• Title/Summary/Keyword: diagnostic approach

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Assessment and Treatment of Somatization (신체화의 평가 및 치료)

  • Koh, Kyung-Bong
    • Korean Journal of Psychosomatic Medicine
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    • v.8 no.2
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    • pp.149-164
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    • 2000
  • Somatization is regarded as a process rather than a diagnostic entity. It should be emphasized to identify psychopathology rather than to make a choice regarding diagnosis in assessing somatizing patients. Psychiatrists should be aware of the psychosocial cues underlying the patients' physical symptoms. Special skills and strategies are required by nonpsychiatric physicians to facilitate the patients' acceptance of psychiatric treatment. The goal of treatment for somatization is management but not cure. The approach should be flexible, depending on the patients' responses and need. The difficulty in diagnosing and treating somatization is likely to be related to abnormal illness behavior such as the patients' denial of their psychosocial problems and resistance to psychiatric approach. In conclusion, biopsychosocial approach is needed to treat these patients effectively. Psychiatrists should also teach other physicians the interview skill that they could identify these patients as early as possible and facilitate their acceptance of psychiatric treatment.

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Surgical Treatment of Orbital Tumors at a Single Institution

  • Park, Hyun-Joon;Yang, Seung-Ho;Kim, Il-Sup;Sung, Jae-Hoon;Son, Byung-Chul;Lee, Sang-Won
    • Journal of Korean Neurosurgical Society
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    • v.44 no.3
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    • pp.146-150
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    • 2008
  • Objective : The authors reviewed the experience of 19 patients with orbital tumors and summarize the clinical features, surgical treatment and outcomes. Methods : The authors searched the database for all patients who underwent surgery for the treatment of orbital tumors at a single institution between 1999 and 2007. Data from clinical notes, surgical reports, and radiological findings were obtained for the analysis. Results : Orbital tumors constituted a heterogenous array of histopathology. The presenting symptoms were exophthalmos (52.6%), visual disturbance (26.3%) and pain (21.1%). The surgical approaches used were transcranial in 17 patients. Tumors located in the intraconal or perioptic space were surgically excised using a frontoorbital approach (8 cases). while pterional (3 cases). orbital (2 cases) and combined approaches (6 cases) were used for tumors in other sites. Total resection of tumors was achieved in 12 of 19 patients. In 4 patients with glioma and lymphoma only diagnostic biopsy was done. Three patients experienced visual deterioration postoperatively. Two patients had temporary diplopia, and one patient had temporary ptosis. Conclusion : Surgical treatment could be the mainstay of therapy for the majority of symptomatic orbital tumors. Many orbital tumors can be treated safely via a transcranial approach. Frontoorbital approach allows the surgeon to reach both the intraorbital and intracranial structures. Knowledge of the microanatomy of the orbit and meticulous surgical skills are necessary to overcome the pitfalls of intraorbital surgery.

Glomus Tumor of the Hand

  • Lee, Won;Kwon, Soon Beom;Cho, Sang Hun;Eo, Su Rak;Kwon, Chan
    • Archives of Plastic Surgery
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    • v.42 no.3
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    • pp.295-301
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    • 2015
  • Background Glomus tumors were first described by Wood in 1812 as painful subcutaneous tubercles. It is an uncommon benign neoplasm involving the glomus body, an apparatus that involves in thermoregulation of cutaneous microvasculature. Glomus tumor constitutes 1%-5% of all hand tumors. It usually occurs at the subungual region and more commonly in aged women. Its classical clinical triad consists of pain, tenderness and temperature intolerance, especially cold sensitivity. This study reviews 15 cases of glomus tumor which were analyzed according to its anatomic location, surgical approach and histologic findings. Methods Fifteen patients with subungual glomus tumors of the hand operated on between January 2006 and March 2013, were retrospectively reviewed. Patients were evaluated preoperatively with standard physical examination including ice cube test and Love's test. Diagnostic imaging consisted of ultrasonography, computed tomography, and magnetic resonance imaging. All procedures were performed with tourniquet control under local anesthesia. Eleven patients underwent excision using the transungual approach, 3 patients using the volar approach and 1 patient using the lateral subperiosteal approach. Results Total of 15 cases were reviewed. 11 tumors were located in the nail bed, 3 in the volar pulp and 1 in the radial aspect of the finger tip. After complete excision, patients remained asymptomatic in the immediate postoperative period. In the long term follow up, patients exhibited excellent cosmetic results with no recurrence. Conclusions Accurate diagnosis should be made by physical, radiologic and pathologic examinations. Preoperative localization and complete extirpation is essential in preventing recurrence and subsequent nail deformity.

The Occlusal Evaluation and Treatment Planning for Prosthodontic Full Mouth Rehabilitation (보철학적 교합 재구성을 위한 교합진단과 치료계획)

  • Lee, Seung-Kyu;Lee, Sung-Bok;Choi, Dae-Gyun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.16 no.2
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    • pp.149-159
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    • 2000
  • Occlusal disease is comparable to periodontitis in that it is generally not reversible. Occlusal disease, however, like periodontitis, often maintainable. It does itself to treatment and when restorative dentistry is utilized it becomes, in that sense, reversible. Moreover, a systematized and integrated approach will lead to a prognosis that is favorable and predictable. This approach facilitates development of optimum oral function, comfort, and esthetics, resulting in a satisfied patient. Such a systematized approach consists of four logical phase : (1) patient evaluation, (2) comprehensive analysis and treatment planning, (3) integrated and systematic reconstruction, and (4) postoperative maintenance. An integrated treatment plan is first developed on one set of diagnostic casts, properly mounted on a semiadjustable articulator using jaw relationship records. This is accomplished by using wax to make reconstructive modifications to the casts. These modified casts become the blueprint for planned occlusal changes and the fabrication of provisional restorations. The treatment goals are : (1) comfortably functioning temporomandibular joints and stomatognathic musculature, (2) adherence to the basic principle of occlusion advocated by Schuyler, (3) anterior guidance that is in harmony with the envelope of function, (4) restorations that will not violate the patient's neutral zone. This report shows the treatment procedures for a patient whose mandibular position has been altered due to posterior bite collapse. Migration of the maxillary anterior teeth had occurred, and the posterior occlusal contacts showed pathologic interference. Precise diagnosis using mounted casts was executed and prosthodontic reconstruction by the aid of an unconventional orthodontic correction on maxillary flaring was planned. An unconventional orthodontic correction can be accomplished by using preexisting natural teeth, which can be modified for use in active tooth movement or splinted together for orthodontic anchorage. This technique has an advantage over conventional fixed appliance orthodontic therapy because it can accomplish tooth movement concurrently with restorative and periodontal therapy. On occasion, minor tooth movement can be necessary to achieve the optimum occlusal scheme, crown form, and tooth position for the forces of occlusion to be displaced down the long axis of the periodontally compromised teeth. Once the occlusion, periodontal health, and crown contours for the provisional splinted restoration are acceptable, the final splinted restoration can be similarly fabricated, and it becomes an excellent orthodontic retainer.

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Dual-Phase Approach to Improve Prediction of Heart Disease in Mobile Environment

  • Lee, Yang Koo;Vu, Thi Hong Nhan;Le, Thanh Ha
    • ETRI Journal
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    • v.37 no.2
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    • pp.222-232
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    • 2015
  • In this paper, we propose a dual-phase approach to improve the process of heart disease prediction in a mobile environment. Firstly, only the confident frequent rules are extracted from a patient's clinical information. These are then used to foretell the possibility of the presence of heart disease. However, in some cases, subjects cannot describe exactly what has happened to them or they may have a silent disease - in which case it won't be possible to detect any symptoms at this stage. To address these problems, data records collected over a long period of time of a patient's heart rate variability (HRV) are used to predict whether the patient is suffering from heart disease. By analyzing HRV patterns, doctors can determine whether a patient is suffering from heart disease. The task of collecting HRV patterns is done by an online artificial neural network, which as well as learning knew knowledge, is able to store and preserve all previously learned knowledge. An experiment is conducted to evaluate the performance of the proposed heart disease prediction process under different settings. The results show that the process's performance outperforms existing techniques such as that of the self-organizing map and gas neural growing in terms of classification and diagnostic accuracy, and network structure.

A Clinical Evaluation of Mediastinoscopy (종격동경 검사의 임상적 의의)

  • Go, Yeong-Sang;Jo, Jung-Gu;Kim, Gong-Su
    • Journal of Chest Surgery
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    • v.26 no.9
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    • pp.705-709
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    • 1993
  • The mediastinoscopy was a well known useful diagnostic tool for detection of certain mediastinal tumors ,mediastinal lymph nodes invasion by bronchogenic carcinoma and metastatic cancer. A total of 33 cases of mediastinoscopies were reviewed, which were experienced at Chon Buk National University Hospital from August,1980 to October 1991. Mediastinoscopy was performed through anterior or parasternal approach in 18 cases, cervical approach in 14 cases and both in 1 case. In 12 cases which were used for preoperative stagig of lung cancer, 10 cases[83.3%] had the positive biopsy results at mediastinal nodes. In 11 cases for diagnosis of lymph nodes and masses with unknown lung lesion, small cell carcinoma revealed in 3 cases,squamous cell carcinoma in 2 , adenocarcinoma in 1 case and the others were had the negative biopsy results. In 10 cases for diagnosis of mediastinal tumors, lymphoma revealed in 2 cases, malignant thymoma in 2, sarcoidosis in 2, tuberculous granuloma in 1, mesothelioma in 1, metastatic cancer with unknown origin in 1 case. Thoracotomy was performed in 3 cases of lung cancers, 2 patients with negative biopsy results in preoperative staging and 1 patient with subcarinal lymph node involvement only. Bleeding complications during mediastinoscopy were developed in 2 cases, managed by anterior mini-thoracotomy.

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Oriental Medical Approach to Attention-deficit/hyperactivity disorder(ADHD) (주의력결핍 과잉운동장애에 대한 한의학적 접근)

  • Chang Gyu-Tae
    • The Journal of Pediatrics of Korean Medicine
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    • v.15 no.2
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    • pp.141-165
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    • 2001
  • Attention-deficit/hyperactivity disorder(ADHD) is one of the most common childhood-onset psychlatric disorders. It is distinguished by symptoms of inattention, hyperactivity, and impulsivity. ADHD may be accompanied by learning disabilities, depression, anxiety, conduct disorder, and oppositional defiant disorder. The etiology of ADHD is unknown, and the disorder may have several different causes. Individual with ADHD present in childhood and may continue to show symptoms as they enter adolescence and adult life. Public interest in ADHD has increased along with debate in the media concerning the diagnostic process and treatment strategies. The purpose of this study is oriental medical approach to ADHD. This study was progressed for oriental diagnosis and treatment for ADHD. In oriental medicine, the reason of ADHD was deficiency of the kidney, hyperactivity of the liver(腎虛肝亢), deficiency of the heart and the spleen(心脾不足), heart disturbed by phlegm and heat(痰熱擾心). The method of medical treatment was nourishing the kidney and checking exuberance of yang(滋腎潛陽), relieving mental stress and promoting wisdom(寧神益智), nourishing the heart and strengthening the spleen(養心健脾), tranquilzation(安神定志). removing heat-phlegm(淸熱化痰), inducing resuscitation and tranquilzation(開窮安神). The prescription was commonly used as Liuwei Dihuang Wan jiajian(六味地黃丸加減), Guipi Tang he Ganmai Dazao Tang jiajian(歸脾湯合甘麥大棗湯加減), Huanglian Wendan Tang jiawei(溫黃連溫膽湯加味). It should help primary care providers in their assessment of a common child health problem.

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Clinical Reference of the Maximum Standardized Uptake Values to the Pancreatic Cancer, Pancreatitis and Normal Pancreas in the 18F-FDG PET-CT (18F-FDG PET-CT 검사에서 췌장암, 췌장염, 정상 췌장에 대한 최대 표준섭취계수의 임상적 기준 설정)

  • Lee, Jae-Seung;Kweon, Dae Cheol
    • Journal of Biomedical Engineering Research
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    • v.39 no.2
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    • pp.80-86
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    • 2018
  • The aim of this study were to establish the clinical references and guidelines for the maximum standardized uptake ($SUV_{max}$) value of pancreatic cancer, pancreatitis, and normal pancreas in $^{18}F-FDG$ PET-CT examinations for pancreatic disease. For this purpose, we performed the statistical analysis on the descriptive statistics, percentiles and inter quartiles range (IQR), normal distribution, and using the probability density function for pancreatic cancer, pancreatitis, and normal pancreas. As a result, the clinical reference of $SUV_{max}$ for the pancreatic cancer, pancreatitis, and normal pancreas was more than 3.45, 1.91 to 2.62, and less than 1.91, respectively. Also, optimal cut-off value for applying the dual time point PET-CT examination was determined to be 2.62. The results of this study are summarized as follows: first, we suggests the clinical reference and guideline for the pancreatic cancer, pancreatitis, and normal pancreas, and second, suggests a scientific approach to improve diagnostic accuracy of pancreatic disease by deviating from an approximate experience approach.

Stator Winding Fault Diagnosis in Small Three-Phase Induction Motors by Park's Vector Approach (Park's Vector 기법을 이용한 소형 3상 유도 전동기의 권선 고장 진단)

  • 박규남;한민관;우혁재;송명현
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.7 no.6
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    • pp.1291-1296
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    • 2003
  • This paper deals with efficient diagnostic for stator winding fault of 3-phase induction motor using a current Park's vector approach. This method firstly transforms 3-phase stator current to vertical axis current and horizontal axis current of Park's Vector, and then obtains the each Park's Vector Pattern and detects stator winding fault by comparing to Park's Vector Pattern of healthy and fault. Experimental results, obtained by using induction motor having inter-turn fault of 2, 10, 20 turn, demonstrate the effectiveness of the proposed technique, for detecting the presence of stator winding fault under 25%, 50%, and 100% of full load condition.

Application of digital polymerase chain reaction technology for noninvasive prenatal test

  • Lee, Seung Yong;Hwang, Seung Yong
    • Journal of Genetic Medicine
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    • v.12 no.2
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    • pp.72-78
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    • 2015
  • Recently, noninvasive prenatal test (NIPT) has been adopted as a primary screening tool for fetal chromosomal aneuploidy. The principle of NIPT lies in isolating the fetal fraction of cell-free DNA in maternal plasma and analyzing it with bioinformatic tools to measure the amount of gene from the target chromosome, such as chromosomes 21, 18, and 13. NIPT will contribute to decreasing the need for unnecessary invasive procedures, including amniocentesis and chorionic villi sampling, for confirming fetal aneuploidy because of its higher positive predictive value than that of the conventional prenatal screening method. However, its greater cost than that of the current antenatal screening protocol may be an obstacle to the adoption of this innovative technique in clinical practice. Digital polymerase chain reaction (dPCR) is a novel approach for detecting and quantifying nucleic acid. dPCR provides real-time diagnostic advantages with higher sensitivity, accuracy, and absolute quantification than conventional quantitative PCR. Since the groundbreaking discovery that fetal cell-free nucleic acid exists in maternal plasma was reported, dPCR has been used for the quantification of fetal DNA and for screening for fetal aneuploidy. It has been suggested that dPCR will decrease the cost by targeting specific sequences in the target chromosome, and dPCR-based noninvasive testing will facilitate progress toward the implementation of a noninvasive approach for screening for trisomy 21, 18, and 13. In this review, we highlight the principle of dPCR and discuss its future implications in clinical practice.