• Title/Summary/Keyword: 진단 지연

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Bilateral Delayed Nonarteritic Anterior Ischemic Neuropathy Following Acute Primary Angle-closure Crisis (양안 급성 폐쇄각녹내장 환자에서 발생한 양안 지연 비동맥염 앞허혈시신경병증 1예)

  • Park, Eun Jung;Chun, Yeoun Sook;Moon, Nam Ju
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.11
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    • pp.1091-1096
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    • 2018
  • Purpose: We report a case of bilateral nonarteritic anterior ischemic optic neuropathy (NAION) following acute angle-closure crisis (AACC). Case summary: A 76-year-old female visited our clinic because of a 1-day history of ocular pain and vision loss in both eyes. The visual acuity was 0.02 in both eyes and her intraocular pressure (IOP) was 52 mmHg in the right eye (RE) and 50 mmHg in the left eye (LE). She had corneal edema and a shallow anterior chamber in both eyes, with 4 mm fixed dilated pupils. After decreasing the IOP with intravenous mannitol, laser iridotomy was performed. However, 2 days later, visual acuity was further reduced to finger counting at 10 cm RE and at 50 cm LE, and her optic disc was swollen. Bilateral NAION following AACC was diagnosed. One month later, visual acuity slightly improved to 0.02 RE and 0.04 LE, and the optic disc edema resolved. A small cup-disc ratio, optic disc pallor, and atrophy were observed. Humphrey visual fields demonstrated superior and inferior altitudial visual field defects in the LE, and almost total scotoma in the RE. Conclusions: AACC can be a predisposing factor for NAION, so the relative afferent pupillary defect, papilledema, and presentation of other risk factors are important clues to a diagnosis of NAION.

Review of Psychiatric Adolescent Inpatient with Dermatologic Consultations (청소년 정신과 입원 환자들의 피부과 자문 의뢰에 관한 행태 분석 및 고찰)

  • Kwon, Hyunjung;Jo, Hyunyoung;Kim, Youngil;Park, Kyungduck;Chung, Hyun;Park, Joonsoo
    • Korean Journal of Psychosomatic Medicine
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    • v.23 no.1
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    • pp.20-25
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    • 2015
  • Objective:To review the patterns of the dermatologic consultations of psychiatric adolescent inpatient and to explore the relationship between the dermatologic disorders and psychiatric disorders. Methods:We retrospectively studied the data from 22 cases referred by psychiatric adolescent for a dermatologic consultation over 10 years in Daegu Catholic University Medical Center and compared with the data from 108 cases referred by the other department adolescent patients. Results:The mean age of patients was 15.9. The male to female ratio was 1:1.44. The most common psychiatric and dermatologic disorder was major depressive disorder and acne, respectively. The most frequent reason for consultation was to ask for dermatologic disease or condition(54.5%) followed by to perform cosmetic procedure of patients need(40.9%) and to perform dermatologic test(4.6%). Conclusions:More than just a cosmetic disfigurement, dermatologic disorders are associated with a variety of psychopathologic problems that can affect the patient. Increased understanding of biopsychosocial approaches and liaison among psychiatrists and dermatologists could be beneficial.

Defining the Tumour and Gross Tumor Volume using PET/CT : Simulation using Moving Phantom (양전자단층촬영장치에서 호흡의 영향에 따른 종양의 변화 분석)

  • Jin, Gye-Hwan
    • Journal of the Korean Society of Radiology
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    • v.15 no.7
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    • pp.935-942
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    • 2021
  • Involuntary movement of internal organs by respiration is a factor that greatly affects the results of radiotherapy and diagnosis. In this study, a moving phantom was fabricated to simulate the movement of an organ or a tumor according to respiration, and 18F-FDG PET/CT scan images were acquired under various respiratory simulating conditions to analyze the movement range of the tumor movement by respiration, the level of artifacts according to the size of the tumor and the maximum standardized uptake value (SUVmax). Based on Windows CE 6.0 as the operating system, using electric actuator, electric actuator positioning driver, and programmable logic controller (PLC), the position and speed control module was operated normally at a moving distance of 0-5 cm and 10, 15, and 20 reciprocations. For sphere diameters of 10, 13, 17, 22, 28, and 37 mm at a delay time of 100 minutes, 80.4%, 99.5%, 107.9%, 113.1%, 128.0%, and 124.8%, respectively were measured. When the moving distance was the same, the difference according to the respiratory rate was insignificant. When the number of breaths is 20 and the moving distance is 1 cm, 2 cm, 3 cm, and 5 cm, as the moving distance increased at the sphere diameters of 10, 13, 17, 22, 28, and 37 mm, the ability to distinguish images from smaller spheres deteriorated. When the moving distance is 5 cm compared to the still image, the maximum values of the standard intake coefficient were 18.0%, 23.7%, 29.3%, 38.4%, 49.0%, and 67.4% for sphere diameters of 10, 13, 17, 22, 28, and 37 mm, respectively.

Diagnostic Utilization of Laser Fluorescence for Resin Infiltration in Primary Teeth (유치의 레진침투법을 위한 레이저 형광법의 진단적 활용)

  • Park, Soyoung;Jeong, Taesung;Kim, Jiyeon;Kim, Shin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.46 no.3
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    • pp.265-273
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    • 2019
  • This study was performed to evaluate clinical use of laser fluorescence (LF) to identify early childhood caries lesions suitable for applying resin infiltration. 20 exfoliated primary molars with proximal caries were selected and cut buccolingually cross the central pit for regarding the mesial and distal surfaces respectively. 27 specimens corresponding to ICDAS code 1 and 2 were selected and the LF values were measured. When infiltrant resin was applied, double staining for microscopy detection has done simultaneously. Tooth samples were sliced with 0.7 mm thick. The maximum lesion depth, maximum penetration depth, and average penetration rate were measured from the confocal scanning laser microscope image. Pearson correlation analysis was performed. The intraclass correlation coefficient of LF values shows excellent agreement. LF values had positive correlation with penetration rate, but not lesion depth and penetration depth. Significant correlation between LF readings and penetration rate was verified in deep enamel caries and dentin caries except shallow enamel caries. Infiltrant resin could penetrate with a higher rate and LF values could be increased in more active caries lesions. In assessing radiologically similar caries lesion, laser fluorescence might be useful for identifying caries activity.

Early Frost Damage and Diagnose of Damage Depth Due to Early Frost Damage of the Concrete According to the Thickness of Members (부재 두께 변화에 따른 콘크리트의 초기동해 특성 분석 및 깊이진단)

  • Kim, Tae-Woo;Han, Min-Cheol
    • Journal of the Korea Institute of Building Construction
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    • v.19 no.2
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    • pp.131-138
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    • 2019
  • Recently, there are many structures exposed to severe outdoor environments, which results in rapid degradation of durability of the concrete structures. there can be rapid deterioration of the concrete structures from early frost damage due to the insufficient curing in low outdoor temperature condition. The objective of this study is to investigate the effect of thickness change conditions and binding material on early frost damage depth of the concrete exposed to cold weather in winter, and is to clearly assess damage depth of the concrete structure due to early frost damage. Specimens with 300x300x(150, 200, 250, 300mm) were prepared. OPC and OPC+FA+BS were adopted for binders. Test results indicate that the depth of the early frost damage was deeper with the decrease of thickness of members. The brightness of specimens were reduced when the member thickness was thinner. When determining the depth of early frost damage, it can be distinguished into dark color and relatively bright color when dried for approximately 30 minutes in the indoors of $20^{\circ}C$ in temperature and 60% in relative humidity after submerging in water for 24 hours. The dark colored part can be determined easily when measured with vernier calipers.

Trend of Emergency Department Visits for Elderly Patients with Chronic Diseases : 2014-2019 (만성질환을 동반한 노인 응급환자 추이: 2014-2019)

  • Lee, Myoung-Hwa;Kim, Ji-Yeon;Huh, Young-Jin;Oh, Mi-Ra
    • Journal of Convergence for Information Technology
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    • v.11 no.1
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    • pp.183-190
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    • 2021
  • The purpose of this study was to determine the change trend of emergency department visits among elderly patients with chronic diseases. Using the National Emergency Department Information System data, from January 1, 2014 to December 31, 2019, the selected patient data were evaluated for the emergency department discharge main diagnosis codes for eight chronic diseases. The incidence of elderly chronic diseases, emergency department visits, and admission rates were analyzed. Since 2014, there has been a consistent increase in the number of elderly patients visiting the emergency department, especially among those aged over 85 years. The number of emergency department visits among the elderly chronically ill patients also increased, with a significant increase in ischemic heart disease and arthrosis cases. Furthermore, there was a significant difference in the number of chronically ill patients in each year from 2014-2019 (P<0.001). With respect to the trend of admission rates to the emergency department by chronic disease, most diseases showed an increasing trend (P<0.001). however, hyperlipidemia showed a continuous decreasing trend in all age groups since 2014 (P<0.001). Among the elderly chronically ill patients, a greater increase in the admission rate following emergency department visits was noted in those over 85 years of age, with a significant difference in all diseases, except for hyperlipidemia, hypertension, and tuberculosis (P<0.001). As the aging population grows, the emergency department admission rates among the elderly chronically ill patients will rise rapidly. This could create issues with respect to the use and consumption of emergency medical resources. Hence, it is necessary to manage chronic diseases effectively in the elderly.

Laryngeal height and voice characteristics in children with autism spectrum disorders (자폐스펙트럼장애 아동의 후두 높이 및 음성 특성)

  • Lee, Jung-Hun;Kim, Go-Woon;Kim, Seong-Tae
    • Phonetics and Speech Sciences
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    • v.13 no.2
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    • pp.91-101
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    • 2021
  • The purpose of this study was to investigate laryngeal characteristics in children with autism spectrum disorders (ASD). A total of 50 children participated, including eight children aged 2 to 4 years old diagnosed with ASD and 42 normal controls at the same age. All children recorded X-ray images of the midsagittal plane of the cervical spine and larynx, and compared the laryngeal positions of ASD and control. In addition, samples of children with vowel prolongation were collected and analyzed for acoustic parameters. X-rays showed that the height of the hyoid bone in the normal group was the lowest at 3 years of age, and ascended at 4 years of age. Nevertheless, the distance from the external acoustic meatus to the hyoid bone was longest at age 4. 4-year-olds with explosive language development showed laryngeal height elevation and anteriorization. In contrast, the hyoid height of the ASD group of all ages was lower than that of the control group, and there was no difference in the hyoid position between the ages. As a result of acoustic evaluation, PFR, vFo, and vAm were significantly higher ASD than control. Low laryngeal height of ASD children may be associated with delayed language development. PFR, vFo, and vAm seem to be voice markers showing the difference between normal and ASD children.

Research Trends in Occupational Therapy Intervention for Children in Korea (국내 작업치료의 아동 중재 연구 동향)

  • Choi, Yeon-Woo;Kim, Kyeong-Mi
    • The Journal of Korean Academy of Sensory Integration
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    • v.20 no.1
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    • pp.55-72
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    • 2022
  • Objective : The purpose of this study was to identify the status and trends of Korean child occupational therapy intervention studies according to the International Classification of Functioning, Disability, and Health, Children and Youth Version (ICF-CY). Methods : In this research, 47 studies on occupational therapy interventions for children that were published between January 2017 and December 2021 in the Journal of Occupational Therapy, registered in the Korea Citation Index, and analyzed the classification of the study type and evidence level to understand the trends. Moreover, intervention objectives and approaches were analyzed on the basis of the ICF-CY. Results : The outcomes of the analysis of the articles published in the Journal of Occupational Therapy were as follows: (1) Level IV was the highest evidence level (53.19%). (2) Among the studies, most (53.7%) included school-age children as subjects. Autism spectrum disorders and developmental delays were the most common diagnoses (14.8%). (3) As for the purpose of intervention according to ICF-CY, activity and participation factors were the most common (48.94%), and a sensory approach was frequently used. Conclusion : This study reviewed articles on occupational therapies for children that were published in the Journal of Occupational Therapy to understand the trends in occupational therapy interventions for children in South Korea. For the development of occupational therapies for children in the future, more qualitative research types and studies on various intervention approaches are needed.

A Review on the Cause of Fever During Clozapine Treatment (클로자핀 투약시 나타나는 발열의 원인)

  • Jihye, Song;Sungsuk, Je;Jaejong, Lee;Seungyun, Lee;Seung-Hoon, Lee;Eunyoung, Lee;Hyungseok, So;Hayun, Choi;Jinhee, Choi
    • Korean Journal of Psychosomatic Medicine
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    • v.30 no.2
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    • pp.66-72
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    • 2022
  • Clozapine is accepted as the "gold standard" antipsychotics for treatment-resistant schizophrenia. Clozapine rarely causes extrapyramidal syndrome and tardive dyskinesia, which are common with other antipsychotics, and only a transient elevation of hyperprolactinemia has been reported. Despite such clinical usefulness, there are limitations to the use of clozapine due to adverse drug reactions (ADR). Fever is a common in adverse drug reactions associated with clozapine. At initiation of clozapine most fatal ADR such as agranulocytosis and neuroleptic malignant syndrome associated with fever, in which case clozapine should be discontinued immediately. However, as benign causes of fever are much more frequent than life-threatening ADR, clozapine should not be discontinued unconditionally in the event of fever during clozapine initiation. In addition, fever may occur at any time during the maintenance of clozapine treatment. In particular, since the risk of pneumonia does not decrease over time, and clozapine has a higher risk of pneumonia than other antipsychotic drugs, it is recommended to adjust clozapine dosage through therapeutic drug monitoring.

Development and Validation of Figure-Copy Test for Dementia Screening (치매 선별을 위한 도형모사검사 개발 및 타당화)

  • Kim, Chobok;Heo, Juyeon;Hong, Jiyun;Yi, Kyongmyon;Park, Jungkyu;Shin, Changhwan
    • 한국노년학
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    • v.40 no.2
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    • pp.325-340
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    • 2020
  • Early diagnosis and intervention of dementia is critical to minimize future risk and cost for patients and their families. The purpose of this study was to develop and validate Figure-Copy Test(FCT), as a new dementia screening test, that can measure neurological damage and cognitive impairment, and then to examine whether the grading precesses for screening can be automated through machine learning procedure by using FCT imag es. For this end, FCT, Korean version of MMSE for Dementia Screening (MMSE-DS) and Clock Drawing Test were administrated to a total of 270 participants from normal and damaged elderly groups. Results demonstrated that FCT scores showed high internal constancy and significant correlation coefficients with the other two test scores. Discriminant analyses showed that the accuracy of classification for the normal and damag ed g roups using FCT were 90.8% and 77.1%, respectively, and these were relatively higher than the other two tests. Importantly, we identified that the participants whose MMSE-DS scores were higher than the cutoff but showed lower scores in FCT were successfully screened out through clinical diagnosis. Finally, machine learning using the FCT image data showed an accuracy of 73.70%. In conclusion, our results suggest that FCT, a newly developed drawing test, can be easily implemented for efficient dementia screening.