• Title/Summary/Keyword: pathological change

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Hepatic encephalopathy on magnetic resonance imaging and its uncertain differential diagnoses: a narrative review

  • Chun Geun Lim;Myong Hun Hahm;Hui Joong Lee
    • Journal of Yeungnam Medical Science
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    • v.40 no.2
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    • pp.136-145
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    • 2023
  • Hepatic encephalopathy (HE) is a severe neuropsychiatric abnormality in patients with either acute or chronic liver failure. Typical brain magnetic resonance imaging findings of HE are bilateral basal ganglia high signal intensities due to manganese deposition in chronic liver disease and hyperintensity in T2, fluid-attenuated inversion recovery, or diffusion-weighted imaging (DWI) with hemispheric white matter changes including the corticospinal tract. Low values on apparent diffusion coefficient mapping of the affected area on DWI, indicating cytotoxic edema, can be observed in acute HE. However, neuropsychological impairment in HE ranges from mild deficits in psychomotor abilities affecting quality of life to stupor or coma with higher grades of hepatic dysfunction. In particular, the long-lasting compensatory mechanisms for the altered metabolism in chronic liver disease make HE imaging results variable. Therefore, the clinical relevance of imaging findings is uncertain and differentiating HE from other metabolic diseases can be difficult. The recent introduction of concepts such as "acute-on-chronic liver failure (ACLF)," a new clinical entity, has led to a change in the clinical view of HE. Accordingly, there is a need to establish a corresponding concept in the field of neuroimaging diagnosis. Herein, we review HE from a historical and etiological perspective to increase understanding of brain imaging and help establish an imaging approach for advanced new concepts such as ACLF. The purpose of this manuscript is to provide an understanding of HE by reviewing neuroimaging findings based on pathological and clinical concepts of HE, thereby assisting in neuroimaging interpretation.

Risk factors for prostate-specific antigen persistence in pT3aN0 prostate cancer after robot-assisted laparoscopic radical prostatectomy: a retrospective study

  • Jun Seop Kim;Jae Hoon Chung;Wan Song;Minyong Kang;Hyun Hwan Sung;Hwang Gyun Jeon;Byong Change Jeong;Seong Il Seo;Hyun Moo Lee;Seong Soo Jeon
    • Journal of Yeungnam Medical Science
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    • v.40 no.4
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    • pp.412-418
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    • 2023
  • Background: The aim of this study was to evaluate the risk factors for prostate-specific antigen (PSA) persistence in pathological stage T3aN0 prostate cancer (PCa) after robot-assisted laparoscopic radical prostatectomy (RALP). Methods: A retrospective study was performed on 326 patients with pT3aN0 PCa who underwent RALP between March 2020 and February 2022. PSA persistence was defined as nadir PSA of >0.1 ng/mL after RALP, and the risk factors for PSA persistence were evaluated using logistic regression analysis. Results: Among 326 patients, 61 (18.71%) had PSA persistence and 265 (81.29%) had PSA of <0.1 ng/mL after RALP (successful radical prostatectomy [RP] group). In the PSA persistence group, 51 patients (83.61%) received adjuvant treatment. Biochemical recurrence occurred in 27 patients (10.19%) in the successful RP group during the mean follow-up period of 15.22 months. Multivariate analysis showed that the risk factors for PSA persistence were large prostate volume (hazard ratio [HR], 1.017; 95% confidence interval [CI], 1.002-1.036; p=0.046), lymphovascular invasion (LVI) (HR, 2.605; 95% CI, 1.022-6.643; p=0.045), and surgical margin involvement (HR, 2.220; 95% CI, 1.110-4.438; p=0.024). Conclusion: Adjuvant treatment may be needed for improved prognosis in patients with pT3aN0 PCa after RALP with a large prostate size, LVI, or surgical margin involvement.

Ginsenoside Rg1 alleviates vascular remodeling in hypoxia-induced pulmonary hypertension mice through the calpain-1/STAT3 signaling pathway

  • Chenyang Ran;Meili Lu;Fang Zhao;Yi Hao;Xinyu Guo;Yunhan Li;Yuhong Su;Hongxin Wang
    • Journal of Ginseng Research
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    • v.48 no.4
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    • pp.405-416
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    • 2024
  • Background: Hypoxic pulmonary hypertension (HPH) is the main pathological change in vascular remodeling, a complex cardiopulmonary disease caused by hypoxia. Some research results have shown that ginsenoside Rg1 (Rg1) can improve vascular remodeling, but the effect and mechanism of Rg1 on hypoxia-induced pulmonary hypertension are not clear. The purpose of this study was to discuss the potential mechanism of action of Rg1 on HPH. Methods: C57BL/6 mice, calpain-1 knockout mice and Pulmonary artery smooth muscle cells (PASMCs) were exposed to a low oxygen environment with or without different treatments. The effect of Rg1 and calpain-1 silencing on inflammation, fibrosis, proliferation and the protein expression levels of calpain-1, STAT3 and p-STAT3 were determined at the animal and cellular levels. Results: At the mouse and cellular levels, hypoxia promotes inflammation, fibrosis, and cell proliferation, and the expression of calpain-1 and p-STAT3 is also increased. Ginsenoside Rg1 administration and calpain-1 knockdown, MDL-28170, and HY-13818 treatment showed protective effects on hypoxia-induced inflammation, fibrosis, and cell proliferation, which may be associated with the downregulation of calpain-1 and p-STAT3 expression in mice and cells. In addition, overexpression of calpain 1 increased p-STAT3 expression, accelerating the onset of inflammation, fibrosis and cell proliferation in hypoxic PASMCs. Conclusion: Ginsenoside Rg1 may ameliorate hypoxia-induced pulmonary vascular remodeling by suppressing the calpain-1/STAT3 signaling pathway.

A Study of Changes in Body Shape, Temperament, Symptoms and Sasang Constitutional Values Using the Korea Sasang Constitutional Diagnostic Questionnaire (KS-15) : 5 Year Follow Up (사상체질 진단설문지(KS-15)를 이용한 외형, 성정, 병증의 추적관찰 및 체질값 변화 연구 : 5년 추적)

  • Kyoungsik Jeong;Bok-Nam Seo;Yunyoung Kim;Eunsu Jang
    • Journal of Sasang Constitutional Medicine
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    • v.36 no.2
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    • pp.1-11
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    • 2024
  • Objectives The purpose of this study was to compare between baseline and follow up data after 5 years about the change of Sasang constitutional value. Methods Cohort data of educational personnel in D University was used. Korean Sasang Constitutional Diagnostic Questionnaire was used to compare Sasang value including body shape, temperament, and pathological symptoms in baseline with those of follow up. Paired t test, chi-square test, correlation analysis and cohen's kappa coefficient was used. Results Total 150 subjects participated in this analysis. Taeeumin, Soeumin and Soyangin was 71, 46 and 33 respectively. Height decreased in follow-up, and weight increased, accordingly body mass index increased(p<.05). The score of nocturia was significantly increased, and the temperature of drinking water was significantly decreased. The consistency rate of the Sasang constitutional values in KS-15 between baseline and follow up was 76%, and the kappa value was 0.607. Compared to the expert's diagnosis, the agreement rate was 66.7% in baseline and 69.3% in follow up. Conclusion As times goes by, Sasang Constitutional phenotype, such as body mass index, nocturia, and temperature of drinking water, and accordingly, the predicted value of Sasang constitution may be changed. Those who use Sasang constitutional type and therapy in clinics should consider these factors.

Inhibition of Apoptosis by Nitric Oxide in MCF-7 Cells (유방암 세포(MCF-7)에서 nitric oxide에 의한 apoptosis 억제)

  • Kim, Kyun-Ha;Roh, Sang-Geun;Park, Hae-Ryun;Choi, Won-Chul
    • Journal of Life Science
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    • v.19 no.2
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    • pp.157-162
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    • 2009
  • Nitric oxide (NO) is a diffusible, multifunctional and transcellular messenger that has been implicated in numerous physiological and pathological conditions. It has been reported that NO induced apoptosis in tumor cells, macrophage cells and inhibited apoptosis in normal cells, endothelial cells. To examine whether NO could induce apoptosis in MCF-7 cells, cells were treated with SIN-1 (3-morpholinosydnonimine), NO donor. Cell viability did not change in SIN-1 treated cells for 48 h and there was no significantly changes in cell cycle progression or growth pattern by FACS analysis. But p53 protein, an apoptosis-related factor, increased SIN-1 treatment time dependently. Bcl-2, MDM2 and p21 were also accumulated. Bax level did not change. A major role of inhibiting apoptosis by NO in MCF-7 cells, cobalt chloride ($CoCl_2$) was added to cells preincubated with SIN-1. Whereas $CoCl_2$ treated cells underwent apoptosis, for 24 h SIN-1 preincubated cells were not induced apoptosis. Inactivated proteins, MDM2 and bcl-2, by $CoCl_2$ levels also increased in SIN-1 pre-treated cells. These results suggested that SIN-1 blocked p53 by MDM2 activation and inhibited apoptosis by inducing p21 and bcl-2 expression.

Effects of Ondamtang, Samulansintang and Shihosogansan Water Extract on the Obesity and Stress (온담탕(溫膽湯)과 사물안신탕(四物安神湯) 및 시호소간산(柴胡疏肝散)이 비만(肥滿)과 스트레스에 미치는 영향(影響))

  • Lee Sang-Yong;Ryu Hui-Yeong
    • Journal of Oriental Neuropsychiatry
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    • v.3 no.1
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    • pp.25-45
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    • 1992
  • Many phychiatrists have reported that the change of serotonin concentration would cause mental disorder and affect the pathological conditions such as schizophrenia, depression and eating behabior. The end product of serotonin metabolism was excreted as 5-HIAA in urine. Serum lipids, according to the report, were concerned with obesity, said it was. This study aims to observe the changes of plasma serotonin, urinary 5-HIAA and serum lipids, making use of Fat Cell Mass rate of 27 normal persons and 42 psychosomatic patients. For this, I also observed the change of serotonin, 5-HIAA and lipids of the psychosomatic patients by the use of 3 kinds of herbs as treatment medication on the basis of physical symptoms and the results were obtained as follows; 1. Urinary 5-HIAA is correlated with the body water rate(r=0.381), while reversely correlated with the Fat Cell Mass rate(r=-0.330). 2. Compared the control group with the patients group for the serum lipids value, they showed the significant results ; $146.4{\pm}5.71$ mg/dl and $166.9{\pm}6.56$ mg/dl in the total cholestrol value over- weights, $471.2{\pm}42.99$ mg/dl in the total lipid value, and $158.1{\pm}6.50$ mg/dl and $181.1{\pm}6.30$ mg/dl in the phospholipid of the obesity, respectively. 3. With comparison of each group to other group to the others for Fat Cell Mass rate, the total cholesterol showed the significant differences when the Fat Cell Mass rate was 20% or more, HDL-cholesterol value when 30% or more, and triglyceride when 30% or more, respectively. 4. there was significant variations in the relations between Fat Cell Mass rate and body water, which body mass index was increased as the body water was decreased. 5. Fat Cell Mass rate was correlated with Cholesterol(r = 0.420), triglyceride (r = 0.443), and $\beta$-lipoprotein(r = 0.450) of serum lipids, while reversely correlated with HDL -Cholesterol(r = -0.354) and urinary 5- HIAA had the correlation coefficient of -0.330. 6. What related with body water rate urinary 5-HIAA (r = 0.381) and $\beta$-lipoprotein(r = -0.405). 7. there were significant changes in the total cholesterol value and HDL-Cholesterol Value of serum lipids after dose of Ondamtang, significant increase in the 5-HIAA value after dose of Samulansintang, and significant devrease in the Trigylceride value of serum lipids after dose of Shihosogansan. As a result, it was seen that there was direct correlations among the Fat Cell Mass, urinary 5-HIAA, and serum lipids and stress from the mental conditions was not correlated directly to Serotonin, 5-HIAA, and serum lipids. I would like to conclude, therefore, that the detailed study should be performed on the function of serotonin of hypothalamus.

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Clinical Pathologic Study on DL-Ethionine Induced Fatty Liver in Korean Black Goats (한국흑염소에 있어서 DL-Ethionine으로 유발시킨 지방간에 관한 연구)

  • Lee Kyoung-Kap;Choi Hee-In
    • Journal of Veterinary Clinics
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    • v.8 no.2
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    • pp.127-142
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    • 1991
  • This study was carried out to investigate fatty liver in Korean black goats. Adult female goats were divided into 3 test groups(A, B and C). Group A and B of goats each received 3 test consecutive daily doses of DL-ethionine at 75mg/kg and 150mg/kg body weight, respectively. Group C of goats was given 3 consecutive doses of the compound every 48 hours at 150mg/kg body weight. The clinical symptoms, hematological values, serum chemical values and histopathological study of the liver were investigated in the test animals. The results obtained are as follows ; 1. Fatty liver were observed in every test animal. 2. Some clinical symptoms( anorexia, depression) were appeared from 1st day to 7th day after administration of the compound in every test animal. In addition to these symptoms, diarrhea and salivation were generally observed in test animals which were given the compound at 150mg/kg body weight. The degree of these symptoms was dose dependent. 3. There was no significant variations in total WBC counts and fibrinogen values in the blood of test goats. The PCV values were significantly increased on 5th day of dosing in group A and B of goats. 4. The total lipid value was not changed but the concentration of NEFA was significantly increased on 3rd day of dosing with the compound and returned to normal value after 10 days hereafter. The value of triglycerides was significantly increased on 1st day and returned to normal value on 3rd day of dosing. The value of cholesterol was significantly decreased on 3rd day and returned to normal value on 10th day after treatment. 5. Total protein level was decreased on 10th day of dosing in the groups of B and C, and billirubin level was significantly increased on 7th day of dosing in every test group and returned to normal level after 13th day of administration. 6. The activity of GGT in serum was not changed while the activities of SDH and AST were significantly increased in every test goat and those values were returned to normal after 10~13th day of trestment. 7 The 35K-protein fraction in serum was not detected by SDS-polyacrylamide gel electrophoresis, but this protein fraction was detected by the same method after treating the 21st and 22nd fraction which were obtained by column chromatography with Sephadex G-100. 8. The affected liver was congested and swollen on 3rd day, and yellowish brown in color and mottled appearance on 7th day of treatment. Histopathologically, fat droplets were common in the hepatocytes, this change was intensive on 7th day after treatment in group B and C. Hepatic cell necrosis was observed in some livers but this pathological change was disappeared and returned to normal after 13 days of treatment.

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Study on Inhalation Toxicity of Iso-butylalcohol Using SD Rats (Rats를 이용한 Iso-butylalcohol의 아만성 흡입독성 연구)

  • Kin, Hyeon Yeong;Yun, Hyo In;Lee, Sung Bea;Chang, Beom Su;Jeong, Jae Hwang;Lim, Cheol Hong;Chung, Yong Hyun;Han, Jeong Hee;Zeon, Yoon Seok;Jang, Dong Hyuk;Ha, Chang Soo;Kim, Jong Chun;Lee, Yong Mook
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.9 no.2
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    • pp.66-78
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    • 1999
  • The purpose of this study was to investigate the toxic effects of iso-butylalcohol on Sprague-Dawley (SD) rats which were treated 0, 333, 1,000 and 3,000 ppm for 6 hours a day, 5 days a week for 13 weeks by inhalation. Iso-butylalcohol did not induce any abnormal change in the viewpoint of clinical signs, feed consumption, ophthalmic test, urinalysis, hematology and blood biochemistry during and at the termination of the inhalation toxicity test. We did not find any abnormal findings in the gross and microscopic observations due to the inhalation of iso-butylalcohol. There was no alteration in relative organ weight owing to the inhalation of the iso-butylalcohol. In conclusion, concentration was 3,000 ppm in rats under the inhalation of 6 hours a day, 5 days a week for 13 week. Iso-butylalcohol did not show any change in the clinical signs, feed consumption, ophthalmic test, urinalysis, hematology and blood biochemistry, together with no alteration in the gross and pathological findings.

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DIFFERENTIAL DIAGNOSIS BY JOINT CAVITY PUMPING WITH LOCAL ANESTHETIC FOR PAIN OF TEMPOROMANDIBULAR JOINT ARTHROSIS (악관절증의 동통에 대한 국소마취제의 관절강내 Pumping에 의한 감별법)

  • Chung, Hoon;Jung, Hak;Kino, Koji
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.14 no.1_2
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    • pp.146-153
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    • 1992
  • In the outpatient clinic, we have many patients who suffer from temporomandibular joint disorders. These vary from MPD syndrome to osteoarthrosis, and many cases have tender spots or areas on the temporomandibular joint region and/or masticatory muscles. Further, they frequently have masticatory muscle pain when opening the jaw. This paper presents the results of our research on the differential diagnosis for tendernesses and pain on opening the jaw in the temporomandibular joint region and the masticatory muscles by joint cavity pumping with local anesthestic. The areas of tenderness and jae-opening paw in 65 patient suffering from temporomandibular joint disorder were examined and recorded before and after anesthetizing the upper joint cavity with 2% lidocaine. Maximum interincisal distance was similarly recorded. The results were as follows : In the area surrounding the upper joint cavity including the lateral pterygoid muscle, the tenderness and jaw-opening pain vanished almost entirely after anesthesia. This was considered a direct infiltrative effect of the local anesthesia. After the anesthesia, 86% of the tendernesses on the sternocleidomastoid muscles, and 66% of those on the posterior belly of the diagstric muscles vanished, while the disappearance rates on the masseter, temporal, and medial pterygoid muscles were 50~60%. Apart from the temporomandibular region, pain on opening the jaw was found on the masseter, temporal, posterior belly of the digastric muscles, and medial pterygoid muscles before anesthesia. The disappearance rates after anesthesia were 90~100% except for the pain of the posterior belly of the digastric muscles, for which the rate was 66%. These results suggest that more than 88% of the tendernesses on the sternocleidomastoid muscle, more than 60% of the tendernesses and jaw-opening pains on the digastric muscle, and more than half of the tendernesses and almost all of the jaw-opening pains in the jaw-closing muscles are referred pains from the temporomandibular joint. The tendernesses that had no change after anesthesia were considered to be derived from spasms of the muscles proper. Generally, maximum interincisal distance increased after anesthesia. The average distance was 34mm before anesthesia, but increased to 41mm after anesthesia. In a few cases, however little or no change was found in those distances. In these cases, pathological changes were found in the joint cavities arthrographically or arthroscopically.

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Comparisons of the Plastic Changes in the Central Nervous System in the Processing of Neuropathic Pain (신경병증성 통증의 처리 과정에 있어 중추신경계의 가소성 변화 비교)

  • Kwon, Minjee
    • Science of Emotion and Sensibility
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    • v.24 no.2
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    • pp.39-48
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    • 2021
  • According to International Associating for the Study of Pain (IASP) definition, neuropathic pain is a disorder characterized by dysfunction of the nervous system that, under normal conditions, mediates virulent information to the central nervous system (CNS). This pain can be divided into a disease with provable lesions in the peripheral or central nervous system and states with an incorporeal lesion of any nerves. Both conditions undergo long-term and chronic processes of change, which can eventually develop into chronic pain syndrome, that is, nervous system is inappropriately adapted and difficult to heal. However, the treatment of neuropathic pain itself is incurable from diagnosis to treatment process, and there is still a lack of notable solutions. Recently, several studies have observed the responses of CNS to harmful stimuli using image analysis technologies, such as functional magnetic resonance imaging (fMRI), positron emission tomography (PET), and optical imaging. These techniques have confirmed that the change in synaptic-plasticity was generated in brain regions which perceive and handle pain information. Furthermore, these techniques helped in understanding the interaction of learning mechanisms and chronic pain, including neuropathic pain. The study aims to describe recent findings that revealed the mechanisms of pathological pain and the structural and functional changes in the brain. Reflecting on the definition of chronic pain and inspecting the latest reports will help develop approaches to alleviate pain.