• 제목/요약/키워드: Pathological feature

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내시경 초음파 영상의 점막하 종양 분석 (Submucosal Tumor Analysis of Endoscopic Ultrasonography Images)

  • 김광백
    • 한국멀티미디어학회논문지
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    • 제13권7호
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    • pp.1044-1050
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    • 2010
  • 내시경 초음파는 초음파 진동자를 내시경 끝에 부착하여 그 주위의 장기를 관찰할 목적으로 개발된 의료기기이다. 내시경 초음파 검사는 점막하 종양을 직접 관찰 할 수 있어 종양의 병리 소견이 예측 가능하지만, 종양의 악성화 여부 등에 대해 주관적인 소견이 개입될 수 있는 문제점이 있다. 따라서 본 논문에서는 주관적인 소견으로 인해 나타나는 문제점을 객관화하여 질병의 정확도와 재현성을 높이기 위해 종양의 각 특징을 분석하는 방법을 제안한다. 제안된 방법을 적용하기 위해서 내시경 초음파 검사로 얻어진 초기 영상에서 분석에 필요한 초음파 영역을 추출한다. 초음파 영역은 여러 요인으로 인하여 명암도 값의 차이가 발생하는데, 이는 객관적인 분석에는 비효율적이다. 따라서 초기 검사 시에 매질로써 주입되는 물 영역의 명암도를 기준으로 하여 초음파 영역의 명암도를 표준화 한다. 표준화된 초음파 영역에서 전문의에 의하여 선택된 종양 영역에 LVQ 알고리즘과 비트 평면 분할 방법을 각각 적용하여 에코가 높은 spot 영역과 칼슘이 침착된 영역을 추출하고 분석한다. 종양 영역의 세밀한 분석을 위하여 명암도 값과, 종양 영역 내에서 전문의가 임의로 선택한 두 지점의 거리에 포함된 명암도 정보를 추출한다. 또한 선택된 종양의 악성도를 구분하기 위하여 종양 영역에서 외곽의 기울기를 계산한다. 내시경 초음파 영상에서 각 질병의 특징을 분석한 결과, 제시된 방법이 종양이 가지는 특징을 분석하는데 도움이 되는 것을 확인할 수 있었다.

A Case of Delayed Diagnosis of Pulmonary Paragonimiasis due to Improvement after Anti-tuberculosis Therapy

  • Lee, Suhyeon;Yu, Yeonsil;An, Jinyoung;Lee, Jeongmin;Son, Jin-Sung;Lee, Young Kyung;Song, Sookhee;Kim, Hyeok;Kim, Suhyun
    • Tuberculosis and Respiratory Diseases
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    • 제77권4호
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    • pp.178-183
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    • 2014
  • Here, we report a case of pulmonary paragonimiasis that was improved with initial anti-tuberculosis (TB) therapy but confused with reactivated pulmonary TB. A 53-year-old Chinese female presented with a persistent productive cough with foul smelling phlegm and blood streaked sputum. Radiologic findings showed subpleural cavitary consolidation in the right upper lobe (RUL). Bronchoscopic and cytological examination showed no remarkable medical feature. She was diagnosed with smear-negative TB, and her radiologic findings improved after receiving a 6-month anti-TB therapy. The chest CT scans, however, obtained at 4 months after completion of anti-TB therapy showed a newly developed subpleural consolidation in the RUL. She refused pathologic confirmation and was re-treated with anti-TB medication. Nevertheless, her chest CT scans revealed newly developed cavitary nodules at 5 months after re-treatment. She underwent thoracoscopic wedge resection; the pathological examination reported that granuloma caused by Paragonimus westermani. Paragonimiasis should also be considered in patients assessed with smear-negative pulmonary TB.

천연자원으로부터 아실코에이: 콜레스테롤아실 전달효소 저해제의 탐색 (Screening of Acyl-CoA:Cholesterol Acyltransferase(ACAT) Inhibitors from Natural Sources)

  • 김미경;권병목;배기환;최돈하;이학주;김홍은;김영국
    • 생약학회지
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    • 제30권4호
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    • pp.384-396
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    • 1999
  • Acyl-CoA: Cholesterol Acyltransferase (ACAT) is a key enzyme responsible for cholesteryl ester formation in atherogenesis and in cholesterol absorption from the intestines. In addition under pathological conditions, formation and accumulation of cholesteryl ester as lipid droplets by ACAT within macrophages constitute a characteristic feature of early lesions of atherosclerotic plaques. ACAT inhibitors are expected to be effective for treatment of atherosclerosis and hypercholesterolemia. ACAT inhibitors of natural origin have been rarely reported. In our screening program for ACAT inhibitors, 303 plants were extracted with methanol or ethanol, and screened for the inhibitory activity against ACAT from the rat liver microsome. Extracts of 13 plants including Quercus aliena, Diospyros kaki, Platycarya strobilacea and Hibiscus syriacus inhibited more than 90% of ACAT activity and 43 samples in alcohol extracts such as Magnolia obovata and Panax ginseng also inhibited more than 70% of ACAT activity at a concentration of $100\;{\mu}g/ml$.

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본태성 다한증 환자의 수술 후 발생하는 보상성 다한증 (Compensatory Hyperhidrosis after Thoracoscopic Sympathectomy in Essential Hyperhidrosis)

  • 서의교;조용은;윤도흠;김영수
    • Journal of Korean Neurosurgical Society
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    • 제30권4호
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    • pp.486-492
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    • 2001
  • Objective : Essential hyperhidrosis is a pathological condition of excessive sweating beyond that required to cool the body, though poorly understood, originating from a dysfunction of the sympathetic nervous system. Thoracoscopic sympathectomy is the most popular treatment for upper limb hyperhidrosis, because it is a safe, effective, minimally invasive, and time-saving method. However, the common complication is the compensatory hyperhidrosis in other areas of the body, notably on the back, chest, abdomen, and buttocks. Compensatory hyperhidrosis is severe enough for some people, especially those living in a warm climate or engaging in heavy physical activities, to regret ever having had operation. The pathophysiological mechanisms underlying compensatory hyperhidrosis are incompletely understood, even though it is thought to be a truly compensatory feature related to thermoregulation of the body. Materials and Methods : we studied the clinical features of total 233 patients who were diagnosed as essential hyperhidrosis and treated with thoracoscopic sympathectomy or sympathicotomy from March 1992 to July 2000. Results : The success rate of thoracoscopic sympathetic surgery(sympathectomy or sympathicotomy) was 98.7%. The global rate of compensatory hyperhidrosis was 77% ; 84% in group T2, 3 sympathectomy, 76% in group T2 sympathectomy, 43% in group T2, 3 sympathicotomy and 59% in group T2 sympathicotomy. The rate of embarrassing or disabling compensatory sweating was significantly higher in T2 sympathectomy and in T2, 3 sympathectomy than in T2 sympathicotomy and T2, 3 sympathicotomy with significancy in statistic analysis(p<0.01). The precipitating factors of compensatory hiperhidrosis, including heat(warm weather), anxiety, stress, and exertion were noted. The compensatory hyperhidrosis was the main cause of patient dissatisfaction after thoracoscopic sympathectomy. Conclusion : The degree of compensatory hyperhidrosis is closely related to the extent of thoracic sympathectomy.

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Alimentary Tract Duplication in Pediatric Patients: Its Distinct Clinical Features and Managements

  • Kim, Soo-Hong;Cho, Yong-Hoon;Kim, Hae-Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제23권5호
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    • pp.423-429
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    • 2020
  • Purpose: Alimentary tract duplication (ATD) is a rare congenital condition that may occur throughout the intestinal tract. Clinical symptoms are generally related to the involved site, size of duplication, or associated ectopic mucosa. This study aimed to identify clinical implications by anatomical locations and age group and then suggest a relevant management according to its distinct features. Methods: We retrospectively reviewed the clinical data of pediatric patients who received a surgical management due to ATD. Furthermore, data including patients' demographics, anatomical distribution of the duplication, clinical features according to anatomical variants, and outcomes were compared. Results: A total of 25 patients were included in this study. ATD developed most commonly in the midgut, especially at the ileocecal region. The most common clinical presentation was abdominal pain, a sign resulting from intestinal obstruction, gastrointestinal bleeding, and intussusception. The non-communicating cystic type was the most common pathological feature in all age groups. Clinically, prenatal detection was relatively low; however, it usually manifested before the infantile period. A laparoscopic procedure was performed in most cases (18/25, 72.0%), significantly in the midgut lesion (p=0.012). Conclusion: ATD occurs most commonly at the ileocecal region, and a symptomatic one may usually be detected before the early childhood period. Surgical management should be considered whether symptom or not regarding its symptomatic progression, and a minimal invasive procedure is the preferred method, especially for the midgut lesion.

Characterization of Venous Involvement in Vasculo-Behçet Disease

  • Lee, Na Hyeon;Bae, Miju;Jin, Moran;Chung, Sung Woon;Lee, Chung Won;Jeon, Chang Ho
    • Journal of Chest Surgery
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    • 제53권6호
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    • pp.381-386
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    • 2020
  • Background: Behçet disease is a chronic inflammatory disorder with a varying etiology. Herein, we report the involvement of peripheral veins in Behçet disease and discuss the treatment thereof. Methods: Thirty-four patients with venous involvement in vasculo-Behçet disease were retrospectively analyzed over 15 years. We reviewed the clinical manifestations, treatment choices, and complications of these patients. Results: Deep vein thrombosis (DVT) was observed in 24 patients (70.59%) and varicose veins in 19 (52.94%). Immunosuppressive treatment was administered to all patients due to the pathological feature of vein wall inflammation. In patients with DVT, anticoagulation therapy was also used, but post-thrombotic syndrome was observed in all patients along with chronic luminal changes. Eleven patients with isolated varicose veins underwent surgery; although symptoms and lesions recurred in half of these patients, no cases of secondary DVT occurred. Conclusion: When DVT was diagnosed in patients with Behçet disease, there was no cure for the lesions. Ultrasonographic abnormalities were observed in all patients, and post-thrombotic syndrome remained to varying degrees. In cases of isolated varicose veins in patients with Behçet disease, DVT did not occur after surgical treatment. If the activity of Behçet disease is controlled, surgical correction of varicose veins is preferable.

학질(瘧疾)의 종류(種類)와 병인(病因).병기(病機)에 대한 고찰(考察) (A Study on the Kinds(種類), Causes(病因) and Mechanisms(病機) of Malaria(瘧疾))

  • 강효진;정창현;장우창;류정아;백유상
    • 대한한의학원전학회지
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    • 제26권2호
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    • pp.133-174
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    • 2013
  • Objective : Malaria(瘧疾) is a disease that's main symptom is paroxysm - a cyclical occurrence of sudden coldness followed by rigor and then fever. Since the introduction of the cause and mechanism of malaria(瘧疾) in the "Suwen(素問)", including Cold malaria(寒瘧), Warm malaria(溫瘧), Heat malaria(癉瘧) and Wind malaria(風瘧), there has been over 20 different kinds of malaria, each of which are introduced in multiple medical texts. Method : Through comparison between "Suwen(素問)" and other medical texts, the categories, causes and mechanisms of malaria can be analysed and organized to overview the whole feature of it. Results & Conclusion : External pathogens of malaria(瘧疾) are wind(風), cold(寒), summerheat (暑), dampness(濕), miasmic toxin(瘴), pestilence(疫), ghost(鬼). Internal pathogens of malaria(瘧疾) are dietary irregularities(飮食不節), overexertion and fatigue(勞倦), phlegm(痰), seven emotion(七情). Malaria can be categorized into four groups according to the pathological mechanism that leads to paroxysm. They are latency of disease(伏氣), external contraction(外感), internal damage(內傷), and combination of disease(合病). Malaria-Paroxysm(瘧疾發作) occurs when the three following factors collide strongly : defense qi(衛氣), latent qi(伏邪) and external pathogen(新邪). When collision of the three factors takes place in the interior(裏), the body experiences chills. When it takes place in the exterior(表), the body experiences fever. The cyclical occurrence of Malaria-Paroxysm follows the circulation of defense qi.

Multiple Myeloma: a Retrospective Analysis of 61 Patients from a Tertiary Care Center

  • Sultan, Sadia;Irfan, Syed Mohammed;Parveen, Saira;Ali, Hamza;Basharat, Maria
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권4호
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    • pp.1833-1835
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    • 2016
  • Background: Multiple myeloma (MM) is an acquired clonal B-cell malignancy which primarily affects elderly individuals with an annual incidence of approximately 1% of all malignancies. Our aim is to study demographic and clinicopathological features of adult Pakistani MM patients at presentation. Materials and Methods: This single centre retrospective study extended from January 2010 to December 2014. Data were retrieved from the patients' maintained records on predetermined performa. Results: Overall, 61 patients were diagnosed at our institution with MM during the study period. There were 43 males and 18 females. Age ranged between 34 and 81 years with a mean of $56.1{\pm}12.8$ and a median of 57 years. The male to female ratio was ~2:1. Common presenting complaints included fatigue (81.9%), backache (80.3%) and bone pain (67.2%). Physical findings revealed pallor (44.2%) as a presenting clinical feature. The mean hemoglobin value was $8.9{\pm}1.7g/dl$ with a mean MCV of $85.3{\pm}11.0fl$. Severe anemia with hemoglobin <8.5 gm/dl was seen in 40.9%. The mean total leukocyte count was $8.9{\pm}8.2{\times}10^9/l$, the ANC was $5.0{\pm}3.1{\times}10^9/l$ and the mean platelet count was $188.4{\pm}150.6{\times}10^9/l$. Conclusions: MM in Pakistani patients is seen in a relatively young population with male preponderance. The majority of patients present with symptomatic anemia and backache to seek medical attention. However, clinico-pathological features appear comparable to the published literature.

Poncirin Inhibits Osteoclast Differentiation and Bone Loss through Down-Regulation of NFATc1 In Vitro and In Vivo

  • Chun, Kwang-Hoon;Jin, Hyun Chul;Kang, Ki Sung;Chang, Tong-Shin;Hwang, Gwi Seo
    • Biomolecules & Therapeutics
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    • 제28권4호
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    • pp.337-343
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    • 2020
  • Activation of osteoclast and inactivation of osteoblast result in loss of bone mass with bone resorption, leading to the pathological progression of osteoporosis. The receptor activator of NF-κB ligand (RANKL) is a member of the TNF superfamily, and is a key mediator of osteoclast differentiation. A flavanone glycoside isolated from the fruit of Poncirus trifoliata, poncirin has anti-allergic, hypocholesterolemic, anti-inflammatory and anti-platelet activities. The present study investigates the effect of poncirin on osteoclast differentiation of RANKL-stimulated RAW264.7 cells. We observed reduced formation of RANKL-stimulated TRAP-positive multinucleated cells (a morphological feature of osteoclasts) after poncirin exposure. Real-time qPCR analysis showed suppression of the RANKL-mediated induction of key osteoclastogenic molecules such as NFATc1, TRAP, c-Fos, MMP9 and cathepsin K after poncirin treatment. Poncirin also inhibited the RANKL-mediated activation of NF-κB and, notably, JNK, without changes in ERK and p38 expression in RAW264.7 cells. Furthermore, we assessed the in vivo efficacy of poncirin in the lipopolysaccharide (LPS)-induced bone erosion model. Evaluating the micro-CT of femurs revealed that bone erosion in poncirin treated mice was markedly attenuated. Our results indicate that poncirin exerts anti-osteoclastic effects in vitro and in vivo by suppressing osteoclast differentiation. We believe that poncirin is a promising candidate for inflammatory bone loss therapeutics.

Ginseng total saponin modulates the changes of ${\alpha}$-actinin-4 in podocytes induced by diabetic conditions

  • Ha, Tae-Sun;Choi, Ji-Young;Park, Hye-Young;Nam, Ja-Ae;Seo, Su-Bin
    • Journal of Ginseng Research
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    • 제38권4호
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    • pp.233-238
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    • 2014
  • Background: The actin cytoskeleton in podocytes is essential for the maintenance of its normal structure and function. Its disruption is a feature of podocyte foot-process effacement and is associated with proteinuria. ${\alpha}$-Actinin-4 in podocytes serves as a linker protein binding the actin filaments of the cytoskeleton. Methods: To investigate the effect of ginseng total saponin (GTS) on the pathological changes of podocyte ${\alpha}$-actinin-4 induced by diabetic conditions, we cultured mouse podocytes under normal glucose (5mM) or high glucose (HG, 30mM) conditions, with or without the addition of advanced glycosylation end products (AGE), and treated with GTS. Results: In confocal imaging, ${\alpha}$-actinin-4 colocalized with the ends of F-actin fibers in cytoplasm, but diabetic conditions disrupted F-actin fibers and concentrated ${\alpha}$-actinin-4 molecules at the peripheral cytoplasm. GTS upregulated ${\alpha}$-actinin protein in a time- and dose-dependent manner, and suppressed the receptor for AGE levels in western blotting. Diabetic conditions, including HG, AGE, and both together, decreased cellular ${\alpha}$-actinin-4 protein levels at 24 h and 48 h. Such quantitative and qualitative changes of ${\alpha}$-actinin-4 protein induced by diabetic conditions were mitigated by GTS. Conclusion: These findings imply that both HG and AGE have an influence on the distribution and amount of ${\alpha}$-actinin-4 in podocytes that can be recovered by GTS.