• Title/Summary/Keyword: Diagnostic Possibility

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Treatment of the Perinatally Diagnosed Asymptomatic Adrenal Gland Mass (출산 전후기에 진단된 무증상 부신 종괴의 치료)

  • Hwang, Seung-Hyun;Lim, Jun-Sup;Oh, Jung-Tak;Kim, Myung-Joon;Han, Seok-Joo;Choi, Seung-Hoon
    • Advances in pediatric surgery
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    • v.10 no.2
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    • pp.107-111
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    • 2004
  • Recently, the incidence of perinatally detected asymptomatic adrenal gland masses has increased because of widespread use of radiological diagnostic tools. However, optimal treatment of these masses has not been determined. The aim of this study is to elucidate the treatment guideline of perinatally diagnosed adrenal gland masses. The authors retrospectively reviewed the medical records of the 11 patients with asymptomatic adrenal gland mass, detected perinatally, between 1999 and 2004. Six cases were detected by prenatal ultrasound and 5 cases were incidentally detected by postnatal ultrasound. Six patients (surgery group) underwent mass excision. The pathologic diagnoses were neuroblastoma (n=4), adrenocortical adenoma (n=1) and adrenal pseudocyst (n=1). The indications for operation were suspicion of neuroblastoma (n=5) or absence of size decrease during observation (n=1). Three of the 5 suspicious cases of neuroblastoma and one case under observation were proven to be neuroblastoma. There was no surgical complication in the urgery group. All neuroblastoma patients have been well during the follow up period ($24.4{\pm}14.4$ month) without evidence of recurrence. Five cases (observation group) were closely observed because of the benign possibility or size decrease in follow up ultrasound. During the observation period ($39{\pm}21$ week), 4 cases showed complete spontaneous resolution and 1 case showed markedly decreased size of the mass but could not be followed up completely. Surgical resection of the perinatally diagnosed asymptomatic adrenal gland mass is a safe treatment method especially in case of suspicion of neuroblastoma, but closed observation can be applied.

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FUZZY LOGIC KNOWLEDGE SYSTEMS AND ARTIFICIAL NEURAL NETWORKS IN MEDICINE AND BIOLOGY

  • Sanchez, Elie
    • Journal of the Korean Institute of Intelligent Systems
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    • v.1 no.1
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    • pp.9-25
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    • 1991
  • This tutorial paper has been written for biologists, physicians or beginners in fuzzy sets theory and applications. This field is introduced in the framework of medical diagnosis problems. The paper describes and illustrates with practical examples, a general methodology of special interest in the processing of borderline cases, that allows a graded assignment of diagnoses to patients. A pattern of medical knowledge consists of a tableau with linguistic entries or of fuzzy propositions. Relationships between symptoms and diagnoses are interpreted as labels of fuzzy sets. It is shown how possibility measures (soft matching) can be used and combined to derive diagnoses after measurements on collected data. The concepts and methods are illustrated in a biomedical application on inflammatory protein variations. In the case of poor diagnostic classifications, it is introduced appropriate ponderations, acting on the characterizations of proteins, in order to decrease their relative influence. As a consequence, when pattern matching is achieved, the final ranking of inflammatory syndromes assigned to a given patient might change to better fit the actual classification. Defuzzification of results (i.e. diagnostic groups assigned to patients) is performed as a non fuzzy sets partition issued from a "separating power", and not as the center of gravity method commonly employed in fuzzy control. It is then introduced a model of fuzzy connectionist expert system, in which an artificial neural network is designed to build the knowledge base of an expert system, from training examples (this model can also be used for specifications of rules in fuzzy logic control). Two types of weights are associated with the connections: primary linguistic weights, interpreted as labels of fuzzy sets, and secondary numerical weights. Cell activation is computed through MIN-MAX fuzzy equations of the weights. Learning consists in finding the (numerical) weights and the network topology. This feed forward network is described and illustrated in the same biomedical domain as in the first part.

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Assessment of Gait as a Diagnostic Tool for Patients with Dementia (치매 진단도구로서 치매노인의 보행능력 평가에 대한 연구)

  • Lee, Han-Suk;Park, Sun-Wook
    • Journal of the Korean Society of Physical Medicine
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    • v.12 no.2
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    • pp.129-136
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    • 2017
  • PURPOSE: The purpose of this study was to compare the gait of elderly patients with and without dementia to investigate the possibility of an ambulation assessment test as a diagnostic tool for dementia. METHODS: A total of 96 subjects were included with 60 participants without dementia (control group) and 36 patients with dementia (dementia group). To compare the walking ability of the two groups, a 4-m walking test (4MWT) and Groningen Meander Walking Test (GMWT) were conducted. The GMWT is graded by amount of time in seconds and by number of oversteps outside the track. Mann-Whitney U test was used to compare the gait between the groups and the area under the curve (AUC) with Received Operating Characteristic (ROC) curve was analyzed. Statistical significance was considered at a p<.05, with a 95% confidence interval. RESULTS: There were statistically significant differences (p<.05) between the dementia group and the control group for the 4MWT, GMWTSEC, and GMWTSTEP scores. The AUC was .95 for 4MWT, .92 for GMWTSEC, and .96 for GMWTSTEP with the 95% confidence interval. The cut-off values of the ROC curve were 1.03m/s for 4MWT, 10.8 second for GMWTSEC, and 3.75 steps for GMSTEP. CONCLUSION: In our study, we investigated the utility of ambulatory assessment tools to predict dementia. The results of this study suggest that the 4MWT and the GMWT used in this study are appropriate assessment tools for dementia prediction.

Anticorrosive Monitoring and Complex Diagnostics of Corrosion-Technical Condition of Main Oil Pipelines in Russia

  • Kosterina, M.;Artemeva, S.;Komarov, M.;Vjunitsky, I.;Pritula, V.
    • Corrosion Science and Technology
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    • v.7 no.4
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    • pp.208-211
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    • 2008
  • Safety operation of main pipelines is primarily provided by anticorrosive monitoring. Anticorrosive monitoring of oil pipeline transportation objects is based on results of complex corrosion inspections, analysis of basic data including design data, definition of a corrosion residual rate and diagnostic of general equipment's technical condition. All the abovementioned arrangements are regulated by normative documents. For diagnostics of corrosion-technical condition of oil pipeline transportation objects one presently uses different methods such as in-line inspection using devices with ultrasonic, magnetic or another detector, acoustic-emission diagnostics, electrometric survey, general external corrosion diagnostics and cameral processing of obtained data. Results of a complex of diagnostics give a possibility: $\cdot$ to arrange a pipeline's sectors according to a degree of corrosion danger; $\cdot$ to check up true condition of pipeline's metal; $\cdot$ to estimate technical condition and working ability of a system of anticorrosive protection. However such a control of corrosion technical condition of a main pipeline creates the appearance of estimation of a true degree of protection of an object if values of protective potential with resistive component are taken into consideration only. So in addition to corrosive technical diagnostics one must define a true residual corrosion rate taking into account protective action of electrochemical protection and true protection of a pipeline one must at times. Realized anticorrosive monitoring enables to take a reasonable decision about further operation of objects according to objects' residual life, variation of operation parameters, repair and dismantlement of objects.

A Study on the Validity of DSOM According to Alcohol Intake (알코올 섭취량에 따른 한의변증설문(DSOM)의 타당성에 대한 연구)

  • Hong, Sang-Hoon;Kim, Jung-Eun;Kim, Sung-Hwan;Park, Sang-Eun;Hong, Su-Hvun;Kang, Chang-Wan;Lee, In-Sun
    • The Journal of Internal Korean Medicine
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    • v.30 no.1
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    • pp.119-128
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    • 2009
  • Purpose : This study was conducted to find the possibility of DSOM (Diagnosis System of Oriental Medicine) as a diagnostic method according to alcohol intake. Method : 49 men who drink alcohol over 40g per day and whose AUDIT scores were over 12 were allocated to the drinker group. 30 men who do not drink alcohol at all were allocated to the control (non-drinker) group. The study period was from June 15, 2006 to September 30, 2008. All of both groups were analyzed using DSOM. Result : There were some differences between the drinker group and the non-drinker group in stagnation of Ki(氣滯), deficiency of Yin(陰虛), insufficiency of Yang(陽虛), heat syndrome(熱), dryness (燥), and lung(肺). A group whose gamma-GTP is over twice the normal condition shows meaningful difference in stagnation of Ki(氣滯), heat syndrome(熱), dryness(燥), and insufficiency of Yang(陽虛). Conclusion : We found out that DSOM can be a diagnostic method on alcoholic liver disease patients. However, other studies to supplement it should be continued.

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Pathophysiology of Potassium-competitive Acid Blocker-refractory Gastroesophageal Reflux and the Potential of Potassium-competitive Acid Blocker Test

  • Masaoka, Tatsuhiro;Kameyama, Hisako;Yamane, Tsuyoshi;Yamamoto, Yuta;Takeuchi, Hiroya;Suzuki, Hidekazu;Kitagawa, Yuko;Kanai, Takanori
    • Journal of Neurogastroenterology and Motility
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    • v.24 no.4
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    • pp.577-583
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    • 2018
  • Background/Aims Potassium-competitive acid blockers are expected to be the next generation of drugs for the treatment of diseases caused by gastric acid. In 2015, vonoprazan fumarate, a novel potassium-competitive acid blocker, was approved by the Japanese health insurance system. Since its approval, patients refractory to vonoprazan can be encountered in clinical settings. We designed this study to clarify the pathophysiology of gastroesophageal reflux disease refractory to vonoprazan. Methods In this retrospective study, we involved patients who had refractory symptoms after administration of standard-dose proton pump inhibitors or vonoprazan and underwent diagnostic testing with esophageal high-resolution manometry and 24-hour multichannel intraluminal impedance and pH monitoring while using proton pump inhibitors or vonoprazan. Patients were diagnosed based on the Rome IV criteria for functional gastrointestinal disorders and diagnostic test results. Results Twenty-seven patients were analyzed during this study. Gastric pH ${\geq}4$ was sustained for a longer period of time, and the esophageal acid exposure time and number of acid reflux events were shorter in the vonoprazan group than in the proton pump inhibitor group. The percentage of patients diagnosed with acidic gastroesophageal reflux disease in the vonoprazan group was lower than that in the proton pump inhibitor group. Conclusions Intra-gastric pH and acid reflux were strongly suppressed by 20-mg vonoprazan. When patients with gastroesophageal reflux disease present symptoms after administration of 20-mg vonoprazan, the possibility of pathophysiologies other than acid reflux should be considered.

Evaluation of Usefulness for Diagnosis of Lung Cancer on Integrated PET-MRI Using Decision Matrix (판정행렬을 기반한 일체형 PET-MRI의 폐암 진단 유용성 평가)

  • Kim, Jung-Soo;Yang, Hyun-Jin;Kim, Yoo-Mi;Kwon, Hyeong-Jin;Park, Chanrok
    • Journal of radiological science and technology
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    • v.44 no.6
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    • pp.635-643
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    • 2021
  • The results of empirical researches on the diagnosis of lung cancer are insufficient, so it is limited to objectively judge the clinical possibility and utilization according to the accuracy of diagnosis. Thus, this study retrospectively analyzed the lung cancer diagnostic performance of PET-MRI (Positron Emission Tomography-Magnetic Resonance Imaging) by using the decision matrix. This study selected and experimented total 165 patients who received both hematological CEA (Carcinoembryonic Antigen) test and hybrid PET-MRI (18F-FDG, 5.18 MBq/kg / Body TIM coil. VIVE-Dixon). After setting up the result of CEA (positive:>4 ㎍/ℓ. negative:<2.5㎍/ℓ) as golden data, the lung cancer was found in the image of PET-MRI, and then the SUVmax (positive:>4, negative:<1.5) was measured, and then evaluated the correlation and significance of results of relative diagnostic performance of PET-MRI compared to CEA through the statistical verification (t-test, P>0.05). Through this, the PET-MRI was analyzed as 96.29% of sensitivity, 95.23% of specificity, 3.70% of false negative rate, 4.76% of false positive rate, and 95.75% of accuracy. The false negative rate was 1.06% lower than the false positive rate. The PET-MRI that significant accuracy of diagnosis through high sensitivity and specificity, and low false negative rate and false positive rate of lung cancer, could acquire the fusion image of specialized soft tissue by combining the radio-pharmaceuticals with various sequences, so its clinical value and usefulness are regarded as latently sufficient.

Clinical and Hematologic Characteristics of Temporomandibular Disorders Patients

  • Park, Seo Eun;Kim, Ji Rak;Jo, Jung Hwan;Park, Ji Woon
    • Journal of Oral Medicine and Pain
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    • v.43 no.2
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    • pp.41-51
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    • 2018
  • Purpose: The aim of this study was to evaluate the possibility of utilizing blood tests for the diagnosis of temporomandibular disorders (TMDs) by investigating the hematologic characteristics of TMD patients according to the main source and level of TMD pain and analyzing their interrelationship. Methods: Clinical examination following the research diagnostic criteria for TMD and hematological and psychological evaluations were conducted in 357 TMD patients. Patients were divided into groups according to the main source of pain (myogenous, arthrogenous, and combined pain) and the degree of pain according to the graded chronic pain scale (GCPS). Hematological differences among the groups were statistically analyzed. Results: The C-reactive protein (CRP) level was significantly higher in the arthrogenous pain group compared to the combined pain group (p=0.032). There was no significant difference according to the GCPS classification. There were significant correlations between some of the TMD pain indices and the hematologic indices, and also between the psychological indices and the hematologic indices. Conclusions: This study suggests the possibility of applying blood tests to the diagnosis, treatment and prevention of TMD. Further research should be conducted focusing on the role of CRP in TMD pain with more refined methodology and a longitudinal study design.

Role of Oxytocin in Post-traumatic Stress Disorder: A Systematic Review (외상 후 스트레스 장애에 대한 옥시토신의 역할: 체계적 문헌 고찰)

  • Oh, Jaeuk;Kim, Minsu;Chu, Sang Hui
    • Journal of Korean Biological Nursing Science
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    • v.24 no.1
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    • pp.1-16
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    • 2022
  • Purpose: Recently, oxytocin has been introduced experimentally as a pharmacological treatment for post-traumatic stress disorder (PTSD). This study attempted to investigate the possibility of oxytocin as a treatment option for patients with PTSD by examining its dose, interval, and effectiveness in patients with PTSD. Methods: A systematic review was done on articles published from 1967 to 2020 using the PubMed, PsycINFO, and Cochrane databases. Our inclusion criteria were 1) subjects 18 years of age or older diagnosed with PTSD or exposed to a traumatic event that met criterion A of the Diagnostic and Statistical Manual of Mental Disorders (DSM) for PTSD, 2) oxytocin was administered at least once, 3) clinical trials, and 4) studies published in Korean or English. Two independent researchers reviewed 22 articles and recorded the contents. The risk of bias was evaluated to determine the quality of the reviewed article. Results: The parameters for evaluating the effectiveness of oxytocin were identified as socio-behavioral measures in 11 articles, neuronal imaging in 9, and biomarkers in 4. In 5 papers, oxytocin was administered multiple times. Socio-behavioral measures were improved in 3 out of 5 studies in which oxytocin was administered multiple times. In 2 studies in which prolonged exposure treatment and nasal oxytocin administration were combined for 10 weeks, patient symptoms were decreased compared to the control group. Conclusion: The possibility of oxytocin as an adjuvant treatment for PTSD psychotherapy was confirmed. Further studies are necessary to evaluate the long term effectiveness of administering oxytocin multiple times combined with psychotherapy.

An Efficient Correction Process of CT-Simulator Couch with Current Diagnostic CT Scanners (진단용 CT-모의치료기 테이블의 효율적인 교정 방법)

  • Goo, Eun-Hoe;Lee, Jae-Seung;Cho, Jung-Keun;Moon, Seong-Kwon
    • The Journal of the Korea Contents Association
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    • v.9 no.11
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    • pp.254-261
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    • 2009
  • This study suggested that the table of CT-simulator and the laser alignment system using diagnostic CT scanner have an efficient method for improvement in alignment between the planned target center of traverse image with CT scanner. It was conducted on the daily QA when presented in the AAPM TG66 with correcting the laser alignment system using geometric trigonometric functions and investigated the effectiveness of correction methods as compared with those before and after correction. Before correction error was 3.82mm between the planned target center of image, the table longitudinal axis was twisted with 0.436o. The laser alignment system using geometric trigonometric functions in after correction was satisfied with tolerance limits of ${\pm}2mm$ when occurred about 0.7mm in errors between the planned target center. The table correction to satisfy the geometric accuracy is very inefficient over against the time and economic loss as well as technical limits in the case of application as only radiation therapy associated with CT-simulator with diagnostic CT scanner in use. But, the method which corrects the laser alignment system is economic and relatively simple with possibility of getting well geometric accuracy and we suppose that it is efficient method for applying in the clinic.