• 제목/요약/키워드: Evidence based diagnosis

검색결과 227건 처리시간 0.026초

Clinical Practice Guidelines for Gastric Cancer in Korea: An Evidence-Based Approach

  • Lee, Jun Haeng;Kim, Jae G.;Jung, Hye-Kyung;Kim, Jung Hoon;Jeong, Woo Kyoung;Jeon, Tae Joo;Kim, Joon Mee;Kim, Young Il;Ryu, Keun Won;Kong, Seong-Ho;Kim, Hyoung-Il;Jung, Hwoon-Yong;Kim, Yong Sik;Zang, Dae Young;Cho, Jae Yong;Park, Joon Oh;Lim, Do Hoon;Jung, Eun Sun;Ahn, Hyeong Sik;Kim, Hyun Jung
    • Journal of Gastric Cancer
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    • 제14권2호
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    • pp.87-104
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    • 2014
  • Although gastric cancer is quite common in Korea, the treatment outcome is relatively favorable compared to those in western countries. However, there are currently no Korean multidisciplinary guidelines for gastric cancer. Experts from related societies developed guidelines de novo to meet Korean circumstances and requirements, including 23 recommendation statements for diagnosis (n=9) and treatment (n=14) based on relevant key questions. The quality of the evidence was rated according to the GRADE evidence evaluation framework: the evidence levels were based on a systematic review of the literature, and the recommendation grades were classified as either strong or weak. The applicability of the guidelines was considered to meet patients' view and preferences in the context of Korea. The topics of the guidelines cover diagnostic modalities (endoscopy, endoscopic ultrasound, and radiologic diagnosis), treatment modalities (surgery, therapeutic endoscopy, chemotherapy, and radiotherapy), and pathologic evaluation. An external review of the guidelines was conducted during the finalization phase.

Dry Socket Etiology, Diagnosis, and Clinical Treatment Techniques

  • Mamoun, John
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제44권2호
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    • pp.52-58
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    • 2018
  • Dry socket, also termed fibrinolytic osteitis or alveolar osteitis, is a complication of tooth exodontia. A dry socket lesion is a post-extraction socket that exhibits exposed bone that is not covered by a blood clot or healing epithelium and exists inside or around the perimeter of the socket or alveolus for days after the extraction procedure. This article describes dry socket lesions; reviews the basic clinical techniques of treating different manifestations of dry socket lesions; and shows how microscope level loupe magnification of $6{\times}$ to $8{\times}$ or greater, combined with co-axial illumination or a dental operating microscope, facilitate more precise treatment of dry socket lesions. The author examines the scientific validity of the proposed causes of dry socket lesions (such as bacteria, inflammation, fibrinolysis, or traumatic extractions) and the scientific validity of different terminologies used to describe dry socket lesions. This article also presents an alternative model of what causes dry socket lesions, based on evidence from dental literature. Although the clinical techniques for treating dry socket lesions seem empirically correct, more evidence is required to determine the causes of dry socket lesions.

한열 변증 설문지 개발에 관한 연구 (Study on Development of Cold-Heat Pattern Questionnaire)

  • 유현희;이혜정;장은수;최선미;이성근;이시우
    • 동의생리병리학회지
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    • 제22권6호
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    • pp.1410-1415
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    • 2008
  • Acupuncture and herbal treatment are based on diagnosis of cold and heat pattern in Traditional Korean Medicine. This diagnosis is accomplished through pulse, tongue and question examination, which are not objective. Quantification and objectification of this diagnosis process are required for efficacious treatment and traditional medicine development. In this study, we developed the cold-heat pattern questionnaire for this purpose. Seventy nine patients who visited oriental medical hospital were included in this study. The cold-heat pattern questionnaire was composed of many questions about patient's physical condition, which were derived from The Traditional Oriental Medical Literature with Delphi Technique. Patients filled out the cold-heat pattern questionnaire by themselves. Diagnosis of cold and heat pattern are conducted separately by oriental medical doctors with more than 5 years' clinical experience. Various physical condition factors were derived for the cold-heat pattern questionnaire. (Preference temperature, Body temperature, Pain type, Face color, Urine, Stool and secretion features) Each cold and heat symptoms group acquired internal consistency. (Cronbach's ${\alpha}$ : Cold - 0.605, Heat - 0.722) There were significant associations between doctor's diagnosis and cold symptoms in 'Aversion to cold', 'Desire for heat', 'Pale face', 'Loose stools'. (p-value < 0.05) There were significant associations between doctor's diagnosis and heat symptoms in 'Desire for cold', 'Body feverishness', 'Thirst'. (p-value < 0.05) The internal consistency results suggest that the cold-heat pattern questionnaire assured reliability. Besides, these results showed that cold-heat symptoms are apt to appear together with, and this can be indirect evidence that diagnosis of cold-heat pattern is valuable for comprehension about disease pattern. Moreover, respective symptoms of cold-heat pattern showed different significance with doctor's diagnosis. Consequently these significant symptoms can be more considered for comprehension of cold-heat pattern.

『소문(素問)·맥요정미론(脈要精微論)』의 촌구(寸口) 육부정위(六部定位)에 대한 고찰 (A Study on the Wrist Pulse Six Positions Correlation in the Maiyaojingweilun Chapter of the Huangdineijing)

  • 張祐彰;南杰
    • 대한한의학원전학회지
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    • 제34권3호
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    • pp.101-123
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    • 2021
  • Objectives : To examine the six positions correlation[六部定位] principle that is the basis of the wrist pulse diagnosis in the Neijing. Methods : The basis for argument was established by correcting an interpretation error of the theory of chi (尺) skin diagnosis. In order to accomplish this, the annotations of Yang Shangshan and Wangbing were investigated first, after which the specific meaning and methodology of the chi diagnostic method as written in many chapters of the Neijing were examined. The evidence and reasoning for the six positions correlation[六部定位] was looked into, in relation to Wangbing's annotation of the chapter, Maiyaojingweilun. The theoretical basis of the six positions correlation was searched throughout the entire Neijing, based on the correlation between Liuhe and the six positions, the five elements inter-supporting theory embedded in the six positions correlation as a diagnosis model that integrates zhangfu and meridians/channels, and the meaning of the spacial concepts used when describing the tactile technique within the chapter. Lastly, contents related to the five zhang channels within the Neijing were reviewed, to determine whether the six positions correlation was applied in wrist pulse taking Results & Conclusions : Some interpretations of the verse on matching the positions in the Maiyaojingweilun chapter of the Neijing are erroneous, while the argument that the three positions[cun-guan-chi] cannot be found in the Neijing is false as well. The wrist pulse taking in the Neijing is precisely based on the three positions correlation that divides the cun-guan-chi positions into three, and the correlation verse in the Maiyaojingweilun chapter clearly suggests the principle of matching the zhangfu and meridian/channels to the six positions of the cun-guan-chi of both left and right.

요통의 진단과 치료 (Diagnosis and Management of Low Back Pain)

  • 장재홍;김병조
    • Annals of Clinical Neurophysiology
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    • 제14권1호
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    • pp.1-6
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    • 2012
  • Low back pain is a common clinical condition with heterogeneous causes and challenges to manage. High prevalence and numerous assessments result in an enormous socioeconomic burden. Clinician must conduct efficient and stepwise evaluation process to rule out serious spinal pathology, neurologic involvement, and identify risk factors for chronicity. The process can be achieved through the focused history taking and physical examination. Certain factors related to serious spinal pathology include age (>50 years), trauma, unexplained fever, recent urinary or skin infection, unrelenting night or rest pain, unexplained weight loss, osteoporosis, immunosuppression, steroid use, and widespread neurological symptoms. In non-specific low back pain, diagnostic imaging and laboratory studies are often unnecessary and can disturb an appropriate management. For the management of acute low back pain, patient education and medication such as acetaminophen, non-steroidal anti-inflammatory drugs, and muscle relaxants are recommended. For chronic low back pain, behavior therapy, back exercise, and spinal manipulation are beneficial. The evidence based approach could improve success rate of management, result in prevention of acute low back pain from being chronic intractable pain.

Non-Dura Based Intaspinal Clear Cell Meningioma

  • Ko, Jun-Kyeung;Choi, Byung-Kwan;Cho, Won-Ho;Choi, Chang-Hwa
    • Journal of Korean Neurosurgical Society
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    • 제49권1호
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    • pp.71-74
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    • 2011
  • A 34-year-old female patient was presented with leg and hip pain for 6 months as well as voiding difficulty for 1 year. Magnetic resonance imaging revealed a well-demarcated mass lesion at L2-3. The mass was hypo-intense on T1- and T2-weighted images with homogeneous gadolinium enhancement. Surgery was performed with the presumptive diagnosis of intradural extramedullary meningioma. Complete tumor removal was possible due to lack of dural adhesion of the tumor. Histologic diagnosis was clear cell meningioma, a rare and newly included World Health Organization classification of meningioma usually affecting younger patients. During postoperative 2 years, the patient has shown no evidence of recurrence. We report a rare case of cauda equina clear cell meningioma without any dural attachment.

Fractal behavior identification for monitoring data of dam safety

  • Su, Huaizhi;Wen, Zhiping;Wang, Feng
    • Structural Engineering and Mechanics
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    • 제57권3호
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    • pp.529-541
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    • 2016
  • Under the interaction between dam body, dam foundation and external environment, the dam structural behavior presents the time-varying nonlinear characteristics. According to the prototypical observations, the correct identification on above nonlinear characteristics is very important for dam safety control. It is difficult to implement the description, analysis and diagnosis for dam structural behavior by use of any linear method. Based on the rescaled range analysis approach, the algorithm is proposed to identify and extract the fractal feature on observed dam structural behavior. The displacement behavior of one actual dam is taken as an example. The fractal long-range correlation for observed displacement behavior is analyzed and revealed. The feasibility and validity of the proposed method is verified. It is indicated that the mechanism evidence can be provided for the prediction and diagnosis of dam structural behavior by using the fractal identification method. The proposed approach has a high potential for other similar applications.

Myofascial Orofacial Pain Exacerbated after Masseteric Nerve Neurectomy

  • Nam, Hyun;Ko, Daeun;Kang, Jin-Kyu;Shim, YoungJoo
    • Journal of Oral Medicine and Pain
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    • 제45권4호
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    • pp.110-114
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    • 2020
  • Myofascial pain (MFP) is one of the most common causes of persistent orofacial pain. Patients with chronic myofascial orofacial pain may present with diffuse heterotopic pain, complicating the correct diagnosis. Treatment of chronic MFP should focus on the elimination of aetiologic factors. This article describes two cases of chronic MFP of the masticatory muscles, whose symptoms were exacerbated after masseteric nerve neurectomy. The patients had suffered from irrelevant treatment which did not resolve the symptom. Their symptom was managed by conventional treatment protocol. These cases emphasize the importance of correct diagnosis and evidence-based approach.

Comparative Analysis of American Academy of Pediatrics and European Society of Hypertension Guidelines for the Diagnosis and Treatment of Pediatric Hypertension

  • Park, Se Jin;Shin, Jae Il
    • Childhood Kidney Diseases
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    • 제25권2호
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    • pp.71-77
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    • 2021
  • Childhood hypertension (HTN) has become a significant public health issue because of the increased risk of cardiovascular disease in adulthood. However, childhood HTN is underrecognized and underdiagnosed in clinical practice. The European Society of Hypertension in 2016 and the American Academy of Pediatrics (AAP) in 2017 published updated guidelines for the screening, prevention, and management of pediatric HTN. There were notable differences between the two guidelines as well as many similarities. The updated AAP guidelines have clarified and simplified the recommendations for screening, diagnosis, and treatment of childhood HTN based on current evidence. This review highlights the important developments in both guidelines, focusing on recent advances in the classification and treatment of childhood HTN.