• Title/Summary/Keyword: Blood features

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Tumor-like Presentation of Tubercular Brain Abscess: Case Report

  • Karki, Dan B.;Gurung, Ghanashyam;Sharma, Mohan R.;Shrestha, Ram K.;Sayami, Gita;Sedain, Gopal;Shrestha, Amina;Ghimire, Ram K.
    • Investigative Magnetic Resonance Imaging
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    • v.19 no.4
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    • pp.231-236
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    • 2015
  • A 17-year-old girl presented with complaints of headache and decreasing vision of one month's duration, without any history of fever, weight loss, or any evidence of an immuno-compromised state. Her neurological examination was normal, except for papilledema. Laboratory investigations were within normal limits, except for a slightly increased Erythrocyte Sedimentation Rate (ESR). Non-contrast computerized tomography of her head revealed complex mass in left frontal lobe with a concentric, slightly hyperdense, thickened wall, and moderate perilesional edema with mass effect. Differential diagnoses considered in this case were pilocytic astrocytoma, metastasis and abscess. Magnetic resonance imaging (MRI) obtained in 3.0 Tesla (3.0T) scanner revealed a lobulated outline cystic mass in the left frontal lobe with two concentric layers of T2 hypointense wall, with T2 hyperintensity between the concentric ring. Moderate perilesional edema and mass effect were seen. Post gadolinium study showed a markedly enhancing irregular wall with some enhancing nodular solid component. No restricted diffusion was seen in this mass in diffusion weighted imaging (DWI). Magnetic resonance spectroscopy (MRS) showed increased lactate and lipid peaks in the central part of this mass, although some areas at the wall and perilesional T2 hyperintensity showed an increased choline peak without significant decrease in N-acetylaspartate (NAA) level. Arterial spin labelling (ASL) and dynamic susceptibility contrast (DSC) enhanced perfusion study showed decrease in relative cerebral blood volume at this region. These features in MRI were suggestive of brain abscess. The patient underwent craniotomy with excision of a grayish nodular lesion. Abundant acid fast bacilli (AFB) in acid fast staining, and epithelioid cell granulomas, caseation necrosis and Langhans giant cells in histopathology, were conclusive of tubercular abscess. Tubercular brain abscess is a rare manifestation that simulates malignancy and cause diagnostic dilemma. MRI along with MRS and magnetic resonance perfusion studies, are powerful tools to differentiate lesions in such equivocal cases.

CORRELATION BETWEEN VASCULAR ENDOTHELIAL GROWTH FACTOR EXPRESSION AND MALIGNANCY GRADING IN BIOPSY SPECIMENS OF TONGUE CANCERS (설암의 술전 조직표본에서 악성도와 혈관내피세포성장인자 발현과의 상관관계)

  • Byun, June-Ho;Park, Bong-Wook;Chung, In-Kyo;Kim, Jong-Ryoul;Kim, Uk-Kyu;Park, Bong-Soo;Kim, Gyoo-Cheon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.27 no.6
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    • pp.528-534
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    • 2005
  • Angiogenesis is important for the growth and metastasis of solid tumors. Some growth factors, inflammatory cytokines, and angiogenin are known to promote tumor angiogenesis. Among them, Vascular endothelial growth factor (VEGF) is the most intriguing factor in regard to tumor angiogenesis. Inhibition of VEGF activity by neutralizing antibodies or by the introduction of dominant negative VEGF receptors into endothelial cells of tumor-associated blood vessels resulted in the inhibition of tumor growth and in tumor regression, indicating that VEGF is a major initiator of tumor angiogenesis. VEGF promotes angiogenesis through their receptors, Flt-1 and Flk-1/KDR. on vascular endothelial cells. These two receptors were usually believed to be expressed specifically on vascular endothelial cell. Several reports have now shown that VEGF is not only significantly associated with microvessel density but also has prognostic value in both node-negative and node-positive oral squamous cell carcinoma. For many years several histologic features of the neoplasms are being considered when assessing the influence of malignancy grading on recurrence and prognosis. Among the characteristics investigated, degree of keratinization, nuclear pleomorphism, mode of invasion, microscopic depth of invasion, intravascular invasion, lymphocyte infiltration, and number of mitoses have been considered as important prognostic factors. So, this study was conducted to evaluate the correlation of vascular endothelial growth factor expression with malignancy in paraffin-embedded biopsy specimens from 11 patients with tongue cancers. Our results showed that high immunoreactivity specimens of VEGF expression were significantly lower keratinization degree and more pronounced nuclear pleomorphism than in low immunoreactivity specimens. Thus, VEGF expression could be used as a prognostic marker in tongue cancer.

Intelligent Diagnosis Assistant System of Capsule Endoscopy Video Through Analysis of Video Frames (영상 프레임 분석을 통한 대용량 캡슐내시경 영상의 지능형 판독보조 시스템)

  • Lee, H.G.;Choi, H.K.;Lee, D.H.;Lee, S.C.
    • Journal of Intelligence and Information Systems
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    • v.15 no.2
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    • pp.33-48
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    • 2009
  • Capsule endoscopy is one of the most remarkable inventions in last ten years. Causing less pain for patients, diagnosis for entire digestive system has been considered as a most convenience method over a normal endoscope. However, it is known that the diagnosis process typically requires very long inspection time for clinical experts because of considerably many duplicate images of same areas in human digestive system due to uncontrollable movement of a capsule endoscope. In this paper, we propose a method for clinical diagnosticians to get highly valuable information from capsule-endoscopy video. Our software system consists of three global maps, such as movement map, characteristic map, and brightness map, in temporal domain for entire sequence of the input video. The movement map can be used for effectively removing duplicated adjacent images. The characteristic and brightness maps provide frame content analyses that can be quickly used for segmenting regions or locating some features(such as blood) in the stream. Our experiments show the results of four patients having different health conditions. The result maps clearly capture the movements and characteristics from the image frames. Our method may help the diagnosticians quickly search the locations of lesion, bleeding, or some other interesting areas.

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The Usefulness of $SurePath^{TM}$ Liquid-Based Smear in Sono-Guided Thyroid Fine Needle Aspiration; a Comparison of a Conventional Smear and $SurePath^{TM}$ Liquid-Based Cytology (초음파 유도 갑삼샘 세침흡인 세포검사에서 $SurePath^{TM}$ 액상세포검사의 유용성; 고식적 도말검사와 $SurePath^{TM}$ 액상세포검사와의 비교)

  • Kim, Dong-Hoon;Kim, Min-Kyung;Chae, Seoung-Wan;Lee, Kyoung-Bun;Han, Eun Mee;Kang, Sung-Hee;Sohn, Jin-Hee
    • The Korean Journal of Cytopathology
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    • v.18 no.2
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    • pp.143-152
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    • 2007
  • Sono-guided fine needle aspiration (FNA) of the thyroid is widely used, but the aspirated samples are typically not well preserved and low cellularity makes diagnosis difficult in many cases. The object of the current study is to evaluate the adequacy and diagnostic accuracy of the use of $SurePath^{TM}$ liquid-based cytology (SP-LBC) in the sonoguided fine needle aspiration of the thyroid nodule and to compare its use with that of the use of a conventional smear (CS). A total of 172 sono-guided FNAs of thyroid nodules from April to June, 2006 were prepared by the use of the split method with either SP-LBC or CS; the samples were stained with the use of hematoxylin-eosin (H&E) and Papanicolaou (Pap) stains. A cyto-histological correlation was performed in 69 (30 SP and 39 CS) cases that had been histologically confirmed. The rate of producing unsatisfactory slides by the use of the SP-LBC method (9.3%) was less than that of the use of the CS method (20.9%). The diagnostic accuracy of the SP method (93.3%) was better than that of the CS method (85.3%). The sensitivity and specificity of the SP method (94.4% and 92.3%) was better than that of the CS method (83.3% and 70%), respectively (p < 0.05). The CS of sono-guided aspirated specimens had some unavoidable limitations related to inadequate sampling such as a bloody background, low cellularity and an indication that some clinicians smeared many useless slides (averaging four to ten slides), and that most slides showed only blood that included few follicular cells. The SP method resulted in more thinly smeared slides and showed cleaner background and greater cellularity than the use of the CS method. Each follicular cell shows superior nuclear detail, and more distinct cytoplasmic features than with the use of the CS method. SP-LBC appears to be an easy, highly accurate, and reliable cytological method for employ for a diagnostic approach of thyroid disease and thyroid nodules. The SP-LBC method is a suitable alternative to the CS method to overcome diagnostic difficulties.

Brain MRI Template-Driven Medical Images Mapping Method Based on Semantic Features for Ischemic Stroke (허혈성 뇌졸중을 위한 뇌 자기공명영상의 의미적 특징 기반 템플릿 중심 의료 영상 매핑 기법)

  • Park, Ye-Seul;Lee, Meeyeon;Lee, Jung-Won
    • KIPS Transactions on Software and Data Engineering
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    • v.5 no.2
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    • pp.69-78
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    • 2016
  • Ischemic stroke is a disease that the brain tissues cannot function by reducing blood flow due to thrombosis or embolisms. Due to the nature of the disease, it is most important to identify the status of cerebral vessel and the medical images are necessarily used for its diagnosis. Among many indicators, brain MRI is most widely utilized because experts can effectively obtain the semantic information such as cerebral anatomy aiding the diagnosis with it. However, in case of emergency diseases like ischemic stroke, even though a intelligent system is required for supporting the prompt diagnosis and treatment, the current systems have some difficulties to provide the information of medical images intuitively. In other words, as the current systems have managed the medical images based on the basic meta-data such as image name, ID and so on, they cannot consider semantic information inherent in medical images. Therefore, in this paper, to provide core information like cerebral anatomy contained in brain MRI, we suggest a template-driven medical images mapping method. The key idea of the method is defining the mapping characteristics between anatomic feature and representative images by using template images that can be representative of the whole brain MRI image set and revealing the semantic relations that only medical experts can check between images. With our method, it will be possible to manage the medical images based on semantic.

Analysis of the Prognostic Factors for Abdominal Trauma (복부외상환자의 예후에 영향을 미치는 인자들에 대한 분석)

  • Kim, Hee Joon;Kim, Hyung Soo;Seo, Kyung Won;Ju, Jae Kyun;Ryu, Seong Yeop;Kim, Jeong Cheol;Kim, Hyung Rok;Park, Young Kyu;Kim, Dong Yi;Kim, Young Jin;Kim, Shin Kon
    • Journal of Trauma and Injury
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    • v.20 no.1
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    • pp.12-18
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    • 2007
  • Purpose: Recently, trauma is more frequent due to the increases in the population, the number of traffic accident, and the incidence of violence. Especially, abdominal trauma is a leading cause of morbidity and mortality. We analyzed the clinical features and the factors associated with morbidity and mortality. Methods: We analyzed 136 patients of abdominal trauma who were admitted at the Department of Surgery, Chonnam National University Hospital, from January 2003 to June 2005. We analyzed the cause of trauma, the injured organ, combined injuries, mental status, blood pressure, laboratory findings, morbidity, and mortality. The relationships between by variable were assesed by using the independent samples test and the Kruskal?Wallis test. Results: The causes of trauma were traffic accidents (98 cases, 72%), falling accidents (9 cases, 6.6%), violence (6 cases, 4.4%), and stab injuries (6 cases, 4.4%). The injured organs were the small intestines (47 cases, 34.6%), the liver (35 cases, 25.7%), the spleen (26 cases, 19.1%), the mesentery (17 cases, 12.5%), the large intestines (15 cases, 11.0%), the pancreas (14 cases, 10.3%), etc. The most common combined injury was chest injury (53 cases, 39%). Comatose or semicomatose mental status and shock on admission (<60 mmHg in systolic) were related to high mortality (85.7%). In laboratory findings, decreased hemoglobin (<8 g/dL), and platelet count (<$50,000/mm^3$), and increased creatinine level (>1.6 mg/dL) were significant prognostic factors. The incidence of postoperative complications was 40.4%, and frequent complications were wound infection (8.1%) and re-bleeding (8.1%). The overall mortality rate was 18.4%, and most common cause was hypovolemic shock (18 cases, 13.2%), however, there was no statistical difference according to injurd organ. Conclusion: In the multivariate analysis, mental status, hemoglobin, and serum creatinine level were the most significant prognostic factors. When an abdominal trauma patient arrives at the emergency room, a rapid and accurate evaluation of the patient's status and risk factors, and resuscitation, if necessary, have to be performed to lower the morbidity and mortality.

Study on Connection between Physiology of Old People and Pathological Symptom in Dongeuibogam (동의보감(東醫寶鑑)에 나타난 노인병증(老人病症)과 노인생리(老人生理)의 연계성 연구)

  • Park, Jong-Woon;Im, Chae-Kwang;Kim, Kwang-Joong
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.26 no.1
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    • pp.10-18
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    • 2012
  • In this paper, to find out how different the treatment of special individuals named 'old people' is with that of ordinary cases, Dongeuibogam(東醫寶鑑) was chosen as the study material and some parts in it where the symptoms of old people in the same disease category were treated in different ways were excerpted to analyze the tendency of pathological symptoms and prescriptions in the physiological perspective. As the result of analysis on the parts in Dongeuibogam(東醫寶鑑) where the old people were treated in different ways, it turned out that 65 prescriptions were used in 24 pathological symptoms. The 24 symptoms are included mainly in chapters of 'inner view(內景)' and 'outer form(外形)'. They are including the pathological symptoms which had been presented as general geriatric symptoms and also seems to have added other symptoms which should be clinically reflected in the specialty of treatment for geriatric diseases. The 65 prescriptions are also recorded mainly in chapters of 'inner view(內景)' and 'outer form(外形)'. The herbs used for them were sweet and warm herbs such as Rehmannia glutinosa (Gaertner) Libosch(熟地黃), Angelica gigas Nakai(當歸), Panax ginseng C. A. Mey(人蔘) and Atractylodes macrocephala Koidz(白朮) that can support the essence blood of liver and kidney and the energy of spleen, lung and stomach. Those herbs could be added or subtracted according to the symptom. It seems to have resulted from the treatment method that old people was applied to old people in consideration of their physiological features. When the 24 symptoms and 65 prescriptions for geriatric diseases different from ordinary ones in Dongeuibogam(東醫寶鑑) were considered in the physiological view point, it could be seen that each pathological symptom was manifested as a exhaustion of kidney qi(腎氣枯渴) which was a characteristic physiologic state of old people. Through this, it could be seen that the use of prescriptions was also made to mitigate the body fluid deficiency(津液不足), the kidney yin inner heat(腎陰內熱), the heart spirit void and loss(心神虛損), the kidney yang deficiency(腎陽不足), the spleen failing in transportation(脾失健運), the spleen yang deficiency(脾陽不足), the liver fire inner movement(肝火內動) and the lung energy void and loss(肺氣虛寒).

The Antidiabetic Effect of Gamiyookmijihwangtang on Diabetes-prone BB Rats (Diabetes-prone BB Rat을 이용한 가미육미지황탕의 항당뇨 효과)

  • Lee, Yoon-Gyeong;Kim, Soon-Dong
    • Korean Journal of Food Science and Technology
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    • v.32 no.5
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    • pp.1206-1212
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    • 2000
  • This study was conducted to know whether Gamiyookmijihwangtang(GY) which is Yookmijihwang added with Liriopis tuber, Anemarrhenae rhizoma and Phellodendri cortex can remedy the overt diabetes in diabetes-prone BB(BBDP) rats. The rats were given GY through the mother from the fetal stage until birth. After birth they received GY through breast feeding until 20 days old. From 21 days old which is the beginning of the weaning period 60 BB rats(30 males and 30 females) were divided into 2 experimental groups(BBDP and BBDP-GY) and placed individually in metabolic cages. BBDP was the control group which didn't receive any GY and BBDP-GY received 16 mL/㎏ B.W./day of GY until 120 days old. The antidiabetic effects of GY were characterized by the clinical features such as polyurea, polydipsia, hyperglycaemia and the rapid loss of body weight. Body weight, water consumption, urine volume and blood glucose level showed no signs of impending diabetes but after onset there were big changes in those parameters. The onset of diabetes was delayed and the incidence of diabetes was also much decreased with GY but after onset there were no beneficial effects from it.

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Association of Alcoholic & Nonalcoholic Fatty Liver Disease with Metabolic Syndrome in Health Screen Examinees of Men (남성 건강검진 수진자들에서 알코올성 및 비알코올성 지방간과 대사증후군과의 관련성)

  • Jeong, Eui-Kyeong;Kang, Yeong-Han;Park, Jae-Yong
    • The Journal of the Korea Contents Association
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    • v.9 no.6
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    • pp.237-246
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    • 2009
  • This study was carried out to investigate of the associations of Alcoholic & Nonalcoholic fatty liver disease(AFLD & NAFLD) with metabolic syndrome(MS) defined by IDF criteria. We conducted a cross-sectional study of 799 adult males with alcohol consumption underwent laboratory investigation(control 297, alcoholic 206, nonalcoholic 296). The ultrasound scan of the liver was performed to determine the presence and the severity of FLD. We analyzed the association between the severity of AFLD & NAFLD and MS by logistic regression analysis. The distribution of metabolic syndrome was 7.4%, 48.8%, 34.9% in control, AFLD & NAFLD. The association of blood pressure, glucose, triglycerides, obesity were risk factor in AFLD & NAFLD. According to the severity of FLD, AFLD was significantly increased with MS, Obesity, low HDL-cholesterol. MS, High triglycerides was increased significantly in NAFLD(p<0.05). The prevalence of AFLD & NAFLD was increased with increasing the number of features of metabolic syndrome. This study shows that AFLD & NAFLD was closely associated with MS and its components. The patients of AFLD & NAFLD should managed and monitored to prevent metabolic abnormalities.

Lung Function Trajectory Types in Never-Smoking Adults With Asthma: Clinical Features and Inflammatory Patterns

  • Kim, Joo-Hee;Chang, Hun Soo;Shin, Seung Woo;Baek, Dong Gyu;Son, Ji-Hye;Park, Choon-Sik;Park, Jong-Sook
    • Allergy, Asthma & Immunology Research
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    • v.10 no.6
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    • pp.614-627
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    • 2018
  • Purpose: Asthma is a heterogeneous disease that responds to medications to varying degrees. Cluster analyses have identified several phenotypes and variables related to fixed airway obstruction; however, few longitudinal studies of lung function have been performed on adult asthmatics. We investigated clinical, demographic, and inflammatory factors related to persistent airflow limitation based on lung function trajectories over 1 year. Methods: Serial post-bronchodilator forced expiratory volume (FEV) 1% values were obtained from 1,679 asthmatics who were followed up every 3 months for 1 year. First, a hierarchical cluster analysis was performed using Ward's method to generate a dendrogram for the optimum number of clusters using the complete post-FEV1 sets from 448 subjects. Then, a trajectory cluster analysis of serial post-FEV1 sets was performed using the k-means clustering for the longitudinal data trajectory method. Next, trajectory clustering for the serial post-FEV1 sets of a total of 1,679 asthmatics was performed after imputation of missing post-FEV1 values using regression methods. Results: Trajectories 1 and 2 were associated with normal lung function during the study period, and trajectory 3 was associated with a reversal to normal of the moderately decreased baseline FEV1 within 3 months. Trajectories 4 and 5 were associated with severe asthma with a marked reduction in baseline FEV1. However, the FEV1 associated with trajectory 4 was increased at 3 months, whereas the FEV1 associated with trajectory 5 was persistently disturbed over 1 year. Compared with trajectory 4, trajectory 5 was associated with older asthmatics with less atopy, a lower immunoglobulin E (IgE) level, sputum neutrophilia and higher dosages of oral steroids. In contrast, trajectory 4 was associated with higher sputum and blood eosinophil counts and more frequent exacerbations. Conclusions: Trajectory clustering analysis of FEV1 identified 5 distinct types, representing well-preserved to severely decreased FEV1. Persistent airflow obstruction may be related to non-atopy, a low IgE level, and older age accompanied by neutrophilic inflammation and low baseline FEV1 levels.