• 제목/요약/키워드: Guidance in diagnosis and treatment

검색결과 68건 처리시간 0.027초

CT/MRI 간영상 판독과 자료체계: 표준화, 근거 및 발전방향 (CT/MRI Liver Imaging Reporting and Data System (LI-RADS): Standardization, Evidence, and Future Direction)

  • 김연윤;최진영
    • 대한영상의학회지
    • /
    • 제84권1호
    • /
    • pp.15-33
    • /
    • 2023
  • 간영상 보고 및 자료체계(liver imaging reporting and data system; 이하 LI-RADS)는 간세포암종 고위험군에서 간세포암종의 진단과 치료반응평가 등을 표준화하기 위해 미국영상의 학회의 후원을 받아 개발되었다. CT/MRI LI-RADS는 2018년 버전이 가장 최근에 개정된 것인데, 미국간학회 가이드라인에 간세포암종 진단기준으로서 통합되었다. 이 종설에서는 CT/MRI LI-RADS가 간영상의 표준화된 보고에 미친 영향을 살펴보고, CT/MRI LI-RADS를 이용한 간세포암종 진단과 국소치료 후의 치료반응평가에 있어 현시점에서 축적된 근거 및 다른 간세포암종 진단가이드라인들과의 비교 결과를 살펴볼 것이며, 추후 발전방향에 대해 기술하고자 한다.

보철물 제작 후 부정확한 발음을 가진 환자에서 체계적인 진단 및 치료과정을 통한 보철 수복 증례 (Prosthetic restoration of the patient with inaccurate pronunciation after prosthesis fabrication through systematic diagnosis and treatment procedure: A case report)

  • 최유성;이성민
    • 대한치과보철학회지
    • /
    • 제54권4호
    • /
    • pp.413-422
    • /
    • 2016
  • 최근 들어 치아의 심미적 개선을 위해 전치부 심미 보철물을 제작하는 치료를 진행하는 경우가 있는데, 이 때 심미적인 요소에 치중하여 생물학적, 기계적 요소를 간과하기 쉽다. 이로 인해 중립대 공간 및 치열에 변화가 발생하고, 혀와 구순의 위치가 변화하고, 교합 및 전방유도 변화로 인해 부정확한 발음문제가 유발될 수 있어 이에 대한 체계적인 진단 및 치료과정에 대한 고려가 필요하다고 사료된다. 본 증례에서는 10년 전 제작한 고정성 보철물로 인해 부정확한 발음 및 비심미성으로 불편감을 호소하는 환자에서 음향학적 분석, 심미적 분석, 교합, 중립대 라는 4가지 요소를 이용하여 체계적인 진단 및 치료과정을 통하여 보철물을 재수복하였고, 이에 기능적, 심미적 회복을 도모하여 환자와 술자 모두에게 만족스러운 결과를 얻었기에 보고하는 바이다.

'윤락여성의 성병감염에 관한 조사' -영등포 및 성북지역을 중심으로- (A Survey on Prevalence of S.T.D for Prostitutes in Seoul District - About Young Dung Po and Sung Buk Areas-)

  • 유병태;박상현
    • 환경위생공학
    • /
    • 제2권2호
    • /
    • pp.49-60
    • /
    • 1987
  • The incidence of Sexually Transmitted Disease has risen despite the progress in its diagnosis and treatment methods. For the effective control programs of S.T.D it should be required medical and social approaches. This survey was conducted in Young Dung Po and Sung Buk areas from June, 1986 to September, 1986. The 1185 prostitutes were studies in order to determine the prevalences of sexually transmitted disease. The results were as follows: 1. The average age of prostitutes was $24.0\pm3.9$ years. The age group of 21-25 years old was the highest level of about $70.3\%$. 2. The positive rate on non Gonococcal urethites was $9.1\%$ at Sung Buk area and $15.3\%$ at Young Dung Po area. 3. The positive rate of Neisseria Gonorrhoeae on culture of TM media was $6.4\%$ or total level and incidence ratio of Neisseria Gonorrhoeae: Non Gonococcal urethritis was 1: 1.7. 4. The positive rate of PPNG was occupied about $26.3\%$ among the total NG positive case. 5. The positive rate of VDRL Slide Test was $2.9\%$, and antibody Titer level of 1:2 was $38.8\%$. it was the highest of all Titer distribution.

  • PDF

수상 후 천측두동맥에 발생한 가성동맥류의 치료 2례 (Traumatic Pseudoaneurysm of the Superficial Temporal Artery: Two Cases Report)

  • 김연환;황원중;송순영
    • Archives of Plastic Surgery
    • /
    • 제34권1호
    • /
    • pp.115-118
    • /
    • 2007
  • Purpose: It is even less common traumatic pseudoaneurysm of the superficial temporal artery and rare with fewer than 200 cases reported in the recent literature. Most common causes of traumatic pseudoaneurysm is sequelae of blunt, penetrating, or iatrogenic surgical trauma. The diagnosis is based on physical findings and can be confirmed by duplex ultrasonogram, computed tomography, and angiography. Surgical resection, percutaneous embolization and conservative treatment have all been used to treat pseudoaneurysm. However recently, non invasive technique like percutaneous thrombin injection under ultrasonographic guidance has been done rather than surgical ligation. In this report, we proposed the several treatment options such as conservative treatment, thrombin injection, and surgical ligation according to the multifarous conditions of pseudoaneurysm, patient, and causes. Methods: We describe two cases of traumatic pseudoaneurysm of superficial temporal artery in which CT angiography was effective in diagnosis and characterization. One is chronic pseudoaneurysm after traffic accident, which is fusiform shape and small size. Since the patient prefered it, we proposed percutaneous thrombin injection first. But we recognize that this method failed, we used surgical ligation according to information of CT angiographic findings. The other is acute pseudoaneurysm after blunt trauma, which is large size accompanying large hematoma. So we proposed compressive dressing and aspiration of hematoma. Results: Two cases were well treated with no recurrence or complication. Conclusion: In conclusion, when selecting a treatment options, followings should be considered: pseudoaneurysm in CT angiography, chronicity, cause, and patient's preference.

Transventricular Biopsy of Brain Tumor without Hydrocephalus Using Neuroendoscopy with Navigation

  • Song, Ji-Hye;Kong, Doo-Sik;Seol, Ho-Jun;Shin, Hyung-Jin
    • Journal of Korean Neurosurgical Society
    • /
    • 제47권6호
    • /
    • pp.415-419
    • /
    • 2010
  • Objective : It is usually difficult to perform the neuroendoscopic procedure in patients without hydrocephalus due to difficulties with ventricular cannulation. The purpose of this study was to find out the value of navigation guided neuroendoscopic biopsy in patients with peri- or intraventricular tumors without hydrocephalus. Methods : Six patients with brain tumors without hydrocephalus underwent navigation-guided neuroendoscopic biopsy. The procedure was indicated for verification of the histological diagnosis of the neoplasm, which was planned to be treated by chemotherapy and/or radiotherapy as the first line treatment, or establishment of the pathological diagnosis for further choice of the most appropriate treatment strategy. Results : Under the guidance of navigation, targeted lesion was successfully approached in all patients. Navigational tracking was especially helpful in entering small ventricles and in approaching the third ventricle through narrow foramen Monro. The histopathologic diagnosis was established in all of 6 patients : 2 germinomas, 2 astrocytomas, 1 dysembryoplastic neuroepithelial tumor and 1 pineocytoma. The tumor biopsy sites were pineal gland (n = 2), suprasellar area (n = 2), subcallosal area (n = 1) and thalamus (n = 1). There were no operative complications related to the endoscopic procedure. Conclusion : Endoscopic biopsy or resection of peri- or intraventricular tumors in patients without hydrocephalus is feasible. Image-guided neuroendoscopic procedure improved the accuracy of the endoscopic approach and minimized brain trauma. The absence of ventriculomegaly in patients with brain tumor may not be served as a contraindication to endoscopic tumor biopsy.

유착된 유구치와 후속 영구 소구치의 맹출 유도 : 증례보고 (Ankylosed Primary Molar and Eruption Guidance of Succeeded Permanent Premolar : Case Reports)

  • 장하영;오소희
    • 대한소아치과학회지
    • /
    • 제44권1호
    • /
    • pp.99-107
    • /
    • 2017
  • 유착된 유구치의 치료에 있어 조기 진단이 매우 중요하다. 유착으로 인하여 발생된 저위교합을 방치하는 경우 교합적인 문제가 생길 수 있으므로 정기검진을 통한 진단과 이에 따른 적절한 치료가 필요하다. 저위교합 된 유구치의 치료 방법으로 정기검진, 보존적 접근, 보철적 수복, 발치를 수반한 공간획득 등이 있다. 본 증례에서는 상악 제2유구치의 유착으로 인하여 제2소구치 치배의 변위를 보이는 두 명의 환아를 대상으로 이환치의 발거를 먼저 시행하고 고정성 혹은 가철성 교정장치를 이용하여 공간확장술을 함으로써 변위 되었던 제2소구치 치배의 정상 맹출을 유도하였으며 장기간에 걸쳐 부작용이 없었음을 보고하는 바이다.

악관절진동의 임상적 관련요인에 관한 연구 (A Study on the Clinical Factors Related to Vibration of Temporomandibular Joint)

  • 김종영;남천우;한경수
    • Journal of Oral Medicine and Pain
    • /
    • 제24권1호
    • /
    • pp.37-47
    • /
    • 1999
  • This study was performed to investigate the factors related to vibration of temporomandibular joint during mandibular opening movement. For this study, 144 patients with temporomandibular disorders were randomly selected. Angle's classification, lateral guidance pattern, range of maximal mouth opening, preferred chewing side, and affected side were investigated clinically. Mandibular torque rotational movement during opening was recorded with $BioEGN^{(R)}$ and vibration of temporomandibular joint during opening was recorded with $Sonopak^{(R)}$. After clinical diagnosis was made, visual analogue scale(VAS) was used for evaluation of clinical progress of the subject's chief complaints. The author calculated VAS treatment index(VAS Ti) from the record of VAS. The more VAS Ti was, the less remission of subjective symptom was, The data were analyzed with SAS/Stat program and the results of this study were as follows: 1. There were no significant difference in all the variables of joint vibration by age and sex. 2. Integral and peak amplitude in patients of Angle's class I were higher than those of class II or III patients. Integral in patients of group function was higher than that in patients of canine guidance or other types of lateral excursion. 3. As to Angle's classification or lateral guidance type, there were almost not significant difference between subgroup of same class or type and subgroup of different class or type on both sides. And there were also almost not difference between one side and the other side related to preferred chewing side or affected side. 4. Patients with disk displacement with reduction showed higher value of integral and peak amplitude than any other patients. 5. Joint vibration variables significantly correlated with VAS Ti of pain. with clinical range of mouth opening, and with ingredients of mandibular torque rotational movement.

  • PDF

비행청소년 인성치료를 위한 독서요법 (Bibliotherapy for human nature therapy of the juvenile delinquent)

  • 변우열
    • 한국도서관정보학회지
    • /
    • 제26권
    • /
    • pp.131-168
    • /
    • 1997
  • The future of a country is influenced by the youth. Sound fostering of the youth is important for the country's future. Because of mechanization, industrialization and urbanization of our society, many social problems, such as confusion of the sense of value, dehumanization, money worshi n.0, ppings, juvenile delinquency are increasing. For the solution of problems of juvenile crime and dehumanization, bibliotherapy should be practiced in juvenile reformatories, schools and societies. The purpose of this study is to investigate the effectiveness and value of reading. And also the characteristics, brief history, principles and procedures of bibliotherapy are examined. In addition, the book catalog suitable for bibliotherapy is considered. The results of the study are as follows. (1) In order to solve the problem of dehumanization, and the confusion of the sense of value among young adults, we should enrich and cultivate the characters of young adults through the bibliotherapy. So, bibliotherapy for the treatment of human nature of juveniles should be practiced in the juvenile reformatories, schools and societies. (2) The values of reading in the past were inspiration, information and recreation. But, in recent times, the interest in therapeutic value of reading is increasing. (3) Bibliotherapy is a kind of psychotherapy using selected reading materials. A n.0, pplication scopes of bibliotherapy are very wides, including mental medicine, alcoholic poisoning, drug addiction, juvenile delinquency, counselling and education for school life, etc. (4) The principles of bibliotherapy consist of identification, catharsis, insight and it has self therapeutic principles through the reading. The procedures of bibliotherapy is similar to any other kind of psychotherapy: the participant's statement, diagnosis, treatment, continuous recognition of remedial value. (5) The well suited reading materials for bibliotherapy are literature and biography. Literature and biography are familiar to everyone, because they describe the mentalities, emotions and life styles of human beings. (6) The standard reading lists for bibliotherapy for the proper guidance of juvenile delinquency should be prepared for the solution of developmental tasks, such as, drinking, smoking, friendship, family, love, money, marriage, pregnancy, violence, etc. Finally, Bibliotherapy should be introduced to our school settings and corrections institutions for the proper guidance and prevention of the malpractice of the youths. In addition, we should be endeavor to develop the standard reading lists for bibliotherapy and case study.

  • PDF

$\ll$황제내경(黄帝内经)$\gg$ 혈맥이론탐토(血脉论探讨) (Research on The Theory of Blood Vessels in "Hwangjenaegyeong(黃帝內經)")

  • 국보조;김효철
    • 대한한의학원전학회지
    • /
    • 제22권4호
    • /
    • pp.217-220
    • /
    • 2009
  • In "Hwangjenaegyeong(黃帝內經)", the name of blood vessels is closely related to images of the river, and the word for blood vessel contains the following meaning, such as blood vessel, blood wind as well as blood stasis and so on. In a physiological perspective, the unobstructed blood vessel and normal operation blood are important symbols of health, for blood is the basis for human survival, physical activity and mental activity. In pathology, the external cold, excessive seven emotions and a biased diet can cause many kinds of abnormalities of the blood vessels, which can in turn become causes for a variety of diseases. The theory of blood vessels in "Hwangjenaegyeong" can provide guidance for diagnosis and treatment of cardiovascular diseases in practice.

  • PDF

Transbronchial Lung Cryobiopsy for Diagnosing Interstitial Lung Disease: A Retrospective Single-Center Experience

  • Park, Jin Han;Jang, Ji Hoon;Kim, Hyun Kuk;Jang, Hang-Jea;Lee, Sunggun;Kim, SeongHo;Kim, Ji Yeon;Choi, Hee Eun;Han, Ji-yeon;Kim, Da Som;Kang, Min Kyun;Kang, Eunsu;Kim, Il Hwan;Lee, Jae Ha
    • Tuberculosis and Respiratory Diseases
    • /
    • 제85권4호
    • /
    • pp.341-348
    • /
    • 2022
  • Background: An accurate diagnosis in patients with interstitial lung diseases (ILDs) by multidisciplinary discussion (MDD) based on histopathologic information is essential for optimal treatment. Transbronchial lung cryobiopsy (TBLC) has increasingly been used as a diagnostic alternative to surgical lung biopsy. This study aimed to evaluate the appropriate methods of TBLC in patients with ILD in Korea. Methods: A total of 27 patients who underwent TBLC were included. TBLC procedure details and clinical MDD diagnosis using TBLC histopathologic information were retrospectively analyzed. Results: All procedures were performed under general anesthesia with the fluoroscopic guidance in the operation room using flexible bronchoscopy and endobronchial balloon blocker. The median procedure duration was less than 30 minutes, and the median number of biopsies per participant was 2. Most of the bleeding after TBLC was not severe, and the rate of pneumothorax was 25.9%. The most common histopathologic pattern was alternative (48.2%), followed by indeterminate (33.3%) and usual interstitial pneumonia (UIP)/probable UIP (18.5%). In the MDD after TBLC, the most common diagnosis was idiopathic pulmonary fibrosis (33.3%), followed by smoking-related ILD (25.9%), nonspecific interstitial pneumonia (18.6%), unclassifiable-ILD (14.8%), and others (7.4%). Conclusion: This first single-center experience showed that TBLC using a flexible bronchoscopy and endobronchial balloon blocker with the fluoroscopic guidance under general anesthesia may be a safe and adequate diagnostic method for ILD patients in Korea. The diagnostic yield of MDD was 85.2%. Further studies are needed to evaluate the diagnostic yield and confidence of TBLC.