• Title/Summary/Keyword: Clinical characteristic

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Limited Diagnostic Value of microRNAs for Detecting Colorectal Cancer: A Meta-analysis

  • Zhou, Xuan-Jun;Dong, Zhao-Gang;Yang, Yong-Mei;Du, Lu-Tao;Zhang, Xin;Wang, Chuan-Xin
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.8
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    • pp.4699-4704
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    • 2013
  • Background: MicroRNAs have been demonstrated to play important roles in the development and progression of colorectal cancer. Several studies utilizing microRNAs as diagnostic biomarkers for colorectal cancer (CRC) have been reported. The aim of this meta-analysis was to comprehensively and quantitatively summarize the diagnostic value of microRNAs for detecting colorectal cancer. Methods: We searched PubMed, Embase and Cochrane Library for published studies that used microRNAs as biomarkers for the diagnosis of colorectal cancer. Summary estimates for sensitivity, specificity and other measures of accuracy of microRNAs in the diagnosis of colorectal cancer were calculated using the bivariate random effects model. A summary receiver operating characteristic (SROC) curve was also generated to summarize the overall effectiveness of the test. Result: Thirteen studies from twelve published articles met the inclusion criteria and were included. The overall sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odd ratio of microRNAs for the diagnosis of colorectal cancer were 0.81 (95%CI: 0.79-0.84), 0.78 (95%CI: 0.75-0.82), 4.14 (95%CI: 2.90-5.92), 0.24 (95%CI: 0.19-0.30), and 19.2 (95%CI: 11.7-31.5), respectively. The area under the SROC curve was 0.89. Conclusions: The current evidence suggests that the microRNAs test might not be used alone as a screening tool for CRC. Combining microRNAs testing with other conventional tests such as FOBT may improve the diagnostic accuracy for detecting CRC.

Hearing loss screening tool (COBRA score) for newborns in primary care setting

  • Poonual, Watcharapol;Navacharoen, Niramon;Kangsanarak, Jaran;Namwongprom, Sirianong;Saokaew, Surasak
    • Clinical and Experimental Pediatrics
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    • v.60 no.11
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    • pp.353-358
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    • 2017
  • Purpose: To develop and evaluate a simple screening tool to assess hearing loss in newborns. A derived score was compared with the standard clinical practice tool. Methods: This cohort study was designed to screen the hearing of newborns using transiently evoked otoacoustic emission and auditory brain stem response, and to determine the risk factors associated with hearing loss of newborns in 3 tertiary hospitals in Northern Thailand. Data were prospectively collected from November 1, 2010 to May 31, 2012. To develop the risk score, clinical-risk indicators were measured by Poisson risk regression. The regression coefficients were transformed into item scores dividing each regression-coefficient with the smallest coefficient in the model, rounding the number to its nearest integer, and adding up to a total score. Results: Five clinical risk factors (Craniofacial anomaly, Ototoxicity, Birth weight, family history [Relative] of congenital sensorineural hearing loss, and Apgar score) were included in our COBRA score. The screening tool detected, by area under the receiver operating characteristic curve, more than 80% of existing hearing loss. The positive-likelihood ratio of hearing loss in patients with scores of 4, 6, and 8 were 25.21 (95% confidence interval [CI], 14.69-43.26), 58.52 (95% CI, 36.26-94.44), and 51.56 (95% CI, 33.74-78.82), respectively. This result was similar to the standard tool (The Joint Committee on Infant Hearing) of 26.72 (95% CI, 20.59-34.66). Conclusion: A simple screening tool of five predictors provides good prediction indices for newborn hearing loss, which may motivate parents to bring children for further appropriate testing and investigations.

A Contractual Study on the Clinical Trial of Medicine (의약품 임상시험의 계약적 일고찰)

  • Song, Young-Min
    • The Korean Society of Law and Medicine
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    • v.12 no.1
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    • pp.257-285
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    • 2011
  • This thesis has studied about the legal characteristic of injection of the trial drug, the position of the pharmaceutical firm as a contractor of the clinical trial, the possibility of compulsory performance of consistent injection of the trial drug, and the damage claim caused in the process of the clinical trial from the viewpoint of protecting the trial subject in the clinical trial. According to court's judgement in the United States, the lawsuit of the trial subject, although the trial subject had expected consistent injections, was dismissed because there was no direct contract between pharmaceutical and trial subject. However, Helsinki Declaration prescribe the medical research as follows. 'All patients who participated in the research should be able to use the best precaution, diagnosis, and treatment proved by the final outcome of the research'. The trial subject is entitled to demand only the pharmaceutical firm which developed and provided the trial drug, and the pharmaceutical firm has the obligation to supply the trial drug to the trial subject. Therefore, it would be not enough to protect the trial subject if the pharmaceutical firm which makes the trial drug is ruled out. In addition, especially, in case the trial drug has a constant effect with the aim of treatment, if the injection of the trial drug is suddenly stopped, the trial subject would not have the benefit of treatment by the trial drug. In this case, the best remedy against the damage is to urge a constant injection of the trial drug. Thus, in certain case, it is reasonable to consider that the pharmaceutical firm has the obligation to supply the trial drug to the trial subject constantly, and it is also necessary to compel it through effective means in case the pharmaceutical firm do not fulfill its obligation to supply the trial drug. However, as an essential prerequisite for the assertion mentioned above, it should be judged under the principle of good faith considering the concrete situation, that is, what roles the pharmaceutical firm has played.

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Evaluation of the correlation between gross lung score and microscopic diagnosis for swine pneumonia in Korean slaughterhouses (국내 도축돈에서 발생한 폐렴에 대한 실물 폐 병변 지수와 조직병리학적 진단의 상관성 평가)

  • Lee, Hong-Seok;Kim, Myung-Chul;Kim, Na-Yon;Hwang, Sung-Hyun;Ji, Sumin;Park, Young Kyung;Park, Yong Ho;Kim, Yongbaek
    • Korean Journal of Veterinary Research
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    • v.57 no.4
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    • pp.227-233
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    • 2017
  • To reduce swine production costs, a slaughter check system has been developed in countries with an advanced swine industry. Evaluation of lung lesions in carcasses is a critical part of the slaughter check system. This study was performed to collect background information for use in developing a slaughter check system in Korea. Lung tissues and their gross images were collected from slaughterhouses in Gyeonggi-do, Korea. Scoring of the gross lung lesions was performed on the lung images. Histopathologic examination was conducted to classify the pulmonary lesions as bronchopneumonia or interstitial pneumonia. Scores of the gross lung lesions were significantly different between bronchopneumonia and interstitial pneumonia groups (p < 0.001). A 90% confidence interval of gross lung lesion scores was established for the bronchopneumonia group, and the lesion scoring had a sensitivity of 100% and specificity of 77.3%. The gross lung lesion scoring test was subjected to a diagnostic distinction evaluation by examining the receiver operating characteristic curve and was appraised as having good discrimination for bronchopneumonia. Establishment of a gross lung lesion scoring test for the diagnosis of bronchopneumonia could be valuable as a screening test of macroscopic bronchopneumonia in swine slaughter check system.

Endometrial histology and predictable clinical factors for endometrial disease in women with polycystic ovary syndrome

  • Park, Joon-Cheol;Lim, Su-Yeon;Jang, Tae-Kyu;Bae, Jin-Gon;Kim, Jong-In;Rhee, Jeong-Ho
    • Clinical and Experimental Reproductive Medicine
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    • v.38 no.1
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    • pp.42-46
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    • 2011
  • Objective: This study was aimed to investigate endometrial histology and to find predictable clinical factors for endometrial disease (hyperplasia or cancer) in women with polycystic ovary syndrome (PCOS). Methods: We investigated the endometrial histology and analyzed the relationship between endometrial histology and clinical parameters, such as LH, FSH, estradiol, testosterone, fasting and 2 hours postprandial glucose and insulin, insulin resistance, body mass index, endometrial thickness, menstrual status from 117 women with PCOS. Statistical analysis was performed with chi square and t-test, p-value<0.05 was considered as statistically significant. And receiver operating characteristic curve was used to find predictable clinical factors for endometrial disease and to decide the cuff off values. Results: In 117 women with PCOS, endometrial histologic profiles are as follows: proliferative phase in 90 women (76.9%), endometrial hyperplasia in 25 women (21.4%), and endometrial cancer in 2 women (1.7%). Of 25 women with endometrial hyperplasia, simple hyperplasia without atypia, complex hyperplasia without atypia and complex hyperplasia with atypia were diagnosed in 15 (12.8%), 6 (5.1%), 4 (3.4%) women, respectively. Age and endometrial thickness were significantly related with endometrial disease, p=0.013 and p=0.001, respectively. At the cut off level of 25.5 years in age, sensitivity and specificity predicting for endometrial disease were 70.4% and 55.6%, respectively (p=0.023). At the cut off level of 8.5 mm in endometrial thickness, sensitivity and specificity were 77.8% and 56.7%, respectively (p=0.000). Conclusion: In women with PCOS, the incidence of endometrial hyperplasia and cancer were 21.4% and 1.7%. The age and endometrial thickness may be used as clinical determining factors for endometrial biopsy.

Clinical investigation on acute pyelonephritis without pyuria: a retrospective observational study

  • Song, Hyung Keun;Shin, Dong Hyuk;Na, Ji Ung;Han, Sang Kuk;Choi, Pil Cho;Lee, Jang Hee
    • Journal of Yeungnam Medical Science
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    • v.39 no.1
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    • pp.39-45
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    • 2022
  • Background: The current guidelines for the diagnosis of acute pyelonephritis (APN) recommend that APN be diagnosed based on the clinical features and the presence of pyuria. However, we observed that some of the patients who are diagnosed with APN do not have characteristic clinical features or pyuria at the initial examination. We performed this study to investigate the characteristics of APN without pyuria. Methods: A retrospective, cross-sectional study was conducted on 391 patients diagnosed with APN based on clinical and radiologic findings, between 2015 and 2019. The clinical features, laboratory results, and computed tomography (CT) findings were compared between patients with normal white blood cell (WBC) counts and those with abnormal WBC counts (WBC of 0-5/high power field [HPF] vs. >5/HPF) in urine. Results: More than 50% of patients with APN had no typical urinary tract symptoms and one-third of them had no costovertebral angle (CVA) tenderness. Eighty-eight patients (22.5%) had normal WBC counts (0-5/HPF) on urine microscopy. There was a negative correlation between pyuria (WBC of >5/HPF) and previous antibiotic use (odds ratio, 0.249; 95% confidence interval, 0.140-0.441; p<0.001), and the probability of pyuria was reduced by 75.1% in patients who took antibiotics before visiting the emergency room. Conclusion: The diagnosis of APN should not be overlooked even if there are no typical clinical features, or urine microscopic examination is normal. If a patient has already taken antibiotics at the time of diagnosis, imaging studies such as CT should be performed more actively, regardless of the urinalysis results.

A Case Report on Exfoliative Dermatitis (박탈성피부염(剝脫性皮膚炎) 증례(證例) 보고(報告) 1례(例))

  • An, Chan-Gn;Shin, Eun-Ki;Youn, In-Hwan;Zo, Zoon-Ki;Hwang, Chung-Yeon
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.19 no.2
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    • pp.304-312
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    • 2006
  • Exfoliative Dermatitis is a name of a group of symptoms which is characterized by red rash, itching and scale in almost whole body. The patients are suffered from hypoalbuminemia, general weakness and fever sign in addition to characteristic skin lesions. So in the treatment of this disease, adequate symptomatic treatment is important with adequate topical skin management. We experienced a 69 year old Korean male patient diagnosed as Exfoliative Dermatitis based on clinical symptoms and a medical certificate. We concluded that the symptoms of this patient are Sun-symptoms(癬症) and gave him Bangpungtongsung-san(剝脫性皮膚炎) and Geunsun-bang(乾癬方). After taking Oriental Medicine(the hebal medicine of internal use), clinical improvement was noticed. Based on this experience, internal use of Oriental Medicine have a good effect in Exfoliative Dermatitis.

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A Case of Non-alcoholic Steatohepatitis Treated with Herbal Medicine

  • Son, Chang-Gue
    • The Journal of Korean Medicine
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    • v.32 no.3
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    • pp.50-54
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    • 2011
  • Objective: To understand the characteristic of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH), and study the traditional Korean medicine (TKM)-based strategies or therapeutics for them. Methods: A male patient with NASH was treated with only Oriental therapies, and then the clinical outcome was evaluated by serum biochemical parameters and radiographs. Result: The clinical and biochemical values of the patient fluctuated over three years according to the treatments and cessation of herbal medicines. Conclusion: NASH or NAFLD are now prevalent and these disorders could be targets of TKM, and this case report would provide useful information.

The Nutritional Assessment in Children - Understanding of Anthropometric Assessment and Biochemical Indexes in Children (소아의 영양 평가 - 소아 신체계측과 생화학적 지표의 특성을 중심으로)

  • Park, Kie Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.sup1
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    • pp.6-11
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    • 2009
  • Nutritional assessment is based on anthropometric, clinical, dietary and biochemical data. There is a lack of studies about the propriety of biochemical indexes for the nutritional assessment in children despite biochemical data in pediatric population are different from them in adult's in many respects. Serum albumin is useful index to evaluate the severity of malnutrition. Hemoglobin and hematocrit tend to decrease in malnutrition on account of defect of iron metabolism and to increase in metabolic syndrome on account of enhancement of erythropoiesis. But, unlike adult, total lymphocyte count is not so useful biochemical indexes in children. We should consider pediatric characteristic when interpret biochemical indexes for nutritional assessment in children, and nutritional status in children should be assessed comprehensively with anthropometric, clinical, dietary and biochemical data.

High grade carcinoma ex pleomorphic adenoma of parotid gland: a case report

  • Kim, Ji-Kwan;Kim, Moon-Young;Choi, Seung-Kyu
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.5
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    • pp.348-352
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    • 2020
  • Pleomorphic adenoma is the most prevalent benign tumor of the parotid gland, and shows potential malignancy. Carcinoma ex pleomorphic adenoma (CXPA) can occur in 3%-15% of pleomorphic adenoma cases. Owing to its clinical similarity to benign tumors, critical information related to CXPA can be easily overlooked, leading to frequent misdiagnosis of the condition. In this article, we report a rare case of CXPA found in the 55-year-old male patient with characteristic clinical, radiographic, and histological features, and subsequent treatment.