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Autoimmune encephalitis and epilepsy: evolving definition and clinical spectrum

  • Seo, Joo Hee;Lee, Yun-Jin;Lee, Ki Hyeong;Gireesh, Elakkat;Skinner, Holly;Westerveld, Michael
    • Clinical and Experimental Pediatrics
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    • v.63 no.8
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    • pp.291-300
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    • 2020
  • Advances in autoimmune encephalitis studies in the past 10 years have led to the identification of new syndromes and biomarkers that have transformed the diagnostic approach to the disorder. The disorder or syndrome has been linked to a wide variety of pathologic processes associated with the neuron-specific autoantibodies targeting intracellular and plasma membrane antigens. However, current criteria for autoimmune encephalitis are quite dependent on antibody testing and responses to immunotherapy, which might delay the diagnosis. This form of encephalitis can involve the multifaceted presentation of seizures and unexpected behavioral changes. The spectrum of neuropsychiatric symptoms in children is less definitive than that in adults, and the incorporation of clinical, immunological, electrophysiological, and neuroradiological results is critical to the diagnostic approach. In this review, we document the clinical and immunologic characteristics of autoimmune encephalitis known to date, with the goal of helping clinicians in differential diagnosis and to provide prompt and effective treatment.

Clinical Information Interchange System using HL7-CDA

  • Jung, Yong Gyu;Lee, Young Ho
    • International journal of advanced smart convergence
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    • v.1 no.2
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    • pp.47-51
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    • 2012
  • In highly developed society, information and communication technologies are widely used for better medical services. These information and communication technologies should be more and more acceptable in all hospitals for exchange medical records. EMR becomes more convenient than the previously used paper charts. It will be able to record medical institutions every time and dual treatment. Each is different specifications for each medical institution to use the program or document to exchange it. The personal clinic records still does not exchange well. To solve this gap between medical alienation, this paper describes the concepts of HL7-CDA and proposes types of telemedicine system. To resolve time and space constraints, new form of treatment methods presents in future directions after described about related systems. CDA enables electronic medical records to the each medical center and gradually expanded by exchanging the patient's medical records. This paper is using XML-based CDA documents as a hierarchical for medical information exchange standards compliant HL7-CDA documents. It could be possible currently used structural variety of multimedia data. Thus It is able to send and receive HL7-CDA-based medical information and clinical information to identify the medical institutions of medical information with interchange system design and building standards, and through mutual exchange of clinical information.

Comparison of Clinical Characteristics and Severity of Glyphosate and Glufosinate Herbicide Poisoning Patients (Glyphosate와 Glufosinate 제초제 중독 환자의 임상양상과 중증도 비교)

  • Joo, Hyung Sun;Yoo, Tae Ho;Cho, Soo Hyung
    • Journal of The Korean Society of Clinical Toxicology
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    • v.16 no.2
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    • pp.124-130
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    • 2018
  • Purpose: The number of glyphosate and glufosinate intoxication cases are increasing in Korea. This study was undertaken is to compare the clinical manifestations of poisoning by these two herbicides and to document severities and clinical outcomes. Methods: We retrospectively evaluated cases of glyphosate or glufosinate intoxication among patients that visited our emergency department between January 1, 2013, and December 31, 2017. Incidences of intoxications were analyzed over this five year period, and underlying diseases, transportation, mental state, shock occurrence, inotropics, gastric lavage, charcoal administration, intubation and ventilator therapy, and hemodialysis were investigated. In addition, we included transfer to the intensive care unit, incidences of pneumonia and of other complications, death, and hopeless discharge. Results: There were 119 cases of glyphosate intoxication and 42 of glufosinate intoxication. Levels of consciousness were lower for glufosinate and vasopressor usage was higher due to a high shock rate (p=0.019). In addition, many patients were referred to the ICU for intubation and ventilation. The incidences of pneumonia and of other complications were significantly higher for glufosinate. Conclusion: Overall glufosinate intoxication was found to be more severe than glyphosate intoxication as determined by complication and ICU admission rates.

A Design of Clinical Information Exchange Framework for Performance Improvement based on Lazy Response Model (지연 응답 모델에 기반한 성능 개선 진료정보 교류 프레임워크의 설계)

  • Lee, Se-Hoon;Shim, Woo-Ho
    • Journal of the Korea Society of Computer and Information
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    • v.17 no.9
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    • pp.157-164
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    • 2012
  • Recently medical service environment, the clinical information exchange which contribute to medical safety, promotion of service quality and patient's convenience, efficiency of medical procedures and medical management is essential medical service model. But, practical exchange of clinical information which variation of information level, absence of standardization system, build of heterogeneous information systems is difficult in each medical institute. In this paper, We analyzed the related technical standardizations and the models of clinical information exchange. So, we designed the clinical information exchange system based on the ideal lazy response model which is aimed at vitalizations the exchange of clinical information under domestic law environment. In case of exchange the clinical information, we separate CDA document flow from metadata flow. As a experimental result we acquired 24% improved performance compared with existed system based on the lazy response model.

Using Status of Computer and Internet in University Students (대학생들의 컴퓨터 및 인터넷 이용 실태)

  • Roh, Hyol-yun
    • Journal of Korean Clinical Health Science
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    • v.4 no.2
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    • pp.566-570
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    • 2016
  • Purpose. The purpose of this study was to determine the using state of computers and internet in university students. Method. This research conducts a survey of 50 university students. Researcher personally visited lecture room to explain the purpose of research. The questionnaire was made by the researcher and consists of seven questions. Result. In this study, university students of 74% using computer more than one hour per day. The most of purpose of internet use was internet surfing and writing a document. University students of 42% were play games with internet. Conclusion. The continuous tracking is need of computer and internet use and need to be healthy for the use of guidance of university students.

PHR Profiling System Based on FHIR (FHIR 기반 개인건강기록 프로파일링 시스템 개발방법)

  • Kim, Young Sik;Kim, Il Kon
    • KIPS Transactions on Software and Data Engineering
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    • v.4 no.7
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    • pp.277-282
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    • 2015
  • HL7 released V3 CDA(Clinical Document Architecture) and V2.x message standards for medical information exchange. Currently, these standards are successfully adopted by a number of nations across the globe. However, substantial amount of time is required to develop and implement these standards. Moreover, developers need a lot of time to understand these standards. To solve these issues from 2011, the HL7 standard framework started to discuss Fast Healthcare Interoperability Resources(FHIR) as next generation standard of healthcare information exchange. People's interests toward personal health record and smartphone penetration rate are growing and increasing rapidly. Therefore, our research team believes it is necessary to develop a PHR profiling system which could be accessed by using a smartphone and we developed the system. Through a FHIR Profile editor tool developed in Furore, we found that improvements could be made in generating and changing the profile. In order to build the PHR Profiling system, an Open-API on FHIR is used for exchanging information between electronic medical record system and PHR Profiling system. In the PHR Profiling system, the transactions of information between two systems are provided by RESTful service. In this study, we verify the efficiency of development of the PHR Profiling system through FHIR.

Distribution of Symptoms and Syndrome Differentiation Using Common Clinical Document Forms - Focused on Deficiency Syndrome Differentiation - (한의 공통 임상 기록 서식을 이용한 변증(辨證)과 증상(症狀)의 분포 조사 - 허증(虛證)을 중심으로 -)

  • Moon, Jin-Seok;Kim, Jeong-Cheol;Kang, Byoung-Gab;Kim, Bo-Young;Kang, Kyung-Won;Choi, Sun-Mi
    • Korean Journal of Oriental Medicine
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    • v.14 no.2
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    • pp.47-66
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    • 2008
  • Background: It is insufficient information that are syndrome differentiations and detail symptoms in Korean. Methods: 19 traditional korean medical agencies collected 190 cases with vital sign, body measurement, patient own symptoms report and doctor diagnosis. And then we analyzed general distributions and comparisons of deficiency and non-deficiency. Results: The most past histories, in order, were the arthritis(20%), gastroenteropathy, hypertension, anemia, diabete mellitus. In chief complains, musculoskeletal occupies 60 percent of the total, and digestive system, head in order. In the syndrome differentiation, it appeared deficiency, spleen, Qi deficiency in order. Age(p=0.000), systolic blood pressure(p=0.044) and the waist-hip ratio(p=0.000) was significantly higher in the deficiency group compared with non-deficiency group. Patients with condition which dislikes the wind and with anxiety and with amazing and fear(驚恐) were significantly more in deficiency group(p=0.029, p=0.017, p=0.044). Conclusions: These statistics are continually revised report and it will be reported comparison of several syndrome differentiations and therapeutic effects by treatment methods.

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Analysis of Symptoms-Herbs Relationships in Shanghanlun Using Text Mining Approach (텍스트마이닝 기법을 이용한 『상한론』 내의 증상-본초 조합의 탐색적 분석)

  • Jang, Dongyeop;Ha, Yoonsu;Lee, Choong-Yeol;Kim, Chang-Eop
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.34 no.4
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    • pp.159-169
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    • 2020
  • Shanghanlun (Treatise on Cold Damage Diseases) is the oldest document in the literature on clinical records of Traditional Asian medicine (TAM), on which TAM theories about symptoms-herbs relationships are based. In this study, we aim to quantitatively explore the relationships between symptoms and herbs in Shanghanlun. The text in Shanghanlun was converted into structured data. Using the structured data, Term Frequency - Inverse Document Frequency (TF-IDF) scores of symptoms and herbs were calculated from each chapter to derive the major symptoms and herbs in each chapter. To understand the structure of the entire document, principal component analysis (PCA) was performed for the 6-dimensional chapter space. Bipartite network analysis was conducted focusing on Jaccard scores between symptoms and herbs and eigenvector centralities of nodes. TF-IDF scores showed the characteristics of each chapter through major symptoms and herbs. Principal components drawn by PCA suggested the entire structure of Shanghanlun. The network analysis revealed a 'multi herbs - multi symptoms' relationship. Common symptoms and herbs were drawn from high eigenvector centralities of their nodes, while specific symptoms and herbs were drawn from low centralities. Symptoms expected to be treated by herbs were derived, respectively. Using measurable metrics, we conducted a computational study on patterns of Shanghanlun. Quantitative researches on TAM theories will contribute to improving the clarity of TAM theories.

A RADIOGRAPHIC STUDY OF CEMENTOMA (백악종에 관한 방사선학적 연구)

  • Hwang Eui Hwan;Lee Sang Rae
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.16 no.1
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    • pp.113-126
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    • 1986
  • This study was undertaken to document and better define this condition to help clarify this clinical and radiographic appearances by the analysis of clinical and radiographic features of cementoma. A study was made of a series of 104 cases with cementoma. This investigation of cementoma revealed the following features: 1. The female occurred in 73% of periapical cemental dysplasia and benign cementoblastoma, and 80% of cementifying fibroma. 2. 40% of periapical cemental dysplasia occurred in the fifth decades, and 73% of benign cementoblastoma during the second and third decades, while there was no age predilection in the cementifying fibroma. 3. 63% of periapical cemental dysplasia occurred in the mandibular anterior region. 91% of benign cementoblastoma and 80% of cementifying fibroma occurred in the mandibular premolar and/or molar region. 4. There were no cases complaining the associated clinical signs and subjective symptoms in the periapical cemental dysplasia, however the patient complained the pain in 36% of benign cementoblastoma and 40% of cementifying fibroma. 5. There were no cases expanding the cortical plates in the periapical cemental dysplasia, however 73% of benign cementoblastoma and all of 5 cases of cementifying fibroma showed the expansion of cortical plates. 6. Several radiographic features of the periapical cemental dysplasia were shown: a. 29% of the cases had multiple lesions. b. 53% of the cases were in the mature stage. c. During the osteolytic stage, the alveolar lamina dura was lost in 89% of the cases.

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Pre-clinical QT Risk Assessment in Pharmaceutical Companies - Issues of Current QT Risk Assessment -

  • Takasuna, Kiyoshi; Katsuyoshi, Chiba;Manabe, Sunao
    • Biomolecules & Therapeutics
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    • v.17 no.1
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    • pp.1-11
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    • 2009
  • Since the Committee for Proprietary Medicinal Products (CPMP) of the European Union issued in 1997 a "points to consider" document for the assessment of the potential for QT interval prolongation by non-cardiovascular agents to predict drug-induced torsades de pointes (TdP), the QT liability has become the critical safety issue in the development of pharmaceuticals. As TdP is usually linked to delayed cardiac repolarization, international guideline (ICH S7B) has advocated the standard repolarization assays such as in vitro IKr (hERG current) and in vivo QT interval, or in vitro APD (as a follow up) as the best biomarkers for predicting the TdP risk. However, the recent increasing evidence suggests that the currently used above biomarkers and/or assays are not fully predictive for TdP, but also does not address potential new druginduced TdP due to the selective disruption of hERG protein trafficking to the cell membrane or VT and/or VF with QT shortening. There is, therefore, an urgent need for other surrogate markers or assays that can predict the proarrhythmic potential of drug candidate. In this review, we provide an ideal pre-clinical strategy to predict the potentials of QT liability and lethal arrhythmia of the drug candidates with recent issues in this field in mind, not at the expense of discarding therapeutically innovative drugs.