• Title/Summary/Keyword: Diagnostic Possibility

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Clinical Considerations of the Surgical Treatments of the Pressure Sore (욕창의 수술적 치료에 대한 임상적 고찰)

  • Lee, Keun Cheol;Moon, Joo Bong;Kwon, Yong Seok;Cha, Byung Hoon;Kim, Seok Kwun
    • Archives of Plastic Surgery
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    • v.34 no.5
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    • pp.574-579
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    • 2007
  • Purpose: The number of sore patients are increasing steadily, especially in old ages, chronic disease and paralytic patients. Most of patients need to surgical treatment. The aim of this paper is to assess clinical analysis of surgical treatment and to consider operative methods, complications, and recurrences.Methods: We reviewed the data from 82 consecutive patients with 101 pressure sores from March 2003 to May 2006 to discuss the occurrence rate and recurrence rate according to the site on the basis of the presence or absence of paraplegic and its etiology-the patients were categorized into three diagnostic groups: traumatic paraplegics(TP), nontraumatic paraplegics (NTP), and nontraumatic nonparaplegics(NTNP). We examined the sites and sizes of each lesions, patient's state, primary causes of pressure sore, operative methods as each sites and groups, occurrence of complications and recurrences on each groups. Results: In 82 patients, 52 patients were male, 30 patients were female. The male to female ratio was 1.7 :1. Mean age was 55.8 years. 27 patients were in TP group, 35 in NTP group, and 20 in NTNP group, respectively. The common site of sore were sacral area (50.5%), greater trochanteric area(15.8%) and ischial area(13.9%). In each group, incidence rate of recurrence and complication were 11.1%, 40.7% in TP, 5.7%, 5.7% in NTP and 15%, 45% in NTNP. Conclusion: Surgeons must consider the general condition of the patient and possibility of recurrence and returning of daily life. We propose that cutaneous flap, fasciocutaneous flap or skin graft as well as musculocutaneous flap be useful to repair of sore site as each patient's state.

Assessing Misdiagnosis of Relapse in Patients with Gastric Cancer in Iran Cancer Institute Based on a Hidden Markov Multi-state Model

  • Zare, Ali;Mahmoodi, Mahmood;Mohammad, Kazem;Zeraati, Hojjat;Hosseini, Mostafa;Naieni, Kourosh Holakouie
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.9
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    • pp.4109-4115
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    • 2014
  • Background: Accurate assessment of disease progression requires proper understanding of natural disease process which is often hidden and unobservable. For this purpose, disease status should be clearly detected. But in most diseases it is not possible to detect such status. This study, therefore, aims to present a model which both investigates the unobservable disease process and considers the error probability in diagnosis of disease states. Materials and Methods: Data from 330 patients with gastric cancer undergoing surgery at the Iran Cancer Institute from 1995 to 1999 were analyzed. Moreover, to estimate and assess the effect of demographic, diagnostic and clinical factors as well as medical and post-surgical variables on transition rates and the probability of misdiagnosis of relapse, a hidden Markov multi-state model was employed. Results: Classification errors of patients in alive state without a relapse ($e_{21}$) and with a relapse ($e_{12}$) were 0.22 (95% CI: 0.04-0.63) and 0.02 (95% CI: 0.00-0.09), respectively. Only variables of age and number of renewed treatments affected misdiagnosis of relapse. In addition, patient age and distant metastasis were among factors affecting the occurrence of relapse (state1${\rightarrow}$state2) while the number of renewed treatments and the type and extent of surgery had a significant effect on death hazard without relapse (state2${\rightarrow}$state3)and death hazard with relapse (state2${\rightarrow}$state3). Conclusions: A hidden Markov multi-state model provides the possibility of estimating classification error between different states of disease. Moreover, based on this model, factors affecting the probability of this error can be identified and researchers can be helped with understanding the mechanisms of classification error.

A fMRI study on the cerebral activity induced by Electro-acupuncture on Zusanli(St36) (족삼리(足三里)(St36)의 전침자극(電鍼刺戟)이 fMRI상 뇌활성(腦活性) 변화(變化)에 미치는 영향(影響))

  • Kim, Young-il;Kim, Young-hwa;Lim, Yun-kyoung;Lee, Hyen;Lee, Byung-ryul;Kim, Yeon-jin
    • Journal of Acupuncture Research
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    • v.20 no.5
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    • pp.133-150
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    • 2003
  • Objective: Recently. many studies have showed the evidences of the effect of the Electro-acupuncture treatment through scientific. Methods : One of these methods is functional MRI. We performed electro-acupuncture on Zusanli(St36) and observed the change of brain activation using fMRI. Zusanli(St36) is located on the lateral side of the lower leg. 3 cun(寸) inferior to the Patella of the lower border. Theoretically and clinically. this point has been considered very important for gynecological disorders. spleen and stomach disorders. and psychological disorders. To see the effects of electro-acupuncture stimulation on Zusanli(St36). the experiment was carried out on twelve healthy volunteers. using the gradient echo sequence with the 3.0T whole-body fMRI system(ISOL). After the needle insertion on right Zusanli(St36). 2 Hz of electric stimulation was given for 30 seconds. repeated five times. with 30 seconds' intervals. The Image analysis including motion correction. talairach transformation, and smoothing was done with SPM99. Results ad conclusion : The electro-acupuncture stimulation on Zusanli(St36) activates Brodmann Area 6, 13, 2, 19, 21, 22, 39, 40, 38, 3which indicates the pathways of the electro-acupuncture stimulation on Zusanli(St36) and the possibility of the relationship of the electro-acupuncture stimulation on Zusanli(St36) with autonomic nervous system, internal organic system.

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Characterization of CCND1 and TWIST1 as Prognostic Markers with the Mortality Rate of Breast Cancer

  • Ahn, Sungwoo;Park, Sangjung;Wang, Hye-Young;Park, Sunyoung;Kim, Jungho;Lee, Hyeyoung
    • Biomedical Science Letters
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    • v.24 no.2
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    • pp.76-86
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    • 2018
  • Breast cancer is one of the most common cancers affecting women worldwide. Although the survival rate of breast cancer has increased, breast cancer still results in a high mortality rate. Breast cancer deaths are caused by metastasis that occurs in organ dysfunction. Recently, there have been many studies on circulating tumor cells (CTCs), which are related to breast cancer metastasis in the blood. Recent studies have demonstrated that some CTCs do not express epithelial markers. Therefore, in this study, total RNA was extracted from blood without separating out the CTCs, and the characteristics of the CTCs were analyzed by RT-qPCR. Cyclin D1 and twist-related protein 1 (TWIST1) are well-known markers for predicting the prognosis of patients with breast cancer. However, few studies have demonstrated the use of CCND1 and TWIST1 in blood as diagnostic and prognostic markers of breast cancer. In this study, patients with late-stage breast cancer had overexpressed CCND1 and TWIST1 than patients with different stages of breast cancer (P < 0.001 and P < 0.01, respectively). The relative expression level of CCND1 in survivors was higher than in patients who died (P = 0.06). The relative expression level of TWIST1 in survivors was lower than in patients who died (P = 0.08). Overall CCND1 and TWIST1 were not useful as markers for the diagnosis of breast cancer through blood. However, we showed the possibility of using CCND1 and TWIST1 as prognostic markers, and a large-scale study is needed to confirm the usefulness of these prognostic markers.

A Case of Pulmonary Thromboembolism with JAK2 Mutation (JAK2 돌연변이를 동반한 폐색전증 1예)

  • Kim, Jin-Jin;Kwon, Soon-Seog;Lee, Hyun-Jeong;Lee, Hea-Yon;Jeong, Myung-Hee;Kim, Yong-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.4
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    • pp.351-355
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    • 2009
  • The incidence of pulmonary thromboembolism increases with age. The risk factors of pulmonary thromboembolism include surgery, malignancy, obesity, lupus anticoagulants, and vascular conditions such as deep vein thrombosis. Thromboembolism in younger patients or in unusual locations, the possibility of primary thrombophilic conditions should be considered. Primary thrombophilic states include myeloproliferative disorders (MPD). JAK2 V617F mutation is found commonly in patients diagnosed with MPD, in 90~95% of polycythemia vera (PV) and in 50~60% of essential thrombocytosis (ET) patients. Sometimes the JAK2 V617F mutation is found in cases without MPD. The relationship between JAK2 V617F mutation and thrombosis has not been defined. Recently, clinical evidence suggests that this mutation may be variably associated with thrombosis. We present one case of pulmonary thromboembolism in a young patient, who was positive for the JAK2 V617F mutation and did not have MPD.

Development of Novel Diagnostic Testing Strips for Measuring Leukocyte Levels in Urine (요 중 백혈구를 측정하기 위한 새로운 진단 시험지 개발에 관한 연구)

  • Park, Soo Min;Park, Chung Oh;Jang, Won Cheoul
    • Journal of the Korean Chemical Society
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    • v.43 no.1
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    • pp.104-109
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    • 1999
  • A number of leukocytes increases when infected by a germ or virus. Detection of leukocyte levels can indicate of such medical informations as urogenital tract infection or other dysfunction. In this study, pentyl-3-thiophene-carboxlyate (PTC), pentyl-8-quinolinecarboxylate (PQC), and 2-Phenyl-4(N-tosyl-alanyloxyl)-thiazole (PTT) were synthesized, and the test strips were prepared with these substrates for quantifying leukocytes in urine. Among these substrates, the PTT test strip prepared in 0.5% borate buffer pH 8.0, 0.03% PTT, 0.1-0.8% PVP, and 1% decanol showed not only better color reaction but also an excellent application possibility to be used in automatic urine analyzer.

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Correlation Between High-Sensitive Collimator and Quantitave Analysis in Lung Ventilation SPECT (폐 환기 SPECT에서 고감도 Collimator와 정량분석의 상관관계)

  • Kim, Jung-Soo;Kim, Sang-Hyun
    • Journal of radiological science and technology
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    • v.38 no.2
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    • pp.89-99
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    • 2015
  • This study investigated the correlation between the characteristics of collimator in accordance with the efficiency of detecting photon signals and the quantitative analysis of the lung function, thereby assessing the possibility of clinically applying high sensitivity lung ventilation SPECT. From March to May, 2014, 10 subjects in normal volunteers underwent an ultra high resolution, high resolution and high sensitivity collimator planar scan and SPECT. The experiment showed that compared with the collimator scan, the quantitative analysis results were significant (p=0.89), and compared to the high resolution collimator SPECT, the time was reduced by 4.9 fold. Therefore, the lung ventilation SPECT that had not been used due to an undermined effectiveness can offer usefulness when clinically applied if a high sensitivity collimator is used since the quality and quantity of information and the duration of scan time all offer an improvement.

Spontaneously Occurring Chemodectoma in a Yorkshire Terrier Dog

  • Park, Chul;Yoo, Jong-Hyun;Kim, Dae-Young;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.25 no.3
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    • pp.187-191
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    • 2008
  • A 7-year-old, intact female Yorkshire terrier dog was presented for coughing, anorexia, chest pain and dyspnea. Right lateral thoracic radiograph demonstrated a large mass shape on the heart base with decreased cardiac silhouette and severe right deviation of the trachea with the heart shifted to the left thoracic wall was observed on the ventrodorsal thoracic projection. Echocardiographic examination revealed a large rounded mass compressing left atrium around the heart base without signs of pericardial effusion. On computed tomographic (CT) findings, sagittal CT images depicted the possibility of cranial vena caval invasion and heart base involvement of the mass associated with biatrial compression. Dorsal CT image revealed the right deviation of trachea due to the heart base mass and markedly shrunk lung space was detected on the transverse CT image. Because the dog suddenly had died during the recovery from anesthesia after finishing CT scan, necropsy was performed. On gross findings, a large and lobulated mass was located at the base of the heart. A poorly-demarcated, infiltrative, multilobulated tumor composed of polyhedral cells in solid cellular sheets was confirmed based on histopathologic examination. This dog was diagnosed as a chemodectoma. This case report describes the clinical findings, diagnostic consistency of thoracic radiography, echocardiography and CT, and histopathologic confirmation in a spontaneously occurring chemodectoma with a Yorkshire terrier dog.

The Use of Skin Resistance Point Finder for the Diagnosis of Myofascial Trigger Points (피부 저항점 탐지기를 사용한 근근막 통증 유발점의 진단)

  • Kang, Mi-Suk;Hong, Jung-Eun;Lim, Young-Jin;Lee, Sang-Chul
    • The Korean Journal of Pain
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    • v.12 no.2
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    • pp.195-199
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    • 1999
  • Background: At present, there is no reliable objective test for the diagnosis of myofascial trigger points (MFTP). We evaluated the usefulness of skin resistance point finder for the diagnosis of MFTP. Methods: 40 subjects with clinical MFTPs at the upper trapezius muscle were included in this study. Using skin resistance point finder (UNIQUE S-2010$^{(R)}$, Seik medical, Korea), we tried to find out the point of low skin resistance. At three different current level, sensitivity and specificity of this method for the diagnosis of clinically identified MFTP was evaluated. Pressure threshold for pain of low skin resistance point was measured using Pressure Threshold Meter$^{(R)}$ (Pain Diagnostics and Thermography, U.S.A.). 3 groups of point detected at different current were compared in mean pressure threshold. Results: Fixed single current of skin resistance point finder showed variable sensitivity and specificity. But, by adjusting current level, skin resistance point finder detected all of 40 clinically identified MFTPs. Although it is partially statistically significant, the mean pressure threshold of points detected at high current was high. Conclusion: Skin resistance finder can be used as objective diagnostic tool of MFTPs. There is possibility that it can be useful in evaluating treatment effect. However, more investigation is necessary.

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Analysis of Mitochondrial DNA in Patients with Essential Tremor (본태성 수전증 환자의 미토콘드리아 DNA 분석)

  • Lee, Uhn;Yoo, Young Mi;Yoo, Chan Jong
    • Journal of Korean Neurosurgical Society
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    • v.29 no.2
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    • pp.188-195
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    • 2000
  • Objective : Essential tremor(ET) is the most common movement disorder, however, there has been little agreement in the neurologic literature regarding diagnostic criteria for ET. Familial ET is an autosomal dominant disorder presenting as an isolated postural tremor. The main feature of ET is postural tremor of the arms with later involvement of the head, voice, or legs. In previous studies, it was reported that ET susceptibility was inherited in an autosomal dominant inheritance. As previous results, it would suggest that ET might be associated with defect of mitochondrial or nuclear DNA. Recent studies are focusing on molecular genetic detection of movement disorders, such as essential tremor and restless legs syndrome. Moreover, authors have analysed mitochondrial DNA(mtDNA) from the blood cell of positive control(PC) and ET patients via long and accurate polymerase chain reaction(LA PCR). Materials & Methods : Blood samples were collected from PC and 9 ET patients. Total DNA was extracted twice with phenol followed by chloroform : isoamylalcohol. For the analysis of mtDNA, LA PCR was performed by mitochondrial specific primers. Results : With this technique, deletions of large quantities were detected within several regions of mtDNA in ET patients except for D-loop and CO I regions. Conclusion : The authors believe that ET is a genentic disorder with deficiency of mitochondrial DNA multicomplexes and mitochondiral dysfunction could be one of major causative factors of ET. Mitochondrial dysfunction may play an important role in the pathogenesis and possibility of disease progression among familial group with ET patients.

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