• Title/Summary/Keyword: Medical Diagnosis

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Study on the ${\ulcorner}$Medical Recoreds as a Guide to Diagnosis${\lrcorner}$ ("임증지남의안(臨證指南醫案)"에 관한 연구)

  • Shin, Soon-Shik;Hong, Won-Sik
    • Korean Journal of Oriental Medicine
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    • v.1 no.1
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    • pp.47-68
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    • 1995
  • A proper understanding of 'diagnosis and treatment based on overall analysis of symptoms and signs' can result in efficient clinical effect. Studies on the ${\lceil}$Medical Recoreds as a Guide to Diagnosis${\rfloor}$ can be expected to achieve a part of this purpose. In this study, the period, author, xylographica, contents and influence of next generation of ${\lceil}$Medical Records as a Guide to Diagnosis${\rfloor}$were investigated. Tian shi and his 12 followers completed thsis Medical recoreds with clinical experiences and data obtained throughout their lives. These books were first published in 1764. Since then these books have been published twenty times based on the first edition. These books are comprised of 10 volumes, from ${\lceil}$volume 1${\rfloor}$to ${\lceil}$volum 8${\rfloor}$are internal medicine, ${\lceil}$volum 9${\rfloor}$ is gynecology, ${\lceil}$volum 10${\rfloor}$ is pediatrics. The contents are as follows; 'method of regluating astenia-syndrome' , 'diagnosis and treatment based on overall analysis of symptoms and signs on eight extra meridians', 'theory of Yang forms endogenous wind-syndrome', 'theory of spleen-energy rise up and stomach-energy descend', 'theory of stmach-Yeum', 'diagnosis and treatment based on overall analysis of symptoms and signs on collaterals'. Tian shi completed his work by compling the previous medical theories and through clinical studies. It is expected that his theories are effectively applied to improve clinical medicine.

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Sensitivity, specificity, and predictive value of cardiac symptoms assessed by emergency medical services providers in the diagnosis of acute myocardial infarction: a multi-center observational study

  • Park, Jeong Ho;Moon, Sung Woo;Kim, Tae Yun;Ro, Young Sun;Cha, Won Chul;Kim, Yu Jin;Shin, Sang Do
    • Clinical and Experimental Emergency Medicine
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    • v.5 no.4
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    • pp.264-271
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    • 2018
  • Objective For patients with acute myocardial infarction (AMI), symptoms assessed by emergency medical services (EMS) providers have a critical role in prehospital treatment decisions. The purpose of this study was to evaluate the diagnostic accuracy of EMS provider-assessed cardiac symptoms of AMI. Methods Patients transported by EMS to 4 study hospitals from 2008 to 2012 were included. Using EMS and administrative emergency department databases, patients were stratified according to the presence of EMS-assessed cardiac symptoms and emergency department diagnosis of AMI. Cardiac symptoms were defined as chest pain, dyspnea, palpitations, and syncope. Disproportionate stratified sampling was used, and medical records of sampled patients were reviewed to identify an actual diagnosis of AMI. Using inverse probability weighting, verification bias-corrected diagnostic performance was estimated. Results Overall, 92,353 patients were enrolled in the study. Of these, 13,971 (15.1%) complained of cardiac symptoms to EMS providers. A total of 775 patients were sampled for hospital record review. The sensitivity, specificity, positive predictive value, and negative predictive value of EMS provider-assessed cardiac symptoms for the final diagnosis of AMI was 73.3% (95% confidence interval [CI], 70.8 to 75.7), 85.3% (95% CI, 85.3 to 85.4), 3.9% (95% CI, 3.6 to 4.2), and 99.7% (95% CI, 99.7 to 99.8), respectively. Conclusion We found that EMS provider-assessed cardiac symptoms had moderate sensitivity and high specificity for diagnosis of AMI. EMS policymakers can use these data to evaluate the pertinence of specific prehospital treatment of AMI.

Study on the Diagnosis of the Abdominal Region from Physiological Viewpoint (복부 망진에 관한 생리적 연구)

  • Lee Yong Chol;Kang Jung Soo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.18 no.2
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    • pp.349-354
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    • 2004
  • It is impossible to overestimate the importance of the medical examination. The medical examination and treatment method is composed of Mang(inspection)-Moon(listening)-Moon(anammesis & question)-Jeol(pulse feeling, precussion etc.). Among these 4 methods, the Diagnosis of the Abdominal Region, which is one of the JeolJin, is regarded as the most important method along with pulse feeling. The Diagnosis of the Abdominal Region, which includes the examination of the symptoms and their changes in stomach area to understand the pathological progress of the JangFu, Meridian and Qi-Blood, has been highly emphasized in Western and Eastern Medical Science. External trouble, for instance a cold, can be detected by examining pulse, Internal trouble, for instance indigestion, by Diagnosis of the Abdominal Region. Though the Diagnosis of the Abdominal Region was the important part of the JeolJin, it was often devaluated. The Diagnosis of the Abdominal Region will also be composed of 4 kinds of method on Mang-Moon-Moon-Jeol. We thought that the first of the Abdominal Region Diagnosis is a Mangjin(inspection). So we present the new viewpoint of the abdomen of a diagnosis through emphasizing the importance of Mangjin(inspection).

Age of Diagnosis of Breast Cancer in China: Almost 10 Years Earlier than in the United States and the European Union

  • Song, Qing-Kun;Li, Jing;Huang, Rong;Fan, Jin-Hu;Zheng, Rong-Shou;Zhang, Bao-Ning;Zhang, Bin;Tang, Zhong-Hua;Xie, Xiao-Ming;Yang, Hong-Jian;He, Jian-Jun;Li, Hui;Li, Jia-Yuan;Qiao, You-Lin;Chen, Wan-Qing
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.22
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    • pp.10021-10025
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    • 2014
  • Background: The study aimed to describe the age distribution of breast cancer diagnosis among Chinese females for comparison with the United States and the European Union, and provide evidence for the screening target population in China. Materials and Methods: Median age was estimated from hospital databases from 7 tertiary hospitals in China. Population-based data in China, United States and European Union was extracted from the National Central Cancer Registry, SEER program and GLOBOCAN 2008, respectively. Age-standardized distribution of breast cancer at diagnosis in the 3 areas was estimated based on the World Standard Population 2000. Results: The median age of breast cancer at diagnosis was around 50 in China, nearly 10 years earlier than United States and European Union. The diagnosis age in China did not vary between subgroups of calendar year, region and pathological characteristics. With adjustment for population structure, median age of breast cancer at diagnosis was 50~54 in China, but 55~59 in United States and European Union. Conclusions: The median diagnosis age of female breast cancer is much earlier in China than in the United States and the European Union pointing to racial differences in genetics and lifestyle. Screening programs should start at an earlier age for Chinese women and age disparities between Chinese and Western women warrant further studies.

Current Topics on Quality Assurance of X-ray Diagnosis in Japan

  • Katoh, Tuguhisa;Imamura, Keiko;Matumoto, Toru
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2002.09a
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    • pp.13-16
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    • 2002
  • Recent topics on quality assurance (QA) of X-ray diagnosis in Japan were reported in this presentation. These were related to mass screening mammography (MMG), lung screening CT (LSCT), skin injury caused by interventional radiology (IVR) and traceable system of dosimeters for x-ray diagnosis. In these successful stories, the author would like to stress the cooperation of all the medical am: clinical staff including medical doctors, radiological technologists, medical physicists, manufacturers of medical devices and others.

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The Value of Submitting Multiple Sputum Specimens for Accurate Diagnosis of Pulmonary Tuberculosis

  • Kisa, Ozgul;Albay, Ali;Baylan, Orhan;Doganci, Levent
    • Journal of Microbiology
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    • v.40 no.4
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    • pp.301-304
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    • 2002
  • Is a multiple number of sputum specimens necessary for the diagnosis of pulmonary tuberculosis? To answer this question, 6844 respiratory specimens obtained from previously untreated patients suspected of having pulmonary tuberculosis between 1998 and 2001 were evaluated retrospectively. All of the specimens were evaluated by acid fast bacilli smear and BACTEC 460 TB culture system. A total of 785 (11%) specimens from 353 patients were positive for Mycobacterium tuberculosis complex. For 76% (270/353) of these patients the organism was detected from sputum specimens collected sequentially for daily basis. Mycobacterium tuberculosis was isolated in the first, second and third samples of the majority (98%,195/199) of patients who had three or more sputum samples sent to the laboratory. Our results indicate that, we could carry out Mycobacterium tuberculosis isolation in the first, second and third sputum samples of the overwhelming majority of the patients and the diagnostic value of four or more sputum specimens submitted to the laboratory was very low (2%). We recommend that, for definitive and cost-effective diagnosis of pulmonary tuberculosis at least three sequential sputum specimens be collected for all patients suspected pulmonary tuberculosis.

Evaluation of Rapid IgG4 Test for Diagnosis of Gnathostomiasis

  • Wang, Yue;Ma, An;Liu, Xiao-Long;Eamsobhana, Praphathip;Gan, Xiao-Xian
    • Parasites, Hosts and Diseases
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    • v.59 no.3
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    • pp.257-263
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    • 2021
  • Human gnathostomiasis is a parasitic disease caused by Gnathostoma nematode infection. A rapid, reliable, and practical immunoassay, named dot immuno-gold filtration assay (DIGFA), was developed to supporting clinical diagnosis of gnathostomiasis. The practical tool detected anti-Gnathostoma-specific IgG4 in human serum using crude extract of third-stage larvae as antigen. The result of the test was shown by anti-human IgG4 monoclonal antibody conjugated colloidal gold. The sensitivity and specificity of the test were both 100% for detection in human sera from patients with gnathostomiasis (13/13) and from healthy negative controls (50/50), respectively. Cross-reactivity with heterogonous serum samples from patients with other helminthiases ranged from 0 (trichinosis, paragonimiasis, clonorchiasis, schistosomiasis, and cysticercosis) to 25.0% (sparganosis), with an average of 6.3% (7/112). Moreover, specific IgG4 antibodies diminished at 6 months after treatment. This study showed that DIGFA for the detection of specific IgG4 in human sera could be a promising tool for the diagnosis of gnathostomiasis and useful for evaluating therapeutic effects.

An Analysis of Medical Expenses for In-patients in an Oriental Medical Hospital and Factors Affecting Them (한방병원 입원환자의 진료비와 이에 영향을 미치는 요인 분석)

  • Ko, Min-Seok;Choi, Joon-Young
    • Journal of Society of Preventive Korean Medicine
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    • v.15 no.1
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    • pp.71-87
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    • 2011
  • Objective : The present study is aimed at providing basic data to help oriental medical hospitals devise efficient operational plans by analyzing the medical expenses of in-patients in an oriental medical hospital and the factors affecting such expenses. Methods : PASW 18.0 was used to analyze the medical insurance program data of 929 patients who were discharged from a university oriental medical hospital(with 105 sick-beds) during the period from January 1 to December 31, 2010 after treatment under the coverage of health insurance and medical aid. Results : 1) Of all the patients hospitalized, 63.3% were females, their mean age was 52.73 years old, and 87.7% was covered by the health insurance program. The biggest number or 31.2% of the patients were treated by the department of acupuncture, 31.5% suffered mainly from the diseases of musculoskeletal system and connective tissues, and the average length of stay at the hospital was 19.49 days. 2) There were statistically significant differences in total medical expenses by age, clinical department in charge, principal diagnosis, and number of days hospitalized while daily average medical expenses differed depending on age, type of medical security, clinical department, principal diagnosis, and number of days staying at the hospital. 3) Total medical expenses were found significantly influenced by age, type of medical security, clinical department, principal diagnosis, and number of days hospitalized(explanatory power : 95.9%), whereas type of medical security, clinical department and principal diagnosis turned out to exercise significant influence on the daily average medical expenses(explanatory power : 26.9%). Conclusion : Oriental medical hospitals are suggested to make efforts to ensure geographical and economical accessibility for their main clients, the elderly and middle-aged, as well as to improve satisfaction of the clients with the medical service provided. They are also encouraged to work out systems to specialize in treatment with a focus on chronic degenerative and adult diseases. In addition, they are expected to try to enhance people's awareness of oriental medicine in an attempt to diversify the brackets of clients and increase frequency of their utilization.

Fuzzy Inference in Medical Diagnosis

  • Kim, Soon-Ki
    • Proceedings of the Korean Institute of Intelligent Systems Conference
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    • 1995.10b
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    • pp.92-97
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    • 1995
  • In medical diagnostic process we are dealing with the preliminary diagnosis based on the interview chart. We will quantify the qualitative information of a patient by dual scaling and establish both prototypes of fuzzy diagnostic sets and the fuzzy linear regressions. Its utility is shown in the diagnosis of headache and CAFDDH.

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A Comparison of Fasting Glucose and HbA1c for the Diagnosis of Diabetes Mellitus Among Korean Adults (공복혈당과 당화혈색소에 의한 당뇨병 진단 비교)

  • Yun, Woo-Jun;Shin, Min-Ho;Kweon, Sun-Seong;Park, Kyeong-Soo;Lee, Young-Hoon;Nam, Hae-Sung;Jeong, Seul-Ki;Yun, Yong-Woon;Choi, Jin-Su
    • Journal of Preventive Medicine and Public Health
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    • v.43 no.5
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    • pp.451-454
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    • 2010
  • Objectives: The American Diabetes Association (ADA) has recently recommended the HbA1c assay as one of four options for making the diagnosis of diabetes mellitus, with a cut-point of $\geq$ 6.5%. We compared the HbA1c assay and the fasting plasma glucose level for making the diagnosis of diabetes among Korean adults. Methods: We analyzed 8710 adults (age 45-74 years), who were not diagnosed as having diabetes mellitus, from the Namwon study population. A fasting plasma glucose level of $\geq$126 mg/dL and an A1c of $\geq$ 6.5% were used for the diagnosis of diabetes. The kappa index of agreement was calculated to measure the agreement between the diagnosis based on the fasting plasma glucose level and the HbA1c. Results: The kappa index of agreement between the fasting plasma glucose level and HbA1c was 0.50. Conclusions: The agreement between the fasting plasma glucose and HbA1c for the diagnosis of diabetes was moderate for Korean adults.