• 대한치과의사협회지
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• 제42권6호통권421호
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• pp.414-421
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• 2004

Sjogren syndrome is a chronic systemic autoimmune disorder that chiefly involves the salivary gland and the lacrimal gland, resulting in xerostomia and xerophthalmia. Although the exact cause of the disease is not early diagnosis, treatment and observation must be emphasized because of its poor prognosis, such as the high occurrence of malignant lymphoma and other autoimmune disease that may be accompanied. In the present case, a twenty-year-old woman whose chief complaint was multiple dental hard tissue loss and xerostomia, which was misdiagnosed as iron deficiency anemia at first, but through re-evaluation and differential diagnosis it was Sjogren syndrome. the diagnosis approach was discussed in this report, suggesting that Sjogren syndrome should be considered as a differential diagnosis in a with xerostomia.

• Journal of Yeungnam Medical Science
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• 제31권1호
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• pp.1-8
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• 2014

Dizziness can be classified mainly into 4 types: vertigo, disequilibrium, presyncope, and lightheadedness. Among these types, vertigo is a sensation of movement or motion due to various causes. The main causes of peripheral vertigo are benign paroxysmal positional vertigo (BPPV), acute vestibular neuritis (AVN), and Meniere's disease. BPPV is one of the most common causes of peripheral vertigo. It is characterized by brief episodes of mild to intense vertigo, which are triggered by specific changes in the position of the head. BPPV is diagnosed from the characteristic symptoms and by observing the nystagmus such as in the Dix-Hallpike test. BPPV is treated with several canalith repositioning procedures. AVN is the second most common cause of peripheral vertigo. Its key symptom is the acute onset of sustained rotatory vertigo without hearing loss. It is treated with symptomatic therapy with antihistamines, anticholinergic agents, anti-dopaminergic agents, and gamma-aminobutyric acid-enhancing agents that are used for symptoms of acute vertigo. Meniere's disease is characterized by episodic vertigo, fluctuating hearing loss, and tinnitus. It is traditionally relieved with life-style modification, a low-salt diet, and prescription of diuretics. However, diagnosis and treatment of the peripheral vertigo can be difficult without knowledge of BPPV, AVN, and Meniere's disease. This article provides information on the differential diagnosis of peripheral vertigo in BPPV, AVN, and Meniere's disease.

• 한국정보통신학회논문지
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• 제6권1호
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• pp.76-82
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• 2002

본 연구에서는 계층적 신경회로망을 사용하여 정상, 후두질환(polyp, nodule, palsy 등), 후두질환 중 성문암 시기별 감별진단이 가능한 후두질환 감별진단 분류기를 구현하였다. 후두질환을 가진 환자군과 정상군, 그리고 성문암의 각 시기별에 해당되는 환자군으로부터 /a/, /e/, /i/, /o/, /u/ 모음에 따른 분류작업을 수행하였다. 각 모음별 분류 실험을 수행한 결과 모든 입력 파라미터에 대해서 /a/모음이 다른 모음에 비해 우수한 분류율을 나타내므로, /a/모음만을 사용하여 후두질환을 감별진단하기 위한 계층적 신경회로망을 구현하였다. 구현된 계층적 신경회로망은 각 계층별로 서로 다른 파라미터들을 적용하여 여러 후두질환을 감별진단하도록 구성되었다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제16권4호
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• pp.225-232
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• 2013

Children with abnormal liver function can often be seen in outpatient clinics or inpatients wards. Most of them have respiratory disease, or gastroenteritis by virus infection, accompanying fever. Occasionally, hepatitis by the viruses causing systemic infection may occur, and screening tests are required. In patients with jaundice, the tests for differential diagnosis and appropriate treatment are important. In the case of a child with hepatitis B virus infection vertically from a hepatitis B surface antigen positive mother, the importance of the recognition of immune clearance can't be overstressed, for the decision of time to begin treatment. Early diagnosis changes the fate of a child with Wilson disease. So, screening test for the disease should not be omitted. Non-alcoholic fatty liver disease, which is mainly discovered in obese children, is a new strong candidate triggering abnormal liver function. Muscular dystrophy is a representative disease mimicking liver dysfunction. Although muscular dystrophy is a progressive disorder, and early diagnosis can't change the fate of patients, it will be better to avoid parent's blame for delayed diagnosis.

• Clinical and Experimental Pediatrics
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• 제61권5호
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• pp.160-166
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• 2018

Purpose: This study aimed to analyse laboratory values according to fever duration, and evaluate the relationship across these values during the acute phase of Kawasaki disease (KD) to aid in the early diagnosis for early-presenting KD and incomplete KD patients. Methods: Clinical and laboratory data of patients with KD (n=615) were evaluated according to duration of fever at presentation, and were compared between patients with and without coronary artery lesions (CALs). For evaluation of the relationships across laboratory indices, patients with a fever duration of 5 days or 6 days were used (n=204). Results: The mean fever duration was $6.6{\pm}2.3days$, and the proportions of patients with CALs was 19.3% (n=114). C-reactive proteins (CRPs) and neutrophil differential values were highest and hemoglobin, albumin, and lymphocyte differential values were lowest in the 6-day group. Patients with CALs had longer total fever duration, higher CRP and neutrophil differential values and lower hemoglobin and albumin values compared to patients without CALs. CRP, albumin, neutrophil differential, and hemoglobin values at the peak inflammation stage of KD showed positive or negative correlations each other. Conclusion: The severity of systemic inflammation in KD was reflected in the laboratory values including CRP, neutrophil differential, albumin, and hemoglobin. Observing changes in these laboratory parameters by repeated examinations prior to the peak of inflammation in acute KD may aid in diagnosis of early-presenting KD patients.

• 대한세포병리학회지
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• 제19권2호
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• pp.72-85
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• 2008

Cytologic examination of the body cavity fluid is very important because the specimens represent a significant percentage of nongynecologic samples and this cytologic examination may be the first, best or only chance for making the diagnosis of an underlying malignancy. The purposes of body cavity fluid examination are to correctly identify cancer cells and if possible, to identify the tumor types and primary sites when presented with unknown primary tumor sites. The most important basic differential diagnosis is that of benign and reactive disease vs malignant disease. Reactive mesothelial cells are a consistent population in body cavity fluid, and these are the most versatile cells in the body. Due to the specific environment of the body cavity, the exfoliated reactive mesothelial cells may show significant morphologic overlap with the morphology of cancer cells. With a focus on the differential points between reactive mesothelial cells and metastatic adenocarcinoma cells, the practical diagnostic approaches, the diagnostic clues and the pitfalls to achieve a correct diagnosis are presented in this review.

• Journal of Medicine and Life Science
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• 제16권3호
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• pp.64-75
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• 2019

Vertigo and dizziness are common symptoms with various etiologies and pathogeneses. Vertigo is an illusion of motion due to disease of the vestibular system, usually a sense of rotation. Dizziness, a term that represents a wide range of non-vertigo symptoms, is commonly associated with non-vestibular disorders including old age, cardiac syncope, orthostatic hypotension, metabolic disease, anxiety, and drugs. Vertigo should be determined whether the cause is central or peripheral. Peripheral vertigo is usually benign but central vertigo is serious and often require urgent treatment. The careful history and detailed physical examinations(pattern of nystagmus, ocular tilt reaction, head impulse test and positional tests such as Dix-Hallpike maneuver) provide important clues to the diagnosis of vertigo. Most of patients have benign peripheral vestibular disorders - vestibular neuritis, benign paroxysmal positional vertigo (BPPV), and Meniere's disease. BPPV is a leading cause of peripheral vertigo and can easily be cured with a canalith repositioning maneuver. In this review, a focus is on the differential diagnosis of common vestibular disorders with peripheral and central causes.

• Clinical and Experimental Pediatrics
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• 제53권11호
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• pp.931-935
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• 2010

Juvenile idiopathic arthritis (JIA) is comprised of a heterogeneous group of several disease subtypes that are characterized by the onset of arthritis before the age of 16 years and has symptoms lasting at least 6 weeks. The previous classification of JIA included seven different categories, whereas its current classification was compiled by the International League of the Association for Rheumatology, and replaced the previous terms of "juvenile chronic arthritis" and "juvenile rheumatoid arthritis," which were used in Europe or North America, respectively, with the single nomenclature of JIA. As mentioned above, JIA is defined as arthritis of unknown etiology that manifests itself before the age of 16 years and persists for at least 6 weeks, while excluding other known conditions. The clinical symptoms of JIA can be quite variable. Several symptoms that are characteristic of arthritis are not necessarily diagnostic of JIA and may have multiple etiologies that can be differentiated with careful examination of patient history. The disease may develop over days or sometimes weeks, thereby making the diagnosis difficult at the time of presentation. To make a clinical diagnosis of JIA, the first step is to exclude arthritis with known etiologies. Of note, late treatment due to excessive delay of diagnosis can cause severe damage to joints and other organs and impair skeletal maturation. Therefore, early detection of JIA is critical to ensure prompt treatment and to prevent long-term complications including the likelihood of disability in childhood.

• Korean Journal of Radiology
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• 제23권6호
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• pp.581-597
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• 2022

Left ventricular (LV) wall thickening, or LV hypertrophy (LVH), is common and occurs in diverse conditions including hypertrophic cardiomyopathy (HCM), hypertensive heart disease, aortic valve stenosis, lysosomal storage disorders, cardiac amyloidosis, mitochondrial cardiomyopathy, sarcoidosis and athlete's heart. Cardiac magnetic resonance (CMR) imaging provides various tissue contrasts and characteristics that reflect histological changes in the myocardium, such as cellular hypertrophy, cardiomyocyte disarray, interstitial fibrosis, extracellular accumulation of insoluble proteins, intracellular accumulation of fat, and intracellular vacuolar changes. Therefore, CMR imaging may be beneficial in establishing a differential diagnosis of LVH. Although various diseases share LV wall thickening as a common feature, the histologic changes that underscore each disease are distinct. This review focuses on CMR multiparametric myocardial analysis, which may provide clues for the differentiation of thickened myocardium based on the histologic features of HCM and its phenocopies.

• 음성과학
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• 제12권3호
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• pp.19-33
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• 2005

Tremor is a main factor of parkinsonism. Voice tremor may be the first, later or the only symptom of a neurological disease and its frequency, amplitude, and regularity may differ among the diseases of different neural subsystems. Differential diagnosis between idiopathic Parkinson's disease (IPD) and multiple system atrophy (MSA) has been difficult. This study included three groups: (1) 6 IPD patients; (2) 6 MSA patients; and (3) 20 ageand sex-matched normal controls. The MDVP (Multidimensional Voice Program) was used to analyze the sustained /a/phonation. The results were as follows: (1) frequency perturbation parameters (jitter, sPPQ, Vf0) and FTRI of tremor parameter of two patient groups were statistically different from those of the controls (p < .01); (2) measures were higher in short-term and long-term f0 and amplitude perturbation in MSA than IPD; (3) however, any acoustic parameters between IPD and MSA were not statistically different; except for the rate of frequency tremor, 4$\sim$5 Hz in IPD, 5$\sim$11 Hz in MSA and (4) the pattern of regularity for voice tremor through histogram indicated that amplitude of IPD was irregular while both f0 and amplitude of MSA were irregular. In conclusion, F0, rate of frequency tremor, and pattern of f0 regularity may be predictors for differential diagnosis. These findings might signify that voice tremor of parkinsonism was resulted from modulation of f0.