1.Comparison of Clinical Feature, CSF Cytology, Neuroimaging, and CSF Biochemical Marker in Leptomeningeal Metastasis.
Phil Hyu LEE ; Il Saing CHOI ; Seung Min KIM ; Dong Chul PARK
Journal of the Korean Neurological Association 1999;17(1):45-52
Background: It is important to make the accurate diagnosis of leptomeningeal metastasis(LM) because the institution of appropriate therapy may produce symptomatic improvement, prevent neurologic deterioration, and prolong survival. To evaluate the appropriate diagnostic methods of LM, we conducted the comparison of diagnostic yield in each diagnostic method and analyzed factors influencing the diagnostic results. METHODS: We analyzed 62 patients of LM with following inclusion criteria: positive CSF cytology, or abnormal neuroimaging, or elevated CSF biochemical marker, or characteristic clinical symptom and abnormal routine CSF examination. RESULTS: Primary cancer of LM was following; lung cancer 21, lymphoma 15, stomach cancer 13, breast cancer 9, rhabdomyosarcoma 2, bladder cancer 1, and colon cancer 1. The positive yield in the diagnosis of LM was 54.5% in CSF cytology, 55.9% in neuroimaging, 62.5% in CSF biochemical marker. As each diagnostic method was combined, the positive yield was increased to 86.4-88.5% with the highest in combination of CSF cytology with neuroimaging. The relationship between CSF cytology and neuroimaging is complementary in the diagnosis of LM (p=0.01). In positive group of CSF cytology, the count of CSF WBC was higher than in negative group (p=0.026), and clinical feature revealed a tendency of combined cerebral and cranial symptom than isolated symptom. The interval from the diagnosis of primary cancer to diagnosis of LM was most prolonged in breast cancer with a mean of 38.2 month. CONCLUSIONS: Combination of each diagnostic method increases the diagnostic yield, and CSF cytology and neuroimaging must be performed with each other.
Biomarkers*
;
Breast Neoplasms
;
Colonic Neoplasms
;
Diagnosis
;
Humans
;
Lung Neoplasms
;
Lymphoma
;
Neoplasm Metastasis*
;
Neuroimaging*
;
Rhabdomyosarcoma, Alveolar
;
Stomach Neoplasms
;
Urinary Bladder Neoplasms
2.Influence of various photoperiods on stress hormone production, immune function, and hematological parameters in ICR mice.
Seung Hyu PARK ; Il Gyue KIM ; Hyung Chan KIM ; Mi Jeong GANG ; Song Ee SON ; Hu Jang LEE
Korean Journal of Veterinary Research 2015;55(2):111-116
In the present study, the effects of different photoperiods on stress, immunity, and hematological parameters in ICR mice were evaluated. Fifty male ICR mice 7 weeks old (body weight, 27.3 +/- 2.5 g) were divided into five groups: DP-0 (0/24-h light/dark cycle), DP-6 (6/18-h light/dark cycle), DP-12 (12/12-h light/dark cycle), DP-18 (18/ 6-h light/dark cycle), and DP-24 (24/0-h light/dark cycle). During the experimental period, no significant differences in body weight or feed intake were observed between the groups. Hematological analysis revealed that white blood cell, red blood cell, and hemoglobin values for the DP-0 group were significantly different compared to those of the other groups. After 28 days, no significant difference in serum cortisol concentration was observed among the groups, but serum cortisol levels increased in a light exposure-dependent manner. Total serum immunoglobulin G (IgG) concentrations of the DP-0 and PD-6 groups were significantly increased compared to those of the other groups (P < 0.05), and serum total IgG levels decreased in a light exposure-dependent manner. Results of the present study indicated that various photoperiods affect hematological parameters and total serum IgG levels in ICR mice while having no significant effects on body weight, feed intake, or cortisol levels.
Animals
;
Body Weight
;
Erythrocytes
;
Humans
;
Hydrocortisone
;
Immunoglobulin G
;
Leukocytes
;
Male
;
Mice
;
Mice, Inbred ICR*
;
Photoperiod*
3.Pendulum Test Using Video-Based Two Dimensional Motion Analysis Program.
Seung Han YANG ; Eun Seok CHOI ; No Kyoung PARK ; Min Ki KIM ; Jang Hyu CHOI
Journal of the Korean Academy of Rehabilitation Medicine 1997;21(5):942-949
The pendulum test, recognized as a reliable measure of spasticity, has been replaced in this study by a video-based two dimensional motion analysis system. Using twenty five patients with spasticity(21 males, 4 females; mean age 46.6 year-old) in their lower legs due to lesions affecting the central nervous system and twenty two persons without any evidence of hypertonia(all males; mean age 23.4 year-old), five parameters such as relaxation index(RI), amplitude ratio(AR), torque at maximal acceleration velocity, number of swing and swing time were obtained for the purpose of documenting the reliability of the video-based two dimensional motion analysis system for the evaluation of spasticity. The values of RI(P<0.05), AR(P<0.01), and swing time(P<0.05) in patients with spasticity were significantly lower than control, whereas the value of torque in patients was significantly higher than control(P<0.01). Spearman's correlation coefficients of the RI(r=+/-0.70894, P<0.001), AR(r=+/-0.71832, P<0.001), number of swing(r=+/-0.59037, P<0.05) and swing time(r=+/-0.59648, P<0.01) showed a statistically significant negative correlation with the modified Ashworth scale, whereas that of torque(r=0.59037, P<0.01) showed a significant positive correlation. In conclusion, a pendulum test using a video-based two dimensional motion analysis system is a simple, and a reliable method for the quantitative evaluation of spasticity.
Acceleration
;
Central Nervous System
;
Evaluation Studies as Topic
;
Female
;
Humans
;
Leg
;
Male
;
Muscle Spasticity
;
Relaxation
;
Torque
4.Predicting the Long-Term Outcome after Subacute Stroke within the Middle Cerebral Artery Territory.
Oh Young BANG ; Hee Young PARK ; Jung Han YOON ; Seung Hyeon YEO ; Ji Won KIM ; Mi Ae LEE ; Mi Hee PARK ; Phil Hyu LEE ; In Soo JOO ; Kyoon HUH
Journal of Clinical Neurology 2005;1(2):148-158
BACKGROUND AND PURPOSE: The National Institutes of Health Stroke Scale (NIHSS) score is known to be effective in predicting the likelihood of recovery after stroke. However, the baseline NIHSS score predicts long-term outcomes rather crudely because early changes in stroke scores may influence the stroke outcomes. Therefore, a precise prognostic algorithm or a cutoff point for predicting long-term outcomes based on data from serial NIHSS scores is needed. METHODS: We serially assessed 437 patients with acute symptomatic ischemic stroke within the middle cerebral artery territory who presented with nonlacunar stroke and were followed-up for at least 6 months after symptom onset. The NIHSS score was serially checked at 0, 1, 3, 7, and 14 days after admission. In all patients, the Barthel index (BI) and the modified Rankin Scale (mRS) score were checked, with a poor outcome defined as any of the following endpoints: death, modified mRS score of >3, or BI of <60. RESULTS: A marked neurological improvement or worsening (i.e., a change in the NIHSS score of at least 4) was seen in 13.5% or 5.5% of the patients, respectively, during the first 7 days after admission. About 25% of the 437 patients had poor long-term outcomes. Analysis of receiver operating characteristic curves showed that the NIHSS score at day 7 after admission was better for predicting poor long-term outcomes than was the baseline score (P=0.003). In addition, we analyzed the cutoff point of the 7th-day NIHSS score for predicting a poor outcome at 6 months after symptom onset. An NIHSS score of at least 6 at day 7 after admission predicted poor long-term outcomes with a sensitivity of 84% [95% confidence interval (CI), 76-90%], a specificity of 92% (95% CI, 88-94%), and positive and negative predictive values of 77% and 95%, respectively. A logistic regression analysis revealed that age, diffusion-weighted imaging lesion volume, stroke history, and 7th-day NIHSS score were independently associated with poor outcome. However, no score used in addition to the 7th-day NIHSS score improved the prediction of a poor outcome. CONCLUSIONS: An NIHSS score of at least 6 on day 7 after admission accurately forecasts a poor long-term outcome after stroke. Our data may be helpful in predicting the long-term prognosis as well as in making decisions regarding novel therapeutic applications in subacute-stroke trials.
Humans
;
Logistic Models
;
Middle Cerebral Artery*
;
National Institutes of Health (U.S.)
;
Prognosis
;
ROC Curve
;
Sensitivity and Specificity
;
Stroke Volume
;
Stroke*
5.Prevalence of Occupational Asthma and Exposure Level of Pharmaceutical Dust of Workers in a Pharmaceutical Company.
Sung Soo OH ; Yong Hyu CHOI ; Eun A KIM ; Young Mok LEE ; Jae Kil JANG ; Jang Jin YOO ; Seung Hyun PARK ; Soo Young JUNG ; Tae Kyun KIM ; Kyoo Sang KIM ; Seong Kyu KANG
Korean Journal of Occupational and Environmental Medicine 2006;18(2):94-102
OBJECTIVES: After the investigation of one worker with occupational asthma, we surveyed the prevalence of occupational asthma and the exposure level of pharmaceutical dust of 32 workers in a pharmaceutical company. METHODS: Thirty-two of the 90 employees participated in the survey which consisted of questionnaire, blood sampling, spirometry and skin prick tests with 8 common allergens as well as 9 antibiotics and 2 enzymes. Various indices of the working environment were also measured. Subjects who had a symptom suggestive of work-related asthma or positive skin prick test were further investigated by PC20 methacholine. Nine subjects who had a PC20 result of 16 mg/ml or less (n=7) or had work-related symptoms and positive skin prick test (n=2) were referred to undergo a specific bronchial provocation test to pharmaceutical dust in an academic allergic disease center. RESULTS: Eleven of 32 workers (34.4%) had a work-related symptom suggestive of occupational asthma. Ten (31.2%) showed positive skin prick test. 8 (25.0%) had a PC20 result of 16 mg/ml or less (indicative of significant bronchial hyperresponsiveness), and 5 (15.6%) had a positive result on the specific bronchial provocation test. Exposure levels of stuffing, input of raw materials and screening process were relatively high. CONCLUSIONS: This survey showed that pharmaceutical workers have an increased risk of occupational asthma. Although pharmaceutical factories maintain a relatively good working environment, careful control of respiratory tract exposures, especially during stuffing, input of raw materials and screening process, is important to prevent occupational asthma. Pharmaceutical workers need to undergo regular skin prick and methacholine bronchial provocation tests, as well as asthmatic symptom survey, to ensure the early detection and prevention of occupational asthma.
Allergens
;
Anti-Bacterial Agents
;
Asthma
;
Asthma, Occupational*
;
Bronchial Provocation Tests
;
Dust*
;
Mass Screening
;
Methacholine Chloride
;
Prevalence*
;
Questionnaires
;
Respiratory System
;
Skin
;
Spirometry
6.Clinical and Genetic Aspects in Twelve Korean Patients with Adrenomyeloneuropathy.
Hyung Jun PARK ; Ha Young SHIN ; Hoon Chul KANG ; Byung Ok CHOI ; Bum Chun SUH ; Ho Jin KIM ; Young Chul CHOI ; Phil Hyu LEE ; Seung Min KIM
Yonsei Medical Journal 2014;55(3):676-682
PURPOSE: This study was designed to investigate the characteristics of Korean adrenomyeloneuropathy (AMN) patients. MATERIALS AND METHODS: We retrospectively selected 12 Korean AMN patients diagnosed by clinical analysis and increased plasma content of very long chain fatty acids. RESULTS: All 12 patients were men. Patient ages at symptom onset ranged from 18 to 55 years. Family history was positive in two patients. The phenotype distributions consisted of AMN without cerebral involvement in seven patients, AMN with cerebral involvement in two patients, and the spinocerebellar phenotype in three patients. Nerve conduction studies revealed abnormalities in four patients and visual evoked tests revealed abnormalities in three patients. Somatosensory evoked potential tests revealed central conduction defects in all of the tested patients. Spinal MRI showed diffuse cord atrophy or subtle signal changes in all 12 patients. Brain MRI findings were abnormal in six of the nine tested patients. These brain abnormalities reflected the clinical phenotypes. Mutational analysis identified nine different ABCD1 mutations in 10 of 11 tested patients. Among them, nine have been previously reported and shown to be associated with various phenotypes; one was a novel mutation. CONCLUSION: In conclusion, the present study is the first to report on the clinical and mutational spectrum of Korean AMN patients, and confirms various clinical presentations and the usefulness of brain MRI scan.
ATP-Binding Cassette Transporters/genetics
;
Adolescent
;
Adrenoleukodystrophy/*diagnosis/*genetics
;
Adult
;
Brain/pathology
;
Humans
;
Magnetic Resonance Imaging
;
Male
;
Middle Aged
;
Republic of Korea
;
Young Adult
7.Familiar Myxoma with a Positive Genetic Test: A case report.
Hyang Lim LEE ; Kook Yang PARK ; Kyung Hee KIM ; Seung Tae LEE ; Chang Seok KI ; Yang Bin JEON ; Chang Hyu CHOI
The Korean Journal of Thoracic and Cardiovascular Surgery 2010;43(1):67-72
Ten percent of all myxomas are the familial form. Familial myxomas appear to have autosomal dominant transmission. We experienced two siblings with familial myxomas. A left atrial myxoma was surgically removed in a 21-year-old woman. Six years later, other myxomas were found in the right atrium and the left atrium and these were also surgically removed. Right ventricular and right atrial myxomas were surgically excised in her brother. The two siblings were found to have frame-shift mutations in the PRKAR1A gene (c.537delA; p.Gly180GlufsX26), which is the causative gene for Carney complex. Obtaining the genetic diagnosis makes it possible to prepare more effective therapeutic strategies for these patients and the gene carriers. Complete excision, ruling out multicentricity and proper postoperative follow up are all necessary to avoid recurrence of myxoma.
Carney Complex
;
Female
;
Follow-Up Studies
;
Heart Atria
;
Humans
;
Myxoma
;
Recurrence
;
Siblings
;
Young Adult
8.Animal Experiment of the Pneumatic Ventrivular Assist Device.
Sung Sik PARK ; Sam Hyun KIM ; Pil Won SEO ; Chang Hyu CHOI ; Hoon Sang LEE ; Hyuck Soo LEE ; Seung Ok HWANG ; Hyuk AN
The Korean Journal of Thoracic and Cardiovascular Surgery 1999;32(12):1065-1077
BACKGROUND: Ventricular assist devices(VADs) are being used for patients in postcvardiotomy cardiogenic shock status bridge to cardiac transplant settings and in post-myocardial infarction cardiogenic shock. The VAD which was developed at the Deparment of medical engineering in Dankook University College of Medicine was a pneumatically driven device and can maintain pulsatile flow. The goal of this study is to develop animal experimental models using the VAD and to clarify the reliability and hemodynamic property adequacy of end organ perfusion durability and severity of thrombotic-hemolytic tendency of the device. MATERIAL AND METHOD: The pneumatic VAD was applied to 8 adult female lambs, We examined some hemodynamic parameters such as arterial blood pressure pulmonary capillary wedge pressure(pcwp) pulmonary artery pressure(PAP) left atrial pressure hour urine output cardiac index VAD flow EKG to determine the reliability of the VAD and hemodynamic compatibility of the experimental animals within 24 hours of experiment. We also observed the end organ perfusion durability of the VAD and thrombotic-hemolytic property of the VAD after 24 hours of VAD insertion. RESULT: We could monitor all hemodynamic parameters including pcwp PAP cardiac index EKG, adn hour urine as true clinical settings. We observed that the reliability of the VAD was excellent and the hemodynamic property of the experimental animal and end organ perfusion were adequate within 24 hours of experiment. In four lambs surviving 24 hours after insertion the reliability of the VAD and end organ perfusion were excellent and no thrombotic-hemolytic tendency was noted. However after 15 days of experiment the diaphragm of the VAD was torn and it was recommende that the durability of the VAD should be extended. CONCLUSION: e conclude that the pneumatic VAD developed at Dankook University Biomedical Engineering has good hemodynamic property and low thromboembolic tendency and presents adequate end organ perfusion but we noted that the durability of the device should be expanded further. It will be possible to do more reliable experiment in the future according to the animal experimental method developed in this study especially with the heart failure models.
Adult
;
Animal Experimentation*
;
Animals*
;
Arterial Pressure
;
Atrial Pressure
;
Biomedical Engineering
;
Capillaries
;
Diaphragm
;
Electrocardiography
;
Female
;
Heart Failure
;
Hemodynamics
;
Hemolysis
;
Humans
;
Infarction
;
Perfusion
;
Pulmonary Artery
;
Pulsatile Flow
;
Shock, Cardiogenic
;
Thrombosis
9.Extensive Enteritis with Rapid Onset of Massive Ascites as the Initial Presentation of Systemic Lupus Erythematosus.
Joong Gi BAE ; Hyun Chul JUNG ; Seung Won CHOI ; Bong Hee PARK ; Sun Hyu KIM ; Eun Seog HONG
Journal of the Korean Society of Emergency Medicine 2012;23(2):284-287
Systemic lupus erythematosus (SLE) is a multisystemic autoimmune disorder with protean manifestations. However, compared with articular, cutaneous, or renal involvement, gastrointestinal symptoms are far less common and are particularly unusual for the initial presentation of SLE. Gastrointestinal manifestations range from mild nonspecific symptoms to serious life-threatening complications, such as mesenteric vasculitis, intestinal pseudoobstruction, acute pancreatitis, and protein-losing enteropathy. Therefore, in order to improve the prognosis, early diagnosis and timely treatment are important. We describe a 45-year-old female patient who presented with extensive enteritis and peritonitis as the initial manifestation of SLE. Symptoms at presentation included severe abdominal pain and rapid development of massive ascites. After administration of high-dose corticosteroid therapy, her symptoms showed prompt improvement.
Abdomen, Acute
;
Abdominal Pain
;
Ascites
;
Early Diagnosis
;
Enteritis
;
Female
;
Humans
;
Intestinal Pseudo-Obstruction
;
Lupus Erythematosus, Systemic
;
Middle Aged
;
Pancreatitis
;
Peritonitis
;
Prognosis
;
Protein-Losing Enteropathies
;
Vasculitis
10.Structural and Resting-State Brain Alterations in Trauma-Exposed Firefighters: Preliminary Results
Yae Won PARK ; Suhnyoung JUN ; Juwhan NOH ; Seok Jong CHUNG ; Sanghoon HAN ; Phil Hyu LEE ; Changsoo KIM ; Seung-Koo LEE
Journal of the Korean Radiological Society 2020;81(3):676-687
Purpose:
To analyze the altered brain regions and intrinsic brain activity patterns in trauma-exposed firefighters without posttraumatic stress disorder (PTSD).
Materials and Methods:
Resting-state functional MRI (rsfMRI) was performed for all subjects. Thirty-one firefighters over 40 years of age without PTSD (31 men; mean age, 49.8 ± 4.7 years) were included. Twenty-six non-traumatized healthy controls (HCs) (26 men; mean age, 65.3 ± 7.84 years) were also included. Voxel-based morphometry was performed to investigate focal differences in the brain anatomy. Seed-based functional connectivity analysis was performed to investigate differences in spontaneous brain characteristics.
Results:
The mean z-scores of the Seoul Verbal Learning Test for immediate and delayed recall, Controlled Oral Word Association Test (COWAT) score for animals, and COWAT phonemic fluency were significantly lower in the firefighter group than in the HCs, indicating decreased neurocognitive function. Compared to HCs, firefighters showed reduced gray matter volume in the left superior parietal gyrus and left inferior temporal gyrus. Further, in contrast to HCs, firefighters showed alterations in rsfMRI values in multiple regions, including the fusiform gyrus and cerebellum.
Conclusion
Structural and resting-state functional abnormalities in the brain may be useful imaging biomarkers for identifying alterations in trauma-exposed firefighters without PTSD.