• Title/Summary/Keyword: Clinical symptoms and signs

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The Efficacy of Radiation Therapy in the Treatment of Pituitary Adenoma (뇌하수체 선종의 방사선치료 효과 및 결과)

  • Cho Heung Lae;Yang Kwang Mo;Shon Seung Chang;Suh Hyung Suk
    • Radiation Oncology Journal
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    • v.8 no.2
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    • pp.163-167
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    • 1990
  • Between 1984 and 1989, 22 patients with pituitary adenomas were treated with radiation therapy. The tumor was controlled in 18 of 22 ($81.8\%$) patients for an observed period of II to 98 months. Eleven of 12 ($92\%$) patients with visual field defect experienced normalization or improvement, and 3 of 5 evaluable patients with hyperprolactinemia achieved normalization in one and decrement in two patients. We concluded that: (a) postoperative radiotherapy is clearly effective in the controlling of clinical symptoms and signs resulting from pituitary adenoma: (b) In the macroadenoma, the difference of control rate between suprasellar, <2 cm. and suprasellar,> 2 cm. was not significant.

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Study on the Diagnostic Indicators of Fire-heat Pattern Identification in Stroke Patients (중풍환자의 화열변증 진단지표에 관한 연구)

  • Lee, Jung-Sup;Ko, Mi-Mi;Kang, Byoung-Kab;Kim, Jeong-Cheol;Kim, Bo-Young;Lee, In;Kim, Yun-Sik;Choi, Sun-Mi;Bang, Ok-Sun
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.2
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    • pp.499-504
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    • 2009
  • The purpose of this study was to evaluate the diagnostic indicators which are used for the identification of fire-heat pattern in stroke patients. For evaluation of diagnostic indicator, we analyzed the indicators which are composed of symptoms and signs collected from stroke patients based on the clinical records using case report form (CRF). Patients had a first-ever stroke within 1 month after the onset of stroke. Pattern identification was performed and decided by two independent physicians. Two patient groups that consist of fire-heat pattern and the other patterns were compared to isolate important indicators affecting the fire-heat pattern identification of stroke patients. The 8 indicators among 16 fire-heat pattern indicators were significantly more frequent compared with non fire-heat pattern group. Logistic regression analysis revealed that 5 indicators among fire-heat indicators were significantly sensitive indicators being capable of identification of fire-heat pattern. But two of them was from the indicators of dampness-phlegm pattern and yin deficiency pattern. Therefore, further studies are required for the development of Korean standard indicators of Fire-heat pattern identification.

Novalis Radiosurgery of Primary Central Nervous System Lymphoma in Elderly Patients : Preliminary Results

  • Han, Seong-Rok;Yee, Gi-Taek;Choi, Chan-Young;Sohn, Moon-Jun;Lee, Dong-Joon;Whang, Choong-Jin
    • Journal of Korean Neurosurgical Society
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    • v.39 no.6
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    • pp.409-412
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    • 2006
  • Objective : Primary central nervous system lymphoma[PCNSL] is a non-Hodgkin's lymphoma arising in the central nervous system. Combined chemotherapy and radiation therapy is the standard treatment for PCNSL. However, treatment induced neurotoxicity is a major problem especially in elderly patients. Methods : From May 2001 to April 2004, elderly five patients with PCNSL confirmed via pathological examination were underwent Novalis radiosurgery in authors' institution, who were investigated retrospectively. Of these patients, 2 were male and 3 were female, with a mean age 68 years old [range $65{\sim}73$]. The number of lesions was 1 in 2 patients, 2 in 2, and 3 in 1. The mean follow up period was 12.6 months [range $8{\sim}16$]. Results : Clinical symptoms and signs in all patients markedly improved within 1 weeks after Novalis radiosurgery. The Karnofsky performance status score was also improved from a pre-radiosurgery average of 68 to a post-radiosurgery one of 82. All of treated lesions showed a partial or complete regression of the original mass. There have been no complication following Novalis radiosurgery. Conclusion : The preliminary results of our experience indicate that radiosurgery with Novalis provides a safe and effective therapeutic alternative treatment of PCNSL in elderly patients.

Predictive value of C-reactive protein for the diagnosis of meningitis in febrile infants under 3 months of age in the emergency department

  • Lee, Tae Gyoung;Yu, Seung Taek;So, Cheol Hwan
    • Journal of Yeungnam Medical Science
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    • v.37 no.2
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    • pp.106-111
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    • 2020
  • Background: Fever is a common cause of pediatric consultation in the emergency department. However, identifying the source of infection in many febrile infants is challenging because of insufficient presentation of signs and symptoms. Meningitis is a critical cause of fever in infants, and its diagnosis is confirmed invasively by lumbar puncture. This study aimed to evaluate potential laboratory markers for meningitis in febrile infants. Methods: We retrospectively analyzed infants aged <3 months who visited the emergency department of our hospital between May 2012 and May 2017 because of fever of unknown etiology. Clinical information and laboratory data were evaluated. Receiver operating characteristic (ROC) curves were constructed. Results: In total, 145 febrile infants aged <3 months who underwent lumbar punctures were evaluated retrospectively. The mean C-reactive protein (CRP) level was significantly higher in the meningitis group than in the non-meningitis group, whereas the mean white blood cell count or absolute neutrophil count (ANC) did not significantly differ between groups. The area under the ROC curve (AUC) for CRP was 0.779 (95% confidence interval [CI], 0.701-0.858). The AUC for the leukocyte count was 0.455 (95% CI, 0.360-0.550) and that for ANC was 0.453 (95% CI, 0.359-0.547). The CRP cut-off value of 10 mg/L was optimal for identifying possible meningitis. Conclusion: CRP has an intrinsic predictive value for meningitis in febrile infants aged <3 months. Despite its invasiveness, a lumbar puncture may be recommended to diagnose meningitis in young, febrile infants with a CRP level >10 mg/L.

Effects and Safety of Minocycline Loaded Polycaprolactone for Pericoronitis (미노클린 첨부제의 지치주위염에 대한 유효성 및 안전성 평가를 위한 위약대조 이중 맹검 제3상 비교임상시험)

  • Seol, Yang-Jo;Ko, Young-Kyung;Lee, Yong-Moo;Ku, Young;Rhyu, In-Cheul;Han, Soo-Boo;Choi, Sang-Mook;Chung, Chong-Pyoung
    • Journal of Periodontal and Implant Science
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    • v.30 no.3
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    • pp.619-632
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    • 2000
  • This clinical study was designed to determine the clinical and microbiological outcomes and safety of using minocycline loaded polycaprolactone strip for pericoronitis patients. 64 patients showing symptoms and signs of pericoronitis were enrolled according to the inclusion criteria in this double blind study. They were randomly assigned to two groups. 32 patients comprised control group and they received only polycaprolactone films in pericoronal spaces, and another 32 patients comprised experimental group and they received polycaprolactone films loaded with 30% minocycline. Informed consent was obtained from all the participants before beginning the study. At the initial visit, gingival index(GI), papillary bleeding index(PBI), amount of gingival crevicular fluid(GCF) were recorded, and microbiological sampling was done. Then, loaded or unloaded polycaprolactone film was inserted into the pericoronal spaces. No drug was prescribed excepting this film. After one week, clinical and microbiological exam was repeated. Presence of any side effects or inconveniences were checked. Chi-square test and t-test was performed to compare outcomes. At baseline, there were no significant differences in all the criteria between experimental group and control group. Experimental group showed significant improvement compared with control group both in GI(p<0.01) and PBI(p<0.01). The amount of GCF of the experimental group was significantly decreased compared with the control group(p<0.01) and baseline(p<0.01). In microbiological study, percentage of motile rod was prominently decreased in the experimental group. Also, aerobic(p<0.001), anaerobic(p<0.001) and black pigmented(p<0.01) bacteria were significantly decreased from the baseline. Furthermore, no side effects or inconveniences was reported in the experimental group. From this study, it was concluded that insertion of polycaprolactone film with 30% minocycline into the pericoronal spaces would be effective and safe treatment for pericoronitis.

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The National Survey of Acute Pulmonary Thromboembolism in Korea (급성 폐혈전색전증 전국 실태 조사 보고)

  • Scientific Committee for National Survey of Acute Pulmonary Thromboembolism, Korean Academy of Tuberculosis and Respiratory Diseases
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.1
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    • pp.5-14
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    • 2003
  • Background : According to the study in ICOPER (International Cooperative Pulmonary Embolism Registry), the overall mortality rate of acute pulmonary thromboembolism (APTE) at 3 months is 17.4%. According to the study for current status of APTE in Japan, the hospital mortality rate is 14%. Although the incidence and mortality rate of APTE has been increasing, patient characteristics, management strategies, and outcome of APTE in the Korean population have not yet been assessed in large series. We therefore performed the national survey for the current status of APTE in the Korean population. Methods : 808 registry patients with APTE were analyzed with respect to clinical characteristics, risk factors, diagnostic procedures, treatment, and clinical outcome. Results : Main risk factors were immobilization, recent major surgery, and cancer. Common symptoms were dyspnea and chest pain. Common signs were tachypnea and tachycardia. The majority of registry patients underwent lung perfusion scanning. Spiral CT was used in 309 patients(42.9%), and angiography in 48 patients(7.9%). Heparin was the most widely used treatment. On multivariate logistic regression analysis, onset in hospital (odds ratio 1.88, p=0.0385), lung cancer (odds ratio 9.20, p=0.0050), tachypnea (odds ratio 3.50, p=0.0001), shock (odds ratio 6.74, p=0.0001), and cyanosis (odds ratio 3.45, p=0.0153) were identified as significant prognostic factors. The overall mortality rate was 16.9% and mortality associated with APTE was 9.0%. Conclusions : The present registry demonstrated the clinical characteristics, diagnostic strategies, management and outcome of patient with APTE in Korea. The mortality rate was 9.0%, and the predictors of mortality were onset in hospital, lung cancer, tachypnea, shock, and cyanosis. These results may be important for risk stratification as well as for the identification of potential candidates for more aggressive treatment.

The Clinical Manifestations of the Five Cases of Lymphangitic Carcinomatosis of the Lung Presented as Diffuse and Interstitial Disease (미만성 간질성 폐질환으로 발현한 폐장의 암종성 림프관염 환자 5예에 대한 임상적 고찰)

  • Sung, Young-Joo;Choi, Soo-Jeon;Lee, Bong-Chun;Kim, Dong-Soon;Seo, Yeon-Lim
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.1
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    • pp.55-61
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    • 1992
  • Background: The lung is the most common site of metastasis and usually it manifests as a single or multiple nodules in chest X-ray. But less commonly the cancer spreads through the lymphatics and X-ray shows diffuse reticulonodular densities. Sometimes, patient is presented with respiratory symptoms only with interstitial lung infiltration before the signs of primary tumor and in that cases, the differential diagnosis with other interstitial lung disease is required. We have experienced 5 such cases, who were diagnosed as lymphangitic carcinomatosis by transbronchial lung biopsy. Methods: Clinical manifestation, pulmonary function test, modified thin section CT, bronchoalveolar lavage and transbronchial lung biopsy were done. Results: The primary tumor was gastric cancer in 3, lung cancer in 2. Pulmonary function test showed restrictive pattern with low DLco in 2 patients and obstructive pattern in one. Bronchoalveolar lavage showed lymphocytosis in 4 patients and malignant cells were found in one patient. Transbronchial lung biopsy revealed malignant cells localized to the lymphatics (peribronchial, perivascular and perialveolar). Cell type was adenocarcinoma in 4 and squamous cell carcinoma in one. Conclusion: Rarely lymphangitic carcinomatosis can be presented as diffuse interstitial lung disease and easily diagnosed by transbronchial lung biopsy.

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Development of Questionnaires for Differentiation of $q{\grave{i}}-x{\bar{u}}$, $xu{\grave{e}}-x{\bar{u}}$, $yang-x{\bar{u}}$, $y{\bar{i}}n-x{\bar{u}}$ analysis (기혈음양허손(氣血陰陽虛損) 변증(辨證) 분석을 위한 설문문항 개발)

  • Woo, Hong-Jung;Kim, Se-Hoon;Lee, Seung-Bo;Choi, Mi-Young;Kim, Young-Chul;Lee, Jang-Hoon
    • The Journal of Internal Korean Medicine
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    • v.29 no.4
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    • pp.856-870
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    • 2008
  • Objectives : Consumption is a chronic wasting disease and major portion of Oriental Medicine's therapy. However, there is no standard diagnostic method for consumption that is $q{\grave{i}}-x{\bar{u}}$, $xu{\grave{e}}-x{\bar{u}}$, $yang-x{\bar{u}}$, $y{\bar{i}}n-x{\bar{u}}$. Methods : A questionnaire which includes symptoms and signs for diagnosis of $q{\grave{i}}-x{\bar{u}}$, $xu{\grave{e}}-x{\bar{u}}$, $yang-x{\bar{u}}$, $y{\bar{i}}n-x{\bar{u}}$ was evaluated by Delphi technique. Each question was valuated by interviewing 27 oriental medicine doctors. Then. we choose questions given over 5 points and reorganized some items according to the recommendations by interviewed-doctors. We then accessed the value of re-organized questions composing of the questionnaires. Conclusion : We finally chose each 9 items of $q{\grave{i}}-x{\bar{u}}$, $xu{\grave{e}}-x{\bar{u}}$, $yang-x{\bar{u}}$, $y{\bar{i}}n-x{\bar{u}}$'s questionnaire. Further study is necessary for modification of questionnaire by statistics and certification by clinical trial.

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Simultaneous Bucket-handle Tears of both Medial and Lateral Meniscus - A Case Report - (내측 및 외측 반월상 연골에 동시 발생한 양동이 손잡이형 파열 - 증례 보고 -)

  • Yoon, Jung-Ro;Kim, Taik-Sun;Yang, Jai-Hyuk;Kang, Kyu-Bok;Kim, Young-Chan
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.1
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    • pp.25-28
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    • 2010
  • Most of bucket handle meniscal tears are associated with anterior cruciate ligament (ACL) deficiency. Lateral meniscus lesions are more common with acute ACL deficiency, where medial meniscus lesions are more associated with chronic ACL deficiency. We reported an ACL deficient knee with bucket handle tears of medial and lateral meniscus of the same knee. The report suggests the need for increased awareness of the possible presence of this. Additionally, we discuss injury mechanism, clinical symptoms, specific signs on Magnetic Resonance Imaging (MRI), and treatment options.

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A Case of Tuberculous Arthritis on Left Knee Joint in a Child (소아에서 발생한 슬관절의 결핵성 관절염)

  • Lee, Hye Jin;Lee, Ji Hun;Mok, Hye Rin;Lee, Soo Young;Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.13 no.2
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    • pp.174-179
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    • 2006
  • Tuberculosis still ranks as one of the three most important infectious diseases in the world in terms of morbidity and mortality. In Korea, an increased incidence of tuberculosis has been observed in recent years. With the resurge of tuberculosis, extrapulmonary tuberculosis has increased, too. From this point of view, tuberculous arthritis affecting knee is rare in all forms of tuberculosis, but we can consider tuberculous arthritis in patients with osteomyelitis. We report the case of a 14-month-old male child who presented with fever and swelling on the left knee joint. Histologic examination of knee joint fluid showed consistent with tuberculosis. Ziehl-Neelsen stain of joint fluid was positive for acid-fast bacilli(AFB). The outcome was favorable after treatment with anti-tuberculosis medication. Because clinical signs and symptoms of musculoskeletal tuberculosis in children is more indolent, we can misdiagnose or delay diagnosis. The diagnosis of tuberculous arthritis can be elusive, necessitating a high index of suspicion.

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