• Title/Summary/Keyword: Clinical Manifestation

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A Study on Correlation of Melanin & Pigmentation Disorder and Viscera and Bowels(臟腑) (멜라닌 및 색소 이상 질환과 장부(臟腑)와의 연관성 고찰)

  • Jung, Yu-Jin;Ko, Woo-Shin;Yoon, Hwa-Jung
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.29 no.3
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    • pp.27-41
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    • 2016
  • Objectives : The purpose of this research is to understand melanin with both Korean and Western medicine.Methods : We investigated the comprehension of melanin in both western and Korean medicine through literature review and studied relationships between melanin and five viscera(五臟), especially liver(肝), spleen(脾), kidney(腎). We Also studied representative pigmentary disorders(melasma, vitiligo) in western and Korean medicine to figure out how to understand pigmentary disorders in oriental medicine.Results : The results are as follows. 1. Melanin is associate with liver, because free coursing(疎泄) function of liver is the origin of transport melanin to keratinocyte from melanocyte. Also, melanogenesis factors like MITF and CREB are closely associated with liver and pigmentary disorders occur frequently after stress conditions or women. 2. Melanin is absorbed and scattered in keratinocytes by the function of spleen. Pigmentary disorders result from failure of spleen and formation of phlegm-retained fluid(痰飮). 3. Kidney essence(腎精) is the origin of melanin formation. In addition, corticosteroid, the major hormone of melanogenesis is secreted by adrenalin and adrenalin belongs to kidney(腎) in Korean medicine. 4. Melasma is created by disorder of melanin transport and absorbtion, so melasma is associated liver (肝) and spleen(脾). Therefore the treatment for melasma may focus on improvement function of liver and spleen. 5. The destruction of melanocyte or abnormal melanogenesis by disorder of the immune system, metabolic and affective disorders can make vitiligo, so vitiligo is associated with liver and kidney which are major part of melanin formation. Therefore the treatment of vitiligo can focus on improvement function of liver(肝) and kidney(腎).Conclusion : We compared Korean and western medicine to understand melanin. We also interpreted the mechanism of melanin and pigmantary disorders in western medicine and considered the relationship with visceral manifestation theory(臟象論) in traditional Korean medicine. Further studies are needed to apply comprehension of melanin to clinical stage.

A Diagnostic Algorithm after Newborn Screening for Hypermethioninemia (고메티오닌혈증의 신생아 선별 검사 후 진단 알고리즘)

  • Kim, Yoo-Mi
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.16 no.1
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    • pp.1-9
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    • 2016
  • Newborn screening (NBS) is important if early intervention is effective in a disorder and if there are sensitive and specific biochemical markers to detect disorder. Methionine is a useful marker to detect abnormal methionine-homocysteine metabolism, especially homocystinuria which needs urgent medical intervention. However, hypermethioninemia could occur in other metabolic disorder including liver disease, tyrosinemia type I, methionine adenosyltransferase (MAT) I/III deficiency, glycine N-methyltransferase (GNMT) deficiency, or adenosylhomocysteine hydrolase deficiency. However, experience with NBS for homocystinurias and methylation disorders is limited. Especially, MAT I/III deficiency which is the most common cause of persistent hypermethioninemia have two inheritance, autosomal recessive (AR) and autosomal dominant (AD), and their clinical manifestation is different between AR and AD. Here, author reviewed recent articles of guideline and proposed guideline for homocystinuria and methylation disorder.

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A Case of Pulmonary Sarcoidosis Combined with Neurosarcoidosis (신경유육종증이 병발한 폐유육종증 1예)

  • Park, Byung Hoon;Park, Seon Cheol;Shin, Sang Yun;Jeon, Han Ho;Jung, Kyung Soo;Chung, Woo Young;Byun, Min Kwang;Moon, Ji Ae;Kim, Young Sam;Kim, Se Kyu;Chang, Joon;Kim, Sung Kyu;Park, Moo Suk
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.6
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    • pp.549-553
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    • 2007
  • Sarcoidosis is a multi-systemic syndrome of an unknown etiology, and it is characterized by the formation of multiple noncaseating granulomas that disrupt the architecture and function of the tissues in which they reside. The most commonly affected organs are lung, skin and lymph nodes. Overt clinical involvement of the nervous system is uncommon and this occurs in about 5% of all patients during the course of their disease. The most common manifestations are granulomatous leptomeningitis, cranial nerve palsy, electrolyte or other endocrinologic abnormalities, but isolated memory impairment is a rare manifestation. This is a case of 59 years-old male with recent memory impairment, and he was previously diagnosed with pulmonary sarcoidosis by transbronchial lung biopsy. The brain MRI imaging revealed the leptomeningeal and parenchymal involvement of sarcoidosis. He was treated with high dose corticosteroid and his memory function was improved to nearly a normal level. We report here on a case of successful treatment of pulmonary sarcoidosis combined with neurosarcoidosis with using high dose corticosteroid, and the patient presented with recent memory impairment.

A Study of Premenstrual Syndrome(PMS) and the Nutritional Intake of College Women Residing in Busan Metropolitan City (부산지역 여대생의 월경전 증후군 실태 및 영양섭취상태에 관한 연구)

  • 황혜진;김영만
    • Korean Journal of Community Nutrition
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    • v.7 no.6
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    • pp.731-740
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    • 2002
  • This study was designed to identify premenstrual syndrome (PMS) and to investigate the correlation between premenstrual syndrome and nutritional intakes. The subjects of this study were 138 college women residing in Busan Metropolitan City. The subjects were asked to complete Menstrual Discomfort Questionnaire (MDQ) regarding PMS, food intake frequencies and nutritional intake. We studied the correlation between PMS symptoms and nutritional intake. The average height and weight of anemic subjects were 161.42 $\pm$ 3.50 cm and 51.87 $\pm$ 5.42 kg. The average BMI (body mass index, kg/$m^2$) was 19.92 $\pm$ 2.14 and PIBW (percent ideal body weight) were 93.02 $\pm$ 9.75%. Except for phosphorous, vitamin A and vitamin C intakes, the intake levels of all other nutrients were below the Korean RDA. The average calorie intake of the subjects was 1645.65 $\pm$ 352.63 kcal (82.2% of the Korean RDA) and iron intake of the subject was 11.06 $\pm$4.03 mg (69.1% of the Korean RDA) . The calcium and vitamin $B_6$ intakes were 512.26 $\pm$ 183.12 mg (73.1% of the Korean RDA) and 1.12 $\pm$ 0.14 mg (80.0% of the Korean RDA), respectively. With regard to their menstrual state, 45.9% subjects responded that their menstrual cycles were irregular. The frequency of PMS of the subjects was 30.2% (over 3 points) on 5 point scale (1 : no. 5 severe). The common symptoms of PMS of the subjects were pain (2.32 $\pm$ 1.01), negative effects (2.27 $\pm$ 0.87), behavioral changes (2.26 $\pm$ 0.85), water retention (2.07 $\pm$ 0.78) , arousal (1.79 $\pm$ 0.84) , autonomic reactions (1.77 $\pm$ 0.87) , lack of control (1.69 $\pm$ 0.75) and decreased concentration (1.68 $\pm$ 0.75) . There was significant correlation between all the PMS symptoms and calcium (p < 0.01) , vitamin E (p < 0.05) , carbohydrate (p < 0.05) . This suggests that PMS represents the clinical manifestation of nutrient deficiency states especially calcium. Therefore we concluded that calcium supplementation is likely to be of benefit in relieving PMS symptoms.

CYP2C19 Genotype Could be a Predictive Factor for Aggressive Manifestations of Hepatocellular Carcinoma Related with Chronic Hepatitis B Infection in Thailand

  • Nun-anan, Pongjarat;Chonprasertsuk, Soonthorn;Siramolpiwat, Sith;Tangaroonsanti, Anupong;Bhanthumkomol, Patommatat;Pornthisarn, Bubpha;Vilaichone, Ratha-korn
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.8
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    • pp.3253-3256
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    • 2015
  • Background: Chronic hepatitis B virus (HBV) infection related hepatocellular carcinoma (HCC) is a major health problem in the Asia-Pacific region including Thailand. Several factors have been proposed as contributing to hepatocarcinogenesis. This study was aimed to investigate the impact of CYP2C19 genotypic polymorphism in HCC related to chronic HBV infection in Thailand. Materials and Methods: A cross-sectional study was performed between April 2014 and January 2015. Chronic HBV patients with HCC (n=50) and without HCC (n=50) were included. Clinical information and blood samples of all patients were collected. The CYP2C19 genotype was determined by polymerase chain reaction-restriction fragment length polymorphism method, and was classified as rapid metabolizer (RM), intermediate metabolizer (IM) or poor metabolizer (PM). Results: The CYP2C19 genotype frequencies of RM, IM and PM in HBV patients were found to be 19/50 (38%), 25/50 (50%) and 6/50 (12%), respectively. The CYP2C19 genotype frequencies of RM, IM and PM in HBV with HCC patients were 21/50 (42%), 25/50 (50%) and 4/50 (8%), respectively. The distribution of CYP2C19 genotype was not different between patients with and without HCC. Interestingly, among HBV with HCC patients, the RM genotype of CYP2C19 tended to increase risk of aggressive manifestation (OR=2.89, 95%CI=0.76-11.25, P-value=0.07), compared with non RM genotype carriers. Conclusions: CYP2C19 genotype IM was the most common genotype in Thai patients with chronic HBV infection. In addition, genotype RM could be an associated factor for aggressive presentation in HCC related to chronic HBV infection.

Liver Involvement in Multiple Myeloma: A Hospital Based Retrospective Study

  • Poudel, Bibek;Mittal, Ankush;Shrestha, Rojeet;Farooqui, Mohammad Shamim;Yadav, Naval Kishor;Shukla, Pramod Shanker
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.2153-2155
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    • 2012
  • Objective: This study was to assess liver involvement in multiple myeloma with the aid of liver function tests. Materials and Methods: A hospital based retrospective study was undertaken using data retrieved of multiple myeloma from the register maintained in the Department of Biochemistry of the Manipal Teaching Hospital, Pokhara, Nepal between $1^{st}$ January, 2007 and $28^{th}$ February, 2012. We collected biomarkers of liver profiles including bilirubin (Total, Direct and Indirect), total protein, albumin, AG ratio, SGOT, SGPT, ALP, ${\gamma}GT$, LDH, ferritin, renal profile and hematological profile. Descriptive statistics and testing of hypothesis were used for the analysis using EPI INFO and SPSS 16 software. Results: Out of 37 cases of multiple myeloma, serum level of AST, ALT, ALP, ${\gamma}GT$ and LDH were increased above the cut-off point in 22 (59.5%), 24 (64.86%), 13 (35.13%), 9 (24.3%) and 11 (29.7%) respectively. The mean values of AST ($65.5{\pm}28.18$ U/L), ALT ($68.37{\pm}29.74$ U/L), ALP ($328.0{\pm}148.4$ U/L), ${\gamma}GT$ ($44.5{\pm}29.6$ U/L) and LDH ($361.7{\pm}116.5$ U/L), total protein ($9.79{\pm}1.03$ gm/dl) were significantly increased when compared with controls. In contrast, albumin ($3.68{\pm}0.43$ gm/dl) and the AG ratio ($0.62{\pm}0.15$) were significantly decreased. Similarly, anemia, hyperuricemia, azotemia, hypercalcaemia and Bence Jones proteinuria were found in 30 (78.9%), 27 (71.1%), 19 (51.5%), 15 (39.5%) and 16 (42.1%) respectively, in cases of multiple myeloma. Conclusions: While clinical manifestation of liver disease among the multiple myeloma was not common, abnormalities in liver function were characteristic.

Expression Levels of Tetraspanin KAI1/CD82 in Breast Cancers in North Indian Females

  • Singh, Richa;Bhatt, Madan Lal Brahma;Singh, Saurabh Pratap;Kumar, Vijay;Goel, Madhu Mati;Mishra, Durga Prasad;Srivastava, Kirti;Kumar, Rajendra
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3431-3436
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    • 2016
  • Background: Carcinogenesis is a multifaceted intricate cellular mechanism of transformation of the normal functions of a cell into neoplastic alterations. Metastasis may result in failure of conventional treatment and death Hence, research on metastatic suppressors in cancer is a high priority. The metastatic suppressor gene CD82, also known as KAI1, is a member of the transmembrane 4 superfamily which was first identified in carcinoma of prostate. Little work has been done on this gene in breast cancer. Herein, we aimed to determine the gene and protein level expression of CD82/KAI1 in breast cancer and its role as a prognosticator. Materials and Methods: In this study, 83 histologically proven cases of breast cancer and a similar number of controls were included. Patient age ranged from 18-70 years. Quantitative Real Time Polymerase Chain Reaction (q-RT PCR) and immunohistochemistry (IHC) were used to investigate KAI1 expression at gene and protein levels, respectively. Statistical analysis was done to correlate expression of KAI1 and clinicopathological parameters. Results: It was revealed that: (i) KAI1 was remarkably diminished in metastatic vs non metastatic breast cancer both at the gene and the protein levels (P < .05); (ii) KAI1 expression levels were strongly correlated with TNM staging, histological grade and advanced stage (p<0.001) and no association was found with any other studied parameter; (iii) Lastly, a significant correlation was observed between expression of KAI1 and overall median survival of BC patients (P = 0.04). Conclusions: Our results suggest that lack of expression of the KAI1 might indicate a more aggressive form of breast cancer. Loss of KAI1 may be considered a significant prognostic marker in predicting metastatic manifestation. When evaluated along with the clinical and pathological factors, KAI1 expression may be beneficial to tailor aggressive therapeutic strategies for such patients.

A case of atypical hemolytic uremic syndrome as an early manifestation of acute lymphoblastic leukemia (비전형적 용혈성 요독 증후군으로 조기 발현한 급성 림프모구성 백혈병 1예)

  • Han, Dong Kyun;Baek, Hee Jo;Cho, Young Kuk;Kim, Chan Jong;Shin, Myung Geun;Kook, Hoon;Hwang, Tai Ju
    • Clinical and Experimental Pediatrics
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    • v.53 no.2
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    • pp.253-257
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    • 2010
  • Hemolytic uremic syndrome (HUS) is the most common cause of acute renal failure in children younger than 4 years and is characterized by microangiopathic hemolytic anemia, acute renal failure, and thrombocytopenia. HUS associated with diarrheal prodrome is usually caused by Shiga toxin-producing Escherichia coli O157:H7 or by Shigella dysenteriae, which generally has a better outcome. However, atypical cases show a tendency to relapse with a poorer prognosis. HUS has been reported to be associated with acute lymphoblastic leukemia (ALL) in children. The characteristics and the mechanisms underlying this condition are largely unknown. In this study, we describe the case of an 11-year-old boy in whom the diagnosis of ALL was preceded by the diagnosis of atypical HUS. Thus, patients with atypical HUS should be diagnosed for the possibility of developing ALL.

Change of Cerebral Blood Flow during Tilt Tests in Children with Vasovagal Syncope (혈관미주 신경성 실신 소아에서 기립경사 검사 동안에 뇌혈류 변화)

  • Kim, Su Jung;Yom, Hye Won;Hong, Young Mi;Yoo, Jung Hyen;Lee, Sook Hee;Kim, Chong Hee
    • Clinical and Experimental Pediatrics
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    • v.46 no.10
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    • pp.983-988
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    • 2003
  • Purpose : Syncope appears to be common. However, the mechanism of syncope is not clear. Increased vagal activity and withdrawal of sympathetic stimulation cause hypotension, bradycardia and finally loss of consciousness. The purpose of this study was to evaluate changes of cerebral blood flow velocity, blood pressure, and heart rate during tilt test in children with vasovagal syncope. Methods : Sixty four children with a past history of syncope were evaluated. The stand up test was performed for 15 minutes after a rest at supine position for 10 minutes, followed by an $80^{\circ}$ tilt test lasting 45 minutes. If presyncope(lightheadedness, nausea, blurred vision, or sweating) or syncope occurred, the study was discontinued. 12-lead electrocardiography, echocardiography, and electroencephalography were performed. Transcranial Doppler study was performed at the middle cerebral artery with 2 MHz continuous Doppler probe in 10 children with positive tilt test. Systolic, diastolic, mean cerebral blood flow velocity, integral, and pulsatility index were measured with blood pressure, heart rate, and $O_2$ saturation. Results : The positive rate of tilt test was 31.3%(20/64). Systolic, diastolic, and mean cerebral blood flow velocity decreased significantly in absence of hypotension or bradycardia during presyncope. Time velocity integral of cerebral artery also decreased significantly. Conclusion : Decreased cerebral blood flow velocity can predict the presyncope manifestation. Impairment of autoregulation of cerebral blood flow might play an important role in the pathophysiology of vasovagal syncope.

Ultrasonographic Findings in 132 Cases of Renal Disease (신질환(腎疾患) 132례(例)의 초음파진단(超音波診斷))

  • Han, Hye-Jin;Kim, Kang-Sueck
    • The Journal of the Korean life insurance medical association
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    • v.3 no.1
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    • pp.187-208
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    • 1986
  • The conclusions which was acquired one renal cell carcinoma and renal disease 132 cases that was tested renal echogram among 4,499 cases for recent 16 months at medical department, Dae Han Kyoyuk Insurance company from August, 1984 to November, 1985 are as follows: 1. On bur ultrasonography, the echo of tumor was demonstrated with echogenicity as compared with renal parenchyme. 2. The case was stage I by Robson's modification method for pathologic histology. 3. There is no fever, typical triad of renal cell carcinoma and the result of serum biochemical test was within normal limit. 4. The frequency with disease was renal cell carcinoma(0.76%), ureteral stone(1.5%), multicystic kidney(2.27%), hydroureter(2.27%), Bilateral poly cystic kidney(4.55%), hydronephrosis(4.55%), renal agenesis(6.06%) renal calculi(18.18%), simple cyst(60.61%). 5. The frequency with age was 55/1200 case(4.58%) in $41{\sim}50$ years, 13/296 cases(4.39%) in $51{\sim}60$ years, 43/2144 cases(2.01%) in $31{\sim}40$ years, 14/791 cases(1.77%) in $21{\sim}30$ years, 7/53 cases(1.32%) more than 61 years and 0/15(0%) under 20 years. 6. The affected site of renal agenesis 8 cases was right side all. 7. In total renal disease 132 cases, the affected site of 126 cases except bilateral polycystic kidney 6 cases was right kidney 72 cases, left kidney the proportion of right to left 1.6:1 8. In total renal disease 132 cases except bilateral polycystic kidneys 6 cases, the patients affected with both side kidneys were 14 cases. 9. The affection rate with sex in total renal disease 132 cases was 98/2860 cases in male, 34/1819 cases in female and the former was about 2 times than the latter. 10. Classifying the stone with part, nephrolithiasis 24 cases were appeared high frequency, on the contray, ureteral stone 2 cases. 11. 2 cases of ureteral stone developed complication, hydronephrosis and hydroureter. 12. The linear array type transducer was not helpful for the diagnosis of lower ureteral calculi but for the lower ureteral calculi, we could see the stone with high echo in accompanying with acoustic shadowing. 13. In 24 cases of renal calculi, both side nephrolithiasis was 3 cases(12.5%). 14. In renal calculi, solitary stone could be seen extremely much and the number of stone was so much variable from 2 to 10. 15. In 26 cases with renal calculi and ureteral stone, the common clinical manifestation was a intermittent and slight pain. 16. In 80 cases of renal cyst, as one's get older, the affection rate of cyst extremely rised. 17. In bilateral polycystic kidney, large cyst had septum on the whole. 18. The patients with complication were 14 cases(10.6%) of total patients.

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