• 제목/요약/키워드: clinical examination experience

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Role of colonoscopy in the diagnosis and treatment of pediatric lower gastrointestinal disorders

  • Park, Jae-Hong
    • Clinical and Experimental Pediatrics
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    • 제53권9호
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    • pp.824-829
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    • 2010
  • The safety and effectiveness of colonoscopy in the investigation of lower gastrointestinal tract pathology in children has been established for more than 2 decades in Korea. The skill and experience have since advanced to the point that both diagnostic and therapeutic colonoscopy are now routinely performed by most pediatric gastroenterologists. Pediatric colonoscopy differs significantly from its adult parallels in nearly every aspect including patient and parent management and preparation, selection criteria for sedation and general anesthetic, bowel preparation, expected diagnoses, instrument selection, imperative for terminal ileal intubation, and requirement for biopsies from macroscopically normal mucosa. Investigation of inflammatory bowel disease, whether for diagnosis or follow-up evaluation, and suspected colonic polyps are the most common indication for pediatric colonoscopy. The child who presents with signs and symptoms of lower gastrointestinal disorder should undergo colonoscopy with biopsy to make the diagnosis, as well as to help determine the appropriate therapy. This review introduces practical information on pediatric colonoscopy, the author's experiences, and the role of colonoscopic examination in the diagnosis and treatment of pediatric lower gastrointestinal disorders.

General Cytological Characters of Malignant Breast Lesions (유방의 세침흡인 세포검사 -악성 병변의 일반적인 세포 소견-)

  • Kim, Jee-Yeon
    • The Korean Journal of Cytopathology
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    • 제18권2호
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    • pp.100-111
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    • 2007
  • Fine needle aspiration (FNA) cytology of breast disease is recognized to be highly accurate and cost effective, especially when this is used in combination with clinical examination and imaging as part of a triple approach. A probabilistic/categorical approach is used for the classification of breast FNA specimens. Criteria are defined from the perspective of the likelihood of making a definitive diagnosis of cancer on excision. This approach is an accurate way of classifying breast FNA specimens, and this can be reliably applied regardless of the level of experience of the pathologist for interpreting the case. When a definitive diagnosis of malignancy is made, the next step is to determining the specific histologic types of the malignancy according to their cytological features. In order to make an accurate diagnosis of carcinoma and for correct typing a tumor, an adequate, correctly sampled aspirate without any other artifacts is required.

Osseous metaplasia of the palate: a case report

  • Kim, Won-Yong;Kim, Chul-Hwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제48권5호
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    • pp.315-317
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    • 2022
  • Osseous metaplasia is defined as the formation of lamellar bone inside soft tissue structures where bone normally does not exist. It results from the transformation of non-osseous connective tissue into mature bone. This condition is rare in the oral and maxillofacial region. We report a case of osseous metaplasia of the maxilla, a rare benign tumor in an uncommon region. A 60-year-old male patient visited our clinic complaining of foreign body sensation and asymptomatic swelling on the right palatal side. However, he did not experience pain and reported no local trauma that he could remember. Intra-oral examination revealed an exophytic lesion on the right palatal portion. On computed tomography, there was a round hard-tissue mass approximately 2 cm in diameter on the right palate area. The mass was biopsied and diagnosed as an osseous metaplasia. We review the clinical, radiographic, and histologic features and common causes of osseous metaplasia and report a rare case of osseous metaplasia of the palate.

Photon-Counting Computed Tomography: Experience in Musculoskeletal Imaging

  • Jan-Peter Grunz;Henner Huflage
    • Korean Journal of Radiology
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    • 제25권7호
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    • pp.662-672
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    • 2024
  • Since the emergence of the first photon-counting computed tomography (PCCT) system in late 2021, its advantages and a wide range of applications in all fields of radiology have been demonstrated. Compared to standard energy-integrating detector-CT, PCCT allows for superior geometric dose efficiency in every examination. While this aspect by itself is groundbreaking, the advantages do not stop there. PCCT facilitates an unprecedented combination of ultra-high-resolution imaging without dose penalty or field-of-view restrictions, detector-based elimination of electronic noise, and ubiquitous multi-energy spectral information. Considering the high demands of orthopedic imaging for the visualization of minuscule details while simultaneously covering large portions of skeletal and soft tissue anatomy, no subspecialty may benefit more from this novel detector technology than musculoskeletal radiology. Deeply rooted in experimental and clinical research, this review article aims to provide an introduction to the cosmos of PCCT, explain its technical basics, and highlight the most promising applications for patient care, while also mentioning current limitations that need to be overcome.

Isolated aortic valvular heart disease : analysis of etiology and surgical experience (대동맥판막질환의 임상적 고찰 -판막병리 및 임상성적에 대하여-)

  • 이승구
    • Journal of Chest Surgery
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    • 제20권2호
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    • pp.300-308
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    • 1987
  • Clinical and pathologic data were reviewed in 20 patients who had have surgery for isolated aortic valvular heart disease between April 1978 and April, 1987. Hospital mortality was 10%, with no additional late mortality during a mean follow-up period of 24.1 months. Prosthetic valve failure developed in 3 patients and two had reoperation. Niety four percent of the survivors who were in NYHA Funtional class III or IV before operation are now in class I or II. Ninety percent of all patients are still alive at a maximum follow up of 9 years. The clinical histories, gross and histologic examination of valves estabilished the causes for isolated aortic valve disease: 3 rheumatic, 2 congenital bicuspid, 2 hypertention, 2 aortitis and each one case of floppy valve, medial cystic necrosis of aorta, bacterial endocarditis. But etiology was unknown in 8 cases. Sixteen patietns had myxoid degeneration, defined as significant disruption of the valve fibrosa and its replacement by acid mucosaccharides and cystic changes. Myxoid degeneration was also the primary pathologic abnormality in the patients with 2 hypertention, 2 rheumatic, 1 aortitis, 1 bacterial endocarditis, 1 floppy valve, 1 congenital bicuspid. The patients with myxoid degeneration of uncertain origin were 8. Histologic finding of all of them revealed nonspecific patients with myxoid degeneration of uncertain orgin were 8. Histologic finding of all of them revealed nonspecific chronic valvulitis with myxoid degeneration. This finding may indicate that the etiology w uld be infectious.

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Glucose transport 1 deficiency presenting as infantile spasms with a mutation identified in exon 9 of SLC2A1

  • Lee, Hyun Hee;Hur, Yun Jung
    • Clinical and Experimental Pediatrics
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    • 제59권sup1호
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    • pp.29-31
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    • 2016
  • Glucose transport 1 (GLUT-1) deficiency is a rare syndrome caused by mutations in the glucose transporter 1 gene (SLC2A1) and is characterized by early-onset intractable epilepsy, delayed development, and movement disorder. De novo mutations and several hot spots in N34, G91, R126, R153, and R333 of exons 2, 3, 4, and 8 of SLC2A1 are associated with this condition. Seizures, one of the main clinical features of GLUT-1 deficiency, usually develop during infancy. Most patients experience brief and subtle myoclonic jerk and focal seizures that evolve into a mixture of different types of seizures, such as generalized tonic-clonic, absence, myoclonic, and complex partial seizures. Here, we describe the case of a patient with GLUT-1 deficiency who developed infantile spasms and showed delayed development at 6 months of age. She had intractable epilepsy despite receiving aggressive antiepileptic drug therapy, and underwent a metabolic workup. Cerebrospinal fluid (CSF) examination showed CSF-glucose-to-blood-glucose ratio of 0.38, with a normal lactate level. Bidirectional sequencing of SLC2A1 identified a missense mutation (c.1198C>T) at codon 400 (p.Arg400Cys) of exon 9.

Two Cases of Disc Internal Disruption Syndrome (추간판 내부 파열 증후군(Internal disc disruption) 2례)

  • Lee, Jong-Hyeung;Ahn, Myun-Whan;Ahn, Jong-Chul
    • Journal of Yeungnam Medical Science
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    • 제8권1호
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    • pp.238-245
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    • 1991
  • The disc internal disruption syndrome is not well known to us, but the following hypothesis is widely accepted in clinical practice. The disc internal disruption syndrome may develop intractable back pain with aggrevated of pain, loss of spinal motion with any physical exercise, leg pain, loss of energy, marked weight loss, and profound depression. The patient with this syndrome will be found to have normal plain roentgenograms, myelograms, CT scans, results of blood examination and neurologic findings. For these reasons, this syndrome was frequently diagnosed by abnormal discographic findings. We had experience with two cases of disc internal disruption syndrome with clinical, roentgenographic and discographic evaluations. Thus We present these cases with a brief review of the concerned literature.

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The Educational Effects of the Experience of Nursing Students' Patients Role in the Simulation Practice Education for the Women's Health Nursing (여성건강간호학의 시뮬레이션 실습교육에서 간호대학생의 환자역할경험의 교육적 효과)

  • Lee, Bo Gyeong;Kim, Sun-Hee
    • The Journal of Korean Academic Society of Nursing Education
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    • 제25권4호
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    • pp.436-447
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    • 2019
  • Purpose: The purpose of this study is to identify the educational effect among nursing students who performed the patient role in women's health nursing simulations. Methods: In this exploratory qualitative study, a sample of 31 third- and fourth-grade nursing students who participated in scenario-based patient roles in clinical performance examination of the women's health nursing simulation practice training. Data were collected through focus group interviews. Qualitative data were analyzed using qualitative content analysis. Results: Three themes emerged from the data analysis. Participants experienced an enhancement of patient-centered nursing competence, deep learning immersion and display of self-regulated learning. The difficulty of performing the patient role contributed additional effects such as the difficulty to perform the patient role in the psychological training environment. Conclusion: It is recommended to utilize nursing students as patients in simulation practice training. On the other hand, the psychological training environment can cause difficulties in performing patient roles, a burden on the role of the patient, and involves the interruption of the role.

Awareness of the Guidelines for Institutionalization of Physical Therapist Specialization (물리치료사 전문화 제도 기준에 대한 인식)

  • Roh, Hyo-Lyun
    • Journal of the Korean Society of Physical Medicine
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    • 제16권4호
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    • pp.67-75
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    • 2021
  • PURPOSE: This study examined the level of awareness of the guidelines of the physical therapist specialization system. METHODS: This study was a cross-sectional survey of 364 clinical physical therapists working in hospitals. A structured questionnaire consisting of 17 questions was used. The questionnaire consisted of standards and management for the institutionalization of physical therapist specialization, intentions to acquire specialized physical therapist qualifications, specialized fields, and general information of the research subjects. RESULTS: At least five years of clinical experience and a bachelor's degree or higher were required to obtain a specialized physical therapist qualification. Many physical therapists said they would accept the qualification of a specialized physical therapist. Training and examination were appropriate for acquiring specialized physical therapist qualifications, and it was desirable to manage qualifications at the national level or the association of physical therapists. As for the specialized fields of physical therapy, musculoskeletal physical therapy, pediatric physical therapy, and nervous system physical therapy were prioritized, and electrotherapy was not recognized as a specialized field. CONCLUSION: A detailed discussion is needed on the system and cost for acquiring a specialized physical therapist qualification and economic benefits after acquiring the qualification.

Diagnostic Approaches for Idiopathic Pulmonary Fibrosis

  • Jae Ha Lee;Jin Woo Song
    • Tuberculosis and Respiratory Diseases
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    • 제87권1호
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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.