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  • Title/Summary/Keyword: Diagnosis and treatment

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Clinical Features of Clonorchiasis (간흡충증의 임상 양상)

  • Kim, Kook-Hyun;Jang, Byung-Ik;Kim, Tae-Nyeun
    • Journal of Yeungnam Medical Science
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    • v.23 no.2
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    • pp.171-181
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    • 2006
  • Background: Clonorchis sinensis is an important human parasite that is usually found in the biliary tract. It is widely distributed in East Asia in Taiwan, Japan, China and Korea. About 2 million people are estimated to be infected with C. sinensis in Korea. This study was conducted to evaluate the state of infestation and clinical aspects of C. sinensis. Material and Methods: We evaluate 1,063 patients with clonorchiasis retrospectively at Yeungnam University Hospital and Health Promotion Center from January 2001 to December 2003. All patients were diagnosed by a positive stool test for C. sinensis eggs. Clinical features, laboratory data and imaging studies were evaluated. Results: The ratio between affected males and females was 3.6 : 1. The highest infection rate was noted in the 40-60 age groups regardless of sex. The infection rate of C. sinensis among the residents of urban areas was higher than in rural areas. There were 813 (76.5%) patients who were asymptomatic. Common symptoms included right upper abdominal pain in 7.6% and epigastric pain in 7.2%. For the laboratory studies, serum ALP and GGT levels were within normal limits in 85.2% and 56.0% respectively. Peripheral eosinophilia was noted in 66.1% of cases. Of the 83 cases undergoing ERCP, 27 cases (32.5%) showed peripheral dilatation of the intrahepatic duct. Conclusion: This study suggests that C. sinensis infection is still endemic even in rural areas of Korea and that asymptomatic infections are common. Further work should be focused on the early diagnosis and treatment of patients with subclinical infection.

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A Nationwide Study on the Epidemiology of Head Trauma and the Utilization of Computed Tomography in Korea (건강보험심사평가원 환자표본자료를 이용한 국내 두부손상의 역학 및 뇌 CT 시행 분석)

  • Park, So Young;Jung, Jae Yun;Kwak, Young Ho;Kim, Do Kyun;Suh, Dong Bum
    • Journal of Trauma and Injury
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    • v.25 no.4
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    • pp.152-158
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    • 2012
  • Purpose: To understand the epidemiology of head trauma and the utilization of brain CT in Korea, we analyzed a national sampling data set, the National Patient Sample obtained from the Health Insurance Review and Assessment Service. Methods: We retrospectively collected and analyzed demographic and clinical data on enrolled patients from the National Patient Sample based on medical claims data for 2009. The data included patient's age, sex, treatment date, diagnosis codes, procedure codes related with CT, holiday or night consultation fee, and fee for emergency management services. Results: In 2009, the estimated population with head trauma was 819,059(1.8%), and the rate of brain CT utilization was 22.4%. Children ages 5 to 15 were the most commonly injured group(22.8%), but had the lowest brain CT utilization(16.5%). The mean age of the estimated population with head trauma was 34.9±0.5years old, and male patients accounted for 60.5% of that population. Intracranial injury was found in 8.6% of all head traumas, and the rate of intracranial injury in children was lower than it was in adults(4.1% vs. 10.9%, p<0.001). Twenty- three percent of patients with head trauma visited the emergency department (ED). More patients with head trauma visited medical facilities in the daytime on weekdays(66.5% vs. 33.5%, p<0.001), but head CT was performed more frequently at night or on weekends/holidays(16.1% vs. 34.7%, p<0.001) There is low incidence of head trauma in the winter in children (p<0.001). In the multivariate logistic regression analysis, patients who were adults, female, or ED visitors were more likely to undergo brain CT (odds ratio (OR): 1.65, 95% confidence interval (CI): 1.47-1.84; OR: 1.40, 95% CI: 1.27-1.54; OR: 7.80, 95% CI: 6.91-8.80, respectively). Conclusion: In this study, we analyzed the national epidemiologic trend for head trauma, and the pattern of utilization of brain CT.

Electroacupuncture and "Duhuojisheng-tang" Administration for Postoperative Treatment in 3 dogs with Traumatic Spinal Cord Injury (외상성 척수 손상에 대한 척추 수술을 한 3마리의 개에서, 술 후 처치로써 전침과 독활기생탕을 적용한 증례)

  • Kim, Min-Su;Kim, Se-Hoon;Cha, Jae-Gwan;Kim, Nam-Soo;Kang, Hyung-Sub
    • Journal of Veterinary Clinics
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    • v.28 no.3
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    • pp.318-322
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    • 2011
  • Three dogs with severe traumatic spinal cord injury (TSCI) due to falling wound were admitted to the Veterinary Medical Center, Chonbuk National University for evaluation of severe pelvic limbs paralysis without deep pain, normal defecation and urination. Based on physical examination, neurological assessment and computed tomogram (CT), the diagnosis was made as subluxation and compressed fracture. All the cases were surgically treated with dorsal laminectomy and a spondylosyndesis using pin and bone cements. For 2 weeks, the dogs didn't show any improvement. Consequently, the dogs were treated with electroacupuncture (EA) and Duhuojisheng-tang (DHJST). All the dogs got back the deep pain and presented wagged tail on 14-35 days after starting EA with DHJST. Especially, two of 3 dogs recovered almost normal ambulation and capacities of urination and defecation. But, one dog failed to regain normal ambulation due to inflammation of operative site which is thought to be caused by the bone cement. From these cases, it was thought that the combination of EA and DHJST mightbe one of the suitable therapies in dogs with no neurological improvement.

Thrombotic thrombocytopenic purpura with decreased level of ADAMTS-13 activity and increased level of ADAMTS-13 inhibitor in an adolescent (청소년기에 발생한 ADAMTS-13 활성도 저하와 항체 양성을 보인 혈전저혈소판혈증자색반병 1례)

  • Yang, Eun Mi;Han, Dong Kyun;Baek, Hee Jo;Shin, Myung Geun;Kim, Young Ok;Kook, Hoon;Hwang, Tae Ju
    • Clinical and Experimental Pediatrics
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    • v.53 no.3
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    • pp.428-431
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    • 2010
  • Thrombotic thrombocytopenic purpura (TTP) is a thrombotic microangiopathy characterized by endothelial cell damage, resulting in microangiopathic hemolytic anemia, thrombocytopenia, and various degrees of neurological and renal impairment caused by microvascular thrombi. It is rare in children and frequently follows a fatal course. TTP is divided into 2 types: one is inherited and associated with ADAMTS-13 gene mutations and the other is acquired and associated with anti-ADAMTS-13 autoantibodies. The measurement of ADAMTS-13 activity in plasma, identification of ADAMTS-13 circulating inhibitor, anti-ADAMTS-13 IgG, and ADAMTS-13 gene sequencing are crucial to the diagnosis of TTP. Plasma exchanges are the first-line treatment for acquired TTP, combined with steroids and immunosuppressive drugs. Here, we describe the case of an adolescent patient with TTP, confirmed by decreased level of ADAMTS-13 activity and an increased level of ADAMTS-13 inhibitor, who was successfully treated by plasma exchanges.

Periodontopathogen LPSs Regulate MicroRNA Expression in Human Gingival Epithelial Cells

  • Lee, Hwa-Sun;Na, Hee-Sam;Jeong, So-Yeon;Jeong, Sung-Hee;Park, Hae-Ryoun;Chung, Jin
    • International Journal of Oral Biology
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    • v.36 no.3
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    • pp.109-116
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    • 2011
  • Periodontitis results from the activation of host immune and inflammatory defense responses to subgingival plaque bacteria, most of which are gram-negative rods with lipopoly-saccharides (LPSs) in their cell walls. LPSs have been known to induce proinflammatory responses and recently it was reported also that they induce the expression of microRNAs (miRNAs) in host cells. In our current study therefore, we aimed to examine and compare the miRNA expression patterns induced by the LPSs of major periodontopathogens in the human gingival epithelial cell line, Ca9-22. The cells were treated with 1 μg/ml of E. coli (Ec) LPS or 5 μg/ml of an LPS preparations from four periodontopathogens Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Aggregatibacter actinomycetemcomitans (Aa), and Fusobacterium nucleatum (Fn) for 24 h. After small RNA extraction from the treated cells, miRNA microarray analysis was carried out and characteristic expression profiles were observed. Fn LPS most actively induced miRNAs related to inflammation, followed by Aa LPS, Pi LPS, and Ec LPS. In contrast, Pg LPS only weakly activated miRNAs related to inflammation. Among the miRNAs induced by each LPS, miR-875-3p, miR-449b, and miR-520d-3p were found to be commonly up-regulated by all five LPS preparations, although at different levels. When we further compared the miRNA expression patterns induced by each LPS, Ec LPS and Pi LPS were the most similar although Fn LPS and Aa LPS also induced a similar miRNA expression pattern. In contrast, the miRNA profile induced by Pg LPS was quite distinctive compared with the other bacteria. In conclusion, miR-875-3p, miR-449b, and miR-520d-3p miRNAs are potential targets for the diagnosis and treatment of periodontal inflammation induced by subgingival plaque biofilms. Furthermore, the observations in our current study provide new insights into the inflammatory miRNA response to periodontitis.

The Clinical Review of Superior Vena Cava Syndrome (상대정맥 증후군의 임상적 고찰)

  • Kang, Joung-Sun;Lee, Sam-Beom;Lee, Choong-Ki;Chung, Jin-Hong;Lee, Hyoung-Woo;Lee, Kwan-Ho;Hyun, Myung-Soo;Lee, Hyun-Woo;Shin, Sei-One;Kim, Myung-Se
    • Journal of Yeungnam Medical Science
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    • v.7 no.2
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    • pp.151-158
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    • 1990
  • We reviewed 30 cases of superior vena cava syndrome in adult patients who were seen at the Yeungnam University Hospital from January 1985 to June 1990. The results were as follows : 1. The male-to-female ratio was 6.5:1, and the most patients were in the age group between the sixth and seventh decades. 2. The most common symptoms were dyspnea (87%) and followed by cough (63%), facial swelling (63%) and chest pain (44%) and the physical signs were dilated neck vein (97%), facial edema (93%) and facial flushing (45%) in order of frequency. 3. The simple chest x-ray findings were superior mediastinal widening (90%), right hilar mass (77%) and pleural effusion (31%). 4. Diagnosis was made by history and physical examination (100%), chest C-T scan (100%), simple chest x-ray (97%), bronchoscopy with biopsy (40%) and so on. 5. 21 cases of patients were confirmed by histology : 14 cases (46%) of bronchogenic ca. 4 cases (14%) of lymphoma, 3 cases (10%) of metastic lung ca. Of bronchogenic ca. small cell ca was 7 cases (23%), squamous cell ca, 5 cases (17%), and unclassified ca was 2 cases (6%). 6. In response of treatment, the clinical improvement was achieved in 18 cases with radiotherapy alone. 1 case with chemotherapy only, and 6 cases with radio-chemotherapy.

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Risk Factors for Predicting Hypoxia in Adult Patients Undergoing Bronchoscopy under Sedation

  • Choi, Ji Soo;Lee, Eun Hye;Lee, Sang Hoon;Leem, Ah Young;Chung, Kyung Soo;Kim, Song Yee;Jung, Ji Ye;Kang, Young Ae;Park, Moo Suk;Chang, Joon;Kim, Young Sam
    • Tuberculosis and Respiratory Diseases
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    • v.83 no.4
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    • pp.276-282
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    • 2020
  • Background: Flexible bronchoscopy is one of the essential procedures for the diagnosis and treatment of pulmonary diseases. The purpose of this study was to identify the risk factors associated with the occurrence of hypoxia in adults undergoing flexible bronchoscopy under sedation. Methods: We retrospectively analyzed 2,520 patients who underwent flexible bronchoscopy under sedation at our tertiary care university hospital in South Korea January 1, 2013-December 31, 2014. Hypoxia was defined as more than 5%-point reduction in the baseline percutaneous oxygen saturation (SpO2) or SpO2 <90% for >1 minute during the procedure. Results: The mean age was 64.7±13.5, and 565 patients developed hypoxia during the procedure. The mean sedation duration and midazolam dose for sedation were 31.1 minutes and 3.9 mg, respectively. The bivariate analysis showed that older age, a low forced expiratory volume in one second (FEV1), use of endobronchial ultrasound, the duration of sedation, and the midazolam dose were associated with the occurrence of hypoxia during the procedure, while the multivariate analysis found that age >60 (odds ratio [OR], 1.32), a low FEV1 (OR, 0.99), and a longer duration of sedation (>40 minutes; OR, 1.33) were significant risk factors. Conclusion: The findings suggest that patients older than age 60 and those with a low FEV1 tend to develop hypoxia during the bronchoscopy under sedation. Also, longer duration of sedation (>40 minutes) was a significant risk factor for hypoxia.

Maintenance of Platelet Counts with Low Level QC Materials and the Change in P-LCR according to Hemolysis with XN-9000 (XN-9000장비에서 Low Level QC물질에서의 혈소판 수 관리와 용혈에 따른 P-LCR의 변화)

  • Shim, Moon-Jung;Lee, Hyun-A
    • Korean Journal of Clinical Laboratory Science
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    • v.50 no.4
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    • pp.399-405
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    • 2018
  • The platelet count in clinical laboratories is essential for the diagnosis and treatment of hemostasis abnormalities, and accurate platelet counting in the low count range is of prime importance for deciding if a platelet transfusion is needed and for monitoring after chemotherapy. Quality control is designed to reduce and correct any deficiencies in the internal analytical process of a clinical laboratory prior to the release of patient results. Fragmented erythrocytes are the major confusing factors for platelet counting because of their similar size to platelets. The authors found that the low range QC values were out of 2SD with a Sysmex automatic analyzer in internal quality control process. Thus far, there has been little discussion on the relationship between hemolysis and the platelet parameters. Therefore, this study focused on the performance of automated platelet counts, including the PLT-F, the PLT-I, and PLT-O methods at the low platelet range using the low level QC materials and compared the 5 platelet parameters with the hemolyzed samples. The results showed that the CV was the smallest with PLT-F and P-LCR increased from 18.4 to 31.9% in the hemolysis samples. These results indicate that a more accurate estimation of the platelet counts can be achieved using the PLT-F method than the PLT-I method at the low platelet range. The use of the PLT-F system improves the confidence of results in low platelets samples in a routine hematology laboratory. The results suggest that P-LCR is a new parameter in assessing samples when the specimen is suspected of hemolysis and deterioration. Nevertheless, further studies will be needed to establish the relationship with P-LCR and hemolysis using human blood specimens.

Evaluation of Midpalatal Suture Maturation using Cone-Beam Computed Tomography in Children and Adolescents (CBCT를 이용한 소아청소년의 정중구개봉합 성숙도 평가)

  • Lee, Yeonju;Mah, Yonjoo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.46 no.2
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    • pp.139-146
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    • 2019
  • This study aimed to analyze the association of midpalatal suture (MPS) maturation stages with skeletal maturation and age and to obtain references for establishing a treatment plan for rapid maxillary expansion (RME). Cone-Beam Computed Tomography (CBCT) images from 480 children (240 boys, 240 girls) aged 7 - 15 years were obtained. MPS maturation stages and cervical vertebral maturation indicator (CVMI) were evaluated, and the correlations between MPS maturation stages, CVMI, and age were determined using the Spearman's correlation test. The positive likelihood ratio (LHR) of CVMI for MPS maturation stages was calculated. MPS maturation stages and CVMI showed a strong correlation. Especially, CVMI 1 - 3 showed positive LHR greater than 10 for the diagnosis of stages A - C. MPS maturation stages and age were correlated strongly in girls and moderately in boys. Conventional RME produces the most favorable skeletal effect at CVMI 1 - 3 or those up to 12 years of age and fewer skeletal effects at CVMI 4 or at 13 years of age in girls and 13 - 15 years in boys. It is recommended to evaluate MPS maturation stages using CBCT before RME application at CVMI 5, 6 or at 14, 15 years of age in girls.

Detection of the Carbapenem Resistance Gene in Gram-negative Rod Bacteria Isolated from Clinical Specimens (임상검체에서 분리된 그람음성막대균으로부터 카바페넴 내성 유전자 검출)

  • Yang, Byoung Seon
    • Korean Journal of Clinical Laboratory Science
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    • v.54 no.3
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    • pp.179-191
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    • 2022
  • Carbapenem-resistant Enterobacteriaceae (CRE) poses an increasing public health threat and has limited treatment options with high associated mortality. Genotypes of carbapenemase that threaten public health (blaKPC, blaNDM, blaIMP, and blaVIM) and blaOXA-48-like genes were detected by phenotypic and molecular diagnosis, and related gene distribution patterns were investigated. Phenotypic testing using the modified Hodge test confirmed positivity in all 41 strains examined, and carbapenemase inhibitory testing using meropenem+phenyl boronic acid or meropenem+EDTA confirmed positivity in 18 and 8 strains, respectively. Polymerase chain reaction revealed the presence of amplification products in 28 strains of blaKPC, 25 strains of blaNDM, 5 strains of blaIMP, 1 strain of blaVIM, and 13 blaOXA-48-like strains. In addition, 7 strains of blaKPC+blaNDM, 1 strain of blaKPC+blaIMP, 1 strain of blaNDM+blaOXA-48-like, 1 strain of blaNDM+blaVIM, 4 strains of blaKPC+blaNDM+blaIMP, and 4 strains of blaKPC+blaNDM+blaOXA-48-like were identified. Melting curve analysis using real-time PCR was wholly consistent with PCR results. The study shows genetic identification of highly specific CRE by real-time PCR could be used to provide early diagnoses and infection control, improve surveillance, and prevent the transmission of CRE.