• Title/Summary/Keyword: disease diagnosis

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Accuracy of Spirometry at Predicting Restrictive Pulmonary Impairment (제한성 환기장애의 진단에서 폐활량검사의 정확성)

  • Ahn, Young Mee;Koh, Won-Jung;Kim, Cheol Hong;Lim, Seong Yong;An, Chang Hyeok;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Kwon, O Jung
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.3
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    • pp.330-337
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    • 2003
  • Background : Low spirometric forced vital capacity(FVC) in conjunction with a normal or high ratio of the forced expiratory volume at 1 second to the forced vital capacity($FEV_1$/FVC%) has traditionally been classified as a restrictive abnormality. However, the gold-standard diagnosis of a restrictive pulmonary impairment requires a measurement of the total lung capacity (TLC). This study was performed to determine the predictive value of spirometric measurements of the FVC for diagnosing a restrictive pulmonary abnormality. Methods : Test results from 1,371 adult patients who undertook both spirometry and lung volume measurements on the same visit from January 1999 to December 2000 were enrolled in this study. The test values for the FVC, the TLC that was below 80% of predicted value, and a $FEV_1$/FVC% that was below 70%, were classified as being abnormal. Results : Of the 1,371 patients, 353 patients had a reduced a FVC. Of these patients, 186 patients had a reduced TLC. Therefore, the positive predictive value was 52.7%. Of the 196 patients with a normal $FEV_1$/FVC% and a reduced FVC, 148(75.5%) patients had a lower TLC. Thirty eight (24.2%) patients out of 157 patients with a low $FEV_1$/FVC% and a low FVC showed a restrictive defect. Conclusion : Spirometry is useful to rule out a restrictive pulmonary abnormality, but a restrictive pattern on the spirometry dose not mean there is a true restrictive disease. For the patients with a low FVC, TLC measurements are essential for diagnosing a restrictive pulmonary impairment.

The characteristics of neurocardiogenic syncope in children (소아 신경-심인성 실신의 특징)

  • Lee, Kyung Yeon;Lee, Jin Young;Kim, Myoung Hyun;Lee, Jeong Eun;Kim, Yong Dae;Lee, Eun Ju;Lim, Young Su;Kim, Won Seop
    • Clinical and Experimental Pediatrics
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    • v.51 no.5
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    • pp.512-517
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    • 2008
  • Purpose : Syncope is relatively common in children and adolescents. Among the etiologies of syncope, neurocardiogenical syncope is the most common, but it is often confounded with seizure. We investigated the clinical features of patients under the age of 15 with neurocardiogenical syncope, compared to patients with neurologic disorders including epilepsy. Methods : Among the children who visited the Department of Pediatrics at Cheongju St. Mary's Hospital and Chungbuk National University Hospital from March 2005 to February 2007, we retrospectively analyzed 69 patients whose chief complaint was syncope. We classified the patients by syncope etiology and made comparisons between the neurocardiogenical syncope (NCS) group and the neurological disorders (ND) group regarding to age; location; time and season in which syncope occurred; associated symptoms, including seizures, provocation factors; prodromes; duration of syncope; frequency of previous syncope; birth history; associated disease; past medical history; family history; neurological exam; physical exam; laboratory findings; electrocardiography; electroencephalography (EEG); head-up tilt test; brain CT; and MRI. Results : Among 69 syncope patients, 53 (76.8%) were in the NCS group and 11 (15.9%) were in the ND group. There were no statistically significant differences between the two study groups except for the presence of prodromes and EEG abnormalities. The presence of prodromes in the NCS group was more common than in the ND group [46.9% (23/49) vs. 9.1% (1/11), (P=0.038)]. The EEG abnormality in the ND group was more common than in the NCS group [90% (9/10) vs. 5.8% (3/52), (P<0.01)]. Conclusion : Our study suggests that detailed history-taking, including that concerning prodromes, is important for the accurate diagnosis of neurocardiogenical syncope, and EEG should be obtained if neurological disorders are suggested.

Genotype and clinical features of Korean patients with methylmalonic aciduria and propionic aciduria (한국인 메틸말로닌산뇨증 및 프로피온산뇨증의 유전자형과 임상 양상)

  • Lee, Eun Hye;Ko, Jung Min;Kim, Jae-Min;Yoo, Han-Wook
    • Clinical and Experimental Pediatrics
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    • v.51 no.9
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    • pp.964-970
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    • 2008
  • Purpose : Methylmalonic aciduria (MMA) and propionic aciduria (PA) are inborn errors in the catabolism of branched-chain amino acids. The study was undertaken to investigate the genotypes and clinical features of Korean patients with MMA and PA. Methods : This study examined 12 patients with MMA and eight with PA. We analyzed various clinical features, laboratory findings, treatments, and neuro-developmental outcomes. Diagnoses were based on the presence of characteristic compounds detected by amino acid analysis in serum and organic acid analysis in urine. Mutation analysis was performed in the genes of MUT, MMAA, MMAB, and MMACHC for MMA and PCCA and PCCB for PA. Results : Among the 20 patients, six patients were diagnosed before one month of age and nine patients were diagnosed after the newborn period. Five patients were diagnosed via a neonatal screening test. Patients with early-onset forms had more severe illness at presentation and generally poor outcomes. A favorable outcome was obtained in 55% patients; most of them were of a late-onset type or diagnosed by neonatal mass screening test without symptoms. Genotypes were confirmed in all patients with MMA. We detected 11 different mutations by MUT gene analysis in 10 patients, and three different mutations in MMACHC genes in two patients. PCCA and PCCB gene mutations were identified in 14 of the 16 alleles, in eight patients with PA. Conclusion : Organic aciduria is a fatal disease; however, better outcomes are expected whenever early diagnosis and prompt management are made possible. Mutation analysis is useful for confirming diagnoses and planning management strategies.

Clinical Aspects in Patients with Thyrotoxic Periodic Hypokalemic Paralysis (갑상선 중독성 주기성마비 환자의 임상적 고찰)

  • Narn, Sang-Yob;Kirn, Jae-Hong;Oh, Jung-Hyn;Park, Jin-Chul;Yoon, Hyun-Dae;Won, Kyu-Chang;Cho, Ihn-Ho;Sung, Cha-Kyung;Lee, Hyoung-Woo
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.228-236
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    • 1999
  • Background: Thyrotoxic periodic paralysis is an uncommon illness characterized by intermittent flaccid paralysis of skeletal muscle, usually accompanied by hypokalemia, in patient with hyperthyroidism. However, the pathophysiology of thyrotoxic periodic paralysis remains largely unexplained and controversial. This report describes the clinical and biochemical findings in 19 patients with thyrotoxic periodic paralysis who were examined at the Yeungnam University Medical Center(YUMC) during the past decade. Methods: The medical records of 997 YUMC patients, seen between 1986 and 1996, with diagnosis of hyperthyroidism were reviewed. Nineteen patients out of 997 hyperthyroidism patients were diagnosed, and examined by history, physical examination, serum electrolyte value, and thyroid function test during paralysis. On the basis of these results, comparisons were made on age, sex, precipitating factors, timing, affected limbs, prognosis, serum potassium and serum phosphate and thyroid hormone levels. Results: The prevalence of periodic paralysis in hyperthyroidism was 1.9 percent and the male to female prevalence ratio was 30:1 and in all patients, the development of perodic paralysis was correlated with hyperfunctional state of the thyroid gland. Eleven cases of periodic paralysis were associated with hypokalemia and their thyroid hormone levels were significantly more increased than those of the patients without hypokalemia. Interestingly, our study shows the recurrence of paralysis after treatment. Conclusion: Although the precise pathophysiology of the disease is as yet undefined and controversial, it occurs primarily in Asians with an overwhelming male preponderance and prevalence of 2 percent in hyperthyroidism. The interactive roles of thyroid hormone, Na-K pump, and genetically inherited defect in the cellular membrane potential of the skeletal muscle can be speculated. Further investigation will be needed to firmly establish the mechanism of thyrotoxic periodic paralysis.

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A Clinical Study on the Hypercalcemia in Primary Bronchogenic Carcinoma (고칼슘혈증을 동반한 원발성 폐암의 임상적 특징)

  • Park, Hye-Jung;Shin, Kyeong-Cheol;Moon, Young-Chul;Chung, Jin-Hong;Lee, Kwan-Ho;Sung, Cha-Kyung;Lee, Hyun-Woo
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.208-218
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    • 1999
  • Background: Lung cancer-associated hypercalcemia is one of the most disabling and life-threatening paraneoplastic disorders. Humoral hypercalcemia is responsible for most lung cancer-associated hypercalcemia. Patients with hypercalcemia are usually in the advanced stage with obvious bulky tumor and carry a poor prognosis. Materials and Methods: Total 29 patients satisfied the following criteria: histologically proven primary lung cancer, corrected calcium level ${\geq}$ 10.5 mg/dL, and symptoms which could possibly be attributed to hypercalcemia. In this retrospective study, we evaluated the various clinical aspects of hypercalcemia, in relation to cancer stage, histologic cell type, mass size, bone metastasis, performance status, and other possible characteristics. Results: Total 29 lung cancer patients with hypercalcemia were studied, and most of them had squamous cell carcinoma in their histologic finding. The incidence of hypercalcemia was significantly higher between 50 and 69 years of age, and in the advancement of cancer stage. Although serum calcium level showed positive correlation with mass size, performance status, and bone metastasis, it was not significant statistically. Altered consciousness was significantly more frequent in the patients with higher serum calcium level. There were no differences in effectiveness among therapeutic regimens. Hypercalcemia was more frequently in the later stage of disease than during the initial diagnosis of lung cancer. Most of the patients died within 1 month after development of hypercalcemia. Conclusion: We concluded that hypercalcemia in lung cancer is related to extremely poor prognosis, and may be one of the causes of death and should be treated aggressively to prevent sudden deterioration or death.

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First Report of Soybean Dwarf Virus on Soybean(Glycine max) in Korea (콩(Glycine max)에서 콩위축바이러스(Soybean dwarf virus)의 최초 발생보고)

  • Kim, Sang-Mok;Lee, Jae-Bong;Lee, Yeong-Hoon;Choi, Se-Hoon;Choi, Hong-Soo;Park, Jin-Woo;Lee, Jun-Seong;Lee, Gwan-Seok;Moon, Jung-Kyung;Moon, Jae-Sun;Lee, Key-Woon;Lee, Su-Heon
    • Research in Plant Disease
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    • v.12 no.3
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    • pp.213-220
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    • 2006
  • In year 2003, a soybean(Glycine max) sample showing severe dwarfing symptom was collected from a farmers' field in Cheongsong in Korea. The results from the diagnosis of the sample by RT-PCR revealed that it was infected by Soybean dwarf virus(SbDV), SbDV-L81. This study could be the first report of the occurrence of the virus in Korea. To further characterize the virus, the partial nucleotide sequence of the genomic RNA of SbDV-L81 was determined by RT-PCR using species-specific primers. The sequences were analyzed and subsequently compared to previously characterized strains of SbDV based on the pattern of symptom expression and vector specificities. The intergenic region between ORF 2 and 3 and the coding regions of ORF 2, 3 and 4 were relatively similar to those of dwarfing strains(SbDV-DS and DP) rather than those of yellowing strains(SbDV-YS and YP). Likewise, the result from the analysis of 5'-half of the coding region of ORF5 indicated that SbDV-L81 was closely related to strains(SbDV-YP and DP) transmitted by Acyrthosiphon pisum. These data from the natural symptom and the comparisons of five regions of nucleotide sequences of SbDV suggested that SbDV-L81 might be closely related SbDV-DP.

Effects on Growth and Yield of Korean Malting Barley Cultivars by Soil-borne Bymovirus Infection (맥류의 토양 전염성 Bymovirus의 감염이 국내 육성 맥주보리의 생육 및 수량에 미치는 영향)

  • Park, Jong-Chul;Kim, Mi-Jung;Lee, Eun-Sook;Park, Chul-Soo;Kang, Chun-Sik;Hyun, Jong-Nae;Lee, Jung-Joon;Kim, Tae-Soo;Kim, Ki-Jong
    • Research in Plant Disease
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    • v.16 no.1
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    • pp.21-26
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    • 2010
  • Viral diseases, especially Barley yellow mosaic virus (BaYMV) and Barley mild mosaic virus (BaMMV) have been most serious in barley fields. In this study, we investigated the effect of different level of resistance to viral diseases on the plant growth and yield in malting barley. In diagnosis of virus infection, BaYMV and BaMMV were detected in 'Doosan 29' (susceptible), however, 'Jinyangbori' (moderate susceptible) and 'Hopumbori' (moderate) was infected by only BaYMV. Plant height was restrained about 8~29% in overwintered plant regeneration stage depending on the resistant of each cultivar. The culm length damaged also to 9~12% by BaYMV infection. The tiller numbers reduced to 10~14% in overwintering season, however, the head numbers in harvest season more decreased to 26~33%. Heading date was delayed to 3~3 days by the infection. In examination of yield components, 1,000 kernel weight and $\ell$ weight reduced according to culrivar's resistant degrees to 4.0~6.4% and 1.0~4.2%, respectively. The yield of abortive grain was doubled in BaYMV infection comparing to non-infested field. Three varieties tested in the non-infected field over two years were not significantly different for yield potential with ranges of 509kg~632kg/10a. However, significant yield reduction was observed in 'Saessalbori' and 'Baegdong' with ranges of 77~177kg/10a as compared to 'Hopumbori' (467 kg/10a) when tested in the virus-infected field. Yield potentials of these cultivars reduced by 26~43%, respectively, in the virus-infected field as compared to those in the non-infected field.

Orbital and Periorbital Cellulitis in Children: A Recent 7-Year Clinical Review (소아에서 안와와 안와주위 봉와직염에 관한 최근 7년간의 임상적 고찰)

  • Choi, Jeong Ho;Hon, Sun Yeong;Park, Sung Sin;Cha, Sung Ho;Kim, Eun Jin;Lee, Jin;Chang, Jin Keun
    • Pediatric Infection and Vaccine
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    • v.15 no.1
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    • pp.36-44
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    • 2008
  • Purpose : Orbital cellulitis is rare, but it could be from the serious complication of sinusitis in children. It is often difficult to distinguish periorbital cellulitis from orbital cellulitis. The purpose of this study is to describe the clinical features of orbital and periorbital cellulitis in a pediatric population and to assess the predisposing factors and their complications. Methods : Forty-one patients aged 18 years and younger who were admitted between January 2000 and December 2006 to Hanil General Hospital and Kyunghee University Hospital with orbital or periorbital cellulitis. The retrospective analyses included clinical characteristics of orbital and periorbital cellulitis, dermographics, past history, predisposing factors, clinical presentations, treatments, and complications. Results : Among 41 patients, 34 patients had periorbital cellulitis, 7 patients had orbital cellulitis. While paranasal sinus disease was the most common predisposing cause in orbital cases, skin lesion, insect bite, dacrocystitis and conjunctivitis were the common causes in periorbital cases. In comparison with periorbital cases, orbital cases had higher level of white blood cell count, erythrocyte sedimentation rate, and C-reactive protein. Blood cultures were taken in 23 patients, but only one had Staphylococcus aureus from blood. Only one case had surgical incision and drainage and recovered without complications. Conclusion : From the results of our data, when patient shows erythematous swelling of periorbital area with opthalmoplegia, chemosis and proptosis, orbital CT scan is required to make diagnosis of orbital cellulitis. Most cases of orbital cellulitis can be treated successfully without surgical intervention. If there is no clinical improvement, repeated CT scan and/or surgical intervention should be considered.

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Changes in the complete blood count and serum biochemical parameters of Sapsaree dogs according to different age groups (삽살개의 연령에 따른 혈구 및 혈청 생화학 수치 변화 양상 연구)

  • Yi, Seung-Won;Kim, Eunju;Oh, Sang-Ik;Ha, Ji-Hong;Lee, Bugeun;Yoo, Jae Gyu;Do, Yoon Jung
    • Korean Journal of Veterinary Service
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    • v.42 no.4
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    • pp.227-236
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    • 2019
  • The complete blood count and serum biochemical parameters are essential tools for diagnosis and monitoring of physiological and disease conditions in dogs. These parameters may be affected by the breed and age of dogs. This study aimed to compare the changes of complete blood count and serum biochemical parameters according to the increasing age in 156 Sapsarees. In this study, the Sapsarees were clustered into ten age groups: four to six months, seven to nine months, ten to twelve months, one year, two years, three to four years, five to six years, seven to eight years, nine to ten years, and, eleven to twelve years old. In the result of the complete blood count, the total red blood cell count (P<0.001), hematocrit (P<0.001), and hemoglobin (P<0.001) values were significantly increased from 4~6 months to 2 years old Sapsarees. While the mean corpuscular volume (P<0.001) and mean corpuscular hemoglobin (P<0.001) values were significantly increased from 4~6 months to 3~4 years old. The mean corpuscular hemoglobin concentration was significantly (P=0.037) increased from 4~6 to 10~12-month-old Sapsarees. Total white cell count was significantly (P<0.001) decreased from 1 year to 9~10 years old. The result of differential white blood cell count showed that neutrophil count was significantly (P<0.001) increased from the age 4~6 months to 11~12 years old Sapsarees, whereas, lymphocyte (P<0.001), monocyte (P<0.001), and eosinophil (P=0.042) counts were significantly decreased from 7~9 months to 7~8 years, 4~6 months to 9~10 years, 3~4 to 5~6 years old, respectively. In the serum biochemistry result, the creatinine concentration was significantly (P<0.001) increased from 4~6 to 10~12 months, but significantly (P=0.006) decreased from 7~8 to 10~12 years old. Phosphate concentration was significantly (P<0.001) decreased from 3~4 to 9~10 years old, but significantly (P=0.021) increased from 9~10 to 11~12 years old. Calcium concentration significantly (P<0.001) decreased from 10~12 months to 11~12 years old. Total protein concentration significantly (P<0.001) increased from 4~6 months to 2 years old. While concentrations of albumin (P=0.004) and globulin (P<0.001) was significantly increased from 4~6 months to 3~4 years old, and from 4~6 months to 11~12 years old, respectively. The alkaline phosphate concentration was significantly (P<0.001) decreased from 4~6 months to 2 years old. We found that there are differences in the hematological parameters in relation with the increasing age in Sapsaree breed.

Surgical Treatment of Primary Lung Cancer (원발성 폐암의 외과적 치료)

  • 김성완;구본원;이응배;전상훈;장봉현;이종태;김규태;강덕식
    • Journal of Chest Surgery
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    • v.31 no.2
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    • pp.134-141
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    • 1998
  • Primary lung cancer has recently increased progressively in its incidence in Korea. It is clearly evident that surgical resection offers the best offortunity for cure of non-small cell carcinoma. This study was designed to analyse the clinical data of 100 primary non-small cell carcinoma patients who underwent lung resection surgery from January 1992 to July 1995 at the department of Thoracic and Cardiovascular Sugery, Kyungpook National University Hospital. There were 86 males and 14 females(6:1). In the age distribution, the peak incidence was recorded in the seventh decade(43%). The methods of tissue diagnosis were bronchoscopic biopsy in 53 patients(50.5%), percutaneous needle aspiration in 17 patients(16.2%), transbronchial lung biopsy in 11 patients(10.5%), mediastinoscopic biopsy in 2 patients (1.9%), sputum cytology in 2 patients(1.9%), and thoracotomy in 20 patients(19.0%). Fifty-five lobectomies, 22 pneumonectomies, 15 bilobectomies, 2 segmentectomies, 4 sleeve lobectomies, a sleeve pneumonectomy, and a wedge pneumonectomy were performed. Operative mortality occured in 4 cases(sepsis in 2 cases, respiratory failure in 1 case, and acute myocardiac infarction in 1 case). The histologic types of tumor were 67 squamous cell carcinomas, 26 adenocarcinomas, 6 large cell carcinomas, and an adenosquamous cell carcinoma. Eighteen patients with N2 mediastinal lymph node metastases had 8 squamous cell carcinomas(11.9%), 9 adenocarcinomas(34.6%), and a large cell carcinoma(16.7%). The primary tumors in these patients were in the right upper lobe in 4 patients, the right middle and lower lobe in 9 patients, the left upper lobe in 3 patients, and the left lower lobe in 2 patients. With regard to pathologic stages, 45 patients had stage I disease; 13 patients, stage II; 36 patients, stage IIIa; 5 patients, stage IIIb; and 1 patient, stage IV. The overall actuarial survival rate was 77.5% at 12 months, 56.1% at 24 months and 43.7% at 43 months. The actuarial survival rates at 43 months were 81.3% in Stage I, 20.8% in Stage II, 27.9% in Stage IIIa, 25.0% in Stage IIIb and 33.3% in Stage IV. These facts suggest that early detection and surgical resection are recommended for favorable postoperative survival in non-small cell lung cancer.

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