• Title/Summary/Keyword: disease pattern

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Microsatellite Instability in Non-Small Cell Lung Cancer (비소세포폐암에서 Microsatellite Instability)

  • Jeon, Hyo-Sung;Kim, Jeong-Ran;Son, Ji-Woong;Park, Sun-Ha;Park, Tae-In;Kim, Chang-Ho;Kim, In-San;Jung, Tae-Hoon;Park, Jae-Yong
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.1
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    • pp.24-32
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    • 2000
  • Purpose: Microsatellite instability(MSI) is frequently used as an indicator of microsatellite mutator phenotype(MMP) tumors. MSI has been observed in a percentage of non-small cell lung cancer(NSCLC). However, its role in tumorigenesis of NSCLC remains unknown. The frequency and pattern of MSI in NSCLC were evaluated and clinical parameters of MSI-positive tumors with those of MSS(microsatellite stable) tumors were compared. Materials and Methods: Twenty surgically resected NSCLCs were analyzed for 15 microsatellite markers located at chromosomes 3p and 9p. The peripheral blood lymphocytes of patients were used as the source of the normal DNA. Results: 1) Of 20 cases, 8(40%) demonstrated MSI. 2) Instability was observed more frequently in tri- and tetra-nucleotide repeats than in dinucleotide repeats. In all cases, instability appeared as a shift of individual allelic bands. 3) LDH was observed in 10(50%) of 20 tumors analyzed. 4) Of 20 cases, MSI-H tumor(showing MSI in the majority of markers) was absent. There were 5 MSI-L tumors(showing MSI in a greater than 10% of markers). 5) No significant difference was observed between MSI-L tumors and MSI-negative tumors in terms of clinicopathologic features such as pack-year history of smoking, histologic subtype, and(delete) stage of disease. There was also no significant difference in the incidence of LDH in relation to the status of MSI. Conclusion: These data strongly suggest that MSI plays different roles in lung and colon cancer. MMP pathway appears to be far less important in the tumorigenesis of NSCLC, caused mainly by cigarette smoke, with little familial tendency.

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Clinical Study of Pulmonary Thromboembolism (폐혈전색전증의 임상적 연구)

  • Bak, Sang-Myeon;Lee, Sang-Hwa;Lee, Sin-Hyung;Sin, Cheol;Cho, Jae-Youn;Shim, Jae-Jeong;In, Kwang-Ho;Kang, Kyung-Ho;Yoo, Se-Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.1
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    • pp.106-116
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    • 2001
  • Background : Pulmonary thromboembolism is relatively frequent and potentially fatal. However, it is commonly misdiagnosed. The incidence of pulmonary thromboembolism is not decreasing despite advances in diagnosis and effective prophylatic measures. Its potential for significant sequela necessitates a prompt diagnosis and treatment. Unfortunately, there are many difficulties and problems regarding accurate diagnosis. There is a low prevalence of deep vein thrombosis and pulmonary thromboembolism in Korea and only few reports on this subject are available. Method : The clinical features of 36 patients, who were diagnosed with pulmonary thromboembolism at the Korea University medical center, were reviewed. Results : 1) There was no significant difference in prevalence between men an women, and the mean age was 50.9 years in men 59.2 years in women. 2) The frequent causes of pulmonary thromboembolism were malignancies (22.2%), surgery (22.2%), and heart disease(8.2%). Specific causes were not identified in 33.3%. 3) The most common symptom was dyspnea(72.2%), and the most common sign was tachypnea(61.1%). 4) The EKG findings were normal in 28.6%, an S1Q3T3 pulmonale pattern in 25.7%, ST or QRS changes in others. 5) The chest X-ray findings indicated pulmonary infiltration in 37.5%, cardiomegaly in 15.6%, pleural effusion in 12.5%, and normal in 27.8%. The perfusion lung scan showed a high probability in 66.7%, and intermediate or low probability in 33.3%. 6) The pulmonary arterial pressure(PAP) in the high probability groups was 57.9mmHg with a higher mortality rate(35%). Conclusion : Pulmonary thromboembolism is not uncommon in Korea and its clinical features do not differ greatly from thase reported in the literature. When pulmonary thromboemblism of unknown causes are diagnosed, a search for an occult malignancy is recommended. Rapid diagnosis and treatment are achieved when thromboemblism is suspected.

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Diagnostic Value of Adenosine Deaminase(ADA) and its Isoenzyme in Pleural Effusion (흉수의 감별진단에서 Adenosine Deaminase (ADA) 및 동종효소의 유용성)

  • Kim, Keun-Youl;Kweon, Suk-Hoe;Park, Jae-Seuk;Jee, Young-Koo;Lee, Kye-Young;Kim, Youn-Seup;Chun, Yong
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.2
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    • pp.388-396
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    • 1998
  • Background: Etiologic diagnosis of pleural effusion is usually made by clinical characteristics, pleural fluid analysis and pleural biopsy. But, despite careful diagnostic study, the cause of pleural effusion cannot be found in about 20 percent of patients, especially in loculated pleural effusions. Tuberculous pleurisy is one of the most common cause of pleural effusion in Korea. But, pleural fluid culture for Mycobacterium tuberculosis are positive in only 20 to 30 percent of patients and typical pleural biopsy finding in less than 50 percent of patients with this disease. In recent studies, adenosine deaminse(ADA) and its isoenzymes were proposed to be a useful diagnostic tool for differential diagnosis of pleural effusion. We investigated the pattern of ADA and its iscenzyme activities in various cause of pleural effusions to evaluate the diagnostic value of measuring ADA and its isoenzymes. Method: We measured total ADA and its isoenzyme activities in pleural fluid and serum from 54 patients with pleural effusion(25 tuberculous pleural effusion, 10 parapneumonic effusion, 14 malignant pleural effusion, 5 transudative pleural effusion), including 5 loculated tuberculous pleural effusions and 6 loculated parapneumonic effusions. Total ADA activity was measured by the spectrophotometric method and ADA2 isoenzyme activity was measured with same method using EHNA, potent inhibitor of ADA1 isoenzyme activity. Result: Total ADA activity of tuberculous pleural effusion was higher than malignant pleural effusion(p<0.01), but no significant difference was found between tuberculous pleural effusion and parapneumonic effusion(tuberculous pleural effusion: $148.9{\pm}89.9IU/L$, parapneumonic effusion: $129.0{\pm}119.4IU/L$, malignant pleural effusion: $48.7 {\pm}39.7IU/L$). Percentage of ADA2 activity to total ADA activity(ADA2%) of pleural effusion of tuberculous pleurisy was higher than parapneumonic effusion(p<0.05). but no significant difference was found between tuberculous pleural effusion and malignant pleural effusion(tuberculous pleural effusion: $57.2{\pm}10.7%$, parapneumonic effusion: $35.9{\pm}17.8%$, malignant pleural effusion: $60.7{\pm}4.1%$). In loculated pleural effusion, ADA2% of tuberculous pleural effusion was higher than parapneumonic effusion(tuberculous pleural effusion: $53.3{\pm}3.9%$, parapneumonic effusion: $27.8{\pm}7.9%$). Conclusion: Measurement of ADA isoenzyme activity is useful for differentiating tuberculous pleural effusion from parapneumonic effusion, especially in loculated pleural effusion.

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Etiologic Distribution, Diagnostic Tests and Treatment in Prospectively Registered Patients with DILD for Two Years in a Tertiary Medical Center (한 3차 병원에서 2년간 전향적으로 등록된 DILD 환자의 원인, 진단 수기 및 치료 현황)

  • Kwon, Yong Soo;Chung, Man Pyo;Jeon, Gyeong Man;Lyu, Yeon Ju;Yu, Chang Min;Choi, Jae Chul;Kang, Eun Hae;Koh, Won-Jung;Suh, Gee Young;Kim, Hojoong;Kwon, O Jung
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.6
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    • pp.570-575
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    • 2005
  • Introduction : Diffuse interstitial lung diseases (DILD) comprise of a large group of lung diseases with diverse etiologies. They are classified into four categories based on the etiology and pathological findings. In Korea, epidemiological data on DILD has never been reported in a prospective manner. Method : From May 2002 to April 2004, total 487 patients with DILD were prospectively registered at Samsung Medical Center. The prospective observational analysis of the etiologies, its classification based on 2002 ATS/ERS (American Thoracic Society/European Respiratory Society) guidelines, as well as diagnostic tests and the retrospective analysis of the treatment modalities were carried out. Any infectious and malignant causes were excluded. Results : 1) The patients were classified into idiopathic interstitial pneumonia (IIP) in 269 patients (55.2%), known causes of DILD in 168 patients (34.5%), sarcoidosis in 27 patients (5.5%), other forms of DILD in 14 patients (2.9%), and undetermined DILD in 9 patients (1.9%). 2) The diagnostic test showed that most patients had undergone chest high resolution computed tomography (HRCT) and pulmonary function test (PFT) (97%, 89%). Transbronchial lung biopsy (TBLB) and surgical lung biopsy (SLB) were performed in limited patients (38%, 29%). 3) Among 269 patients with IIP, 220 (82%) had idiopathic pulmonary fibrosis (IPF) while 23 (9%) had nonspecific interstitial pneumonia. SLB was carried out in 36% of patients with IIP. 4) Symptomatic supportive care was given to 67% of IPF, but specific medical treatment including corticosteroids was administered to 89% of non-IPF patients. Conclusion : A nationwide registry of DILD patients is required to determine the annual incidence, etiology, and practice pattern of diagnosis and treatment in Korea.

Acromial Morphology in Different MR Oblique Sagittal Slices: Correlation with Rotator Cuff Disorder (자기 공명 영상의 사 시상면에서의 견봉 형태의 변화: 회전근 개 질환과의 임상적 연관성 분석)

  • Jo, Chris H.;Kim, Ji-Beom;Choi, Hye-Yeon;Ko, Young-Whan;Yoon, Kang-Sup;Lee, Ji-Ho;Kang, Seung-Baik;Lee, Jae-Hyup;Han, Hyuk-Soo;Rhee, Seung-Whan
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.173-179
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    • 2009
  • Purpose: On the hypothesis that the acromion morphology is changed according to the its site, we identified the morphology of the acromion on the oblique slices of MRI and we investigated the association of the acromial shape with the clinical stages of rotator cuff disorder on the magnetic resonance (MR) images. In addition, we compared the acromion morphology on MRI and simple X-rays. Material and Methods: The MR images of seventy one patients with rotator cuff disorder and who underwent arthroscopic surgery were compared with that of a control group of sixteen patients who didn't have rotator cuff disorder on MRI. On three subsequent oblique sagittal slices from the lateral edge of the acromion (S1, S2 and S3), each acromion morphology on the MRI slices was classified according to Epstein et al: flat, curved or hooked. We investigated the changing parttern of the acromion shape and we compared the acromion shape on MRI and that on simple X-rays. We classified the rotator cuff tear by the severity: bursitis, partial thickness tear or full thickness tear. We investigated which acromial type on the MRI oblique slice was associated with the severity of rotator cuff disease. Results: Changes of the acromial shape occurred in 54 patients (76.1%). The most frequent pattern was that the types are same on S1 and S2 and different on S3 (22 cases, 31.0%). The acromial type on S1 and S2 was significantly associated with the severity of rotator cuff disorder (p=0.001 and 0.022), respectively. There was no reliability of the acromial shape on MRI and roentgenography (p>0.05) Conclusion: The type of acromion changed from lateral to medial. Among the three positions, the shape of the acromion on S1 and S2 had meaningful correlation with the clinical stage of rotator cuff disorder. There was no statistical correlation of the acromial shape between MRI and simple X-ray.

Computerized Quantative Analysis of Cornary Angiogram in Patients without Coronary Pathology (Computer System을 이용한 정상 관상동맥 조영 사진의 양적분석)

  • Yun, Yang-Koo;Park, Kay-Hyun;Choi, Young-Soo;Kim, Kwhan-mien;Jun, Tae-Gook;Kim, Jhin-gook;Shim, Young-Mog;Park, Pyo-Won;Chae, Hurn
    • Journal of Chest Surgery
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    • v.31 no.5
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    • pp.488-493
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    • 1998
  • In the preoperative evaluation before coronary artery bypass surgery, review of the coronary arteriogram is the most important step. Expected "normal" lumen diameter at a given coronary anatomic location is a basis for quantative estimation of coronary disease severity that could be more useful than the traditional "percent stenosis". The distribution and number of major coronary artery branches are determinants of number of bypass grafts needed. We reviewed the coronary artery anatomy in 174 adult patients who revealed no coronary pathology in angiographic studies done from September 1994 to June 1996. Quantative analysis was done in all cases by a single person using a Computerized System (Arripro 35ⓡ). The results were follows; 1) The mean diametre of left main coronary artery was 4.45 mm(range 2.74~6.72). The pattern of branching was bifurcation in 67.24%, trifurcation in 28.74% and quadrifurcation in 4.02% of the patients. 2) The mean diametre of left anterior descending artery was 3.17 mm(range 2.10~5.85), 2.79 (range 1.55~5.59) and 2.17 mm(range 1.37~3.81) in the proximal, mid, and the distal portions, respectively. The number of diagonal branches of left anterior artery was from one to four(mode=2). 3) The mean diametre of proximal and distal left circumflex artery were 3.17mm(range 1.74~4.89) and 2.19 mm(range 1.21~4.46). The number of obtuse marginal branches of left circumflex artery is from one to six(mode 2). 4) The mean diametre of proximal and distal right coronary artery, the posterior descending artery and the largest posterolateral branch were mean 3.51 mm(range 2.07~5.67), 2.09 mm (range 1.42~3.60), 2.09 mm(range 1.02~3.60) and 2.30 mm(range 1.39~4.39). 5) The right coronary artery dominant was 163 cases(93.68%) of the total 174 cases. 6) The large significant acute marginal artery was visualized in more than half of the people. half of the people.

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An Analysis of Prognostic Factors Affecting the Outcome of Radiation Therapy for Nasopharyngeal Carcinoma (비인강암의 방사선치료 곁과 및 생존율에 관한 예후인자 분석)

  • Jung, Young-Yeon;Kim, Ok-Bae;Kim, Jin-Hee
    • Radiation Oncology Journal
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    • v.23 no.2
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    • pp.71-77
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    • 2005
  • Purpose: This retrospective study was conduced to analyze the treatment results and to evaluate the prognostic factors affecting the survival of nasopharyngeal carcinoma patients. Materials and Methods: From 1987 to 2002, we analyzed 43 patients who had nasopharyngeal carcinomas that were histologically confirmed and who had also completed the planned radiation therapy course at Keimyung University Dongsan Medical Center According to the 6th edition of American Joint Committee on Cancer staging system, 12 patients ($27.9\%$) were at Stage 11, 13 ($30.2\%$) were at Stage III and 18 ($41.9\%$) were at Stage IV Histopathologically, there were 15 ($34.9\%$) squamous cell carcinomas, 8 ($18.5\%$) nonkeratinizing carcinomas, 17 ($39.5\%$) undifferentiated carcinomas, and 3 ($7.0\%$) lymphoepitheliomas. Among the total 43 patients, 31 patients ($72.1\%$) were treated with only radiation therapy. Neoadjuvant chemotherapy was peformed on 7 patients ($16.3\%$) and concurrent chemoradiotherapy was performed on S patients ($11.6\%$). Cisplatin and 5-Fluorouracil were administered to 11 patients for 4 cycles, and Cisplatin and Taxotere were administered to 1 patient for 6 cycles. The range of the total radiation dose delivered to the primary tumor was from 61.2 to 84 Gy (median 70.4 Gy), The follow-up period ranged from 2 to 197 months with median follow-up of 84 months. Results: The local control rate at 6 months after radiation therapy was $90.7\%$. The five year overall survival and disease free survival rates were $50.7\%$ and $48.9\%$, respectively. On the multivariate analysis, the age, T-stage ($T_{1-3}\;vs\;T_4$), N-stage and AJCC stage were the statistically significant prognostic factors affecting survival (p<0.05). The patterns of failure were as follows: local failure only in 3 patients ($7.0\%$), local and systemic failure in 1 patient ($2.3\%$), and distant metastasis only in 11 patients ($25.6\%$). Conclusion: The prognostic factors affecting the outcome of nasopharyngeal carcinoma were age, T-stage (7$T_{1-3}\;vs\;T_4$), N-stage and stage. Because systemic metastasis was the main failure pattern noted for nasopharyngeal carcinoma, systemic chemotherapy is needed to decrease the rate of distant metastasis for nasopharyngeal carcinoma. In audition, research for more effective chemotherapeutical regimens and schedules is also needed.

Relationship of Fixation Disparity and Heterophoria According to Fixation Distance (원, 근거리에서 주시시차와 사위와의 관계)

  • Kim, Chang-Jin;Jeong, Ju-Hyun
    • Journal of Korean Ophthalmic Optics Society
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    • v.13 no.3
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    • pp.79-87
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    • 2008
  • Purpose: This study measured Y-intercept that means a fixation disparity, X-intercept that means a associated phoria and slope of a fixation disparity curve (FDC), which are variables of dissociated phoria and the FDC. We searched for the result value and examined the direction, distribution pattern and a variable that give an most affect on dissociated phoria and the FDC at distance and near. Also this study examined that there were statistically significant differences between distance and near, comparing the result value. Methods: We measured the dissociated phoria and the fixation disparity for 51 subjects at distance and near in June, 2007. All subjects ranged from 20 to 25 years of age (average 21.72${\pm}$1.88 years old) and had no eye disease. At distance the dissociated phoria measured with the distance MIM card (muscle imbalance measure card, Bernell co., USA), and the fixation disparity measured with the modified Mallett Far Unit (Bernell co., USA). At near the dissociated phoria measured with the near MIM card (muscle imbalance measure card, Bernell co., USA), and the fixation disparity measured with the Wesson fixation disparity card (American Optical co., USA). Results: The percentage distribution of types of fixation disparity curves was that at distance prevalence of Type I (74.6%) was the highest, followed by Type IV (17.6%) and Type II (3.9%), Type III (3.9%) and that at near prevalence of Type I (53.0%) was the highest, followed by Type III (29.4%), Type IV (13.7%) and Type II (3.9%). 2. There were significantly correlation in dissociated phoria, fixation disparity (Y-intercept) and associated phoria (X-intercept). 3. The fixation disparity at distance was most affected by associated phoria (X-intercept) (p=0.000). The distance dissociated phoria was most affected by fixation disparity (Y-intercept) (p=0.342), but the influence was weak. 4. The fixation disparity at near was most affected by associated phoria (X-intercept) (p=0.000). The near also dissociated phoria was most affected by associated phoria (X-intercept) (p=0.009). The result that compared the each variables with the same variables at distance and near had statistically significant on paired t-test for among dissociated phoria (t=7.529, p=0.000), X-intercept (t=5.860, p=0.000), the Y-intercept (t=4.640, p=0.000) but slope of the FDC did not differ significant (t=1.336 p=0.188). Conclusions: Relationship of fixation disparity and Heterophoria had close correlation at distance and near.

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Antibiotic Susceptibility of Salmonella spp. Isolated From Diarrhoea Patients in Seoul From 1996 to 2001 (서울 시내 설사환자에서 분리한 살모넬라의 항생제 감수성의 년도별 변화 추이)

  • 박석기;박성규;정지헌;진영희
    • Journal of Food Hygiene and Safety
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    • v.17 no.2
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    • pp.61-70
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    • 2002
  • In order to investigate the classification and antibiotic resistance of Salmonella species,718 isolates were isolated from patient in Seoul from 1996 to 2001. The two hundred and ninety eight isolates (41.5%) were identified as Sal. Enteritidis, followed by Sal. Typhi 218 isolates (30.4%), and Sal. Typhimurium 87 isolates (12.1%). The identified Salmonella species were most resistant to tetracycline (32.7%), followed by streptomycin (28.0%), ticarcillin (18.1%) and ampicillin (12.4%). Among isolates,34.7% of Sal. Enteritidis were resistant to tetracycline, 32.3% to streptomycin,23.2% to ticarcillin,13.5% to ampicillin, respectively. 13.8% of Sal. Typhi were resistant to streptomycin,10.6% to tetracycline, respectively.66.7% of Sal. Typhimurium were resistant to tetracycline, 42.5% to streptomycin, 28.7% to ticarcillin, 26.4% to ampicillin and 17.2% to chloramphenicol, respectively. Of 718 isolates, 324 isolates (45.1%) were resistant to 1 or more drugs and 64 isolates (19.8%) were resistant to 1 drug, 132 isolates (40.7%) were resistant to 2 drugs,50 isolates (15.4%) were resistant to 3 drugs, 27 isolates (8.3%) to 4 drugs,27 isolates (8.3%) to 5 drugs,22 Isolates (6.8%) to 6 drugs. The most prevalent multiple resistant pattern was tetracycline-kanamycin (35.5%), followed by tetracycline-kanamycin-ticarcillin (8.3%), and tetracycline-kanamycin-ticarcillin-ampicillin (7.4%) . Antibiotic resistant rate of Sal. Typhimurium was 73.6%,1311owe4 by Sal. Enteritidis 53.7% and Sal. Typhi 19.3%. Most Sal. Enteritidis was resistant to 1 drug o.2 drugs, whereas Sal. Typhi. and Sal.. Typhunurium were more .resistant to 5 (16.7%) or 6 drugs (26.6%). The old generation antibiotics such as ampicillin, tetracycline, and streptomycin were annually more resistant than the new generation antibiotics such as ceftriaxone, ciprofloxacin or cefoxitin.

Incidence and Occurrence Pattern of Viruses in Lilies (Lilium spp.) on Jeju Island (제주지역 백합에서의 바이러스 발생 현황)

  • Kim, Hyo Jeong;Song, Jeong Heub;Song, MinA;Lee, Kwang Ju;Ko, Yoon Jeong;Park, Jeong Hoon;Yang, Young Taek;Heo, Tae Hyeon
    • Research in Plant Disease
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    • v.25 no.2
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    • pp.79-83
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    • 2019
  • To investigate the incidence status of lily viruses on Jeju island, lily samples were collected from 2015 to 2018 and examined for virus infection using RT-PCR. Of the viral infections, mixed and single infections were 70.0% and 17.9%, respectively. The incidence of mixed infections was highest for PlAMV and LSV as 43.4% in 2015; PlAMV, LSV 33.1% in 2016; LSV, LMoV 10.2% in 2017; and PlAMV, LSV, LMoV and CMV 15.8% in 2018. The incidence of PlAMV was observed to be 82.0% in 2015, 49.4% in 2016, 13.6% in 2017, and 39.5% in 2018 after the first occurrence of PlAMV in 2013. No symptoms were observed for single infection with LSV. However, in the case of mixed infection with LSV and LMoV, mosaic and leaf malformation symptoms appeared. With mixed infection with LSV and CMV, pale brown necrotic spots appeared, and mosaic and leaf curling were induced. PlAMV was more common in mixed infection than in single infection, and caused necrosis following the development of reddish-brown spots. PlAMV significantly decreased the marketability of lilies owing to the generation of leaf anomalies and curls, and its symptoms were more severe in mixed infections.