• Title/Summary/Keyword: clinical diagnostic procedure

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Clinical study of Pulmonary Sequestration (폐격리증에 대한 임상적 고찰)

  • Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.18 no.2
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    • pp.320-326
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    • 1985
  • Pulmonary sequestration occurs when some disturbance produces a cystic mass of nonfunctioning lung tissue which lacks normal communication with the tracheobronchial tree. Between 1971 and 1985, pulmonary sequestration was diagnosed in 11 patients, ranging age from 3 to 29 years. All sequestration were intralobar type. Definitive diagnosis can only be obtained by aortography and/or surgical exploration in 10 cases. The other one was confirmed by pathologic examination postoperatively. The presenting complaints were mostly recurrent local pulmonary infection, but in 2 cases mediastinal mass with respiratory symptoms was presented, and cardiac murmur was only finding in one case. Preoperative diagnostic procedure revealed 3 associated anomalies which were funnel chest, right aortic arch, and pulmonic stenosis with vascular ring. Operative treatment for sequestration was lobectomy in 10 cases, and a segmentectomy in one. There was no operative mortality, but 3 complications [empyema, B-P fistula, post-op bleeding] which were controlled by subsequent operations or conservative measure. Aortography is strongly advocated not only for its diagnostic value, but for its preoperative localization of the aberrant vessels that are the major concern to the surgeon.

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Diagnostic Value of Ultrasound-Guided Fine Needle Aspiration Biopsy in Malignant Thyroid Nodules: Utility for Micronodules

  • Unal, Betul;Sezer, Cem
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8613-8616
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    • 2014
  • Background: The diagnostic approach to thyroid nodules involves ultrasound-guided fine needle aspiration biopsy (US-FNAB). We especially aimed to evaluate the contribution and the place of US-FNAB in preoperative evaluation of the malignant cases and draw attention to discordant cases diagnosed with papillary thyroid microcarcinoma (PTMC). Materials and Methods: A total of 276 cases were retrospectively reviewed who were subsequently diagnosed with a malignancy and who underwent US-FNAB. Results: Some 45 were found to have previously undergone the US-FNAB procedure. Of the patients in whom the surgical specimen was diagnosed with a malignancy, 21 (46.7%) were diagnosed as malignant or suspicious for malignancy, and 24 (53.3%) were concluded as benign or insufficient for diagnosis. Patients with the diagnosis of PTMC outnumbering the others was a striking finding (11 cases, 24%). Conclusions: We suggest performing repeat aspiration biopsy considering sampling errors in cases where inconsistency exists between clinical findings and cytological results in thyroid nodules smaller than 10 mm in diameter and with suspicious findings on ultrasonography.

The role of cap-assisted endoscopy and its future implications

  • Sol Kim;Bo-In Lee
    • Clinical Endoscopy
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    • v.57 no.3
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    • pp.293-301
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    • 2024
  • Cap-assisted endoscopy refers to a procedure in which a short tube made of a polymer (mostly transparent) is attached to the distal tip of the endoscope to enhance its diagnostic and therapeutic capabilities. It is reported to be particularly useful in: (1) minimizing blind spots during screening colonoscopy, (2) providing a constant distance from a lesion for clear visualization during magnifying endoscopy, (3) accurately assessing the size of various gastrointestinal lesions, (4) preventing mucosal injury during foreign body removal, (5) securing adequate workspace in the submucosal space during endoscopic submucosal dissection or third space endoscopy, (6) providing an optimal approach angle to a target, and (7) suctioning mucosal and submucosal tissue with negative pressure for resection or approximation. Here, we review various applications of attachable caps in diagnostic and therapeutic endoscopy and their future implications.

Study of Sasang Constitution Classification Method Based on Elasticity Coefficient of Hand Doral Skin of Elderly People (고령자의 손등피부 탄성 특성을 활용한 체질분류 방법 연구)

  • Kang, Nam-Sik;Lee, Jae-Chul;Ku, Bon-Cho;Kim, Jong-Yeol;Kim, Young-Min
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.25 no.6
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    • pp.1050-1055
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    • 2011
  • This paper presents a novel diagnostic method to determine Sasang Consitution (SC) by elasticity coefficient of hand dorsal skin of elderly people. For this purpose, we carried out a clinical test, in which Our SC diagnostic tool and one Oriental medical doctor with SC medicine expertise participated to categorize 458 healthy subjects into four constitutions. After excluding heavy-noise, we extracted 295 subjects' elasticity coefficient feature data and statistically analyzed their SC relevance with ANOVA test. It resulted in that, Taeum-in has high elasticity coefficient compared to Soeum-in in a significance level of 0.05. There are no differences of elasticity coefficient in genders. This result is supported by the theory of Longevity and Life Preservation in Eastern Medicine(Donguisusebowon, 동의수세보원) which suggested that Taeum-in's flesh is solid and Soeum-in's one is tender. This is the first work which reports the relatedness of skin elasticity coefficient and SC by an objective clinical test.

Diagnostic Approaches for Idiopathic Pulmonary Fibrosis

  • Jae Ha Lee;Jin Woo Song
    • Tuberculosis and Respiratory Diseases
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    • v.87 no.1
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    • pp.40-51
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    • 2024
  • Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, fibrosing interstitial pneumonia with a very poor prognosis. Accurate diagnosis of IPF is essential for good outcomes but remains a major medical challenge due to variability in clinical presentation and the shortcomings of existing diagnostic tests. Medical history collection is the first and most important step in the IPF diagnosis process; the clinical probability of IPF is high if the suspected patient is 60 years or older, male, and has a history of cigarette smoking. Systemic assessment for connective tissue disease is essential in the initial evaluation of patients with suspected IPF to identify potential causes of interstitial lung disease (ILD). Radiologic examination using high-resolution computed tomography plays a pivotal role in the evaluation of patients with ILD, and prone and expiratory computed tomography images can be considered. If additional tests such as surgical lung biopsy or transbronchial lung cryobiopsy are needed, transbronchial lung cryobiopsy should be considered as an alternative to surgical lung biopsy in medical centers with experience performing this procedure. Diagnosis through multidisciplinary discussion (MDD) is strongly recommended as MDD has become the cornerstone for diagnosis of IPF, and the scope of MDD has expanded to monitoring of disease progression and suggestion of appropriate treatment options.

A Study on the Perception of the Importance and Performance of Patient Education of the Clinical Nurses (종합병원 간호사가 인식하는 환자교육 중요도와 수행도의 관계연구)

  • Yoo, Eun-Kyung;Suh, Moon-Ja
    • The Journal of Korean Academic Society of Nursing Education
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    • v.6 no.2
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    • pp.287-302
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    • 2000
  • The purpose of the study are to examine the perception of the importance and performance of patient education of the clinical nurse and find out the interfering factors in practicing patient education. The data were collected from convenient sample of 256 clinical nurses working in the nursing units of adult patients except the psychiatric unit, obstetric unit, dental surgical unit and intensive care unit of one University Hospital in Seoul from September 29 to October 2, 1998. Three measurement tools of self-report- questionnaires developed by researcher used. For the content validity of the questionnaires, two sessions of panel discussion and a pilot test were done and finally factor analysis was done with Varimax method. Analysis of data was done with SAS program using frequency, percentage, means, standard deviation, Pearson's Correlation Coefficients, t-test and ANOVA. The obtained results were as follows : 1. The surveyed nurses perceived the importance of patient education at higher level with mean score of 4.08 among 5 point than their perception of practice( mean score : 3.42). 2. There was positive significant correlation(r=.29, p=0.0001)between nurses' perception of the importance of patient education and it's practice 3. Among the teaching contents for patients, 'information of diagnostic procedure and operation' and 'orientation of hospitalization' were perceived most important. And 'preparation for discharge' and 'understanding of disease and health promotion' were perceived least important 4. Among the teaching contents for patients, 'orientation of hospitalization' and 'information of diagnostic procedure and operation' were perceived highly performable. And 'understanding of disease and health promotion' and 'preparation for discharge' were perceived least performable. 5. Three types of interfering factors were identified as patient-factor, situational factor, nurse-factor. The mean degree of impediment with the interfering factors was at average level(3.09 among 5). The patient and situational factors of impediments were more interfering than nurse- factor for teaching patients. 6. In older age(p<.05), married state (p<.05), higher educational status (p<.01), higher clinical experience (p<.01) and higher position(p<.01), the score of perceived importance of patients education was more high. 7. In older age(p<.01), higher clinical experience(p<.001) and surgical unit (p<.01), the score of perceived performance of patients education was more high. In conclusion, in order to activate patient education practice in the clinical setting, the continuing education for patients education should be more emphasized and the effective teaching methods and materials should be developed to help patient teaching. And an organizational support such as budgeting for patient education and reimbursement system should be administrated.

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Transarterial Therapies for Hepatocellular Carcinoma: a Comprehensive Review with Current Updates and Future Directions

  • Kumar, Yogesh;Sharma, Pranav;Bhatt, Neeraj;Hooda, Kusum
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.2
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    • pp.473-478
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    • 2016
  • Hepatocellular cancer is a very common cause of cancer related deaths worldwide. Only 30-40% of patients present with early-stage disease open to curative treatments, such as resection or transplantation, while others can only undergo local therapies or palliative care. Various trans-arterial approaches have been used for treatment of hepatocellular carcinoma in patients who need a down-staging to liver transplantation, and who are not candidates for transplantation or radiofrequency ablation. Transarterial chemoembolization (TACE), transarterial embolization (TAE), drug-eluting beads, and radioembolization have been used for locoregional control, and have been shown to prolong the overall survival when compared with supportive care. In this review, we discuss patient selection, pre- and post-procedure imaging, techniques, safety, and clinical outcomes related to these therapies. Newer advances with future directions in various fields related to trans-arterial therapies are also discussed.

Case report of esthetic maxillary anterior crown lengthening (상악 전치부에서 심미적 치관 연장술의 치유 양상 보고)

  • Kim, Sun-Ha;Park, Jin-Woo;Suh, Jo-Young;Lee, Jae-Mok
    • Journal of Periodontal and Implant Science
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    • v.39 no.2
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    • pp.199-204
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    • 2009
  • Purpose: Excessive gingival display and short clinical crowns due to altered passive eruptions are major concerns for a considerable number of patients visiting dental clinics. Altered passive eruptions could be corrected through various types of periodontal surgery conformable to a classification. 3 cases are reported here on the esthetic correction of altered passive eruption to evaluate results of crown lengthening procedure. Methods: Three patients whose major complaints were excessive gingival display and short teeth were picked out for this case study. Before treatment, clinical and radiological exam was performed to choose type of surgery. Thickness and width of keratinized gingiva was measured in all three patients then they were treated by surgical methods including flap operation and depigmentation under subsequent diagnosis. Results: Uneventful healing and stable gingival margin were observed in all three patients except recurrence of gingival pigmentation of one patient. Conclusions: The treatment of altered passive eruption requires precise diagnostic procedure and could achieve better esthetic outcomes when it is accompanied by other orthodontic and orthognathic treatment.

Combined Predictors of Long-Term Outcomes of Kasai Surgery in Infants with Biliary Atresia

  • Anna Degtyareva;Medan Isaeva;Elena Tumanova;Elena Filippova;Anna Sugak;Alexander Razumovsky;Nadezhda Kulikova;Marina Albegova;Denis Rebrikov
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.27 no.4
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    • pp.224-235
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    • 2024
  • Purpose: Biliary atresia (BA) is the leading cause of neonatal cholestasis (25-45%). The primary treatment is hepatic portoenterostomy (Kasai procedure), but only 20-40% provide long-term benefits. This study aimed to develop a predictive model for surgical efficacy by comparing preoperative and early postoperative indicators in infants with different outcomes. Methods: We enrolled 166 infants with BA (93 girls, 73 boys) who underwent the Kasai procedure between September 2002 and December 2021, dividing them into favorable or adverse outcome groups. Over 40 parameters were measured, and the diagnostic significance of the prognostic model was evaluated. Results: Kasai surgery was efficacious in 69 patients (42%) and non-efficacious in 97 (58%). Our model assesses efficacy by day 14 after surgery, improving on the <34 µmol/L direct bilirubin threshold established for 3-6 months after the procedure. Including the Desmet fibrosis score refined the model. Conclusion: Blood cholesterol below 5.41 mmol/L, direct bilirubin below 56.3 µmol/L on postoperative days 14±3, and a low Desmet score indicate a high probability of efficacious Kasai surgery in infants with BA.

Clinical Application of an Image-Guided Intervention in Three Dogs

  • Choi, Minsik;Kwon, Dohoon;Ahn, Jisoo;Ko, Minjung;Ahn, Jiyoung;Jung, Joohyun;Kim, Hakhyun;Kang, Ji-Houn;Chang, Dongwoo
    • Journal of Veterinary Clinics
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    • v.37 no.2
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    • pp.100-105
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    • 2020
  • A 9-month-old, 11.3 kg, intact, male, mixed-breed dog was referred for treatment of cor triatriatum dexter (CTD); a 5-month-old, 1.9 kg, intact, male Maltese for pulmonic stenosis (PS); and a 3-year-old, 6.62 kg, intact, female West Highland white terrier for esophageal stricture with regurgitation. A balloon catheter intervention was performed in the dog with CTD, and subsequent color Doppler ultrasound and abdominal ultrasound showed normal blood flow across the perforated membrane dividing the right atrium and the disappearance of the severe ascites present before treatment. Balloon catheter intervention in the dog with PS reduced the blood flow through the stenosis from 5.82 m/s to 3.97 m/s. In the dog with esophageal stricture, balloon catheter intervention widened the esophagus and no subsequent regurgitation was observed. Balloon catheter intervention is an interventional radiology procedure that represents a definitive treatment option for various stenotic lesions in dogs, including CTD, PS, and esophageal stricture. Although interventional radiology procedures for these diseases have already been reported, details of procedures and successful outcome have not been reported in Korea.