• Title/Summary/Keyword: Asymptomatic disease

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Sensitivity of Whole-Blood Interferon-Gamma Release Assay According to the Severity and the Location of Disease in Patients with Active Tuberculosis (활동성 결핵의 중증도 및 병변 부위에 따른 전혈 인터페론 감마 분비능 측정의 민감도)

  • Kim, Yi-Young;Lee, Jae-Hee;Lee, Yoon-Jee;Lee, So-Yeon;Lee, Yong-Hun;Choi, Keum-Ju;HwangBo, Yup;Cha, Seung-Ick;Park, Jae-Yong;Jung, Tae-Hoon;Park, Jun-Sik;Kim, Chang-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.70 no.2
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    • pp.125-131
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    • 2011
  • Background: The clinical manifestation of $M.$ $tuberculosis$ infection ranges from asymptomatic latent infection, to focal forms with minimal symptoms and low bacterial burdens, and finally to advanced tuberculosis (TB) with severe symptoms and high bacillary loads. We investigated the diagnostic sensitivity of the whole-blood interferon-${\gamma}$ release assay according to the wide spectrum of clinical phenotypes. Methods: In patients diagnosed with active TB that underwent $QuantiFERON^{(R)}$ (QFT) testing, the QFT results were compared with patients known to be infected with pulmonary tuberculosis (P-TB) and extra-pulmonary TB (EP-TB). In addition, the results of the QFT test were further analyzed according to the radiographic extent of disease in patients with P-TB and the location of disease in patients with EP-TB. Results: There were no statistical differences in the overall distribution of QFT results between 177 patients with P-TB and 84 patients with EP-TB; the positive results of QFT test in patients with P-TB and EP-TB were 70.1% and 64.3%, respectively. Among patients with P-TB, patients with mild extents of disease showed higher frequency of positive results of QFT test than that of patients with severe form (75.2% vs. 57.1%, respectively; p=0.043) mainly due to an increase of indeterminate results in severe P-TB. Patients with TB pleurisy showed lower sensitivity by the QFT test than those with tuberculous lymphadenitis (48.8% vs. 78.8%, respectively; p=0.019). Conclusion: Although QFT test showed similar results between overall patients with P-TB and EP-TB, individual sensitivity was different according to the radiographic extent of disease in P-TB and the location of disease in EP-TB.

Hepatitis B Virus DNA Mutation, Pattern of Major Histocompatibility Class-I among Familial Clustered HBV Carriers in Relation to Disease Progression (가족집적성을 보이는 B형간염 바이러스 만성보유자에서 바이러스 유전자의 돌연변이와 주조직접합체 양상 - 질병발현 형태와의 관련성을 중심으로 -)

  • Jung, Seung-Pil;Lee, Hyo-Suk;Kim, Chung-Yong;Ahn, Yoon-Ok
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.3
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    • pp.323-333
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    • 2000
  • Objectives : Chronic HBsAg carriers are the principal source of infection for other susceptible people, and are themselves at high risk of developing serious liver diseases. In Korea, it has been estimated that 65-75% of the HBsAg positives remained as persistent carriers. Additionally, familial clustering of MBV infection has frequently been observed among carriers. Some would become progressive, chronic hepatitis patients, and others would not. The aim of this study was to evaluate the association between various factors, such as the duration of infection, type of virus, mutation of precore/core region in HBV, major histocompatibility class-I, and developing chronic liver diseases among familial HBV carriers. Methods : Chronic carrier status was identified by repeated serological tests for HBsAg at intervals of six months or more. A familial chronic carrier was defined when the disease was observed in a family member over two generations. Two families were recruited, among which a total of 20 chronic HBsAg carriers(11 carriers in No.1, and 9 in No.2 family) were identified. Data on the general characteristics and liver disease status were collected. Identification of the HBV-DNA was successful only for 13 subjects among the 20 carriers. Analysis of viral DNA in terms of subtype, pre-core and core region mutations was carried out. The type of major histocompatibility class-1 for the 13 subjects was also analysed. Results & Conclusions : Seven of 10 chronic HBV carriers of the 1st generation and one of 10 of the 2nd generation were clinical patients with chronic hepatitis, the others, three of the 1 st and nine of the 2nd generation, were asymptomatic carriers. This data indicates that the duration of HBV carriage is one of the major factors for disease severity. The subtype of HBsAg analysed using MBV-DNA identified in 13 carriers were adr, and the pattern of precore nonsense mutation in HBV-DNA was identical among family members, which meads that the same virus strains were transmitted between the family members. The association between the precore or core mutations in HBV-DNA and the disease severity was not observed. While it was suggested that a specific type of MHC class-I may be related to disease progression.

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Characteristics of Individuals Seeking Comprehensive Health Check-ups (종합 건강검진을 원하는 피검진자의 건강특성에 관한 연구)

  • 성미혜
    • Journal of Korean Academy of Nursing
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    • v.27 no.3
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    • pp.563-576
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    • 1997
  • This study was carried out to identify basic data for more efficient operation of comprehensive health check-up centers in the national health care system. The researcher reviewed and analyzed the main symptoms of the subjects according to sex, age, occupation and positive rate in the screening tests of a comprehensive health check-up, performed at one comprehensive health check-up center in located in a hospital. The subjects were 512 persons who had a check-up at the comprehensive health check-up, center in K university hospital in Seoul from October 2, 1996 to March 30, 1997. A questionaire developed by the researcher to obtain subject's general characteristics, main symptoms, medical examination, diagnosed disease was used as the tool for the study. The researcher analyzed the data with SPSS PC/sup +/ program. : the distribution of the subject's general characteristics and main symptoms was described with percentages and the difference between main symptoms and screening tests analyzed with X²-test, t-test, ANOVA. The result of this study are as follows : 1. For the distribution of diagnosis in males. liver disease was most frequent and hypertension was second : in females, hypertention and liver disease were not common in that order. 2. The most common complaints were indigestion in the digestive system, sputum in the respiratory system, irregular heart beat in the cardiovascular system, frequent urine in the urinary system vertigo in the hematologic system. 3. The main symptoms according to sex were for females, a statistically siguificant higher rate of complaints in the digestive system, cardiovascular system, urinary system, hematologic system, musculoskeletal, mental & nervous system as compared to males. 4. The main symptoms according to age were that in the the second decade there wara higher rate of complaints in the digestive system, and cardiovascular system than in the older age groups : and in the fifth decade more in the musculoskeletal system. 5. The main symptoms according to occupation were that formers and fishers had a higher rate of complaints in the mental and nervous system as compared to other occupation groups : and office workers, in gynecology. 6. The main symptoms according to diagnosis, were symptoms of the digestive system, frequent in liver disease : symptoms of the cardiovascular system in allergic disease. 7. The screening tests which showed the highest rates were UGI /FGS, PFT : In males a higher rate of abnormality was seen in abdominal ultrasono- graphy and in, females, in mammography. 8. In screening tests according to sex, males showed a higher positive rate for chest X-rays, and LFT, and females, in mammography, pap smear, CBC. 9. In screening tests according to age, higher positive rates of obesity, high blood pressure, chest X-ray, mammography, pap smear, FBS, CBC, urine test were seen in the fifth decade : PFT and abdominal ultrasonography in the third decade. The subjects who wanted comprehensive health check-up were not asymptomatic but had an illness with several symptoms. It is found that the most frequent diagnosed diseases were hypertention and liver disease. So proper observations must be done for them. Comprehensive health check-ups should be changed to a comprehensive examination including treatment beyond examination for those subjects with positive results.

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A Case of Gitelman Syndrome Presented with Epileptic Seizure (간질 발작으로 내원하여 진단된 Gitelman 증후군 1례)

  • Park Jee-Min;Kim Jeong-Tae;Shin Jae-Il;Kim Heung-Dong;Kim Tae-Young;Cheong Hae-Il;Lee Jae-Seung
    • Childhood Kidney Diseases
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    • v.8 no.1
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    • pp.68-73
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    • 2004
  • Both Gitelman syndrome and Bartter syndrome are autosomal recessively inherited renal tubular disorders characterized by hypokalemic metabolic alkalosis, salt wasting and normal to low blood pressure. Gitelman syndrome is caused by mutations in the thiazide-sensitive Na-Cl cotransporter (NCCT) and distinguished from Bartter syndrome, which is associated with mutations of several genes, by the presence of hypomagnesemia and hypocalciuria. In most of the patients with Gitelman syndrome, the disease manifests with transient episodes of muscular weakness and tetany in the adult period, but, often, is asymptomatic. We report here an 11 years-old female with Gitelman syndrome who presented with aggravation of epileptic seizure. The diagnostic work-up showed typical clinical features of metabolic alkalosis, hypokalemia, hypomagnesemia and hypocalciuria. We also identified a heterozygote mutation($^{642}$CGC(Arg)>TGC(Cys)) and an abnormal splicing in the SLC12A3 gene encoding NCCT.

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Heterogenous Clinical Manifestations in Adult Patients with Late Diagnosis of Glycogen Storage Disease type Ia (성인기에 진단된 당원병 제 Ia형의 다양한 임상 양상)

  • Kim, Yoo-Mi;Cheon, Chong Kun;Kim, Gu-Hwan;Yoo, Han-Wook
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.15 no.1
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    • pp.9-17
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    • 2015
  • Glycogen storage disease (GSD) type Ia is rare inborn metabolic disorder, caused by glucose-6-phosphatase deficiency. It characterized by hepatomegaly, hypoglycemia, lactic acidosis, hypertriglyceridemia, and hyperuricemia and it is usually manifested in the infantile period. In addition, it is also associated with growth failure, pubertal delay, anemia, platelet dysfunction, osteopenia, and pulmonary hypertension. Hepatocellular adenoma and renal dysfunction are frequent late complications. Delayed diagnosis and inappropriate therapy lead to many complications such as growth failure, osteoporosis, refractory gout, renal failure, hepatocellular carcinoma (HCC), and pulmonary hypertension. Here, two Korean sisters diagnosed with GSD Ia, aged 33 and 36 respectively, were described and compared to recent articles about four adults with late diagnosis of GSD Ia. One sister had typical manifestations of GSD Ia including short stature (height, 145 cm), multiple hepatic adenoma, chronic kidney disease stage IV, and severe osteoporosis, whereas the older sister had normal stature (162 cm), one tiny hepatic nodule, and normal renal function. Direct sequencing of G6PC in two sisters identified a homozygous splicing mutation, c.645G>T, which is a prevalent mutation in Korea. Interestingly, our cases and four adults from recent reports had asymptomatic mild hypoglycemia and various manifestations including renal failure, HCC, fatty liver, or uncontrolled hyperlipidemia. These adult cases represent not only heterogenous phenotype to genotype within family members with GSD Ia but also long-term complications such as gouty arthritis, renal failure, and osteoporosis in untreated adult GSD Ia patients. In addition, lactic academia and hypertriglyceridemia are good markers of GSD Ia to distinguish from metabolic disease.

Aberrant Right Subclavian Artery with Dysphagia and Recurrent Pneumonia -A case report - (연하곤란 및 반복괵인 폐렴를 동반한 이상우쇄골하동맥 - 1예 보고 -)

  • 장원채;임영혁;임성철;오봉석
    • Journal of Chest Surgery
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    • v.37 no.3
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    • pp.282-285
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    • 2004
  • Aberrant right subclavian artery (ARSA) is an anomaly with a reported incidence of 0.5% to 2%. Most patients with an ARSA remain asymptomatic; however about to% of adult patients have compressive symptoms. A case is reported of a 64-year old female patient who had a few years of history of dysphagia and recurrent pneumonia. Angiography was performed, which demonstrated an ARSA with common origin of the right and left carotid arteries. Surgical correction was performed via right thoracotomy. The proximal aberrant artery was mobilized behind the esophagus. The distal, right subclavian artery was exposed, transected, and transposed with reimplantation into the aortic root by graft bypass.

Familial Sick Sinus Syndrome (가족성 동기능 장애 증후군 1례)

  • Nam, In-Hye;Cheon, Sung-Hee;Kil, Hong-Ryang
    • Clinical and Experimental Pediatrics
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    • v.46 no.2
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    • pp.195-197
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    • 2003
  • Sick sinus syndrome(SSS) constitutes a spectrum of cardiac arrhythmia, including sinus bradycardia, sinus pause-arrest, sinoatrial block, slow escape rhythm, bradyarrhythmia and tachyarrhythmia. SSS is relatively uncommon in children but its exact incidence is unknown because diagnostic criteria are not uniform and most children with SSS, in general are asymptomatic. SSS may be primary(organic sinus node disease) or secondary(cardiac surgery comprises much of SSS in children and adolescents), but it can hardly be caused by familial relations as well. We reports an occurrence of familial sick sinus syndrome. Mother was diagnosed as SSS, which was presented by symptoms of dizziness and treated by permanent pacemaker(DDD). Also, two daughters revealed SSS with non-compacted cardiomyopathy on neonatal screening and fetal echocardiography respectively. We concluded that familial SSS may occur, so familial screening should be suggested.

Pulmonary Hamartoma (A report of 3 cases) (폐과오종 치험 3례)

  • Cho, Kwang-Hyun;Park, Dong-Sick;Hong, Sook-Hee
    • Journal of Chest Surgery
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    • v.15 no.2
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    • pp.155-161
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    • 1982
  • The term hamartoma was first used by Albrecht to describe what he considered to be localized errors of development involving one or more tissue native to the organ of origin. The definition was meant to encompass not only abnormal local growth rate, but also the spatial arrangement, relative proportions and degree of the component tissue. But lately the major conclusions are that this group of lesion is neoplastic than developmental in origin. The Importance of pulmonary hamartoma is that they are relatively common among the benign tumor of the lung, but they usually present as asymptomatic coin lesion on chest x-ray film and were find out In routine check up and frequently mimic clinically the more common lung tumor such as cancer. Recently, we have experienced three cases of pulmonary hamartoma which were all discovered during routine chest film check up for certificate of health and evaluation of other disease. All of these were surgically resected with good result. Among the operations, one of these was mass enucleation and the others were lobectomy of lung involved by the mass.

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Multifocal nodular lymphoid hyperplasia of the lung

  • Lee, Gil Tae;Kim, Eun Kyoung;Cho, Eirie;Lee, Seung-Sook;Kim, Seo Yun;Kim, Cheol Hyeon;Kim, Hye-Ryoun
    • Journal of Yeungnam Medical Science
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    • v.34 no.1
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    • pp.84-87
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    • 2017
  • Nodular lymphoid hyperplasia (NLH) is a benign lymphoproliferative disease that can affect the lung. Because of its rarity, little is known about the etiology and natural history of NLH. Most cases are usually asymptomatic and found incidentally on imaging studies. Imaging finding of NLH has shown most commonly as a solitary lesion, although multifocal pulmonary nodules may be seen. Surgical resection has proved curative in the cases previously described. We report a rare case of NLH in a 55 year-old man who presented with bilateral multiple pulmonary nodules on chest radiography. Open biopsy was performed from the upper and lower lobe of the left lung. The lesions were pathologically diagnosed as pulmonary NLH. Multifocal residual nodules in both lungs remain stable without spontaneous regression during the 3 years of follow-up.

Listeriosis and Listeria monocytogenes (리스테리아증과 Listeria monocytogenes)

  • Bahk, Jae-Rim;Elmer H. Marth
    • Microbiology and Biotechnology Letters
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    • v.17 no.6
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    • pp.634-644
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    • 1989
  • Listeria monocytogenes, one of five species in the genus Listeria and the only one currently believed to be pathogenic for humans, is a small gram-positive, nonsporeforming, aerobic, motile and hemolytic rod-shaped bacterium. The bacterium is widespread in the environment, having been isolated from soil, dust, animal feed, water, sewage, almost every type of animal that has been cultured, and asymptomatic humans. L. monocytogenes causes listeriosis, a disease which most often affects humans with a compromised immune system. Included are pregnant woman, infants and adults suffering from such diseases as cancer, cirrhosis of liver or AIDS or are being treated with drugs such as corticosteroids. Listeriosis is manifested by such syndromes as pregnancy infections, granulomatosis infantiseptica, sepsis, meningoencephalitis, and focal infections. Infections, can be treated successfully with penicillin, ampicillin, or erythromycin. However, a mortality rate of about 30% has occurred in outbreaks of listeriosis. Food-associated outbreaks of listeriosis have been attributed to coleslaw (Canada, 1981), pasteurized milk (U.S., 1983), and soft cheese (U.S., 1985). Presence of L. monocytogenes in various dairy foods has prompted recall of such products from the U.S. market-place. L. monocytogenes also has been found in raw meats and seafood.

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