• Title/Summary/Keyword: Clinical Manifestation

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Radiologic Diagnosis of Gastrointestinal Bleeding (위장관 출혈의 영상의학적 진단법)

  • Se Hyung Kim
    • Journal of the Korean Society of Radiology
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    • v.84 no.3
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    • pp.520-535
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    • 2023
  • Gastrointestinal (GI) bleeding is not a single disease but a symptom and clinical manifestation of a broad spectrum of conditions in the GI tract. According to its clinical presentation, GI bleeding can be classified into overt, occult, and obscure types. Additionally, it can be divided into upper and lower GI bleeding based on the Treitz ligament. Variable disease entities, including vascular lesions, polyps, neoplasms, inflammation such as Crohn's disease, and heterotopic pancreatic or gastric tissue, can cause GI bleeding. CT and conventional angiographies and nuclear scintigraphy are all radiologic imaging modalities that can be used to evaluate overt bleeding. For the work-up of occult GI bleeding, CT enterography (CTE) can be the first imaging modality. For CTE, an adequate bowel distention is critical for obtaining acceptable diagnostic performance as well as minimizing false positives and negatives. Meckel's scintigraphy can be complementarily useful in cases where the diagnosis of CTE is suboptimal. For the evaluation of obscured GI bleeding, various imaging modalities can be used based on clinical status and providers' preferences.

Clinical Characteristics of Miliary Tuberculosis (속립성 폐결핵의 임상적 특성)

  • Kim, Jin-Ho;Moon, Doo-Seop;Lee, Dong-Suck;Park, Ik-Soo;Yoon, Ho-Joo;Shin, Dong-Ho;Kim, Tae-Wha;Park, Sung-Soo;Lee, Jung-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.2
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    • pp.144-151
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    • 1994
  • Background: Miliary tuberculosis almost always results from the discharge of infected caseous material into the blood stream, usually from a well hidden lymph node in the presentation of this disease in the past four decades, and although it is seen less frequent1y today than previously, its presentation and manifestation may require greater suspicion and diligence by the physician. We investigated the clinical characteristics, predisposing factors and accompanying diseases of miliary tuberculosis and tried to acquire the early diagnosis and treatment of this disease. Methods: A retrospective clinical study was done on 40 cases of miliary tuberculosis admitted to Hanyang University Hospital from Mar. 1989 to Dec.1992. The study investigated age and sex distribution, seasonal distribution, duration of symptoms before admission, pre-disposing factors, clinical symptoms, biochemical findings, chest X-ray findings, extrapulmonary tuberculosis associated with miliary tuberculosis, prognosis and mortality rate. Results: 1) The patients were most common in the age group between 20 and 29(23%) and the ratio of male to female was 1.4:1(male 23 : female 17). 2) Sputum smears for tubercle bacilli were positive in 5 cases(13%). 3) The most common clinical symptoms were fever with chilling(47.5%), coughing(47.5%), second most common symptom was dyspnea(32.5%), and the physical findings on admission were tachycardia(30%), weight loss(27.5%), meningeal signs(17.5%) in order. 4) The predisposing factors were heavy alcohol drinking(6 cases), steroid use(3 cases), pregnancy(2 cases) etc. 5) The chest X-ray findings on admission were miliary shadow only(40%), in addition pneumonic infiltration, pleurisy, and calcification in order. 6) The extrapulmonary tuberculosis associated with miliary tuberculosis were tuberculous meningitis(30%), bone and joint tuberculosis(17.5%), intestinal tuberculosis(15%) in order. 7) Biochemical findings were increased SGOT/SGPT(32.5%), increased alkaline phosphatase(32.5%), hypoalbuminemia(15%), hyponatremia(15%) etc. 8) About 4-6 weeks later after treatment(INH, RFP, PZA, EMB), 26 cases(65%) were improved on clinical symptoms or chest X-ray, 12 cases(30%) were stationary or aggravated, and 2 cases(5%) were died. Conclusion: For the early diagnosis and treatment of miliary tuberculosis, we must see its presentation and manifestation with greater interest and suspicion and investigate its predisposing factors and accompanying diseases.

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A Study on the Medical Costs on Last Admission in Terminal Cancer Inpatients for Hospice Care (호스피스 케어를 위해 입원한 말기 암 환자의 사망직전 의료비용 실태 조사)

  • Yoo, Sang-Yeon;Lee, Hye-Ree;Lee, Yong-Je;Ahn, Mi-Hong;Yeom, Chang-Hwan
    • Journal of Hospice and Palliative Care
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    • v.5 no.2
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    • pp.146-154
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    • 2002
  • Purpose : Death due to cancer has been continuously increasing, therefore cancer is the first in the cause of death now. A national policy for the elevation of medical costs in cancer patients is necessary, therefore, we searched for the medical costs and its related factors in terminal cancer patients for the effective reduction of the medical costs. Methods : We reviewed the medical records of 259 hospitalized terminal cancer patients who had died during the period of July 1, 2000 to June 30, 2002. History of cancer included type of cancer, type of past treatment, existence of metastasis. Clinical manifestation was examined and medical costs on last admission was categorized based on the account of charges of the department of patient affair on the last hospitalization. For analysis of factors related with medical costs, ANOVA was used. Results : Of the 259 patients, the number of male was 135 cases (52.1%), and the female, 124 cases (47.9%). The most frequent type of cancer was stomach (21.9%) cancer. Of the clinical manifestation, anorexia (87.6%) was the most frequent manifestation. Total medical costs was 740,628,045won, the mean costs was $285,968{\pm}3,070,272won$. The frequent category of medical costs was injection (32.0%), medical accommodation (27.9%), examination (14.0%), in order. The only factor related with mean medical costs was pain (P<0.05). Conclusion : If unnecessary injection of opioid analgesics is reduced, hospice care at home is activated and excessive examination is reduced In terminal cancer inpatients, it will be possible to reduce the medical costs in terminal cancer patients more effectively.

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A Case of Neonatal Lupus Erythematosus Associated with Anti-U1RNP Antibodies (항-U1RNP 항체 양성인 신생아 홍반성 루푸스 1례)

  • An, Byung-Hoon;Lee, Gu Chang;Yoon, Tae Young;Kim, Mi-Jung
    • Clinical and Experimental Pediatrics
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    • v.48 no.3
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    • pp.342-345
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    • 2005
  • Neonatal lupus erythematosus(NLE) is a distinct subset of lupus characterized by cutaneous findings, cardiac conduction defects, hepatic or hematologic abnormalities. These manifestations are associated with the presence of maternal auto-antibodies such as anti-SSA/Ro, anti-SSB/La, and rarely anti-RNP($U_1RNP$) antibodies. Cases of $U_1RNP$ antibody-positive NLE have somewhat atypical cutaneous manifestation without cardiac or systemic abnormalities. We report a case of cutaneous NLE associated with $U_1RNP$ antibodies.

Consideration of the Nature of Disease (병성에 대한 소고)

  • Cho Seoung Yeoun;Lee Kwang Gyu
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.16 no.5
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    • pp.857-866
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    • 2002
  • The main current in the pathology of oriental medicine is composed of etiologic factor, pathogenesis and clinical manifestation. The access of a disease is consist of etiologic factor, location of the lesion, nature of the disease and patient's condition. The nature of disease and the property of a drug are inseparably related to each other. The nature of disease is composed of six exogenous factors, cold and heat, deficiendy and excess, Yinyang and pain. Cold nature is divided into cold symptom due to excess and asthenia cold, fever nature is divided into sthenic fever and asthenic fever. According to the location, cold and heat can be subdivided into heat in the upper and cold in the lower, cold in the upper and heat in the lower, exterior cold and interior heat, exterior heat and interior cold. Yin syndrome characterized by hypofunction of the viscera is generated from insufficiency of yang-qi, excess of yin-coldness, deficiency of both qi and the blood.

Benign Recurrent Intrahepatic Cholestasis with a Single Heterozygote Mutation in the ATP8B1 Gene

  • Lee, Yun Seok;Kim, Mi Jin;Ki, Chang Seok;Lee, Yoo Min;Lee, Yoon;Choe, Yon Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.15 no.2
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    • pp.122-126
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    • 2012
  • Benign recurrent intrahepatic cholestasis (BRIC) is a rare autosomal recessive inherited disorder characterized by multiple recurrent episodes of severe cholestatic jaundice without obstruction of extrahepatic bile duct. We present the case of a 7-year-old boy with BRIC confirmed by mutation analysis in the ATP8B1 gene and typical clinical manifestation. Despite inheritance of BRIC, we detected a mutation on only one allele. To our knowledge, this is the first report of BRIC with a confirmed single heterozygote novel mutation in the ATP8B1 gene in Korea.

Depression and Executive Dysfunction in Stroke (뇌졸중에서 우울증과 실행기능부전에 대한 고찰)

  • Na, Kyoung-Sae;Kim, Shin-Gyeom;Lee, Soyoung Irene;Jung, Han-Yong
    • Korean Journal of Biological Psychiatry
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    • v.19 no.4
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    • pp.179-186
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    • 2012
  • Depression and executive dysfunction are common neuropsychiatric sequelae of stroke. Patients with stroke are more predisposed to depression and executive dysfunction compared to patients with similar degree of physical disability. Both depression and executive dysfunction are also associated with poor prognosis such as high mortality and delayed recovery after stroke. Complex neurobiological and anatomical mechanisms are associated with the development of depression and executive dysfunction after stroke. Activation of pro-inflammatory cytokines is thought to be associated with onset of depression, whereas injuries in frontal-subcortical circuit are thought to be a link between depression and executive dysfunction. Early detection of depressive symptoms and both pharmacological and non-pharmacological treatment would be helpful. In this review paper, the authors investigated 1) biological and neuroanatomical substrate for poststroke depression and executive dysfunction, 2) the relationship and common etiopathology for poststroke depression and executive dysfunction, and 3) pharmacological and non-pharmacological treatment for poststroke depression. The contents of the paper are as follows : the prevalence, clinical manifestation, and biological etiology for poststroke depression, neuroanatomical abnormalities as a common etiological factor for depression and executive dysfunction, pharmacotherapy and non-pharmacological approach.

A Case of Invasive Riedel's Thyroiditis with Follicular Neoplasm (여포성 종양을 동반한 침윤성 리들씨 갑상선염 (Riedel's Thyroiditis) 1예)

  • Park Jong-Hoon;Kang Hyo;Cho Mun-Hyeong;Yoon Jung-Han;JaeGal Young-Jong;Park Min-Ho
    • Korean Journal of Head & Neck Oncology
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    • v.22 no.1
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    • pp.40-42
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    • 2006
  • Riedel's thyroiditis is an uncommon disorder of unknown etiology that is characterized by an invasive process that partially destroys the gland and extends into adjacent neck structures. Its clinical manifestation as a stonyhard, poorly defined enlargement over the thyroid gland and local compression of the trachea, esophagus and recurrent laryngeal nerve can mimic invasive thyroid carcinoma and mask the accompanied thyroid neoplasm. A case of Riedel's thyroiditis in a 59-year-old female patient, admitted with a previous diagnosis of adenomatous goiter, is reported. So, we present this case with the review of literatures.

REGIONAL ODONTODYSPLASIA : A REPORT OF TWO CASE (국소적 치아이형성증(regional odontodysplasia)에 대한 증례보고)

  • Son, Duk-Il;Kim, Hyun-Jung;Nam, Soon-Hyeun;Kim, Young-Jin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.24 no.1
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    • pp.19-26
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    • 1997
  • Odontodysplasia is a rare developmental anomaly of tooth formation in which hard tissue are affected. Odontodyplasia affects the primary and permanent dentitions in the maxilla, mandible, or both jaws. The maxilla is involved twice as often as the mandible. The condition is more common in female than in male patients and in the anterior than in the posterior regions. The clinical manifestation of odontodysplasia are hypoplasia and hypocalcification of the enamel and dentin of affected teeth. Teeth tend to be small and discolored, with short roots and widely open pulp canal. Delayed eruption of affected teeth with abscess formation is common. Radiographically teeth assume a faint radiolucent image ("ghost teeth"). enamel and dentin appear thin and are similar in radiodensity. The pulp chambers are often larger than normal, calcifications(pulp stone and denticle) are found within them. The etiology of regional odontodysplasia is unknown. However, several causes have been discussed, including somatic mutation, local circulatory disorders, local trauma, failure of migration and differentiation of neural crest cells, local infection.

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The effects of Korean double-headed drum janggu rhythm on the life forces for the elderly made by In-seok Seo

  • Ko, Kyung Ja;Kim, Ji-Youn;Oh, Ji Yun
    • CELLMED
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    • v.8 no.1
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    • pp.3.1-3.3
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    • 2018
  • The aim of this article is to argue that rhythm of janggu may have meaningful effects as a form of vitality for the elderly. Janggu is the most popular and soft pitched instrument in the percussion family in Korean music. It is warm and soft makes very deep and exquisite sounds. Janggu is a source of Korean national pride because of unique, manifestation of yin-yang five-elements represented in Korean music. The meaning and influence of rhythm in human is in essence and natural. This style paper is a course of happy life and a basic step toward in the world. Music therapy has been employed as a therapeutic intervention to facilitate healing across a many of clinical populations. A cheerful rhythm of janggu promotes the vitality of the elderly. This joining has contributed to the vitality, health improvement and the whole body for the elderly. Instead of visiting hospital, they sit in front of the janggu what could be better than a daily dose of exercise. Therefore, the author thinks this might help them forget their anxieties, this very moment, janggu music rhythm therapy lays the foundation of a more vital lifestyle.