• Annals of Clinical Neurophysiology
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• 제18권1호
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• pp.7-10
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• 2016

Ulnar neuropathy at the elbow (UNE) may seem easy to diagnose when the characteristic clinical manifestations are present, and electrodiagnostic studies have high sensitivity, although they are non-localizing in some cases and unable to reveal structural lesions. Ultrasonography is noninvasive and able to find the exact location of the lesion and visualize perineural structures. We present two cases of UNE in which we found hypoechoic mass lesions near medial epicondyle with ultrasonography and discuss its usefulness in diagnosis of UNE.

• Annals of Clinical Neurophysiology
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• 제20권1호
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• pp.36-40
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• 2018

Lennox-Gastaut syndrome (LGS) is an electro-clinical syndrome composed of the triad of mental retardation, multiple seizure types, and the characteristic generalized slow spike-wave complexes in the electroencephalogram. In this article, we report on two patients with LGS whose brain magnetic resonance imaging showed dysgenesis of corpus callosum (CC). We discuss the role of CC in the genesis of secondary bilateral synchrony.

• 대한임상검사과학회지
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• 제46권3호
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• pp.85-90
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• 2014

The purpose of this study was to investigate the prevalence and differences of risk factors of Metabolic syndrome according to menopausal status. From the database of the 5th Korea National Health and Nutrition Examination Survey (KNHANES V) conducted in 2012, data of 3,537 women who responded to health interview and health examination questionnaires. The presence of Metabolic syndrome was assessed using the International Diabetes Federation (IDF) criteria. The prevalence of Metabolic syndrome was 17.3% in premenopause and 54.3% in postmenopause. BMI, waist circumference, blood pressure, total cholesterol, LDL cholesterol, triglyceride, and Ferritin were higher in postmenopausal women compared to premenopausal women. However, postmenopausal women had lower HDL cholesterol and TIBC when compared to premenopausal women. Hypertension was the most prominent characteristic of postmenopausal women. Low HDL cholesterol showed up as a meaningful factor in premenopausal women. According to multiple regression analysis, waist circumference, fasting glucose, and HDL cholesterol were independent predictors of menopause. Therefore, obesity control and blood lipids management is recommended for postmenopausal women.

• Asian-Australasian Journal of Animal Sciences
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• 제21권7호
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• pp.1003-1010
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• 2008

The objective of the present study was to identify differences in the expression levels of liver proteins between healthy and ketotic cows, establish a liver metabolic interrelationship of ketosis and elucidate the metabolic characteristics of the liver during ketosis. Liver samples from 8 healthy multiparous Hostein cows and 8 ketotic cows were pooled by health status and the proteins were separated by two-dimensional-electrophoresis (2D-E). Statistical analysis of gels was performed using PDQuest software 8.0. The differences in the expression levels of liver proteins (p<0.05) between ketotic and healthy cows were identified by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF-TOF) tandem mass spectrometry. Five enzymes/proteins were identified as being differentially expressed in the livers of ketotic cows: expression of 3-hydroxyacyl-CoA dehydrogenase type-2 (HCDH), acetyl-coenzyme A acetyltransferase 2 (ACAT) and elongation factor Tu (EF-Tu) were down-regulated, whereas that of alpha-enolase and creatine kinase were up-regulated. On the basis of this evidence, it could be presumed that the decreased expression of HCDH, which is caused by high concentrations of acetyl-CoA in hepatic cells, in the livers of ketotic cows, implies reduced fatty acid ??oxidation. The resultant high concentrations of acetyl-CoA and acetoacetyl CoA would depress the level of ACAT and generate more ??hydroxybutyric acid; high concentrations of acetyl-CoA would also accelerate the Krebs Cycle and produce more ATP, which is stored as phosphocreatine, as a consequence of increased expression of creatine kinase. The low expression level of elongation factor Tu in the livers of ketotic cows indicates decreased levels of protein synthesis due to the limited availability of amino acids, because the most glucogenic amino acids sustain the glyconeogenesis pathway; thus increasing the level of alpha-enolase. Decreased protein synthesis also promotes the conversion of amino acids to oxaloacetate, which drives the Krebs Cycle under conditions of high levels of acetyl-CoA. It is concluded that the livers of ketotic cows possess high concentrations of acetyl-CoA, which through negative feedback inhibited fatty acid oxidation; show decreased fatty acid oxidation, ketogenesis and protein synthesis; and increased gluconeogenesis and energy production.

• 대한세포병리학회지
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• 제6권2호
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• pp.204-208
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• 1995

The cytologic findings of endodermal sinus tumor of the ovary are reported. The cytologic preperations were obtained from ascitic specimens. The findings on Papanicolaou-stained smears included a clean background and poorly preserved atypical cells loosely arranged in irregular or papillary groups. At high magnification, the cells had ill-defined and microvacuolated cytoplasms, with an increased nuclear-cytoplasmic ratio and prominent nucleoli. Hyaline globules characteristic of the alpha-fetoprotein (AFP)-synthesizing cells of endodermal sinus tumor were observed within the cells with periodic-acid-Schiff(PAS) stain. The presence of PAS-positive hyaline globules can be regarded, therefore, as a diagnostic clue to endodermal sinus tumor in an appropriate clinical setting and in the presence of AFP production. The cytologic findings in a cell block is important, in addition to smears, to obtain more diagnostic clues. A preliminary cytomorphologic diagnosis of this highly malignant tumor is valuable as a guide in planning further immunocytochemical and serologic studies.

• 대한세포병리학회지
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• 제6권1호
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• pp.71-75
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• 1995

A fine needle aspiration biopsy specimen of a retroperitoneal mass in a 26-year-old man who had had an orchiectomy for seminoma was submitted for cytologic evaluation. Cytologic features of the specimen included uniform neoplastic cells found singly or in groups of several cells intermingled with lymphocytes in a characteristic foamy, lacelike background. These cells varied from 10 to 20 m in diameter. The nuclei were round to ovoid with fine or reticular chromatin and one or more prominent nucleoli. The poorly defined cytoplasm stained pale-blue or blue with cytoplasmic vacuoles. The cytologic appearance was consistent with seminoma. Documented reports of the cytological appearance of seminoma are rare. The diagnosis of primary gonadal seminoma by fine needle aspiration biopsy is probably not indicated since the treatment of a primary gonadal tumor, regardless of its histogenesis, requires surgical resection. However, fine needle aspiration biopsy is extremely valuable in the diagnosis of extragonadal as well as metastic and recurrent seminoma.

• 대한한방소아과학회지
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• 제16권2호
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• pp.1-22
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• 2002

Purpose : This Study was conducted to evaluate clinical characteristic of children with recurrent abdominal pain (RAP) and to be classified by its six subtype in the Oriental Pediatric Text Book and to find out relationship of western classification. Methods : Patients who visited Dong-Eui Oriental Medical hospital from August, 2001 to October, 2002 due to RAP were included. According to questionnaire and history taking, RAP was classified by its six subtype based on Oriental medical theory. Results : 1. Patients with RAP were more internalized, have a close relation with their parents, and have strong desires of success, but social intercourse is low. 2. 76% of Patients have a less desire to eat and 67% of Patients have a diarrhea or constipation. 3. According to questionnaire, first abdominal pain was their $3{\sim}5$ ages most, cause of occurrence was more 'eating cold foods' most, time of AP (abdominal pain) was $1{\sim}2$ hours after eating and no characteristic most, site of AP was the umbilicus most, shape of AP was impotent pain most, cause of reduce pain was abdominal massage and defection most. 4. frequency of RAP's type, AP caused by diet(食積腹痛) is 45.5%, AP caused by cold(寒腹痛) is 29.1%, AP caused by cold in internal organs of deficiency(臟腑虛冷腹痛) is 12.7%, stagnation of qi and stasis of blood(氣滯血瘀腹痛) is 10.9%, AP caused by internal diet and external cold(內食外寒腹痛) is 1.8%. There is no AP caused by parasites(蟲腹痛). 5. During clinical classifications of RAP, cause of occurrence was most important cause of reduce pian, defection practice was helpful for diagnosis, but shape of AP, site of AP was not helpful. 6. With relationship of Oriental classification and western classification, AP caused by diet is similar to dysmotilitylike dyspepsia and irriTable bowel syndrome. AP caused by cold is similar to irriTable bowel syndrome. AP caused by cold in internal organs of deficiency is similar to unspecified dyspepsia. stagnation of qi and stasis of blood and AP caused by internal diet and external cold is not like to western classification. Conclusion : RAP in Childhood is most occurred by food and cold. there is few AP caused by stagnation of qi and stasis of blood and internal diet and external cold. So the study on subclassification and clinical Manifestations of RAP in Childhood is more performed.

• 한국임상수의학회지
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• 제19권3호
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• pp.312-315
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• 2002

질병에 이환된 개체로부터 이환되지 않은 개체를 구분하기 위해 사용되는 대부분의 진단검사는 판별의 기준점 (cut-off value)을 필요로 한다. ROC (receiver operating characteristic) 곡선은 이러한 목적으로 흔히 사용되고 있으며 진단의 기준점을 다양하게 변화시킬 때 진단검사의 정확도 (민감도와 특이도)를 제시해주는 지표로 활용되고 있다. 저자들은 수의학관련 연구자들이 이 방법을 효과적으로 사용할 수 있도록 EXCEL에 내장된 비쥬얼 베이직으로 binormal ROC 곡선의 최대우도비를 계산해주는 프로그램을 작성하였다. 방사선 분야의 자료와 미생물학 자료를 예제로 들어 이 프로그램의 활용성을 높이고자 하였고 이 분야에 관심이 있는 연구자는 저자에게 연락하여 이 프로그램을 얻을 수 있다.

• Korean Journal of Radiology
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• 제22권3호
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• pp.442-453
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• 2021

Artificial intelligence (AI) will likely affect various fields of medicine. This article aims to explain the fundamental principles of clinical validation, device approval, and insurance coverage decisions of AI algorithms for medical diagnosis and prediction. Discrimination accuracy of AI algorithms is often evaluated with the Dice similarity coefficient, sensitivity, specificity, and traditional or free-response receiver operating characteristic curves. Calibration accuracy should also be assessed, especially for algorithms that provide probabilities to users. As current AI algorithms have limited generalizability to real-world practice, clinical validation of AI should put it to proper external testing and assisting roles. External testing could adopt diagnostic case-control or diagnostic cohort designs. A diagnostic case-control study evaluates the technical validity/accuracy of AI while the latter tests the clinical validity/accuracy of AI in samples representing target patients in real-world clinical scenarios. Ultimate clinical validation of AI requires evaluations of its impact on patient outcomes, referred to as clinical utility, and for which randomized clinical trials are ideal. Device approval of AI is typically granted with proof of technical validity/accuracy and thus does not intend to directly indicate if AI is beneficial for patient care or if it improves patient outcomes. Neither can it categorically address the issue of limited generalizability of AI. After achieving device approval, it is up to medical professionals to determine if the approved AI algorithms are beneficial for real-world patient care. Insurance coverage decisions generally require a demonstration of clinical utility that the use of AI has improved patient outcomes.

• Annals of Clinical Neurophysiology
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• 제6권1호
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• pp.14-19
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• 2004

Backgrounds and objectives: POEMS (polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes) syndrome is the rare cause of polyneuropathy. Although the polyneuropathy is essential for the diagnosis of the disease, the pattern of electrodiagnostic abnormalities has not been characterized in detail. The purpose of this study was to elucidate the features of nerve conduction abnormalities in POEMS syndrome. Methods: We reviewed the medical records and nerve conduction studies (NCS) of 12 consecutive patients with POEMS. Results: A total of 68 motor and 46 sensory nerves were examined. Compound muscle action potentials (CMAPs) and sensory nerve action potentials were abnormally attenuated or not elicited in majority of motor and sensory nerves (80.88% in motor, and 82.6% in sensory nerves). Frequency of the nerves with no potential was significantly higher in lower limbs than in upper limbs (p<0.01 in both motor and sensory nerves), and CMAP amplitude was more reduced in lower limbs than in upper limbs (p<0.01). Conduction slowing was very frequently observed with 95% and 76% of motor and sensory nerves, respectively, having the abnormally reduced values of conduction velocity. Distal motor latencies were abnormally prolonged in 75% of motor nerves, and terminal latency indices were significantly higher in patients than in normal controls (p < 0.05). Conduction block was observed only in 5% of motor nerves. Conclusions: NCS in POEMS syndrome showed characteristic patterns, in which conduction abnormalities were more frequently and severely affected in the lower limbs, and more predominantly in the intermediate nerve segments than in the distal portions. The recognition of these characteristic patterns may be helpful in early diagnosis of polyneuropathy in POEMS syndrome.