• Title/Summary/Keyword: Diagnostic utility

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The Usefulness of Capsule Endoscopy in Diagnosis of Small Bowel Diseases (소장질환의 진단에 캡슐내시경 검사의 유용성)

  • Eun, Jong-Ryul;Jang, Byung-Ik
    • Journal of Yeungnam Medical Science
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    • v.23 no.1
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    • pp.45-51
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    • 2006
  • Background: This study was conducted to evaluate the usefulness of capsule endoscopy (CE) for the diagnosis of small bowel diseases. Materials and Methods: We reviewed the medical records of 66 patients (mean age: 52.1 years, male/female: 39/27), who underwent CE at Yeungnam University Hospital from August 2003 to March 2006. Results: Suspicious gastrointestinal (GI) bleeding presenting as anemia or history of gross bleeding was the most common reason to perform CE (71.2%). Other indications included GI symptoms (21.2%) such as abdominal pain/discomfort, nausea, diarrhea, and others (7.6%). In studies performed for GI bleeding (n=47), ulcer/erosion was the most common finding (n=22, 46.8%) followed by tumor (n=5, 10.6%), angiodysplasia (n=3, 6.4%), polyp (n=3, 6.4%), active bleeding (n=1, 2.1 %), ulcer with stenosis (n=1, 2.1%), and normal findings (n=12, 25.5%). Of these, a bleeding focus was detected in 32 cases (68.1%) undergoing CE studies. Among 14 patients with GI symptoms, only two patients had typical findings related with symptoms. Surgical resection was performed in five cases with tumor. Of these, four were diagnosed as gastrointestinal stromal tumor and the other one was a lymphangioma. There were no complications associated with the CE procedure. Conclusion: Capsule endoscopy is a safe, noninvasive diagnostic tool for small bowel diseases and may be useful for the diagnosis of small bowel hemorrhage including obscure bleeding. However, further studies are needed to confirm its utility for abdominal symptoms other than hemorrhage because of the low diagnostic yield.

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Frozen Section Biopsy to Evaluation of Obscure Lateral Resection Margins during Gastric Endoscopic Submucosal Dissection for Early Gastric Cancer

  • Kang, Eun-Jung;Cho, Joo-Young;Lee, Tae-Hee;Jin, So-Young;Cho, Won-Young;Bok, Jin-Hyun;Kim, Hyun-Gun;Kim, Jin-Oh;Lee, Joon-Seong;Lee, Il-Hyun
    • Journal of Gastric Cancer
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    • v.11 no.3
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    • pp.155-161
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    • 2011
  • Purpose: To determine the diagnostic utility of a frozen section biopsy in patients undergoing endoscopic submucosal dissection (ESD) for early gastric neoplasms with obscure margins even with chromoendoscopy using acetic acid and indigo carmine (AI chromoendoscopy). Materials and Methods: The lateral spread of early gastric neoplasms was unclear even following AI chromoendoscopy in 38 patients who underwent ESD between June 2007 and May 2011. Frozen section biopsies were obtained by agreement of the degree of lateral spread between two endoscopists. Thus, frozen section biopsies were obtained from 23 patients (FBx group) and not in the other 15 patients (AI group). Results: No significant differences were observed for size, histology, invasive depth, and location of lesions between the AI and FBx groups. No false positive or false negative results were observed in the frozen section diagnoses. Adenocarcinoma was revealed in three patients and tubular adenoma in one, thereby changing the delineation of lesion extent and achieving free lateral margins. The rates of free lateral resection margins and curative resection were significantly higher in the FBx group than those in the AI group. Conclusions: Frozen section biopsy can help endoscopists perform more safe and accurate ESD in patients with early gastric neoplasm.

Analysis of Climate Characteristics Observed over the Korean Peninsula for the Estimation of Climate Change Vulnerability Index (기후변화 취약성 지수 산출을 위한 한반도 관측 기후 특성 분석)

  • Nam, Ki-Pyo;Kang, Jeong-Eon;Kim, Cheol-Hee
    • Journal of Environmental Impact Assessment
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    • v.20 no.6
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    • pp.891-905
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    • 2011
  • Climate vulnerability index is usually defined as a function of the climate exposure, sensitivity, and adaptive capacity, which requires adequate selection of proxy variables of each variable. We selected and used 9 proxy variables related to climate exposure in the literature, and diagnosed the adequacy of them for application in Korean peninsula. The selected proxy variables are: four variables from temperature, three from precipitation, one from wind speed, and one from relative humidity. We collected climate data over both previous year (1981~2010) and future climate scenario (A1B scenario of IPCC SERES) for 2020, 2050, and 2100. We introduced the spatial and temporal diagnostic statistical parameters, and evaluated both spatial and time variabilities in the relative scale. Of 9 proxy variables, effective humidity indicated the most sensitive to climate change temporally with the biggest spatial variability, implying a good proxy variable in diagnostics of climate change vulnerability in Korea. The second most sensitive variable is the frequency of strong wind speed with a decreasing trend, suggesting that it should be used carefully or may not be of broad utility as a proxy variable in Korea. The A1B scenario of future climate in 2020, 2050 and 2100 matches well with the extension of linear trend of observed variables during 1981~2010, indicating that, except for strong wind speed, the selected proxy variables can be effectively used in calculating the vulnerability index for both past and future climate over Korea. Other local variabilities for the past and future climate in association with climate exposure variables are also discussed here.

Findings of an Intravenous Catheter Fragment in the Vein Using the 3D Image Reformations of MDCT (정맥내의 IV 카테터 조각의 3D MDCT 재구성 영상)

  • Kweon, Dae-Cheol;Yoo, Beong-Gyu;Yang, Sung-Hwan;Kim, Jeong-Goo
    • Progress in Medical Physics
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    • v.17 no.3
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    • pp.167-172
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    • 2006
  • Catheter fragment and embolism are both potentially serious complications associated with the use of an intravenous (IV) catheter for contrast media bolus injection, and may be followed by serious or lethal sequelae. Though catheter fragment is a rare complication of IV catheter insertion, especially in peripheral veins, CT can be used to detect residual fragment. This study demonstrates the utility of MDCT to localize a small, subtle peripheral venous catheter, which can be easily reformatted of MDCT reformations. Various 3D techniques such as MPR and MIP, volume rendering, and shaded-surface displays are currently available for reconstructing MDCT data. Advances in MDCT technology contribute substantially to the detection and accurate localization of smaller IV catheter fragment.

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p53 Immunoreactivity in the Cytology of Body Cavity Fluid (체강 삼출액의 세포학적 검사에서의 p53 면역염색의 유용성)

  • Sung, Sun-Hee;Han, Woon-Sup
    • The Korean Journal of Cytopathology
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    • v.9 no.1
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    • pp.15-20
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    • 1998
  • Mutant form of the p53 gene product is abnormally accumulated in the nuclei of the tumor cells due to prolonged half life, and readily detected by immunohistochemical methods. To determine the positivity rate of p53 in body cavity fluid according the primary site and histological types of tumors and the utility of p53 immunostaining as an adjunct in the diagnosis of malignancy, we reviewed 69 effusions, including pleural effusion, ascitic fluid, and pericardial fluid, that were diagnosed as overt malignancy and 21 effusions of suspicious malignancy, immunohistochemistry was performed on paraffin-embedded cell blocks using a monoclonal antibody to p53 supressor gene product(Clone DO7) and a standard avidin-biotin complex technique with a citrate buffer antigen retrieval solution. The results were as follows; of the 46 pleural effusions with overt malignancy, 22 were immunopositive for p53 protein; of the 21 ascitic fluids with overt malignancy, 5 were positive for p53. Positivity rates according to the primary sites of tumors were 18 of 34(52.9%), 8 of 21(38.1%), 1 of 9(11.1%) cases of the tumors of the lung, GI tract, and ovary, respectively. According to the histologic types of lung cancer, 11 cases(61.6%) were positive out of 18 adenocarcinomas, 2 of 5 large cell undifferentiated carcinomas, and 1 of 2 small cell undifferentiated carcinomas. Of 21 cases of suspicious malignancy, 6 were positive for p53 and all of them(6/6) were confirmed as adenocarcinoma of the lung or GI tract. These findings indicate that p53 immunostaining using paraffin embedded cell block is useful diagnostic and prognostic marker in body fluid cytology although negative immunostaining does not exclude malignancy.

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Cerebral Hemodynamic Analysis in Pediatric Moyamoya Patients using Perfusion Weighted MRI (관류 강조 자기공명 영상을 이용한 소아 모야모야 환아의 뇌 혈역학 분석)

  • Chang, Won-Seok;Kim, Tae-Gon;Lee, Seung-Koo;Choi, Jung-Uhn;Kim, Dong-Seok
    • Journal of Korean Neurosurgical Society
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    • v.37 no.3
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    • pp.207-212
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    • 2005
  • Objective: Classically, single photon emission tomography is known to be the reference standard for evaluating the hemodynamic status of patients with moyamoya disease. Recently, T2-weighted perfusion magnetic resonance(MR) imaging has been found to be effective in estimating cerebral hemodynamics in moyamoya disease. We aim to assess the utility of perfusion-weighted MR imaging for evaluating hemodynamic status of moyamoya disease. Methods: The subjects were fourteen moyamoya patients(mean age: 7.21 yrs) who were admitted at our hospital between Sep. 2001 to Sep 2003. Four normal children were used for control group. Perfusion MR imaging was performed before any treatment by using a T2-weighted contrast material-enhanced technique. Relative cerebral blood volume(rCBV) and time to peak enhancement(TTP) maps were calculated. Relative ratios of rCBV and TTP in the anterior cerebral artery(ACA), middle cerebral artery(MCA) and basal ganglia were measured and compared with those of the posterior cerebral artery(PCA) in each cerebral hemispheres. Using this data, we analysed the hemodynamic aspect of pediatric moyamoya disease patients in regarding to the age, Suzuki stage, signal change in FLAIR MR imaging, and hemispheres inducing symptoms. Results: The mean rCBV ratio of ACA, MCA did not differ between normal children and moyamoya patients. However the significant TTP delay was observed at ACA, MCA territories (mean = 2.3071 sec, 1.2089 see, respectively, p < 0.0001). As the Suzuki stage of patients is advanced, rCBV ratio is decreased and TTP differences increased. Conclusion: Perfusion MR can be applied for evaluating preoperative cerebral hemodynamic status of moyamoya patients. Furthermore, perfusion MR imaging can be used for determine which hemisphere should be treated, first.

Design and Implementation of Occlusion Force Analysis Software for Malocclusion Diagnosis : A Pilot Study (부정교합 진단을 위한 교합력 분석 소프트웨어의 설계 및 구현 : A Pilot Study)

  • Park, Kyoung-Jong;Kim, Tae-Yun;Choi, Heung-Kook
    • Journal of Korea Multimedia Society
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    • v.12 no.1
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    • pp.147-155
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    • 2009
  • Occlusion force measuring and analysis is a diagnostic method of tooth dynamics through the related force analysis. In this paper, we design and implement a series of occlusion force measuring software and evaluate its utility as a base system for a new occlusion force measure and analysis system development. For the reason, we developed a group of tools to measure the normal and abnormal occlusion force. Firstly, we have visualized the occlusion force distribution with quantitative figures. The center of force (COF) variation was visualized the path of marker according to teeth dynamics and the distribution of occlusion forces in 14 tooth regions. Secondly, we have implemented a left and right tooth force balance measurement ratio tool to estimate a specific tooth region force. Furthermore, the measured occlusion force variation recorded in the software each 0.5 second. As the result of the physical examination by the accessed hardware of sensor sheet method, we confirmed the distribution and balance of forces effectively.

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A Role of Serum-Based Neuronal and Glial Markers as Potential Predictors for Distinguishing Severity and Related Outcomes in Traumatic Brain Injury

  • Lee, Jae Yoon;Lee, Cheol Young;Kim, Hong Rye;Lee, Chang-Hyun;Kim, Hyun Woo;Kim, Jong Hyun
    • Journal of Korean Neurosurgical Society
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    • v.58 no.2
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    • pp.93-100
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    • 2015
  • Objective : Optimal treatment decision and estimation of the prognosis in traumatic brain injury (TBI) is currently based on demographic and clinical predictors. But sometimes, there are limitations in these factors. In this study, we analyzed three central nervous system biomarkers in TBI patients, will discuss the roles and clinical applications of biomarkers in TBI. Methods : From July on 2013 to August on 2014, a total of 45 patients were included. The serum was obtained at the time of hospital admission, and biomarkers were extracted with centrifugal process. It was analyzed for the level of S-100 beta (S100B), glial fibrillary acidic protein (GFAP), and ubiquitin carboxy-terminal hydrolase-L1 (UCH-L1). Results : This study included 33 males and 12 females with a mean age of 58.5 (19-84) years. TBI patients were classified into two groups. Group A was severe TBI with Glasgow Coma Scale (GCS) score 3-5 and Group B was mild TBI with GCS score 13-15. The median serum concentration of S100B, GFAP, and UCH-L1 in severe TBI were raised 5.1 fold, 5.5 fold, and 439.1 fold compared to mild injury, respectively. The serum levels of these markers correlated significantly with the injury severity and clinical outcome (p<0.001). Increased level of markers was strongly predicted poor outcomes. Conclusion : S100B, GFAP, and UCH-L1 serum level of were significantly increased in TBI according to severity and associated clinical outcomes. Biomarkers have potential utility as diagnostic, prognostic, and therapeutic adjuncts in the setting of TBI.

Inhibitory Effect of Retinoids on Alkaline Phosphatase Isoenzymes Activity in Human Serum

  • Kim, Seung Hee;Moon, Ki-Young
    • Biomedical Science Letters
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    • v.23 no.3
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    • pp.230-237
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    • 2017
  • Changes in the activity of alkaline phosphatase (ALP) isoenzymes and isoforms in human serum have a major diagnostic value, therefore the regulation of ALP activities is a valuable target for therapeutic interventions. To assess the pharmacological activity of retinoids, i.e., all-trans retinoic acid and 13-cis retinoic acid, their tissue-specific inhibitory effect on human serum ALP activity was elucidated by chemical inhibition methods, heat-sensitive inactivation, and wheat-germ lectin precipitation test. Retinoids showed significant inhibition of the total ALP activity in human serum at a concentration of 5 mM. All-trans retinoic acid (5 mM) and 13-cis retinoic acid (5 mM) inhibited ALP activities by up to 12% and 15%, respectively, compared to that by guanidine hydrochloride (200 mM). L-phenylalanine (100 mM) and urea (30 mM) had no further inhibitory effect on ALP activities in human serum pretreated with retinoids (5 mM). Retinoids significantly inhibited ALP activities by up to 20% compared with that of tetramisole (30 mM). The ALP activities in retinoid-pretreated serum remained unchanged after the heat inactivation process. These results suggest that retinoids are inhibitors of the intestinal ALP isoenzyme. Remarkably, retinoids revealed potent inhibitory activities against ALP in wheat-germ lectin precipitant serum, indicating that they also function as inhibitors of the bone ALP isoform. The results show that retinoids inhibit the specific tissue-derived human serum ALP activities, moreover, the inhibitory effect of retinoids against bone ALP activity suggests their clinical utility as monitoring and prevention of metastasis of bone cancer.

Endoscopic Findings of Children with Familial Mediterranean Fever

  • Sag, Elif;Demir, Ferhat;Saygin, Ismail;Kalyoncu, Mukaddes;Cakir, Murat
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.4
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    • pp.271-277
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    • 2018
  • Purpose: Familial Mediterranean fever (FMF) is an auto inflammatory disease characterized by periodic fever, synovitis and serositis. Patients may be admitted to gastroenterology units due to gastrointestinal symptoms. In this study; we aimed to analyze endoscopic findings and diagnostic utility of endoscopic procedure in children with FMF. Methods: Patient with FMF that was performed endoscopy for the gastrointestinal symptoms were included to the study (39 of 164 patients, 53 procedure). A control group was randomly designed as age and gender matched four endoscopic procedures per one endoscopic procedure of patients with FMF (n=212). Results: No different was found between the patients and control group in esophagogastroscopy findings. However, the diagnosis of gastrointestinal pathology was made by esophagogastroscopy in 46.2% patients. Colonoscopic examination revealed that the frequency of inflammatory bowel disease (IBD) was higher in undiagnosed patients compared to both the control group (50.0% vs. 6.9%, p<0.05, odds ratio [OR]:13.4 and 95% confidence inteval [95% CI]: 2.1-84.3) and the patients under colchicine treatment (50.0% vs. 8.3%, p<0.05, OR: 11 and 95% CI: 0.8-147.8). Colonoscopic procedure that was made after the diagnosis was found to provide contribution by 16.7% in determining the etiology of the additional symptoms. Conclusion: Patients with FMF may be admitted to pediatric gastroenterology outpatient clinic prior to diagnosis or during the follow-up period. The frequency of IBD is high in undiagnosed patients with FMF. Endoscopic procedures may be helpful in these patients for the diagnosis accompanying mucosal lesions.