• Title/Summary/Keyword: Clinical patterns

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A Case of Sarcoidosis That Was Initially Misdiagnosed as Nontuberculous Mycobacteria Pulmonary Disease (비결핵항산균 폐질환으로 오인되었던 사르코이드증 1예)

  • Choi, Hyun Ho;Hong, Yu Ah;Choi, Jae Ki;Kim, Ju Sang;Kim, Seung Joon;Kim, Seok Chan;Lee, Sook Young;Kim, Young Kyoon;Park, Sung Hak;Kim, Tae Jung;Lee, Kyo Young;Park, Hyun Jin;Kim, Hyo Lim;Ahn, Myeong Im
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.4
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    • pp.309-313
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    • 2009
  • There are several respiratory diseases that show chronic granulomatous inflammation for the histologic finding. Among them, sarcoidosis and tuberculosis are not easy to differentiate when the clinical and radiological features present similar patterns. The increasing incidence of nontuberculous mycobacteria pulmonary disease is making it more difficult for clinicians to arrive at a proper diagnosis. A 69 year old male patient visited our hospital with chronic cough as his chief compliant. His radiologic findings were multiple enlarged mediastinal lymphadenpathies with innumerable micronodules and multiple patch infiltrations. The spleen biopsy finding showed chronic granulomatous inflammation, and Mycobacterium avium was identified on the bronchoscopic culture. Because of these findings, we treated him with drugs for nontuberculous mycobacteria disease other than sarcoidosis. However, during the treatment, his symptoms and radiological features became aggravated. Thus, we reviewed the radiologic and pathologic findings and decided to treat him with steroid, which relieved his symptoms and improved the radiologic findings. We report here on a case of sarcoidosis that was initially misdiagnosed as nontuberculous mycobacteria pulmonary disease.

A COMPARATIVE STUDY OF THE SHEAR BOND STRENGTH AND ADHESIVE FAILURE PATTERN OF METAL BRACKETS BONDED ON NATURAL TEETH AND PORCELAIN TEETH (자연 치관과 포세린 치관상에서 교정용 브라켓 부착시 전단 결합 강도와 파절 양상에 관한 비교 연구)

  • Lee, Hyun-Sun;Kim, Jong-Soo;Yoo, Seung-Hoon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.2
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    • pp.195-204
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    • 2008
  • Orthodontic brackets often need to be bonded to porcelain such as porcelain fused to metal crowns and porcelain jacket crowns. The purpose of this study was to evaluate the clinical usability of direct bonding system on porcelain teeth by measuring shear bond strength according to various conditions and observing adhesive failure patterns. The specimens, 20 maxillary premolars and 80 porcelain teeth that were produced by duplication of the labial surface of a maxillary first premolar were used and randomly divided into four groups of twenty teeth each. The 5 different preparation procedures tested: (1) application of 37% phosphoric acid on natural teeth, (2) sandblasting on porcelain surfaces, (3) sandblasting and application of 9.6% hydrofluoric acid on porcelain surfaces, (4) sandblasting and application of silane on porcelain surface, (5) sandblasting and application of 9.6% hydrofluoric acid and silane on porcelain surfaces. The metal brackets were bonded with Transbond $XT^{(R)}$ bonding material. The shear bond strength was tested by the micro universal testing machine(Kyung-Sung, Korea) and the amount of residual adhesive on the tooth surface after debonding was examined by stereoscope and assessed with an adhesive remnant index. The results of this study suggest that the direct bonding system on porcelain teeth with sandblasting, HF and porcelain primer is clinically useful.

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Antibiotic Resistant Pattern of Helicobacter Pylori Infection Based on Molecular Tests in Laos

  • Vannarath, Sengdao;Vilaichone, Ratha-korn;Rasachak, Bouachanh;Mairiang, Pisaln;Yamaoka, Yoshio;Mahachai, Varocha
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.1
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    • pp.285-287
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    • 2016
  • Background: The efficacy of standard treatment of Helicobacter pylori (H. pylori) is declining because of antibiotic resistance. Clarithromycin resistance is also increasing in many Asian countries. The aim of this study was to determine the antibiotic susceptibility patterns of H. pylori infection and clinical association in Laos. Materials and Methods: A total of 329 Lao dyspeptic patients who underwent gastroscopy at Mahosot Hospital, Vientiane, Laos during December 2010-March 2012 were enrolled in this study. During gastroscopy, 4 biopsies were collected (2 each from the antrum and body) for CLO-test and histopathology. Only the positive CLO-test gastric tissues was stored at $-80^{\circ}C$ in a freezer until DNA was extracted and a GenoType$^{(R)}$HelicoDR test was conducted for detecting mutations in the rrl gene encoding 23S rRNA (clarithromycin resistance) and mutations in gyrA gene (fluoroquinolone resistance). Results: Of the total, 119 Lao patients (36.2%) were infected with H. pylori including 59 males (49.6%) and 60 females (50.4%) with a mean age of 46 years. Clarithromycin and fluoroquinolone resistance of H. pylori infection was demonstrated in 15 (12.6%) and 16 strains (13.4%) respectively. In clarithromycin resistance, the number of patients who had education above primary school and $BMI{\geq}25kg/m^2$ were significantly higher than those who had education below primary school and BMI<$25kg/m^2$ (23.1% vs 7.5%, P-value= 0.036 and 20.5% vs 8%, P-value= 0.048, respectively). In fluoroquinolone resistance, the number of lowland Lao was significantly higher than those of non-lowland (highland and midland) Lao ethnic groups (16.7% vs 0%, P-value= 0.039). Conclusions: H. pylori infections remain common in Laos. Clarithromycin and fluoroquinolone resistance with H. pylori infection are growing problems. Education above primary school and $BMI{\geq}25kg/m^2$ might be predictors for clarithromycin resistance and lowland Lao ethnicity might be predictors for fluoroquinolone resistance with H. pylori infection in Laos.

Loss of p15INK4b Expression in Colorectal Cancer is Linked to Ethnic Origin

  • Abdel-Rahman, Wael Mohamed;Nieminen, Taina Tuulikki;Shoman, Soheir;Eissa, Saad;Peltomaki, Paivi
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.2083-2087
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    • 2014
  • Colorectal cancers remain to be a common cause of cancer-related death. Early-onset cases as well as those of various ethnic origins have aggressive clinical features, the basis of which requires further exploration. The aim of this work was to examine the expression patterns of $p15^{INK4b}$ and SMAD4 in colorectal carcinoma of different ethnic origins. Fifty-five sporadic colorectal carcinoma of Egyptian origin, 25 of which were early onset, and 54 cancers of Finnish origin were immunohistochemically stained with antibodies against $p15^{INK4b}$ and SMAD4 proteins. Data were compared to the methylation status of the $p15^{INK4b}$ gene promotor. $p15^{INK4b}$ was totally lost or deficient (lost in ${\geq}50%$ of tumor cell) in 47/55 (85%) tumors of Egyptian origin as compared to 6/50 (12%) tumors of Finnish origin (p=7e-15). In the Egyptian cases with $p15^{INK4b}$ loss and available $p15^{INK4b}$ promotor methylation status, 89% of cases which lost $p15^{INK4b}$ expression were associated with $p15^{INK4b}$ gene promotor hypermethylation. SMAD4 was lost or deficient in 25/54 (46%) tumors of Egyptian origin and 28/48 (58%) tumors of Finnish origin. 22/54 (41%) Egyptian tumors showed combined loss/deficiency of both $p15^{INK4b}$ and SMAD4, while $p15^{INK4b}$ was selectively lost/deficient with positive SMAD4 expression in 24/54 (44%) tumors. Loss of $p15^{INK4b}$ was associated with older age at presentation (>50 years) in the Egyptian tumors (p=0.04). These data show for the first time that $p15^{INK4b}$ loss of expression marks a subset of colorectal cancers and ethnic origin may play a role in this selection. In a substantial number of cases, the loss was independent of SMAD4 but rather associated with $p15^{INK4b}$ gene promotor hypermethylation and old age which could be related to different environmental exposures.

Correlation of Posterior Echo Patterns and Histopathologic Features in Invasive Ductal Carcinoma of Breast (유방 침윤성 관상피암의 초음파 소견 중 후방 에코 양상과 조직소견의 상호 비교)

  • Choi, Jong-O;Cho, Hyun-Cheol;Hwang, Mi-Soo;Park, Bok-Hwan;Kim, Dong-Sug
    • Journal of Yeungnam Medical Science
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    • v.15 no.1
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    • pp.151-158
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    • 1998
  • Traditionally posterior shadowing is regarded as a malignant criterion in the evaluation of breast mass by sonogram. But on the basis of our clinical experiences of breast sonogram, we often met a breast mass without posterior shadowing later confirmed breast carcinoma through pathologic examination. For the focus of what character of pathologic breast tissue influence the posterior shadowing in breast sonogram, we analyzed retrospectively the sonographic findings of 26 histologically proven invasive ductal carcinomas. Even though invasive ductal carcinoma is the only one of the many breast cancers, it represents the greater part of breast malignancy. The posterior echo pattern was compared with various histologic characteristics, such as the amount of connective tissue, degree of elastosis, necrosis, gross circumscription, accompanying inflammation, histologic differentiation, and mitotic index. Nine breast masses (35%) demonstrated posterior echo shadowing, while 17 masses (65%) showed enhancement. The tumors with posterior echo shadowing had more abundant connective tissue, increased elastosis, and poorly demarcated margin (p<0.05). Other histologic characteristics are not influence in posterior shadowing with significant in stastically. On the basis of our study, the phenomenon of posterior shadowing by sonogram is difficult to accept as a specific criterion for malignancy. It is only a phenomenon influenced by the amount of connective tissue volume and elastosis.

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Proteomic analysis of human serum from patients with temporal lobe epilepsy (측두엽 간질환자의 혈청에서 프로테오믹스기법을 활용한 질병관련 단백질 동정)

  • Lee, Chang Woo;Yu, Seung Taek;Choi, Ha Young;Koh, Bun Jeong;Kwak, Yong Guen
    • Clinical and Experimental Pediatrics
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    • v.52 no.5
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    • pp.567-575
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    • 2009
  • Purpose : Epilepsy affects more than 0.5% of the world's population. It has a large genetic component and is caused by electrical hyperexcitability in the central nervous system. Despite its prevalence, the disease lacks definitive diagnostic serological biomarkers. To identify potential biomarkers for epilepsy by a convenient method, we analyzed the expression of serum proteins, reflecting alterations in the patient's proteomes. Methods : We compared two-dimensional electrophoretic band patterns of human sera from eight patients with temporal lobe epilepsy (TLE) with those of eight control subjects. The differentially expressed bands were identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and electrospray ionization quadrupole time-of-flight mass spectrometry. esults : Twelve proteins were differentially expressed in the TLE group, of which 6 were identified. Expression of haptoglobin Hp2, PRO2675, immunoglobulin heavy chain constant region gamma 2, an unnamed protein, and three unidentified proteins were upregulated in serum from the patients with TLE, whereas those of major histocompatibility complex (MHC) class I antigen, plasma retinol-binding protein precursor, and three unidentified proteins were downregulated in these patients. After resection of the epileptogenic zone, the expressions of MHC class I antigen, immunoglobulin heavy chain constant region gamma 2, two of the downregulated unidentified proteins, and one of the upregulated unidentified proteins returned to the normal range. Conclusion : The 12 serum proteins in this study are potentially useful biomarkers for the diagnosis and monitoring of TLE.

The Clinical Study on 197 Cases with Patients of Neck Pain Caused by Traffic Accident (교통사고로 유발된 경항통 환자 197례에 대한 임상적 고찰)

  • Jeon, Hyeon-Jeong;Kim, Sung-Hwan;Kim, Jee-Hyun;Lee, Se-Min;Shin, Hwa-Young;Lee, Yun-Kyu;Lee, Bong-Hyo;Jung, Tae-Young;Kim, Jae-Su;Lee, Kyung-Min;Lim, Sung-Chul
    • Journal of Acupuncture Research
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    • v.27 no.2
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    • pp.143-154
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    • 2010
  • Objectives : The main purpose of this research is to make a survey of the effective way of the Oriental medical care and to enlarge the range of Oriental medical treatment about neck pain patients caused by traffic accident. Methods : In following research. we surveyed 197 neck pain patients of traffic accident who admitted in Daegu Hanny University Oriental Medical Hospital from May, 1, 2008 to september, 30, 2009 according to medical chart. Results : 1. In distribution of gender and age, the rate of female was 74.6%, that of male was 25.4% and the majority of the patients were thirties. In results of treatment according to gender and age, the effective rate of female was higher than the male. that of teens was highest. 2. In total results of treatment, the highest distribution was fair with 40.1%, the effective rate was 90.9%. 3. In category of traffic accident patterns, the highest distribution was car to car crash with 81.7%. The results of treatment according to the significance test were shown statistical significance. 4. In admission days, the highest distribution was 6~10 days with 41.1%. The highest effective rate was 21~25days with 100%. The results of treatment according to the significance test were shown statistical significance. Conclusions : This study suggested that Oriental medical treatments are effective in patients of neck pain caused by traffic accident. Further studies are needed for progress report that after accident patients are discharged from the Oriental Medical Hospital.

A RECENT 5-YEAR RETROSPECTIVE STUDY ON NASAL BONE FRACTURE (비골 골절에 대한 최근 5년간의 후향적 연구)

  • Oh, Hee-Kyun;Park, Young-Jun;Kim, Hyun-Syeob;Ryu, Jae-Young;Kook, Min-Suk;Park, Hong-Ju;Ryu, Sun-Youl
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.2
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    • pp.230-236
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    • 2008
  • Purpose: This study was performed to investigate the incidence, types of fracture, treatment, associated fracture and complications in patients with nasal bone fracture. Materials and methods: Clinical examination, patient's records and radiographic images were evaluated in 230 cases of nasal bone fractures who were treated at the Department of Oral and Maxillofacial Surgery, Chonnam National University Hospital for recent 5 years; from January 2002 to December 2006. Results: 1. The age of patient was ranged from 4 to 77 years (mean age=36.6 years); Males was 75.7% (n=174), and females 24.3% (n=56). 2. The cause of the nasal bone fracture in this study was a fall or slip down (28.8%, n=66), sports accident (26.0%, n=60), fighting (21.3%, n=49), traffic accident (9.6%, n=22), industrial trauma (7.8%, n=18), and the others (6.6%, n=15). 3. For the patterns of fracture, simple fracture without displacement occured in 10.4% (n=24). Simple fracture with displacement without septal bone fracture was found in 49.5% (n=114). Simple fracture with displacement in company with septal bone fracture showed in 32.6% (n=75). Commiuted fracture with severe depression was presented in 7.4% (n=17). 4. The reduction the displaced nasal bone was carried out in 2 to 10 days (mean 6.8 days) after the injury. 5. Nasal bone fracture associated with Le Fort I fracture (6.5%, n=6.5), Le Fort II fracture (7.4%, n=17), Le Fort III fracture (1.3%, n=3), NOE fracture (13.9%, n=32), ZMC fracture (17.4%, 40), maxillary bone fracture (8.3%, n=19), orbital blow-out fracture (15.7%, n=36), frontal bone fracture (1.3%, n=3) and alveolar bone fracture (10.9%, n=25). 6. The major type of treatment method was closed reduction in 90% (n=207), open reduction in 3% (n=7), and observation in 7% (n=16). 7. There were some complications such as ecchymosis, hyposmia, hypo esthesia and residual nasal deformity which are compatible. Open rhino-plasty was conducted for 3 patients who had residual nasal deformity. Conclusions: These results suggest that most of nasal bone fractures are occurred physically active aged groups(age 10-49 years) and could be treated successfully with closed reduction at 7 days after the injury.

An Effect of Dietary Chlorella on Bone Mineral Density in Postmenopausal Women

  • Yong-Ho Kim;Yoo-Kyeong Hwang;Su-Mi Ko;Jung-Min Hwang;Yong-Woo Lee;Hee-Kyung Seong;Dong-Uk Kim
    • Biomedical Science Letters
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    • v.8 no.4
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    • pp.217-221
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    • 2002
  • Age-related osteopenia and osteoporosis are common in postmenopausal women due to decrease in bone mass and ovarian function. A therapy for osteoporosis would depend on only drugs to inhibit bone loss, hormonal replacement therapy, exercise and dietary supplementation and it is very hard to fad an ideal therapy for osteoporosis as yet. Chlorella which is rich in minerals such as calcium magnesium fatty acids, vitamins and sterol, could be applicable for prevention and co-treatment of osteoporosis, but it has yet to be studied. The purpose of this study was to assess the relationship between the effect of dietary chlorella on bone mineral density (BMD) and nutritional improvement. BMD was measured in the femural neck and lumber spine portion. Nutritional and bone turnover markers from blood samples were assessed serum lkaline phosphatase, hemoglobin, number of erythrocytes and total protein. Studies for the femur neck measurement showed that normal BMD increased 2.1% for the group fed chlorella supplemented diet for four month and increased 6.6% fur group treated for one year when compared to the control group, and for the lumber spine measurements the few month group showed an increase of 9.1% over the control group, the one year group showed an increase of 64.2% over the control group. Hemoglobin content, number of erythrocytes and total protein showed similar increased patterns with BMD measurement, meanwhile, serum alkaline phosphatase increased 3% for the four month group and decrease 16% for the one year group compare to the control group. In conclusion, the postmenopausal women fed chlorella supplemented diet results in an increase in BMD. This is a marked increment in lumber spine, enhancement of nutritional state and stable bone turnover. This data showed a positive relationship between BMD and nutritional change with chlorella treatment, and suggested that chlorella dietary may lead to improving and preventing rapid loss of BMD in postmenopausal women.

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THE LEVELS OF INTERLEUKIN-2, INTERFERON-γ, INTERLEUKIN-4 AND TLYMPHOCYTE SUBPOPULATIONS IN RAT PULPAL INFLAMMATION INDUCED EXPERIMENTALLY BY SPECIFIC BACTERIA (특정 세균으로 유도된 백서의 치수염에서 T 세포 아군집의 분포와 interleukin-2, interferon-γ, interleukin-4의 수준에 관한 연구)

  • Kim, Seon-Ah;Lim, Sung-Sam
    • Restorative Dentistry and Endodontics
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    • v.27 no.1
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    • pp.1-11
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    • 2002
  • Immune responses associated with bacterial infection involve various inflammatory cells. Clinical symptoms and pathologic features are particularly influenced by the predominant cells Among inflammatory cells, T cells have the heterogenity. T cells may develop into the mature cells expressing the cell surface markers with different functions and T helper cells are categorized into Th1 and Th2 cells based on their different patterns of cytokine production. The objective of this study was to investigate the change of expression of surface markers on T cells and the Th1/Th2 immune response in pulpal inflammation associated with specific bacteria. We experimentally induced pulpal inflammation in rat incisors by drilling without coolant and innoculated with Streptococcus mutans (S.M. group), Porphyromonas endodontalis (P.E. group), or only sterile cotton (control group). After 1, 2, and 5 days, mandibular incisors were extracted and the pulp tissues were extirpated The expressions of IL-2 recepters (CD25) and ICAM-1 (CD54) on CD4+ and CD8+ cells in the pulps were determined using a flow cytometer, and the concentration of IL-2, IFN-$\gamma$ and IL-4 was measured by enzyme-linked immunosorbent assay. The results were as follows: 1 In the S.M. group, CD4+ cells were more increased at 2nd day than 1st day and in the P.E. group, CD8+ cells were more increased at 2nd day than 1st day. 2. The percentages of CD4+, CD4+25+ and CD4+54+ cells were decreased in the pulp tissues at 5th day after irritation in all groups. 3. The ratios of CD4+/CD8+, CD4+/CD4+25+ and CD4+/CD4+54+ in the pulps at 2nd day after irritation by P. endodontalis were significantly lower than the other groups. 4. The higher concentrations of IFN-$\gamma$ than IL-4 in the pulps at 2nd day after irritation by P. endodontalis showed that T helper 1 reaction were predominant in the early stage of the pulpal inflammation induced by P. endodontalis. 5. The higher concentrations of IL-4 than IFN-$\gamma$ in the pulps at 1st day and 5th day after irritation by S. mutans were measured but the differences were not significant.