• Title/Summary/Keyword: Medical examiners

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Review of silent lacunar infarct and cerebral microbleeds : in the aspect of insurance medicine and independent medical examiners (보험 및 장애평가 대상으로서 무증상 뇌경색과 뇌미세출혈의 의미)

  • Joung, Jae-hoon
    • The Journal of the Korean life insurance medical association
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    • v.28 no.1_2
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    • pp.11-14
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    • 2009
  • It is common to find cerebral infarct and hemorrhage without definite neurologic signs but with lesions on neuroimaging. These lesions are called silent lacunar infarct and cerebral microbleed. Silent lacunar infarct are frequently seen in the elderly and are associated with clinically apparent stroke and vascular dementia. Known stroke risk factors, such as hypertension, diabetes mellitus, smoking, hypercholesterolemia and heart problems may increase the risk of silent lacunar infarct. Metabolic syndrome, homocysteinemia, renal failure and intima media thickness(IMT) are also other risk factors of the silent lacunar infarct. Cerebral microbleed, lacunar infarct and intracerebral hemorrhage(ICH) have similar pathology and pathogenesis. So, cerebral microbleed are coexisted with lacunar infarct, leukoaraiosis, hypertensive ICH and vascular dementia. Cerebral microbleed are associated with volume and recurrence of ICH. Also cerebral microbleed may reflect baseline status of blood brain barrior disruption. Silent lacunar infarct and cerebral microbleed are very important to clinical management, but in the aspect of insurance medicine and independent medical examiners, these lesions are not subject of evaluation for handicap.

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Comparison of three-dimensional digital technique with two-dimensional replica method for measuring marginal and internal fit of full coverage restorations

  • Hasanzade, Mahya;Koulivand, Soudabeh;Moslemian, Naeime;Alikhasi, Marzieh
    • The Journal of Advanced Prosthodontics
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    • v.12 no.3
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    • pp.173-180
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    • 2020
  • PURPOSE. This study compared digital (reference point matching) and replica methods for measuring marginal and internal fit of full coverage restorations. MATERIALS AND METHODS. A maxillary left first molar typodent was fixed on to an aluminum base and prepared to receive all-ceramic full coverage restoration. The model was scanned with an intraoral scanner (CEREC Omnicam, Sirona, York, PA, USA). Twelve crowns were fabricated from lithium disilicate blocks (IPS emax CAD, Ivoclar Vivadent) and then crystalized. Marginal and internal fit of each restoration was measured by two examiners using replica and a new digital three-dimensional technique. Reliability between the two methods and two examiners was assessed by correlation and Cronbach's Alpha coefficient (P<.05). A Bland-Altman assessment for agreement was used to compare the two methods. RESULTS. Bland-Altman assessment showed that the mean of difference for marginal, absolute marginal, and axial gap was respectively -1.04 ㎛, -41.9 ㎛, and -29.53 ㎛ with limit of agreement (LOA) between -37.26 to 35.18 ㎛ for marginal, -105.85 to 22.05 ㎛ for absolute marginal and -80.52 to 22.02 ㎛ for axial gap. Positive correlation for repeatability (P<.05) in determining marginal and internal gaps by the two examiners in both techniques was revealed. Reliability of both techniques in all sites of measurements was at least good (0.8 ≤ α < 0.9). CONCLUSION. Both measuring techniques appeared highly reliable for evaluating fit of fixed dental restorations, while reference point matching provided higher values in axial and absolute marginal gap assessment.

Inter- and Intra-Observer Variability of the Volume of Cervical Ossification of the Posterior Longitudinal Ligament Using Medical Image Processing Software

  • Shin, Dong Ah;Ji, Gyu Yeul;Oh, Chang Hyun;Kim, Keung Nyun;Yoon, Do Heum;Shin, Hyunchul
    • Journal of Korean Neurosurgical Society
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    • v.60 no.4
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    • pp.441-447
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    • 2017
  • Objective : Computed tomography (CT)-based method of three dimensional (3D) analysis ($MIMICS^{(R)}$, Materialise, Leuven, Belgium) is reported as very useful software for evaluation of OPLL, but its reliability and reproducibility are obscure. This study was conducted to evaluate the accuracy of $MIMICS^{(R)}$ system, and inter- and intra-observer reliability in the measurement of OPLL. Methods : Three neurosurgeons independently analyzed the randomly selected 10 OPLL cases with medical image processing software ($MIMICS^{(R)}$) which create 3D model with Digital Imaging and Communication in Medicine (DICOM) data from CT images after brief explanation was given to examiners before the image construction steps. To assess the reliability of inter- and intra-examiner intraclass correlation coefficient (ICC), 3 examiners measured 4 parameters (volume, length, width, and length) in 10 cases 2 times with 1-week interval. Results : The inter-examiner ICCs among 3 examiners were 0.996 (95% confidence interval [CI], 0.987-0.999) for volume measurement, 0.973 (95% CI, 0.907-0.978) for thickness, 0.969 (95% CI, 0.895-0.993) for width, and 0.995 (95% CI, 0.983-0.999) for length. The intra-examiner ICCs were 0.994 (range, 0.991-0.996) for volume, 0.996 (range, 0.944-0.998) for length, 0.930 (range, 0.873-0.947) for width, and 0.987 (range, 0.985-0.995) for length. Conclusion : The medical image processing software ($MIMICS^{(R)}$) provided detailed quantification OPLL volume with minimal error of inter- and intra-observer reliability in the measurement of OPLL.

The Role of Aviation Medical Examiners in the Diagnosis, Treatment and Aeromedical Assessment of Patients with Allergic Rhinitis (알레르기 비염 진단 및 치료, 항공업무 적합성 평가에 있어 항공전문의사의 역할)

  • Kim, Young Hyo
    • Korean journal of aerospace and environmental medicine
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    • v.30 no.2
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    • pp.66-69
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    • 2020
  • Since allergic rhinitis is a disease with a very high prevalence, it is common to find patients with allergic rhinitis among aviation workers. However, they are so afraid that the report of rhinitis will have a negative effect on the evaluation of one's work suitability. Therefore, aviation medical examiners (AMEs) must be able to accurately understand the nature of allergic rhinitis, and confidently explain that appropriate treatment of rhinitis has a positive effect on their performance. In the treatment of allergic rhinitis, there are some medications that may cause drowsiness, which may impair the accuracy and safety of the aviation service. Therefore, AMEs should accurately know safe drugs that do not cause drowsiness and prescribe them to patients. In addition, it is necessary to know exactly whether air workers may receive the latest treatments for allergic rhinitis, such as surgical treatment and immunotherapy, and be able to recommend these treatments appropriately. Therefore, in this paper, we first briefly describe the pathophysiology, genetics, causative antigen, symptoms, diagnosis, and treatment of allergic rhinitis. We also aimed to discuss safe medication and other treatment modalities for allergic rhinitis.

Substandard Life Insurance and Medical Selection (표준하체보험(標準下體保險)과 의학적(醫學的) 선택(選擇))

  • Hirao, Masaharu
    • The Journal of the Korean life insurance medical association
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    • v.2 no.1
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    • pp.3-16
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    • 1985
  • Necessity of life insurance is stronger for people who feel some anxiety of their health. However, in fact, it is not permitted for them to get a contract, because life insurance stands on the mutual benefit system. Life insurance must be impartial to all applicants. However, it is very reasonable that an applicant, who has high medical impairment like heart infarction or cancer, is rejected, to have a contract by underwriting decision. On the other hand, if his medical impairment is not so severe, we might accept his application by giving some restriction. Numericalratingsystem by hunter-rogers gave us one of solutions to this problem. We can keep impartiality by using more restrictive decision, in order that we demand additional payment to the impairment applicant according to his mortality. We call this system as substandard life insurance. In this system we need detail information about impairments of applicants in order to decide the condition of substandard risks. Therefore, medical examiners are required to have high diagnostic technique.

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Understanding Peripheral Dizziness and Evaluating Suitability for Aviation Work (말초성 어지럼의 이해 및 항공업무 적합성 평가)

  • Kim, Hyun Ji;Kim, Kyu-Sung;Kim, Young Hyo
    • Korean journal of aerospace and environmental medicine
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    • v.31 no.1
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    • pp.9-12
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    • 2021
  • Aircraft accidents caused by dizziness of aviation workers are so common that they account for 5% to 10% of the total, and in most cases, have fatal consequences. Therefore, it is essential to diagnose and treat the dizziness of aviation workers properly. Common diseases caused by abnormal vestibular function include benign paroxysmal positional vertigo, Meniere's disease, and vestibular neuritis. In this paper, we first proposed an overview of these diseases' pathophysiology, diagnosis, and treatment. Also, we evaluated the importance of these diseases in aerospace medicine and presented aerospace medical dispositions for aviation medical examiners.