• 제목/요약/키워드: differential diagnosis

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Clinical Features of the Persistent Idiopathic Dentoalveolar Pain Compared with Inflammatory Dental Pain

  • Jang, Ji Hee;Chung, Jin Woo
    • Journal of Oral Medicine and Pain
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    • 제47권2호
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    • pp.87-94
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    • 2022
  • Purpose: This study aimed to evaluate the differences between clinical and quantitative sensory testing (QST) results among persistent idiopathic dentoalveolar pain (PIDP), inflammatory dental pain, and control group subjects to identify discriminative clinical features for differential diagnosis. Methods: Thirty-three patients (5 PIDP-a without surgical procedures 10 PIDP-b with surgical procedures, 8 dental pain patients, and 10 controls) were evaluated for clinical features and QST results. Cold pain threshold, heat pain threshold, mechanical pain threshold (MPT), mechanical pain sensitivity, and pressure pain threshold (PPT) were performed. Psychological factors were assessed using Symptom Checklist-90-Revision (SCL-90-R) and a chart review was conducted to evaluate additional discriminative clinical features such as pain quality and treatment prognosis. Results: The dental pain group had lower PPT than the PIDP-b and the control group. The PIDP-a group showed higher MPT and PPT than the PIDP-b and dental pain group but the difference was not statistically significant. Differences in SCL-90-R SOM (Somatization), O-C (obsessive-compulsive), ANX (anxiety), and PSY (Psychoticism) values were statistically significant among groups. PIDP-a and PIDP-b groups showed remaining symptoms after treatment and the pain tended to spread widely, whereas, in toothache patients, symptoms disappeared after treatment. However, factors that confound the diagnosis, such as an increase in pain during chewing and a decrease in the pain threshold at the affected site, could also be identified. Conclusions: PIDP and dental pain groups have distinct clinical symptoms, but there are also factors that cause confusing in diagnosis. Therefore, various clinical examination results should be carefully reviewed and comprehensively evaluated in the differential diagnosis process.

사상체질과 맥진기 검사 결과와의 상관성에 대한 연구 - 국내 논문에 대한 체계적 고찰 - (Study on the Correlation between Sasang Constitution and the Data of Pulse Diagnosis Device - A Systematic Review in Korean Articles -)

  • 이혜윤;정아람;손한범;황만석;이정원;김경철;윤영주
    • 동의생리병리학회지
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    • 제26권5호
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    • pp.621-629
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    • 2012
  • This study aimed to examine the possibility of data from pulse diagnosis device to be used for diagnosis of Sasang constitution. Systematic searches of 5 major Korean medical database were conducted for articles published up to May 2012. Searching key word was "Sasang" or "Constitution". Studies dealt with correlation between Sasang constitution and the pulse wave data from pulse diagnosis machine were included. Totally 2886 studies are searched and 3 studies are added from references of evaluated articles. Among them, 12 studies were met our inclusion criteria (2 Xishu Mac, 2 Self-made pulse diagnosis machine, 8 3D-Mac). Three of the eight 3D-Mac studies intended to develop a formula of constitutional differential diagnosis, 2 studies compared variables by Sasang constitution in healthy group and 3 studies compared variables by Sasang constitution in healthy group and special disease group. They all reported some significant variables, however results are not consistent between studies. The accuracy of the formula of constitutional differential diagnosis using 3D-Mac pulse diagnosis devices is 46.0% by now. Improvements in measuring pulse are required to achieve more accurate result and be used for diagnosis of Sasang constitution. Compensating B.M.I. among Sasang constitutional groups and separating constitutional pulse factors from acquired characteristics are also needed in further study.

Recent Update of Advanced Imaging for Diagnosis of Cardiac Sarcoidosis: Based on the Findings of Cardiac Magnetic Resonance Imaging and Positron Emission Tomography

  • Chang, Suyon;Lee, Won Woo;Chun, Eun Ju
    • Investigative Magnetic Resonance Imaging
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    • 제23권2호
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    • pp.100-113
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    • 2019
  • Sarcoidosis is a multisystem disease characterized by noncaseating granulomas. Cardiac involvement is known to have poor prognosis because it can manifest as a serious condition such as the conduction abnormality, heart failure, ventricular arrhythmia, or sudden cardiac death. Although early diagnosis and early treatment is critical to improve patient prognosis, the diagnosis of CS is challenging in most cases. Diagnosis usually relies on endomyocardial biopsy (EMB), but its diagnostic yield is low due to the incidence of patchy myocardial involvement. Guidelines for the diagnosis of CS recommend a combination of clinical, electrocardiographic, and imaging findings from various modalities, if EMB cannot confirm the diagnosis. Especially, the role of advanced imaging such as cardiac magnetic resonance (CMR) imaging and positron emission tomography (PET), has shown to be important not only for the diagnosis, but also for monitoring treatment response and prognostication. CMR can evaluate cardiac function and fibrotic scar with good specificity. Late gadolinium enhancement (LGE) in CMR shows a distinctive enhancement pattern for each disease, which may be useful for differential diagnosis of CS from other similar diseases. Effectively, T1 or T2 mapping techniques can be also used for early recognition of CS. In the meantime, PET can detect and quantify metabolic activity and can be used to monitor treatment response. Recently, the use of a hybrid CMR-PET has introduced to allow identify patients with active CS with excellent co-localization and better diagnostic accuracy than CMR or PET alone. However, CS may show various findings with a wide spectrum, therefore, radiologists should consider the possible differential diagnosis of CS including myocarditis, dilated cardiomyopathy (DCM), hypertrophic cardiomyopathy, amyloidosis, and arrhythmogenic right ventricular cardiomyopathy. Radiologists should recognize the differences in various diseases that show the characteristics of mimicking CS, and try to get an accurate diagnosis of CS.

A Fuzzy Differential Diagnosis of Headache

  • Kim, Young-Hyun;Kim, Soon-Ki;Oh, Sun-Young;Ahn, Jeong-Yong
    • Journal of the Korean Data and Information Science Society
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    • 제18권2호
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    • pp.429-438
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    • 2007
  • Headache is one of the most common reasons for neurological consultation. Headache as many causes and symptoms. Therefore, screening method using questionaire is helpful in diagnosis of headache. This paper is to propose a medical diagnostic method to grasp patient's diseases using the relations between symptoms and diseases. For this purpose, we develop an interview chart assigned IF(intuitionistic fuzzy) grade with the relation among symptoms and three labels of headache. The method can be used to classify patient's tone of diseases with certain degrees of belief and its concerned symptoms.

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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.