• Title/Summary/Keyword: clinical implication

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Update of Korean Standard Classification of Diseases for Rectal Carcinoid and Its Clinical Implication (직장 유암종 질병 분류 코드 변경과 임상적 의의)

  • Kim, Eun Soo
    • Journal of Digestive Cancer Reports
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    • v.9 no.2
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    • pp.57-59
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    • 2021
  • Carcinoid tumor is called as neuroendocrine tumor and is classified into neuroendocrine tumor Grade 1, neuroendocrine tumor Grade 2, and neuroendocrine carcinoma based on the differentiation of tumors. Recently, the incidence of rectal carcinoid tumor has been increasing probably due to the increased interest on screening colonoscopy and the advancement of endoscopic imaging technology. As the rectal carcinoid shows a wide range of clinical characteristics such as metastasis and long-term prognosis depending on the size and histologic features, it is a challenge to give a consistent diagnostic code in patients with the rectal carcinoid. If the rectal carcinoid tumor is less than 1 cm in size, it can be given as the code of definite malignancy or the code of uncertain malignant potential according to International Classification of Diseases for Oncology (ICD-O) by World Health Organization (WHO). Because patients get different amount of benefit from the insurance company based on different diagnostic codes, this inconsistent coding system has caused a significant confusion in the clinical practice. In 2019, WHO updated ICD-O and Statistics Korea subsequently changed Korean Standard Classification of Diseases (KCD) including the code of rectal carcinoid tumors. This review will summarize what has been changed in recent ICD-O and KCD system regarding the rectal carcinoid tumor and surmise its clinical implication.

Spontaneous Perforation of Colon in Previously Healthy Infants and Children: Its Clinical Implication

  • Kim, Soo-Hong;Cho, Yong-Hoon;Kim, Hae-Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.19 no.3
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    • pp.193-198
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    • 2016
  • Purpose: Spontaneous colon perforations are usually encountered as necrotizing enterocolitis in the neonatal period, but occur rarely in infants and children without pathological conditions. This study was conducted to describe its clinical implication beyond the neonatal period. Methods: Cases of spontaneous colon perforation confirmed after the operation were reviewed retrospectively and the clinicopathological characteristics were analyzed. Clinical data were compared according to the presence of pneumoperitoneum as initial findings. Results: Eleven patients were included in the study period and showed a history of hospitalization before transfer due to management for fever, respiratory or gastrointestinal problems. Six patients showed a sudden onset of abdominal distention and only seven patients showed a pneumoperitoneum as initial radiologic findings, however there were no significant clinicopathological differences. Perforation was found evenly in all segments of the colon, most commonly at the sigmoid colon in four cases. There were no specific pathologic or serologic causes of perforation. Conclusion: When previously healthy infants and children manifest a sustained fever with a sudden onset of abdominal distention during management for fever associated with respiratory or gastrointestinal problems, there is a great likelihood of colon perforation with no pathological condition. Prompt surgical management as timely decision-making is necessary in order to achieve a good progress.

The Angiographic Feature and Clinical Implication of Accessory Middle Cerebral Artery

  • Kim, Myoung-Soo;Lee, Hyun-Koo
    • Journal of Korean Neurosurgical Society
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    • v.45 no.5
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    • pp.289-292
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    • 2009
  • Objective : Although there are several descriptions of this vessel, there is no detailed angiographic study of the accessory middle cerebral artery (AMCA) in Korea. We describe the angiographic characteristics of the cortical territory and origin of AMCA and discuss the clinical significance of this anomaly. Methods : We searched for patients with AMCAs from a retrospective review of 1,250 conventional cerebral angiograms. We determined the origins, diameters and cortical territories of these AMCAs. Results : Fifteen patients (15 of 1250 = 1.2%) had 16 AMCAs (one patient had bilateral AMCAs). AMCAs originated from the distal A1 in eleven cases, middle A1 in two, proximal A1 in two, and proximal A2 in one case. All AMCAs followed a course parallel to the main middle cerebral artery (MCA). All but three of these arteries were smaller than the main MCA. Thirteen of the smaller diameter AMCAs had cortical distribution to the orbito-frontal and prefrontal, and precentral areas. Three AMCAs had diameter as large as the main MCA. These three supplied the orbito-frontal, prefrontal, precentral, central and anterior-parietal arteries. Conclusion : The AMCAs originated from A1 or A2. Most had smaller diameter than the main MCA. The AMCAs coursed along the horizontal portion of the MCA, but supplied the orbital surface, the anterior frontal lobe and sometimes wider cortical territory, including the precentral, central, anterior-parietal areas.

Literature Review of Listening Effort Using Subjective Scaling (주관적 측정을 이용한 청취 노력의 문헌 고찰)

  • Lee, Jihyeon;Lee, Seungwan;Han, Woojae;Kim, Jinsook
    • Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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    • v.60 no.3
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    • pp.99-106
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    • 2017
  • Listening effort is defined as a listener's mental exertion required to understand a speaker's auditory message, especially when distracting conditions are present. This review paper analyzed several subjective scaling tools used to measure the listening effort in order to suggest the best tool for use with hearing-impaired listeners who have to expend much effort even in everyday life. We first explained the importance of measuring listening effort and discussed various kinds of measurements. We then analyzed and categorized 15 recently published articles (i.e., from 2014 to 2016) into three topics: performance and listening effort, listening effort and fatigue, and clinical implication of listening effort. We compared the articles in terms of pros and cons and also identified 10 tools for use in the subjective scaling. Although none of these tools were unified or standardized easily, we concluded that 7-point scale would be the most reasonable as a less time-consuming measurement for compartmentalizing the degree of listening effort. If used with objective tools for measuring the listening effort, the subjective scaling could be a powerful tool for clinical use.