• Title/Summary/Keyword: Young-onset

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Stroke-like Manifestation in a Patient with Leptomeningeal Metastasis of Pancreatic Cancer (급성뇌졸중 양상으로 발현된 췌장암의 연수막 전이)

  • Boo Suk Na;Soo Jin Song;Jong Min Song;Ho Geol Woo;Young Nam Kwon;Dokyung Lee;Tae-Beom Ahn
    • Journal of Digestive Cancer Research
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    • v.3 no.2
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    • pp.113-115
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    • 2015
  • Pancreatic cancer is commonly presented with distant metastasis. However metastasis to central nervous system (CNS) of pancreatic cancer was rarely reported. 79-years-old man was hospitalized with sudden onset right arm dysesthesia and weakness. In brain magnetic resonance imaging, multifocal high signal intensity lesions in cerebral and cerebellar cortices were observed. Leptomeningeal and parenchymal enhanced lesions were also noted in contrast-enhanced T1 images suggesting a metastasis from the pancreatic cancer. Stroke like manifestation of CNS metastasis of pancreatic cancer is extremely rare. Careful history taking and evaluation should be performed to find the origin of the sudden neurologic deficit.

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Biochemical Biomarkers for Alzheimer's Disease in Cerebrospinal Fluid and Peripheral Blood (뇌척수액과 말초혈액 내 알츠하이머병의 생화학적 생체표지자)

  • Lee, Young Min;Choi, Won-Jung;Park, Minsun;Kim, Eosu
    • Journal of Korean geriatric psychiatry
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    • v.16 no.1
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    • pp.17-23
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    • 2012
  • The diagnosis of Alzheimer's disease (AD) is still obscure even to specialists. To improve the diagnostic accuracy, to find at-risk people as early as possible, to predict the efficacy or adverse reactions of pharmacotherapy on an individual basis, to attain more reliable results of clinical trials by recruiting better defined participants, to prove the disease-modifying ability of new candidate drugs, to establish prognosis-based therapeutic plans, and to do more, is now increasing the need for biomarkers for AD. Among AD-related biochemical markers, cerebrospinal beta-amyloid and tau have been paid the most attention since they are materials directly interfacing the brain interstitium and can be obtained through the lumbar puncture. Level of beta-amyloid is reduced whereas tau is increased in cerebrospinal fluid of AD patients relative to cognitively normal elderly people. Remarkably, such information has been found to help predict AD conversion of mild cognitive impairment. Despite inconsistent findings from previous studies, plasma beta-amyloid is thought to be increased before the disease onset, but show decreasing change as the disease progress. Regarding other peripheral biochemical markers, omics tools are being widely used not only to find useful biomarkers but also to generate novel hypotheses for AD pathogenesis and to lead new personalized future medicine.

The Physicochemical Properties of Starch from Tongil-type Rice Varieties

  • Jong-Hee Shin;Chae-Min Han;Young-Un Song;Sang-Kuk Kim;Jung-Gi Ryu
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.68 no.3
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    • pp.99-105
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    • 2023
  • Starch characteristics and pasting properties of Tongil-type rice varieties with different amylose content were analyzed. Three different Tongil-type rice varieties and one Japonica-type rice variety were examined for their properties. Tongil-type rice varieties have longer panicles and higher rice yield (721-765 kg per 10a) than Boramchan, a Japonica-type high-yield rice variety. The protein content of the Tongil-type rice variety was higher than that of Boramchan. Japonica-type rice varieties had lower amylose content than Japonica-type rice varieties, except for Amimyeon (Milyang355). Amimyeon had higher protein content than the other varieties, and its amylose content was particularly high at 39.2%. The distribution of starch granule sizes of the four varieties was similar, and the particle size corresponding to D50 was approximately 87.8-81.9 ㎛. The pasting properties of rice flour varied among varieties. The Dasanbyeo and Hanarum2 amylogram patterns were similar. These two varieties had a higher peak viscosity (PV) and lower setback (SB) than Boramchan. In the case of Amimyeon, the hot paste viscosity (HPV), cool paste viscosity (CPV), and SB were significantly higher than those of the other Toingil-type varieties, and the breakdown (BD) was very low, showing pasting properties significantly different from that of the other varieties. The onset (To), peak (Tp), and conclusion temperature (Tc) of gelatinization of rice flour from Amimyeon were lower than those of the other tested varieties. In addition, the gelatinization temperature, measured using differnetial scanning calorimetry (DSC), and BD, measured using al rapid visco analyzer (RVA) were low in Amimyeon. Amylose content showed a high positive correlation with pasting time (PTi), HPV, and SB and a negative correlation with PV and BD.

Monitoring Posterior Cerebral Perfusion Changes With Dynamic Susceptibility Contrast-Enhanced Perfusion MRI After Anterior Revascularization Surgery in Pediatric Moyamoya Disease

  • Yun Seok Seo;Seunghyun Lee;Young Hun Choi;Yeon Jin Cho;Seul Bi Lee;Jung-Eun Cheon
    • Korean Journal of Radiology
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    • v.24 no.8
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    • pp.784-794
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    • 2023
  • Objective: To determine whether dynamic susceptibility contrast-enhanced (DSC) perfusion magnetic resonance imaging (MRI) can be used to evaluate posterior cerebral circulation in pediatric patients with moyamoya disease (MMD) who underwent anterior revascularization. Materials and Methods: This study retrospectively included 73 patients with MMD who underwent DSC perfusion MRI (age, 12.2 ± 6.1 years) between January 2016 and December 2020, owing to recent-onset clinical symptoms during the follow-up period after completion of anterior revascularization. DSC perfusion images were analyzed using a dedicated software package (NordicICE; Nordic NeuroLab) for the middle cerebral artery (MCA), posterior cerebral artery (PCA), and posterior border zone between the two regions (PCA-MCA). Patients were divided into two groups; the PCA stenosis group included 30 patients with newly confirmed PCA involvement, while the no PCA stenosis group included 43 patients without PCA involvement. The relationship between DSC perfusion parameters and PCA stenosis, as well as the performance of the parameters in discriminating between groups, were analyzed. Results: In the PCA stenosis group, the mean follow-up duration was 5.3 years after anterior revascularization, and visual disturbances were a common symptom. Normalized cerebral blood volume was increased, and both the normalized time-topeak (nTTP) and mean transit time values were significantly delayed in the PCA stenosis group compared with those in the no PCA stenosis group in the PCA and PCA-MCA border zones. TTPPCA (odds ratio [OR] = 6.745; 95% confidence interval [CI] = 2.665-17.074; P < 0.001) and CBVPCA-MCA (OR = 1.567; 95% CI = 1.021-2.406; P = 0.040) were independently associated with PCA stenosis. TTPPCA showed the highest receiver operating characteristic curve area in discriminating for PCA stenosis (0.895; 95% CI = 0.803-0.986). Conclusion: nTTP can be used to effectively diagnose PCA stenosis. Therefore, DSC perfusion MRI may be a valuable tool for monitoring PCA stenosis in patients with MMD.

Effects of Continuous Nutrition Care on Nutritional Status and Dietary Habits of Patients With Colorectal Cancer Receiving Adjuvant Chemotherapy After Surgery

  • Jina Son;Ha I Kang;Eun young Jung;Hae won Ryu;Kyung-Ha Lee
    • Clinical Nutrition Research
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    • v.12 no.2
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    • pp.99-115
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    • 2023
  • Patients with colorectal cancer may experience symptoms such as diarrhea, nausea, and anorexia, during surgery and chemotherapy, which can increase the risk of malnutrition. In addition, dietary habits play a key role in the onset of colorectal cancer; therefore, it is necessary to improve dietary habits to prevent recurrence during treatment after diagnosis. In this study, a clinical nutritionist conducted 4 interviews for patients diagnosed with colorectal cancer and scheduled for colectomy: before surgery, after surgery, 1st chemotherapy, and 2nd chemotherapy, and provided nutrition care for each treatment course to determine its effects on nutrition status and disease prognosis. Significant weight loss but no decrease in muscle mass was observed during treatment. Body fat mass, although not statistically significant, showed a decreasing tendency. The percentage of people who responded 'yes' to the below items increased after compared to before receiving nutrition education: 'I eat meat or eggs more than 5 times a week,' 'I eat seafood at least three times a week,' 'I eat vegetables at every meal,' 'I eat fruits every day,' and 'I eat milk or dairy products every day.' These results indicate that the patients changed their dietary habit from a monotonous eating pattern to a pattern of consuming various food groups after receiving nutrition education. These results suggest that continuous nutrition care by clinical dietitians, according to the patient's treatment process, can help improve the patient's nutritional status and establish healthy eating habits.

Gerstmann-Sträussler-Scheinker Disease: A Case Report (Gerstmann-Sträussler-Scheinker병: 증례 보고)

  • Minji Shin;Donghyun Kim;Young Jin Heo;Jin Wook Baek;Suyoung Yun;Hae Woong Jeong
    • Journal of the Korean Society of Radiology
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    • v.84 no.3
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    • pp.745-749
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    • 2023
  • Gerstmann-Sträussler-Scheinker (GSS) disease is a rare hereditary prion disease which is clinically characterized by a progressive cerebellar ataxia followed by cognitive impairment. We report a rare case of GSS disease in a 39-year-old male patient who complained of a progressive gait disturbance followed by dysarthria with cognitive impairment, after five months from the onset of initial symptom. His brain MRI scan revealed multifocal symmetric diffusion restricted lesions with T2/FLAIR hyperintensities in bilateral cerebral cortices, basal ganglia, and thalami. His family members also manifested similar symptoms in their 40-50s, suggesting the possibility of a genetic disease. Finally, he was genetically diagnosed with GSS disease by real-time quaking-induced conversion and prion protein (PRNP) gene sequencing test.

A review on the gut microbiome dysbiosis in diabetic patients and the improvement effects of traditional herbal medicine treatments (당뇨병 환자의 장내미생물 변화와 한의소재에 의한 개선효과 논문고찰)

  • Hye-Min Yi;Sun-Young Hwang;Mee-Hyun Lee
    • The Korea Journal of Herbology
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    • v.39 no.5
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    • pp.39-51
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    • 2024
  • Objectives : Diabetes is a chronic disease that is rapidly increasing worldwide, and recent studies suggest that gut microbiome dysbiosis may be one of the main reasons for diabetes. Therefore, we have reviewed the relationship between diabetes and microbiome changes and their regulation by treatment of traditional herbal medicine. Methods : This review was prepared by querying in PubMed with the key words such as diabetes, microbiome and traditional herbal medicine. The search was conducted for research articles including both in vivo preclinical reports and clinical studies, up to July 22, 2024 within the past five years. Results : Gut microbiota dysbiosis is implicated in diabetes through major mechanisms, including increased endotoxin (LPS), decreased short-chain fatty acid (SCFA) production, reduced gut microbiota diversity, and impaired bile acid metabolism in mouse models and human cohorts. Traditional herbal medicines including berberine and bicalein and formulations such as Gegen Qinlian Decoction, Banxia Xiexin Decoction, and Huang-Lian-Jie-Du-Decoction improved diabetes by increasing the gut microbiota diversity and SCFA generation. Conclusion : Gut microbiota imbalance plays an important role in the onset and progression of diabetes especially type 2 diabetes which is improved by traditional herbal medicines promoting the growth of beneficial microbiome and suppressing pathogenic abundance. It may provide a promising prospect for more effective diabetes management and treatment strategies.

Treatment Outcome of Langerhans Cell Histocytosis (랑게르한스 세포 조직구증의 치료 결과)

  • Chung, So Hak;Kim, Jae Do;Jo, Hyun Ik
    • The Journal of the Korean bone and joint tumor society
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    • v.20 no.1
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    • pp.14-21
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    • 2014
  • Purpose: To analyze the clinical features and treatment outcome of Langerhans' cell histocytosis. Materials and Methods: From August 1996 to June 2013, 28 patients who histologically proven with LCH were analyzed of medical records, radiography, pathologic character retrospectively. Results: A total of 28 cases of LCH including 22 child has been reported. Onset age was 0.6 to 51 years old, occurred in the average age was 14.8 years. Follow-up period was 6 months to 134 months average was 44.6 months. The M:F ratio was 2.5:1. The initial symptoms was pain in 18 cases, 5 cases of pathologic fracture, 3 case of palpable mass, 1 case of discovered by accident in radiography, 1 case of torticollis. In radiological examination osteolysis was seen all cases, 7 cases showed a periosteal reaction, 1 case showed soft tissue extension. Clinical type of all cases were eosinophilic granuloma. 25 cases were classified as unifocal disease and 3 cases were multifocal single systemic diseases. In all cases, incisional biopsy was performed. After histologic confirmed, 14 cases was treated with curettage or surgical excision of the lesion and the other 14 cases were followed up without treatment. There is no death during follow up period. 11 cases has no radiological improvement after 3-6 months observation, intralesional steroid injection was performed. Conclusion: Patients with LCH who has rapid systemic onset is very rare, so if you meet the young children who suspected LCH, you shoulder avoid the examination which cause excessive radiation exposure to the young patient. In order to confirm the diagnosis of disease, biopsy is needed. Close observation after confirmed by histological method will bring the satisfactory results. But the patients who had pathologic fracture or wide bone destruction already may need curettage and bone grafting to lesion or internal fixation. The lesion which has no radiological improvement after 3-6 months observation or appear with pain interferes daily life may need local steroid injection as a good treatment.

Risk Factors of Catheter-related Bloodstream Infection Due to Methicillin-resistant Staphylococcus aureus in Very Low Birth Weight Infants (극소저체중 출생아에서 메티실린 내성 포도상구균으로 인한 카테터 연관 혈류감염의 위험인자)

  • Cho, Il-Hyun;Jung, Tae-Woong;Lee, Ju-Young;Moon, Se-Na;Bin, Joong-Hyun;Lee, Hyun-Seung;Lee, Jung-Hyun;Kim, So-Young;Sung, In-Kyung
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.288-292
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    • 2011
  • Purpose: The incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection has increased in children and in neonates, and is particularly associated with frequent use of central venous catheter in very low birth weight (VLBW) infants. It is known that the morbidity and mortality of MRSA infection are low in neonates, as compared with adults. The objective of this study was to examine the difference in clinical characteristics between VLBW infants that survived and those that did not, a catheter-related bloodstream infection (CRBSI) of MRSA. Methods: Thirty-four VLBW infants had laboratory-confirmed bloodstream infection with S. aureus. We examined the incidence, mortality and morbidity of CRBSI, and predictive factors associated with mortality. Results: Twenty-six infants had same pathogen (24 MRSA, 2 Methicillin-sensitive Staphylococcus aureus) in the blood and in the catheter tip. Eight infants (25.8%) died in the CRBSI and they all had MRSA blood infections. Sex ratio, gestational age, duration between blood collection and identification of pathogens, and WBC and platelet count were not significantly different between patients that died from and patients that survived CRBSI of MRSA. C-reactive protein (CRP) was significantly higher in VLBW infants that died. Mean age of onset and hospital day was earlier (9.1${\pm}$6.6 vs. 26.9${\pm}$20.2; P=0.005) and shorter for patients that died (10.1${\pm}$7.0 vs. 73.0${\pm}$32.4; P=0.000). Two survivors had complications of pyogenic arthritis of the lower extremities and soft tissue infection, respectively. Conclusion: Mortality of CRBSI was likely to be high in VLBW infants and might be anticipated by CRP and early onset of disease.

A Follow-Up Study after Discontinuation of Antiepileptic Drug Therapy in Children with Well-Controlled Epilepsy : The Factors that Influence Recurrence (항전간제로 조절된 간질 환아에서 약물 중지 후 추적 관찰 - 재발위험인자)

  • Chung, Sa Jun;Chung, Hye Jeon;Choi, Young Mi;Cho, Eu Hyun
    • Clinical and Experimental Pediatrics
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    • v.45 no.12
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    • pp.1559-1570
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    • 2002
  • Purpose : There has been no exact answer to the question of when to discontinue antiepileptic drugs(AEDs) in children with well-controlled epilepsy for a long period. This study is about the risk factors of relapse after withdrawal of AEDs in seizure(Sz)-free patients to show a guideline for discontinuation of AEDs. Methods : One hundred and sixty-nine children were diagnosed as epileptic at the Pediatric Dept. of Kyung-Hee Univ. between 1993 to 1998, in whom AEDs had been withdrawn after at least two years of Sz-free period. Univariate analysis using Kaplan-Meier survival analysis and multivariate analysis using Cox-proportional hazard model were performed for sixteen risk factors. Results : Forty-nine of the 169 patients(28.9%) had recurrence of Szs. The mean follow-up after withdrawal of AEDs was 4.1 years, mean treatment period was 4.1 years, and the mean Sz-free period was 3.3 years. Factors associated with an increased risk of relapse were young age at onset, symptomatic Sz, Sz type in West and Lennox-Gastaut syndrome, neurologic deficit, longer Sz-controlling period, shorter total treatment period, number of AEDs used(more than one drug), age at withdrawal of AEDs, and Sz-free period less than two years in univariate analysis using Kaplan-Meier mothod. From multivariate analysis, the factors indicating a significantly higher relapse risk were pre-treatment period after first Sz attack, Sz-controlling period, Sz-free period, number of AEDs used, neurologic abnormalities. Conclusion : For epileptic children who were Sz-free for more than two years, and were more than six-years-old, the discontinuation of AEDs should be considered positively, according to age of onset, Sz type, age at withdrawal of AEDs, total treatment period, Sz-controlling period, number of AEDs used, etiology, neurologic deficit, and the wishes of the patients and the their parents.