• 제목/요약/키워드: Initial diagnosis

검색결과 1,041건 처리시간 0.028초

Features and Outcomes of Children with Ulcerative Colitis who Undergo a Diagnostic Change: A Single-Center Experience

  • Ito, Natsuki;Takeuchi, Ichiro;Kyodo, Reiko;Hirano, Yuri;Sato, Takuro;Usami, Masaaki;Shimizu, Hirotaka;Shimizu, Toshiaki;Arai, Katsuhiro
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제24권4호
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    • pp.357-365
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    • 2021
  • Purpose: A change in diagnosis from ulcerative colitis (UC) to Crohn's disease (CD) has been reported in pediatric inflammatory bowel disease; however, only a few clinical characteristics and predictors of this diagnostic change have been reported. We aimed to describe the clinical characteristics of patients with UC who underwent a change in diagnosis to CD and identify variables associated with the change. Methods: The medical records of pediatric patients with UC who were followed up at the National Center for Child Health and Development between 2006 and 2019 were retrospectively reviewed. Clinical data on disease phenotype, laboratory parameters, endoscopic findings, and treatment of patients whose diagnosis changed to CD (cCD) were compared to those of patients whose diagnosis remained UC (rUC). Results: Among the 111 patients initially diagnosed with UC, 11 (9.9%) patients were subsequently diagnosed with CD during follow-up. There was no significant difference between the cCD and rUC groups in terms of sex, age at initial diagnosis, and the extent and severity of disease at initial diagnosis. Albumin and hemoglobin levels were significantly lower in the cCD group than in the rUC group. The proportion of patients who required biologics was significantly higher in the cCD group than in the rUC group (p<0.05). Conclusion: Approximately 10% children initially diagnosed with UC were subsequently diagnosed with CD. Hypoalbuminemia and anemia at initial diagnosis and use of biologics could be predictors of this diagnostic change.

조기 진단 파킨슨병 환자 최초 약물의 유효성 및 약물 내성 기간에 대한 평가 (Evaluation for Effectiveness and Tolerance Duration of Initial Medication on Untreated Early Parkinson's Disease)

  • 천영주;박용성;김정태;임성실
    • 약학회지
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    • 제59권3호
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    • pp.127-134
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    • 2015
  • The aim of this study was to investigate the correlation among age, symptoms and initial medication (IM), and the tolerance duration of IM in Korean people with Parkinson's disease (PD). We studied 60 patients with untreated early PD who were initially diagnosed in our hospital between Jun 2006 and Sep 2014. We collected data on sex, age at diagnosis, symptom duration until diagnosis, main motor symptoms, frequency and duration of IM through electronic medical records. We divided patients into groups depending on the number of drugs (MONO/COMBI) and whether to contain dopaminergic property (DOPA/NDOPA). We analyzed the correlation between age and symptoms in each two groups and calculated the mean tolerance duration of IM in each of the groups. The mean symptom duration until diagnosis was 12.2 months. The most frequent drug was levodopa formulations (80%) compared to dopamine agonists (58.3%). The number of patients in the COMBI group (63.3%) was more than that in the MONO group (36.7%). Half of the patients in the COMBI group were taking LDF+DA (50%). Except for tremor, no other symptom showed a significant correlation between with IM. The mean tolerance duration of IM was within 200 days. The mean duration for COMBI group (342.7 days) was longer than that for MONO group (209.8 days). Among regimens, the mean tolerance duration of DOPA group (293.3 days) was longer than for NDOPA group (251.4 days). There was no difference in survival curves between any of the two groups. We found that patients experienced symptoms for over a year in Korea. This indicates that diagnosis time is faster than reported in other previous studies. The longest tolerance duration among IM was for dopaminergic combination therapy. More research is needed to design the most appropriate treatment for PD in Korean patients.

Rapid progression from trochlear nerve palsy to orbital apex syndrome as an initial presentation of advanced gastric cancer

  • Kong, Eunjung;Koh, Sung Ae;Kim, Won Jae
    • Journal of Yeungnam Medical Science
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    • 제36권2호
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    • pp.159-162
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    • 2019
  • The most cases with orbital metastases have been reported in patients with a prior established diagnosis of cancer and widespread systemic involvement. However, ocular symptoms can be developed as an initial presentation of cancer in patients without cancer history. We report a case of rapid progression from trochlear nerve palsy to orbital apex syndrome as an initial presentation of advanced gastric cancer.

RNN-based integrated system for real-time sensor fault detection and fault-informed accident diagnosis in nuclear power plant accidents

  • Jeonghun Choi;Seung Jun Lee
    • Nuclear Engineering and Technology
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    • 제55권3호
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    • pp.814-826
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    • 2023
  • Sensor faults in nuclear power plant instrumentation have the potential to spread negative effects from wrong signals that can cause an accident misdiagnosis by plant operators. To detect sensor faults and make accurate accident diagnoses, prior studies have developed a supervised learning-based sensor fault detection model and an accident diagnosis model with faulty sensor isolation. Even though the developed neural network models demonstrated satisfactory performance, their diagnosis performance should be reevaluated considering real-time connection. When operating in real-time, the diagnosis model is expected to indiscriminately accept fault data before receiving delayed fault information transferred from the previous fault detection model. The uncertainty of neural networks can also have a significant impact following the sensor fault features. In the present work, a pilot study was conducted to connect two models and observe actual outcomes from a real-time application with an integrated system. While the initial results showed an overall successful diagnosis, some issues were observed. To recover the diagnosis performance degradations, additive logics were applied to minimize the diagnosis failures that were not observed in the previous validations of the separate models. The results of a case study were then analyzed in terms of the real-time diagnosis outputs that plant operators would actually face in an emergency situation.

소음인체질병증 임상진료지침: 진단 및 알고리즘 (Clinical Practice Guideline for Soeumin Disease of Sasang Constitutional Medicine: Diagnosis and Algorithm)

  • 이준희;이의주
    • 사상체질의학회지
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    • 제26권1호
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    • pp.11-26
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    • 2014
  • Objectives This research was proposed to present Clinical Practice Guideline(CPG) for Soeumin Disease of Sasang Constitutional Medicine(SCM): Diagnosis and Algorithm. This CPG was developed by the national-wide experts committee consisting of SCM professors. Methods We searched the literature and articles related to Soeumin Symptomatology diagnosis and algorithm. For developin diagnosis and algorithm, we searched the classification, ordinary symptom, present symptom of the Soeumin Symptomatology Results & Conclusions We classified the Soeumin Symptomatology by 4 steps: Exterior-Interior disease, favorable-unfavorable pattern, mild-moderate-severe-critical pattern, initial-intermediate-advanced pattern. And at the unfavorable pattern, ordinary symptom is very important. So Doctors focuss on the symptom of unfavorable's ordinary symptom such as temperament inclined symptom, excessive sweating, diarrhea, and vexation.

소양인체질병증 임상진료지침: 진단 및 알고리즘 (Clinical Practice Guideline for Soyangin Disease of Sasang Constitutional Medicine: Diagnosis and Algorithm)

  • 이준희;이의주
    • 사상체질의학회지
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    • 제26권3호
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    • pp.224-240
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    • 2014
  • Objectives This research was proposed to present Clinical Practice Guideline(CPG) for Soyangin Disease of Sasang Constitutional Medicine(SCM): Diagnosis and Algorithm. This CPG was developed by the national-wide experts committee consisting of SCM professors. Methods We searched the literature and articles related to Soyangin Symptomatology diagnosis and algorithm. For developing diagnosis and algorithm, we searched the classification, ordinary symptom, present symptom of the Soyangin Symptomatology. Results & Conclusions We classify the Soyangin Symptomatology by 4 steps: Exterior-Interior disease, favorable-unfavorable pattern, mild-moderate-severe-critical pattern (initial-advanced pattern). And at the unfavorable pattern, ordinary symptom is very important. So doctors need to focus on the symptom of unfavorable's ordinary symptom such as temperament inclined symptom, diarrhea, and diurnal body fever.

급성 췌장염 진료 권고안 (Clinical Practice Guidelines for Acute Pancreatitis)

  • 고동희
    • 대한소화기학회지
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    • 제72권6호
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    • pp.281-285
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    • 2018
  • Acute pancreatitis is a common gastrointestinal disease that is associated with significant morbidity and consumes enormous health care resources. As such, it requires up-to-date evidence-based diagnosis and standard treatment guidelines with broad support from the clinician. Korean Pancreatobiliary Association has developed clinical practice guidelines for the diagnosis and treatment of acute pancreatitis to provide a framework for clinicians to manage acute pancreatitis and to improve national health care. The guidelines were divided into four parts: the diagnosis of acute pancreatitis, the assessment of the severity, the initial management, and the treatment of necrotizing pancreatitis and local complications of acute pancreatitis. In this article, we summarize and present the diagnosis and treatment guidelines for acute pancreatitis established in Korea.

Aggressive unicystic ameloblastoma affecting the posterior mandible: late diagnosis during orthodontic treatment

  • Lopes, Sergio Lucio Pereira de Castro;Flores, Isadora Luana;Gamba, Thiago de Oliveira;Ferreira-Santos, Rivea Ines;Moraes, Mari Eli Leonelli de;Cabello, Aline Alvarez;Moutinho, Paula Nascimento
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제43권2호
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    • pp.115-119
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    • 2017
  • Maxillofacial images must be examined to find pathologies not identified during clinical examination. Unicystic ameloblastoma (UA) extending to the mandibular body and ramus was neglected on initial panoramic radiographic examination. After orthodontic therapy, a huge lesion was observed clinically and through imaging exams. After the conservative surgery, no recurrence was observed during five years of follow-up. This case emphasized the need for careful evaluation of patient images focusing on the oral diagnosis before any dental treatment planning, including orthodontic therapy.

Atypical Extraventricular Neurocytoma

  • Choi, Hyun-Ho;Park, Sung-Hye;Kim, Dong-Gyu;Paek, Sun-Ha
    • Journal of Korean Neurosurgical Society
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    • 제50권4호
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    • pp.381-384
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    • 2011
  • The authors report a case of atypical extraventricular neurocytoma (EVN) transformed from EVN which had been initially diagnosed as an oligodendroglioma 15 years ago. An 8-year-old boy underwent a surgical resection for a right frontal mass which was initially diagnosed as oligodendroglioma. When the tumor recurred 15 years later, a secondary operation was performed, followed by salvage gamma knife treatment. The recurrent tumor was diagnosed as an atypical EVN. The initial specimen was reviewed and immunohistochemistry revealed a strong positivity for synaptophysin. The diagnosis of the initial tumor was revised as an EVN. The patient maintained a stable disease state for 15 years after the first operation, and was followed up for one year without any complications or disease progression after the second operation. We diagnosed an atypical extraventricular neurocytoma transformed from EVN which had been initially diagnosed as an oligodendroglioma 15 years earlier. We emphasize that EVN should be included in the differential diagnosis of oligodendroglioma.

Intramuscular epidermal cyst in the masticator space: a case report

  • Sang Woo Han;Jiye Kim;Sug Won Kim;Minseob Eom;Chae Eun Yang
    • 대한두개안면성형외과학회지
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    • 제24권4호
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    • pp.193-197
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    • 2023
  • An epidermal cyst, also known as an epidermoid cyst or epidermal inclusion cyst, is the most prevalent type of cutaneous cyst. This non-cancerous lesion can appear anywhere on the body, typically presenting as an asymptomatic dermal nodule with a visible central punctum. In the case presented herein, an epidermal cyst with uncommon features was misdiagnosed as a lymphatic malformation based on preoperative magnetic resonance imaging (MRI). A 61-year-old man came to us with a swollen left cheek that had been present for 11 months. The preoperative MRI revealed a 3×3.8×4.6 cm lobulated cystic lesion with thin rim enhancement in the left masticator space. The initial differential diagnosis pointed toward a lymphatic malformation. We proceeded with surgical excision of the lesion via an intraoral approach, and the specimen was sent to the pathology department. The pathological diagnosis revealed a ruptured epidermal cyst, indicating that the initial diagnosis of a lymphatic malformation based on preoperative MRI was incorrect. Epidermal cysts located under the muscle with no visible central punctum are uncommon, but should be considered if a patient presents with facial swelling.