• Title/Summary/Keyword: Diagnosis delay

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Oral Cancer Knowledge and Practice among Dental Patients and their Attitude Towards Tobacco Cessation in Iran

  • Razavi, Sayed Mohammad;Tahani, Bahareh;Nouri, Samin;Khazaei, Azadeh
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.13
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    • pp.5439-5444
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    • 2015
  • Background: One of the main causes of delay in diagnosis of oral cancer is lack of awareness about aetiology and symptoms among the general population. The aim of this study was to assess the knowledge and practice of patients regarding oral cancer and their attitude towards tobacco cessation. Materials and Methods: This study was carried out in Isfahan-Iran in 2014. A 29-item self-administrated questionnaire was designed and piloted and distributed to patients attending dental clinics. Questions were focused on awareness about oral cancer risk factors, signs and symptoms, places in the mouth which are more susceptible and attitude toward tobacco cessation. Chi-square, T-test, ANOVA and logistic regression tests were used for statistical analysis. Results: A total of 546 valid completed questionnaires were obtained. The mean knowledge score of patients was 4.1(${\pm}2.7$) out of 13. Some 80% of patients did not know about early manifestations of oral cancer. Only 18% knew the most likely sites of oral cancer. Only 43.1% and 65.2% of patients reported alcohol and tobacco consumption as the main risk factors but they had a fair knowledge about other risk factors. There was no significant difference in Knowledge level between patients regarding their sex, educational levels and age. Most patents (90%) expected their dentists to warn them about the harmful effects of smoking and showed willingness to quit if recommended. Conclusions: Knowledge about oral cancer was found to be quite low. It seems necessary to increase the level of public awareness using educational programs with cooperation of dentists in tobacco cessation programs.

Comparison of WHO and RECIST Criteria for Evaluation of Clinical Response to Chemotherapy in Patients with Advanced Breast Cancer

  • Khokher, Samina;Qureshi, Muhammad Usman;Chaudhry, Naseer Ahmad
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.7
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    • pp.3213-3218
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    • 2012
  • When patients with advanced breast cancer (ABC) are treated with neoadjuvant chemotherapy (NACT), efficacy is monitored by the extent of tumor shrinkage. Since their publication in 1981, World Health Organization (WHO) guidelines have been widely practiced in clinical trials and oncologic practice, for standardized tumor response evaluation. With advances in cancer treatment and tumor imaging, a simpler criterion based on one-dimensional rather than bi-dimensional (WHO) tumor measurement, named Response Evaluation Criteria in Solid Tumors (RECIST) was introduced in 2000. Both approaches have four response categories: complete response, partial response, stable disease and progressive disease (PD). Bi-dimensional measurement data of 151 patients with ABC were analysed with WHO and RECIST criteria to compare their response categories and inter criteria reproducibility by Kappa statistics. There was 94% concordance and 9/151 patients were recategorized with RECIST including 6/12 PD cases. RECIST therefore under-estimates and delays diagnosis of PD. This is undesirable because it may delay or negate switch over to alternate therapy. Analysis was repeated with a new criteria named RECIST-Breast (RECIST-B), with a lower threshold for PD (${\geq}10%$ rather than ${\geq}20%$ increase of RECIST). This showed higher concordance of 97% with WHO criteria and re-categorization of only 4/151 patients (1/12 PD cases). RECIST-B criteria therefore have advantages of both ease of measurement and calculations combined with excellent concordance with WHO criteria, providing a practical clinical tool for response evaluation and offering good comparison with past and current clinical trials of NACT using WHO guidelines.

Compound heterozygous mutations of ACADS gene in newborn with short chain acyl-CoA dehydrogenase deficiency: case report and literatures review

  • An, Se Jin;Kim, Sook Za;Kim, Gu Hwan;Yoo, Han Wook;Lim, Han Hyuk
    • Clinical and Experimental Pediatrics
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    • v.59 no.sup1
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    • pp.45-48
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    • 2016
  • Short-chain acyl-CoA dehydrogenase deficiency (SCADD) is a rare autosomal recessive mitochondrial disorder of fatty acid ${\beta}$-oxidation, and is associated with mutations in the acyl-CoA dehydrogenase (ACADS) gene. Recent advances in spectrometric screening for inborn errors of metabolism have helped detect several metabolic disorders, including SCADD, without symptoms in the neonate period. This allows immediate initiation of treatment and monitoring, so they remain largely symptomless metabolic disease. Here, we report a 15-month-old asymptomatic male, who was diagnosed with SCADD by newborn screening. Spectrometric screening for inborn errors of metabolism 72 hours after birth revealed an elevated butyrylcarnitine (C4) concentration of $2.25{\mu}mol/L$ (normal, < $0.99{\mu}mol/L$). Urinary excretion of ethylmalonic acid was also elevated, as detected by urine organic acid analysis. To confirm the diagnosis of SCADD, direct sequencing analysis of 10 coding exons and the exon-intron boundaries of the ACADS gene were performed. Subsequent sequence analysis revealed compound heterozygous missense mutations c.164C>T (p.Pro55Leu) and c.1031A>G (p.Glu344Gly) on exons 2 and 9, respectively. The patient is now growing up, unretarded by symptoms such as seizure and developmental delay.

A Study on Perspirations(汗出) in Daily Time Cycle (하루 중 시간변화(時間變化)에 따른 한출(汗出)의 기전(機轉)에 대한 연구(硏究))

  • Lyu, Jeong-Ah;Jeong, Chang-Hyun
    • Journal of Korean Medical classics
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    • v.22 no.3
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    • pp.271-289
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    • 2009
  • This thesis intend to help the eastern medical doctor to understand body condition from interpretation of perspirations(汗出) in daily time cycle. The conclusion is followed. 1. In most Eastern Medical classic and clinic literatures, the time of fever and perspirations are described as a result of disease's position at human body. Following this description, in daytime the perspirations must come from the Gi phase and night time the perspirations must come from the blood phase. Because in daytime the skin pores are opening and the defensive Gi is going out to the superficial portion of the body. In night time the skin pores are shutting and the defensive Gi is going in to the five solid organs. So a sweat in daytime comes out from the Gi phase and superficial portion of the body. And in night time comes out from the blood phase and five solid organs. But in recent real clinic cases, in daytime, there are so many perspirations from the five solid organs. Comparatively, the perspirations from the superficial portion of body are very little. And in same daytime perspirations, when the heat pathogens mixed with moist, the symptom revelation time delay to the afternoon. Therefore it can be concluded that the time of perspirations are combination of disease's Gi or blood phase and characteristics of pathogens. The position of disease at human body cannot simply judge the symptom revelation time. 2. The exchange of climate following time cycle of a day effect to the condition of human body. At same time it activates or not activates the pathogens in human body. So we can consider the kinds and characteristics of pathogens by distinguishing the symptom revelation time. In general differentiation of syndromes[辨證] pathogen's kinds and location are generally judged. By understanding the characteristics of pathogen, doctor can devise more correct and delicate prescription.

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A case of severe transient hyperammonemia in a newborn (신생아의 심한 일과성 고암모니아혈증 1례)

  • Hwang, Min-Woo;Yu, Seung-Taek;Oh, Yeon-Kyun
    • Clinical and Experimental Pediatrics
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    • v.53 no.4
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    • pp.598-602
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    • 2010
  • Transient hyperammonemia in a newborn is an overwhelming disease manifested by hyperammonemic coma. The majority of affected newborns are premature and have mild respiratory syndrome. The diagnosis may be difficult to determine. This metabolic disorder is primarily characterized by severe hyperammonemia in the postnatal period, coma, absence of abnormal organic aciduria and normal activity of the enzymes of the urea cycle. Hyperammonemic coma may develop within 2-3 days of life, although its etiology is unknown. Laboratory studies reveal marked hyperammonemia (>$4,000{\mu}mol/L$). The degree of neurologic impairment and developmental delay in this disorder depends on the duration of hyperammonemic coma. Moreover, the infant may succumb to the disease if treatment is not started immediately and continued vigorously. Hyperammonemic coma as a medical emergency requires dialysis therapy. Here, we report a case of severe transient hyperammonemia in a preterm infant (35 week of gestation) presented with respiratory distress, seizure, and deep coma within 48 hours and required ventilatory assistance and marked elevated plasma ammonia levels. He survived with aggressive therapy including peritoneal dialysis, and was followed 2 years later without sequelae.

A Case of Hunter Syndrome Diagnosed at Age of 2.5 Year (2.5세에 진단된 헌터증후군 1례)

  • Choi, Miran;Kwun, Younghee;Jin, Dongkyu;Lee, Jieun
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.14 no.2
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    • pp.178-181
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    • 2014
  • Hunter syndrome (mucopolysaccharidosis type II, MPS II) is a X-linked lysosomal storage disease caused by a deficiency in the lysosomal enzyme, iduronate-2-sulfatase (IDS), leading to accumulation of glycosaminoglycans within lysosomes of many organs and tissues. Since the enzyme replacement therapy was approved and available in the treatment of MPS I, II, VI, early diagnosis and early therapy can bring the better prognosis of disease and the better quality of life in patients. We described a 2.5 year old child presented with frequent otitis media and developmental delay including speech impairment, who was diagnosed as Hunter syndrome with IDS NM_000202.5:c. 263G>A(p.Arg88His) mutation.

Renal failure associated with ingestion of grapes and raisins in dogs (개에서 포도 및 건포도 섭취가 신부전에 미치는 영향)

  • Yuk, Jin-yub;Kim, Cheol-ho;Kim, Tae-yung;Kang, Chung-boo
    • Korean Journal of Veterinary Research
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    • v.45 no.2
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    • pp.287-296
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    • 2005
  • This experiments was designed to observe the effect of period and dose of ingestion of grapes on renal failure in dog. After the dogs had been mixed of general feed, raisins from U.S.A and fresh grapes from Chile selling in Korea. We observed the clinical sign, and analyzed the blood and urine using by biochemical test. The experiment was executed by the two following groups. The experiment group 1. derived renal failure by supplying the mixed general feed with fresh grapes and dry grapes 15 g per weight kg, 2 times a day (AM 09, PM 21), the experiment group 2. executed to derive renal failure by supplying the mixed general feed with fresh grapes and dry grapes 40 g per weight kg, 2 times a day. Extraction of blood for analysis was conducted one time a day and clinical test for renal failure was executed by means of a blood analysis, biochemical analysis, urine analysis, excretory urography (E.U) and E.R.D-$screen^{TM}$ urine test (Heska, USA). The results of group 1 were normal ranges (BUN 9.0~22.6 mg/dl, creatinine 0.8~1.2 mg/dl, Ca 9.7~12.3 mg/dl, Pi 2.9~4.6 mg/dl), renal failure was not observed. On the 3rd day in group 2, azotemia was arisen from the increasing BUN 83 mg/dl (7~25 mg/dl), creatinine 2.3 mg/dl (0.5~1.4 mg/dl), when executed urine was tested by E.R.D-$screen^{TM}$ test using in the early kidney disease diagnosis, microalbumine state was high positive, and it showed stale delay by using excretory urography (EU). This study demonstrated that acute renal failure by grapes and raisins dependent on food dose, and specific characters of individual.

Reduction of Length of Stay in Emergency Room by Using Critical Pathway for Stroke Patients (Critical pathway 적용을 통한 급성 뇌졸중 환자의 응급실 체류시간 단축 효과)

  • Yun, Yeo-Ok;Kim, Min-Young;Kim, Woo-Jeong;Kang, Young-Joon;Park, Ju-Ok;Park, Kyung-Hye
    • Journal of Korean Academy of Nursing Administration
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    • v.17 no.1
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    • pp.66-73
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    • 2011
  • Purpose: The purpose of this study was to demonstrate effects of a critical pathway (CP) for stroke patients seen in emergency rooms (ER). Method: The CP developed by the CP committee consisted of 8 criteria: behavior of doctors and nurses, laboratory tests, Image testing, medication, treatment, activity, and nutrition. According to application of CP, a control group (n=17) and experimental group (n=17) were defined. Time was checked by the electronic medical records. Result: Use of CP for stroke patients in the ER, resulted in a decreased length of stay in ER (t=2.341, p=.026), and time required for image testing (t=2.623, p=.021), and an increased number of patients using rtPA ($x^2$=4.802, p=.049). Time required for neurology doctor contact, for neurology doctor to see patient in the ER, and for report of blood tests decreased, but there were no statistical significance. Conclusion: Quick responses are most important in the ER, so CP for these patients is a very effective patient management tool. To reduce delay in stroke diagnosis, continuous education programs for similar symptoms are necessary. CPs for other patients in the ER should be developed, and studies on cost and satisfaction, as well as length of stay, should be done.

Matching Pursuit based on Frequency Characteristics of Heart Sounds for Phonocardiogram Analysis (심음 분석을 위한 주파수 특성에 기반한 매칭퍼슈잇 방법)

  • Kim, Il-Dong;Jeong, Gyu-Hyeok;Lim, Jong-Ha;Lee, In-Sung
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.47 no.1
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    • pp.47-55
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    • 2010
  • Although heart auscultation is an important tool for the diagnosis of heart disease, it is seen that the human ear is poorly suited for cardiac auscultation such as the paradoxical split of S2, the split of S2, and the summation of S2 and S3 gallop. In this paper, the analysis-synthesis method that is suitable for the characteristics of PCG is proposed to classify the heart sound. In analyzing the PCG according to matching pursuit method and synthesizing the PCG in each bandwidth based on the frequency characteristics, it sorts normal hearts with abnormal hearts that is difficult to classify as cardiac auscultation. The result shows that it qualifies the appearance of split in S2 and the paradoxical split of S2 and also can estimate the delay between the two components.

Three Korean patients with Cantú syndrome caused by mutations in ABCC9 and their clinical manifestations

  • Jang, Jin Hee;Ko, Jung Min;Yang, Sei Won;Chae, Jong Hee;Bae, Eun Jung
    • Journal of Genetic Medicine
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    • v.13 no.2
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    • pp.99-104
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    • 2016
  • $Cant{\acute{u}}$ syndrome (CS, OMIM 239850) is a very rare autosomal dominantly inherited genetic disease characterized by congenital hypertrichosis, neonatal macrosomia, a distinct facial features such as macrocephaly, and cardiac defects. Since the first description by $Cant{\acute{u}}$ et al. in 1982, about 50 cases have been reported to date. Recently, two causative genes for CS has been found by using exome sequencing analyses: ABCC9 and KCNJ8. Most cases of clinically diagnosed CS have resulted from de novo mutations in ABCC9. In this study, we report three independent Korean children with CS resulting from de novo ABCC9 mutations. Our patients had common clinical findings such as congenital hypertrichosis, distinctive facial features. One of them showed severe pulmonary hypertension and hypertrophic cardiomyopathy, which require medical treatment. And, two patients had a history of patent ductus arteriosus. Although two of our patients had shown early motor developmental delay, it was gradually improved during follow-up periods. Although CS is quite rare, there are the concerns about development of various cardiac problems in the lifetime. Therefore, an accurate diagnosis followed by appropriate management and genetic counseling should be provided to CS patients.