• Title/Summary/Keyword: Clinical scoring system

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A Clinical Score and Ultrasonography for the Diagnosis of Childhood Acute Appendicits (소아급성충수염의 진단에서 점수제와 초음파검사)

  • Chung, Jae-Hee;Jeon, Su-Youn;Song, Young-Tack
    • Advances in pediatric surgery
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    • v.10 no.2
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    • pp.117-122
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    • 2004
  • Diagnosis of acute appendicitis in children is sometimes difficult. The aim of this study is to validate a clinical scoring system and ultrasonography for the early diagnosis and treatment of appendicitis in childhood. This is a prospective study on 59 children admitted with abdominal pain at St. Mary's Hospital, the Catholic University of Korea from July 2002 to August 2003. We applied Madan Samuel's Pediatric Appendicitis Score (PAS) based on preoperative history, physical examination, laboratory finding and ultrasonography. This study was designed as follows: patients with score 5 or less were observed regardless of the positive ultrasonographic finding, patients with score 6 and 7 were decided according to the ultrasonogram and patients above score 8 were operated in spite of negative ultrasonographic finding. The patients were divided into two groups, appendicitis (group A) and non-appendicitis groups (group B). Group A consisted of 36 cases and Group B, 23 cases. Mean score of group A was 8.75 and group B was 6.13 (p<0.001). Comparing the diagnostic methods in acute appendicitis by surveying sensitivity, specificity, positive predictive value, negative predictive value, and accuracy, PAS gave 1.0000, 0.3043, 0.6923, 1.0000, and 0.7288, and ultrasonography gave 0.7778, 0.9130, 0.9333, 0.7241, and 0.8300 while the combined test gave 1.0000, 0.8696, 0.9231, 1.0000, and 0.9490, respectively. Negative laparotomy rate was 3 %. In conclusion, the combination of PAS and ultrasonography is a more accurate diagnostic tool than either PAS or ultrasonography.

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Morphological Changes of Bones and Joints with Rheumatoid Arthritis and Osteoarthritis

  • Hong, Yun-Kyung;Javaregowda, Palaksha Kanive;Lee, Sang-Kil;Lee, Sang-Rae;Chang, Kyu-Tae;Hong, Yong-Geun
    • Reproductive and Developmental Biology
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    • v.35 no.2
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    • pp.143-149
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    • 2011
  • Arthritis is a common disease in aged people, and is clinically divided into rheumatoid arthritis (RA) and osteoarthritis (OA). Although common symptoms such as pain are present, the underlying pathological mechanisms are slightly different. Therefore, the objectives of the present study were to compare joint damage induced by RA and OA by analyzing the major morphological and molecular differences, and to propose a suitable therapeutic intervention based on the pathophysiological conditions of bones and joints. For the RA animal model, 8-week-old DBA1/J mice were immunized with bovine type II collagen emulsified in complete Freund's adjuvant (CFA). Normal C57BL/6 mice (over 2 years of age) were used for OA. The clinical arthritis score was calculated using a subjective scoring system, and paw thicknesses were measured using calipers. The serum TNF ${\alpha}$ level was analyzed using an ELISA kit. Micro-CT was used to identify pathological characteristics and morphological changes. In collagen-induced RA mice, there were increased ankle joint volumes and clinical scores (p<0.01). The concentration of TNF ${\alpha}$ was significantly increased from 3 to 7 weeks after immunization. Micro-CT images showed trabecular bone destruction, pannus formation, and subchondral region destruction in RA mice. OA among aged mice showed narrowed joint spaces and breakdown of articular cartilage. This study suggests that a careful therapeutic intervention between RA and OA is required, and it should be based on morphological alteration of bone and joint.

Effect of tuberculosis treatment on leptin levels, weight gain, and percentage body fat in Indonesian children

  • Mexitalia, Maria;Dewi, Yesi Oktavia;Pramono, Adriyan;Anam, Mohammad Syarofil
    • Clinical and Experimental Pediatrics
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    • v.60 no.4
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    • pp.118-123
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    • 2017
  • Purpose: Tuberculosis (TB) remains a problem in the community. TB patients usually experience malnutrition, which is characterized by both decreased body weight (BW) and body fat percentage (BFP). Leptin, an important regulator of BW, also plays an important role in cellular immunity, which is integral to defense against Mycobacterium tuberculosis infection. We analyzed the effect of an anti-TB treatment regimen on the leptin level, BW, and BFP of children with TB. Methods: The design of this study was a group interrupted time series. The subjects were children with probable TB according to clinical criteria based on an Indonesian scoring system adopted from the Consensus of Expert Panel. BW; BFP; energy intake; fat and protein intake; and leptin levels before, 2 months after (intensive phase), and 6 months after (continuation phase) anti-TB treatment, were measured. About 40 children, aged 5-14 years, participated in this study. Results: The BW, BFP and leptin level increased from before treatment to after completion of the intensive phase and still showed an increased during the continuation phase: BW 18.65 kg, 19.75 kg, and 20.85 kg; BFP 18.3%, 19.5%, and 20.2%; and leptin level 1.9 mg/dL, 3.07 mg/dL, and 3.4 mg/dL, respectively (P<0.01). Conclusion: Leptin level, BW, and BFP increased throughout the course of anti-TB treatment, compared with pretreatment values. Further research is needed to compare the results with data for healthy children.

Fixation with Bioabsorbable Polylactide Plate and Screws for the Treatment of the Ankle Fractures (생체 흡수성 판과 나사못을 이용한 족근 관절 골절의 치료)

  • Kwon, Duck-Joo;Lee, Yong-Beom;Shin, Jun
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.1
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    • pp.80-84
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    • 2009
  • Purpose: The purpose of this article is to assess the efficacy of a bioabsorbable polylactide (PLA) plate and screw for treating injuries of ankle fractures. Materials and Methods: 24 patients who underwent an open reduction and internal fixation operation for ankle fractures from July 2005 to March 2007 were enrolled into the study. There were 15 men and 9 women. The average age of the patients was 44 years and the average follow-up period was 16 years and two months (16.2 months). All cases were divided into low grade fracture patient (11) who belongs in type A and B of Danis-Weber classification and high grade fracture patient (13) who belongs in type C1, C2 of Danis-Weber classification, and each groups were analyzed by clinical (Meyer score) and radiological finding at the time of their last follow-up evaluation. Results: The clinical results according to Meyer scoring system, showed that all patient with low grade fracture had good to excellent result, but only 54% of patient with high grade fracture had good to excellent result. According to Cedell's radiologic finding, there were 91% cases above fair in low grade fracture. But there were 62% of patient above fair result in high grade fracture, the reduction losses were seen in 38% of patient with high grade fracture. Conclusion: Bioabsorbable PLA plate and screw is good internal fixation device which doesn't have additional operation for removal of implant because of slow absorption within the human body. It showed sufficient strength for acquisition and maintenance of reduction in low grade fracture, but need attention to use because of many cases of reduction loss in high grade fracture. So, it seems to be safe and effective when used in heeling of low grade fracture under considering about type of fracture sufficiently.

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Three Cases of Chronic Adult Atopic Dermatitis (만성 성인형 아토피 피부염의 한방 치험 3례)

  • Ku, Young-Hui;Choi, In-Hwa
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.15 no.1
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    • pp.140-150
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    • 2002
  • Introduction: Atopic dermatitis is chronic eczematous dermatosis which is related strongly to a family history of atopic disease and hereditary disposition. Its threshold of itching is low so that severe itching occurs and causes secondary eczema. Adult atopic dermatitis has mostly severe symptoms and progresses to chronic relapsing. Objective: The purpose of this study was to estimate the efficacy of oriental medical treatment and management on chronic adult atopic dermatitis. Subject: We studied 3 patients who visited Dongguk University Gangnam Oriental Hospital Dept. of Dermatol. with chronic adult atopic dermatitis from August 2001 to April 2002 and were observed for over 4 months. Methods: We treated them with herb-medication, acupuncture, negative therapy, aroma therapy, full spectrum visible ray therapy(by carbon arc) and external application(Jaun-go). We used the SCORAD index to assess the severity of atopic dermatitis. Results: There were 3 patients with chronic adult atopic dermatitis we could check for over 4 months by clinical scoring using the SCORAD system. 1. The grades of the severity of atopic dermatitis were lower only by the oriental medical treatments and management. 2. Intensities of relapse cases were lower then before the oriental medical treatments. 3. The secondary treatment term for relapse cases was shorter then the first treatment term after oriental remedies were used. Conclusion: Considering the above results, more study is needed on the chronic relapse cases with adult atopic dermatitis, the factors of increasing seventy of adult atopic dermatitis, the prognostic factors of adult atopic dermatitis, and the clinical interchange of chronic adult atopic dermatitis between oriental medicine and western medicine.

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Effective professional intraoral tooth brushing instruction using the modified plaque score: a randomized clinical trial

  • Park, Se-Ho;Cho, Sung-Hee;Han, Ji-Young
    • Journal of Periodontal and Implant Science
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    • v.48 no.1
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    • pp.22-33
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    • 2018
  • Purpose: The purpose of this study was to evaluate the efficacy of the modified plaque score (MPS) for assessing the oral hygiene status of periodontitis patients. Methods: A total of 116 patients were included in this study. After evaluation of the $L{\ddot{o}}e$ and Silness gingival index (GI), Silness and $L{\ddot{o}}e$ plaque index (PlI), O'Leary plaque control record (PCR), and MPS, patients were randomly assigned to either a conventional tooth brushing instruction (C-TBI) group (n=56) or a professional intraoral tooth brushing instruction (P-TBI) group (n=60). The MPS and clinical parameters were re-evaluated after scaling and a series of root planing. The convergent validity of MPS with the PlI and PCR was assessed. The measurement time for MPS and PCR was compared according to the proficiency of the examiner. Results: After root planing, the GI, PlI, PCR, and MPS improved from their respective baseline values in both groups. Three different plaque indices including the MPS, showed significant differences between the C-TBI group and the P-TBI group after root planing. The MPS showed significant concurrence with the PCR and PlI. The mean time for PCR measurement was $2.76{\pm}0.71$ times longer than that for MPS measurement after 2 weeks of training. Conclusions: MPS seems to be a practical plaque scoring system compared with the PlI and PCR. These findings suggest that repetitive plaque control combined with an easily applicable plaque index (MPS) may facilitate more effective oral hygiene education and improved periodontal health.

Efficacy and safety of radioiodine therapy for 10 hyperthyroid cats: a retrospective case series study in South Korea

  • Yeon Chae;Jae-Cheong Lim;Taesik Yun;Yoonhoi Koo;Dohee Lee;Mhan-Pyo Yang;Hakhyun Kim;Byeong-Teck Kang
    • Korean Journal of Veterinary Research
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    • v.64 no.2
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    • pp.10.1-10.9
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    • 2024
  • Hyperthyroidism, characterized by elevated thyroid hormone levels and thyroid gland hyperplasia or adenoma, is a prevalent endocrinopathy in older cats. Treatment options include antithyroid drugs, surgical thyroidectomy, and radioiodine therapy (RAIT), which is non-invasive treatment option that can achieve complete remission. However, efficacy and safety of RAIT in hyperthyroid cats have not been investigated in South Korea. This study includes 10 hyperthyroid cats with RAIT. Initial assessments comprised history, physical examination, blood analysis, and serum total T4 (tT4) concentration. Thyroid scintigraphy revealed hyperactivity and enlargement of thyroid gland at 24 hours before the RAIT. Radioiodine (RAI) was injected subcutaneously with 2 to 6 mCi, determined by the fixed dose or the scoring system based on severity of clinical signs, tT4 concentration, and thyroid size individually. After RAIT, the concentration of serum tT4 and liver enzymes were significantly decreased at discharge. However, no significant differences were noted in blood urea nitrogen, creatinine, symmetric dimethylarginine, hematocrits, and white blood cell counts pre- and post-treatment. Although 4 cats received RAI twice, clinical signs disappeared and tT4 levels decreased following the RAIT. All 10 cats achieved complete remission after 6 months without critical adverse effect. The safety and the effectiveness of RAIT was confirmed based on protocols reported other countries. Therefore, RAIT could be considered the treatment option and prevent adverse effects from medication or surgery. This preliminary study presents the first evaluation of RAIT for hyperthyroid cats using locally produced RAI in South Korea and provide valuable insight for clinicians and further studies.

Positive rate of canine pancreatic lipase immunoreactivity (SNAP cPL) in relationship with severity of clinical signs and concurrent disorders: a retrospective study

  • Jongjin Park;Solji Choi;YoungMin Yun;Myung-Chul Kim;Woo-Jin Song
    • Korean Journal of Veterinary Research
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    • v.64 no.3
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    • pp.27.1-27.6
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    • 2024
  • Acute pancreatitis (AP) is a common disorder characterized by the inflammation of the exocrine pancreas in dogs, and the severity of the clinical signs of pancreatitis varies greatly. Therefore, the diagnosis of pancreatitis is challenging. The canine pancreatic lipase immunoreactivity test (SNAP cPL; IDEXX Laboratories Inc., USA) is rapid and relatively accurate in diagnosing pancreatitis. The purpose of this study was to evaluate the positivity rate of the SNAP cPL test in dogs regarding the severity of gastrointestinal (GI) signs and concurrent diseases. Electronic medical records of dogs were reviewed. For retrospective classification, 80 dogs with GI signs who underwent the SNAP cPL test were enrolled. Additionally, concurrent diseases on the day of the SNAP cPL test were reviewed. A positive SNAP cPL test result was observed in 26 of the 80 dogs (32.5%) with GI signs. The severity of GI signs using a scoring system and the positivity rate of SNAP cPL were statistically related. Furthermore, dogs with concurrent chronic kidney disease had a significantly higher positivity rate of SNAP cPL than those without chronic kidney disease. This information might help clinicians to decide whether a SNAP cPL test is needed.

Clinicopathologic Characteristics of Incidentally Discovered Thyroid Carcinomas (갑상선 우연암종의 임상병리적 특성)

  • Chung Woung-Youn;Cheong Jae-Ho;Chang Hang-Seok;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.16 no.1
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    • pp.64-68
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    • 2000
  • Objectives: With the recent advances and increasing use of imaging techniques in examination of the neck, the incidence of incidentally discovered thyroid carcinoma has been increasing. This study was carried out to evaluate the clinicopathologic characteristics of incidental thyroid carcinomas and to find optimal therapeutic strategies for these lesions. Materials & Methods: From Jan. 1988 to Aug. 1998, 1,053 patients were operated on for thyroid cancer, of whom 127(12.1%) had incidentally discovered thyroid cancers which were identified during routine health checkups(n=40), diagnostic procedures for unrelated medical conditions(n=39) and mass screening for thyroid cancer(n=48). The preoperative diagnosis was obtained by ultrasound-guided FNAB and the extent of surgery was determined based on frozen section examinations, as well as prognostic factors and gross findings at the time of surgery. Results: There were 6 men and 121 women with a mean age of 45.9 years. Histopathological diagnosis included papillary carcinomas(n=1l9), follicular carcinomas(n=6), poorly differentiated carcinoma(n=l) and medullary carcinoma(n=1). Thirty patients(23.6%) had multifocallesions. The mean diameter of the tumors was 1.1 cm(0.2-3.4 cm). Capsular invasions were found in 53 patients(41.7%) and nodal metastases in 41(32.3%). The surgical procedures used were: 90 less-than total thyroidectomies and 37 total thyroidectomies with central neck node dissection. Lateral neck dissection was added in 5 patients. According to TNM staging, 79 patients(63.2%) were at stage I, 15(12.0%) at stage II, 31(24.8%) at stage III and 0(0.0%) at stage IV. By AMES scoring system, 102 patients(81.6%) were in the low-risk group and 23(18.4%) in the high-risk group. And by MACIS scoring system, 103(86.6%) of 119 papillary thyroid cancer patients were less than 6. Conclusions: The clinicopathological characteristics of incidentally discovered thyroid carcinomas are similar to ordinary thyroid carcinomas. The treatment of choice should be individualized based on the particular clinical situation encountered, as in ordinary thyroid carcinomas.

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Autograft versus Allograft for Anterior Cruciate Ligament Reconstruction - The clinical analysis of patellar tendon autografts compared with allografts - (자가 슬개건과 동종 슬개건을 이용한 전방 십자 인대 재건술의 비교)

  • Chun, Churl-Hong;Kim, Young-Jin;Yang, Jae-Hyun
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.1
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    • pp.13-18
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    • 2000
  • Purpose : The purpose of this study was to compare the efficacy of bone-patellar tendon-bone(B-PTB) allograft with autograft B-PTB reconstruction of anterior cruciate ligament(ACL) according to the subjective and objective criteria. Materials and Methods : 42 patients were treated for acute rupture or chronic insufficiency of the ACL between March 1993 and June 1996. There were 18 autografts and 24 allografts for ACL reconstruction. At 2 years of follow-up after operation, autograft and allograft groups were compared based on subjective, objective criteria and Telos stress arthrometer. Results : The modified Feagin Scoring System revealed 16 patients$(88.9\%)$ with a satisfactory result by autografts, but 21 patients$(87.5\%)$ with a satisfactory result by allografts after 2-years follow-lip. There was no statistically significant difference between the two groups. ACL reconstruction with B-PTB allograft did not produce a significant functional deficit. But patellofemoral pain and crepitus were more frequent in the autografts$(33.3\%)$ than allografts$(8.3\%)$ (p<0.05). Conclusion : The ACL deficient knees treated with allografts for ACL reconstruction tended to be better than those reconstructed with autografts fur the reduction of patellofemoral crepitus and pain. B-PTB allograft provides an acceptable alternative to autograft tissue for reconstruction of the ACL.

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