• Title/Summary/Keyword: 진단 지연

Search Result 624, Processing Time 0.029 seconds

The Consequence of Delayed Diagnosis of an Occult Hip Fracture (잠행 고관절 골절의 진단 지연의 결과)

  • Je, Sangbong;Kim, Hyejin;Ryu, Seokyong;Cho, Sukjin;Oh, Sungchan;Kang, Taekyung;Choi, Seungwoon
    • Journal of Trauma and Injury
    • /
    • v.28 no.3
    • /
    • pp.91-97
    • /
    • 2015
  • Purpose: Occult hip fracture is not evident on radiographs and the diagnosis is often missed or delayed. This study was undertaken in order to identify the clinical characteristics and complications of patients with a delayed diagnosis of an occult hip fracture. Methods: We retrospectively reviewed patients with occult hip fracture who had normal findings on initial radiographs, the diagnosis was made on additional studies between August 2006 and February 2012. Patients who were diagnosed as having occult hip fractures at the first visit were categorized as non-delayed group and those who were not diagnosed at the first visit were categorized as delayed group. Results: Non-delayed group included 43 patients (86%). In the remaining 7 patients (delayed group), the diagnosis was delayed by a mean of 9.6 days (range 3~19 days). Patients who were diagnosed with an occult fracture on the initial visit presented later than those with a delayed diagnosis (41/43 .vs. 3/7, p=0.002). Other clinical features were no difference between the two groups. Patients in the delayed diagnosis group were more likely to have fracture displacement (4/7 .vs. 0/43)15patients in non-delayed group (34.9%) needed operative treatment, whereas all delayed patients (100%) needed operative treatment. Conclusion: A delayed diagnosis of occult hip fractures was associated with increased rate of displacement and operation. In patients suspected of having occult hip fractures, additional studies should be recommended.

  • PDF

Delayed Diagnosis of Cerebral Infarction after Complete Occlusion of ICA due to Blunt Head Trauma: A Case of Report (두부둔상 후 내경동맥손상으로 인한 뇌경색의 지연진단: 증례보고)

  • Yun, Jung-Ho;Ko, Jung Ho;Cho, Chun-Sung
    • Journal of Trauma and Injury
    • /
    • v.28 no.3
    • /
    • pp.190-194
    • /
    • 2015
  • Blunt cerebrovascular injury is defined as a vertebral or carotid arterial structural wall injury resulting from nonpenetrating trauma. Complete traumatic internal carotid artery occlusion is very rare condition accounting for 0.08~0.4 0f all trauma patients and believed to be associated with the greatest risk of ischemic stroke reported in 50~90% in a few small series. A 55-year-male was admitted with drowsy mentality and severe headache after a fall down accident. Brain computed tomography showed a subdural hematoma at the both frontal area with a fracture of the occipital skull bone. Two days after admission, he suddenly complained with a right side hemiparesis of motor grade 2. Brain magnetic resonance diffusion demonstrated multiple high flow signal changes from the left frontal and parietal lesion. Computed tomographic angiogram (CTA) revealed absence of the left ICA flow. Trans femoral cerebral angiography (TFCA) showed complete occlusion of the left internal carotid artery (ICA) at ophthalmic segment in the left ICA angiogram and flows on the left whole hemispheric lesions through the anterior communicating artery in the right ICA angiogram. We decided to conduct close observations as a treatment for the patient because of acute subdural hematoma and sufficient contralateral cerebral flow by perfusion SPECT scan. Two weeks after the accident, he was treated with heparin anticoagulation within INR 2~4 ranges. He recovered as the motor grade 4 without another neurologic deficit after 3 months.

  • PDF

A Rare Case of Irreducible Knee Dislocation: Vastus Medialis Obliqus-Buttonholing of Medial Femoral Condyle - A Case Report - (정복 불가능한 슬관절 탈구의 드문 예: 내측광근의 단추구멍손상 - 증례 보고 -)

  • Kim, Hyoung-Soo;Park, Seung-Rim;Kang, Joon-Soon;Lee, Woo-Hyeong;Kim, Ki-Wook
    • Journal of the Korean Arthroscopy Society
    • /
    • v.5 no.1
    • /
    • pp.41-44
    • /
    • 2001
  • The muscular button holing of vastus medialis is a very rare case of irreducible knee dislocations, and rapid reduction of this can diminish the complications which delayed reduction accompanies. We diagnosed a patient who appeared posterolateral dislocation of the knee and protrusion of the medial femoral condyle with MRI grossly. That was reduced by open arthrotomy, followed the reconstruction of both cruciate ligaments and repair of medial collateral ligament. Patient didn't show joint instability except minor posterior sagging and had full range of motion postoperatively after 10 months.

  • PDF

Design of Real time Vital Signal Streaming Service Based on Self-Organizing Internet of Things Platform (자율군집 IoT 플랫폼기반 실시간 생체신호 스트리밍 서비스 설계)

  • Kim, Hyunho;Son, Taeyoung;Kang, Soonju
    • KIISE Transactions on Computing Practices
    • /
    • v.23 no.7
    • /
    • pp.434-439
    • /
    • 2017
  • More and more people are suffering from sleep disturbance, which can have many different causes. The healthcare industry, which can help people with this disability, is one technology that is currently in the spotlight. However, current services are vulnerable to data concentration, because they are simple telemedicine services that transmit all data to a remote server and process the data on the server. They have a disadvantage in that the data cannot be streamed in real time by synchronizing the biometric data of remotely protected persons. In order to solve this problem, we propose a service structure for streaming biometric data of protected persons to a hospital or guardian in real time, using a self-organizing distributed middleware platform without a central server. We prove that it is possible to provide an effective streaming service by evaluating the service start time and average delay time.

A Case of Hemolytic Disease in a Newborn Due to Anti-Jkb (Anti-Kidd(Jkb) 항체 부적합증에 의한 신생아 용혈성 질환 1례)

  • Park, Dong-Kyun;Kim, Young-Min;Bae, Chong-Woo;Choi, Yong-Mook;Lee, Woo-In
    • Clinical and Experimental Pediatrics
    • /
    • v.46 no.7
    • /
    • pp.718-721
    • /
    • 2003
  • The isoimmune hemolytic disease of newborn due to the incompatibility of minor blood groups is characterized by progressive neonatal hyperbilirubinemia and anemia caused by the IgG antibody transmitted from the mother to the fetus. Recently we had a case of hemolytic disease in a newborn due to $anti-Jk^b$. There were no ABO and Rh(D) incompatibilities between mother and baby. The infant's direct and indirect antiglobulin tests were strongly positive. From the mother and baby, an irregular antibody was found and identified as $anti-Jk^b$. Generally, hemolytic disease of the newborn resulting from $anti-Jk^b$ incompatibility has a benign clinical course and a good prognosis. This patient completely recovered without exchange transfusion. We report this case with a brief review of relevant literature.

A Case of Lesch-Nyhan Syndrome (Lesch-Nyhan 증후군 1례)

  • Kim, Joon-Sung;Lee, Jae-Seung;Noh, Ha-Young;Kim, Byung-Ju;Woo, Young-Jong;Park, Jee-Min;Kim, Myung-Gwan;Kim, Gu-Hwan;Yoo, Han-Wook
    • Clinical and Experimental Pediatrics
    • /
    • v.46 no.5
    • /
    • pp.505-509
    • /
    • 2003
  • Lesch-Nyhan syndrome is an X-linked recessive disorder characterized by hyperuricemia, choreoathetosis, spasticity, mental retardation, and compulsive, self-injurious behavior. This disorder results from a complete deficiency of the purine salvage enzyme, hypoxanthine-guanine phosphoribosyl transferase(HPRT). We report here on a case of Lesch-Nyhan syndrome in a 1-year, 7-month-old male who presented with frequent vomiting, failure to thrive, and developmental delay. The diagnostic work-up revealed hyperuricemia, hyperuricosuria, and medullary nephrolithiasis. The HPRT activity in the erythrocytes was undetectable with a biochemical assay. We also identified de novo mutation which was a deletion of the 649th base, adenosine, in HPRT gene(649delA) by analysis of cDNA using RT-PCR technique coupled with direct sequencing.

A Case of Imperforate Hymen with Acute Urinary Retention (급성 뇨 폐색을 동반한 처녀막 폐쇄증 1례)

  • Choi, Lim;Cho, Sea-Eun;Yim, Hyung-Eun;Yoo, Kee-Hwan;Hong, Young-Sook;Lee, Joo-Won
    • Childhood Kidney Diseases
    • /
    • v.15 no.1
    • /
    • pp.86-89
    • /
    • 2011
  • Imperforate hymen is, with an incidence of 0.1%, a rare female anomaly, which can appear with symptoms such as lower abdominal pain, primary amenorrhea, dysuria, anuria, caused by retention of menstrual blood after the onset of menstruation. Generally urinary retention is caused by psychological conditions, drug effect, infection or congenital anomaly causing acute urinary obstruction. We experienced a patient with symptoms of acute urinary retention, suggesting acute urinary obstruction. The cause for the retention turned out to be an imperforated hymen, which should therefore be mentioned in the literature as a possible cause in cases suspected of urinary retention.

The Case Study on the Niche Experimentation in Offshore Wind Renewable Energy Transition (해상풍력 기술의 사회-기술시스템 전환과정에 관한 탐색적 사례연구)

  • Kim, Bonggyun;Kim, Dukyoung;Kim, Kyungnam;Kim, Donghwan
    • Journal of Korea Technology Innovation Society
    • /
    • v.17 no.2
    • /
    • pp.355-379
    • /
    • 2014
  • For the transition to the low carbon society, it is inevitable but difficult journey that the new energy technology spread co-exists with formal social system. The objective of offshore wind power plant that has been implemented by the government is to connect large capacity new renewable energy to the central electric power system. Therefore, for the successful introduction of offshore wind power system, the transition of the formal social technology system should be companied. This study analysis the energy system transition about niche strategy adjustment using Multiple Level Perspectives & Strategic Niche Management. It also multi level analyzes and structuralizes the process that new technology, as a research result, evolves through connecting and communicating with formal regime and landscape. Also, adjusting Strategic Niche Management, it diagnoses the obstructive factors in the initial stage of niche experiment and found the major reasons why offshore wind power test plant had been delayed. Through this study, it reaches to the practical implication that offshore niche technology could grow stably in the energy system and various policies.

The Ewha Infant Develomental Screening Test (이화 영아 발달 선별 검사(Ewha Infant Development Screening Test)에 대한 연구)

  • Lee, Keun
    • Clinical and Experimental Pediatrics
    • /
    • v.45 no.6
    • /
    • pp.700-711
    • /
    • 2002
  • Purpose : Early identification and treatment of developmental disabilities is of considerable importance in the health care of children. Screening of development is aimed at identifying infants who may need more comprehensive evaluations. Methods : A new test, the Ewha Infant Development Screening Test(EDST) has been created to screen the development of infants, 0-4 years of age. EDST was constructed so that results can be calculated into developmental ages and developmental quotients. The test consists of three sectors, e.g. language, social-adaptive and motor, and of 158 test items. A total of 104 infants, aged from one month to four years, including healthy infants as well as 10 with chief complaints of developmental delay, who visited the pediatric clinic of Ewha Womans University Dongdaemun Hospital, from June, 25 to November 30, 2001, were given the Bayley Scale of Infant Development as a base test and EDST. Results : The result showed the appropriate cut-off of EDST was 90 with better sensitivity and specificity, compared to cut-offs of 85 or 80. Conclusion : Further study with a large number of infants in the future is needed to make EDST more reliable and accurate.

A case of hereditary pancreatitis with a N29I mutation in the cationic trypsinogen gene (Cationic Trypsinogen N29I 유전자 변이에 의한 유전 췌장염 1례)

  • Shin, Jee Youn;Oh, Dae Sung;Rheu, Jeong Min;Shim, Jeong Ok;Park, Ji Sook;Ko, Jae Sung;Seo, Jeong Kee
    • Clinical and Experimental Pediatrics
    • /
    • v.49 no.10
    • /
    • pp.1111-1115
    • /
    • 2006
  • Hereditary pancreatitis is an autosomal dominant disease characterized by recurrent episodes of pancreatitis, often beginning in childhood, with a positive family history involving at least two other affected family members with no known other precipitating factors. Most forms of hereditary pancreatitis are caused by one of two common mutations, i.e., R122H in exon 3 and N29I in exon 2 of the cationic trypsinogen (CT) (PRSS1) gene, located on chromosome 7. The authors describe the case of a 15-year-old boy who had suffered from recurrent attacks of pancreatitis since age three. His mother and grandmother had chronic pancreatitis and diabetes mellitus. Mutation analysis was performed on the family due to the suspicion of hereditary pancreatitis. The CT gene was analyzed in DNA samples extracted from the peripheral blood of three family members, the mother, the proband, and the proband's sister. Two members of the family, the mother and the proband, were found to have a N29I mutation in the CT gene. The authors document the first family with hereditary pancreatitis associated with the N29I mutation in Korea.