• Title/Summary/Keyword: late diagnosis

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Study on the Epidemiological Features of Lyme Disease in Korea between 2011 and 2018 (2011~2018년 라임병의 역학적 특성 연구)

  • Seo, Choong Won
    • Korean Journal of Clinical Laboratory Science
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    • v.51 no.4
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    • pp.436-443
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    • 2019
  • Lyme disease is a national notifiable infectious disease as of September 2018. The number of cases of Lyme disease has recently been increasing. This study analyzed the epidemiological features and clinical symptoms of domestic and imported. From 2011 to December 31, 2018, of the 119 cases, 48 confirmed cases, 63 probable cases, and 8 suspected cases. 70 cases (58.8%) were reported in Korea and 49 cases (41.2%) of imported. In addition, 91 cases (76.5%) were reported during the summer~autumn season (June~November). In 2017, the highest number of 31 cases. The time needed to make a diagnosis was 2.8±14.7 days for domestic occurrences versus 1.4±4.5 days for those cases that infection occurred imported. Among the clinical symptoms, fever and rash were statistically significant (P<0.001). Clinical trials included early localized 31 cases (52.1%), early disseminated 43 cases (35.3%), and late disseminated 15 cases (12.6%). The estimated regions of infection in Korea were Chungnam 12 cases (17.1%), Gyeonggi 12 cases (17.1%), and Gangwon 8 cases (11.4%), Patient care is also considered to be very important as this disease occurs of all ages. Therefore, the promotion of preventive education and identification of epidemiological features are of paramount importance and should be implemented. The study's findings can be used as basic data for the prevention and management of patients with lyme disease.

A Study on the summer mortality of Korean rockfish Sebastes schlegeli in Korea (하절기 조피볼락, Sebastes schlegeli의 대량폐사에 관한 고찰)

  • Choi, Hye-Sung;Myoung, Jeong-In;Park, Myoung-Ae;Cho, Mi-Young
    • Journal of fish pathology
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    • v.22 no.2
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    • pp.155-162
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    • 2009
  • The mass mortality of Korean rockfish, Sebastes schlegeli that occured at the fish farms in Tongyeong and Geoje City regions between late August and early September in 2006 was investigated. Sixty two fish showed no significant external symptoms except ulcerative lesions with reddish foci on the skin. From the internal observations and diagnosis results, some yellowish brown liver, intestine bleeding, atrophy and congestion in the abdominal cavity of the fish were found. In the gill, swelled filaments caused by foreign material accumulation and mucus secretion were observed. However, the main cause of the fish mass mortality in both sampling regions could be due to physiological weakness induced by significant change of water temperature causing by typhoon Wookong during the summer in 2006.

Diagnostic Efficiency of Lactate Dehydrogenase, Creatine Kinase and Troponin T in Acute Myocardial Infarction (심근 손상에 있어서 Lactate Dehydrogenase, Creatine Kimase 및 Troponin T 진단적 유용성 비교)

  • Lee, Chae-Hoon;Kim, Kyung-Dong;Kim, Chung-Sook
    • Journal of Yeungnam Medical Science
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    • v.12 no.1
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    • pp.48-55
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    • 1995
  • The present study was designed to evaluate the efficiency of total lactate dehydrogenase, total creatine kinase, LD1/LD2 ratio, CK-MB and newly developed troponin T in acute myocardial infarction. The level of troponin T was $0.01{\pm}0.02{\mu}g/L$ in 34 healthy person, but the peak vaule of acute myocardial infarction ranged in 4.7-24.2 ${\mu}g/L$. Total lactate dehydrogenase was peaked in 1 to 3 days after chest pain and then progressively decreased, but LD1/LD2 ratio was persistently higher than 1.0 for 10 days in most patients. Total creatine kinase and CK-MB were peaked in 1-2 days, and normalized in 3-4 days, so they were useful in early diagnosis of acute myocardial infarction, but not for the late stages of acute myocardial infarction. Troponin T is early elevated and persistently high level for more than 10 days. Comparing with total lactate dehydrogenase, total creatine kinase, LD1/LD2 ratio and CK-MB, troponin-T test improves the efficiency of serodiagnostic method for the detection of ischemic myocardial damage.

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A Literature Review on the Evidence that Hemorrhoids Were Included in the Efficacy of LU6 (공최(LU6)를 활용한 치질치료의 근거에 대한 문헌고찰)

  • Cho, Eunbyul;Kim, Cheoung Su;Nam, Yeonkyeong;Sang O;Yang, Seung Bum;Kim, Jae-Hyo
    • Korean Journal of Acupuncture
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    • v.38 no.4
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    • pp.235-249
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    • 2021
  • Objectives : Acupoint LU6 (Gongchoe) is known as an acupoint for the treatment of pain and bleeding caused by hemorrhoids. The purpose of this study was to critically review acupoint LU6 for treating hemorrhoids. Methods : We searched both ancient and modern literature of acupuncture and moxibustion using keywords "Gongchoe" and "hemorrhoids". We further performed an online ancient literature search for crosscheck. The searched literature was stratified by country (Korea, China, and Japan), and data were organized chronologically. Concerning literature related to hemorrhoids, data based on acupuncture treatment were compiled. Results : The bone proportional measurement of the forearm had been 12.5 cun until the Qing Dynasty but was recorded as 10 cun in "Shinkyushinzui," and the majority of modern Japanese and Korean literature indicated it as 10 cun. Gongchoe for treating hemorrhoids has been reported in the literature, including "Shinkyushinzui" (Japan, 1941), "Shiyoungzongguozhenjiujingxuexue" (Taiwan, 1963), "Gyeonghyeolhak" (Korea, 1971), and "Jinzhenmeihuashichao" (China, late Qing dynasty), but except "Jinzhenmeihuashichao", the location is different from the World Health Organization (WHO) standard acupoint location as it is 7 cun from the wrist out of 10 cun of the forearm bone proportional measurement. In addition, classical guides published until the Qing Dynasty did not report acupoint LU6 for the treatment of hemorrhoids. Conclusions : It is necessary to distinguish between Gongchoe in "Shinkyushinzui" and LU6 in WHO standard acupuncture point locations. Gongchoe (LU6)'s primary treatment for hemorrhoids has not been described in the classical literature, and further clinical evidence is needed to support it. When using Gongchoe for hemorrhoids, we should consider that the location of Gongchoe is closer to the LU5 than the standard acupuncture point locations and it is meaningful not only for treatment but also for diagnosis.

Profile and Outcome of Management of Brain Tumours in Kaduna Northwestern Nigeria

  • Danjuma, Sale;Dauda, Happy Amos;Kene, Aghadi Ifeanyi;Akau, Kache Stephen;Jinjiri, Ismail Nasiru
    • Journal of Korean Neurosurgical Society
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    • v.65 no.5
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    • pp.751-757
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    • 2022
  • Objective : Tumours of the brain are a rare occurrence accounting for approximately 2% of all neoplasms in adults. Few studies have been done in Nigeria on the profile of brain tumours. The aim of this study is to determine the profile of brain tumours in general and determine the change in Kanofsky Performance Score (KPS) after treatment. Methods : This is a prospective hospital-based study in Kaduna. All consecutive patients over 18 years of age with diagnosis of brain tumours from January 2016 to December 2019 were included in the study. Demographic and clinical data was collected using a proforma during the study. Patients who received treatment were followed up for 12 months. The primary outcome data was the difference in the quality of life as measured by KPS at the point of first contact and at 1-month after treatment and at 12-month follow up. Data obtained was analysed with SPSS version 25.0 for Windows. Descriptive statistics was done to determine the profile. Paired t-test at 95% confidence interval was done to check for significant correlation between the mean KPS. Results : A total of 39 consecutive patients were included in the study. There was a slight male preponderance with a M : F of 1.17 : 1. Meningioma and metastasis were more common in females while gliomas and pituitary tumours were more common in males. The mean age of patients was 49.8 years and standard deviation of 11.8 years. Pituitary tumours were the most common tumours. The most common location of the tumour was frontal lobe followed by the pituitary gland. The mean duration of symptoms before neurosurgical consultation was 38 weeks. The most common presenting symptoms of patient with brain tumour was headache. The quality of life improve compare to the baseline in 81% of patient at discharge and at 1 year follow up. The overall mortality rate was 25.6%. Conclusion : The most common brain tumour in our study is pituitary tumour. Most patients present late. The most common presenting symptoms is headache. There is significant improvement in the KPS of patients following treatment. The overall mortality rate at 1-year post treatment is 25.6%.

A Case of Propionic Acidemia Presenting with Dilated Cardiomyopathy (확장성 심근병증으로 발현된 프로피온산혈증 1례)

  • Son, Jisoo;Choi, Yoon-Ha;Seo, Go Hun;Kang, Minji;Lee, Beom Hee
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.21 no.1
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    • pp.22-27
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    • 2021
  • Propionic acidemia (PA) is an inherited autosomal recessive disorder, due to the deficiency of propionyl-CoA carboxylase (PCC). PCC is the enzyme which catalyzes the conversion of propionyl-CoA to D-methylmalonyl-CoA, and it is critical for the metabolism of amino acids, odd-chain fatty acids, and side chains of cholesterol. The clinical manifestations present mostly at the neonatal period with life-threatening metabolic acidosis and hyperammonemia. Here, we described a case of a 16-year-old Korean boy with late-onset PA who presented with embolic cerebral infarction due to dilated cardiomyopathy (DCMP) with left ventricular noncompaction. And he has family history of sudden cardiac death, so we performed metabolic screening and genetic tests. Elevated levels of 3-hydroxypropionic acid, methylcitric acid and propionylglycerine were detected in urine. Plasma acylcarnitine profile showed elevated propionylcarnitine (C3). Diagnosis of PA was confirmed by genetic analysis, which revealed compound heterozygous mutations, c.[1151T>G] (p.[Phe384Cys]) and c.[1228C>T] (p.[Arg410Trp]) in PCCB gene. His heart function is in improving state and the results of biochemical analysis are stable with heart failure medication and metabolic managements. We present a case of patient without episodes of metabolic decompensation who manifests DCMP as the first symptom of PA.

Implementation of an Automated Agricultural Frost Observation System (AAFOS) (농업서리 자동관측 시스템(AAFOS)의 구현)

  • Kyu Rang Kim;Eunsu Jo;Myeong Su Ko;Jung Hyuk Kang;Yunjae Hwang;Yong Hee Lee
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.26 no.1
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    • pp.63-74
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    • 2024
  • In agriculture, frost can be devastating, which is why observation and forecasting are so important. According to a recent report analyzing frost observation data from the Korea Meteorological Administration, despite global warming due to climate change, the late frost date in spring has not been accelerated, and the frequency of frost has not decreased. Therefore, it is important to automate and continuously operate frost observation in risk areas to prevent agricultural frost damage. In the existing frost observation using leaf wetness sensors, there is a problem that the reference voltage value fluctuates over a long period of time due to contamination of the observation sensor or changes in the humidity of the surrounding environment. In this study, a datalogger program was implemented to automatically solve these problems. The established frost observation system can stably and automatically accumulate time-resolved observation data over a long period of time. This data can be utilized in the future for the development of frost diagnosis models using machine learning methods and the production of frost occurrence prediction information for surrounding areas.

Solitary, Endobronchial Metastasis from Renal Cell Carcinoma 20 Years after Nephrectomy (신절제술 20년 후에 발생한 신세포암종의 단발성 기관지 내 전이)

  • Min Ju Kim;Jung Im Kim;Kyu Yeoun Won;Han Na Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.994-999
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    • 2021
  • Late recurrence over 10 years after surgery and endobronchial metastasis are some of the specific biological behaviors of renal cell carcinoma (RCC). The current report describes a case of solitary endobronchial metastasis at a subsegmental bronchus that developed 20 years after curative nephrectomy for RCC. A 71-year-old male was admitted to our hospital for pneumonia. Chest radiography showed multifocal ill-defined nodular opacities in the right lower lung zone, suggesting pneumonia. Subsequent chest CT confirmed pneumonic infiltration in the right lung. However, a 4.3-cm, well-defined, elongated mass with a branching pattern was also identified in the right lower lobe, and a right nephrectomy scar was detected on the covered upper abdomen. The patient had undergone right nephrectomy 20 years ago due to clear cell RCC. After right lower lobectomy, the postoperative pathological diagnosis was endobronchial metastatic clear cell RCC. Endobronchial metastasis should be considered in a patient with a history of RCC who presents with a suspected endobronchial tumor, even decades after curative surgery.

SonazoidTM versus SonoVue® for Diagnosing Hepatocellular Carcinoma Using Contrast-Enhanced Ultrasound in At-Risk Individuals: A Prospective, Single-Center, Intraindividual, Noninferiority Study

  • Hyo-Jin Kang;Jeong Min Lee;Jeong Hee Yoon;Jeongin Yoo;Yunhee Choi;Ijin Joo;Joon Koo Han
    • Korean Journal of Radiology
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    • v.23 no.11
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    • pp.1067-1077
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    • 2022
  • Objective: To determine whether Sonazoid-enhanced ultrasound (SZUS) was noninferior to SonoVue-enhanced ultrasound (SVUS) in diagnosing hepatocellular carcinoma (HCC) using the same diagnostic criteria. Materials and Methods: This prospective, single-center, noninferiority study (NCT04847726) enrolled 105 at-risk participants (71 male; mean age ± standard deviation, 63 ± 11 years; range, 26-86 years) with treatment-naïve solid hepatic nodules (≥ 1 cm). All participants underwent same-day SZUS (experimental method) and SVUS (control method) for one representative nodule per participant. Images were interpreted by three readers (the operator and two independent readers). All malignancies were diagnosed histopathologically, while the benignity of other lesions was confirmed by follow-up stability or pathology. The primary endpoint was per-lesion diagnostic accuracy for HCC pooled across three readers using the conventional contrast-enhanced ultrasound diagnostic criteria, including arterial phase hyperenhancement followed by mild (assessed within 2 minutes after contrast injection) and late (≥ 60 seconds with a delay of 5 minutes) washout. The noninferiority delta was -10%p. Furthermore, different time delays were compared as washout criteria in SZUS, including delays of 2, 5, and > 10 minutes. Results: A total of 105 lesions (HCCs [n = 61], non-HCC malignancies [n = 19], and benign [n = 25]) were evaluated. Using the 5-minutes washout criterion, per-lesion accuracy of SZUS pooled across the three readers (72.4%; 95% confidence interval [CI], 64.1%-79.3%) was noninferior to that of SVUS (71.4%; 95% CI, 63.1%-78.6%), meeting the statistical criterion for non-inferiority (difference of 0.95%p; 95% CI, -3.8%p-5.7%p). The arterial phase hyperenhancement combined with the 5-minutes washout criterion showed the same sensitivity as that of the > 10-minutes criterion (59.0% vs. 59.0%, p = 0.989), and the specificities were not significantly different (90.9% vs. 86.4%, p = 0.072). Conclusion: SZUS was noninferior to SVUS for diagnosing HCC in at-risk patients using the same diagnostic criteria. No significant improvement in HCC diagnosis was observed by extending the washout time delay from 5 to 10 minutes.

Utility of H-reflex in the Diagnosis of Cervical Radiculopathy (경수 신경근병증 진단에서의 H-reflex의 유용성)

  • Lee, Jun;Park, Gun-Ju;Doo, Hyun-Cheol;Park, Sung-Geon;Jeong, Yun-Seog;Hah, Jung-Sang
    • Journal of Yeungnam Medical Science
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    • v.14 no.1
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    • pp.111-122
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    • 1997
  • H-reflex is a kind of late respons which can be used for the proximal nerve conduction study. Also it is a useful and widely used nerve conduction technique es to look electrically at the monosynaptic reflex. Although recordable from all muscles theoretically, H-reflexes are most commonly recorded from the calf muscles following stimulation of the tibial nerve in the popliteal fossa. But in this study, We tried to establish the normal data and to evaluate the significance of the H-reflex study in cervical radiculopathy. H-reflexes were recorded from flexor carpi radialis (FCR) muscle, extensor carpi radialis (ECR) muscle, brachioradialis (BR) muscle, and abductor digiti minimi (ADM) muscle in 31 normal adults (62 cases) and 12 patients with cervical radiculopathy. The mean values of H-reflex latency in normal control group were $16.16{\pm}1.65$ msec in FCR; $15.99{\pm}1.25$ msec in ECR; $16.47{\pm}1.59$ msec in BR; $24.46{\pm}1.42$ msec in ADM. And the mean values of side to side difference of H-reflex latency were $0.47{\pm}0.48$ msec in FCR; $0.68{\pm}0.72$ msec in ECR; $0.63{\pm}0.43$ msec in BR; $22.31{\pm}1.24$ msec in ADM. Mean values of side to side differences of interlatency time were $0.49{\pm}0.47$ msec in FCR; $0.73{\pm}0.62$ msec in ECR; $0.79{\pm}0.71$ msec in BR; $0.69{\pm}0.44$ msec in ADM. Also, there were no significant differences in H-reflex latency between right and left side. H-reflex tests in patient group with cervical radiculopathy revealed abnormal findings in 11 out of 12 patients. These results suggest that H-reflex in the upper extremity would be helpful in the diagnosis of the cervical radiculopathy.

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