• Title/Summary/Keyword: Diagnostic assessment

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Clinical Features of Endobronchial Tuberculosis (기관지 결핵)

  • Park, Sung-Soo;Lee, Jung-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.223-231
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    • 1997
  • A total of 322 patients with endobronchial tuberculosis (8.1%) out of 3,982 subjects who had a flexible fiberoptic bronchoscopic examination at the Department of Pulmonary Medicine of Hanyang University Hospital between the beginning of March 1982 and the end of April 1996 were included in this study. The peak incidence occurred in the second decade, and the male to female was 1 : 3.0. The barking cough with variable amounts of sputum was the most common chief complaint in 56.9% of the 313 patients. Other complaints included dyspnea, chest pain, fever, hemoptysis, and generalized weakness. Localized wheeze was heard over the chest in 16.9% of the 313 patients. Infiltration/consolidation was the most common roentgenographic finding of the chest in 64.2%. Bronchoscopically, hypertrophy with luminal narrowing was the most common findings in 32.3% of the 322 patients and left main bronchus was the most frequently involved in 24.0%. Using fiberoptic bronchoscopy allows not only substantial meaningful assessment of endobronchial tuberculosis but also makes a differential diagnosis of lung cancer in older patients. We need further evaluations of standard bronchoscopic classification of endobronchial tuberculosis, diagnostic accuracy of endobronchial tuberculosis by PCR, a large prospective study of effects of corticosteroids in endobronchial tuberculosis patients, and appropriate treatment of atelectasis by endobronchial tuberculosis.

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Humidifier Disinfectant-Associated Lung Injury: Six Years after the Tragic Event

  • Kim, Won-Young;Hong, Sang-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.80 no.4
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    • pp.351-357
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    • 2017
  • In 2011, a cluster of peripartum patients were admitted to the intensive care unit of a tertiary hospital in Seoul with signs and symptoms of severe respiratory distress of unknown etiology. Subsequent epidemiological and animal studies suggested that humidifier disinfectant (HD) might represent the source of this pathology. Epidemiological studies, animal studies, and dose-response analysis demonstrated a strong association between HD use and lung injuries. The diagnostic criteria for HD-associated lung injury (HDALI) was defined on the basis of the clinical, pathological, and radiological attributes of the patients. The clinical spectrum of HDALI appears to range from asymptomatic to full-blown acute respiratory failure, and some patients have required actual lung transplantation for survival. The overall mortality of the exposed population was not significant, although peripartum patients and children who were admitted to the intensive care unit did show high mortality rates. Persistent clinical findings such as diffuse ill-defined centrilobular nodules and restrictive lung dysfunction were observed in some of the survivors. The findings of this review emphasize the importance of assessment of the level of toxicity of chemical inhalants utilized in a home setting, as well as the need to identify and monitor afflicted individuals after inhalational injury.

Aero-Optical Diagnostic Technique for the Hypersonic Boundary Layer Transition on a Flat Plate

  • Li, Ruiqu;Gong, Jian;Bi, Zhixian;Ma, Handong
    • International Journal of Aerospace System Engineering
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    • v.2 no.2
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    • pp.6-9
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    • 2015
  • A new cross disciplinary conception of transitional aero-optics is built up during analyzing and measuring the linkage between the hypersonic boundary layer transition on a flat plate and the jittering characteristics of the small-aperture beam through that boundary layer. Based on that conception, the Small-Aperture Beam Technique (SABT) and high-speed Imaging Camera System (ICS) used in aero-optical studies are considered as new techniques for the assessment of the hypersonic transition in the boundary layer on a flat plate. In the FD-20 gun tunnel, for the free stream parameters with Mach number of 8 and unit Reynolds number of $1{\times}10^7$ (1/m), those two optical techniques are used to measure the jitter of the small-aperture beam. At the same free stream parameters, the distribution of the heat transfer along the centerline of the flat plate is also measured by the thin film resistance gauge technique. The results show the similarity of the increase trend between the heat transfer and the jitter of the small-aperture beam in the transitional region. It helps us to surmise that it may be feasible to diagnose the transition in a hypersonic boundary layer on a flat plate by means of those above optical techniques.

Development of an In-service Education Program for Emergency Room Nurses According to Their Career Ladders (응급실 간호사의 업무분석을 통한 경력등급별 실무교육안 개발)

  • Lee, Eun Nam;Kim, Bog Ja;Kim, Sung Sook;Kang, Kyung Hee;Kim, Young Soon
    • Journal of Korean Clinical Nursing Research
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    • v.14 no.1
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    • pp.99-111
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    • 2008
  • Purpose: This study was done to provide basic data for developing an in-service education program to improve nurses' quality. First, frequency of nursing activities and competency levels of emergency nurses according to their career ladders were compared through job analysis and then practical education programs were presented on based of the results. Method: Data were collected from 335 nurses working in emergency rooms in 31 tertiary hospitals. Data collection was done from September to November 2005 using the job analysis questionnaire. Results: There were 41 nursing activities that showed differences in frequency and 78 activities that showed differences in perceived competency level. Irrespective of emergency nurses' careers, activities that show high frequency but low competency were sputum liquefying therapy, assessment of cranial nerve function, identification of diagnostic radiology, and communication with various departments. In-service education content according to nurse's career ladders was presented by adding high frequency nursing activities and activities with low competency level even though having high frequency. Conclusion: There is a need to develop and provide in-service education programs, which consider nurses' difference in frequency and competency level for their career ladders.

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Subclinical Hypothyroidism;Controversial Subjects and Therapeutic Regimen (준임상적 갑상선기능저하증;논란이 되는 주제들)

  • Park, Ji-Hun;Kim, Ho-Jun;Lee, Myeong-Jong
    • Journal of Korean Medicine for Obesity Research
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    • v.6 no.2
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    • pp.29-41
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    • 2006
  • Subclinical hypothyroidism is defined as a normal serum free thyroxine level combined with an elevated thyroid stimulating hormone level. The causes of subclinical hypothyroidism are the same as those of overt hypothyroidism. There is good evidence that subclinical hypothyroidism is associated with progression to overt disease. The management of subclinical hypothyroidism is remains controversial. Patients with a serum thyroid stimulating hormone level greater than 10 mU/L have a higher incidence of elevated serum low-density lipoprotein cholesterol concentrations; however, evidence is lacking for other associations. There is insufficient evidence that hormone treatment of subclinical hypothyroidism is beneficial. The use of thyroid stimulating hormone level lone as a diagnostic and assessment tool for hypothyroidism is inadequate because this test cannot identify numerous conditions this sentence is unclear in its meaning. Using an expanded list of clinical signs and symptoms associated with dysfunction of the Hypothalamus-Pituitary-Thyroid axis, it is possible to hypothesize that subclinical hypothyroidism may be more common in a population of patients with early signs of age-related diseases than most practitioners realize. To improve thyroid function in subclinical hypothyroidism patients, practitioners should become familiar with foods and nutrients that can hinder or support thyroid function.

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Review of Traditional Chinese Medicine Clinical Studies on Tuina Treatment of Children's Autism Spectrum Disorder (소아 자폐스펙트럼 장애의 추나 치료에 대한 중의학 임상 연구 고찰)

  • Park, Jem Ma
    • The Journal of Pediatrics of Korean Medicine
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    • v.35 no.3
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    • pp.28-42
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    • 2021
  • Objectives The purpose of this study is to investigate the effect of Tuina treatment for children with Autism Spectrum Disorder (ASD), and to propose guidance to future studies or application in clinical setting. Methods The articles published from year 2000 to May 2021 by China National Knowledge Infrastructure (CNKI) were searched by setting up field as '中醫學', '中藥', '中西醫結合' and by setting up keyword as '小儿自閉症', '儿童自閉症', '自閉症譜系障碍', 'Autism', 'Autism spectrum disorder' that corresponds to participant and '推拿', '導引', '按摩', 'Tuina', 'massage'. Results Nine selected articles were analyzed and summarized by authors and year published, characteristics, diagnostic criteria, treatment methods and contents, treatment duration, evaluation criteria and results of the study. The articles were also reviewed by reported side effects, and evaluated the quality of the study according to Cochrane Handbook's Risk of Bias 2 (RoB 2) assessment of the Randomized Control Trial (RCT) articles. All studies used Tuina treatment to achieve effective results for pediatric autism spectrum disorder. Conclusion Pediatric Tuina treatment (TM) is a non-invasive treatment that does not stimulate patients with unstable ASD but increase patient adherence, and can be safely and simply operated. Therefore, pediatric Tuina treatment is worth utilizing as a clinical basis for further development of ASD treatment.

Biomarkers for Evaluating the Inflammation Status in Patients with Cancer

  • Guner, Ali;Kim, Hyoung-Il
    • Journal of Gastric Cancer
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    • v.19 no.3
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    • pp.254-277
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    • 2019
  • Inflammation can be a causative factor for carcinogenesis or can result from a consequence of cancer progression. Moreover, cancer therapeutic interventions can also induce an inflammatory response. Various inflammatory parameters are used to assess the inflammatory status during cancer treatment. It is important to select the most optimal biomarker among these parameters. Additionally, suitable biomarkers must be examined if there are no known parameters. We briefly reviewed the published literature for the use of inflammatory parameters in the treatment of patients with cancer. Most studies on inflammation evaluated the correlation between host characteristics, effect of interventions, and clinical outcomes. Additionally, the levels of C-reactive protein, albumin, lymphocytes, and platelets were the most commonly used laboratory parameters, either independently or in combination with other laboratory parameters and clinical characteristics. Furthermore, the immune parameters are classically examined using flow cytometry, immunohistochemical staining, and enzyme-linked immunosorbent assay techniques. However, gene expression profiling can aid in assessing the overall peri-interventional immune status. The checklists of guidelines, such as STAndards for Reporting of Diagnostic accuracy and REporting recommendations for tumor MARKer prognostic studies should be considered when designing studies to investigate the inflammatory parameters. Finally, the data should be interpreted after adjusting for clinically important variables, such as age and cancer stage.

Evidence-Based Practice Guideline for Surgical Treatment of Gastroesophageal Reflux Disease 2018

  • Seo, Ho Seok;Choi, Miyoung;Son, Sang-Yong;Kim, Min Gyu;Han, Dong-Seok;Lee, Han Hong
    • Journal of Gastric Cancer
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    • v.18 no.4
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    • pp.313-327
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    • 2018
  • The prevalence of gastroesophageal reflux disease (GERD) is increasing in Korea, and physicians, including surgeons, have been focusing on its treatment. Indeed, in Korea, medical treatment using a proton pump inhibitor is the mainstream treatment for GERD, while awareness of surgical treatment is limited. Accordingly, to promote the understanding of surgical treatment for GERD, the Korean Anti-Reflux Surgery Study Group published the Evidence-Based Practice Guideline for the Surgical Treatment of GERD. The guideline consists of 2 sections: fundamental information such as the definition, symptoms, and diagnostic tools of GERD and a recommendation statement about its surgical treatment. The recommendations presented 5 debates regarding fundoplication: 1) comparison of the effectiveness of medical and surgical treatments, 2) effectiveness of surgical treatment in cases of refractory GERD, 3) effectiveness of surgical treatment of extraesophageal symptoms, 4) comparison of effectiveness between total and partial fundoplication, and 5) effectiveness of fundoplication in cases of hiatal hernia. The present guideline is the first to demonstrate the efficacy of the surgical treatment GERD in Korea.

A Review on Clinical Research Trends in the Treatment of Tai Chi on Anxiety (불안에 대한 태극권 치료의 해외 임상연구 동향)

  • Kim, Ju-Young;Hong, Min-Ho;Koo, Byung-Su;Kim, Geun-Woo
    • Journal of Oriental Neuropsychiatry
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    • v.30 no.3
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    • pp.275-285
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    • 2019
  • Objectives: This study was performed to review the research trends in the treatment of Tai Chi on anxiety. Methods: We searched for articles in Pubmed and China National Knowledge Infrastructure (CNKI) from January 2009 to December 2018. The selected studies were evaluated by Jadad Scale. Results: One pre-post comparison study and seven controlled clinical trials were selected. HAMA (Hamilton Rating Scale for Anxiety) and STAI (State Anxiety Inventory) were the most frequently used diagnostic criteria. For outcome measurement, STAI was again the most commo. From Jadad Quality Assessment Scale of 8 articles, the overall quality of the studies was low. Conclusions: According to this study, it seemed that Tai Chi treatment on anxiety disorder is an effective and safe intervention. Therefore, based on this study, more clinical research on diverse forms of treatments of anxiety disorder should be performed in Korean medicine in the near future.

Robust Ultrasound Multigate Blood Volume Flow Estimation

  • Zhang, Yi;Li, Jinkai;Liu, Xin;Liu, Dong Chyuan
    • Journal of Information Processing Systems
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    • v.15 no.4
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    • pp.820-832
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    • 2019
  • Estimation of accurate blood volume flow in ultrasound Doppler blood flow spectrograms is extremely important for clinical diagnostic purposes. Blood volume flow measurements require the assessment of both the velocity distribution and the cross-sectional area of the vessel. Unfortunately, the existing volume flow estimation algorithms by ultrasound lack the velocity space distribution information in cross-sections of a vessel and have the problems of low accuracy and poor stability. In this paper, a new robust ultrasound volume flow estimation method based on multigate (RMG) is proposed and the multigate technology provides detail information on the local velocity distribution. In this method, an accurate double iterative flow velocity estimation algorithm (DIV) is used to estimate the mean velocity and it has been tested on in vivo data from carotid. The results from experiments indicate a mean standard deviation of less than 6% in flow velocities when estimated for a range of SNR levels. The RMG method is validated in a custom-designed experimental setup, Doppler phantom and imitation blood flow control system. In vitro experimental results show that the mean error of the RMG algorithm is 4.81%. Low errors in blood volume flow estimation make the prospect of using the RMG algorithm for real-time blood volume flow estimation possible.