• Title/Summary/Keyword: Evidence Based Diagnosis

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F-18 FDG Uptake in a Toxic Autonomous Thyroid Nodule

  • Lee, Myoung-Hoon;Park, Chan-H.;Kim, Hyun-Soo;Yoon, Seok-Nam;Hwang, Kyung-Hoon
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.4
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    • pp.286-287
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    • 2001
  • A 44 year-old male patient was undergoing diagnosis and therapy for acute myelogenous leukemia (AML, M2). On physical examination a thyroid mass was palpated in the left lower lobe. He had palpitation and intolerance to heat. Thyroid function tests revealed hyperthyroidism; T3: 150ng/dl (N:60-90), fT4: 2.26 ng/dl (N:0.70-1.80), TSH: 0.01 ulU/ml (N:0.25-5.00). Ultrasonography demonstrated a hypoechoic mass with scattered calcifications measuring 2.55 2.03 3.64 cm in size. F-18 FDG camera-based PET scan performed as a follow-up study of AML revealed a focal increased uptake in the left neck, where an autonomous nodule was detected on Tc-99m thyroid scan. After the diagnosis of toxic autonomous nodule, Goetz disease, he underwent surgical nodulectomy. Microscopically, the nodule contained follicular proliferation with degenerative change but without evidence of thyroid carcinoma. Focal uptake in autonomous thyroid nodules is due to increased glycolysis within the nodules.

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Radiographic Diagnosis of 'Rubber Jaw Syndrome' Secondary to Chronic Renal Failure Due to Ethylene Glycol Intoxication in a Dog (개에서 Ethylene glycol 중독에 의한 만성신부전증의 속발성 'Rubber jaw syndrome'의 방사선학적 진단례)

  • Choi, Ho-Jung;Lee, Young-Won;Wang, Ji-Hwan;Jung, In-Jo;Yeon, Seong-Chan;Lee, Hyo-Jong;Lee, Hee-Chun
    • Journal of Veterinary Clinics
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    • v.24 no.2
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    • pp.260-263
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    • 2007
  • A 9-month-old, intact female mixed dog was referred to Veterinary Medical Teaching Hospital of Gyeongsang National University with symmetrically enlarged and protruded upper jaw. The patient was diagnosed as acute renal failure due to ethylene glycol poisoning and was treated for 1 month in a local animal hospital. In spite of treatment, the patient proceeded to chronic renal failure. Also, the patient's upper jaw begun to enlarge continuously. To evaluate this upper jaw, radiographic examination was performed. Skull radiographs revealed thickening of maxilla, decreased bone opacity, cortical thinning, loss of lamina dura and periodontal space in the maxilla. Diagnosis of rubber jaw syndrome is based on clinicial signs, radiographic findings and laboratory evidence of chronic renal failure due to ethylene glycol poisoning.

A systematic review of treatment and outcomes in patients with mandibular coronoid process hyperplasia

  • Parmentier, Griet I.L.;Nys, Margaux;Verstraete, Laurence;Politis, Constantinus
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.3
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    • pp.133-148
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    • 2022
  • Treatment of mandibular coronoid process hyperplasia (MCPH) has been described and explored in the literature. This systematic review aims to provide a comprehensive overview of the surgical and non-surgical treatment options for MCPH in pediatric and adult populations. Three databases were searched for treatment of MCPH patients (MEDLINE, Embase, and Web of Science). Two reviewers selected case reports and case series based on titles and abstracts. Finally, 55 studies reporting a total of 127 cases were included for qualitative synthesis and data extraction. The mean age at symptom onset was 15.6 years, while the mean age at diagnosis was 23.5 years. Of the included cases, 83.7% were male, and the condition was bilateral in more than 81% of the cases. Coronoidectomy was performed in 82.7% of the included cases, while coronoidotomy was performed in 3.9% of the cases. In 85.0% of the surgically treated cases, the approach was intraoral. The mean maximal intraoperative mouth opening was 38.1 mm compared with 16.5 mm at diagnosis. The mean maximal postoperative mouth opening was 35.3 mm, and the mean follow-up period was 16.3 months. Maximum mouth opening was achieved intraoperatively, and non-surgical treatment after surgery aims to reduce the risk of relapse. Additional research with a higher level of evidence is necessary to confirm these findings.

Hematuria in children: causes and evaluation

  • Eujin Park;Sang Woon Kim;Su Jin Kim;Minki Baek;Yo Han Ahn;Myung Hyun Cho;Hyun Kyung Lee;Kyoung Hee Han;Yae Lim Kim;Miyoung Choi;Hee Gyung Kang;Jin-Soon Suh;Eun Mi Yang
    • Childhood Kidney Diseases
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    • v.28 no.2
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    • pp.66-73
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    • 2024
  • Hematuria is the presence of blood in the urine and is classified as either gross hematuria or microscopic hematuria. There are many causes of hematuria, and the differential diagnosis depends on the presence or absence of comorbidities and whether it is glomerular or non-glomerular. When hematuria in children is symptomatic or persistent, an evaluation of the cause is essential. The causes of hematuria and basic approaches to its diagnosis are discussed in this review.

Variation in hospital length of stay according to the DRG-based prospective payment system in the voluntarily participating providers (DRG(Diagnosis-Related Group)를 이용한 포괄진료비 지불제도의 선택 참여에 따른 재원일수 변화)

  • Choi, Sook-Ja;Kwon, Soon-Man;Kang, Gil-Won;Moon, Sang-Jun;Lee, Jin-Seok
    • Health Policy and Management
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    • v.20 no.2
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    • pp.17-39
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    • 2010
  • This study explored the impact on the DRG(Diagnosis-Related Groups)-based prospective payment system(PPS) operated by voluntarily participation providers. We analyzed whether the provides in the DRG-based PPS and in traditional fee-for-service(FFS) systems showed different the degree of variation in length of stay(LOS), and the providers' behaviors depending on the differences according to the varied participation periods. The study sample included all data 2,061 institutions participated in DRG-PPS in 2007 and all cases 473 FFS institutions which reported fee-for-service claims were reviewed same diagnosized diseases at least 10cases claims during three months We compared the differences of the LOS among health care institutions according to their type, region, and size. For DRGs showing significant differences in LOS, multiple regression analyses were performed to find out factors associated with LOS and interaction effect participation and hospital types or participation periods. The result provide the evidence that the DRG payment system operated by volunteering health care institutions had impact on resources use, which can reduce the institutions' the length of stay. While some DRGs had no correlation between participation periods and LOS, other DRGs, DRG participation period reversely linear relationship with LOS. That is to say, the longer participation year, the less reducing the LOS. These results support the future expansion of the DRG-based PPS plan to all health care services in Korea.

Establishing Diagnosis Systems for Impaired Stream Ecosystem using Stream/River Ecosystem Survey and Health Assessment (수생태계 현황 조사 및 건강성 평가결과를 활용한 수생태계 훼손원인 진단체계 구축)

  • Lee, Jong-Won;Lee, Sang-Woo;Hwang, Soon-Jin;Jang, Min-Ho;Won, Doo-Hee;An, Kyung-Jin;Park, Hye-Jin;Lee, Junga
    • Korean Journal of Ecology and Environment
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    • v.53 no.1
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    • pp.1-10
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    • 2020
  • The Stream/River Ecosystem Survey and Health Assessment has been carried out regarding the ecological health of the streams by the Ministry of Environment (MOE), South Korea. However, the sources of impairment of the stream ecosystem and the interactions between the sources, stressors, and the responses of impaired streams have not been taken into consideration. The purpose of this study is to propose the establishment of diagnosis systems for the impaired stream ecosystem because of the need to incorporate the same in the making of the policy to enable the recovery and improvement of the health of the impaired streams or river ecosystem. First, we define the concept of a diagnosis of the impaired stream or river ecosystem through a literature review. Second, through case studies [e.g., US CADDIS (Causal Analysis/Diagnosis Decision Information System), AUS. Eco Evidence, EU WFD (Water Framework Directive)], we try to develop the diagnosis system for the making of policy. In this study, the diagnosis system that is proposed consists of eight steps including the basic data collection, detecting or suspecting impairment, defining the impaired stream reach, identifying the biological impaired cases and listing the candidate causes, illustrating the interactive conceptual diagrams between stressors and responses, investigating the stressors-responses in the field, verifying causes and identifying the probable causes of the impaired cases, and summarizing and proposing the restoration of the streams. The results of this study will support and enable efficient decision-making for sustainable stream restoration and management based on the diagnosis of the probable causes for the impaired complex and the diverse stream ecosystem.

Study of the structural damage identification method based on multi-mode information fusion

  • Liu, Tao;Li, AiQun;Ding, YouLiang;Zhao, DaLiang
    • Structural Engineering and Mechanics
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    • v.31 no.3
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    • pp.333-347
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    • 2009
  • Due to structural complicacy, structural health monitoring for civil engineering needs more accurate and effectual methods of damage identification. This study aims to import multi-source information fusion (MSIF) into structural damage diagnosis to improve the validity of damage detection. Firstly, the essential theory and applied mathematic methods of MSIF are introduced. And then, the structural damage identification method based on multi-mode information fusion is put forward. Later, on the basis of a numerical simulation of a concrete continuous box beam bridge, it is obviously indicated that the improved modal strain energy method based on multi-mode information fusion has nicer sensitivity to structural initial damage and favorable robusticity to noise. Compared with the classical modal strain energy method, this damage identification method needs much less modal information to detect structural initial damage. When the noise intensity is less than or equal to 10%, this method can identify structural initial damage well and truly. In a word, this structural damage identification method based on multi-mode information fusion has better effects of structural damage identification and good practicability to actual structures.

Herbal medicine prescription analyses of bronchiectasis patients with claim data during 5 years (2013~2017) (최근 5개년 (2013~2017)간 기관지확장증(J47) 환자에게 처방한 급여한약제제 현황 분석 - 건강보험청구자료 중심으로)

  • Kang, Sohyeon;Kim, Jinhee;Jang, Soobin;Lee, Mee-Young;Lee, Ju Ah;Park, Sunju
    • Journal of Society of Preventive Korean Medicine
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    • v.23 no.3
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    • pp.1-12
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    • 2019
  • Objectives : Korean national health insurance data is a useful real-world data representing whole medical bills submitted to Health Insurance Review Agency. This study aims to understand recent benefit trend of insurance herbal preparations for treating bronchiectasis(disease code J47) utilizing insurance data. Methods : We reviewed national health insurance claims data from 2013 to 2017 which have main diagnosis or sub diagnosis code of J47 and with the record of prescribing insurance herbal medication. Frequency analysis was performed to analyze the most frequently prescribed prescription. Results & Conclusions : Both the number of claims statement(770 to 1,746cases) and patients(266 to 484) of insurance herbal preparations increased considerably from 2013 to 2017. Top 10 preparations based on the number of claims statement were 'Samso-eum', 'Yeonkyopaedok-san', 'Socheongryong-tang', 'Bojungikgi-tang', 'Hyangsapyungwi-san', 'Yijin-tang', 'Saengmaek-san', 'Jaeumganghwa-tang', 'Ojeok-san' and 'Gungha-tang'. Top 10 preparations based on the number of patients were 'Samso-eum', 'Socheongryong-Tang', 'Saengmaek-san', 'Yeonkyopaedok-san', 'Haengso-tang', 'Hyangsapyungwi-san', Yijin-tang', 'Jaeumganghwa-tang', 'Bojungikgi-tang' and 'Hyeonggaeyeongyo-tang' in respectiv order. Claims of top 10 frequent preparations occupied more than 60% of total claims. We hope this finding to be utilized as basic data for future research of evidence-based bronchiectasis treatment utilizing Korean traditional medicine.

Efficiency and accuracy of artificial intelligence in the radiographic detection of periodontal bone loss: A systematic review

  • Asmhan Tariq;Fatmah Bin Nakhi;Fatema Salah;Gabass Eltayeb;Ghada Jassem Abdulla;Noor Najim;Salma Ahmed Khedr;Sara Elkerdasy;Natheer Al-Rawi;Sausan Alkawas;Marwan Mohammed;Shishir Ram Shetty
    • Imaging Science in Dentistry
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    • v.53 no.3
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    • pp.193-198
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    • 2023
  • Purpose: Artificial intelligence (AI) is poised to play a major role in medical diagnostics. Periodontal disease is one of the most common oral diseases. The early diagnosis of periodontal disease is essential for effective treatment and a favorable prognosis. This study aimed to assess the effectiveness of AI in diagnosing periodontal bone loss through radiographic analysis. Materials and Methods: A literature search involving 5 databases (PubMed, ScienceDirect, Scopus, Health and Medical Collection, Dentistry and Oral Sciences) was carried out. A specific combination of keywords was used to obtain the articles. The PRISMA guidelines were used to filter eligible articles. The study design, sample size, type of AI software, and the results of each eligible study were analyzed. The CASP diagnostic study checklist was used to evaluate the evidence strength score. Results: Seven articles were eligible for review according to the PRISMA guidelines. Out of the 7 eligible studies, 4 had strong CASP evidence strength scores (7-8/9). The remaining studies had intermediate CASP evidence strength scores (3.5-6.5/9). The highest area under the curve among the reported studies was 94%, the highest F1 score was 91%, and the highest specificity and sensitivity were 98.1% and 94%, respectively. Conclusion: AI-based detection of periodontal bone loss using radiographs is an efficient method. However, more clinical studies need to be conducted before this method is introduced into routine dental practice.

A Basic Study for Development of Clinical Practice Guidelines of Korean Medicine in Autism Spectrum Disorder -Based on Pre-existing Clinical Practice Guidelines of Autism Specturm Disorder- (자폐스펙트럼장애의 치료에 대한 한의 임상 가이드라인 개발을 위한 기초연구 -기존에 개발된 자폐스펙트럼장애 가이드라인을 중심으로-)

  • Kim, Sang Min;Lee, Jin Yong;Lee, Sun Haeng;Chang, Gyu Tae
    • The Journal of Pediatrics of Korean Medicine
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    • v.31 no.1
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    • pp.52-62
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    • 2017
  • Objectives The purpose of this study is to review pre-existing clinical practice guidelines for autism spectrum disorders, and refer those in developing a new practice guideline. Methods A total of 9 existing clinical practice guidelines for autism spectrum disorder developed from 2010 to 2016 were searched by Google scholar and Pubmed, and were reviewed those literatures in three parts: general, diagnosis & evaluation, and intervention. Results There were no consistency in the recommendation methods of 9 clinical care guidelines (such as the method of rating and recommendation intensity for diagnosis, evaluation, and treatment). However, in the diagnosis and evaluation section, frequently used evaluation and diagnostic tools are mentioned in most clinical practice guidelines, and the types of pharmacologic and non-pharmacological treatments that are mainly recommended in treatment are equally mentioned in most clinical practice guidelines could confirm. Conclusions 1. Some guideline recommendations are graded according to each criterion. Recommendations presented in various databases were based on systematic reviews or other literatures. The most utilized database were PsycINFO, CINAHL, Cochrane. 2. DSM-5 and ICD-10 were the most common used diagnostic criteria, and DSM-IV was used as a diagnostic standard in the guideline published before 2013. The tools used for diagnosis and evaluation were also varied. However, most recommended ones were ADI-R, ADOS-G, and DISCO. 3. Treatment was largely divided into pharmacological intervention and non-pharmacological intervention. In some guideline, the interventions were divided into pediatric and adult. Most of the pharmacological interventions were not recommended due to lack of evidence, but in cases in which specific symptoms were aimed, they recommended to seek professional help. 4. In addition to interventions, each guideline referred to supportive interventions that may be helpful in the daily life of patients with ASD, which may need to be addressed in future clinical guidelines.