• 제목/요약/키워드: Disease diagnosis and treatment

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오진된 치성 피부 누공의 진단과 치료 (Diagnosis and Treatment of misdiagnosed odontogenic cutaneous sinus tract : a Case report)

  • 김성준;감세훈
    • 대한치과의사협회지
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    • 제52권6호
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    • pp.363-369
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    • 2014
  • The cutaneous sinus tract is an uncommon disease. It is difficult to diagnose exactly of odontogenic cutaneous sinus tract for dentists or dermatologists except experienced clinicians or previously known clinicians. Many patients may be treated with repeated surgical excisions, biopsies, and antibiotic medications, but most of them could be frustrated with the recurrence of disease. There are several methods for diagnosis of odontogenic cutaneous sinus tract - such as GP cone tracing, conventional computed tomography(CT), periapical x-ray imaging, and cone beam computed tomography(CBCT). This case report describes the diagnosis and treatment of odontogenic cutaneous sinus tract that referred from medical doctors.

소아 요로감염의 임상 지침 (Guidelines for childhood urinary tract infection)

  • 이승주
    • Clinical and Experimental Pediatrics
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    • 제52권9호
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    • pp.976-983
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    • 2009
  • Urinary tract infection (UTI), the most common bacterial disease in childhood, is frequently associated with urinary tract anomalies (15-50%) and can induce renal scarring, which is a cause of hypertension and chronic kidney disease. Despite the high risk of renal scarring in infancy, the diagnosis may be delayed due to its nonspecific presenting symptoms; moreover, over-diagnosis is frequent due to the contamination of urine samples. The delay in diagnosis and treatment may induce sepsis or renal scar, while over-diagnosis is responsible for unnecessary antibiotic treatment and costly urinary imaging studies. UTI guidelines have been ever-changing for the past three decades, but some controversial issues remain. This article is a revision of the previous KSPN (Korean Society of Pediatric Nephrology) guideline and addresses the recent controversies concerning childhood UTI.

인후두역류질환의 실험실 검사의 재평가 (Inquiry into the Laboratory Diagnostic Tests in Larygopharyngeal Reflux Disease)

  • 김한수
    • 대한후두음성언어의학회지
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    • 제18권2호
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    • pp.102-107
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    • 2007
  • Laryngopharyngeal reflux disease (LPRD) is the result of retrograde flow of gastric contents to the laryngopharynx. Laryngoscopic findings and special questionnaires are first step of diagnosis of LPRD. Empiric trials of Proton pump inhibitor' test (PPI test) is recommended as treatment and diagnosis. However confirmation of reflux is then recommended primarily in patients with persistent symptoms despite acid-suppressive therapy. The 24 hour ambulatory double pH monitoring has been a gold standard method in diagnosis of LPRD even though it has some limitation. The combined multichannel intraluminal impedance and pH monitoring is a new-rising test tool. It can detect acid/non-acid, liquid/gaseous reflux and clearance of refluxate. The water siphon test is also used for diagnosis of LPRD.

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가족성 고콜레스테롤혈증은 언제 의심해야 할까?: 관상동맥 질환이 없는 젊은 이상지질혈증 환자 증례 (When Should Familial Hypercholesterolemia Be Suspected?: A Case of Dyslipidemia in Young Patient without Coronary Artery Disease)

  • 유인선
    • 비만대사연구학술지
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    • 제2권1호
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    • pp.29-35
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    • 2023
  • Familial hypercholesterolemia (FH) is a genetic disease that is not well known or diagnosed in Korea. This disease is associated with persistently high levels of low-density lipoprotein cholesterol (LDL-C), which increase the risk of coronary artery disease at a young age. Therefore, early diagnosis and treatment are important; however, there are no global consensus diagnostic criteria. In Korea, the Dutch Lipid Clinic Network diagnostic criteria, and the Simon Broome diagnostic criteria were used for diagnosis of FH according to the agreement announced at the Korean Society of Lipid and Atherosclerosis (KSoLA) in 2022. Recently, the absence of coronary artery calcification has been considered a good prognostic factor, even among patients with very high LDL-C levels who are considered to be at high risk for atherosclerotic cardiovascular disease. We describe throughout this paper the diagnosis and treatment of FH in a young male without coronary artery calcification.

전신성 혈관염 환자의 족부 만성 창상의 치험례 (Treatment of Chronic Wound in a Patient with Systemic Vasculitis)

  • 임진수;김형준;주홍실;최윤석
    • Archives of Plastic Surgery
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    • 제33권1호
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    • pp.116-119
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    • 2006
  • Management of chronic wound has been a great problem to many surgeons because the wound is usually associated with an underlying disease of the patient. Without accurate diagnosis and treatment of the disease, the wound can not be healed. Systemic vasculitis is a rare systemic disease which causes inflammation and obstruction of the vessels. This autoimmune disease involves multiple organs and may inflict skin wound spontaneously without traumas. It would improve or aggravate the wound in proportion to the activities of the disease. Our experience is a case of 28-year-old female who has had chronic ulcers on her right foot, especially on the great toe for 1 year. Although she had several operations of sympathectomy, debridement and artificial dermal graft, her wound was not improved. She has been diagnosed as systemic vasculitis during the evaluation for histopathology and cause of fever and pancytopenia. After medical treatments, she had the operation of adipofascial turnover flap coverage and skin graft, and the wound was improved without any complication or relapse. The diagnosis and treatment of the underlying disease should be ahead of the management of chronic wound.

Survival of Patients with Stomach Cancer and its Determinants in Kurdistan

  • Moradi, Ghobad;Karimi, Kohsar;Esmailnasab, Nader;Roshani, Daem
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권7호
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    • pp.3243-3248
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    • 2016
  • Background: Stomach cancer is the fourth most common cancer and the second leading cause of death from cancer in the world. In Iran, this type of cancer has high rates of incidence and mortality. This study aimed to assess the survival rate of patients with stomach cancer and its determinants in Kurdistan, a province with one of the highest incidence rates of stomach cancer in the country. Materials and Methods: We studied a total of 202 patients with stomach cancer who were admitted to Tohid Hospital in Sanandaj from 2009 to 2013. Using Kaplan-Meier nonparametric methods the survival rate of patients was calculated in terms of different levels of age at diagnosis, gender, education, residential area, occupation, underweight, and clinical variables including tumor histology, site of tumor, disease stage, and type of treatment. In addition, we compared the survival rates using the log-rank test. Finally, Cox proportional hazards regression was applied using Stata 12 and R 3.1.0 software. The significance level was set at 0.05. Results: The mean age at diagnosis was $64.7{\pm}12.0$ years. The survival rate of patients with stomach cancer was 43.9% and 7% at the first and the fifth year after diagnosis, respectively. The results of log-rank test showed significant relationships between survival and age at diagnosis, education, disease stage, type of treatment, and degree of being underweight (P<0.05). Moreover, according to the results of Cox proportional hazards regression model, the variables of education, disease stage, and type of treatment were associated with patient survival (P<0.05). Conclusions: The survival rate of patients with stomach cancer is low and the prognosis is very poor. Given the poor prognosis of the patients, it is critical to find ways for early diagnosis and facilitating timely access to effective treatment methods.

메니에르 병 환자의 허실별(虛實別) 치험례 (Clinical Reports of the Meniere's Disease in the Diagnosis of Deficiency-Excess)

  • 장수영;신현철
    • 대한한방내과학회지
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    • 제32권1호
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    • pp.121-128
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    • 2011
  • Meniere's disease is an idiopathic syndrome of endolymphatic hydrops characterized by episodic vertigo, tinnitus, fluctuating hearing loss and ear fullness. The etiology and pathophysiology of the disease is still disputed. As yet, no treatment has conclusively modified the clinical course of the condition and thereby prevented the associated progressive hearing loss. We observed two cases of Meniere's disease treated with oriental herbal medication by the diagnosis of Deficiency-Excess. One patient had taken BangHyunOnDam-tang, and the other had taken ChungGanESa-tang. After treatment, vertigo attacks were controlled in both. Tinnitus and hearing loss were improved in one patient and unchanged in the other. Therefore, we believe that oriental herbal treatment may be a therapeutic modality that is effective in controlling Meniere's disease.

Alexander Disease

  • Kang, Ji Hae;Hong, Seung Jee;Kim, Doo-Kwun
    • Journal of Genetic Medicine
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    • 제10권2호
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    • pp.88-93
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    • 2013
  • Alexander disease (ALXD) is a rare demyelinating disease of the white matter of the brain that is caused by a mutation in the glial fibrillary acidic protein (GFAP) gene. The overexpression of GFAP in astrocytes induces a failure in the developmental growth of the myelin sheath. The neurodegenerative destruction of the myelin sheath of the white matter is accompanied by an accumulation of abnormal deposits of Rosenthal fibers in astrocytes, which is the hallmark of ALXD. The disease can be divided into four groups based on the onset age of the patients: neonatal, infantile, juvenile, or adult. Early-onset disease is more severe, progresses rapidly, and results in a shorter life span than late-onset cases. Magnetic resonance imaging and genetic tests are mostly used for diagnostic purposes. Pathological tests of brain tissue for Rosenthal fibers are definitive diagnostic methods. Therapeutic strategies are being investigated. Ceftriaxone, which is an enhancer of glial glutamate transporter (GLT-1) expression, is currently in clinical trials for the treatment of patients with ALXD. To date, there are no clinically available treatments. The cause, pathology, pathophysiology, inheritance, clinical features, diagnosis, and treatment of ALXD will be reviewed comprehensively.

Very Early-Onset Inflammatory Bowel Disease: A Challenging Field for Pediatric Gastroenterologists

  • Arai, Katsuhiro
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제23권5호
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    • pp.411-422
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    • 2020
  • With the increasing number of children with inflammatory bowel disease (IBD), very early-onset IBD (VEO-IBD), defined as IBD that is diagnosed or that develops before 6 years of age, has become a field of innovation among pediatric gastroenterologists. Advances in genetic testing have enabled the diagnosis of IBD caused by gene mutations, also known as monogenic or Mendelian disorder-associated IBD (MD-IBD), with approximately 60 causative genes reported to date. The diagnosis of VEO-IBD requires endoscopic and histological evaluations. However, satisfactory small bowel imaging studies may not be feasible in this small population. Both genetic and immunological approaches are necessary for the diagnosis of MD-IBD, which can differ among countries according to the available resources. As a result of the use of targeted gene panels covered by the national health insurance and the nationwide research project investigating inborn errors of immunity, an efficient approach for the diagnosis of MD-IBD has been developed in Japan. Proper management of VEO-IBD by pediatric gastroenterologists constitutes a challenge. Some MD-IBDs can be curable by allogenic hematopoietic stem cell transplantation. With an understanding of the affected gene functions, targeted therapies are being developed. Social and psychological support systems for both children and their families should also be provided to improve their quality of life. Multidisciplinary team care would contribute to early diagnosis, proper therapeutic interventions, and improved quality of life in patients and their families.

Change in the treatment strategy for pediatric Crohn's disease

  • Kim, Mi-Jin;Choe, Yon-Ho
    • Clinical and Experimental Pediatrics
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    • 제53권9호
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    • pp.830-833
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    • 2010
  • Crohn's disease is characterized by chronic inflammation involving any portion of the gastrointestinal tract. Treating Crohn's disease is a major challenge for clinicians, as no curative therapy currently exists. Pediatric Crohn's disease is characterized by frequent relapses, a wide extent of disease, a high prevalence of extraintestinal manifestations, and a severe clinical course. The classic therapeutic approach is known as the 'step-up' strategy, and follows a progressive course of treatment intensification as disease severity increases. Although this approach is usually effective for symptom control, many patients become either resistant to or dependent on corticosteroids. The efficacy of infliximab suggests that, rather than a progressive course of treatment, early intense induction may reduce complications associated with conventional treatment and improve quality of life. Intensive early therapy with infliximab is known as the 'top-down' strategy. Such therapy offers the potential for altering the natural history of Crohn's disease, and is changing treatment paradigms. However, the relatively new concept of an early aggressive or 'top-down' treatment approach is not yet widely accepted, especially in pediatric patients. The results of our current study demonstrate that early and intensive treatment of pediatric Crohn's disease patients with infliximab, at initial diagnosis, was more effective for maintaining remission and reducing flares.