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Coexisting Bronchogenic Carcinoma and Pulmonary Tuberculosis in the Same Lobe: Radiologic Findings and Clinical Significance

  • Young Il Kim;Jin Mo Goo;Hyae Young KIm;Jae Woo Song;Jung-Gi Im
    • Korean Journal of Radiology
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    • v.2 no.3
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    • pp.138-144
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    • 2001
  • Objective: Bronchogenic carcinoma can mimic or be masked by pulmonary tuberculosis (TB), and the aim of this study was to describe the radiologic findings and clinical significance of bronchogenic carcinoma and pulmonary TB which coexist in the same lobe. Materials and Methods: The findings of 51 patients (48 males and three females, aged 48-79 years) in whom pulmonary TB and bronchogenic carcinoma coexisted in the same lobe were analyzed. The morphologic characteristics of a tumor, such as its diameter and margin, the presence of calcification or cavitation, and mediastinal lymphadenopathy, as seen at CT, were retrospectively assessed, and the clinical stage of the lung cancer was also determined. Using the serial chest radiographs available for 21 patients, the possible causes of delay in the diagnosis of lung cancer were analyzed. Results: Lung cancers with coexisting pulmonary TB were located predominantly in the upper lobes (82.4%). The mean diameter of the mass was 5.3 cm, and most tumors (n=42, 82.4%) had a lobulated border. Calcification within the tumor was seen in 20 patients (39.2%), and cavitation in five (9.8%). Forty-two (82.4%) had mediastinal lymphadenopathy, and more than half the tumors (60.8%) were at an advanced stage [IIIB (n=11) or IV (n=20)]. The average delay in diagnosing lung cancer was 11.7 (range, 1-24) months, and the causes of this were failure to observe new nodules masked by coexisting stable TB lesions (n=8), misinterpretation of new lesions as aggravation of TB (n=5), misinterpretation of lung cancer as tuberculoma at initial radiography (n=4), masking of the nodule by an active TB lesion (n=3), and subtleness of the lesion (n=1). Conclusion: Most cancers concurrent with TB are large, lobulated masses with mediastinal lymphadenopathy, indicating that the morphologic characteristics of lung cancer with coexisting pulmonary TB are similar to those of lung cancer without TB. The diagnosis of lung cancer is delayed mainly because of masking by a tuberculous lesion, and this suggests that in patients in whom a predominant or growing nodule is present and who show little improvement of symptoms despite antituberculous or other medical therapy, coexisting cancer should be suspected.

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Clinical and genetic characteristics of Korean patients with IARS2-related disorders

  • Lee, Jin Sook;Kim, Man Jin;Kim, Soo Yeon;Lim, Byung Chan;Kim, Ki Joong;Choi, Murim;Seong, Moon-Woo;Chae, Jong-Hee
    • Journal of Genetic Medicine
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    • v.16 no.2
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    • pp.55-61
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    • 2019
  • Purpose: Genetic defects in the nuclear-encoded mitochondrial aminoacyl-tRNA synthetases were first identified as causes of various disorders in 2007. Variants in IARS2, which encodes a mitochondrial isoleucyl-tRNA synthetase, were first reported in 2014. These variants are associated with diverse phenotypes ranging from CAGSSS (CAtaracts, Growth hormone deficiency, Sensory neuropathy, Sensorineural hearing loss, and Skeletal dysplasia) and Leigh syndrome to isolated nonsyndromic cataracts. Here, we describe the phenotypic and genetic spectrum of Korean patients with IARS2-related disorders. Materials and Methods: Using whole-exome sequencing followed by Sanger sequencing, we identified five patients with IARS2 mutations. Their medical records and brain magnetic resonance images were reviewed retrospectively. Results: All five patients presented with developmental delay or regression before 18 months of age. Three patients had bilateral cataracts, but none had hearing loss or sensory neuropathy. No evidence of skeletal dysplasia was noted, but two had short stature. One patient had cardiomyopathy and another exhibited renal tubulopathy and hypoparathyroidism. Their brain imaging findings were consistent with Leigh syndrome. Interestingly, we found the recurrent mutations p.R817H and p.V105Dfs*7 in IARS2. Conclusion: To our knowledge, this is the first report of Korean patients with IARS2-related disorders. Our findings broaden the phenotypic and genotypic spectrum of IARS2-related disorders in Korea and will help to increase clinical awareness of IARS2-related neurodegenerative diseases.

A Study on The Day of Week Effect in International Stock Markets : Focusing on the Settlement and Clearing Procedure (세계증권시장에서 주중 요일별 수익률 효과 분석의 연구 : 결제청산과정을 중심으로)

  • Kim, Kyung-Won
    • The Korean Journal of Financial Management
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    • v.20 no.2
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    • pp.201-234
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    • 2003
  • This paper examines the day of the week effect focusing on the effect of the settlement procedures on the stock price in seven major international stock markets. Settlement dates or procedures may have an effect on rate of return distributions in international stock markets. Those Settlement procedures are different among various international stock markets. Furthermore, several international stock markets change their systems of settlement procedures. On the New York stock exchanges, stock transactions are settled in five business days after the transaction. However, they changed settlement procedures from five business days to three business days from 1995. Those settlement procedures on the London stock exchanges and the Paris stock exchanges were changes from the fixed settlement date systems to the fixed settlement lag systems. Thus, this paper examines the effect of the changes in settlement procedures on the stock price in several stock markets. I found that changes of settlement dates or procedures have an effect on the rate of return distributions for specific days in some stock markets. This paper also examines the day of the week effect for seven international stock markets. I found that strong weekend effect before the period of 1990. However, the weekend effect has disappeared during the period from 1990 to 2002 in international stock markets.

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Study on the hypochlolesterolemic and antioxidative effects of tyramine derivatives from the root bark of Lycium chenese Miller

  • Cho, Sung-Hee;Park, Eun-Jung;Kim, Eun-Ok;Choi, Sang-Won
    • Nutrition Research and Practice
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    • v.5 no.5
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    • pp.412-420
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    • 2011
  • The aim of the present study was to investigate the hypocholesterolemic effect and potential of tyramine derivatives from Lycii Cortex Radicis (LCR), the root bark of lycium (Lycium chenese Miller) in reducing lipid peroxidation. The activities of enzymes, hepatic 3-hydroxy 3-methylglutaryl (HMG) CoA reductase and acyl-CoA:cholesterol acyltransferase (ACAT) and LDL oxidation were measured in vitro and animal experiments were also performed by feeding LCR extracts to rats. The test compounds employed for in vitro study were trans-N-p-coumaroyltyramine (CT) and trans-N-feruloyltyramine (FT), LCR components, N-(p-coumaroyl)serotonin (CS) and N-feruloylserotonin (FS) from safflower seeds, ferulic acid (FA) and 10-gingerol. It was observed that FT and FS at the concentration of 1.2 mg/mL inhibited liver microsomal HMG CoA reductase activity by ~40%, but no inhibition of activity was seen in the cases of CT, CS, FA and 10-gingerol. Whereas, ACAT activity was inhibited ~50% by FT and CT, 34-43% by FS and CS and ~80% by 10-gingerol at the concentration of 1 mg/mL. A significant delay in LDL oxidation was induced by CT, FT, and 10-gingerol. For the animal experiment, five groups of Sprague-Dawley male rats were fed high fat diets containing no test material (HF-control), 1 and 2% of LCR ethanol extract (LCR1 and LCR2), and 1% of extracts from safflower seed (Sat) and ginger (Gin). The results indicated that total cholesterol level was significantly lower in Saf, LCR2 and Gin groups, and HDL cholesterol level was lower only in Gin group when compared with HF-control group; while there was no difference in the serum triglyceride levels among the five experimental groups. The level of liver cholesterol was significantly lower in LCR1 and LCR2 groups than HF-control Serum levels of TBARS were significantly lower only in LCR2 group when compared with HF-control group. From the observed results, we concluded that LCR can be utilized as a hypocholesterolemic ingredient in combination with ginger, especially for functional foods.

A Research on the Total Emergency Room Time for Child Patients under 14 years suffering from External Injuries using Medical Information (의료정보를 활용한 14세 이하 외상환자 응급실 총 경유시간에 미치는 요인)

  • Jeon, Eun-Ju;Kim, Kwang-Hwan
    • Korea Journal of Hospital Management
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    • v.13 no.4
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    • pp.27-45
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    • 2008
  • This research focused on a total of 378 patients with external injuries under the age of 14 who visited the emergency center at a university hospital in Korea, during the months of January, April, August and November between January and December of 2007. In addition, the survey was conducted only on even number days and ranged across the whole year to reflect the impact of seasonal characteristics on the collected data. The research focused on determining the characteristics and inflicting cause of these patients with external injuries, analyzed the total time spent in the emergency room and obtained the following results. 1. When classifying the patients into different genders, the proportion of males (67.5%) was higher than that of females (32.5%). According to the different age groups, the highest ratio, at 61.1 %, was patients under the age of six. 2. Looking at the total number of minutes spent in the emergency room, the longest amount of time occurred during April with 162.7 minutes, followed by 121.9 minutes in January and 92.4 minutes in November. August had the shortest period of time spent in the emergency room, a significant statistical difference from the other periods of the year (p<0.001). 3. Regarding the amount of time required for each examination, patients required to provide a urine test spent an average of 204.7 minutes while those who did not spent 113.5 minutes on average. This is a 5% statistical difference among the two groups (p>0.05). 4. Looking at the five most commonly diagnosed problems in the emergency room, the total number of people with these top five commonly diagnosed illnesses comprised 55.6%, or 210 patients out of 378. 5. Utilizing the Decision Tree Model to estimate the total number of minutes required per visit, the first classifications were made using a chemical examination factor. People subject to chemical classification spent an average of 177.7 minutes, which was longer than the overall average of 115.2 minutes, and those exempt from chemical examination spent an average of 103.8 minutes, which was shorter than the average Conclusion; Effort to curtail the total time spent in emergency rooms is vital in guaranteeing efficient management of hospitals and providing medical services. The delay experienced by many comprehensive professional medical centers must be resolved through the establishment of effective delivery of medical services, increased supply of patient rooms and other policy oriented implementations. However, for now, this problem must be resolved by increasing the level of patient satisfaction and guaranteeing effective operation of patient rooms, which will significantly contribute to the general management and success of hospitals and institutions.

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Congenital Insensitivity to Pain with Anhidrosis: Five-Year-Old Girl with a Neglected Distal Femur Fracture (선천성 무통증과 무한증: 5세 여아에서 발생한 방치된 원위 대퇴골 골절)

  • Woo, Seung Hun;Kim, Tae Woo;Bae, Jung Yun;Kwak, Sang Ho
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.5
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    • pp.463-468
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    • 2019
  • Congenital insensitivity to pain with anhidrosis (CIPA) is a rare disease that affects the sensory and autonomic nervous system. The patients do not have the ability to sense different sensations, such as pain, which tends to lead to different injuries. In addition, the patients suffer from fluctuations in body temperature due to autonomic involvement. The present case was a five-year-old girl with a neglected distal femur fracture. X-rays taken during the follow-up showed marked callus formation and pseudarthrosis of the distal femur. She had biting injuries of the tongue, auto-amputation of the fingers, some developmental delay and a history of recurrent fever with an unknown origin. The electrodiagnostic study was normal. The quantitative sudomotor axon reflex test revealed markedly reduced postganglionic sudomotor axonal responses at all sites recorded on the left. She was diagnosed with CIPA. As the initial presentation of CIPA involves the musculoskeletal system, orthopedic surgeons should have a high index of suspicion.

Clinical Characteristics and Prognosis of Heat Stroke (열사병의 임상적 특징 및 예후에 관한 연구)

  • Park, Noh Han;Ryoo, Hyun Wook;Seo, Kang Suk;Park, Jung Bae;Chung, Jae Mung
    • Journal of Trauma and Injury
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    • v.19 no.2
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    • pp.113-120
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    • 2006
  • Purpose: The aim of this study was to evaluate the clinical characteristics of classic heat stroke in Korea and to identify factors of prognosis for heat stroke by comparing a survival group with a non-survival group. Methods: We retrospectively analyzed 27 patients with heat stroke who visited the Emergency Department of Kyungpook National University Hospital from March 2001 to February 2005. First, we divided the patients into two groups, the classic heat stroke group and the exertional heat stroke group, and compared them. Second, we compared the survival group with the non-survival group. Age, sex, cause, place where patients were found, underlying diseases, cooling time, performance of endotracheal intubation, initial Glasgow Coma Scale, initial vital sign, and laboratory findings were reviewed. Results: Five of 27 patients in heat stroke died. The classic heat stroke group had 20 patients. They were old and had more patients in the bathroom than the exertional heat stroke group had. The non-survival group showed lower blood pressure, lower initial GCS score, and higher respiratory rate than the survival group. In laboratory findings, the non-survival group also showed lower$HCO_3-$ level, lower albumin level, lower glucose level, more prolonged PT, and higher CK-MB level than the survival group. Delay in recognition of heat stroke and cooling were poor prognostic factors in heat stroke. Conclusion: The classic heat stroke group had patients who were old and found in the bathroom. Early recognition and treatment of heat stroke is important to reduce mortality. Cooling time, initial GCS score, mean arterial pressure, resipratory rate, $HCO_3-$, PT, CK-MB, and albumin seem to be meaningful when forming a prognosis for heat stroke patients.

A study on the characterization and traffic modeling of MPEG video sources (MPEG 비디오 소스의 특성화 및 트래픽 모델링에 관한 연구)

  • Jeon, Yong-Hee;Park, Jung-Sook
    • The Transactions of the Korea Information Processing Society
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    • v.5 no.11
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    • pp.2954-2972
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    • 1998
  • It is expected that the transport of compressed video will become a significant part of total network traffic because of the widespread introduction of multimedial services such as VOD(video on demand). Accordingly, VBR(variable bit-rate) encoded video will be widely used, due to its advantages in statistical multiplexing gain and consistent vido quality. Since the transport of video traffic requires larger bandwidth than that of voice and data, the characterization of video source and traffic modeling is very important for the design of proper resource allocation scheme in ATM networks. Suitable statistical source models are also required to analyze performance metrics such as packet loss, delay and jitter. In this paper, we analyzed and described on the characterization and traffic modeling of MPEG video sources. The models are broadly classified into two categories; i.e., statistical models and deterministic models. In statistical models, the models are categorized into five groups: AR(autoregressive), Markov, composite Marko and AR, TES, and selfsimilar models. In deterministic models, the models are categorized into $({\sigma},\;{\rho}$, parameterized model, D-BIND, and Empirical Envelopes models. Each model was analyzed for its characteristics along with corresponding advantages and shortcomings, and we made comparisons on the complexity of each model.

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Feasibility Evaluation of Lane Grouping Methods for Signalized Intersection Performance Index Analysis in KHCM (도로용량편람 신호교차로 성능지표 분석을 위한 차로군 분류의 적정성 평가)

  • Kim, Sang-Gu;Yun, Ilsoo;Oh, Young-Tae;Ahn, Hyun-Kyung;Kwon, Ken-An;Hong, Doo-Pyo
    • The Journal of The Korea Institute of Intelligent Transport Systems
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    • v.13 no.1
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    • pp.109-126
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    • 2014
  • The level of service (LOS) of the Highway Capacity Manual (KHCM) has been used as a basic criterion at decision making processes for signalized intersections in Korea. The KHCM provides five steps for the signalized intersection analysis. Among them, lane grouping, which is the third step, significantly influence the final LOS. The current method presented in the KHCM, however, classifies a shared lane as a de facto turning lane group, even though the turning traffic of the shared lane is few. Thus, this research was initiated to provide an alternative. To this end, three alternatives were suggested, including the method based on the lane grouping presented in the U.S. Highway Capacity Manual, the method using turning ratio of shared turning lane, and the method using a threshold traffic volume in lane grouping. The feasibilities of the three methods were evaluated using a calibrated CORSIM model. Conclusively, the method using a threshold traffic volume in lane grouping outperformed.

Perceptions of Barriers to Cardiovascular Risk Factors and Decision to Seek Treatment among Middle-aged Men with Acute Myocardial Infarction (중장년 남성 급성심근경색증 환자의 심혈관위험인자 인식 및 치료추구 장애요인)

  • Hwang, Seon-Young;Kweon, Young-Ran;Kim, Aee-Lee
    • Korean Journal of Adult Nursing
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    • v.22 no.5
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    • pp.537-551
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    • 2010
  • Purpose: This study was designed to identify meaningful themes related to the recognition of lifestyle risk factors and barriers in seeking treatment following an acute event of first-time acute myocardial infarction. Methods: A methodological mixed method of thematic content analysis and a quantitative analysis was used. The sample consisted of 120 male patients < 65 years of age who agreed to be in the study were interviewed using a semistructured during 2008-2009. Data were analyzed according to the procedure of thematic content analysis and the meaningful themes were coded into SPSS data for quantitative analysis. Results: Pre-hospital delay greater than three hours reported by 58.3% (n=70) of the sample and similarly 63.3% had no recognition about their symptoms as cardiac in origin. The mean number of risk factors was $3.9{\pm}1.8$ out of 11 when lifestyle and psychosocial factors were included. From the interview data among the 70 patients delayed greater than three hours, thirty-five themes categorized into 12 main themes influenced the delayed decision which was identified according to personal-cognitive, socio-cultural, and contextual factors. Conclusion: Health care providers should consider these themes in designing individual interventions to make lifestyle changes and to facilitate more prompt decisions to seek care.