• Title/Summary/Keyword: Symptom severity

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Analysis of Treatment Response in Patients with Oral Lichen Planus

  • Ju, Hye-Min;Kim, Kyung-Hee;Jeon, Hye-Mi;Ahn, Yong-Woo;Ok, Soo-Min;Jeong, Sung-Hee
    • Journal of Oral Medicine and Pain
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    • v.46 no.2
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    • pp.41-48
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    • 2021
  • Purpose: To evaluate compliance by analyzing and comparing treatment duration, degree of improvement after treatment and treatment response of oral lichen planus (OLP) patients according to characteristics of them and the severity of the lesion. Methods: According to treatment process, 132 subjects with OLP who first visited the Department of Oral Medicine at the Pusan National University Dental Hospital from January 2017 to December 2020were classified into three groups: Treatment completed (CT) group, Under treatment (UT) group, and Dropped out during follow-up (DT) group. The reticulation/keratosis, erythema, and ulceration (REU) scoring system was used to assess the severity of OLP. The degree of improvement after treatment was evaluated in CT group. Results: There were 53 (40.15%) CT, 27 (20.45%) UT and 52 (39.39%) DT. In CT group, according to initial REU score there was a statistical difference in the degree of improvement, but not in the length of time to complete treatment. There was no statistical difference between the days it took for patients to feel symptom relief, and the days of entire treatment among three groups. However, there was a positive correlation between the REU score of gingiva and duration of treatment in DT group. In the CT and DT groups, there was a correlation between the length of time taken to relieve symptoms and the duration of treatment. Conclusions: The severity of the gingival lesion and the initial response to treatment have a large effect on the entire treatment period and prognosis, so it should be considered when explaining the disease prognosis and treatment period to patients, and the clinician needs to focus on initial symptom relief.

The Validity and Reliability of Reflux Symptom(RSI) Index and Reflux Finding Score(RFS) (역류증상지수와 역류소견점수의 타당성과 신뢰도)

  • Lee, Byung-Joo;Wang, Soo-Geun;Lee, Jin-Choon
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.18 no.2
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    • pp.96-101
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    • 2007
  • Laryngopharyngeal reflux (LPR) is the retrograde movement of gastric contents into the larynx, pharynx, and upper aero-digestive tract. LPR differs from gastroesophageal reflux in that it is often not associated with heartburn and regurgitation symptoms. Otolaryngological manifestations of acid reflux include a wide range of pharyngeal and laryngeal symptoms. Belafsky et al. developed a useful self-administered tool, the reflux symptom index (RSI), for assessing the degree of LPR symptoms. Patients are asked to use a 0 to 5 point scale to grade the following symptoms: 1) hoarseness or voice problems; 2) throat clearing; 3) excess throat mucus or postnasal drip ; 4) difficulty swallowing; 5) coughing after eating or lying down; 6) breathing difficulties ; 7) troublesome or annoying cough; 8) sensation of something sticking or a lump in the throat; 9) heartburn, chest pain, indigestion or stomach acid coming up. A RSI score greater than 13 is considered abnormal. As there is no validated instrument to document the physical findings and severity of LPR, Belafsky et al. developed an eight-item clinical severity scale for judging laryngoscopic finding, the reflux finding score (RFS). They rated eight LPR-associated findings on a scale from 0 to 4 : subglottic edema, ventricular obliteration, erythema/hyperemia, vocal-fold edema, diffuse laryngeal edema, posterior commissure hypertrophy, granuloma/granulation tissue, and thick endolaryngeal mucus. A RFS score of greater than 7 was found to suggest LPR-associated laryngitis. Although both indices (RSI and RFS) are widely used, there is some controversy about their validity (sensitivity and specificity) and reliability (intra-rater and inter-rater) in LPR diagnosis and treatment. We discuss the validity and reliability of RSI and RFS with literature review.

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LYMPHOCYTES POPULATION IN RELATION TO CLINICAL SYMPTOMS IN IRREVERSIBLE PULPITIS (비가역성 치수염의 임상증상에 따른 임파구 분포에 관한 연구)

  • Lee, Woo-Cheol;Lim, Sung-Sam
    • Restorative Dentistry and Endodontics
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    • v.20 no.1
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    • pp.235-249
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    • 1995
  • This study was designed to identify the lymphocytes present and to examine the relation between lymphocytes population and clinical symptoms of the pulps clinically diagnosed as normal and irreversible pulpitis. We recorded the history and severity of the pain and performed several clinical tests, before extirpation of vital, irreversibly inflamed pulps in routine endodontic treatment. Then the teeth were divided into two groups. Five teeth, categorized in acute symptom group, had severe spontaneous pain, particularly at night and were extremely sensitive to cold and heat. The other 15 teeth with history of mild to moderate pain and with or without cold or heat responses were categorized as chronic symptom group. Inflamed pulps were also classified into 8 minor groups by presence or absence of signs or symptoms related to the involved teeth, including the presence of pain on percussion, pain on heat and cold stimuli and the periodontal pocket depth. All extirpated pulps were immediately immersed in ultra low-temperature freezer($-74^{\circ}C$), and they were sectioned $6{\mu}m$ in thickness. Specimens were stained using three-stage indirect immunoperoxidase techniques(DAKO, LSAB kit) and monoclonal antibodies for detecting the presence of T lymphocytes(T), B lymphocytes(B) and helper(T4) and suppressor(T8) lymphocytes. Following results were obtained; 1. All the examined normal and inflamed pull) tissues had positive staining for T lymphocytes and T helper and T suppressor cells. But B cells were observed only in inflamed pulp. 2. Statistically more T and B cells were observed in acute symptom group as compared with chronic symptom group(p<0.05). 3. Cell ratio of BIT in acute symptom group were significantly higher than that of chronic symptom group(p<0.05). 4. Only B cells were significantly increased in the percussion positive group than the number of B cells in percussion negative group(p<0.05). 5. No differences were observed in the number of different cell types among other minor groups.

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Three cases of chronic cough treated with Gui-Zhi-Tang(桂枝湯) in Shanghanlun 12th, and 15th text (상한론(傷寒論) 12조(條), 15조(條)에 근거한 계지탕(桂枝湯)의 투여를 통해 호전된 만성 기침 환자 치험 3례)

  • Kim, Su-Jung
    • 대한상한금궤의학회지
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    • v.5 no.1
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    • pp.31-43
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    • 2013
  • Objective : This study evaluated the effect of Gui-Zhi-Tang(桂枝湯) on chronic cough. Methods : Three patients who had a chronic cough were diagnosed by the Shanghanlun(傷寒論) Six meridian patterns diagnostic system (六經診斷體系) and treated with Gui-Zhi-Tang(桂枝湯) based on Shang-han-lun's 12th and 15th text. The treatment lasted more than 4 weeks. The severity of Chronic cough was evaluated by the questionnaire(symptom severity assessment) before and after administration of each treatment term. Results : After the treatments, the patients' symptoms and results of the questionnaire improved. Conclusions : This case study showed an effectiveness of using Gui-Zhi-Tang on chronic cough.

Cold stress test for the diagnosis of cold hypersensitivity on hands (냉부하검사를 통한 수부냉증의 진단)

  • Han, Ji-Young;Joe, Jung-Hoon;Jang, Jun-Bock;Kim, Yong-Suk;Lee, Kyung-Sub
    • Journal of Oriental Medical Thermology
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    • v.2 no.1
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    • pp.17-23
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    • 2003
  • Purpose The cold hypersensitivity is a subjective symptom and it is very difficult to evaluate the severity. It is possible to detect cold hypersensitivity by measuring the skin temperature on DITI, but there is limitation only using DITI to find the objective grade of the symptom. To set a new objective standard for the diagnosis of cold hypersensitivity, we examined the relationship between the Visual Analogue Scale (VAS) score for the cold hypersensitivity and the change of skin temperature on hands by cold stress test Method 23 patients with symptom of cold hypersensitivity were participated as subjects who visited the women medical center of Kangnam Kyunghee Korean Hospital, Kyung Hee Univ. from May 1, 2002 to August 31, 2002. There were all carefully examined to rule out other disease such as obesity, skin diseases, spinal nerve lesions and external wounds. Thermographic observations for this study were made using DITI. We performed cold stress test three times to compare with the results from thermographic observations by DITI: first, after 15 minutes-resting, second, right after 1 minutes soak in $20^{\circ}C$ water, the third for last, 10 minutes after the soak. VAS score was chosen to determine the severity of cold hypersensitivity. Result 1 male and 22 female patients were participated ranging in age from 22.17 to 45.21. There was a significant negative correlation between the recovery rate of finger skin temperature after cold stress test and the VAS score. And there was a significant positive correlation between the difference of finger skin temperature and the back and palm of hands after cold stress test and the VAS score. Conclusion In cold hypersensitivity patients, the cold stress test combined with DITI could be a accurate method for the objective evaluation of cold hypersensitivity, especially good at deciding the severity by numeric values. Using a more strict criterion, as diagnosing of cold hypersensitivity, and longer follow-up may improve the validity of the results attained in clinical trials.

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The Nutrient Intakes and their Relationships with the Use of Diuretics, Symptom Severity and Physical Functioning in Heart Failure Patients (심부전 환자의 이뇨제 사용, 증상의 중증도 및 신체활동능력과 영양소 섭취 상태와의 관련성)

  • Jang, Jun Hee;Lee, Haejung;Park, Youngjoo;Chun, Kook Jin;Kim, Jong Hyun
    • Korean Journal of Community Nutrition
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    • v.21 no.2
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    • pp.190-199
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    • 2016
  • Objectives: The purpose of this study was to identify the differences in nutrient intake according to using diuretics, symptom severity and degree of physical functioning in heart failure patients. Methods: A secondary data analysis was conducted by using baseline data of an intervention study for heart failure patients. In this study, 131 heart failure patients were included. Data were collected using medical records, NYHA (New York Heart Association functional classification) class, and 6-minute-walking test and 24-hour diet recall. Data were analyzed using descriptive statistics and Chi-square test by SPSS 21.0. Nutrient intake was assessed using CAN-pro 2.0. Results: Majority of the participants consumed total calorie less than Estimated Energy Requirement (EER) and consumed carbohydrates more than 65% of their total calorie intakes. 24.4% of the participants consumed fat more than 30% of their total calorie intakes and 23.7% consumed saturated fat more than 7% of their total calorie intakes. 100.0% of the participants consumed protein less than 7% of their total calorie intakes and 73.3% of the participants consumed more than recommended intakes of sodium. More than 90.0% of the participants consumed less than adequate intakes of potassium (90.1%) and Vitamin D (91.6%), respectively. 100% and 62.6% of the participants consumed less than Estimated Average Requirement (EAR) of magnesium and Vitamin $B_1$, respectively. Nutrient intakes in heart failure patients were different for potassium intake according to the usage of diuretics. The participants with symptom severity tended to intake protein less properly and the participants walking more than 300.0 m tended to intake sodium improperly high. Conclusions: The findings of this study indicated the need for screening nutrient intakes of heart failure patients. It is necessary to increase the intake of total calories and most nutrients and to restrict sodium intakes among heart failure patients.

Clinical Effects of HongYi Pharmacopuncture on Women with Urinary Disturbance: A Three-case Report (여성의 배뇨장애에 대한 홍의약침의 치료효과 증례 3례)

  • Lee, Bo-ram;Hwang, Yun-kyeong;Jung, Taek-geun;Kim, Won-ill
    • The Journal of Internal Korean Medicine
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    • v.37 no.2
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    • pp.196-201
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    • 2016
  • Objective: This study reports on the effects of HongYi (red ant, or Formica rufa Linne) pharmacopuncture through three cases involving female patients with voiding difficulty.Method: We treated the three patients with HongYi pharmacopuncture and evaluated them using the international prostate symptom score (IPSS), which is used for measuring the severity of voiding difficulty.Result: After treatment, the IPSS showed improvement in each patient. The symptoms of voiding difficulty and other complaints also improved.Conclusion: Based on the three cases, HongYi pharmacopuncture may be a viable option for treating voiding difficulty among women.

IoT-based systemic lupus erythematosus prediction model using hybrid genetic algorithm integrated with ANN

  • Edison Prabhu K;Surendran D
    • ETRI Journal
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    • v.45 no.4
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    • pp.594-602
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    • 2023
  • Internet of things (IoT) is commonly employed to detect different kinds of diseases in the health sector. Systemic lupus erythematosus (SLE) is an autoimmune illness that occurs when the body's immune system attacks its own connective tissues and organs. Because of the complicated interconnections between illness trigger exposure levels across time, humans have trouble predicting SLE symptom severity levels. An effective automated machine learning model that intakes IoT data was created to forecast SLE symptoms to solve this issue. IoT has several advantages in the healthcare industry, including interoperability, information exchange, machine-to-machine networking, and data transmission. An SLE symptom-predicting machine learning model was designed by integrating the hybrid marine predator algorithm and atom search optimization with an artificial neural network. The network is trained by the Gene Expression Omnibus dataset as input, and the patients' data are used as input to predict symptoms. The experimental results demonstrate that the proposed model's accuracy is higher than state-of-the-art prediction models at approximately 99.70%.

Nutcracker syndrome in children: review of symptom, diagnosis, and treatment

  • Diana S. Kalantar;Se Jin Park;Jae Il Shin
    • Childhood Kidney Diseases
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    • v.27 no.2
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    • pp.89-96
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    • 2023
  • Renal nutcracker syndrome (NCS) is the entrapment of the left renal vein between the abdominal aorta and superior mesenteric artery. Although uncommon in pediatric patients, early diagnosis is crucial to avoid potential severe complications, such as anemia or renal vein thrombosis. NCS presents a variety of symptoms, most commonly including "Triade's symptoms"-hematuria, proteinuria, and flank pain. Diagnosis and treatment include invasive and noninvasive management, although due to a lack of pediatric clinical studies, management is widely variable. Conservative diagnosis and treatment are recommended as a first-line option for pediatric patients; however, invasive surgical treatment may be recommended based on symptom severity. This review aims to provide a comprehensive overview of NCS in children to better understand the widely variable incidence, occurrence, and management from early on to allow for early-onset management.

The Clinical Significance of Periodic Limb Movements During Sleep in Various Sleep Disorders (다양한 수면장애의 주기성사지운동증의 임상적 의의)

  • So-Jin Lee
    • Sleep Medicine and Psychophysiology
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    • v.30 no.1
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    • pp.9-12
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    • 2023
  • Periodic limb movements during sleep (PLMS) are prevalent in various sleep disorders, such as restless legs syndrome (RLS), periodic limb movements disorder, obstructive sleep apnea (OSA), REM sleep behavior disorder (RBD), and narcolepsy. PLMS has been hypothesized to be related to the decline of dopaminergic transmission. In RLS, PLMS is suggested to be related to iron deficiency and symptom severity. PLMD is a rare sleep disorder, and the role of PLMS in PLMD has not been clearly investigated yet. PLMS in OSA, which remain after proper PAP therapy, may need further management. The clinical relevance of PLMS in RBD and narcolepsy have not been investigated thoroughly and need further studies. Whether PLMS are to be considered as a mere symptom of individual sleep disorders or not can be elucidated through studies investigating the efficacy of therapeutic approaches to reduce PLMS in various sleep disorders.