• Title, Summary, Keyword: clinical presentation

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Clinical presentation with 『PangYakHapPyon(方藥合編)』 in Korean medicine (방약합편과 한의학 임상표현)

  • Ju, Da Hyun;Kim, Byoung Soo
    • The Journal of Korean Medicine
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    • v.40 no.1
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    • pp.1-11
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    • 2019
  • Objectives: The aim of this study is to introduce the Clinical presentation and announce the importance of developing Clinical presentation of Korean medicine and suggest about development direction of Clinical presentation of Korean medicine. Methods: To Investigate the Clinical presentation used in western medicine. I think that Clinical presentation of Korean medicine is a systematic list of Korean medicine symptoms and a standard syndrome differentiation and treatment(辨證論治). So I would like to offer "PangYakHapPyon(方藥合編)" as a basis for developing Clinical presentation of Korean medicine. Results: The clinical presentation term has become widespread in use at Calgary Medical college. Calgary Medical college created a list of 120 clinical presentations In 1991. In Korea, 101 clinical presentations were made in 2016. "PangYakHapPyon(方藥合編)" has been used effectively for over 130 years and widely used in the public. In addition, "PangYakHapPyon(方藥合編)" is summarized in the symptoms and prescriptions that occur frequently in Korea. Conclusions: For the globalization and standardization of Korean medicine, Clinical presentation of Korean medicine should be developed. The overall form of Clinical presentation of Korean medicine uses the form of Clinical presentation of Canada and a standard syndrome differentiation and treatment(辨證論治) for diagnosis and treatment is based "PangYakHapPyon(方藥合編)".

Diagnosis of incomplete Kawasaki disease

  • Yu, Jeong-Jin
    • Korean Journal of Pediatrics
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    • v.55 no.3
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    • pp.83-87
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    • 2012
  • Several authors suggested that the clinical characteristics of incomplete presentation of Kawasaki disease are similar to those of complete presentation and that the 2 forms of presentation are not separate entities. Based on this suggestion, a diagnosis of incomplete Kawasaki disease in analogy to the findings of complete presentation is reasonable. Currently, the diagnosis of incomplete Kawasaki disease might be made in cases with fewer classical diagnostic criteria and with several compatible clinical, laboratory or echocardiographic findings on the exclusion of other febrile illness. Definition of incomplete presentation in which coronary artery abnormalities are included as a necessary condition, is restrictive and specific. The validity of the diagnostic criteria of incomplete presentation by the American Heart Association should be thoroughly tested in the immediate future.

Consideration of the Effectiveness of Moxibustion and Acupuncture for the Treatment of Fetal Breech Presentation (태아 둔위의 침구치료에 대한 효용성 고찰)

  • Kang, Kiwan;Lee, Eun;Lee, Seungho;Jang, Insoo
    • Korean Journal of Acupuncture
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    • v.30 no.1
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    • pp.16-20
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    • 2013
  • Objectives : The objective of this study is to report the efficacy of acupuncture and moxibustion for the treatment of fetal breech presentation. Methods : We searched papers in PubMed, using the keywords "breech and moxibustion" and "breech and acupuncture". Search range includes randomized clinical trials(RCTs), controlled clinical trials(CCTs), case reports, and case series. Each original article must have an abstract in English. Finally, 7 RCTs from 102 were included in this review. Results : As a result of analyzing the 7 RCTs, five trials hold that moxibustion or acupuncture at BL67 has been shown to produce a positive effect for the correction of breech presentation and the other two trials indicated no beneficial effect. However, one of the latter could not come to a conclusion owing to the unsatisfactory compliance record of the participants. Conclusions : Acupuncture and moxibustion may be effective to correct fetal breech presentation. In this regard, the related clinical researches are worth to be conducted.

Initial Blood Glucose Can Predict the Outcome of OP Poisoning (유기인계 중독환자에서 내원시 혈당과 예후와의 연관성)

  • Lee, Sung Do;Moon, Jeong Mi;Chun, Byeong Jo
    • Journal of The Korean Society of Clinical Toxicology
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    • v.13 no.2
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    • pp.55-61
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    • 2015
  • Purpose: Many studies have examined the mechanisms of impaired glucose homeostasis after organophosphate (OP) exposure, however no study has evaluated the clinical utility of blood glucose measurements in patients with OP poisoning. The current study was conducted to evaluate the initial glucose level at presentation and the glycemic variables during the first 3 days after admission as a predictor of mortality. Methods: This retrospective observational case series included 228 patients with a history of OP poisoning. Among other clinical data, information on the initial glucose level at presentation and mean glucose level, delta glucose level, and the presence of a hypoglycemic event during the first 3 days of admission, was collected. Results: Survivors had lower initial glucose levels at presentation and glucose variability during the first 3 days of admission compared to non-survivors. The frequency of hypoglycemic events was higher in non-survivors. In multivariate analysis, the initial glucose level (> 233 mg/dl) was an independent predictor of mortality, along with age. Conclusion: The initial glucose level at presentation can be helpful in prediction of mortality in cases of OP intoxication at bedside. The physician should pay attention to patients with a glucose level >233 mg/dl at presentation after ingestion of OP.

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A Clinical Study of Intestinal Duplication (장중복증의 임상적 고찰)

  • Kim, Tae-Woo;Jung, Poong-Man
    • Advances in pediatric surgery
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    • v.10 no.1
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    • pp.9-16
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    • 2004
  • Intestinal duplication is a rare congenital anomaly. The diagnostic approach is difficult because of the differences in its location and clinical presentation. To evaluate the diagnostic as well as the therapeutic approaches in children, the medical records of 20 patients with intestinal duplications which had been operated upon from July 1980 to October 2002 were analyzed, retrospectively. The range of age was from 1 day to 11 years. The variables, such as age, sex, clinical presentation, diagnostic method, localization, anatomic type, treatment, complication, and combined anomalies were analyzed. Most of the cases were presented as incidental finding. The majority of the duplications except hindgut were cystic type. Treatment included segmental intestinal resection, excision of the lesion without intestinal resection, and septotomy. Seventy-five percent of the patients were detected before 1 year of age. The anatomic type of the lesion was closely related with its location. The cases of hindgut were almost always tubular type except 1 case. Clinical presentation was related to age, location, and anatomic type. There were no specific diagnostic methods. Perfect localization and application of appropriate operation are the most important requirements for successful treatment.

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Educational Utilization of Microsoft Powerpoint for Oral and Maxillofacial Cancer Presentations

  • Carvalho, Francisco Samuel Rodrigues;Chaves, Filipe Nobre;Soares, Eduardo Costa Studart;Pereira, Karuza Maria Alves;Ribeiro, Thyciana Rodrigues;Fonteles, Cristiane Sa Roriz;Costa, Fabio Wildson Gurgel
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.2337-2339
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    • 2016
  • Electronic presentations have become useful tools for surgeons, other clinicians and patients, facilitating medical and legal support and scientific research. Microsoft(R) PowerPoint is by far and away the most commonly used computer-based presentation package. Setting up surgical clinical cases with PowerPoint makes it easy to register and follow patients for the purpose of discussion of treatment plan or scientific presentations. It facilitates communication between professionals, supervising clinical cases and teaching. It is ofter useful to create a template to standardize the presentation, offered by the software through the slide master. The purpose of this paper was to show a simple and practical method for creating a Microsoft(R) PowerPoint template for use in presentations comcerning oral and maxillofacial cancer.

Radiological Apoplexy and Its Correlation with Acute Clinical Presentation, Angiogenesis and Tumor Microvascular Density in Pituitary Adenomas

  • Lee, Jung-Sup;Park, Yong-Sook;Kwon, Jeong-Taik;Nam, Taek-Kyun;Lee, Tae-Jin;Kim, Jae-Kyun
    • Journal of Korean Neurosurgical Society
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    • v.50 no.4
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    • pp.281-287
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    • 2011
  • Objective : Pituitary apoplexy is life-threatening clinical syndrome caused by the rapid enlargement of a pituitary tumor due to hemorrhage and/or infarction. The pathogenesis of pituitary apoplexy is not completely understood. We analyzed the magnetic resonance imaging (MRI) of pituitary tumors and subsequently correlated the radiological findings with the clinical presentation. Additionally, immunohistochemistry was also performed to determine whether certain biomarkers are related to radiological apoplexy. Methods : Thirty-four cases of pituitary adenoma were enrolled for retrospective analysis. In this study, the radiological apoplexy was defined as cases where hemorrhage, infarction or cysts were identified on MRI. Acute clinical presentation was defined as the presence of any of the following symptoms: severe sudden onset headache, decreased visual acuity and/or visual field deficit, and acute mental status changes. Angiogenesis was quantified by immunohistochemical expression of fetal liver kinase 1 (Flk-1), neuropilin (NRP) and vascular endothelial growth factor (VEGF) expression, while microvascular density (MVD) was assessed using Endoglin and CD31. Results : Clinically, fourteen patients presented with acute symptoms and 20 for mild or none clinical symptoms. Radiologically, fifteen patients met the criteria for radiological apoplexy. Of the fifteen patients with radiologic apoplexy, 9 patients presented acute symptoms whereas of the 19 patient without radiologic apoplexy, 5 patients presented acute symptoms. Of the five biomarkers tracked, only VEGF was found to be positively correlated with both radiological and nonradiological apoplexy. Conclusion : While pituitary apoplexy is currently defined in cases where clinical symptoms can be histologically confirmed, we contend that cases of radiologically identified pituitary hemorrhages that present with mild or no symptoms should be designated subacute or subclinical apoplexy. VEGF is believed to have a positive correlation with pituitary hemorrhage. Considering the high rate of symptomatic or asymptomatic pituitary tumor hemorrhage, additional studies are needed to detect predictors of the pituitary hemorrhage.

Clinical Profile, Treatment and Survival Outcome of Testicular Tumors: A Pakistani Perspective

  • Bhatti, Abu Bakar Hafeez;Ahmed, Irfan;Ghauri, Rashid Khan;Saeed, Qamar;Mir, Khurram
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.1
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    • pp.277-280
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    • 2014
  • Background: Testicular cancer management is considered a marvel of modern science with excellent treatment results. Pakistan has a distinct ethnic variation and geographic distribution but data regarding clinical presentation of testicular tumors and their management is under reported. The objective of this study was to determine clinical profile, treatment modalities and survival outcome of testicular tumors in the Pakistani population. Materials and Methods: A retrospective review of patients who received treatment for testicular cancer at Shaukat Khanum Cancer Hospital from January 2009 to December 2012 was performed. Patient demographics, clinical features at presentation and treatment modalities were assessed. For categorical variables chi square test was used. Survival was calculated using Kaplan Meier survival curves and Log rank test was employed to determine significance. Results: The most common tumor was mixed germ cell tumor in 49% patients. For all tumor variants except seminoma, stage III was the most common clinical stage at presentation. Majority of patients with non seminomatous germ cell tumors presented in the15-30 year age group as compared to seminoma which was most prevalent in the 30-40 year age group. Orchiectomy followed by chemotherapy was the most common treatment modality in 80% patients. Expected 5 year survival for seminomas and non-seminomatous germ cell tumors was 96% and 90% respectively which was not significantly different (p=0.2). Conclusions: Despite a distinct clinical profile of testicular tumors in Pakistani population, survival is comparable with published reports.

Cysts of Gastrointestinal Origin in Children: Varied Presentation

  • Tiwari, Charu;Shah, Hemanshi;Waghmare, Mukta;Makhija, Deepa;Khedkar, Kiran
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.20 no.2
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    • pp.94-99
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    • 2017
  • Purpose: Abdominal cysts of gastrointestinal origin are rare. Their rarity and varied clinical presentations make their pre-operative diagnosis difficult. Methods: Fourteen patients with histological diagnosis of cysts of gastrointestinal origin admitted between 2009 and 2015 were retrospectively analyzed with respect to age, sex, clinical presentation, diagnostic modality, site and type of cyst, management, outcome and follow-up. Results: The mean age at presentation was 4 years and there were six males and eight females. Abdominal pain was the most common presenting symptom. Five patients had an acute presentation-three had distal ileal mesenteric cysts and two had ileal duplication cyst sharing a common wall with ileum. Six patients presented with chronic abdominal pain and lump-three patients had omental cysts and three had mesenteric cysts-two of these in distal ileum and one in sigmoid colon. Two patients presented with antenatally diagnosed palpable abdominal lump. One had a mesenteric cyst of the ileum and the other had a distal ileal duplication cyst which required excision with resection and anastomosis. One patient had an atypical presentation. He was a known case of sickle cell trait and had presented with vague abdominal pain, recurrent cough and multiple episodes of haemoptysis over a period of one year. At laparotomy, gastric duplication cyst was found which was excised completely. Histopathology confirmed the diagnosis. Conclusion: Cysts of gastrointestinal origin are rare and have varied presentation. Surgical excision is the mainstay of treatment. The results and prognosis are good.

Presentation of Retinoblastoma Patients in Malaysia

  • Subramaniam, Shridevi;Rahmat, Jamalia;Rahman, Norazah Abdul;Ramasamy, Sunder;Bhoo-Pathy, Nirmala;Pin, Goh Pik;Alagaratnam, Joseph
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.18
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    • pp.7863-7867
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    • 2014
  • Background: Retinoblastoma is a rare type of cancer that usually develops in early childhood. If left untreated it can cause blindness and even death. The aim of this study is to determine sociodemographic and clinical features of retinoblastoma patients and also to determine the treatment pattern and outcome in Malaysia. Materials and Methods: Data for this study were retrieved from the Retinoblastoma Registry of the National Eye Database (NED) in Malaysia. Hospital Kuala Lumpur, Hospital Umum Kuching, Sarawak and Hospital Queen Elizabeth, Kota Kinabalu were the major source data providers for this study. Data collected in the registry cover demography, clinical presentation, modes of treatment, outcomes and complications. Results: The study group consisted of 119 patients (162 eyes) diagnosed with retinoblastoma between 2004 and 2012. There were 68 male (57.1%) and 51 (42.9%) female. The median age at presentation was 22 months. A majority of patients were Malays (54.6%), followed by Chinese (18, 5%), Indians (8.4%), and indigenous races (15.9%). Seventy six (63.8%) patients had unilateral involvement whereas 43 patients had bilateral disease (36.1%). It was found that most children presented with leukocoria (110 patients), followed by strabismus (19), and protopsis (12). Among the 76 with unilateral involvement (76 eyes), enucleation was performed for a majority (79%). More than half of these patients had extraocular extension. Of the 40 who received chemotherapy, 95% were given drugs systemically. Furthermore, in 43 patients with bilateral involvement (86 eyes), 35 (41%) eyes were enucleated and 17 (49%) showed extraocular extension. Seventy-two percent of these patients received systemic chemotherapy. The patients were followed up 1 year after diagnosis, whereby 66 were found to be alive and 4 dead. Sixteen patients defaulted treatment and were lost to follow-up, whereas follow-up data were not available in 33 patients. Conclusions: Patients with retinoblastoma in this middle-income Asian setting are presenting at late stages. As a result, a high proportion of patients warrant aggressive management such as enucleation. We also showed that a high number of patients default follow-up. Therefore, reduction in refusal or delay to initial treatment, and follow-up should be emphasized in order to improve the survival rates of retinoblastoma in this part of the world.