• Title/Summary/Keyword: standard of diagnosis

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COMPREHENSIVE TREATMENT OF OBSTRUCTIVE SLEEP APNEA - THE ROLE OF DEPARTMENT OF DENTISTRY IN SLEEP CLINIC (폐쇄성 수면 무호흡증에 대한 포괄적 치료 - 수면 클리닉에서 치과의 역할)

  • Kwon, Tae-Geon;Cho, Yong-Won;Ahn, Byung-Hoon;Hwang, Sang-Hee;Nam, Ki-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.2
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    • pp.150-156
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    • 2004
  • The etiology of the obstructive sleep apnea includes the various factors such as anatomical abnormality in upper airway, craniofacial structure, obesity and personal habit. To establish reasonable treatment plan, multi-department approach is should be emphasized because the treatment modality is depend on the result of analysis for degree & site of obstruction and various behavioral factors. In Sleep Clinic in Keimyung University Medical Center, the standard of care for sleep apnea patient was established according to the Standard of practice committee of Americal Sleep Disorders Association. After one year experience of comprehensive approach for sleep apnea we could achieve following recommendation for the treatment. 1) The multi-department examination and diagnosis could prevent unnessesary treatment because the treatment plan could be established under comprehensive discussion. 2) Determination of the site of obstruction is important for treatment planning. However, no single determinant could be found. We expect multi-department approach can reduce the mistake in detection of obstruction. 3) Further evaluation of treatmet outcome should be succeeded to establish Korean standard of care for sleep apnea treatment.

Critical Evaluation of Fine Needle Aspiration Cytology as a Diagnostic Technique in Bone Tumors and Tumor-like Lesions

  • Chakrabarti, Sudipta;Datta, Alok Sobhan;Hira, Michael
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.7
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    • pp.3031-3035
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    • 2012
  • Background: Though open surgical biopsy is the procedure of choice for the diagnosis of bone tumors, many disadvantages are associated with this approach. The present study was undertaken to evaluate the role of fine needle aspiration cytology (FNAC) as a diagnostic tool in cases of bony tumors and tumor-like lesions which may be conducted in centers where facilities for surgical biopsies are inadequate. Methods: The study population consisted of 51 cases presenting with a skeletal mass. After clinical evaluation, radiological correlation was done to assess the nature and extent of each lesion. Fine needle aspiration was performed aseptically and smears were prepared. Patients subsequently underwent open surgical biopsy and tissue samples were obtained for histopathological examination. Standard statistical methods were applied for analysis of data. Results: Adequate material was not obtained even after repeated aspiration in seven cases, six of which were benign. Among the remaining 44 cases, diagnosis of malignancy was correctly provided in 28 (93.3%) out of 30 cases and categorical diagnosis in 20 (66.67%). Interpretation of cytology was more difficult in cases of benign and tumor-like lesions, with a categorical opinion only possible in seven (50%) cases. Statistical analysis showed FNAC with malignant tumors to have high sensitivity (93.3%), specificity (92.9%) and positive predictive value of 96.6%, whereas the negative predictive value was 86.7%. Conclusion: FNAC should be included in the diagnostic workup of a skeletal tumor because of its simplicity and reliability. However, a definitive pathologic diagnosis heavily depends on compatible clinical and radiologic features which can only be accomplished by teamwork. The cytological technique applied in this study could detect many bone tumors and tumor-like conditions and appears particularly suitable as a diagnostic technique for rural regions of India as other developing countries.

Report on the Korean Standard Differentiation of the Symptoms and Signs for the Stroke-1 (한의 중풍변증 표준안-I에 대한 보고)

  • Kim Joong-Kil;Seol In-Chan;Lee In;Jo Hyun-Kyung;Yu Byeong-Chan;Choi Sun-Mi
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.20 no.1
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    • pp.229-234
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    • 2006
  • To develop the Korean standard differentiation of the symptoms and signs for the stroke(KSDS), the committee on Stroke Diagnosis Standardization of traditional Korean medicine(TKM) was organized dy nineteen experts in college of Korean medicine. On July 9th 2005, the second consultation meeting was held in Daejeon, Korea. Fifteen experts of the committee attended the meeting and they discussed the KSDS and came to a consensus. The 15-member committee consensus was as follows: First, board members defined the stroke on the basis of TKM. Second, they divided the symptoms and signs of stroke into five categories- fire and heat, dampness and phlegm, blood stasis, qi deficiency, yin deficiency. Third, the symptom indicator of each differentiation type for the stroke was recommended. KSDS-1 will be applied to the clinical practice and revised.

Study on Laws related to the Scope of Both Medical Doctors' Practice in Korea (의료인 업무범위 관련 법률 고찰)

  • Yu Jin So;Da Hee Lee;Hye In Jeong;Kyeong Han Kim
    • Journal of Society of Preventive Korean Medicine
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    • v.27 no.3
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    • pp.13-24
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    • 2023
  • Objective : This study was aimed to reassess the scope of practice for medical personnel based on laws. Method : The law specifying the scope of practice for medical personnel has been selected searching Korean Law Information Center(https://www.law.gov.kr). The result was categorized as 'examination, diagnosis, treatment, procedure, prescription, and others'. Results : The laws related to medical procedures were divided into three categories: diagnosis, treatments, and public health and others. In the field of diagnosis, traditional Korean medicine practitioners are generally allowed to play a role. However, some laws specify that only medical doctors can be the primary authorities for diagnosing infectious diseases. In the area of treatments, particularly in emergency medical situations, only medical doctors or nurses are typically mentioned. There are debates in the field of public health and other areas concerning issues such as vaccination, disability diagnosis, and the qualifications for health center directors. A reevaluation is also needed for the Occupational Safety and Health Act, where only medical doctors are set as the personnel standard for workers' health examinations. Conclusion : To safeguard and promote the health of the citizens, there is a need for a clear definition of the licensure and scope of practice for healthcare professionals. Consistent interpretation of conflicting provisions among various laws and clear criteria for the term 'physician' in legal contexts are essential.

Utilization of Psychological Tools for Critical Pathway Based Mental Evaluation and Diagnosis (CP 기반 정신 평가 및 진단을 위한 심리검사의 활용)

  • Sunggyu, Hong;Hyun Woo, Lee;Sun-Yong, Chung;Jong-Woo, Kim
    • Journal of Oriental Neuropsychiatry
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    • v.33 no.4
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    • pp.377-388
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    • 2022
  • Objectives: For diagnosis and evaluation, evaluation tools are needed. Various tools can be used to diagnose and evaluate mental disorders. Among them, psychological tests are widely used. For Korean Standard Classification of Diseases (KCD) diagnosis, psychological tests are also required. Currently developed critical pathway (CP) presented tools for diagnosis and evaluation of mental disorders. The CP suggests the use of tools based on the Clinical Practice Guideline (CPG). Therefore, CPG-based tools should be able to be used in the clinical scene of Korean Medicine for diagnosing and evaluating mental disorders according to CP. Methods: Tools suggested by CPs are summarized. The degree of utilization of tools in CPGs is also summarized. A review was conducted by Korean Medicine neuropsychiatrist experts on tools and user's usage plan. Results: As a result, developed CPs suggested using 19 tools for anxiety disorder, 13 tools for insomnia), 12 tools for Hwabyeong, and 9 tools for dementia. In CPG, 48, 34, 44, and 44 tools were used for anxiety disorder, insomnia, Hwabyeong, and dementia, respectively. Among tools presented in CP, HAM-A, HAM-D, CGI, SAS, and TESS for anxiety disorder, CPG, ISI, and PSQI for insomnia disorder, CPG, STAI, and STAXI for Hwabyeong were frequently used in CPG. For dementia CPG, MoCA, MMSE, HDS, ADL, and ADAS-cog were frequently used. Among them, MoCA, ADL, and ADAS-cog were suggested tools in CP. Conclusions: As a result of analyzing tools suggested and used in the developed CPs and CPGs, it was verified that various tools were used in each study. Most of them were symptom and behavioral evaluation scales. Therefore, symptoms and behavior evaluation scales used more frequently should be able to be used in the clinical scene of Korean Medicine.

Fractal dimension analysis as an easy computational approach to improve breast cancer histopathological diagnosis

  • Lucas Glaucio da Silva;Waleska Rayanne Sizinia da Silva Monteiro;Tiago Medeiros de Aguiar Moreira;Maria Aparecida Esteves Rabelo;Emílio Augusto Campos Pereira de Assis;Gustavo Torres de Souza
    • Applied Microscopy
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    • v.51
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    • pp.6.1-6.9
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    • 2021
  • Histopathology is a well-established standard diagnosis employed for the majority of malignancies, including breast cancer. Nevertheless, despite training and standardization, it is considered operator-dependent and errors are still a concern. Fractal dimension analysis is a computational image processing technique that allows assessing the degree of complexity in patterns. We aimed here at providing a robust and easily attainable method for introducing computer-assisted techniques to histopathology laboratories. Slides from two databases were used: A) Breast Cancer Histopathological; and B) Grand Challenge on Breast Cancer Histology. Set A contained 2480 images from 24 patients with benign alterations, and 5429 images from 58 patients with breast cancer. Set B comprised 100 images of each type: normal tissue, benign alterations, in situ carcinoma, and invasive carcinoma. All images were analyzed with the FracLac algorithm in the ImageJ computational environment to yield the box count fractal dimension (Db) results. Images on set A on 40x magnification were statistically different (p = 0.0003), whereas images on 400x did not present differences in their means. On set B, the mean Db values presented promising statistical differences when comparing. Normal and/or benign images to in situ and/or invasive carcinoma (all p < 0.0001). Interestingly, there was no difference when comparing normal tissue to benign alterations. These data corroborate with previous work in which fractal analysis allowed differentiating malignancies. Computer-aided diagnosis algorithms may beneficiate from using Db data; specific Db cut-off values may yield ~ 99% specificity in diagnosing breast cancer. Furthermore, the fact that it allows assessing tissue complexity, this tool may be used to understand the progression of the histological alterations in cancer.

Child Behavior Check List, Korean Personality Inventory for Children, Computerized Attention Diagnostic System and ADHD : The Role of Dimensional Diagnostic Tool in ADHD Diagnosis (주의력결핍 과잉행동장애에서 아동행동평가척도, 아동인성검사, 주의력장애 진단시스템 : 주의력결핍 과잉행동장애의 진단에서 차원적 진단도구들의 역할)

  • Cho, Hwan-Il;Do, Jin-A;Kim, Hyun-Woo;Lim, Myung-Ho
    • Anxiety and mood
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    • v.5 no.2
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    • pp.96-102
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    • 2009
  • Objective : We investigated that ADHD categorical diagnosis and the dimensional tools for the evaluation of ADHD, widely used in the clinical field, such as the child behavior check list- Korean version (K-CBCL), Korean personality inventory for children (KPI-C), computerized Attention Diagnostic System (ADS). Method : The DSM-IV clinical diagnosis applied by child psychiatrist. K-CBCL, KPI-C, ADS are used. Ultimately, totally 161 ADHD children and 161 controls were evaluated. Subject group are consist of 202 boys (62.7%) and 120 girls (37.3%), and the mean age was $9.5{\pm}2.0$ years old. Results and Conclusion : Social problem, and attention problem in the K-CBCL, correct response time standard deviation in the computerized ADS were statistically significant different and attention problem in the K-CBCL, hyperactivity subscale in the KPI-C were significant trait, between subject group and control group. The ROC value of attention problem in the K-CBCL, hyperactivity subscale in the KPI-C, and ADS were .78, .93, .86. Finally, we found that K-CBCL, KPI-C, ADS were significant corelation with the ADHD categorical diagnosis.

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Effect of Taking Meal on Pulse Diagnosis in Healthy Subjects (식사가 정상인의 맥에 미치는 영향 분석)

  • Lee, Yu-Jung;Lee, Jeon;Lee, Hae-Jung;Choi, Eun-Ji;Kim, Jong-Yeol
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.6
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    • pp.1670-1675
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    • 2007
  • The pulse diagnosis studies reported to date has mainly been performed to clinically reveal the pulse wave characteristics according to the specific diseases, whereas no attempts have been made to study the effects on the pulse wave characteristics of the daily activities such as taking meals, exercise, and sleep, etc. This work reports the effect of feeding stimulus on the healthy subjects on the pulse wave pattern which has quantitatively been analyzed using the objective model for the pulse diagnosis in oriental medicine. The pulse waves right before/after the meal and 30 minutes after the meal were measured using the pulse analyzing equipment (3D-Mac, Daeyo Medi, Korea) and at the same time oriental medicine doctors' diagnoses were given. The pulse parameters obtained from the equipment and clinical records on the subjects were statistically processed and the variables showing statistically significant differences were analyzed. The results indicate that the pulse pressure, the pulse rate, and the respiratory rate increase while the blood pressure decreases after the meal. For the floating/sinking and the deficient/excess coefficients characterizing the pulse states described in the oriental medicine, the floating/sinking coefficients were observed to decrease whereas the deficiency/excess coefficients increase after the meal. The results indicates that besides the standard bio-indicators like blood pressure and respiratory rate, etc., the pulse wave characterization in terms of the pulse classifications in the oriental medicine using the floating/sinking, deficient/excess pulse states provide an important piece of biomedical information.

Vertical Axillary Muscle Sparing Thoracotomy in Thoracic Surgery (흉부 수술에 있어 수직액와 근육보존 개흉술의 적용)

  • Won, Tae-Hui;Seong, Suk-Hwan
    • Journal of Chest Surgery
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    • v.28 no.1
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    • pp.42-46
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    • 1995
  • Vertical axillary muscle sparing thoracotomy is newly appeared and excellent alternative method of standard posterolateral thoracotomy.It has many advantages compared to standard posterolateral thoracotomy , less postoperative pain, well preserved thoracic muscle strength, full range of motion of the shoulder girdle and attractive cosmetic results. We performed vertical axillary muscle sparing thoracotomy in 36 patients from November 1993 to July 1994. The ages of the patients ranged from 6 months to 71 years[mean 45.1 years , and the patients consisted of 20 males and 16 females.The preoperative diagnosis were as follows : lung cancer in 17 patients, tbc destroyed lung in 7, bronchiectasis in 3, bullous emphysema in 3 and the others are mediastinal tumor, bronchogenic cyst, lung abscess, empyema, esophageal diverticulum, and CCAM [congenital cystic adenomatoid malformation . The operative procedures were as follows : lobectomy and bilobectomy in 16 patients, segmentectomy in 4, wedge resection in 3, penumonectomy in 7, and the others were open biopsy, lobectomy with diaphragm excision, sleeve right upper lobectomy, decortication, mediastinal mass excision, and esophageal diverticulectomy. We had 6 complications : postoperative bleeding in 2 cases, operative wound infection, arrrhythmia[atrial fibrillation , Horner`s syndrome, hoarseness. The subcutaneous seroma occurred in 4 cases but did not require drainage and relieved within 4 weeks spontaneously. We concluded that vertical axillary muscle sparing thoracotomy could be done in most of all thoracic surgery with safety. Comparing to standard posterolateral thoracotomy vertical axillary muscle sparing thoracotomy has many advantages such as less postoperative pain, well preserved muscle strengths and good cosmetic results.

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Lobectomy with Video-Assisted Thoracoscopy - 4Cases Report - (비디오 흉강경을 이용한 폐엽절제술;4례 보고)

  • 윤용한
    • Journal of Chest Surgery
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    • v.26 no.3
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    • pp.236-240
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    • 1993
  • Video thoracoscopic surgery is a new modality that gains acceptance rapidly from thoracic surgeons. We have experienced two left lower lobectomies, one left upper lobectomy & one right upper lobectomy with using video thoracoscopy for the four patients with lung parenchymal disease from July 1992 to February 1993. The post-operative courses were uneventful. The final pathologic diagnosis were sclerosing hemangioma, adenocarcinoma, bronchiectasis, leiomyoma & the post-operative courses were short. These patients needed less analgesics because postoperative pain was reduced markedly, and hospitalization was shortened due to rapid recovery. We would like to prefer video thoracoscopic lobectomy to the lobectomy through standard thoracotomy in uncomplicated patients with simple pulmonary parenchymal diseases.

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