and treatment are discussed with review of previous literatures. Material and Methods : We reviewed the clinical records, radiological findings, and pathologic reports of 7 patients with aspergillosis which involved CNS. Results : Five patients were immunocompetent, and infection was related with previous operation in 4 of them. Two patients were immunocompromised and had no history of operation. Five patients had intracranial lesions and two had spinal lesions. Mean duration from the onset of initial symptom to pathologic diagnosis was 2.4 months. Mean duration from the previous operation to the onset of symptom was 9.3 months, and from the onset of symptom to diagnosis was 2.9 months in the patients who had histories of operation. All of them were treated with surgical procedures and intravenous and oral antifungal agents, resulting in cure in 6 cases. Mean duration of the treatment was 4.9 months. Conclusion : Because aspergillosis of CNS is a rare disease and is difficult to be differentiated from the pyogenic abscess or recurrent tumor, the pathologic diagnosis is very important for adequate treatment. Although the prognosis of aspergillosis of CNS has been known to be poor, adequate surgery for both diagnosis and treatment and antifungal chemotherapy resulted in good outcome.

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Primary Non-Hodgkin's Gastric Lymphoma (원발성 위 림프종)

  • Kwon, Sung-Joon
    • Journal of Gastric Cancer
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    • v.1 no.4
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    • pp.215-220
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    • 2001
  • Purpose: The aim of the study was to obtain data on the anatomic and histologic distributions, the clinical features, and the treatment results for patients with primary gastric non-Hodgkin's lymphoma. Materials and Methods: One hundred thirty-two patients who were treated at 8 university hospitals and 2 general hospitals between January 1991 and December 2000 were enrolled to evaluate clinico-pathologic features. Results: The lower one-third of the stomach was the most frequent site ($42\%$), and the most frequent chief complaint was epigastric pain ($54\%$). Gastric resection was performed in 114 cases. Pathologic findings of preoperative endoscopic biopsy specimens from the 114 patients that underwent surgery were a gastric lymphoma in 94 cases ($82\%$), a carcinoma in 15 cases ($13\%$), an ulcer in 4 cases ($4\%$), and a gastrointestinal stromal tumor in 1 case ($1\%$). The stage distributions by Musshoff's criteria were 71 cases ($54\%$) of stage IE, 36 cases ($27\%$) of stage $II_{1}E$, 8 cases ($6\%$) of stage $II_{2}E$, 2 cases ($2\%$) of stage IIIE, and 15 cases ($11\%$) of stage IVE. Histologic gradings by the Working Formulation in were 31 cases ($23\%$) of low grade, 96 cases ($73\%$) of intermediate grade, and 5 cases ($4\%$) of high grade. Chemotherapy-related complications occurred in 25 cases ($22\%$) while operation-related complications occurred in 6 cases ($5\%$). Seventeen patients ($13\%$) only underwent surgery, 19 ($14\%$) had chemotherapy (CTx) and/or radiotherapy (RTx) only, and 96 patients ($73\%$) received surgery and CTx and/or RTx. No substantial differences in survival were found in relation to the different histologic grades and different treatments. The five-year survival was $85\%$ in stage I or II and $47\%$ in stage III or IV (P=0.0000). Conclusion: Pathologic stage appears to be the single most important prognostic indicator. Survival differences according to treatment modalities were not statistically significant. However, the low number of patients treated with various approaches over a long period precludes a firm conclusion.

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