Cholangiocarcinoma (CCA) is a cancer of the bile duct epithelial cells. The highest incidence rate of CCA with a poor prognosis and poor response to chemotherapy is found in Southeast Asian countries, especially in northeastern Thailand and Lao PDR. Cathepsin B is a lysosomal cysteine protease which is regulated by cysteine proteinase inhibitors such as cystatin C. Elevation of cathepsin B levels in biological fluid has been observed in patients with inflammatory diseases and many cancers. We aimed to investigate the serum cathepsin B and cystatin C levels of CCA patients to evaluate the feasibility of using cathepsin B and cystatin C as markers for the diagnosis of CCA. Fifty-six sera from CCA patients, 17 with benign biliary diseases (BBD) and 13 from controls were collected and the cathepsin B and cystatin C levels were determined. In addition, cathepsin B expression was investigated immunohistochemically for 9 matched-pairs of cancerous and adjacent tissues of CCA patients. Serum cathepsin B, but not cystatin C, was significantly higher in CCA and BBD patient groups compared to that in the control group. Consistently, all cancerous tissues strongly expressed cathepsin B while adjacent tissues were negative in 7 out of 9 cases. In contrast, serum cystatin C levels were comparable between CCA and control groups, although serum cystatin C levels in the BBD group was higher than that in the control or CCA groups. When the serum cathepsin B to cystatin C ratio was calculated, that of the CCA group was significantly higher than that of the control group, and, although statistically not significant, the ratio of CCA group showed a trend to be higher than that of the BBD group. Thus, the cathepsin B to cystatin C ratio might be used as an alternative marker for aiding diagnosis of CCA.
The purpose of this retrospective study was to evaluate the effects of diagnostic sonography in pediatric patients with inguinal hernias. The patients were classified into two groups. Group A included the patients who had been operated upon for inguinal hernia in 1980's, when diagnostic sonography was not available. Group B included the patients, operated upon for inguinal hernia from 2001 to 2002, when inguinal sonography was employed to detect potential bilateral hernias. The age distribution, sex ratio, laterality, bilaterality, and concomitant symptoms were compared between group A and group B. There were 296 cases in group A and 377 cases in group B. The prevalent age group was from 1 to 5 years. There was no difference in age group distribution between both groups. The male to female ratio was 5.3:1 in group A and 3.5:1 in group B. The ratio of unilateral to bilateral hernia was 5:1 in group A and 3:1 in group B. In cases with a unilateral hernia, the ratio of right to left was 1.5:1 in group A and 1.8:1 in group B. In cases with bilateral hernia, the simultaneous bilateral hernia was 33 cases (67.4 %) in group A and 75 cases (80.6 %) in group B. The sequential bilateral hernia was 16 cases (32.7 %) in group A and 18 cases (19.4 %) in group B. Although the ratio of bilateral hernia was increased in group B, the portion of the sequential bilateral hernia was significantly decreased in group B. In conclusion, there were no differences in the age distribution and the laterality between group A and B. The ratio of female patients and the incidence of bilateral hernia were increased in group B even though the portion of the sequential bilateral hernia was decreased. This result shows that the preoperative inguinal sonography in unilateral hernia with potential bilateral hernia is useful in early detection of the sequential contralateral hernia.
Objectives : The purpose of this study is to compare interrelations between stress and muscles of neck through stress response inventory(SRI), 7 zone diagnostic system and surface electromyography(sEMG). Methods : This study was carried out with the data from SRI, 7 zone diagnostic system and sEMG. First subjects were divided into two group according to the SRI points. subjects in group A had points of SRI in which lower than 30 points. Subjects in group B had points of SRI in which higher than 30 points. And subjects were divided into nonstress group(Group C) and stress grouop(Group D) according to the result of 7 zone diagnostic system. Then we investigated how to differentiate the muscle contraction, fatigue, recovery and asymmetry ratio on sEMG for each groups. Results : In this study, the muscle contraction of both upper trapezius muscle and left sternocleidomastoid muscle and left scalene muscle in stress group were higher than nonstress group significantly. And the muscle recovery of left sternocleidomastoid muscle and left scalene muscle in stress group were higher than nonstress group significantly. Conclusions : This results show that the stress was associated with muscle condition.
Objectives : The purpose of this study was to find the characteristics of Sasang Constitution, Soeumin, Soyangin and Taeumin, Using Regular Medical Inspection. Methods : Subjects of our study were 325 cases who took regular medical inspection. We collected the data of body composition analysis, 7-zone-diagnostic system, blood analysis, and analyzed by Sasang Constitution, Soeumin, Soyangin and Taeumin. Results and Conclusions : 1. In body composition analysis, Taeumin was significantly higher than Soeumin and Soyangin about soft lean mass, body fat mass, waist-hip ratio, body water index, body mass index and basal metabolic rate. In blood analysis, Taeumin was significantly highest about total protein, albumin, GPT, hemoglobin, WBC, triglyceride. In 7-zone-diagnostic system, Taeumin had the highest level at Zone 1, 2. 2. Taeumin had more significant differences than other Sasang constitutions about the parameters of regular medical inspection. 3. Body composition analysis had the most parameters that showed differences among the constitutions, followed by blood analysis and 7-zone-diagnostic system.
Journal of The Korean Society of Inherited Metabolic disease
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v.6
no.1
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pp.40-51
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2006
Purpose: A personal computer-based system was developed for automated metabolic profiling of organic aciduria and aminoacidopathy by gas chromatography-mass spectrometry and data interpretation for the diagnosis of metabolic disorders Methods: For automatic data profiling and interpretation, we compiled retention time, two target ions and their intensity ratio for 77 organic acids and 13 amino acids metabolites. Metabolites above the cut-off values were flagged as abnormal compounds. The data interpretation was a based on combination of flagged metabolites. Diagnostic or index metabolites were categorized into three groups, "and", "or" and "NO" compiled for each disorder to improve the specificity of the diagnosis. Groups "and" and "or" comprised essential and optional compounds, respectively, to reach a specific diagnosis. Group "NO" comprised metabolites that must be absent to make a definite diagnosis. We tested this system by analyzing patients with confirmed Propionic aciduria and others. Results: In all cases, the diagnostic metabolites were identified and correct diagnosis was founded to be made among the possible disease suggested by the system. Conclusion: The study showed that the developed method could be the method of choices in rapid, sensitive and simultaneous screening for organic aciduria and amino acidopathy with this simplified automated system.
Background/Aims: This meta-analysis analyzed the effect of an indwelling biliary stent on endoscopic ultrasound (EUS)-guided tissue acquisition from pancreatic lesions. Methods: A literature search was performed to identify studies published between 2000 and July 2022 comparing the diagnostic outcomes of EUS-tissue acquisition (TA) in patients with or without biliary stents. For non-strict criteria, samples reported as malignant or suspicious for malignancy were included, whereas for strict criteria, only samples reported as malignant were included in the analysis. Results: Nine studies were included in this analysis. The odds of an accurate diagnosis were significantly lower in patients with indwelling stents using both non-strict (odds ratio [OR], 0.68; 95% confidence interval [CI], 0.52-0.90) and strict criteria (OR, 0.58; 95% CI, 0.46-0.74). The pooled sensitivity with and without stents were similar (87% vs. 91%) using non-strict criteria. However, patients with stents had a lower pooled sensitivity (79% vs. 88%) when using strict criteria. The sample inadequacy rate was comparable between groups (OR, 1.12; 95% CI, 0.76-1.65). The diagnostic accuracy and sample inadequacy were comparable between plastic and metal biliary stents. Conclusions: The presence of a biliary stent may negatively affect the diagnostic outcome of EUS-TA for pancreatic lesions.
Objectives : The 7-zone-diagnostic system is a diagnostic device to predetermine bodily locations by measuring the energy of body. This study was to investigate the relation between the different patterns of Zone 2, 6 of Factor AA in VEGA DFM 722(VEGA, Germany), 7-zone-diagnostic system and clinical parameters. The purpose of this study was relation Korean traditional medicine and western medicine with the data from 7-zone-diagnostic system and the clinical parameters. Methods : This study was carried out with the data from some clinical parameters. We made two groups according to the Factor AA patterns of VEGA DFM 722. The Factor AA pattern of Group A is that the red bar graph of zone 2 was higher than the normal range and the red bar graph of zone 6 was lower than the normal range. The Factor AA pattern of Group B was that the red bar graph of zone 2 was lower than the normal range and the red bar graph of zone 6 was higher than the normal range. After the data from clinical parameters to correspond with conditions of each group were selected, the data from clinical parameters between each gropus analyzed statistically. Results and Conclusions : The values of Direct Bilirubin, GOT, BUN and BUN/Creatinine ratio of Group A were higher than them of Group B. The values of Sodium and Tyroxine of Group A were lower than them of Group B. These results mean that Group A has low energy but has increading tendency. To conclude, it is thought that the red bar graph of zone 2 is higher, the group is the more increasing and the red bar graph of zone 6 is lower, the group has the lower energy.
Background: The objective structured clinical examination (OSCE) is used in the colleges of Korean Medicine, but few studies have validated the OSCE evaluation criteria or post-education questionnaires. Diagnostic ultrasound is used in Korean medicine treatment including acupuncture, acupotomy, and pharmacopuncture to increase the safety and efficacy of treatment. We aimed to develop and validate a OSCE checklist and questionnaire for diagnostic musculoskeletal ultrasound training. Methods: A OSCE checklist and rubric for diagnostic ultrasound training, and questionnaire was developed using literature research. Eight expert panelists verified each draft item in a single-round survey. Items with a content validity ratio (CVR) < 0.75 were excluded or modified to reflect the experts' opinions. Results: The OSCE checklist and rubric for diagnostic ultrasound training focusing on volar wrist and carpal tunnel syndrome included: 15 items revised according to CVR and expert opinions, the pre-examination procedure, structures to be identified by ultrasound, scans with 2 diagnostic criteria for carpal tunnel syndrome, an explanation of the exam results, and the post exam procedure. The questionnaire consisted of 15 items, including the overall evaluation of training, the effect of the OSCE, and the perception of the ultrasound. All 6 self-evaluation items were not revised, as they had a CVR of ≥ 0.75. Conclusion: An ultrasound OSCE for scanning the volar wrist and diagnosing carpal tunnel syndrome was developed using 15 validated tasks, 15 survey questions about ultrasound training, and 6 questions for self-evaluation. These results may be used in the future for education in diagnostic ultrasound.
Bo Kiung Kang;Dong Gyu Na;Jae Wook Ryoo;Hong Sik Byun;Hong Gee Roh;Yong Seon Pyeun
Korean Journal of Radiology
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v.2
no.4
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pp.183-191
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2001
Objective: To document the signal characteristics of intracerebral hemorrhage (ICH) at evolving stages on diffusion-weighted images (DWI) by comparison with conventional MR images. Materials and Methods: In our retrospective study, 38 patients with ICH underwent a set of imaging sequences that included DWI, T1-and T2-weighted imaging, and fluid-attenuated inversion recovery (FLAIR). In 33 and 10 patients, respectively, conventional and echo-planar T2* gradient-echo images were also obtained. According to the time interval between symptom onset and initial MRI, five stages were categorized: hyperacute (n=6); acute (n=7); early subacute (n=7); late subacute (n=10); and chronic (n=8). We investigated the signal intensity and apparent diffusion coefficient (ADC) of ICH and compared the signal intensities of hematomas at DWI and on conventional MR images. Results: DWI showed that hematomas were hyperintense at the hyperacute and late subacute stages, and hypointense at the acute, early subacute and chronic stages. Invariably, focal hypointensity was observed within a hyperacute hematoma. At the hyperacute, acute and early subacute stages, hyperintense rims that corresponded with edema surrounding the hematoma were present. The mean ADC ratio was 0.73 at the hyperacute stage, 0.72 at the acute stage, 0.70 at the early subacute stage, 0.72 at the late subacute stage, and 2.56 at the chronic stage. Conclusion: DWI showed that the signal intensity of an ICH may be related to both its ADC value and the magnetic susceptibility effect. In patients with acute stroke, an understanding of the characteristic features of ICH seen at DWI can be helpful in both the characterization of intracranial hemorrhagic lesions and the differentiation of hemorrhage from ischemia.
Background and Purpose: Ovarian cancer is the leading cause of death among gynecologic cancers because of the lack of effective early detection methods. Accuracies of the human epididymis protein 4 (HE4) and mesothelin in detecting ovarian cancer have never been systematically assessed. The current systematic review aimed to tackle this issue. Methods: MEDLINE, EMBASE, and Cochrane databases were searched (September 1995-November 2011) for studies on the diagnostic performances of HE4 and mesothelin in differentiating ovarian cancer from other benign gynecologic diseases. QUADAS items were used to evaluate the qualities of the studies. Meta-DiSc software was used to handle data from the included studies and to examine heterogeneity. All included studies for diagnostic performance were combined with sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratios (DORs) with 95% confidence intervals (CIs), summary receiver operating characteristic (SROC) curves, and areas under the SROC curves (AUC). Results: A total of 18 studies and 3,865 patients were eligible for the final analysis. The pooled sensitivity estimates for HE4 (74.4%) were significantly higher than those for mesothelin (49.3%). The pooled specificity estimates for mesothelin (94.5%) were higher than those for HE4 (85.8%). The pooled DOR estimates for HE4 (26.22) were higher than those for mesothelin (24.01). The SROC curve for HE4 showed better diagnostic accuracy than that for mesothelin. The PLR and NLR of HE4 were 6.33 (95% CI: 3.58 to 11.18) and 0.27 (95% CI: 0.21 to 0.34), respectively. The PLR and NLR for mesothelin were 11.0 (95% CI: 6.21 to 19.59) and 0.51 (95% CI: 0.42 to 0.62), respectively. The combination of the two tumor markers or their combination with CA-125 increased sensitivity and specificity to different extents. Conclusion: The diagnostic accuracy of HE4 in differentiating ovarian cancer from other benign gynecologic diseases is better than that of soluble mesothelin-related protein. Combinations of two or more tumor markers show more sensitivity and specificity.
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