• Title/Summary/Keyword: clinical diagnosis

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Juvenile idiopathic arthritis: Diagnosis and differential diagnosis

  • Kim, Ki-Hwan;Kim, Dong-Soo
    • Clinical and Experimental Pediatrics
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    • v.53 no.11
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    • pp.931-935
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    • 2010
  • Juvenile idiopathic arthritis (JIA) is comprised of a heterogeneous group of several disease subtypes that are characterized by the onset of arthritis before the age of 16 years and has symptoms lasting at least 6 weeks. The previous classification of JIA included seven different categories, whereas its current classification was compiled by the International League of the Association for Rheumatology, and replaced the previous terms of "juvenile chronic arthritis" and "juvenile rheumatoid arthritis," which were used in Europe or North America, respectively, with the single nomenclature of JIA. As mentioned above, JIA is defined as arthritis of unknown etiology that manifests itself before the age of 16 years and persists for at least 6 weeks, while excluding other known conditions. The clinical symptoms of JIA can be quite variable. Several symptoms that are characteristic of arthritis are not necessarily diagnostic of JIA and may have multiple etiologies that can be differentiated with careful examination of patient history. The disease may develop over days or sometimes weeks, thereby making the diagnosis difficult at the time of presentation. To make a clinical diagnosis of JIA, the first step is to exclude arthritis with known etiologies. Of note, late treatment due to excessive delay of diagnosis can cause severe damage to joints and other organs and impair skeletal maturation. Therefore, early detection of JIA is critical to ensure prompt treatment and to prevent long-term complications including the likelihood of disability in childhood.

Clinical Guidelines for Hwabyung III. (Diagnosis and Assessment of Hwabyung) (화병 임상진료지침 III. (화병의 진단과 평가))

  • Jung, In Chul;Choi, Woo Chang;Lee, Sang Ryong
    • Journal of Oriental Neuropsychiatry
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    • v.24 no.spc1
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    • pp.23-36
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    • 2013
  • Objectives : The purpose of this guideline is to show the evidence-based guidelines of diagnosis and evaluation of Hwabyung by the synthesis and organization of existing research contents. Methods : We investigated the existing research on the concept of Hwabyung. Further, we investigated the diagnostic tools, self-diagnostic method, symptoms assessment tools, oriental medical diagnostic methods, treatment evaluation tools and other testing methods of Hwabyung. Results : There was a Hwabyung diagnostic interview schedule (HIBDS) in the standardized measure for the diagnosis of Hwabyung. In the symptoms assessment tools of Hwabyung, there was a self-report measurement tool of Hwabyung and measurement tool of Hwabyung to be evaluated by the interviewer. In the oriental medical diagnostic method, there was an instrument of pattern identification for Hwabyung. In the treatment assessment tool, there was an instrument of oriental medical evaluation for Hwabyung. In addition, MMPI, SCL-90R, Zung's self-rating anxiety scale (SAS), Zung's self-rating depression scale (SDS), State-Trait Anger Expression Inventory (STAXI) and etc. can be used for the diagnosis and assessment of Hwabyung. Conclusions : We expect 'Clinical Guidelines for the Treatment of Hwabyung' to be useful for the diagnosis and assessment of Hwabyung.

A Survey on Korean Medicine Doctors' Recognition and Treatment Method for Developing Clinical Practice Guideline of Nausea and Vomiting of Pregnancy (임신오조 한의표준임상진료지침 개발을 위한 한의사의 인식과 치료 실태에 관한 조사)

  • Heung-Sook Lee;Hyo-Jeong Jung;Su-Ji Choi;Dong-Il Kim
    • The Journal of Korean Obstetrics and Gynecology
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    • v.36 no.2
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    • pp.36-54
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    • 2023
  • Objectives: This study was aimed to develop a Korean Medicine (KM) clinical practice guideline (CPG) of Nausea and Vomiting of Pregnancy (NVP). Methods: We conducted a questionnaire survey targeting KM doctors belonging to the Association of Korean Medicine by e-mail. We received 1,023 responds, and analyzed the answers. Results: 1. 83.0% of respondents knew the concepts and contents of CPG, and 98.1% had practical use plan. 2. 82.1% of respondents used pattern identification diagnosis for NVP patients, and the most commonly diagnosed pattern was spleen-stomach weakness (脾胃虛弱) with 41.3%. 3. The most frequently used treatment for NVP patients was KM combined treatment (46.7%). Herbal medicine+acupuncture (46.8%) was most used among KM combined treatments, and herbal medicine (37.1%) was most used among KM single treatments. 4. Among the contents of CPG for NVP, the fields of interest were selected in the order of KM treatment, KM-Western medicine cooperative treatment, KM diagnosis, prevention and regimen management. In the 'diagnosis part', the use of the symptom evaluation scale questionnaire was 41.8%, higher than the KM pattern diagnosis (34.4%). In the 'treatment part', herbal medicine accounted for 33.8%, higher than that of acupuncture (including electro-acupuncture) at 23.7%. 5. As for the expected development effects, opinions on evidence-based, safety, clinical use, and standardization were the most common. Conclusions: We figured out KM doctors' recognition of KM clinical practice guideline, clinical diagnosis, treatment on NVP to make the contents of the CPG reflecting the clinical situation.

Metastatic intestinal adenocarcinoma with osseous metaplasia in two Domestic Korean Shorthair cats

  • Jae-Ha Jung;Na-Yon Kim;Yeseul Yang;Dansong Seo;Goeun Choi;Hyunki Hong;Taeseong Moon;Hyeong-Mok Kim;Jihee Han;Jihee Hong;Yongbaek Kim
    • Journal of Veterinary Science
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    • v.24 no.5
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    • pp.64.1-64.6
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    • 2023
  • Two Domestic Korean Shorthair cats presented with dyschezia and vomiting. Computed tomography revealed a colonic mass with calcification and lymph node metastasis in case 1, and a small intestinal mass with disseminated mesenteric metastasis and calcification in case 2. Histopathology revealed intestinal adenocarcinoma with osseous metaplasia. Case 1 died two months after surgery from distant metastasis; and case 2 showed no metastasis for five months but presented with anorexia, euthanized seven months after diagnosis. Metastatic intestinal adenocarcinoma with bone formation should be considered as differential diagnosis for calcification on imaging, and lymph node metastasis at diagnosis may indicate poor prognosis.

A Study on the Korean medicine Clinical Use of Moire topography in musculoskeletal diseases (근골격계 질환에 대한 경근무늬측정검사(모아레)의 한의약적 임상응용 고찰)

  • Ryu, Hongsun;Song, Aejin;Chong, Myongsoo
    • Journal of Society of Preventive Korean Medicine
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    • v.20 no.1
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    • pp.75-87
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    • 2016
  • Objectives : This study aims to classify and analyze literature related to moire topography, as a diagnostic device of Korean medicine, discuss research trends and major results, and demonstrate the value of moire topography. Methods : To investigate moire topography research trends, Korean keywords that signify 'moire' were searched in a Korean journal search engine. Initially, 2,988 papers were found in the research, and, after classifying them and removing those that are duplicate in other databases, only 37 papers were applicable for the literature review in this study. To analyze research trends, the 37 papers were analyzed based on the publication year, research field, journal, and research type, and, clinical articles were classified based on the diagnosis purpose, subject characteristics, diagnosis method, test method, and test result, for analysis. Results : Moire topography research in South Korea was first conducted in 1995 and most active in 2003, mostly in the field of Korean medicine. In the journal analysis, The Journal of Korea CHUNA Manual Medicine for Spine & Nerves published the highest number of papers, most of which were clinical articles and the rest were literature review. And, in the analysis of clinical papers, based on the diagnosis purpose, muscle somatotype measurement was most common, followed by diagnosis of scoliosis. In terms of subjects, most studies focused on elementary, middle, and high school students, and, in terms of the diagnosis method, other tests were used in most studies. The analysis of moire topography methods showed that most studies measured the shoulder, back, and hip, and the most common measurement method in the studies measured the difference in contour lines on the left and right by designating a central line of the body. In terms of the result, most moire topography brought about significant diagnosis results, and many studies demonstrated its use for musculoskeletal diseases in particular. Conclusions : Moire topography is believed to be highly significant for diagnosis and treatment of musculoskeletal diseases and further research will be needed to support it.

Acute disseminated encephalomyelitis in children: differential diagnosis from multiple sclerosis on the basis of clinical course

  • Lee, Yun-Jin
    • Clinical and Experimental Pediatrics
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    • v.54 no.6
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    • pp.234-240
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    • 2011
  • Acute disseminated encephalomyelitis (ADEM) is a demyelinating disease of the central nervous system (CNS) that typically presents as a monophasic disorder associated with multifocal neurologic symptoms and encephalopathy. ADEM is considered an autoimmune disorder that is triggered by an environmental stimulus in genetically susceptible individuals. The diagnosis of ADEM is based on clinical and radiological features. Most children with ADEM initially present with fever, meningeal signs, and acute encephalopathy. The level of consciousness ranges from lethargy to frank coma. Deep and subcortical white-matter lesions and gray-matter lesions such as thalami and basal ganglia on magnetic resonance imaging (MRI) are associated with ADEM. In a child who presents with signs of encephalitis, bacterial and viral meningitis or encephalitis must be ruled out. Sequential MRI is required to confirm the diagnosis of ADEM, as relapses with the appearance of new lesions on MRI may suggest either multiphasic ADEM or multiple sclerosis (MS). Pediatric MS, defined as onset of MS before the age of 16, is being increasingly recognized. MS is characterized by recurrent episodes of demyelination in the CNS separated in space and time. The McDonald criteria for diagnosis of MS include evidence from MRI and allow the clinician to make a diagnosis of clinically definite MS on the basis of the interval preceding the development of new white matter lesions, even in the absence of new clinical findings. The most important alternative diagnosis to MS is ADEM. At the initial presentation, the 2 disorders cannot be distinguished with certainty. Therefore, prolonged follow-up is needed to establish a diagnosis.

Pediatric Stroke

  • Jeong, Goun;Lim, Byung Chan;Chae, Jong-Hee
    • Journal of Korean Neurosurgical Society
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    • v.57 no.6
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    • pp.396-400
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    • 2015
  • Pediatric stroke is relatively rare but may lead to significant morbidity and mortality. Along with the advance of brain imaging technology and clinical awareness, diagnosis of pediatric stroke is increasing wordwide. Pediatric stroke differs from adults in variable risk factor/etiologies, diverse and nonspecific clinical presentation depending on ages. This review will be discussed pediatric stroke focusing on their clinical presentations, diagnosis and etiologies/risk factors.

Clinically translatable photoacoustic imaging of cancer diagnosis (임상적용이 가능한 광음향 암 진단 기술)

  • Kim, Mi-Ji;Park, Yeon-Seong;Yoon, Changhan
    • The Journal of the Acoustical Society of Korea
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    • v.38 no.4
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    • pp.476-484
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    • 2019
  • Photoacoustic imaging is a hybrid real-time imaging technique that combines high optical contrast and ultrasonic resolution. It has primarily been utilized in pre-clinical research and has evolved into clinical practice. In this paper, we review photoacosutic imaging for detection of primary canccer and metastatis and its limitation in translation from pre-clinical to clinical application.

Clinical Utility of Haptoglobin in Combination with CEA, NSE and CYFRA21-1 for Diagnosis of Lung Cancer

  • Wang, Bing;He, Yu-Jie;Tian, Ying-Xing;Yang, Rui-Ning;Zhu, Yue-Rong;Qiu, Hong
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.22
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    • pp.9611-9614
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    • 2014
  • Purpose: To investigate the clinical value in lung cancer of a combination of four serum tumor markers, haptoglobin (Hp), carcinoembryonic antigen (CEA), neuron specific enolase (NSE) as well as the cytokeratin 19 fragment (CYFRA21-1). Materials and Methods: Serum Hp (with immune-turbidimetric method), CEA, NSE, CYFRA21-1 (with chemiluminescence method) level were assessed in 193 patients with lung cancer, 87 patients with benign lung disease and 150 healthy controls. Differences of expression were compared among groups, and joint effects of these tumor markers for the diagnosis of lung cancer were analyzed. Results: Serum tumor marker levels in patients with lung cancer were obviously higher than those with benign lung disease and normal controls (p<0.01). The sensitivities of Hp, CEA, NSE and CYFRA21-1 were 43.5%, 40.9%, 23.3% and 41.5%, with specificities of 90.7%, 99.2%, 97.9% and 97.9%. Four tumor markers combined together could produce a positive detection rate of 85.0%, significantly higher than that of any single test. With squamous carcinomas, the positive detection rates with Hp and CYFRA21-1 were higher than that of other markers. In the adenocarcinoma case, the positive detection rate of CEA was higher than that of other markers. For small cell carcinomas, the positive detection rate of NSE was highest. The area under receiver operating characteristic curve ($AUC^{ROC}$) of Hp in squamous carcinoma (0.805) was higher than in adenocarcinoma (0.664) and small cell carcinoma (0.665). Conclusions: Hp can be used as a new serum tumor marker for lung cancer. Combination detection of Hp, CEA, NSE and CYFRA21-1 could significantly improve the sensitivity and specificity in diagnosis of lung cancer, and could be useful for pathological typing.

Extraction Method of Significant Clinical Tests Based on Data Discretization and Rough Set Approximation Techniques: Application to Differential Diagnosis of Cholecystitis and Cholelithiasis Diseases (데이터 이산화와 러프 근사화 기술에 기반한 중요 임상검사항목의 추출방법: 담낭 및 담석증 질환의 감별진단에의 응용)

  • Son, Chang-Sik;Kim, Min-Soo;Seo, Suk-Tae;Cho, Yun-Kyeong;Kim, Yoon-Nyun
    • Journal of Biomedical Engineering Research
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    • v.32 no.2
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    • pp.134-143
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    • 2011
  • The selection of meaningful clinical tests and its reference values from a high-dimensional clinical data with imbalanced class distribution, one class is represented by a large number of examples while the other is represented by only a few, is an important issue for differential diagnosis between similar diseases, but difficult. For this purpose, this study introduces methods based on the concepts of both discernibility matrix and function in rough set theory (RST) with two discretization approaches, equal width and frequency discretization. Here these discretization approaches are used to define the reference values for clinical tests, and the discernibility matrix and function are used to extract a subset of significant clinical tests from the translated nominal attribute values. To show its applicability in the differential diagnosis problem, we have applied it to extract the significant clinical tests and its reference values between normal (N = 351) and abnormal group (N = 101) with either cholecystitis or cholelithiasis disease. In addition, we investigated not only the selected significant clinical tests and the variations of its reference values, but also the average predictive accuracies on four evaluation criteria, i.e., accuracy, sensitivity, specificity, and geometric mean, during l0-fold cross validation. From the experimental results, we confirmed that two discretization approaches based rough set approximation methods with relative frequency give better results than those with absolute frequency, in the evaluation criteria (i.e., average geometric mean). Thus it shows that the prediction model using relative frequency can be used effectively in classification and prediction problems of the clinical data with imbalanced class distribution.