• 제목/요약/키워드: differential diagnosis

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후두외상으로 발생한 일측 성대 마비의 감별진단으로서 후두근전도검사의 유용성 -증례보고- (The Clinical Usefulness of Laryngeal Electromyography(LEMG) for Differential Diagnosis of Traumatic Unilateral Vocal Cord Palsy -A Case Report-)

  • 최홍식;김한수;김정홍;장정현
    • 대한후두음성언어의학회지
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    • 제13권2호
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    • pp.188-192
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    • 2002
  • Unilateral vocal cord palsy which is associated with laryngeal trauma is not uncommon event. In a 42-year-old male, a cricoid cartilage fracure had been developed after blunt trauma. The endoscopic findings showed contusion and diffuse swelling around the left arytenoid and false cord. During phonation, the mobility of left side true vocal cord was decreased. There were no level difference and displacement of the left side arytenoid. We used the laryngeal electromyography (LEMG) to make a differential diagnosis between the cricoarytenoid joint dislocation and the injury of recurrent laryngeal nerve. At the right thyroarytenoid muscle and cricothyroid muscle, the findings of LEMG were normal. But the amplitude and frequency during phonation were decreased (partial denervation) at the left thyroarytenoid muscle. LEMG is a very useful method to predict the diagnosis of vocal cord palsy.

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Diagnostic approach of orthostatic dizziness/vertigo

  • Lee, Hyung;Kim, Hyun Ah
    • Annals of Clinical Neurophysiology
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    • 제22권2호
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    • pp.75-81
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    • 2020
  • This paper introduces new diagnostic criteria and differential diagnosis of orthostatic dizziness to help clinicians to diagnose hemodynamic orthostatic dizziness. Clinicians need to be able to discriminate hemodynamic orthostatic dizziness from other types of dizziness that are induced or aggravated when standing or walking. Measurements of the orthostatic blood pressure and heart rate are important when screening hemodynamic orthostatic dizziness. Detailed history-taking, a physical examination, and laboratory tests are essential for finding the cause of hemodynamic orthostatic dizziness. The differential diagnosis of hemodynamic orthostatic dizziness is crucial because it can be caused by various autonomic neuropathies.

체강액의 세포학 (The Cytopathology of Body Cavity Fluid)

  • 홍은경
    • 대한세포병리학회지
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    • 제19권2호
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    • pp.72-85
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    • 2008
  • Cytologic examination of the body cavity fluid is very important because the specimens represent a significant percentage of nongynecologic samples and this cytologic examination may be the first, best or only chance for making the diagnosis of an underlying malignancy. The purposes of body cavity fluid examination are to correctly identify cancer cells and if possible, to identify the tumor types and primary sites when presented with unknown primary tumor sites. The most important basic differential diagnosis is that of benign and reactive disease vs malignant disease. Reactive mesothelial cells are a consistent population in body cavity fluid, and these are the most versatile cells in the body. Due to the specific environment of the body cavity, the exfoliated reactive mesothelial cells may show significant morphologic overlap with the morphology of cancer cells. With a focus on the differential points between reactive mesothelial cells and metastatic adenocarcinoma cells, the practical diagnostic approaches, the diagnostic clues and the pitfalls to achieve a correct diagnosis are presented in this review.

Application of artificial neural network to differential diagnosis of lung lesion: Preliminary results

  • Lee, Hae-Jun;Lee, Yu-Kyung;Hwang, Kyung-Hoon
    • 한국정보처리학회:학술대회논문집
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    • 한국정보처리학회 2011년도 춘계학술발표대회
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    • pp.1614-1615
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    • 2011
  • It is difficult to differentially diagnose between lung cancer and benign inflammatory lung lesion due to high false positive rate on F-18 FDG-PET. We investigated whether application of artificial neural network to this diagnosis may be helpful. We reviewed the medical records and F-18 FDG PET images of 12 patients, selecting clinical and PET variables such as SUV. For selected variables and confirm, multilayer neural perceptron was applied in crossvalidation method and compared to visual interpretation. Neural network correctly classified the lung lesions in 83%, and reduced greately the false positive rate. However, false negative rate was not influenced. Application of neural network to the differential diagnosis between lung cancer and benigh inflammatory lesion may be helpful. Further studies with more patients are warranted.

내전형 연축성 발성장애 감별진단 문항 개발과 임상적 유용성 평가 (Development of Differential Diagnosis Scale Items for Adductor Spasmodic Dysphonia and Evaluation of Clinical Availability)

  • 조재경;최성희;이상혁;진성민
    • 대한후두음성언어의학회지
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    • 제30권2호
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    • pp.112-117
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    • 2019
  • Background and Objectives The purpose of this study was to develop the differential diagnosis scale containing items from adductor spasmodic dysphonia (ADSD) to muscle tension dysphonia (MTD) and the determine clinical utility of newly developed items. Materials and Method The four parts of pitch, redirected phonation, automatic speech and voiced sound were selected for analyzing the characteristics of ADSD in the literature. One part of tense voiceless sound was developed according to the Korean manner of articulation. The content validity was evaluated based on 5 scales (1-5 point) analysis from 30 experts. One hundred patients (50 ADSD and 50 MTD) were recorded in reading a sentence and sustained phonation. The two speech language pathologist evaluated recorded voices through a blind test using 4 scales (0-3 point) for newly developed items. Results As a result of verifying the content validity of items with experts, it was identified that the differentiated items were valid with 4.2 out of 5. Through the differential diagnosis between two groups according to the items, the correlation between sub-domains and total scores was shown as higher than 0.710. The result of analyzing the reliability on each diagnosis domain was 0.840-0.893, which showed the internal consistency of items was great. Newly developed five parts of ADSD were significantly higher than those of MTD with strong correlation (p<0.01). The reliability among the evaluators was analyzed as high with 0.892. Conclusion In this study, the differential diagnosis scale of ADSD was revealed as having validity and reliability. It is considered that it will be useful for differentiating ADSD and MTD in the clinical field.

Utility of Computed Tomography in a Differential Diagnosis for the Patients with an Initial Diagnosis of Chronic Obstructive Pulmonary Disease Exacerbation

  • Park, Hyung Jun;Kim, Soo Han;Kim, Ho-Cheol;Lee, Bo Young;Lee, Sei Won;Lee, Jae Seung;Lee, Sang-Do;Seo, Joon Beom;Oh, Yeon-Mok
    • Tuberculosis and Respiratory Diseases
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    • 제82권3호
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    • pp.234-241
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    • 2019
  • Background: The utility of computed tomography (CT) in the differential diagnosis of patients with chronic obstructive pulmonary disease (COPD) exacerbation remains uncertain. However, due to the low cost associated with CT scan along with the impact of Koreas' health insurance system, there has been a rise in the number of CT scans in the patients with initial diagnosis of COPD exacerbations. Therefore, the utility of CT in the differential diagnosis was investigated to determine whether performing CT scans affect the clinical outcomes of the patients with an initial diagnosis of COPD exacerbation. Methods: This study involved 202 COPD patients hospitalized with an initial diagnosis of COPD exacerbation. We evaluated the change in diagnosis or treatment after performing a CT scan, and compared the clinical outcomes of patient groups with vs. without performing CT (non-CT group vs. CT group). Results: After performing CT, the diagnosis was changed for two (3.0%) while additional diagnoses were made for 27 of the 64 patients (42.1%). However, the treatment changed for only one (1.5%), and six patients (9.3%) received supplementary medication. There were no difference in the median length of hospital stay (8 [6-13] days vs. 8 [6-12] days, p=0.786) and intensive care unit care (14 [10.1%] vs. 11 [16.7%], p=0.236) between the CT and non-CT groups, respectively. These findings remained consistent even after the propensity score matching. Conclusion: Utility of CT in patients with acute COPD exacerbation might not be helpful; therefore, we do not recommend chest CT scan as a routine initial diagnostic tool.

Post-traumatic Back Pain Revealed as Tuberculous Spondylitis -A Case Report-

  • Kim, Bum-Suk;Shin, Jeong-Hee;Moon, Ho-Sik;Chon, Jin-Young;Sung, Choon-Ho
    • The Korean Journal of Pain
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    • 제23권1호
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    • pp.74-77
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    • 2010
  • Tuberculous spondylitis is a very rare disease, but it can result in bone destruction, kyphotic deformity, spinal instability, and neurologic complications unless early diagnosis and proper management are done. Because the most common symptom of tuberculous spondylitis is back pain, it can often be misdiagnosed. Atypical tuberculous spondylitis can be presented as a metastatic cancer or a primary vertebral tumor. We must make a differential diagnosis through adequate biopsy. A 30-year-old man visited our clinic due to back and chest pain after a recent traffic accident. About 1 year ago, he had successfully recovered from tuberculous pleurisy after taking anti-tuberculosis medication. We performed epidural and intercostal blocks but the pain was not relieved. For the further evaluation, several imaging and laboratory tests were done. Finally, we confirmed tuberculous spondylitis diagnosis with the biopsy results.

국내외 설진기를 활용한 인간 대상 연구현황 (A review on Clinical Trials by Using a Computerized Tongue Diagnosis System)

  • 이현주;권나연;남동현
    • 대한한의진단학회지
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    • 제19권1호
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    • pp.1-10
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    • 2015
  • Objectives The purpose of this study was to survey the status of clinical use of a computerized tongue diagnosis system (CTDS) Methods We searched domestic/international articles using the CTDS from online medical databases including OASIS, NDSL and pubmed. We selected articles on clinical application or reliability of CTDS but excluded articles on mechanical design or software programming for developing a new CTDS. Finally we found 15 articles and classified the articles according to the study purpose. Results Out of the 15 articles, 8 were focused on the clinical application including halitosis, cold/heat syndrome, lung cancer, xerostomia etc. Other 5 articles were aimed at evaluating and improving reliability of CTDS. The other 2 articles were studied for development of differential diagnostic criteria on tongue coating thickness. Conclusion We found out that until now the researches on clinical application of CTDS mainly had been performed for producing a variety of CTDSs. Considering the importance of the tongue color in the traditional Korean medicine, we suggest that at first standard operating procedure for CTDS be developed and researches to develop differential diagnostic criteria on tongue body/coating color be performed and then explore its applications.

Angioleiomyoma of the oral cavity: a case report and brief review of the literature

  • Matiakis, Apostolos;Karakostas, Panagiotis;Pavlou, Achilleia-Maria;Anagnostou, Eleftherios;Poulopoulos, Athanasios
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제44권3호
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    • pp.136-139
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    • 2018
  • This study presents a case of an oral angioleiomyoma along with its clinical diagnostic approach and laboratory confirmation. The differential diagnosis, especially from angioleiomyosarcoma, is also included. A 51-year-old patient presented with a tumor-like lesion on his upper labial mucosa. The clinical examination revealed a benign lesion that was surgically removed. Histopathological and immunohistochemical examinations confirmed the diagnosis of an oral angioleiomyoma. The post-surgical period was uneventful. No recurrence had occurred after a year of follow-up surveillance. Oral angioleiomyoma is a very rarely occurring oral lesion. Clinically, it may mimic some benign lesions, including fibroma, pyogenic granuloma or minor salivary gland tumor. Surgical excision is the treatment of choice. Histological and immunohistochemical examination can confirm the diagnosis. The differential diagnosis is crucial to rule out angioleiomyosarcoma.

치매의 FDG PET 영상 (FDG PET Imaging For Dementia)

  • 안병철
    • Nuclear Medicine and Molecular Imaging
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    • 제41권2호
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    • pp.102-111
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    • 2007
  • Dementia is a major burden for many countries including South Korea, where life expectancy is continuously growing and the proportion of aged people is rapidly growing. Neurodegenerative disorders, such as, Alzheimer disease, dementia with Lewy bodies, frontotemporal dementia, Parkinson disease, progressive supranuclear palsy, corticobasal degeneration, Huntington disease, can cause dementia, and cerebrovascular disease also can cause dementia. Depression or hypothyroidism also can cause cognitive deficits, but they are reversible by management of underlying cause unlike the forementioned dementias. Therefore these are called pseudodementia. We are entering an era of dementia care that will be based upon the identification of potentially modifiable risk factors and early disease markers, and the application of new drugs postpone progression of dementias or target specific proteins that cause dementia. Efficient pharmacologic treatment of dementia needs not only to distinguish underlying causes of dementia but also to be installed as soon as possible. Therefore, differential diagnosis and early diagnosis of dementia are utmost importance. F-18 FDG PET is useful for clarifying dementing diseases and is also useful for early detection of the diseases. Purpose of this article is to review the current value of FDG PET for dementing diseases including differential diagnosis of dementia and prediction of evolving dementia.