• Title/Summary/Keyword: late diagnosis

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A Study of the Case Records of a Herbalist En Su-ryong in the late Chosun dynasty (19세기 고창지방 의원 은수룡이 남긴 경험의안)

  • Lee, Sun Ah
    • The Journal of Korean Medical History
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    • v.18 no.2
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    • pp.63-91
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    • 2005
  • This paper analyzes the case records of a herbalist En Su-ryong who lived at the Kochang area of Chollapukdo province in the 19th century. The records, which were included in his collection of works, Tantojip(呑吐集), were consisted of 11 clinical diagnosis and prescriptions. The result of the analysis is as follows. First, En Su-ryong's records are estimated to be valuable enough to contribute to the development of the Korean clinical medicine, in light of the fact that the present established prescriptions or medical theory came from the repetition of trial and error by many herb doctors. Second, his case records are unique in the style of writing, because they were consisted of only his own clinical diagnosis and prescriptions case by case, while those of ordinary herbalists were classified by the types of the symptoms of a disease, with their prescriptions modified from the past established. Third, in the records he minutely wrote not only the names and the addresses of the patients under his care, but also the names of the diseases, the progress and the contents of his treatment, and even the perfect cure or not. Therefore, his case records are appreciated to be very important from the standpoint of the history of the society.

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ORAL MANIFESTATION AND TREATMENT IN CLEIDOCRANIAL DYSPLASIA PATIENT - A CASE REPORT - (쇄골 두개 이형성증 환자의 구강내 증상과 치료-증례 보고)

  • Jo, Hyung-Woo;Choi, So-Young;Kim, Jin-Wook;Byeon, Ki-Jeong;Kim, Chin-Soo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.5
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    • pp.440-443
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    • 2009
  • Cleidocranial dysplasia(CCD) is a rare syndrome usually caused by an autosomal dominant gene or no apparent genetic cause. The skull is large and short with marked bossing of the frontal bone. Closure on the fontanelles and sutures is delayed. The clavicle may be unilaterally or bilaterally aplastic. Oral manifestations include multiple impacted permanent teeth, prolonged retention of primary teeth and multiple supernumerary teeth. There are many difficulties in the early diagnosis of CCD because a majority of the craniofacial abnormalities becomes obvious only during adolescence. Late diagnosis produce occlusional & psychological problem. Therefore early detection and treatment of CCD can reduce the period and the extent of orthodontic and surgical interventions. We experienced CCD patient with multiple supernumerary teeth and will report it with the literature review.

Nanotechnology in reproductive medicine: Opportunities for clinical translation

  • Shandilya, Ruchita;Pathak, Neelam;Lohiya, Nirmal Kumar;Sharma, Radhey Shyam;Mishra, Pradyumna Kumar
    • Clinical and Experimental Reproductive Medicine
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    • v.47 no.4
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    • pp.245-262
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    • 2020
  • In recent years, nanotechnology has revolutionized global healthcare and has been predicted to exert a remarkable effect on clinical medicine. In this context, the clinical use of nanomaterials for cancer diagnosis, fertility preservation, and the management of infertility and other pathologies linked to pubertal development, menopause, sexually transmitted infections, and HIV (human immunodeficiency virus) has substantial promise to fill the existing lacunae in reproductive healthcare. Of late, a number of clinical trials involving the use of nanoparticles for the early detection of reproductive tract infections and cancers, targeted drug delivery, and cellular therapeutics have been conducted. However, most of these trials of nanoengineering are still at a nascent stage, and better synergy between pharmaceutics, chemistry, and cutting-edge molecular sciences is needed for effective translation of these interventions from bench to bedside. To bridge the gap between translational outcome and product development, strategic partnerships with the insight and ability to anticipate challenges, as well as an indepth understanding of the molecular pathways involved, are highly essential. Such amalgamations would overcome the regulatory gauntlet and technical hurdles, thereby facilitating the effective clinical translation of these nano-based tools and technologies. The present review comprehensively focuses on emerging applications of nanotechnology, which holds enormous promise for improved therapeutics and early diagnosis of various human reproductive tract diseases and conditions.

Diagnosis of Alzheimer's Disease using Wrapper Feature Selection Method

  • Vyshnavi Ramineni;Goo-Rak Kwon
    • Smart Media Journal
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    • v.12 no.3
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    • pp.30-37
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    • 2023
  • Alzheimer's disease (AD) symptoms are being treated by early diagnosis, where we can only slow the symptoms and research is still undergoing. In consideration, using T1-weighted images several classification models are proposed in Machine learning to identify AD. In this paper, we consider the improvised feature selection, to reduce the complexity by using wrapping techniques and Restricted Boltzmann Machine (RBM). This present work used the subcortical and cortical features of 278 subjects from the ADNI dataset to identify AD and sMRI. Multi-class classification is used for the experiment i.e., AD, EMCI, LMCI, HC. The proposed feature selection consists of Forward feature selection, Backward feature selection, and Combined PCA & RBM. Forward and backward feature selection methods use an iterative method starting being no features in the forward feature selection and backward feature selection with all features included in the technique. PCA is used to reduce the dimensions and RBM is used to select the best feature without interpreting the features. We have compared the three models with PCA to analysis. The following experiment shows that combined PCA &RBM, and backward feature selection give the best accuracy with respective classification model RF i.e., 88.65, 88.56% respectively.

Utilities and Limitations of Cardiac Magnetic Resonance Imaging in Dilated Cardiomyopathy

  • Min Jae Cha;Yoo Jin Hong;Chan Ho Park;Yoon Jin Cha;Tae Hoon Kim;Cherry Kim;Chul Hwan Park
    • Korean Journal of Radiology
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    • v.24 no.12
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    • pp.1200-1220
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    • 2023
  • Dilated cardiomyopathy (DCM) is one of the most common types of non-ischemic cardiomyopathy. DCM is characterized by left ventricle (LV) dilatation and systolic dysfunction without coronary artery disease or abnormal loading conditions. DCM is not a single disease entity and has a complex historical background of revisions and updates to its definition because of its diverse etiology and clinical manifestations. In cases of LV dilatation and dysfunction, conditions with phenotypic overlap should be excluded before establishing a DCM diagnosis. The differential diagnoses of DCM include ischemic cardiomyopathy, valvular heart disease, burned-out hypertrophic cardiomyopathy, arrhythmogenic cardiomyopathy, and non-compaction. Cardiac magnetic resonance (CMR) imaging is helpful for evaluating DCM because it provides precise measurements of cardiac size, function, mass, and tissue characterization. Comprehensive analyses using various sequences, including cine imaging, late gadolinium enhancement imaging, and T1 and T2 mapping, may help establish differential diagnoses, etiological work-up, disease stratification, prognostic determination, and follow-up procedures in patients with DCM phenotypes. This article aimed to review the utilities and limitations of CMR in the diagnosis and assessment of DCM.

Patients' Profile, Clinical Presentations and Histopathological Features of Colo-rectal Cancer in Al Hassa Region, Saudi Arabia

  • Amin, Tarek Tawfik;Suleman, Waseem;Al Taissan, Abdul Aziz;Al Joher, Abdul Latif;Al Mulhim, Othman;Al Yousef, Abdul Hameed
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.1
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    • pp.211-216
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    • 2012
  • Background: Patients' demographics, presenting clinical and histopathological features for colo-rectal cancer (CRC) are important factors for patients' outcome and disease prognosis. This study aimed to describe the pattern of CRC in terms of patients' demographics, main presenting symptoms and histopathological features in Al Hassa region of Saudi Arabia. Subjects and Methods: A retrospective hospital records-based study which included reviewing of patients' records diagnosed with CRC at three general hospitals in Al Hassa region, Saudi Arabia. A compilation form was designed to collect information regarding socio-demographics, age at diagnosis; referral sites and the main presentations at CRC diagnosis. sites and the main presentations at CRC diagnosis. Histopathological reports were reviewed to delineate the main cytopathologic features, prominent cytological characteristics, the presence of predisposing pathology, and disease stage. Results: Of the 142 cases with CRC, 15.5% and 33.1% were affected before 40 and 50 years of age respectively. Emergency rooms were main referral sites for CRC cases (31.0%). Right colon was affected in 16.9% while left colonic lesions accounted for 62.7%. Intestinal obstruction was the main presentations (41.5%), and 26.1% presented with symptoms indicating distant metastastic lesions. Adenocarcinoma was the predominant pathological lesions (86.6%). Metastastic CRC was diagnosed in 62.7%. Duke's staging showed that 22.5% and 40.1% of lesions were classified into C and D categories respectively. Conclusion: Saudi patients with CRC present late with distant metastasis, and advanced disease stage. A sizeable proportion of patients developed the lesions at relatively young age. Screening recommendations should be enacted and revised in response to current change with younger age of affection.

Roles Traditional Healers Play in Cancer Treatment in Malaysia: Implications for Health Promotion and Education

  • Merriam, Sharan;Muhamad, Mazanah
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.6
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    • pp.3593-3601
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    • 2013
  • Background: For a number of reasons from cultural compatibility, to accessibility, to cost, traditional healers are a major source of health care in developing countries. In Malaysia, it's been estimated that upwards of 80% of the population consult traditional healers even if simultaneously seeking treatment from the Western medical system. Partially as a result of the widespread practice of visiting traditional healers, cancer diagnosis and treatment in Malaysia is often delayed or interrupted resulting in late presentation, advanced stage diagnosis, and a higher mortality rate than in Western countries. However, there is very little research on the role of traditional healers in cancer treatment in Malaysia. Materials and Methods: This qualitative study was designed to identify the roles traditional healers play in cancer diagnosis and treatment, with an eye to alleviating the cancer burden through educational responses with four publics in mind-policy makers, Western medical personnel, traditional healers, and the general public. In-depth interviews were conducted with 14 Malay traditional healers, 13 cancer survivors who had seen both traditional healers and Western doctors, and 12 cancer medical specialists. Results: Analysis of the data from these 39 participants revealed four roles traditional healers play in cancer treatment-medicinal healer, emotional comforter, spiritual guide, and palliative caregiver. Conclusions: Three roles (emotional, spiritual, palliative) can be seen as complementary to the allopathic system. Emotional and spiritual roles may augment the effectiveness of biomedical treatment. Cancer awareness and education programs need to position traditional healers as complementary, rather than an alternative to Western medical treatment; Validating the roles Traditional Healers can play in cancer treatment in MY through health promotion and education will contribute to alleviating the nation's cancer burden.

Clinical Characteristics and Outcomes of the First Episode of Urinary Tract Infection in Neonates and Infants Younger than 2 Months of Age

  • Cheng, Jackie Ying-Wai
    • Childhood Kidney Diseases
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    • v.21 no.2
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    • pp.94-100
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    • 2017
  • Purpose: The American Academy of Pediatrics provides guidelines for managing febrile urinary tract infection (UTI) in infants and children 2-24 months old, but little guidance is offered regarding UTIs in those younger than 8 weeks of age. The definition of UTI is unclear and whether to proceed with micturating cystourethrography (MCUG) or $^{99m}$technetium-dimercaptosuccinic acid (DMSA) scintigraphy scan in this age group is controversial. Methods: We retrospectively analyzed 29 neonates and infants younger than 2 months of age who underwent late DMSA scans 9 months following the first episode of febrile or symptomatic UTI between July 2009 and June 2016. Results: In total, 192 children aged 0-24 months underwent ultrasound and DMSA scans (MCUG in 174/192). Neonates and infants younger than 2 months of age were significantly less likely to develop fever, and had a lower fever peak, shorter duration of fever before admission and after starting antibiotics, longer hospitalization period, lower C-reactive protein, and greater incidence of nonEscherichia coli infection. There was no difference in pyuria response at diagnosis. The prevalence rates of an ultrasound abnormality (28%), vesicoureteral reflux (28%), UTI recurrence (38%), and renal scarring (10%) in infants younger than 8 weeks of age were similar to those in children 2-24 months old. Conclusion: Neonates and infants younger than 2 months of age with UTI warrant special consideration because the fever response used for diagnosis in older children may be absent or blunted. Clinical guideline is needed for the diagnosis and management of UTI in this age group.

A study on Gigoo-inyoung pulse (기구인영맥(氣口人迎脈)에 관한 연구)

  • Seok, Jin-Han;Sim, Cheol-Ung;Choi, Hyun-Bae;Lee, Si-Hyeong
    • Journal of the Korean Institute of Oriental Medical Informatics
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    • v.18 no.1
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    • pp.78-115
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    • 2012
  • Pulse diagnosis has been highly valued in many East Asian medical books, since "Huangdaineijing(黃帝內經)" published. Gigoo-inyoung pulse method(氣口人迎脈法) is one of the four pulse diagnostic methods originally written in"Huangdaineijing(黃帝內經)". At the late 3rd century, "Maijing(脈經)" redefined the positions of Gigoo-inyoung pulse(氣口人迎脈). According to "Maijing(脈經)", both spots were 1fen(分) in front of guan(關) but Gigoo on the right hand and Inyoung on the left hand. At the middle of 13th century, "Maekgyolejijangbyungsikdoseol(脈訣指掌病式圖說)" had detailed view points about the manner of reading Gigoo-inyoung pulse. "Maekgyolejijangbyungsikdoseol(脈訣指掌病式圖說)" explained clearly the position of 1fen(分) in front of guan(關) by sketch of wrist. The location indicated the border of cun(寸) and guan(關). It also explained clearly corresponding certain cun-guan-chi(寸關尺) with Gigoo-inyoung pulse by sketch. "Euihackipmoon(醫學入門)" is a comprehensive book on medicine written by Lee-Cheon(李梴) in Ming(明) dynasty. In this book, pulse diagnosis is the most emphasized method among the four techniques of diagnosis(四診). Furthermore, it introduces detailed information about Gigoo-inyoung pulse method(氣口人迎脈法) in "Gigoo-inyoungmaekgyole(氣口人迎脈訣)". Lee-Cheon concured in the theory of "Yeongruegumbang(永類鈐方)" and "Maekgyolejijangbyungsikdoseol(脈訣指掌病式圖說)" and put a short essay about Gigoo-inyoung pulse named "Gigoo-inyoungmaekgyole(氣口人迎脈訣)" quoted from the two books. Therefore, throughout many chapters of "Euihackipmoon(醫學入門)", Gigoo-inyoung pulse is used in order to distinguish internal damage(內傷) and external contraction(外感). "Maekgyolejijangbyungsikdoseol(脈訣指掌病式圖說)" and "Euihackipmoon(醫學入門)" understood Gigoo-inyoung pulse commonly by corresponding certain cun-guan-chi(寸關尺) with Gigoo-inyoung pulse. Therefrom, Gigoo-inyoung pulse can distinguish seven emotions(七情) of internal damage(內傷) or six excesses(六淫) of external contraction(外感).

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Challenges in the Management of Breast Cancer in a Low Resource Setting in South East Asia

  • Ley, P;Yip, CH;Hong, C;Varughese, J;Camp, L;Bouy, Sok;Maling, E
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3459-3463
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    • 2016
  • Background: Breast cancer is the second most common cancer in women in Cambodia, a low income country in South-East Asia. The Sihanouk Hospital Centre of Hope (SHCH) is a charity hospital set up by an international non-governmental organisation, HOPE Worldwide. In 2008, SHCH partnered with AmeriCares, a global health organisation to set up and deliver a breast cancer programme to provide education, diagnosis and treatment for women with breast cancer. The objective of this study is to characterise the presentation, diagnosis, treatment and outcomes of women treated under this program. Materials and Methods: A total of 215 women newly diagnosed with breast cancer from 1 March 2008 until 31 March 2011 were studied. Age at diagnosis, tumour size, histological type, tumour grade, ER, lymph node involvement, treatment modalities (surgery, radiotherapy, chemotherapy, hormone therapy) were recorded. Data on mortality at 3 years were obtained whenever possible. Results: The median age was 47 years old. Some 77.8% were diagnosed with stage 3 and 4 lesions, and 78.5% underwent mastectomy, of which 28.4% the intent was palliative. Of those whose ER status were known, only 48.3% were ER positive. Only 6 patients could afford chemotherapy while only 1 patient had radiotherapy. Hormone therapy was provided free for those who were ER positive. The overall survival rate at 3 years was 39.1%. Conclusions: Breast cancer presents at a late stage, and because treatment is suboptimal, survival is poor in Cambodia. A more aggressive approach to early detection and treatment needs to be developed to improve outcome from this potentially curable disease.