• Title/Summary/Keyword: Diagnosis classification

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Distribution and phenotypes of hemifacial microsomia and its association with other anomalies

  • Yang, Il-Hyung;Chung, Jee Hyeok;Yim, Sunjin;Cho, Il-Sik;Lim, Seung-Weon;Kim, Kikap;Kim, Sukwha;Choi, Jin-Young;Lee, Jong-Ho;Kim, Myung-Ji;Baek, Seung-Hak
    • The korean journal of orthodontics
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    • v.50 no.1
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    • pp.33-41
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    • 2020
  • Objective: To investigate the distribution and phenotypes of hemifacial microsomia (HFM) and its association with other anomalies. Methods: This study included 249 Korean patients with HFM, whose charts, photographs, radiographs, and/or computed tomography scans acquired during 1998-2018 were available from Seoul National University Hospital and Dental Hospital. Prevalence according to sex, side involvement, degree of mandibular deformity, compensatory growth of the mandibular body, and Angle's classification, and its association with other anomalies were statistically analyzed. Results: Prevalence was not different between male and female patients (55.0% vs. 45.0%, p > 0.05). Unilateral HFM (UHFM) was more prevalent than bilateral HFM (BHFM) (86.3% vs. 13.7%, p < 0.001). Although distribution of the Pruzansky-Kaban types differed significantly in patients with UHFM (I, 53.0%; IIa, 18.6%; IIb, 24.7%; III, 3.7%; p < 0.001), no difference was observed in occurrence between the right and left sides (52.6% vs. 47.4%, p > 0.05). Among patients with BHFM, prevalence of different Pruzansky-Kaban types on the right and left sides was greater than that of the same type on both sides (67.6% vs. 32.4%, p < 0.05). Despite hypoplasia of the condyle/ramus complex, compensatory growth of the mandibular body on the ipsilateral side occurred in 35 patients (14.1%). Class I and II molar relationships were more prevalent than Class III molar relationships (93.2% vs. 6.8%, p < 0.001). Forty-eight patients (19.3%) had other anomalies, with 50.0% and 14.4% in the BHFM and UHFM groups (p < 0.001). Conclusions: Patients with HFM require individualized diagnosis and treatment planning because of diverse phenotypes and associations with other anomalies.

Clinical Subtypes of Delirium (섬망의 임상적 아형)

  • Seo, Jeong-Seok;Moon, Seok-Woo;Kim, Tae-Ho;Nam, Beom-Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.16 no.2
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    • pp.69-74
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    • 2008
  • Delirium is an organic psychiatric syndrome characterized by an acute onset, prominent disturbance of consciousness and cognitive impairment with fluctuating course. Although there is not a clear consensus concerning the optimal classification system for delirium subtypes, Lipowski(1983) firstly classified delirium by psychomotor activity, namely hyperactive, hypoactive, and mixed. According results of several following studies, prevalence of hypoactive delirium were not less than that of hyperactive delirium. But a diagnosis of hypoactive delirium often missed, which is most frequently misdiagnosed as depression and dementia. Hyperactive delirium can be caused by alcohol or benzodiazepine withdrawal, would be related with excessive dopamine and cholinergic deficiency, and is more responsive to high-potency antipsychotics therapy. Hypoactive delirium would be caused by metabolic encephalopathy, and tends to present a less responsiveness to antipsychotics and poorer overall prognosis with a prolonged duration of admission than hyperactive delirium. Delirium is not a homogenous syndrome. Because of different subtypes, it may have dissimilar underlying pathogenetic pathways. So different treatment strategies between various subtypes may be needed.

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A STUDY OF THE CONTENT VALIDITY IN HYPERKINETIC CONDUCT DISORDER (과잉운동 품행장애의 내용 타당도에 관한 연구)

  • Jeon, Seong-Ill;Cho, Soo-Churl;Jin, Tae-Won;Nam, Min
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.5 no.1
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    • pp.133-140
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    • 1994
  • Conduct disorder is a heterogenous disorder of various etiology affecting 4-10% of school-age children. There is suggestive evidence that the comorbid group of conduct disorder and attention deficit hyperactivity disorder is different from these two separated diseases groups. There findings suggest that this comorbid group may present a meaningful subgroup. This study is conducted to examine the content validity of hyperkinetic conduct disorder that accepted first in International Classification of Disease 10th edition. The results are summarized as follows : 1) Using Conners Parenting Rating Scale, Parent Rating Scale Form for DSM-III-R, the mean scores of attention deficit hyperactivity disorder in conduct disorder were significantly higher compared with those of normal controls. 2) 72.4% of conduct disorder and 41.5% of normal control groups showed simultaneous attention deficit hyperactivity disorder. The diffenence between conduct disorder and normal control groups was significant. There were many previous informations that children with attention deficit hyperactivity disorder had conduct disorder as comorbid disorder and these result show that children with conduct disorder also significantly had attention attention deficit hyperactivity disorder reversibly. Then these show that hyperkinetic conduct disorder-diagnosis used when both the overall criteria for hyperkinetic disorders and the overall criteria for conduct disorders are met-have satisfactory content validity. Biological, familial or long term studies are needed to further validate this diagnostic category.

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Classification of Microsatellite Alterations Detected in Endoscopic Biopsy Specimens of Gastric Cancers (단순반복염기서열의 변이 형태에 따른 위암 내시경 조직의 유전자형 분류)

  • Choi Young Deok;Choi Sang Wook;Jeon Eun Jeong;Jeong Jeong Jo;Min Ki Ouk;Lee Kang Hoon;Lee Sung;Rhyu Mun Gan
    • Journal of Gastric Cancer
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    • v.4 no.2
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    • pp.109-120
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    • 2004
  • Purpose: Individual gastric cancers demonstrate complicated genetic alterations. The PCR-based analysis of polymorphic microsatellite sequences on cancer-related chromosomes has been used to detect chromosomal loss and microsatellite instability. For the purpose of preoperative usage, we analyzed the correspondance rate of the microsatellite genotype between endoscopic biopsy and surgical specimens. Materials and Methods: Seventy-three pairs of biopsy and surgical specimens were examined for loss of heterozygosity and microsatellite instability by using 40 microsatellite markers on eight chromosomes. Microsatellite alterations in tumor DNAs were classified into a high-risk group (baselinelevel loss of heterozygosity: 1 chromosomal loss in diffuse type and high-level loss of heterozygosity: 4 or more chromosomal losses) and a low-risk group (microsatellite instability and low-level loss of heterozygosity: 2 or 3 chromosomal losses in diffuse type or $1\∼3$ chromosomal losses in intestinal type) based on the extent of chromosomal loss and microsatellite instability. Results: The chromosomal losses of the biopsy and the surgical specimens were found to be different in 21 of the 73 cases, 19 cases of which were categorized into a genotype group of similar extent. In 100 surgical specimens, the high-risk genotype group showed a high incidence of nodal involvement (19 of 23 cases: $\leq$5 cm; 23 of 24 cases: >5 cm) irrespective of tumor size while the incidence of nodal involvement for the low-risk genotype group depended on tumor size (5 of 26 cases: $\leq$5 cm; 18 of 27 cases: >5 cm). Extraserosal invasion was more frequent in large-sized tumor in both the high-risk genotype group ($\leq$5 cm: 12 of 23 cases; >5 cm: 23 of 24 cases) and the low-risk genotype group ($\leq$5 cm: 7 of 26 cases; >5 cm: 16 of 27 cases). The preoperative prediction of tumor invasion and nodal involvement based on tumor size and genotype corresponded closely to the pathologic tumor stage (ROC area >0.7). Conclusion: An endoscopic biopsy specimen of gastric cancer can be used to make a preoperative genetic diagnosis that accurately reflect the genotype of the corresponding surgical specimen.

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CALCIFYING ODONTOGENIC CYST ASSOCIATED WITH ODONTOMA : CASE REPORT (치아종을 동반한 석회화 치성낭에 관한 증례 보고)

  • Lee, Seon-Suk;Lee, Chang-Seop;Lee, Sang-Ho;Lee, Nan-Young
    • Journal of the korean academy of Pediatric Dentistry
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    • v.33 no.1
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    • pp.109-115
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    • 2006
  • The calcifying odontogenic cyst (COC) predominantly affected Maxillary anterior segment and it is developmental cyst. But COC showed diverse terminology or classification, clinicopathologic features as well as its biologic behavior COC usually presents as slowly enlarging but otherwise symptomless swelling. Association with impacted teeth and odontoma is described in $24{\sim}30%$. The epithelial lining of COC(ghost cell) appears to have ability to induce the formation of dental tissues in the asjcents connective tissue wall. This case is a COC associated with a odontoma involving an impacted left maxillary canine in 14-year-old female child. Radiographic examination revealed a well-demarcated radiolucent lesion partially occupied by a radiopaque mass, involving the left canine. The histologic sections showed cystic cavity lined with ameloblastic epithelium containing ghost cell masses with regular and irregular shape odontoma. The final pathologic diagnosis was calcifying odontogenic cyst with odontoma(Type IB by Preatorius). Enucleation and elimination of the included tooth were performed. Now endodontic treatment was preformed on the 1st premolar of the upper left jaw, which had a lesion. And the patient and their parents want to have the orthodontic treatment performed and would like to keep the space maintainer.

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A study on the correlativity of EAV (Electroacupuncure acc.Voll)'s measurement and symptoms of a disease (EAV의 측정치(測定値)와 병증유형(病症類型)의 상관성(相關性)에 관(關)한 연구(硏究))

  • Han, Ju Seok;Song, Il Byung
    • Journal of Sasang Constitutional Medicine
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    • v.7 no.1
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    • pp.43-67
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    • 1995
  • By making use of the EVA(Electroacupuncture acc. Voll) combined meridian theory of oriental medicine with electronics which was contrived to recognize the physiological and pathological changes of human body, the following conclusions were made in comparison with EAV measurements and types of symptoms(anxiety & headache, fatigue, palpitation, dizzness, abdominal distension, nausea, gastric distubance, constipation & diarrhea, fatty liver, CVA), QSCC, and blood type test. 367 patients including 124 with nervous gastrointestinal problems were selected for this research. 1. From the point of variance of the tested patients 124 nervous gastrointestinal patients, Liver meridian and Spleen meridian showed Hyperenergia and Large intestine meridian, Circulation meridian, Tripe warmer meridian showed hypoergia. 2. In each symptom as the nervous gastrointestinal symptom Liver Meridian showed hyperenergia, Large intestine meridian, Circulation meridian and Triple warmer meridian showed hypoergia. 3. In an objective Comparison with other symptoms, firstly among the headache & anxiety group left Gall Bladder, Triple warmer and Stomach meridian showed remarkable hypoergia, secondly among fatigue group showed hypoergia in Triple warmer meridian and hyperenergia of Stomach meridian, and thirdly among palpitation group showed hypoergia of Kidney meridian, and lastly among dizzness group showed hypoergia of Gall bladder, Stomach, Circulation and Small intestine meridian. 4. All of gastric distubance, nausea, abdominal distention, constipation and diarrhea group showed hyperenergia in Stomach meridian and spleen meridian, gastric disturbance group showed remarkably hypoergia in Circulation, Small intestine, Lung and Large intestine meridian, Nausea group showed hypoergia of large intestine, Constipation and diarrhea group showed hypoergia of Kidney and left Circulation meridian. 5. Fatty liver group showed hyperenergia of Liver meridian of 83.3%, Gall Bladder, stomach and Spleen meridian, Urinary bladder and Kidney meridian showed hypoergia. 6. CVA group showed hyperenergia in Liver and Corculation meridian. 7. Blood type in typical classification had on signigicant bearings on each other. 8. QSCC for the attempt of objective materials of constitutional diagnosis had no correlaticity in comparison with EAV measurements. In conclusion EAV is thought be used as a diagnostic method in oriental medicine and further research is needed regarding it can be used as useful method for verifying the characteristics and early finding of symptoms.

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A Study on Regional Variations for Disease-specific Cardiac Arrest (질환성 심정지 발생의 지역별 변이에 관한 연구)

  • Park, Il-Su;Kim, Eun-Ju;Kim, Yoo-Mi;Hong, Sung-Ok;Kim, Young-Taek;Kang, Sung-Hong
    • Journal of Digital Convergence
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    • v.13 no.1
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    • pp.353-366
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    • 2015
  • The purpose of this study was to examine how region-specific characteristics affect the occurrence of cardiac arrest. To analyze, we combined a unique data set including key indicators of health condition and cardiac arrest occurrence at the 244 small administrative districts. Our data came from two main sources in Korea Center For Disease Control and Prevention (KCDC): 2010 Out-of-Hospital Cardiac Arrest Surveillance and Community Health Survey. We analyzed data by using multiple regression, geographically weighted regression and decision tree. Decision tree model is selected as the final model to explain regional variations of cardiac arrest. Factors of regional variations of cardiac arrest occurrence are population density, diagnosis rates of hypertension, stress level, participating screening level, high drinking rate, and smoking rate. Taken as a whole, accounting for geographical variations of health conditions, health behaviors and other socioeconomic factors are important when regionally customized health policy is implemented to decrease the cardiac arrest occurrence.

Evaluation of Cognitive Functions in Patients with Narcolepsy (기면병 환자의 인지기능 평가)

  • Jin, You-Yang;Yoon, Jin-Sang;Chung, Eun-Kyung
    • Journal of agricultural medicine and community health
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    • v.38 no.2
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    • pp.97-107
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    • 2013
  • Objective: This study aimed to evaluate attention, memory and executive function in patients with narcolepsy. Methods: This study included 23 narcoleptic patients whose diagnosis were confirmed by the International Classification of Sleep Disorders(ICSD) at Chonnam National University Hospital Sleep Disorders Clinic or an other hospital in Korea, from 2005 to 2008, as well as 23 normal controls. All participants were given an IQ test for Korean-Wechsler Adult Intelligence Scale and several neuropsychological function tests (the d2 test for attention function, the Rey Complex Figure Test for nonverbal memory, the Korean-California Verbal Learning Test [K-CVLT] for verbal memory, and the Wisconsin Card Sorting Test for executive function). Clinical features of narcoleptic patients, including the frequency of excessive daytime sleepiness, cataplexy, sleep paralysis and hypnagogic hallucination, were investigated by a structured clinical interview administered by a neuropsychiatist. Excessive daytime sleepiness was evaluated by the Epworth sleepiness scale. Results: Characteristic symptoms of narcolepsy observed in this study included excessive daytime sleepiness (n=23, 100.0%), cataplexy (n=19, 82.6%), hypnagogic hallucination (n=5, 21.7%) and sleep paralysis (n=12, 52.2%). In nocturnal polysomnographic findings, stage 2 sleep and REM latency were found to be significantly decreased in narcoleptic patients compared with the control group, and were accompanied by significant increases in stage 1 sleep. Narcoleptic patients had lower scores than the control group on total number, Total Number-Total Error, Concentration Performance and Fluctuation Rate on the d2 test, which measures attention. Also, there were significant differences between the performance of patient and control groups on the B list of the K-CVLT, which measures verbal memory. Conclusion: Narcoleptic patients showed decreased attention and verbal memory performance compared to the control group; however, in many areas, narcoleptic patients still demonstrated normal cognitive function.

CALCIFYING ODONTOGENIC CYST ASSOCIATED WITH COMPLEX ODONTOMA : CASE REPORT (치아종을 동반한 석회화 치성낭의 치험례)

  • Lee, Sang-Yup;Kim, Dae-Eop;Lee, Kwang-Hee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.4
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    • pp.645-650
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    • 2004
  • Calcifying odontogenic cyst(COC) is a rare developmental odontogenic cyst, which shows diverse classification and terminology. Cystic epithelial lining of COC is composed of basal cell layer of columnar cells and overlying layer of stellate reticulum. In the epithelium, ghost cells that might induce adjacent mesenchymal tissue to develop dental organ are shown characteristically. In spite of low rate of recurrence, we have to get a histopathological examination so that odontogenic lesions may recur without fully curettage of lining epithelium. 7-year-old male child came pediatric dentistry in wonkwang university dental hospital in order to check the delayed eruption of left maxillary central incisor. Radiographic examination revealed a well-defined radiopaque mass, overlapping impacted left central and lateral incisor crown. Enucleated mass was tooth-like features and also had epithelium lining. Results of histopathologic procedure, we saw the lots of ghost cell and proliferating hard dental tissues. Also we saw the cystic epithelium cells. It revealed diagnosis of the COC associated complex odontoma. For this reason one should consider of COC when patients present odontoma-like lesion with impacted tooth.

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The Clinicopathologic Characteristics of Neuroendocrine Tumor of the Stomach (위에 발생한 신경내분비 종양의 임상병리학적 고찰)

  • Lee, Chul-Min;Shin, Yeon-Myung
    • Journal of Gastric Cancer
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    • v.8 no.4
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    • pp.204-209
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    • 2008
  • Purpose: The goal of this study was to review the clinicopathologic characteristics of neuroendocrine tumor (NET) of the stomach. Materials and Methods: We retrospectively reviewed the medical records of 13 patients who were diagnosed with neuroendocrine tumor from January 1999 to August 2007 at Kosin Medical Center; 4,159 gastric cancer patients were treated surgically during the same time. The average follow up period was 14.3 months. Results: The majority of 13 patients were men (male-female ratio: 11:2) and the average age of patients with NET was 59.4 years (range: 42~72 years). The presenting symptoms were mostly epigastric pain and soreness. The tumor was limited to the mucosa or submucosa in two cases, and the tumor extended beyond the muscle layer in 11 cases. The mean size of the tumor was 7.0 cm, ranging from 0.7 cm to 15 cm. The type of the NEC (according to the WHO classification) was type 3 for eight patients, type 4 for four patients and type 1 for one patient. Regional lymph node metastasis was noted in 11 patients. Four cases showed recurrence of disease and the site of recurrence included liver in two patients, multiple organs (including the peritoneum and lung) in one patient and multiple organs (including liver, pancreas and duodenum) in one patient. The recurrent cases were type 3 and type 4 and the average survival period of the recurrent patients was 12.8 months. Conclusion: The majority of neuroendocrine tumors of the stomach were at an advanced stage at the time of diagnosis. These tumors frequently recurred in the liver and they have a poor prognosis.

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