• Title/Summary/Keyword: diagnosis and treatment

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Diagnosis and Treatment of Latent Tuberculosis Infection

  • Lee, Seung Heon
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.2
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    • pp.56-63
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    • 2015
  • A small number of viable tuberculosis bacilli can reside in an individual with latent tuberculosis infection (LTBI) without obvious clinical symptoms or abnormal chest radiographs. Diagnosis and treatment for LTBI are important for tuberculosis (TB) control in public and private health, especially in high-risk populations. The updated 2014 Korean guidelines for TB recommend that tuberculin skin tests, interferon-gamma release assays, or a combination of the two can be used for LTBI diagnosis according to age and immune status of the host as well as TB contact history. The regimens for LTBI treatment include isoniazid, rifampicin, or isoniazid/rifampicin. However, results of drug susceptibility test from the index case must be considered in selecting the appropriate drug for recent contacts. Standardized LTBI diagnosis and treatment based on the new 2014 guidelines will contribute to the effective TB control in Korea as well as to the establishment of updated guidelines.

Nutcracker syndrome in children: review of symptom, diagnosis, and treatment

  • Diana S. Kalantar;Se Jin Park;Jae Il Shin
    • Childhood Kidney Diseases
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    • v.27 no.2
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    • pp.89-96
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    • 2023
  • Renal nutcracker syndrome (NCS) is the entrapment of the left renal vein between the abdominal aorta and superior mesenteric artery. Although uncommon in pediatric patients, early diagnosis is crucial to avoid potential severe complications, such as anemia or renal vein thrombosis. NCS presents a variety of symptoms, most commonly including "Triade's symptoms"-hematuria, proteinuria, and flank pain. Diagnosis and treatment include invasive and noninvasive management, although due to a lack of pediatric clinical studies, management is widely variable. Conservative diagnosis and treatment are recommended as a first-line option for pediatric patients; however, invasive surgical treatment may be recommended based on symptom severity. This review aims to provide a comprehensive overview of NCS in children to better understand the widely variable incidence, occurrence, and management from early on to allow for early-onset management.

Factors Influencing the Initiation of Treatment after the Diagnosis of Korean Patients with HIV (HIV 감염인의 진단 후 치료 시작에 영향을 미치는 요인)

  • Shim, Mi-So;Kim, Gwang Suk;Park, Chang Gi
    • Research in Community and Public Health Nursing
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    • v.29 no.3
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    • pp.279-289
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    • 2018
  • Purpose: This study has been conducted to identify factors that influence the initiation of treatment after the diagnosis of Korean patients with HIV. Methods: A cross-sectional study design was used, and 290 patients with HIV from outpatient departments of 7 hospitals participated. Self-report questionnaires included items on the days from the primary diagnosis to the initiation of treatment, and the patients' demographic and disease related characteristics. Negative binomial regression model (NBR) was utilized to determine risk factors influencing the initiation of treatment after the diagnosis of the patients with HIV. Results: The skewness of days was 6.62, and the degree of asymmetry of distribution was severe. In NBR, patients who were in their 40s and 50s, female, unmarried and living with their family, jobless, in a middle or high level of economic status, and diagnosed before 2014 showed a higher risk of delayed treatment than patients who were younger, male, married and living with family, in a low level of economic status, and diagnosed in 2014 or afterwards. Conclusion: The findings suggest the necessity of intervention to promote HIV patients' early entry into treatment based on the participants' characteristics.

A Study on the Principles of Regional Perspirations (부위별(部位別) 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.1
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    • pp.71-85
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    • 2009
  • For having good therapeutic value, putting the ideal of diagnosis and treatment based on overall analysis of symptoms and signs[辨證施治] into practice is very important, so the Eastern Medicine's peculiar diagnosis without interference by the western medical diagnosis is very important. The peculiar method of Eastern Medicine's diagnosis is four methods of diagnosis(四診法), a joint term for inspection, auscultation and olfaction, interrogation, pulse feeling and palpation. In the process of interrogation[問診], from analyzing the perspiration phase, doctor can get various physical information. Especially perspiration from particular region can be a clue for founding focus or cause of disease. This thesis divide the phase of perspiration into eight bodily region, perspiration from all body, head, face, back, chest and armpit, stomach, pubic region and lower part, hands and feet, and inquire the possible causes and principles of these perspirations. In conclusion, the regional perspiration can be a clue point out the origin of fever and condition of Gi(氣) flow. Perspiration from head, back, chest and armpit, hands and feet means that certain fever cannot extend to the outside of body, and at the same time, means the Gi(氣) flow of outside is being intercepted. So the perspirations from that region become an object of medical treatment.

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Video-Assisted Thoracoscopic Diagnosis and Treatment of Mediastinal Mass (비디오 흉강경을 이용한 종격동 종양의 진단과 치료)

  • 백희종
    • Journal of Chest Surgery
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    • v.27 no.9
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    • pp.779-784
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    • 1994
  • Vidio-assisted thoracic surgery[VATS] has recently evolved as an alternative to thoracotomy for several thoracic disorders,and the role of thoracoscopy has expanded with advances in surgical techniques and instruments. From May 1993 to May 1994, 13 patients with mediastinal mass underwent VATS for diagnosis and treatment at Gil General Hospital. There were four males and nine females, and their ages raged from 5 years to 66 years with average 38.8 years. Among 13 patients, 3 were operated for tissue diagnosis,9 for treatment,and 1 for diagnosis and treatment. Pathologic diagnoses were as follows; 5 benign neurogenic tumors, 2 thymoma, 2 sarcoidosis, 1 teratoma, 1 peripheral neuroepithelioma, 1 tbc lymphadenitis, and 1 pericardial cyst. The mean time of operation was 111.7 $\pm$ 30.7 minutes[60-160], mean duration of chest tube drainage was 2.9 $\pm$1.9days[1-9], mean hospital stay was 6.2 $\pm$2.6 days[4-13]. There was no patient needed blood transfusion or conversion to open thoracotomy. Accurate diagnosis was possible in all patients operated for diagnosis and /or treatment.[4/4,100%] Two complications occurred in two patients: 1 transient Horner,s syndrome,1 anhydrosis of left arm. Compared with those of conventional thoracotomy done for mediastinal mass during previous 2 years[May 1991 - April 1993], operative results of VATS were better in all aspects. For mediastinal mass, we concluded that VATS can be done with less morbidity,less complication,less blood loss,shorter operation time and hospital stay,and not more expensive in cost than conventional thoracotomy. Noticeably, we think that VATS is the operation of choice for the diagnosis and palliation of malignant mediastinal mass.

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Diagnosis and Treatment of Nontuberculous Mycobacterial Lung Disease: Clinicians' Perspectives

  • Ryu, Yon Ju;Koh, Won-Jung;Daley, Charles L.
    • Tuberculosis and Respiratory Diseases
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    • v.79 no.2
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    • pp.74-84
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    • 2016
  • Nontuberculous mycobacteria (NTM) are emerging pathogens that affect both immunocompromised and immunocompetent patients. The incidence and prevalence of NTM lung disease are increasing worldwide and rapidly becoming a major public health problem. For the diagnosis of NTM lung disease, patients suspected to have NTM lung disease are required to meet all clinical and microbiologic criteria. The development of molecular methods allows the characterization of new species and NTM identification at a subspecies level. Even after the identification of NTM species from respiratory specimens, clinicians should consider the clinical significance of such findings. Besides the limited options, treatment is lengthy and varies by species, and therefore a challenge. Treatment may be complicated by potential toxicity with discouraging outcomes. The decision to start treatment for NTM lung disease is not easy and requires careful individualized analysis of risks and benefits. Clinicians should be alert to those unique aspects of NTM lung disease concerning diagnosis with advanced molecular methods and treatment with limited options. Current recommendations and recent advances for diagnosis and treatment of NTM lung disease are summarized in this article.

Survival and Recurrence Rate after Treatment for Primary Spinal Sarcomas

  • Cho, Wonik;Chang, Ung-Kyu
    • Journal of Korean Neurosurgical Society
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    • v.53 no.4
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    • pp.228-234
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    • 2013
  • Objective : We have limited understanding on the presentation and survival of primary spinal sarcomas. The survival, recurrence rate, and related prognostic factors were investigated after treatment for primary sarcomas of the spine. Methods : Retrospective analysis of medical records and radiological data was done for 29 patients in whom treatment was performed due to primary sarcoma of the spine from 2000 to 2010. As for treatment method, non-radical operation, radiation therapy, and chemotherapy were simultaneously or sequentially combined. Overall survival (OS), progression free survival (PFS), ambulatory function, and pain status were analyzed. In addition, factors affecting survival and recurrence were analyzed : age (${\leq}42$ or ${\geq}43$), gender, tumor histologic type, lesion location (mobile spine or rigid spine), weakness at diagnosis, pain at diagnosis, ambulation at diagnosis, initial treatment, radiation therapy, kind of irradiation, surgery, chemotherapy and distant metastasis. Results : Median OS was 60 months, the recurrence rate was 79.3% and median PFS was 26 months. Patients with distant metastasis showed significantly shorter survival than those without metastasis. No factors were found to be significant relating to recurrence. Prognostic factor associated with walking ability was the presence of weakness at diagnosis. Conclusion : Primary spinal sarcomas are difficult to cure and show high recurrence rate. However, the development of new treatment methods is improving survival.

Ginsenoside Rg1 Epigenetically Modulates Smad7 Expression in Liver Fibrosis via MicroRNA-152

  • Rongrong Zhang ;Xinmiao Li ;Yuxiang Gao ;Qiqi Tao;Zhichao Lang;Yating Zhan;Chunxue Li;Jianjian Zheng
    • Journal of Ginseng Research
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    • v.47 no.4
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    • pp.534-542
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    • 2023
  • Background: Ginsenoside Rg1, a bioactive component of Ginseng, has demonstrated anti-inflammatory, anti-cancer, and hepatoprotective effects. It is known that the epithelial-mesenchymal transition (EMT) plays a key role in the activation of hepatic stellate cells (HSCs). Recently, Rg1 has been shown to reverse liver fibrosis by suppressing EMT, although the mechanism of Rg1-mediated anti-fibrosis effects is still largely unclear. Interestingly, Smad7, a negative regulator of the transforming growth factor β (TGF-β) pathway, is often methylated during liver fibrosis. Whether Smad7 methylation plays a vital role in the effects of Rg1 on liver fibrosis remains unclear. Methods: Anti-fibrosis effects were examined after Rg1 processing in vivo and in vitro. Smad7 expression, Smad7 methylation, and microRNA-152 (miR-152) levels were also analyzed. Results: Rg1 significantly reduced the liver fibrosis caused by carbon tetrachloride, and reduced collagen deposition was also observed. Rg1 also contributed to the suppression of collagenation and HSC reproduction in vitro. Rg1 caused EMT inactivation, reducing Desmin and increasing E-cadherin levels. Notably, the effect of Rg1 on HSC activation was mediated by the TGF-β pathway. Rg1 induced Smad7 expression and demethylation. The over-expression of DNA methyltransferase 1 (DNMT1) blocked the Rg1-mediated inhibition of Smad7 methylation, and miR-152 targeted DNMT1. Further experiments suggested that Rg1 repressed Smad7 methylation via miR-152-mediated DNMT1 inhibition. MiR-152 inhibition reversed the Rg1-induced promotion of Smad7 expression and demethylation. In addition, miR-152 silencing led to the inhibition of the Rg1-induced EMT inactivation. Conclusion: Rg1 inhibits HSC activation by epigenetically modulating Smad7 expression and at least by partly inhibiting EMT.

A study on Twelve meridian Biaoben(標本) pulse diagnosis method among the ancient meridian diagnosis method (고대(古代)의 경맥진단법(經脈診斷法) 중(中) 십이경표본맥진법(十二經標本脈診法)에 관(關)한 연구(硏究))

  • Lee, Dong-hee;Hwang, Min-seob;Yoon, Jong-hwa
    • Journal of Acupuncture Research
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    • v.21 no.1
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    • pp.21-32
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    • 2004
  • Objective: A study on $\ll$Lingchui, 靈樞 Weiqi, 衛氣$\gg$ which descripted Twelve meridian Biaoben(標本) pulse diagnosis method. Methods: A study on Twelve meridian Biaoben(標本) pulse diagnosis method which has the cognizance of Biaoben(標本) on upper and low twelve meridian as linear upper and low pulse diagnosis point. Results: Twelve meridian Biaoben(標本) pulse diagnosis method is derived from using each twelve meridian pulse diagnosis and it can be explained that the ben(本) pulse point on wrist ankle and the biao(標) pulse point on thorax axillary neck head face correspond to upper and low part of meridian for diagnosis and treatment which become the theory of "treat upper disease on low part, treat low disease on upper part". Conclusions: Twelve meridian Biaoben(標本) pulse diagnosis method started confirming the general concept of Jue-symptom(厥症) and Jue-symptom(絶症) and developed upper and low pulse diagnosis point or acupuncture point to treatment.

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An analysis of determining factor for frozen shoulder patients diagnosis and treatment of physical therapists (동결견 환자에 대한 물리치료사의 진단 및 치료방법 결정기준)

  • Oh, Young-Taek;Kim, Ki-Won;Kwon, Hyuk-Cheol
    • Journal of Korean Physical Therapy Science
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    • v.5 no.4
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    • pp.777-784
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    • 1998
  • The purpose of this study was to determine the diagnosis and treatment patterns for frozen shoulder patients. It was used Delphi survey techniques and the subjects were 35 expect physical therapists who agreed participated in the study. The data were analyzed by the x2-test at 0.05 level of statistical significance. The results were as follows : 1. In accordance with open ended question, 11 diagnosis and 14 treatment are collected in the first investigation. 2. In accordance with close ended question, they were selected 5 diagnosis and 5 treatments criteria from the results of the first replied questionnaire. 3. Finally, the third close ended questionnaire, they were selected 3 main driteria of the diagnosis and treatments from the results of the second investigation. The physical therapists prefer to 1) History 2) ROM test 3) Palpation & Inspection in the diagnostic field, and 1) EST and Convex-Concave rule 2) Codman's exercise and MFR 3) Deep friction massage in the treatment field.

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