• Title/Summary/Keyword: 진단명

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Comparison of Diagnostic and Post-therapy Radioiodine Scan in Well-Differentiated Thyroid Cancer and the Clinical Outcome (갑상선암 환자에서 방사성옥소 진단스캔과 치료 후 스캔의 비교 및 임상경과)

  • Lee, Seok-Mo;Bae, Sang-Kyun;Yum, Ha-Yong
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.1
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    • pp.22-29
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    • 2000
  • Purpose: We compared the first postoperative diagnostic and post-therapy scans of patients who received therapeutic doses of I-131, to investigate the difference in clinical outcomes between patients with concordant findings of diagnostic and post-therapy scans and patients with discrepant (more lesions in post-therapy scan) findings. Materials and Methods: The first postoperative diagnostic and post-therapy radioiodine scans of one hundred forty three patients with well differentiated thyroid carcinoma were reviewed. Diagnostic scans were obtained following ingestion of 185 MBq of I-131 and post-therapy scans were obtained after therapeutic dose of $3.7{\sim}9.3$ GBq of I-131. Successful ablation was defined as no radioiodine uptake on diagnostic radioiodine scan and normal range of serum thyroglobulin level (<10 ng/ml) during serum TSH elevation. Results: Discrepant scan findings were noted in 25 (17.5%) patients. Twenty-two patients (15.4%) showed more lesions in post-therapy scan and 3 patients (2.1%) showed stunning effect. Nine (64.3%) of 14 patients with distant metastasis revealed metastatic lesion(s) only on post-therapy scan. Stunning effect was considered as sublethal damage in 1 patient and treatment by a diagnostic dose in 2 patients. Ablation was achieved in 52.4% (75/143) of all patients. Ablation rate and mean cumulative radioiodine dose were not different statistically between concordant and discrepant groups. Conclusion: There were 17.5% difference between diagnostic and post-therapy scan findings when using 185 MBq of I-131 as a diagnostic dose. However, 64.3% of distant metastases were revealed only on post-therapy scan. Ablation rate and mean cumulative radioiodine dose were not different statistically between concordant and discrepant groups. The stunning effect was considered as not only sublethal damage but also treatment by a small diagnostic dose of radioiodine.

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Clinical Findings and Therapy of Ureteral Duplication in 61 Children (소아에서의 중복요관에 관한 임상적 고찰)

  • Yook Jin Won;Kim Ji Hong;Kim Pyung Kil;Han Sang Won
    • Childhood Kidney Diseases
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    • v.2 no.2
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    • pp.169-177
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    • 1998
  • Purpose : Renal duplication is a common occurrence, and the range of ureteral and renal anomalies draining the two poles of the duplex kidney leads to a variety of clinical presentations. Method : A series of 61 children with duplicated systems was studied retrospectively who were admitted during last 12years. Results : Of the children $60.6\%$ were accompanied with urologic anomalies that required surgical treatment, and most children initially were presented with urinary tract infection. $42.6\%$ of children were either diagnosed incidentally during evaluation of other non-urologic disease or during follow-up evaluation of abnormal antenatal renal sonogram. Conclusion : From our point view, children with history of abnormal antenatal renal sonogram, or with symptoms such as urinary tract infection, hematuria, abdominal pain should be evaluated radiologially fully to confirm further abnormality and accompanied complications. And routine follow-up using abdominal ultrasonogram, VCUG, and urine culture should be used to prevent and detect early treatable complications.

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Diffuse Infiltrative Lung Disease : Comparison of Diagnostic Accuracies of High-Resolution CT and Radiography (미만성 침윤성 폐질환의 진단: HRCT와 단순흉부X선사진의 비교)

  • Kim, Kyeong-Ah;Kang, Eun-Young;Oh, Yu-Whan;Kim, Jeung-Sook;Park, Jai-Soung;Lee, Kyung-Soo;Kang, Kyung-Ho;Chung, Kyoo-Byung
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.3
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    • pp.388-402
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    • 1996
  • Background : To compare the diagnostic accuracies of High-resolution CT(HRCI) and chest radiography in the diagnosis of diffuse infiltrative lung disease(DILD). Methods : This study included ninety-nine patients with a diagnosis of acute or chronic DILD, representing 20 different diseases. Twelve normal subjects were included as control. The disease state was confirmed either pathologically or clinically. Radiographs and CT scans were evaluated separately by three independent observers without knowledge of clinical and pathologic results. The observers listed three most likely diagnoses and recorded degree of confidence. Results : The sensitivity of HRCT in the detection of DILD was 98.9% compared to 97.9% of chest radiography. Overall, a correct first-choice diagnosis was made in 48% using chest radiographs and in 60% using HRCT images. The correct diagnosis was among the top-three choices in 64% when chest radiographs were used, and in 75% when HRCT images were reviewed. Overally a confident diagnosis was reached more often with HRCT(55%) than with chest radiography(26%). The correct first-choice diagnosis increased remarkably when the HRCT was used in usual interstitial pneumonia, miliary tuberculosis, diffuse panbronchiolitis and lymphangitic carcinomatosis. Conclusion : HRCT is confirmed to be superior to conventional radiography in the detection and accurate diagnosis of DILD. HRCT is especially valuable in the diagnosis of usual interstitial pneumonia, miliary tuberculosis, diffuse panbronchiolitis, and lymphangitic carcinomatosis.

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Change in Fertility Rates in Korea: Causes and Future Prospect (최근 한국사회의 출산율 변화원인과 향후 전망)

  • Kim, Seung-Kwon
    • Korea journal of population studies
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    • v.27 no.2
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    • pp.1-34
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    • 2004
  • 최근 한국사회에서는 출산율의 저하로 인한 사회경제적 영향을 우려하여 대책방안을 강구하여야 한다는 논의가 증대되고 있다. 그런데 국가정책을 개발${\cdot}$추진하기 이전에 반드시 요구되는 것은 저출산 현상의 올바른 인식과 철저한 원인규명이다. 따라서 본 연구에서는 출산율 변화의 원인을 다각적으로 살펴보고, 향후 변화방향을 전망해 보고자 한다. 먼저 자녀출산의 변화를 결혼상태 변화와 유배우부인의 출산율 변화 부분으로 나누어 살펴본 결과, 과거와는 달리 최근의 출산율 저하는 유배우 부인에 의해서가 아니라 미혼자의 결혼연장 또는 독신생활에서 기인되는 것으로 나타났다. 이들 두 요인에 영향을 주는 변수로는 경기침체 및 직장불안정, 결혼가치관의 변화와 초혼연령의 상승, 자녀양육 관심증대, 자녀양육비 부담, 가정과 직장의 양립을 위한 사회적 인프라 부족, 여성의 자아욕구 및 사회참여 증대, 자녀효용가치 감소, 이혼 등 가족해체의 증대, 그리고 불임부부의 증대 등인 것으로 판단된다. 향후 출산율 변화를 전망해 보면, 저출산을 일찍 경험한 서구 선진국의 경우와는 달리 정책의 추진에 한계가 있어 선진국보다 더 낮은 출산율을 회복하는 데는 많은 어려움이 있을 것이라는 판단이다. 더군다나 젊은 미혼남녀의 가치관이 개인주의화 되는 경향이 있다는 점을 감안한다면 출산율 회복정책을 추진한다 하더라도 한계가 있을 수밖에 없을 것이다. 수년간 실시된 각종 실태조사를 분석한 결과에 의하면 현재의 경기침체가 회복될 경우 약 20%의 출산율 상승 가능성이 있으며, 이 때의 합계출산율은 약 1.43명 수준이 될 수 있을 것으로 예견된다. 또한 종합적 체계적 출산회복정책을 효과적${\cdot}$효율적으로 추진한다면 약 10년 후에는 합계출산율이 약 1.6 수준으로 회복될 것이라는 낙관적 견해를 가져본다. 그렇지만 정책의 강도에 따라서 회복수준은 현저하게 상이할 것이다.를 진단, 치료함에 있어 진행성 신질환의 가능성을 시사하는 예후인자가 없다면 신생검보다는 지속적이고 정기적인 추적관찰만으로도 충분할 것으로 생각된다도 등은 양군 사이에 유의한 차이가 관찰되지 않았다. 발견 당시 혈청 $C_3$치의 감소는 모두 11명(61.1%)에서 관찰되었는데, 증상군에서는 7명(87.5%), 집단뇨검사군에서는 4명(40%)으로 증상군에서 혈청 $C_3$치의 감소가 보다 현저하였다. 그러나 추적관찰 기간 동안 증상군에서는 7명 중 4명, 집단뇨검사군에서는 4명 중 1명에서 혈청 $C_3$치는 정상범위로 증가하여 최종 관찰시점에서는 6명 (33.3%)에서만 혈청 $C_3$치의 감소가 지속되고 있다. 혈청 $C_3$치의 감소를 보인 경우를 다시 병리조직학적 분류에 의해 세분하여보면 발병당시에는 I형 8명(61.5%), II형에 1명(100%), III형 2명(50%)에서 관찰되었는데, 최종 시점에서는 I형 4명(30.8%), II형 1명(100%), III형 1명(33.3%)이었다. 또한 증상군에서 세포성 반월체형성과 세뇨관위축의 빈도가 높았으며, 사구체 혈관벽 비후와 사구체 간질의 증가의 정도가 집단뇨검사군에 비해 통계적으로 유의하게 높았다. 결론: 무증상성 요이상을 가진 환자에서 신장조직검사 실시 후 MPGN으로 진단되는 증례가 증가하고 있고, 오히려 증상을 동반하는 경우보다 빈도가 증가한다는 사실은 집단뇨 검사에서 소변의 이상소견이 발견되어 신장 조직검사를 실시할 경우 혈청 $C_3$치의 감소 여부에 관계없이 MPGN도 진단적 고려 대상이 되어야 한다고 생각한다.신장 조직검사를 시행한 결과 진행성 경과를 취할 수 있는 막 증식성 사구체 신염과 매우 희귀한 증례인 신유전분증 등으로 진단됨으로써 지속성 단백뇨의 경우 정확 진단적 접근이 필수적임을 알 수

Differential Diagnosis of Breast Mass and Staging of Breast Cancer Using F-18-FDG PET (F-18-FDG PET을 이용한 유방종괴의 감별진단과 유방암의 병기설정)

  • Yeo, Jeong-Seok;Lee, Dong-Soo;Kang, Keon-Wook;Noh, Dong-Young;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.6
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    • pp.502-511
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    • 1999
  • Purpose: F-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) has been proven to be useful in the differential diagnosis of breast mass and staging of breast cancer. This study assessed the diagnostic accuracy of F-18-FDG PET in the differentiation of breast mass and staging of breast cancer. Materials and Methods: Total 42 patients who had breast mass underwent F-18-FDG PET (all female, 40: 10 year old). We compared F-18 FDG PET results with pathologic findings in 24 patients Results: In the differentiation of breast mass, sensitivity and specificity were 95% (19/20) and 77% (7/9) respectively. Three false positive cases were due to inflammation and one false negative patient had small tumor less than 1 cm. In the assessment of axillary lymph node status, sensitivity and specificity were 73% (8/11) and 100% (7/7) respectively. We found distant metastasis that were not suspected before F-18-FDG PET in 2 patients. Conclusion: F-18-FDG PET shows good diagnostic performance in differentiation of breast mass and staging of breast cancer.

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Contralateral Vesicoureteral Reflux in Children with Abnormal Unilateral Renal Development (일측성 신발생이상 환아에 동반된 반대측 방광요관역류)

  • Oh Sung-Wook;Lee Jae-Seung;Kim Myoung-Jun;Han Sang-Won;Bae Ki-Soo
    • Childhood Kidney Diseases
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    • v.1 no.1
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    • pp.53-59
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    • 1997
  • There have been many recent reports that unilateral renal agenesis and multicystic dysplastic kidneys are accompanied by contralateral vesicoureteral reflux leading to its injury. We grouped the children with unilateral renal agenesis, renal hypoplasia, multicystic dysplastic kidney into abnormal unilateral renal development and investigated whether it was accompanied with contralateral vesicoureteral reflux. We retrospectively reviewed 96 pediatric cases of unilateral renal agenesis, hypoplasia, multicystic dysplastic kidney diagnosed at Shinchon Severance Hospital, Yongdong Severance Hospital from 1987 to 1996 and Ajou University Hospital from 1994 to 1996. Diagnosis was based on radiological findings, renal hypoplasia being defined as small renal size with no apparent renal scarring and no irregularity of the calyceopelvic system on abdominal sonography or intravenous pyelography. Among the 96 cases,48 cases carried out voiding cystourethrography. 58 cases were male(60%) and 38 cases were female(40%). The cases of abnormal unilateral development on the left side were 45(47%) and that on the right side were 51(53%). Although there were diverse reasons leading to diagnosis, the major ones included were prenatal sonography, urinary tract infection, and other congenital anomalies. In cases of unilateral renal agenesis & hypoplasia the leading factors were urinary tract infection & other congenital anomalies and in cases of multicystic dysplastic kidney that was prenatal sonography. There was a chronological gap between the mean age of diagnosis(1.8 year) and voiding cystouerthrography(2.5 year, P < 0.01). 9 of the 18 unilateral renal agenesis cases, 5 of the 11 unilateral renal hypoplasia cases, and 3 of the 19 unilateral multicystic dysplastic kidney cases showed contralateral vesicoureteral reflux. Average reflux grade was above G III.Among the 17 children who had contralateral vesicoureteral reflux, 3 children had chronic renal failure and ureteroneocystostomy was carried out in 6 children. From the above results we conclude that screening voiding cystourethrography should be performed in children with abnormal unilateral renal development for early detection of vesicoureteral reflux in the contralateral kidney.

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PERFORATION OF THE TEMPOROMANDIBULAR JOINT MENISCUS: DIAGNOSED BY MAGNETIC RESONANCE IMAGING (MAGNETIC RESONANCE IMAGING을 이용한 악관절 원판 천공 진단)

  • Kim, Houng-Gon;Dolan, Eward;Vogler, James B.;Nokes, Steven R.
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.11 no.2
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    • pp.11-18
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    • 1989
  • Advancement of surgical techniques has made it necessary to accurately diagnose internal derangements. Arthrography and computerized tomography have been used to diagnose the majority of temporomandibular joint disorders, however, these methods have had their disadvantages. Magnetic resonance imaging utilizing surface coils has greatly improved the ability to diagnose meniscus abnormalities without using intrarticular injections or ionizing radiation. Ninety-two patients (184 joints) were evaluated by means of magnetic resonance imaging(MRI). Thirty-one patients (39 joints) were diagnosed as having meniscus perforation. Retrospective review of fifteen patients (20 joints) with a perforated meniscus diagnosed by magnetic resonance imaging pre-operatively demonstrated a sixty-five percent correlation between the radiographic diagnosis and the surgical findings.

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CLINICAL EVALUATION OF CHILDREN WITH INATTENTION AND HYPERACTIVITY IN A PSYCHIATRIC CLINIC (주의산만과 과잉운동을 주소로 하는 정신과 내원 아동들의 임상 평가)

  • Kweon, Yong-Sil
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.13 no.1
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    • pp.93-103
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    • 2002
  • The aim of this study is to examine the diagnostic profiles and related clinical variables of children with attention and hyperactivity in psychiatric outpatient clinic. Seventy one children with age range of 5 to 14 were diagnosed by DSM-IV, and assessment battery including KEDI-WISC, KPI-C, ADS(ADHD Diagnostic System) were completed. The subjects were divided into 3 diagnostic groups:ADHD only(n=17), ADHD comorbid(n=27), Other diagnosis(n=27). The results were as follows:In ADHD comorbid group, tic disorder, developmental language disorder, borderline intellectual function, oppositional defiant/conduct disorder, and learning disorder were combined in descending order. Other diagnosis group consisted of tic disorder, borderline intellectual function, depression/anxiety, oppositional defiant/conduct disorder, and others. There were significant differences in IQ, PIQ, and VIQ among the three groups, and ADHD only group showed higher scores of IQ and VIQ than ADHD comorbid group. On the KPI-C, there were no significant differences in all subscales among the three groups. On the visual ADS, omission error and sensitivity showed significant differences among the three groups, and ADHD comorbid group represented higher omission error and lower sensitivity than other diagnostic group. The findings indicated that the inattention and hyperactivity symptoms could be diagnosed into diverse psychiatric disorders in child psychiatry, and ADHD children with comorbidity will show more problems in academic performance and school adjustment.

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Methodology for Implementation of the Portable Disease Diagnosis Platform based on Neural Network Using High Performance Computing (고성능 컴퓨팅을 활용한 뉴럴 네트워크 기반의 휴대용 질병 진단 플랫폼 구현 방법론)

  • Kim, Sang-man;Park, Ju-Sung
    • Journal of IKEEE
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    • v.22 no.4
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    • pp.1093-1098
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    • 2018
  • In this paper, we proposed a methodology for portable disease diagnosis platform using high performance computing. The proposed methodology consists of gathering clinical data, diagnosis and feature selection algorithm, implementation of diagnosis platform. For the algorithm verification, a clinical data which is obtained from 401 people(314 normal subjects and 87 liver cancer patients) using a microarray consists of 1,146 aptamers were used. As the result, we could diagnosis liver cancer with 97.5% accuracy using the 32 selected aptamers. Based on these results, we designed and implemented a portable disease diagnosis platform which has 32 bio-signals as inputs.

Diagnostic Video-Assisted Thoracic Surgery (진단목적의 비디오 흉강경 수술)

  • Baek, Hyo-Chae;Hong, Yun-Ju;Lee, Du-Yeon;Park, Man-Sil
    • Journal of Chest Surgery
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    • v.29 no.5
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    • pp.542-547
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    • 1996
  • All patients who underwent video-assisted thoracic surgery (VATS) for diagnostic purposes from Jan. 1992 to Aug. 1995 were reviewed. The total number of patients were 111 with 57 male and 54 female, and the mean age was 49 years (range 1 to 74). Multiple biopsies from more than one location were performed in 17 patients , pleural biopsies were performed In 49 patients, lung biopsies in 43 patients, mediastinal mass or Iymph node biopsies in 33 patients, and two pericardium biopsies and one dia- phragm biopsy, for a total of 128 biopsies. Seventeen pleural biopsy cases and one lung biopsy case underwent operation under local anesthesia , the rest were performed under general anesthesia. In patients who underwent lung biopsy, the mean age was 49.1 ye rs (range 22~ 73). The operating time was 40 to 170 minutes (mean 97), intravenous or intramuscular injection for pain control was required 0 to 22 times(mean 4.7), and chest tube was inserted from 1 to 26 days(mean 7). In all patients except two, a diagnosis was obtained from the biopsy and complication was encountered in one patient in whom intraoperative paroxysmal atrial tachycardia was detected. In 7 patients, a thorn- cotomy had to be done due to pleural adhesion or intraoperative bleeding, and 7 patients had postoperative complications associated with the chest tube. In the pleural biopsy group, the mean age was 49 years (range 17~ 74). The operating time was 25 to 80 minutes (mean 49), intravenous or intramuscular injection for pain control was needed 0 to 20 times (mean 3.6), and the chest tube was i.nserted for 0 to 67 days(mean 9.8). In all the patients, a diagnosis was possible. The chest tube was inserted for longer than 7 days in 11 patients. In the Iymph node biopsy roup, the mean age was 44.2 years (range 1 ~ 68). The operating time was )0 to 3)5 minutes(mean 105), pain control was required 0 to 15 times(mean 3.2), and a chest tube was kept in place for 1 to 36 days(mean 6.1). In one patient, a diagnosis was not possible and a chest tube was kept in place for longer than 7 days in 7 patients. In the multiple biopsy group, the mean age was 53.1 years(range 20~ 71). The operating time was 15 to 165 minutes(mean 85), and pain control was done from 0 to 17 times(mean 3.1). The chest tube was kept in place for 1 to 16 days (mean 7.9).

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