• Title/Summary/Keyword: Diagnostic assessment

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Prognosis for Blunt Abdominal Trauma Patients with Contrast Extravasation on the Abdominopelvic CT Scan (조영제 혈관 외 유출이 관찰된 복부 둔상 환자의 유출부위에 따른 예후)

  • Shin, Hyung Jin;Lee, Kang Hyun;Kwak, Young Soo;Kim, Sun Hyu;Kim, Hyun;Hwang, Sung Oh
    • Journal of Trauma and Injury
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    • v.22 no.1
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    • pp.57-64
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    • 2009
  • Purpose: Computed tomography (CT) is an accurate test for evaluating hemodynamically stable patients with blunt abdominal trauma. Until now, there have been few studies concentrating on the diagnostic and prognostic significance of the intravenous contrast extravasation (CE) site. We investigated the site of CE on abdominopelvic CT (APCT) and its effect on treating trauma patients and predicting the clinical outcome. Methods: The 50 patients admitted to our emergency department with blunt abdominal trauma showing CE on APCT from January 2004 to September 2006 were included in this study. Patients were prospectively collected, and medical records were reviewed and analyzed. The patients'clinical and lab findings, Focused Assessment with Sonography for Trauma (FAST) findings, CT findings were analyzed. CE sites were classified as intraperitoneal, retroperitoneal, and pelvic cavity and were correlated with post-treatment complications, mortality, and morbidity. Results: Of the 50 patients (mean age : $45{\pm}18years$, 29 males, 21 females) included in our study, 33 patients died (66%). There was no correlation between CE site and ICU or total hospitalization duration (p=0.553, p=0.523). During the first 24 hours of resuscitation, the pelvic cavity group required a mean of 20 units more of packed red blood cell (pRBC) transfusion compared to other groups (p=0.003). In the intraperitoneal group, more patients received operative invasive intervention - either laparotomy or embolization (p=0.025). The intraperitoneal group had the highest mortality, with 13 deaths (11/33, 39%), and the highest early mortality rate (10/13, 76%) in the first 24 hours (p=0.001). Conclusion: Intraperitoneal CE on the CT scan in cases of blunt abdominal trauma is regarded as an indication of a need for invasive intervention (either angiography or laparotomy) and of a higher mortality rate in the first 24 hours. A pelvic cavity CE rquires more aggressive transfusion with pRBC. However, the CT findings themselves showed no significant correlation with overall mortality, morbidity, or hospitalization.

Study on the Correlation between Patients Complaints of Dyspepsia and Stress -Through comparison between functional dyspepsia patients and nonsymptomatic chronic gastritis patients- (소화불량(消化不良)과 과심상(過心傷)의 상관성(相關性)에 대(對)한 고찰(考察) -스트레스, 기울(氣鬱), 비병증(脾病證)의 평가(評價)를 통(通)해-)

  • Kim, Jin-Sung;Yoon, Sang-Hyub;Ryu, Bong-Ha;Ryu, Ki-Won;Lee, Sang-Wook
    • The Journal of Internal Korean Medicine
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    • v.25 no.4
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    • pp.306-317
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    • 2004
  • Background & Object : Dyspepsia for which no organic causes are disclosed is referred to as functional dyspepsia. Functional dyspepsia is here studied in connection with a biopsychosocial model. From the aspect of individual response to external environment, in connection with stress response, functional dyspepsia is studied by both the psychology department and the internal medicine departments. The disease is taken as approachable from the aspect of internal injury due to seven emotions and stress as differentiated by Oriental medicine. Materials and Methods : Targeted at 223 patients underwent medical checks and endoscopy at Kangnam Korean Hospital, Kyunghee University. They agreed to join this clinical experiment. Stress response inventory, GARS (global assessment of recent stress scale), GSRS (gastrointestinal symptom rating scale), diagnostic scores for Ki-depression, and Spleen Disease Differentiation of Syndromes were all measured and evaluated. The test group was comprised of functional dyspepsia patients. The control group was comprised of nonsymptomatic chronic gastritis patients who were found to suffer from chronical gastritis in endoscopy and thus could be diagnosed with functional dyspepsia if symptoms would arise, but did not complain of subjective symptoms. Results showed these corelations: Functional dyspepsia patients were found to have more serious Ki-depression compared to nonsymptomatic chronic gastritis patients. The more serious Ki-depression the more serious the dyspepsia symptoms. The higher the stress response inventory the more serious the dyspepsia. Deficiency of spleen Eum, and Deficiency and Sinking of spleen Gi were found to coincide with serious Ki-depression.

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Assessment of the Effective Dose to the Human Body and Estimation of Lifetime Attributable Risk by CT Examination (CT 검사별 노출되는 유효선량과 생애 암 귀속 위험도 평가)

  • Cho, Yong In;Kim, Jung Hoon
    • Journal of the Korean Society of Radiology
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    • v.14 no.2
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    • pp.169-178
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    • 2020
  • The number of CT scans is increasing every year due to the improvement of the medical standards of the public, and thus the annual dose of medical radiation is also increasing. In this study, we evaluated the effective dose of the human body exposed to CT scans and estimated LAR. First, five region were selected from the CT diagnostic reference level guideline, and the effective dose of human body exposed to each examination was evaluated by clinical CT device. Second, the human organs and effective dose were calculated using the ALARA-CT program under the same conditions. Third, lifetime attributable risk (LAR) estimated by the effective dose exposed through the previous CT scan was estimated. As a result, the most effective dose was 21.18 mSv during the abdomen 4 phase scan, and the dose level was below DRL for all other tests except for the abdominal examination. As a result of evaluating effective dose using a dose calculation program under the same conditions, the results showed about 1.1 to 1.9 times higher results for each examination. In the case of organ dose, the closer the organ to the scan site, the higher the scattering ray. The lifetime attributable risk to CT radiation dose in adults was gradually decreased with age, and the results were somewhat different according to gender.

The Value of Tc-99m DTPA Diuretic Renography for Assessment of Dilated Upper Urinary Tract in Children (소아의 상부 요관확장증에서 폐쇄 유무 감별에 있어 Tc-99m DTPA 이뇨 신장 신티그램의 유용성)

  • Yang, Ki-Ra;Lim, Gye-Yeon;Sohn, Hyung-Sun;Hahn, Seong-Tae;Lee, Jae-Mun
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.1
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    • pp.57-64
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    • 1999
  • Purpose: The purpose of this study was to evaluate the accuracy of Tc-99m DTPA diuretic renal scans in children with dilated upper urinary tract. Materials and Methods: We reviewed diuretic renal scans of 14 pediatric patients (age range: 3 days to 4 years) with unilateral hydronephrosis diagnosed by ultrasonography. Diuretic renal scan was done using Tc-99m DTPA and standardized protocol. In 3 neonates, diuretic renal scans were performed within 1 week and 3-7 months after birth. Results: Six patients required Pyeloplasty and eight were managed conservatively. All 6 patients requiring Pyeloplasty were diagnosed as having ureteropelvic junction obstruction in the diuretic renal scan. In these 6 patients, post-operative renal scans at 3-12 months after surgery were converted to nonobstructive pattern in 5 and a nonfunctioning pattern in 1. In 3 patients who underwent diuretic renal scan within 1 week after birth, nonobstructive patterns of initial scan were converted to obstructive patterns in the follow-up scan. However, all patients with nonobstructive diuretic renal scans performed after the neonatal period did well on serial ultrasonography and showed favorable clinical outcome without progression to obstruction. Conclusion: Tc-99m DTPA diuretic renal scan with standardized protocol is useful in assessing suspected ureteropelvic junction obstruction in children as an initial diagnostic or post-operative follow-up modality. Nonobstructive or indeterminate scan results in the neonatal period requires follow-up scan to monitor development of the obstructive pattern.

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A Case Study on Teaching Mathematics U nderachievers Using the Textbooks of the Previous Grades (이전 학년의 교과서를 활용한 수학 학습 부진아 지도에 관한 사례 연구)

  • Choi, Jung-Hyun;Kim, Sang-Lyong
    • Education of Primary School Mathematics
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    • v.14 no.1
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    • pp.81-95
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    • 2011
  • In order to raise people with mathematical power and positive attitude toward mathematics fit for the 21st century, individual students should be provided with equal learning opportunities according to their ability and level, and the need of such mathematics education is even stronger for underachievers. As textbooks were considered the optimal learning materials at each stage, this study purposed to examine changes in students' mathematical learning abilities and mathematical tendency brought by the activities of analyzing and reviewing the textbooks of the previous grades. The subjects of this study were 5 mathematics underachievers from 3 fifth grade classes at D Elementary School. They were sampled from those who were selected based on the results of diagnostic assessment and the records at the end of April and gave their consent to participation in this study. For the sampled children, their current state was surveyed first, and then the experimental classes were given twice a week and a total of 32 sessions. The children judged their mathematical abilities through reviewing the textbooks from the 1st grade to the 4th grade, and studied the textbook of each stage by themselves. After the self study, they had the textbook contents review activity that extracted 10 problems considered important per semester, and the textbook analysis activity that grouped units in each stage according to relevancy, identified similarities and differences, and examined hierarchy. From the results of this study was found that the mathematics underachiever teaching method using the textbooks of the previous grades gives mathematics underachievers confidence in their abilities, strengthens mathematical connection, and develops the habits of exploring key contents through self study.

Differentiation of Vocal Cyst and Polyp by High-Piched Phonation Characteristics (성대낭종과 성대폴립 간의 고음발성 양상의 차이)

  • Lee, Jong-Ik;Jeong, Go-Eun;Kim, Seong-Tae;Kim, Sang-Yeon;Nam, Soon-Yuhl;Kim, Sang-Yoon;Roh, Jong-Lyel;Choi, Seung-Ho
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.23 no.1
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    • pp.48-51
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    • 2012
  • Background and Objectives : Vocal fold cyst is generally treated by surgical resection, it has a difference with vocal fold polyp, treated by conservative management first. Decrease in mucosal waves is known as main diagnostic criteria of vocal fold cyst. Sometimes there is a difficulty for diffrential diagnosis between cyst and polyp only by endoscopic examination. The purpose of the study is to identify the objective features of vocal cyst and polyp on the basis of voice analysis for the proper differential diagnosis, especially at high pitched phonation. Materials and Method : The voice analysis was done in 15 focal fold cyst patients and 42 vocal fold polyp. Parameters of perceptual assessment, acoustic and aerodynamic measure, and voice range profile were compared between two groups. Results : Vocal fold cyst patients showed significantly reduced MPT by acoustic and aerodynamic analysis, narrowed frequency-range and low maximun frequency by voice range profile analysis compared with vocal fold polyp patient. Maximun frequency 381 Hz is established for cut off value, differential diagnosis between cyst and polyp (ROC analysis, sensitivity 60%, specificity 68%). Conclusion : Voice analysis is helpful for differential diagnosis between vocal fold cyst and polyp, especially there is a difficulty for distinguish cyst from polyp at clinical situation by endoscopic examination. The result of decreased maximum frequncy at vocal fold cyst supports incomplete high-pitched phonation and falsetto regester at vocal fold cyst patients due to decreased mucosal wave, compared with vocal fold polyp patients.

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Review of Recent Clinical Trials for Depression in Traditional Chinese Medicine-Based on Randomized Controlled Trials and Systematic Reviews- (우울증 치료의 중의학 최신 임상연구 동향-무작위 대조군 임상연구와 체계적 문헌 고찰을 중심으로-)

  • Woo, Jeong A;Nam, Yu Jin;Park, Yoon Jin;Kwon, Young Kyu
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.29 no.6
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    • pp.458-466
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    • 2015
  • The purpose of this study was to review the research on treating depression in Traditional Chinese Medicine(TCM) over the last 5 years to set the foundation for further studies. We searched for and analyzed articles about depression in CNKI(China National Knowledge Infrastructure) from January 2010 to December 2014. The results were as follows : The most frequently used diagnostic criteria was CCMD-3(The Chinese Classification of Mental Disorders-3), and the most used evaluation criteria was HAMD(Hamilton Depression Rating Scale). Prescription of decoction of medical herbs was most frequently used as a therapeutic method. Acupuncture, traditional Chinese psychotherapy, and music therapy were also used for some studies. The most frequent TCM Syndrome Differentiation Type was stagnation of liver-QI. For decoction of Chinese herbs, Soyo-san(Xiaoyao-san) and Sihosogan-san(Chaihushugan-san) were most often prescribed, and Bupleuri Radix, Paeoniae Radix Alba, Curcumae Radix, Poria cocos wolf, Angelicae Gigantis Radix, Atractylodis Rhizoma Alba were mainly used for medical herbs. BaekHoi(GV20) and Yindang(Ex-HN3) were often used as acupuncture sites. Post-Stroke Depression was the most common case of intercurrent or secondary depression. According to the Jadad Quality Assessment Scale, the quality of the reports was not high as most of the reports had a score of 3 or below. Most systematic reviews on depression were conducted by Chinese researchers. The problem with Clinical research on depression, according to those reviews, was that there were no standardized criteria for the diagnosis and treatment and the trials were usually not randomized nor controlled. We found out there are various clinical methods for treating depression in TCM, and hope that this research could provide the preliminary data for designing and conducting clinical trials for depression.

Exclusive correlation analysis for algae and environmental factors in weirs of four major rivers in South Korea (4대강 주요지점에서의 조류 발생인자의 배타적 상관성분석에 대한 연구)

  • Lee, Eun Hyung;Kim, Yeonhwa;Kim, Kyunghyun;Kim, Sanghyun
    • Journal of Korea Water Resources Association
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    • v.49 no.2
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    • pp.155-164
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    • 2016
  • Algal blooms not only destroy fish habitats but also diminish biological diversity of ecosystem which results into water quality deterioration of 4 major rivers in South Korea. The relationship between algal bloom and environmental factors had been analyzed through the cross-correlation function between concentration of chlorophyll a and other environmental factors. However, time series of cross-correlations can be affected by the stochastic structure such auto-correlated feature of other controllers. In order to remove external effect in the correlation analysis, the pre-whitening procedure was implemented into the cross correlation analysis. The modeling process is consisted of a series of procedure (e.g., model identification, parameter estimation, and diagnostic checking of selected models). This study provides the exclusive correlation relationship between algae concentration and other environmental factors. The difference between the conventional correlation using raw data and that of pre-whitened series was discussed. The process implemented in this paper is useful not only to identify exclusive environmental variables to model Chl-a concentration but also in further extensive application to configure causality in the environment.

Epidemiology Study of Patients with Neuropathic Pain in Korea (한국의 신경병성 동통 환자에 대한 역학조사)

  • Won, Jung-Yeon;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.33 no.4
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    • pp.353-374
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    • 2008
  • The descriptive epidemiology of specific neuropathic pain disorders has not been well-des-cribed, although the burden of neuropathic pain is well recognized. The true incidence of neuro-pathic pain disorder is unknown, but it is believed to be under diagnosed and treated inade-quately, despite the development of various diagnostic system. The purpose of this study was to report the epidemiology of specific neuropathic pain as managed by all kinds of hospital in Korea. A descriptive analysis of the epidemiology of prevalent trigeminal neuralgia(TN)(n-=77,053 27,6%), atypical facial pain(AFP)(n=12,382 4.4%), glossopharyngeal neuralgia(GN)-(n=1,319 0.5%), post-herpetic neuralgia(PHN)-(n=84,598 30.3%), diabetic neuropathy(DN)-(n=85,989 30.8%), atypical odontalgia(AO)-(n=16,001 5.7%) and glossodynia(GD)(n=2,133 0.8%) and treatment departments and treatment durations from computerized Health Insurance Review and Assessment Service(HIRA) of Korea: January 2003 to December 2005, are reported with rates increasing over time for PHN and DN and decreasing for the other neuropathic pain disorders. Most patients were treated at private clinic record for 57.6-72.8% of patients except OA for 10.3%. The percentage of Dept of dentistry for outpatients was 3.2% for TN, 34.7% for AO and 15.4% for GD. Other neuropathic pain patients visited nearly medical clinic.

ACCURACY OF PREOPERATIVE ASSESSMENTS FOR CERVICAL LYMPH NODE METASTASIS IN ORAL CANCER (구강암 경부임파절 전이에 대한 술전 평가의 정확성)

  • Lee, Jae-Jun;Nam, Woong;Cha, In-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.2
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    • pp.151-156
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    • 2006
  • Purpose : The aim of this study was to determine the accuracy of clinical and radiologic assessments in detecting positive cervical lymph nodes in oral cancer. Materials and Methods : We had reviewed the preoperative clinical, radiologic and postoperative histopathologic reports of 46 patients who had been diagnosed as oral cancer and underwent surgical excision combined with neck dissection (52 sides of neck) in the Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University from the July 1, 1992 to the April 30, 1999. Results : The results were as follows 1. The male to female ratio was 4.38 : 1 and the mean age was 57. 2. Sensitivity values for the preoperative assessment of cervical lymph node metastasis in oral cancer were 62.5 % in clinical examination and 50.0 % in radiologic assessments. Specificity values were 77.8 % in clinical examination and 94.4 % in radiologic assessments. 3. False positive values were 44.4 % in clinical examination and 20.0 % in radiologic assessments. False negative values were 17.6 % in clinical and 19.0% in radiologic assessments. 4. Overall efficiency values were 73.1 % in clinical examination and 80.8 % in radiologic assessments. Summary : There were some limits on the accuracy of clinical and radiologic assessments in the preoperative detection of the cervical lymph nodes in oral cancer. To improve the accuracy, it is important to communicate between clinician and radiologist, and adjunctive diagnostic measures, ultrasound and fine needle aspiration cytology, were helpful increasing the overall efficiency. In the high risk sites (oral tongue and floor of the mouth) the false negative value is higher and the overall efficiency in radiologic evaluation is lower than those of the low risk sites (gingiva and alveolar ridge, retromolar trigone and buccal mucosa ). The elective neck dissection should be considered in the high risk sites.