• Title/Summary/Keyword: Diagnosis delay

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Recent update on reading disability (dyslexia) focused on neurobiology

  • Kim, Sung Koo
    • Clinical and Experimental Pediatrics
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    • v.64 no.10
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    • pp.497-503
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    • 2021
  • Reading disability (dyslexia) refers to an unexpected difficulty with reading for an individual who has the intelligence to be a much better reader. Dyslexia is most commonly caused by a difficulty in phonological processing (the appreciation of the individual sounds of spoken language), which affects the ability of an individual to speak, read, and spell. In this paper, I describe reading disabilities by focusing on their underlying neurobiological mechanisms. Neurobiological studies using functional brain imaging have uncovered the reading pathways, brain regions involved in reading, and neurobiological abnormalities of dyslexia. The reading pathway is in the order of visual analysis, letter recognition, word recognition, meaning (semantics), phonological processing, and speech production. According to functional neuroimaging studies, the important areas of the brain related to reading include the inferior frontal cortex (Broca's area), the midtemporal lobe region, the inferior parieto-temporal area, and the left occipitotemporal region (visual word form area). Interventions for dyslexia can affect reading ability by causing changes in brain function and structure. An accurate diagnosis and timely specialized intervention are important in children with dyslexia. In cases in which national infant development screening tests have been conducted, as in Korea, if language developmental delay and early predictors of dyslexia are detected, careful observation of the progression to dyslexia and early intervention should be made.

Clear cell odontogenic carcinoma: a mini review

  • Kim, Young Hwan;Seo, Eun Jin;Park, Jae Kyung;Jang, Il Ho
    • International Journal of Oral Biology
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    • v.44 no.3
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    • pp.77-80
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    • 2019
  • Clear cell odontogenic carcinoma (CCOC), a very rare neoplasm located mostly in the mandible, has been regarded as a benign tumor. However, due to the accumulation of case reports, CCOC has been reclassified as a malignant entity by the World Health Organization. Patients with CCOC present with regional swelling and periodontal indications with variable pain, often remaining misdiagnosed for a long period. CCOC has slow growth but aggressive behavior, requiring radical resection. Histologic analysis revealed the monophasic, biphasic, and ameloblastic types of CCOC with clear cells and a mixed combination of polygonal and palisading cells. At the molecular level, CCOC shows the expression of cytokeratin and epithelial membrane antigen, along with markers that assign CCOC to the sarcoma family. At the genetic level, Ewing sarcoma breakpoint region 1-activating transcription factor 1 fusion is regarded as the key feature for identification. Nevertheless, the scarcity of cases and dependence on histological data delay the development of an efficient therapy. Regarding the high recurrence rate and the potential of distant metastasis, further characterization of CCOC is necessary for an early and accurate diagnosis.

Analysis of external environmental factors affecting patient transport time

  • LEE, Hyeryeong;PARK, Sang Woong;YUN, Eunjeong;KIM, Dakyeong;CHOI, Hea Kyung
    • The Korean Journal of Food & Health Convergence
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    • v.8 no.6
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    • pp.11-17
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    • 2022
  • Emergency transport is directly related to the life of the patient, and rapid transport to the hospital is crucial. However, external environmental factors such as traffic or weather, interfere with hospital transport. In this study, we investigated the external environment affecting hospital transport time. We examined the transfer time and patient treatment time of emergency patients in an area of northern Gyeonggi-do from 2018 to 2020. Diagnosis after arrival at the hospital was used, and on-site treatment time was measured from paramedic arrival time at the scene to departure. Furthermore, we examined whether there was a correlation between the time paramedics left the scene and hospital arrival time through the reason for the delay as recorded in the emergency log. Traffic jams had the greatest impact on patient transport, while transport delays occurred due to heavy rain, but not snow. Among injured patients, electrical accidents were the most problematic in terms of on-site treatment time. This was because a lot of first aid is needed in electrical accidents. It must be necessary to mobilize two ambulances in an emergency through the expansion of infrastructure, prepare a plan for rapid transport in heavy rain, and implement strong laws against transport obstruction.

Management of Chronic Kidney Disease in Obesity Patients (비만환자의 만성콩팥병 관리)

  • Han, Kunhee
    • Archives of Obesity and Metabolism
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    • v.1 no.2
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    • pp.66-73
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    • 2022
  • Obesity is an increasing public health and medical issue worldwide. It has been associated with several comorbidities, including diabetes, cardiovascular disease, stroke, and cancer. Chronic kidney disease (CKD) is another important comorbidity of obesity. Other major causes of CKD include hypertension and diabetes. However, the association between obesity and CKD is often overlooked. Among patients with CKD, patients with obesity were more vulnerable to have rapid kidney function decline than that of those with normal weight. Additionally, CKD is more prevalent among patients with obesity. These aggravations are induced through multiple mechanisms, specifically metabolic impairment of obesity and mechanical burden because of increasing intraabdominal renal pressure. Furthermore, the inflammation and lipotoxicity, caused by obesity, are critical in the CKD aggravation in patients with obesity. To prevent this, all adult patients with obesity are tested for CKD. The workup includes the estimated glomerular filtration rate and regular follow-up. Step-wise management is required for patients with obesity with CKD. Prompt reduction and management of obesity effectively delay CKD progression among patients with obesity and CKD. Therefore, weight loss is a core management for patients with obesity and CKD. Based on several studies, this article focused on the association between CKD and obesity, as well as the diagnosis and weight management of patients with obesity and CKD.

Enhancement of Semantic Interoper ability in Healthcare Systems Using IFCIoT Architecture

  • Sony P;Siva Shanmugam G;Sureshkumar Nagarajan
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.18 no.4
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    • pp.881-902
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    • 2024
  • Fast decision support systems and accurate diagnosis have become significant in the rapidly growing healthcare sector. As the number of disparate medical IoT devices connected to the human body rises, fast and interrelated healthcare data retrieval gets harder and harder. One of the most important requirements for the Healthcare Internet of Things (HIoT) is semantic interoperability. The state-of-the-art HIoT systems have problems with bandwidth and latency. An extension of cloud computing called fog computing not only solves the latency problem but also provides other benefits including resource mobility and on-demand scalability. The recommended approach helps to lower latency and network bandwidth consumption in a system that provides semantic interoperability in healthcare organizations. To evaluate the system's language processing performance, we simulated it in three different contexts. 1. Polysemy resolution system 2. System for hyponymy-hypernymy resolution with polysemy 3. System for resolving polysemy, hypernymy, hyponymy, meronymy, and holonymy. In comparison to the other two systems, the third system has lower latency and network usage. The proposed framework can reduce the computation overhead of heterogeneous healthcare data. The simulation results show that fog computing can reduce delay, network usage, and energy consumption.

Missed Lung Cancers on Chest Radiograph: An Illustrative Review of Common Blind Spots on Chest Radiograph with Emphasis on Various Radiologic Presentations of Lung Cancers (놓치기 쉬운 폐암: 흉부 X선 진단의 함정에 대한 이해와 다양한 폐암 영상 소견의 중요성)

  • Goun Choi;Bo Da Nam;Jung Hwa Hwang;Ki-Up Kim;Hyun Jo Kim;Dong Won Kim
    • Journal of the Korean Society of Radiology
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    • v.81 no.2
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    • pp.351-364
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    • 2020
  • Missed lung cancers on chest radiograph (CXR) may delay the diagnosis and affect the prognosis. CXR is the primary imaging modality to evaluate the lungs and mediastinum in daily practice. The purpose of this article is to review chest radiographs for common blind spots and highlight the importance of various radiologic presentations in primary lung cancer to avoid significant diagnostic errors on CXR.

The Strategy for Diagnosis and Treatment of Isovaleric Acidemia (아이소발레릭산혈증의 신생아선별검사 후 진단 및 치료 전략)

  • Ko, Jung Min;Lee, Kyung-A
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.16 no.2
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    • pp.57-61
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    • 2016
  • Isovaleric acidemia (IVA) is an autosomal recessively inherited organic acid disorder due to a defect of the enzyme isovaleryl-CoA dehydrogenase in the leucine metabolic pathway. Deficiency of this enzyme results in the accumulation of derivatives of isovaleryl-CoA. In acute illness in IVA, isovaleric acid and its derivatives accumulate and profound metabolic acidosis with ketosis, characteristic pungent body odor, hypoglycemia, and hyperammonemia can be developed. Additionally, recurrent vomiting, failure to thrive, developmental delay, epilepsy and mental retardation are chronic presenting symptoms and signs for IVA. On the result of newborn screening for inherited metabolic disorders, increased levels of isovalerylcarnitine (C5) are shown. However, C5 elevation can be accompanied with short/branched-chain acyl-CoA dehydrogenase (SBCAD) and therapy with certain antibiotics containing pivalic acid. Quantitative measurement of organic acids in urine and acylcarnitine profiles in plasma are necessary to differential diagnosis. Molecular genetic analysis of the IVD gene for IVA and ACADSB is also helpful to confirm IVA and SBCAD deficiency, respectively. Considering that IVA can be associated with significant morbidity and mortality at acute presentation of metabolic crisis, early diagnosis prior to the onset of symptoms by newborn screening enable to introduction of early treatment and prevention of acute and chronic complications.

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Retinoblastoma: Result of Radiotherapy (망막아세포종의 방사선치료 성적)

  • Kim, Il-Han;Kim, Jong-Hoon;Park, Charn-Il
    • Radiation Oncology Journal
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    • v.8 no.2
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    • pp.169-176
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    • 1990
  • Radiotherapy result was analyzed in 23 children with retinoblastoma treated in Seoul National University Hospital from 1980 to 1987. Three ($17\%$) had bilateral tumor at diagnosis. Among 20 children with unilateral retinoblastoma 13 children got radiotherapy after enucleation, 2 were treated with radiotherapy alone, and 5 were delivered with radiotherapy after relapse. Of 15 non-recurrent unilateral tumors, there were 5 stage II children, 8 stage III, and 2 stage IV by staging system proposed by St. Jude Children's Research Hospital. Chemotherapy was combined when resection margin of the optic nerve was positive or when malignant cell was found in CSF. Of 12 children who completed radiotherapy, local or distant failure was not found but 2 cases of relapse at the contralateral retina were observed. Their 5 year survival rate was $82.2\%$. Another case of contralateral relapse was detected in children who was treated with radiotherapy alone. Thus overall frequency of the bilateral disease was $33\%$. Prognosis of recurrent tumors were so poor that no cases of CR was obtained and that 3 year survival rate was $20\%$. Two of 3 bilateral cases at diagnosis were in NED status. Complication were sunken orbit only. Result of radiotherapy was so good in early stage or small bulk tumor that treatment delay after diagnosis must not be allowed.

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A Study on the Effects of Local Factors on the Oral Ulcers Observed in Behcet s Disease (베체트 병의 구강궤양에 대한 국소인자의 영향에 관한 연구)

  • Myoung-Chan Kim;Chong-Youl Kim
    • Journal of Oral Medicine and Pain
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    • v.17 no.2
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    • pp.75-86
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    • 1992
  • Of the many first-occuring major manifestations of Behcet's disease, the oral ulcer is most frequently observed, shows the highest mean recurrence rate, and the longest mean duration period. A study of the relationship between mechanical irritation buy local factors and the recurrence of oral ulcers was carried out to see if there is a correlation. The subjects chosen for the study were 81 patients who were referred to the Department of Oral Diagnosis at Yonsei University Dental Hospital from the Behcet clinic of Severace Hospital after being diagnosed as Behcet's disease patients. 1. By Shimuzu's classification, possible type was the most numerous with 55.55% ; while suspected type was 19.76% ; incomplete type, 17,28% ; and complete type, 7.41% were observed in that order. The male to female ration was 1 to 1.61, and the average age of onset was 17.63 years. 2. Oral ulcers developed most frequently on the tongue (48.28%), and lip(23.15%), buccal mucosa (20.69%), palate\pharynx(4.43%), and gingiva(3.45%) also showed ulceration. 3. 38.27% of the patients were HSV positive : 27.16% were CRP positive ; 12.34% were ASO positive ; 9.87% were RF positive ; and 3.7% were ANA positive. 4. According to the answers to the survey, fatigue(85.18%) was most frequently associated with Behcet's diseage. Trauma by tooth brushing (22.22%), un specified reasons (20.98%), hard food chewing (12.35%), and irritation by dentition and/or prosthesis (13.58%) were observed in association with Behcet's disease. 23.46% had a history of tonsilitis. 5. Oral ulcers on the anterior part of tongue and buccal mucosa were associated with local irritatants. 6. Oral ulcers on the lip and posterior portion of tongue were not associated with local irritants. Local irritation by dentition and oral ulcer on the anterior part of tongue and buccal mucosa was observed to coexit with one another : in other words, lo9cal factors can act to cause of recurrence of an oral ulcer and to delay the healing process in Behcet's disease. Therefore, elimination of local factors along with systemic therapy must be recommended when treating oral ulcers.

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An Analysis and Assessment of Diagnostic and Therapeutic Process in Some Frequent Admissions and Operations (일부 다빈도 입원 및 수술례의 진단과 치료과정에 대한 연구)

  • Kim, Chang-Yup;Kim, Yoon;Kwon, Young-Dae;Kim, Yong-Ik;Shin, Young-Soo;Ahn, Hyeong-Sik
    • Journal of Preventive Medicine and Public Health
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    • v.26 no.3 s.43
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    • pp.400-411
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    • 1993
  • The aim of this study is to analyze the variations among hospitals and hospital groups in resource use and procedures of diagnostic and therapeutic process, such as laboratory tests, radiologic examinations, tissue diagnosis, timing of surgery after admission, the time required for operation. The study was performed for five procedures including cesarean section (C/S), appendectomy, cholecystectomy, cataract extraction, and pediatric pneumonia. The 2,316 subjects were selected from medical insurance claims list, and from this list 413 cases were sampled for medical record review. The patterns of resource utilization and process of treatment were described according to hospitals and characteristics of hospital groups. The major results were as follows : 1. The numbers of laboratory and radiologic tests showed significant difference among hospitals and hospital groups. In case of hospital groups, we could find tendencies of more tests with increasing hospital bed size. 2. In general, the proportion of operative cases evaluated by tissue diagnosis postoperatively among all operations ranged from 28.3% to 100%. The proportion varied among hospital groups, of which general hospital A group(more than 15 specialty) showed the highest proportion. 3. Post-admission delay until operation and the time required for operative procedure were not invariable among hospitals and hospital groups. The duration of operation in tertiary hospitals was slightly shorter than general hospitals, with varying statistical significance. We could find that probably there were differences of quality among hospitals in some components of procedures, which suggested that the implementation of quality assurance activities would be mandatory. In this study, we simply described the patterns of resource utilization and some features of clinical process, with institution of the need for advanced studies with in-depth analyses for each component of diagnosis and treatment procedures.

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