Background: The purpose of this study was to differentiate chromophobe renal cell carcinoma and clear cell renal cell carcinoma on helical CT. Methods: The CT images of 9 patients histopathologically proven to have chromophobe renal cell carcinoma and 20 patients with clear cell renal cell carcinoma were reviewed. The tumor sizes, margins, enhancement degrees and patterns, presence or absence of calcification, and tumor spread patterns (including perinephric changes, venous invasion, lymphadenopathy, and distant metastasis) were compared. Results: All the chromophobe renal cell carcinomas showed well-demarcated margins. Thechromophobe renal cell carcinomas showed milder enhancements than the clear cell renal cell carcinomas. The sensitivity and specificity for differentiating the chromophobe renal cell carcinoma from the clear cell renal cell carcinoma were 100 and 88%, respectively, when 101 Hounsfield units was used as the cut-off value in the corticomedullary phase, and 95 and 100% when a less-than-three-time enhancement change was used as a cut-off value in the corticomedullary phase (p<0.05). The chromophobe renal cell carcinomas (67%) tended to show a homogeneous enhancement whereas the clear cell renal cell carcinomas (85%) usually showed a heterogeneous enhancement (p<0.05). Statistical analysis revealed that the frequencies of the tumor spread pattern and calcification in the two subtypes didnot differ significantly (p>0.05). Conclusion: The CT findings of the chromophobe renal cell carcinomascompared to those of the clear cell renal cell carcinomas showed that there were mild enhancements in the corticomedullary phase, homogeneous enhancements, and well-demarcated margins.
Objectives: Fine needle aspiration cytology(FNAC) is a well established preoperative diagnostic procedure in the thyroid nodules. However, diagnostic accuracy of FNAC varies according to the size and the structural characteristics of thyroid nodule. We performed the ultrasound guided FNAC(US-guided FNAC) for impalpable thyroid nodule, and estimated the sampling accuracy rate through a comparison study between the cytologic diagnosis and the final histologic diagnosis of the postoperative specimens in order to determine clinical efficacy of the US-guided FNAC. Materials and Methods: We evaluated 117 patients underwent US-guided FNAC from January 1997 to December 1998. These patients had 129 thyroid nodules to need cytologic examination. Whereas the nodules were so no graphically classified into cystic, solid, and mixed type according to echo pattern, the aspirated thyroid specimens were classified into benign, malignant, suspicious, and insufficient. Results: Positive sampling for diagnositc examination was achieved in 75 nodules(58.1%), and US-guided FNAC in our study showed the accuracy rate of 95.2%, false positivity rate of 0%, and false negativity rate of 5.5%. Conclusions: US-guided FNAC is a powerful techniques for evaluating cytologic characterics and allowing a reliable diagnositc result in the impalpable thyroid nodule. However, the experienced technique is recommanded in order to obtain the sufficient samples for reliable results.
In this work, a PC-based thermal performance monitoring system is developed for the nuclear power plants. The system performs real-time thermal performance monitoring and diagnosis during plant operation. Specifically, a prototype for the KORI-2 nuclear power unit is developed and examined in this work. The analysis and the fault identification of the thermal cycle of a nuclear power plant is very difficult because the system structure is highly complex and the components are very much inter-related. In this study, some major diagnostic performance parameters are selected in order to represent the thermal cycle effectively and to reduce the computing time. The Fuzzy ARTMAP, a self-organizing neural network, is used to recognize the characteristic pattern change of the performance parameters in abnormal situation. By examination, this algorithm is shown to be able to detect abnormality and to identify the fault component or the change of system operation condition successfully. For the convenience of operators, a graphical user interface is also constructed in this work.
Proceedings of the Korea Association of Information Systems Conference
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2000.11a
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pp.1.2-24
/
2000
The field of neural networks has been a recent surge in activity as a result of progress in developments of efficient training algorithms. For this reason, and coupled with the widespread availability of powerful personal computer hardware for running simulations of networks, there is increasing focus on the potential benefits this field can offer. The neural network may be viewed as an advanced pattern recognition technique and can be applied in many areas such as financial time series forecasting, medical diagnostic expert system and etc.. The intention of this study is to build and implement one simple artificial neural networks hereinafter called ANN. For this purpose, some literature survey was undertaken to understand the structures and algorithms of ANN theoretically. Based on the review of theories about ANN, the system adopted 3-layer back propagation algorithms as its learning algorithm to simulate one case of medical diagnostic model. The adopted ANN algorithm was performed in PC by using turbo PASCAL and many input parameters such as the numbers of layers, the numbers of nodes, the number of cycles for learning, learning rate and momentum term. The system output more or less successful results which nearly agree with goals we assumed. However, the system has some limitations such as the simplicity of the programming structure and the range of parameters it can dealing with. But, this study is useful for understanding general algorithms and applications of ANN system and can be expanded for further refinement for more complex ANN algorithms.
Background: Acute radiation syndrome (ARS) primarily refers to damage to the hematopoietic system, myeloid system, and gastrointestinal (GI) system caused by radiation exposure. Such damage progresses to become life-threatening. In particular, as the syndrome develops very rapidly-within several hours from radiation exposure-prompt and accurate diagnosis and treatment are needed, as is further research into appropriate diagnostic and treatment modalities. Materials and Methods: Minipigs, which display human-like properties, underwent whole-body irradiation at 2 or 4 Gy (doses causing hematopoietic ARS) or at higher doses of 7 or 12 Gy. Changes in the blood cells and clinical symptoms were analyzed and we performed a necropsy when the animals succumbed to ARS. Results and Discussion: The minipig irradiated with 2 Gy showed a decrease in white blood cells, including neutrophils, lymphocytes, and platelets in the early stages. However, the blood cell counts gradually increased and returned to normal values. The minipig irradiated with 4 Gy succumbed due to hematopoietic ARS. In contrast, the minipigs irradiated with 7 or 12 Gy exhibited clinical symptoms of combined GI damage and hematopoietic syndrome. Moreover, a characteristic pattern of platelet changes was observed in the 7 and 12 Gy irradiated minipigs. Conclusion: The changes in the platelet count caused by radiation exposure observed in minipigs, which are hematologically and pathohistologically similar to humans, suggest that they can be used as a novel diagnostic criterion.
Sarcoidosis is a multisystem disease characterized by noncaseating granulomas. Cardiac involvement is known to have poor prognosis because it can manifest as a serious condition such as the conduction abnormality, heart failure, ventricular arrhythmia, or sudden cardiac death. Although early diagnosis and early treatment is critical to improve patient prognosis, the diagnosis of CS is challenging in most cases. Diagnosis usually relies on endomyocardial biopsy (EMB), but its diagnostic yield is low due to the incidence of patchy myocardial involvement. Guidelines for the diagnosis of CS recommend a combination of clinical, electrocardiographic, and imaging findings from various modalities, if EMB cannot confirm the diagnosis. Especially, the role of advanced imaging such as cardiac magnetic resonance (CMR) imaging and positron emission tomography (PET), has shown to be important not only for the diagnosis, but also for monitoring treatment response and prognostication. CMR can evaluate cardiac function and fibrotic scar with good specificity. Late gadolinium enhancement (LGE) in CMR shows a distinctive enhancement pattern for each disease, which may be useful for differential diagnosis of CS from other similar diseases. Effectively, T1 or T2 mapping techniques can be also used for early recognition of CS. In the meantime, PET can detect and quantify metabolic activity and can be used to monitor treatment response. Recently, the use of a hybrid CMR-PET has introduced to allow identify patients with active CS with excellent co-localization and better diagnostic accuracy than CMR or PET alone. However, CS may show various findings with a wide spectrum, therefore, radiologists should consider the possible differential diagnosis of CS including myocarditis, dilated cardiomyopathy (DCM), hypertrophic cardiomyopathy, amyloidosis, and arrhythmogenic right ventricular cardiomyopathy. Radiologists should recognize the differences in various diseases that show the characteristics of mimicking CS, and try to get an accurate diagnosis of CS.
Dong-Hyun Kim;Jun-Hee Cho;Jung-Hwa Lim;Bo-Kyung Kim
Journal of Oriental Neuropsychiatry
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v.34
no.3
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pp.163-179
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2023
Objectives: The purpose of this study was to provide evidence for the clinical effects of foot bath therapy for insomnia disorder through a systematic review and meta-analysis. Methods: Studies were selected from seven domestic and international literature databases. Data on diagnostic tools, pattern identification, sample size, intervention methods, outcome measurements, results, and adverse events were extracted. The quality of the selected literature was assessed using Cochrane's risk of bias (RoB) assessment tool. Results: A total of 11 studies were included in this study. The primary diagnostic tool for insomnia dis- order was the criteria for the diagnosis and therapeutic effect of diseases and syndromes in traditional Chinese medicine (CDTDSTCM), along with the Chinese classification of mental disorders-3 (CCMD-3). Treatment effects were mainly evaluated by the effective rate and the Pittsburgh Sleep Quality Index (PSQI). The meta-analysis results showed statistically higher effectiveness rates for treating insomnia disorder in the experimental groups receiving herbal medicine foot bath therapy with sleeping or herbal medication compared to the control group. The PSQI was lower in the treatment group receiving herbal medicine foot bath therapy with sleeping medication. The herbal materials used in herbal medicine foot bath therapy mainly included Radix Angelicae Sinensis, Polygonum Multiflorum, Ziziphi Spinosae Semen, Rhizoma Coptidis, Radix Salviae Miltiorrhizae, and Cortex Albizziae. The quality of the included studies was generally poor. Conclusions: This study found that foot bath therapy had clinical efficacy for treating insomnia disorder. The research findings could provide foundational evidence for establishing the clinical basis of foot bath therapy in the treatment of insomnia.
Background: Mandibular split fractures, in which the fracture occurs exclusively in the posterior wall, are uncommon. This study aimed to enhance clinicians' understanding of mandibular split fractures and offer insights for future research. Methods: This study included six patients who visited our hospital between January 2020 and June 2023 and were diagnosed with mandibular split fractures. We retrospectively collected data from patients' medical records on their age, sex, symptoms, mechanism, impact site, associated injuries, and treatment method, as well as the location, pattern, and number of fractures observed on computed tomography (CT) and panoramic images. The frequency of split fractures among all mandibular fractures was calculated. Results: The six patients included three men (50%) and three women (50%), ranging in age from 20 to 71 years (mean age, 49.8 years). The split fractures were located in the symphysis in one patient (16.7%), symphysis to parasymphysis in two patients (33.3%), parasymphysis in one patient (16.7%), and parasymphysis to the body in two patients (33.3%). Four patients (66.7%) had condylar head fractures, while two patients (33.3%) had single split fractures. The mechanism of trauma was a slip-down incident in four cases (66.7%), while two cases (33.3%) were caused by motorcycle traffic accidents. Four patients (67%) underwent intermaxillary fixation, while two patients (33%) improved with conservative treatment. Split fractures were diagnosed in all six patients on CT, whereas the fracture line was not clearly visible on panoramic images. Mandibular split fractures accounted for 5.6% of all mandibular fractures. Conclusion: This study provides insights into the clinical characteristics of rare mandibular split fractures and the diagnostic imaging findings. Furthermore, CT scans and three-dimensional image synthesis-instead of panoramic images-may be essential for accurately diagnosing mandibular fractures, including mandibular split fractures, in the future.
Geoncheol Jo;Sejun Yoon;Jeong Woon ,Bae;Byung Joo Kim
The Journal of Korean Medicine
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v.44
no.1
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pp.38-55
/
2023
Objectives: The purpose of this study was to provide direction for future research in the field of Korean medicine by analyzing microbiome based technologies emerging as a new diagnostic and treatment paradigm. Methods: To achieve the purpose of the study intellectual property data was used. After establishing citation network from registered microbiome-related US patents, citation network was analyzed by knowledge persistence-based main path approach to understanding technological trajectories. Furthermore, community detection algorithms were used to quantitatively identifying specific technological domain in a particular time period. Results: Results shows that early technologies in livestock industry contribute most to the recent patents. Knowledge in the patents flow through the path of food and beverage technological domain, and finally are inherited to the recent development of diagnosis, treatment and prevention technic. Conclusions: This study indicate that developing diagnostic tools which can link the composition of microbiome to specific diseases should be given high priority. Researches should lead to novel therapeutic strategies. Specifically, improving reliability of pattern identification and finding effective therapeutic compositions based on principles of Korean medicine is necessary.
Objectives: This study investigated the effectiveness of herbal medicine for generalized anxiety disorder (GAD) based on recent clinical studies. Methods: Studies were searched through four databases. Clinical research studies on herbal medicine treatment for GAD patients were included. The studies were analyzed according to study design, diagnostic criteria, population, and intervention. A risk of bias assessment was performed to assess the quality of the included randomized controlled trials (RCT). If the intervention applied to the treatment and control groups was the same and two or more studies were reporting the same items as outcome indicators, a meta-analysis was performed. Results: A total of 19 studies, including 12 RCTs were selected. The most common pattern identification was 'Phlegm fire disturbing upward' (痰熱上擾), and the most used herb for therapeutic purposes was 'Rhizome of Poria cocos' (茯苓). Meta-analysis results of three studies showed that there were no significant differences in effectiveness between the herbal medicine intervention and the Western medicine intervention. Meta-analysis results of five studies showed that the Hamilton Anxiety Rating Scale was significantly reduced in the case of herbal medicine intervention compared to Western medicine intervention. Conclusions: The results of our study demonstrated that herbal medicine treatment for GAD is effective in alleviating anxiety symptoms and chief symptoms of GAD. However, this study has several limitations; there was a lack of placebo-controlled RCT and an absence of objective diagnostic criteria in case reports. Therefore, further well-designed clinical studies, conducted based on the results of this study, are recommended.
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