• Title, Summary, Keyword: clinical features

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Correlation Between Mammograghic Findings and Clinical/Pathologic Features in Women with Small Invasive Breast Carcinomas

  • Li, Jun-Nan;Xu, Jing;Wang, Ju;Qing, Chun;Zhao, Yu-Mei;Liu, Pei-Fang
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.24
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    • pp.10643-10646
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    • 2015
  • Background: To study the relationship between mammographic findings and clinical/pathologic features in women with 1-15mm sized invasive breast cancer. Materials and Methods: We investigated a consecutive series of 134 cases diagnosed in Tianjin Medical University Cancer Institute and Hospital in 2007. Mammographic findings were classified into five groups as follows :1) stellate mass without calcification; 2) non-stellate mass without calcification; 3) intermediate suspicious calcification with or without associated mass; 4) higher probability malignant calcification with or without associated mass; 5) focal asymmetry/distortion without associated calcification. Associations between mammographic and clinical/pathological features (menopause status/family history/histologic grade/lymph node status and ER/PR/HER2 status) was analyzed through logistic regression and chi square tests. Results: Compared to the stellate mass without calcification group, higher probability malignant calcification patients were associated significantly with a positive lymph node status, always presenting in patients who were non-menopausal and with a family history of carcinoma. Conclusions: Higher probability malignant calcifications with or without associated tumor masses are associated with clinical/pathologic features of poor prognosis.

Pharmacological Treatment of Major Depressive Episodes with Mixed Features: A Systematic Review

  • Shim, In Hee;Bahk, Won-Myong;Woo, Young Sup;Yoon, Bo-Hyun
    • Clinical Psychopharmacology and Neuroscience
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    • v.16 no.4
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    • pp.376-382
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    • 2018
  • We reviewed clinical studies investigating the pharmacological treatment of major depressive episodes (MDEs) with mixed features diagnosed according to the dimensional criteria (more than two or three [hypo]manic symptoms+principle depressive symptoms). We systematically reviewed published randomized controlled trials on the pharmacological treatment of MDEs with mixed features associated with mood disorders, including major depressive disorder (MDD) and bipolar disorder (BD). We searched the PubMed, Cochrane Library, and ClinicalTrials.gov databases through December 2017 with the following key word combinations linked with the word OR: (a) mixed or mixed state, mixed features, DMX, mixed depression; (b) depressive, major depressive, MDE, MDD, bipolar, bipolar depression; and (c) antidepressant, antipsychotic, mood stabilizer, anticonvulsant, treatment, medication, algorithm, guideline, pharmacological. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We found few randomized trials on pharmacological treatments for MDEs with mixed features. Of the 36 articles assessed for eligibility, 11 investigated MDEs with mixed features in mood disorders: six assessed the efficacy of antipsychotic drugs (lurasidone and ziprasidone) in the acute phase of MDD with mixed features, although four of these were post hoc analyses based on large randomized controlled trials. Four studies compared antipsychotic drugs (olanzapine, lurasidone, and ziprasidone) with placebo, and one study assessed the efficacy of combination therapy (olanzapine+fluoxetine) in the acute phase of BD with mixed features. Pharmacological treatments for MDEs with mixed features have focused on antipsychotics, although evidence of their efficacy is lacking. Additional well-designed clinical trials are needed.

The Diagnostic importance of clinical and radiologic features of the Multiple Cemento-osseous dysplasia (다발성 백악질공이형성증 조직병리검사시 임상, 방사선양상의 중요성)

  • Han Mi-Ra;Kim Young-Hee;Kang Byung-Cheol
    • The Journal of Korean Academy of Maxillofacial Radiology
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    • v.28 no.1
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    • pp.299-309
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    • 1998
  • This case was diagnosed as multiple cementoosseous dysplasia on the basis of clinical & radiological features but was diagnosed as ossifying fibroma on the basis of histopathological feature. The histopathologic features of the multiple cementoosseous dysplasia and cementoossifying fibroma have common features of cementum, fibrous network and bone. Multiple cementoosseous dysplasia is reactive lesion and shows restricted lesion size, occurred on anterior and posterior tooth of the mandible and needs no treatement except periodic follow up. But Cementoossifying fibroma is the true neoplasm and grows continuously and needs surgical removal. The final diagnosis of the multiple cementoosseous dysplasia requires good correlation of the clinical, histopathological, and radiological features.

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A Case of Rhabdoid Meningioma

  • Han, Jung-Ho;Seol, Ho-Jun;Kim, Dong-Gyu;Jung, Hee-Won
    • Journal of Korean Neurosurgical Society
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    • v.39 no.2
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    • pp.144-147
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    • 2006
  • Rhabdoid meningioma is an uncommon meningioma variant, which was initially described in 1998 by Perry et al. It is classified as a variant corresponding to grade III in the recent World Health Organization[WHO] classification of tumors of the nervous system, because of its unique histopathological features and its highly aggressive clinical course. To date there were still a lot of arguments about their developmental patterns and the treatment strategy especially for rhabdoid meningiomas lacking other histological features of malignancy. Although the exact causes of rhabdoid transformation of a benign meningioma are unknown, malignant transformation long duration after surgical resection under an underlying predilection for malignancy is suggested in our case. And we suggest that any histological rhabdoid features in recurrent meningiomas or even in primary cases seem to indicate the malignant clinical course and the need for aggressive treatments, because transformation from a benign or atypical one to a malignant one seems to occur at last.

Influence of Clinical and Anatomic Features on Treatment Decisions for Anterior Communicating Artery Aneurysms

  • Choi, Jae-Hyung;Kang, Myung-Jin;Huh, Jae-Taeck
    • Journal of Korean Neurosurgical Society
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    • v.50 no.2
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    • pp.81-88
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    • 2011
  • Objective : The purpose of this study was to analyze the clinical and anatomic features involved in determining treatment modalities for anterior communicating artery (AcoA) aneurysms. Methods : The authors retrospectively evaluated 112 AcoA aneurysms with pretreatment clinical features including age, Hunt and Hess grade, medical or neurological comorbidity, and anatomical features including aneurysm size, neck size, dome-to-neck ratio, vessel incorporation, multiple lobulation, and morphologic scoring system. Post-treatment clinical results were classified according to the Glasgow Outcome Scale, and anatomic results in coiled patients were classified according to the modified Raymond scale. Using multivariate logistic regression, the probabilities for decision making between surgical clipping and coil embolization were calculated. Results : Sixty-seven patients (60%) were treated with surgical clipping and 45 patients (40%) with endovascular coil embolization. The clinical factor significantly associated with treatment decision was age (${\geq}$65 vs. <65 years) and anatomical factors including aneurysm size (small or large vs. medium), dome-to-neck ratio (<2 vs. ${\geq}$2), presence of vessel incorporation, multiple lobulation, and morphologic score (${\geq}$2 vs. <2). In multivariate analysis, older patients (age, 65 years) had significantly higher odds of being treated with coil embolization relative to clipping (adjusted OR=3.78; 95% CI, 1.39-10.3; p=0.0093) and higher morphological score patients (${\geq}$2) had a higher tendency toward surgical clipping than endovascular coil embolization (OR=0.23; 95% CI, 0.16-0.93; p=0.0039). Conclusion : The optimal decision for treating AcoA aneurysms cannot be determined by any single clinical or anatomic characteristics. All clinical and morphological features need to be considered, and a collaborative neurovascular team approach to AcoA aneurysms is essential.

Prediction Models for Solitary Pulmonary Nodules Based on Curvelet Textural Features and Clinical Parameters

  • Wang, Jing-Jing;Wu, Hai-Feng;Sun, Tao;Li, Xia;Wang, Wei;Tao, Li-Xin;Huo, Da;Lv, Ping-Xin;He, Wen;Guo, Xiu-Hua
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.10
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    • pp.6019-6023
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    • 2013
  • Lung cancer, one of the leading causes of cancer-related deaths, usually appears as solitary pulmonary nodules (SPNs) which are hard to diagnose using the naked eye. In this paper, curvelet-based textural features and clinical parameters are used with three prediction models [a multilevel model, a least absolute shrinkage and selection operator (LASSO) regression method, and a support vector machine (SVM)] to improve the diagnosis of benign and malignant SPNs. Dimensionality reduction of the original curvelet-based textural features was achieved using principal component analysis. In addition, non-conditional logistical regression was used to find clinical predictors among demographic parameters and morphological features. The results showed that, combined with 11 clinical predictors, the accuracy rates using 12 principal components were higher than those using the original curvelet-based textural features. To evaluate the models, 10-fold cross validation and back substitution were applied. The results obtained, respectively, were 0.8549 and 0.9221 for the LASSO method, 0.9443 and 0.9831 for SVM, and 0.8722 and 0.9722 for the multilevel model. All in all, it was found that using curvelet-based textural features after dimensionality reduction and using clinical predictors, the highest accuracy rate was achieved with SVM. The method may be used as an auxiliary tool to differentiate between benign and malignant SPNs in CT images.

A Case of a Patient of Pontine Hemorrhage with Clinical Features of Cerebellar Dysfunction (소뇌기능이상의 임상양상을 특징으로 보인 뇌교부출혈 환자 1례)

  • Lee, You-Kyung;Kong, Kyung-Hwan;Yong, Hyung-Soon;Ko, Seong-Gyu;Bu, Song-Ah
    • The Journal of Internal Korean Medicine
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    • v.21 no.5
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    • pp.889-895
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    • 2000
  • I experienced a case of a patient with clinical features of cerebellar dysfunction in the intracranial hemorrhage which encroached the basis of lower pontine and all parts of pontine tegmentum. So I report this case with bibliographical inquiry. In addition, I applied the treatment of Oriental medicine to sequelae of intracranial hemorrhage like disorders of eye movement, central dizziness, cerebellar tremor and ataxias but the effect did not meet my expectation. I anticipate more clinical studies and reports on this hereafter.

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The Study on Post Acupotomy Headache (침도 침술 후 나타나는 두통에 대한 임상적 고찰)

  • Ko, Min-Kyung;Kim, Jung-Ho;Hong, Kwon-Eui
    • Journal of Acupuncture Research
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    • v.27 no.2
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    • pp.89-95
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    • 2010
  • Objectives : This study was designed to investigate incidence rate, clinical features and treatment of headache followed after acupotomy. And based on that, we study correlating between post acupotomy headache and post-lumbar puncture headache(PLPH). Methods : From September 1st, 2007 to December 31st, 2007, the 73 inpatients who admitted to Daejeon Oriental hospital and underwent acupotomy on lumbar spine and cervical spine etc. more than once were observed. Then 9 inpatients who occurred headache after acupotomy was analyzed according to incidence rate, gender, age, clinical features. Results : We investigated clinical features of post acupotomy headache and made comparative study of post acupotomy headache and PLPH. The average frequency of post acupotomy headache was about 12.3%. The risk factors are undergoing acupotomy on lumbar spine, young age. Gender does not affect the incidence of post acupotomy headache. Patients complain of headache which worsen when the patients is upright and improve after the patients lie back down in a few minutes. Those clinical features are similar to PLPH. Conclusions : Although two type of headache have significant similarities, there is no enough evidence to support this study. In addition, the cause and treatment of post acupotomy headache are still unclear. Thus, based on the above study, more studies have to be investigated.

Clinical, radiologic, and genetic features of Korean patients with Mucopolysaccharidosis IVA

  • Lee, Na Hee;Cho, Sung Yoon;Maeng, Se Hyun;Jeon, Tae Yeon;Sohn, Young Bae;Kim, Su Jin;Park, Hyung-Doo;Jin, Dong Kyu
    • Korean Journal of Pediatrics
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    • v.55 no.11
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    • pp.430-437
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    • 2012
  • Purpose: Mucopolysaccharidosis IVA (MPS IVA; Morquio A syndrome) is rare lysosomal storage disorder caused by N-acetylgalactosamine-6-sulfatase (GALNS) deficiency. Only a few MPS IVA cases have been reported in the Korean literature; there is a paucity of research about clinical or radiologic findings for this disorder. Therefore, we studied clinical findings, radiological features, and genetic data of Korean MPS IVA patients for determining factors that may allow early diagnosis and that may thus improve the patients' quality of life. Method: MPS IVA was confirmed via assay for enzymatic activity of leukocytes in 10 patients. The GALNS gene was analyzed. Patients' charts were retrospectively reviewed for obtaining clinical features and evaluated for radiological skeletal surveys, echocardiography, pulmonary function test, and ophthalmologic test results. Result: Nine patients had severe clinical phenotype, and 1 had an intermediate phenotype, on the basis of clinical phenotype criteria. Radiologic findings indicated skeletal abnormalities in all patients, especially in the hips and extremities. Eight patients had an odontoid hypoplasia, and 1 showed mild atlantoaxial subluxation and cord myelopathy. Genetic analysis indicated 10 different GALNS mutations. Two mutations, c.451C>A and c.1000C>T, account for 37.5% (6/16) and 25% (4/16) of all mutations in this samples, respectively. Conclusion: An understanding of the clinical and radiological features involved in MPS IVA may allow early diagnosis of MPS IVA. Adequate evaluations and therapy in the early stages may improve the quality of life of patients suffering from skeletal abnormalities and may reduce life-threatening effects of atlantoaxial subluxation.

Clinical Features of Post-Vaccination Guillain-Barré Syndrome (GBS) in Korea

  • Park, Yong-Shik;Lee, Keon-Joo;Kim, Seung Woo;Kim, Kyung Min;Suh, Bum Chun
    • Journal of Korean Medical Science
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    • v.32 no.7
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    • pp.1154-1159
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    • 2017
  • Guillain-$Barr{\acute{e}}$ syndrome (GBS) is the most common immune-mediated polyradiculoneuropathy and it is also the most commonly reported severe adverse event following immunization in adults. To evaluate the results of clinical and laboratory features of GBS after vaccination in Korea, we analyzed the claims-based data from 2002 to 2014 using materials collected for the Advisory Committee Vaccination Injury Compensation (ACVIC) meeting including, clinical features, nerve conduction studies (NCSs), cerebrospinal fluid (CSF) profiles, treatment, and outcomes. Forty-eight compensated GBS cases (median age, 15 years; interquartile range [IQR], 13-51; male:female ratio, 1:1) of 68 suspected GBS were found following immunization and all of them with influenza immunizations with either monovalent (n = 35) or trivalent (n = 13). Among them, 30 cases fulfilled the Brighton criteria level 1-3 (62.5%). The median duration between the onset of symptoms to nadir, duration of the nadir, and total admission period were 3 (IQR, 2-7 days), 2 (IQR, 1-5 days), and 14 (IQR, 6-33 days) days, respectively. The most frequently reported symptom was quadriparesis which was present in 36 cases (75%) at nadir. CSF examination revealed albuminocytologic dissociation in 25.0% and NCS was abnormal in 61.8%. After treatment, most of them showed improvement. Clinical features were similar to typical post-infectious GBS and there were both demyelinating and axonal forms suggesting heterogeneous pathogenic mechanism. In order to improve the diagnostic certainty of post-vaccination GBS, careful documentation of clinical features and timely diagnostic work-up with follow-up studies are needed.