Chronic kidney disease, the presence of structural and functional abnormalities in the kidneys, is associated with a lower quality of life and increased morbidity and mortality in children. Genetic etiologies account for a substantial proportion of pediatric chronic kidney disease. With recent advances in genetic testing techniques, an increasing number of genetic causes of kidney disease continue to be found. Genetic testing is recommended in children with steroid-resistant nephrotic syndrome, congenital malformations of the kidney and urinary tract, cystic disease, or kidney disease with extrarenal manifestations. Diagnostic yields differ according to the category of clinical diagnosis and the choice of test. Here, we review the characteristics of genetic testing modalities and the implications of genetic testing in clinical genetic diagnostics.
Journal of the Institute of Convergence Signal Processing
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v.2
no.1
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pp.108-112
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2001
Heart sound contains rich information regarding the dynamics of the heart and the auscultation has been a first choice of routine procedures for diagnosis of the heart. However, heart sounds captured using a conventional stethoscope are not often loud or clear enough for doctors to precisely classify their characteristics, especially, under the noisy environments of the hospital. A simple auscultation device that removed shortcomings of the conventional stethoscope was constructed in the study. The device employed a polymer based adherent differential output sensor which was on contact with skin through a coupling medium and appropriated electronic circuits for signal amplification and conditioning An ordinary headphone is taken to hear the captured heart sounds and the volume can be adjusted to hear well. It is also possible that the device sends the captured heart sound signals to a PC where the signals are further processed and viualized.
Proceedings of the Korea Institute of Convergence Signal Processing
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2000.08a
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pp.185-188
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2000
Heart sound contains rich information regarding the dynamics of the heart and the auscultation has been a first choice of routine procedures for diagnosis of the heart. However, heart sounds captured using a conventional stethoscope are not often loud or clear enough for doctors to precisely classify their characteristics, especially, under the noisy environments of the hospital. A simple auscultation device that removed shortcomings of the conventional stethoscope was constructed in the study. The device employed a polymer based adherent differential output sensor which was on contact with skin through a coupling medium and appropriated electronic circuits for signal amplification and conditioning. An ordinary headphone is taken to hear the captured heart sounds and the volume can be adjusted to hear well. It is also possible that the device sends the captured heart sound signals to a PC where the signals are further processed and viualized.
Purpose: Mucinous eccrine carcinoma of the skin is rare skin adnexal malignant tumor, which most commonly occurs in the head and neck regions. This tumor, although rarely metastatic, has a high incidence of local recurrence. We report a case of mucinous eccrine carcinoma developed on the Lt. cheek which was treated by Mohs surgery. Methods: The patient was a 53-year-old man who showed a palpable skin-colored $1.5{\times}1.5cm$ sized mass on Lt. cheek. We treated it by wide excision, but it recurred several times on the same region. So we finally did the Mohs surgery and full thickness skin graft. Results: The histologic characteristics are large mucinous pools with fibrous septae and clusters of tumor cells. Special stains showed that the mucin was positive reactivity on Periodic acid Schiff. Also the immunocytochemical studies showed a positive reactivity to carcinoembryonic antigen, S-100 protein, cytokeratin-7. Therefore pathologist reported it as a mucinous eccrine carcinoma. Conclusion: Authors experienced a rare case of primary mucinous eccrine carcinoma on Lt. cheek which had recurred several times. Because of the high local recurrence rate, we did the Mohs surgery and got an good result. Therefore the early Mohs surgery would be a good choice to primary mucinous eccrine carcinoma.
The Journal of Churna Manual Medicine for Spine and Nerves
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v.11
no.1
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pp.11-23
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2016
Objectives : The purpose of this study was to investigate the characteristics and visiting patterns of traffic accident outpatients Methods : In this study, we reviewed the medical charts of 2,048 traffic accident patients who visited Jaseng Hospital of Korean Medicine from January 1st, 2012 to December 31st, 2012. Results : In the distribution of gender and of age patients, the male percentage was 52.3% and the majority of patients were in their thirties(47.2%). In the distribution of the patient's initial visit, most patients visited our clinic from Monday to Wednesday. By monthly distribution, the more patients visited the clinic at the latter half of the year. In the duration of treatment, 1,389 patients(67.8%) finished treatment within four weeks. The most frequently cited sites of pain were neck(82.0%), followed closely by low back(74.0%). In the access route, 746 patients(36.4%) visited our traffic accident clinic as a first choice for primary treatment. We referred patients for radiologic examination in 159 patients(7.9%), of which the exams were mainly lumbar spine MRIs(3.6%) and cervical spine MRIs(2.8%). The most frequent diagnosis were herniated nucleus pulposus. Conclusions : This study shows that most of the patients who visited the traffic accident clinic of a Korean Medical Hospital presented neck and low back pain, and the majority showed improvement without surgical treatment. Following the increasing minor injury rate caused by traffic accidents, we expect the role of Korean Medicine Hospital to become more prominent.
Objectives : The purpose of this study was to examine the influential factors for the choice of dental institutions among adult office workers who were one of major medical consumer groups, the relationship between their health promotion lifestyle and their choice of dental institutions, ways of boosting the efficiency of hospital management and differences in differentiation strategies among dental institutions. Methods : The subjects in this study were 160 office workers who were aged 20 and over and worked in Seoul, North Jeolla Province and South Jeolla Province. They were selected by convenience sampling, and a survey was conducted from February 1 to July 20, 2011. The answer sheets from 149 respondents were analyzed by the statistical package SPSS WIN 12.0 except for 11 incomplete ones. Results : As for the selection factors of dental institutions by general characteristics, they attached a statistically and significantly different importance to convenience according to gender(p<0.05), to reliability, facilities and cleanness according to age(p<0.05), to reliability and convenience according to academic credential(p<0.05) and to facilities and cleanness according to academic credential(p<0.01). Concerning the links between the form of using dental institutions and the selection factors of dental institutions, they gave a statistically and significantly different weight to reliability according to that(p<0.05). Convenience(p<0.001) was the primary selection factor of dental institutions among those who scored higher in health promotion lifestyle. Conclusions : Given the above-mentioned findings, it seemed that the regular implementation of oral health plans geared toward workers and the development of educational programs are required to promote the oral health of workers. But this study examined the workers in several regions only, and the findings might not be generalizable.
Carillo, Gerardo Andres Obeso;Vazquez, Jose Eduardo Rivo;Villar, Alberto Fernandez
Journal of Chest Surgery
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v.47
no.5
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pp.458-464
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2014
Background: The effort to detect lung cancer in ever-earlier stages leads to the identification of an increasing number of patients without preoperative histological diagnosis. The aim of this study is to determine the prevalence and characteristics of benign lesions excised in the context of lung cancer surgery. Methods: We retrospectively analyzed data from 125 surgical procedures. We compared the preoperative clinical or cyto-histological diagnosis with the surgical-pathologic diagnosis in order to identify the percentage of benign lesions excised. Furthermore, other parameters were analyzed, such as age, sex, tumor size, the presence of calcification, and the type of surgery according to subgroup. Results: Of the 125 patients included in the study, 63 (50.4%) had a preoperative histological diagnosis of malignancy, corresponding to 56 cases (44.8%) of primary lung cancer and 7 cases (5.6%) of metastases. The 62 (49.6%) remaining cases without preoperative histological diagnosis were divided among 50 (40%) solitary pulmonary nodules and 12 (9.6%) pulmonary masses. According to the postoperative pathologic examination, we identified 12 (9.6%) benign lesions excised during lung cancer surgery. There were no statistically significant differences by subgroups with respect to age or sex. We found statistically significant evidence regarding the size and wedge resection as the surgical technique of choice for this type of benign lesion. Conclusion: Our study obtained results similar to those published by other groups regarding the resection of benign lesions in lung cancer surgery. This percentage could be a quality management index of indeterminate lung lesions.
Background : Blood pressure is an important indicator in diagnosis and assessing treatment of a patient. Clinical staffs use blood pressure on the assumption that measured value is accurate and reliable. However, whether measured blood pressure is accurate has been rarely investigated in Korea. Objectives : The aims of this study are to evaluate clinical staffs' knowledge and technique as well as accuracy of sphygmomanometer. Also the program to improve the measurement is developed. Methods : Seventy-three registered nurses were asked nine multiple choice questions including Korotkoff sound, cuff size, and deflation rate. Simultaneously characteristics of nurses were examined, age, working place, duration of employment and academic degree. A testing videotape(Standardizing Measurement Video-Tutored Course) was used for evaluating the accuracy of measurement. Testees were to read and record the 12 cases of blood pressure measurement, watching a falling mercury column and hearing Korotkoff sounds. After 10 minutes' education, they were again tested with the same cases. Additionally, 83 mercury sphygmomanometers were checked to find defects such as inaccurate calibration and zero setting, leaky bladder, etc. Results: For the knowledge testing correct response rate was 41.1%. They were the lowest in selecting the proper cuff size and Korotkoff sound. In examining accuracy of blood pressure with videotape, nurses had 67.7% correct response rate. The correct response rate was significantly improved by a session of education. About 23% of sphygmomanometers was without discernable defects. Conclusion : The knowledge and skill of clinical staffs along with the accuracy of equipment have to be improved. A properly designed education program would contribute to the accuracy improvement of blood pressure measurement. Also, more concerns should be given to the precision and maintenance of equipment.
This study aimed at analyzing and understanding medical tourism patients' pattern of different countries. For this purpose it followed up the international patients who visited W hospitals for spine treatment for last 3 years. In additon, it proposed key marketing strategies for attraction of more patients in the future. Satisfaction survey for 91 foreigner hospitalized patients were conducted from year 2010 to 2011. Each country of the patients showed slightly different motivations of visiting, consumer pattern and satisfaction of medical and non medical services. The current study analyzed factors, socio-demographic characteristics, purposes of visit, duration of stay in Korea, total number of visits to Korea, companions, plan of care, reasons for choice of W Hospital, expenses for medical care, total cost of staying in Korea. The results of this study showed that patients visited Korea more frequently were more satisfied with the medical care. Patients who planned to use medical care prior to visit Korea were more satisfied. Patients who thought he/she paid reasonable medical cost were more satisfied. Invitation to familiarization tour, clarification of medical cost, and provision of high quality medical care were recommended for the higher satisfaction of foreign patients. Fostering of specialized hospitals were recommended.
Background: The aim of our present study was to compare quality of life (QoL) between intermediate-stage (BCLC-B) HCC patients who had undergone either liver resection or transcatheter arterial chemoembolization (TACE). Materials and Methods: A total of 102 intermediate-stage HCC patients participated in our study, including 58 who had undergone liver resection and 44 who had undergone TACE. Baseline demographic characteristics, tumor characteristics, and long-term outcomes, such as tumor recurrence, were compared and analyzed. QoL was assessed using the Short Form (SF)-36 health survey questionnaire with the mental and physical component scales (SF-36 MCS and PCS). This questionnaire was filled out at HCC diagnosis and 1, 3, 6, 12, 24 months after surgery. Results: For the preoperative QoL evaluation, the 8 domains related to QoL were comparable between the two groups. The PCS and MCS scores were significantly decreased in both the TACE and resection groups at1 month after surgery, and this decrease was greater in the resection group. These scores were significantly lower in the resection group compared with the TACE group (P<0.05). However, these differences disappeared at 3 and 6 months following surgery. One year after surgery, the resection group showed much higher PCS scores than the TACE patients (P=0.018), and at 2 years after surgery, the PCS and MCS scores for the resection group were significantly higher than those for the TACE group (P<0.05). Eleven patients (19.0%) in the resection group and 17 (38.6%) in the TACE group suffered HCC recurrence (P<0.05). Univariate and multivariate analyses indicated that tumor recurrence (HR=1.211, 95%CI: 1.086-1.415, P=0.012) was a significant risk factor for poorpostoperative QoL in the HCC patients.Conclusions: Due to its effects on reducing HCC recurrence and improving long-term QoL, liver resection should be the first choice for the treatment of patients with intermediate-stage HCC.
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