• Title/Summary/Keyword: needle biopsy

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Overlap Syndromes in Polymyositis and Dermatomyositis (다발근육염과 피부근육염에서 관찰된 중첩증후군)

  • Park, Kyung Seok;Kim, Nam-Hee;Hong, Yoon-Ho;Sung, Jung-Joon;Nam, Hyunwoo;Park, Seong-Ho;Lee, Kwang-Woo
    • Annals of Clinical Neurophysiology
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    • v.9 no.1
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    • pp.11-15
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    • 2007
  • Background: The term "overlap syndromes" designates a group of diseases in which polymyositis (PM) or dermatomyositis (DM) is associated with some other disorders of connective tissues. The aim of this study was to delineate the clinical features, laboratory findings, and outcome of treatment of "overlap syndromes" Methods: We analyzed the medical records of 16 patients (PM in 10, DM in 6) with well documented "overlap syndromes" between 1997 and 2004. The diagnosis was made when the criteria for two different disorders were fulfilled. Results: All patients were female. Age of onset ranged from 14 to 52 years (mean 29.8 years) with peak incidence in the third and fourth decades. Systemic lupus erythematosus (SLE) was associated in 10, systemic sclerosis in 7, and rheumatoid arthritis in 3 patients. Four of the patients had two different connective tissue diseases simultaneously. The characteristic clinical features were muscle weakness, arthralgia, Raynaud's phenomenon, and myalgia. In laboratory tests, creatine kinase (CK), lactic dehydrogenase (LDH), and transaminases were usually abnormal. Positive antinuclear antibody (ANA), rheumatoid factor (RF), and cryoglobulin were found in 100%, 69%, and 67% of the patients, respectively. Needle electromyography (EMG) showed abnormal findings compatible with myopathy in 15 patients. The pathology of muscle biopsy from 14 patients revealed findings compatible with inflammatory myopathy. Glucocorticoids were administered to 15 patients. The muscle strength improved in all the treated patients, which was well correlated with repeat CK level and EMG findings. Conclusions: The presence of autoantibodies such as ANA, RF, and cryoglobulin in patients with PM or DM highly suggests the possibility of an overlap syndromes. These syndromes reveal a strong female predominance. The myositis associated with them usually shows a good response to glucocorticoids treatment.

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Dedifferentiated Parosteal Osteosarcoma - A Case Report - (역분화성 방골성 골육종 - 증례 보고 -)

  • Sung, Ki-Sun;Chang, Moon-Jong;Lim, Kyung-Sub
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.195-200
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    • 2007
  • Dedifferentiated parosteal osteosarcoma is an uncommon variant of osteosarcoma. Dedifferentiation is known to be associated with a greater metastatic potential and a more rapid lethal clinical course. Thus recognition of dedifferentiation is important to establish the treatment strategy. But there may be few significant clinical clues to distinguish between dedifferentiated parosteal osteosarcoma and conventional one. A 29-year-old woman presented with 2-year history of discomfort and swelling in her proximal thigh. Examination showed a large, hard, non-mobile mass. Radiographs revealed a large ossified mass attached to the proximal femur. Diagnosis of parosteal osteosarcoma was established by MRI and needle biopsy. But she had a history of abrupt severe thigh pain and increased swelling before surgery. Follow up MRI showed enlargement of mass with invasion to muscle around tumor. The patient underwent an en-bloc resection of tumor and reconstruction. Histological examination showed parosteal sarcoma with dedifferentiation. The patient expired due to local recurrence of tumor and distant lung metastasis 2 months after the surgery. In case with rapid growth of a lesion or unusual severe pain, one must have a high index of suspicion with regard to dedifferentiation.

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Developing data quality management algorithm for Hypertension Patients accompanied with Diabetes Mellitus By Data Mining (데이터 마이닝을 이용한 고혈압환자의 당뇨질환 동반에 관한 데이터 질 관리 알고리즘 개발)

  • Hwang, Kyu-Yeon;Lee, Eun-Sook;Kim, Go-Won;Hong, Sung-Ok;Park, Jong-Son;Kwak, Mi-Sook;Lee, Ye-Jin;Im, Chae-Hyuk;Park, Tae-Hyun;Park, Jong-Ho;Kang, Sung-Hong
    • Journal of Digital Convergence
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    • v.14 no.7
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    • pp.309-319
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    • 2016
  • There is a need to develop a data quality management algorithm in order to improve the quality of health care data. In this study, we developed a data quality control algorithms associated diseases related to diabetes in patients with hypertension. To make a data quality algorithm, we extracted hypertension patients from 2011 and 2012 discharge damage survey data. As the result of developing Data quality management algorithm, significant factors in hypertension patients with diabetes are gender, age, Glomerular disorders in diabetes mellitus, Diabetic retinopathy, Diabetic polyneuropathy, Closed [percutaneous] [needle] biopsy of kidney. Depending on the decision tree results, we defined Outlier which was probability values associated with a patient having diabetes corporal with hypertension or more than 80%, or not more than 20%, and found six groups with extreme values for diabetes accompanying hypertension patients. Thus there is a need to check the actual data contained in the Outlier(extreme value) groups to improve the quality of the data.

Clinical Analysis of the primary Mediastinal Tumors (원발성 종격동 종양의 임상적 고찰)

  • Lee, S.Y.;Kang, W.T.;Song, H.S.;Lee, Y.C.;Rhee, Y.K.;Chang, K.;Jung, E.T.;Yu, J.Y.;Song, H.S.;Kim, K.W.
    • Tuberculosis and Respiratory Diseases
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    • v.38 no.2
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    • pp.128-134
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    • 1991
  • This report is an analysis of 60 cases of primary mediastinal tumors and cysts which were experienced in chonbuk National University Hospital, Wonkwang University Hospital and Chonju Presbyterian Medical Center from january 1985 to October 1990. The result was summarized like this; 1) Age distribution was various from ages of 5 to 75 years. There were 26 males and 34 females, sex ratio of patients was 1: 1.3 (M:F). 2) The most common chief compliant was dyspnea (21 cases, 35%) and followed by chest pain, coughing and chest discomfort. 17 patients (28%) were asymptomatic. 3) The most common primary mediastinal tumor was thymoma, which comprise 28% (17 cases) of all our cases and followed by neruogenic tumor (14 cases, 23%) and germ cell tumor (11 cases, 18%). 4) The incidence of malignancy of all case was 22%; 2 cases were asymptomatic and the most common malignancy was malignant lympoma (5 cases, 38.5%). 5) The anterior mediastinum was the most common tumor location and followed by posterior and middle mediastinum. Anterior mediastinal tumors mainly consisted of thymomas and germ cell tumors and posterioc mediastinal tumors mainly did neurogenic tumors. 6) Of 60 cases, 21 cases were confirmed histopathologically by percutaneous transthoracic needle lung biopsy. 7) Of 60 cases, 40 cases were received radical tumor resection.

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Clinical Behaviors and Treatment Outcome of Papillary Thyroid Microcarcinomas:Tumor Size-Based Therapeutic Concept (미세 유두 갑상선암의 크기에 따른 임상상 및 단기간 치료 결과)

  • Lee, Jan-Dee;Oh, Dong-Kyu;Lim, Seung-Soo;Nam, Kee-Hyun;Chung, Woong-Youn;Soh, Euy-Yong;Park, Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.24 no.1
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    • pp.47-52
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    • 2008
  • Purpose:The incidence of papillary thyroid microcarcinoma(PTMC) has increased due to the widespread use of high resolution ultrasonography and fine-needle aspiration biopsy. However, the clinical and biologic behaviors of PTMC is debatable. The aim of this study was to describe clinicopathologic features of PTMC and to suggest whether tumor size(5mm) might prove the useful parameter for determining the surgical strategy in PTMC. Material and Methods:From Jan. 2000 to Dec. 2005, 1355 of 2678 patients with papillary thyroid carcinoma were identified as having PTMC, based on tumor size${\leq}$10mm(50.6%). Among patients with PTMC, we further separated tumors<5mm(minute group:group M) from those 5 to 10mm(tiny group:group T). We compared the clinicopathological characteristics and the TNM stagings between two groups. Results:There were 114(8.4%) men and 1241(91.6%) women with a median age of 47 years(range;13-79). During a mean follow-up of 47.3(range;22-93), 13 patients(1.0%) developed locoregional recurrences and 3 patients(0.2%) showed distant metastases at initial presentation. Statistical analysis revealed that the presence of extracapsular invasion(p<0.0001), invasion to adjacent structure(p<0.0001), multifocality(p<0.0001), central lymph node metastasis(p<0.0001), and lateral lymph node metastasis(p<0.0001) were all significantly higher in tiny group(tumor${\geq}$5mm). Furthermore, minute group demonstrated a significantly lower tumor stage(AJCC TNM classification) compared with tiny group(p<0.0001). Conclusion:Patients with PTMC have a favorable treatment outcomes, although the distinction needs to be made with reference to the clinicopathologic behaviors. It would be reasonable to consider that tumor size(5mm) would be useful parameter for the treatment strategy of PTMC.

Does epithelioid angiomyolipoma have poorer prognosis, compared with classic angiomyolipoma?

  • Lee, Wonchul;Choi, Se Young;Lee, Chanwoo;Yoo, Sangjun;You, Dalsan;Jeong, In Gab;Song, Cheryn;Kim, Kun Suk;Hong, Bumsik;Hong, Jun Hyuk;Ahn, Hanjong;Kim, Choung-Soo
    • Investigative and Clinical Urology
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    • v.59 no.6
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    • pp.357-362
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    • 2018
  • Purpose: Classic angiomyolipoma (AML) is common benign kidney tumor. However, some studies have claimed that epithelioid angiomyolipoma (EAML) has malignant potential. We compared the patient characteristics and prognosis of EAML and classic AML to demonstrate predicting factors and poorer prognosis of EAML. Materials and Methods: The medical records of 231 patients who were diagnosed with EAML (n=27, 11.7%) or classic AML (n=204, 88.3%), were reviewed. All patients underwent computed tomography (CT) scans before operation or needle biopsy. We assessed the age, sex, tumor size, body mass index, comorbidities, and Hounsfield unit (HU) according to each CT phase. We defined the unfavorable group as patients with recurrence, metastasis and death due to tumor progression. Logistic regression analysis was used to predict EAML. Results: EAML patients were younger (41.2 years vs. 49.1 years, p=0.001), predominantly male (55.6% vs. 28.4%, p=0.005), and had a larger tumor (7.5 cm vs. 4.2 cm, p<0.001). The median pre-contrast HU was not significantly different between EAML and classic AML ($29.9{\pm}23.7$ vs. $14.7{\pm}41.0$, p=0.071). In multivariable analysis, younger age (odds ratio [OR], 0.96; p=0.032), male sex (OR, 3.33; p=0.013), and tumor larger than 4 cm (OR, 3.8; p=0.009) were significant predictive factors. Five patients (18.5%) had unfavorable outcomes, two patients had lymph node metastasis, and three patients had lung metastasis. Conclusions: Patient and tumor characteristics can be helpful in determining the type of AML preoperatively. Younger age, male sex, and larger tumor mass may increase the possibility of diagnosing EAML. EAML has malignant potential and requires careful follow-up.

Changes in expression of the autophagy-related genes microtubule-associated protein 1 light chain 3β and autophagy related 7 in skeletal muscle of fattening Japanese Black cattle: a pilot study

  • Nakanishi, Tomonori;Tokunaga, Tadaaki;Ishida, Takafumi;Kobayashi, Ikuo;Katahama, Yuta;Yano, Azusa;Erickson, Laurie;Kawahara, Satoshi
    • Asian-Australasian Journal of Animal Sciences
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    • v.32 no.4
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    • pp.592-598
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    • 2019
  • Objective: Autophagy is a bulk degradation system for intracellular proteins which contributes to skeletal muscle homeostasis, according to previous studies in humans and rodents. However, there is a lack of information on the physiological role of autophagy in the skeletal muscle of meat animals. This study was planned as a pilot study to investigate changes in expression of two major autophagy-related genes, microtubule-associated protein 1 light chain $3{\beta}$ (MAP1LC3B) and autophagy related 7 (ATG7) in fattening beef cattle, and to compare them with skeletal muscle growth. Methods: Six castrated Japanese Black cattle (initial body weight: $503{\pm}20kg$) were enrolled in this study and fattened for 7 months. Three skeletal muscles, M. longissimus, M. gluteus medius, and M. semimembranosus, were collected by needle biopsy three times during the observation period, and mRNA levels of MAP1LC3B and ATG7 were determined by quantitative reverse-transcription polymerase chain reaction. The expression levels of genes associated with the ubiquitin-proteasome system, another proteolytic mechanism, were also analyzed for comparison with autophagy-related genes. In addition, ultrasonic scanning was repeatedly performed to measure M. longissimus area as an index of muscle growth. Results: Our results showed that both MAP1LC3B and ATG7 expression increased over the observation period in all three skeletal muscles. Interestingly, the increase in expression of these two genes in M. longissimus was highly correlated with ultrasonic M. longissimus area and body weight. On the other hand, the expression of genes associated with the ubiquitin-proteasome system was unchanged during the same period. Conclusion: These findings suggest that autophagy plays an important role in the growth of skeletal muscle of fattening beef cattle and imply that autophagic activity affects meat productivity.

A Case of Granular Cell Tumor of the Breast in a Male Patient (남성유방에서 과립세포종양의 증례 보고)

  • Lee, Gyoung-Eun;Kim, Ji-Young;Kim, Jae Hyung;Jeong, Myeong Ja;Kim, Soung Hee;Kim, Soo Hyun;Kang, Mi-Jin;Lee, Ji Hae;Bae, Kyung-Eun;Kim, Tae Gyu
    • Journal of the Korean Society of Radiology
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    • v.79 no.5
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    • pp.259-263
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    • 2018
  • A 52-year-old male complained of a painless, firm, and slow-growing mass in his right breast outer portion. The chest CT revealed a 3.3 cm-sized oval shaped, microlobulated, mild enhancing mass. Ultrasound showed a microlobulated marginated heterogeneous hypoechoic mass with internal vascularity and calcifications in the mass. On the ultrasound-guided core needle biopsy, the mass was confirmed as a benign granular cell tumor (GCT). The patient transferred to another hospital and underwent surgical removal of the lesion. GCT of the breast is uncommon and mostly benign neoplasm to originate from Schwann cell. Clinical and radiologic features of GCTs, including CT and ultrasound images, mimic malignancy and make diagnosis of GCT more difficult. The CT images of GCTs are much rarely reported. Physicians and radiologists must be aware of radiologic characteristics of this rare benign tumor for male breast, to avoid misdiagnosis this tumor for breast malignancy and overtreat.

A Comparison of Conventional Cytology and ThinPrep Cytology of Bronchial Washing Fluid in the Diagnosis of Lung Cancer (폐암의 진단 검사 중 기관지 세척액에서 ThinPrep검사법과 기존의 세포검사법의 유용성에 대한 비교)

  • Kim, Sang-Hoon;Kim, Eun Kyung;Shi, Kyeh-Dong;Kim, Jung-Hyun;Kim, Kyung Soo;Yoo, Jeong-Hwan;Kim, Joo-Young;Kim, Gwang-Il;Ahn, Hee-Jung;Lee, Ji-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.6
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    • pp.523-530
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    • 2007
  • Background: A ThinPrep$^{(R)}$ Processor was developed to overcome the limitations of conventional cytology and is widely used to diagnose various cancers. This study compared the diagnostic efficacy of conventional cytology for lung cancer with that of the ThinPrep$^{(R)}$ cytology using the bronchial washing fluid. Methods: The bronchial washing fluid of 790 patients from Jan. 2002 to Dec. 2006, who were suspected of gaving a lung malignancy, was evaluated. Both ThinPrep$^{(R)}$ and conventional cytology were performed for all specimens. Result: Four hundred forty-six men and 344 women were enrolled in this study, and 197 of them were diagnosed with cancer from either a bronchoscopic biopsy or a percutaneous needle aspiration biopsy. ThinPrep$^{(R)}$ cytology showed a sensitivity, specificity, positive predictive value, negative predictive value and false negative error rate of 71.1%, 98.0%, 92.1%, 91.1%, 8.9%, respectively. The conventional cytology showed sensitivity, specificity, positive predictive value, nagative predictive value and false negative error rate of 57.9%, 98.0%, 90.5%, 87.5%, 12.5%, respectively. For central lesions, the sensitivity of conventional cytology and ThinPrep$^{(R)}$ were 70.1% and 82.8%, respectively. Conclusion: ThinPrep$^{(R)}$ cytology showed a higher sensitivity and lower false negative error rate than conventional cytology. This result was unaffected by the histological classification of lung cancer. Therefore, ThinPrep$^{(R)}$ cytology appears to be a useful method for increasing the detection rate of lung cancer in bronchial washing cytology test.

Radiotherapy of Neck Node Metastases from an Unknown Primary Cancer (원발병소 불명암의 경부림프절 전이에서 방사선치료의 역할)

  • Lee, Jeong-Eun
    • Radiation Oncology Journal
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    • v.25 no.4
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    • pp.219-226
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    • 2007
  • Purpose: The aim of this retrospective analysis was to analyze the results of radiotherapy administered to patients with neck node metastases from an unknown primary cancer, with or without neck dissection. Materials and Methods: From January 1986 to December 2005, 88 patients with neck node metastases from an unknown primary cancer were treated with curative intent. The age of the patients ranged from 35 to 74 years (median age, 59 years). There were 74 male and 14 female patients. Distribution of patients by N status was as follows: N1, 4 patients; N2a, 10 patients; N2b, 48 patients; N2c, 8 patients; N3, 18 patients. Fifty-one patients underwent neck dissection and 37 patients had only a biopsy (31 patients had fine-needle aspiration and 6 patients had an excisional biopsy). All patients received radiotherapy. The follow-up time ranged from 1 to 154 months, with a median time of 32 months. Results: The overall survival (OS) and disease-free survival (DFS) rate at 5 years were 43.9% and 41.7%, respectively. The factors associated with the OS rate were neck dissection, and a subsequent primary tumor. Factors associated with the DFS rate were N stage, neck dissection, and a subsequent primary tumor. Neck failure was noted in 15 patients, distant metastases in 18 patients, and a subsequent primary tumor in 8 patients. Conclusion: With comprehensive radiotherapy given to the bilateral neck and the potential mucosal sites, good survival rates can be obtained in patients with neck node metastases from an unknown primary cancer. However, considering the side effects, a randomized trial is required to determine the optimal radiotherapy volume.