• Title/Summary/Keyword: Diagnostic rate

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Diagnosis and Treatment of Papillary Thyroid Microcarcinoma(PMC) (유두 미세 갑상선암의 진단 및 치료에 대한 고찰)

  • Yoon Kyung-Seok;Oh Sung-Soo;Park Sung-Gil;Chung Eul-Sam
    • Korean Journal of Head & Neck Oncology
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    • v.14 no.2
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    • pp.228-235
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    • 1998
  • Objectives: Papillary microcarcinoma of the thyroid was evaluated as to the effectiveness of diagnostic modalities, lymphatic spread pattern, and therapeutic decision according to tumor size. Material and Methods: We retrospectively analyzed a clinicopathologic findings of 72 papillary microcarcinoma patients who were treated at the over 11 years between 1985 and 1995. The authors divided papillary microcarcinoma of the thyroid into two subgroups according to tumor size: $0{\leqq}5mm$ and $5<0{\leqq}10mm$. An analysis including age and gender distribution, diagnostic tools(thyroid sonogram, thyroid scan, thyroid function test, fine needle aspiration cytology, frozen section), pathological examination of lymphnode, and surgical procedures was carried out in each subgroups. Results: The carcinoma of smaller than 5mm were found in 32 patients, and of 6 -10mm were in 40 patients. The average age of patients was 45years and all of them were female. Cold nodules on thyroid scan were noticed in 53 patientss and normal findings were in 15 patients. Suspicious malignant lesions(fine calcification, solid mass, irregular margin) on thyroid sonography were detected in 23 patients and the sonography was more useful in detecting $0{\leqq}5mm$ small sized lesions than other diagnostic methods. FNAC were performed in 17 patients, and 7 patients were diagnosed as having thyroid papillary cancer. But diagnotic rate in $0{\leqq}5mm$ small sized lesions was very low(one of eights).Frozen section were performed in all patients, among these 15 patients were diagnosed as being benign diseases and false negative rates were higher in $0{\leqq}5mm$ small sized lesions than in $5<0{\leqq}10mm$ sized lesions(p-value<0.006). Only thyroidectomies were performed in 24 patients and thyroidectomy with node dissections in 48 patients. The lymphnode metastatic rates were much higher in multifocal lesions(61.5%) than in single lesion. The incidence of cervical lymphnode metastasis was 19.4% in $0{\leqq}5mm$ sized lesions and 47.9% in $5<0{\leqq}10mm$ sized lesions. Postoperative management were performed with TSH suppression therapy(T4, synthroid) in all patients and RI therapy in 29 patients. Conclusion: On the basis of our study, improved preoperative diagnostic tools for papillary microcarcinoma of the thyroid was helpful in the choice of surgical treatment. As a result of techninological progress(ultrasonography, FNAC), the pencentage of the discovery of papillary microcarcinoma has been increased. The thyroid ultrasonography was useful in detecting small sized lesions($0{\leqq}5mm$), but FNAC may not be beneficial in detecting small sized lesions($0{\leqq}5mm$). In the surgical procedure, thyroid lobectomy alone should be avoided because of the high rate of bilaterality and multifocality.

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Shielding Capability Evaluation of Mobile X-ray Generator through the Production assembled Shield (일체형 방어벽 제작을 통한 이동형 엑스선 발생기의 차폐능 평가)

  • Kim, Seung-Uk;Han, Byeoung-Ju
    • Journal of the Korean Society of Radiology
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    • v.12 no.7
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    • pp.895-908
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    • 2018
  • As modern science is developed and advanced, examination and number of times using radiation are increasing daily. General diagnostic X-ray generator is installed on stationary form, But X-ray generator was developed because patient who is in the intensive care unit, operation room, emergency room can not move to general x-ray room. What we examine patient by x-ray generator is certainly necessary, So patient exposure is inevitable. but reducing radiation exposure is highly important matter about radiation technology, guardian, patient in the same hospital room, nurse etc. For this reason, rule regarding safety control of diagnostic x-ray generator revised for radiation worker, patient and protector proclaim that mobile diagnostic x-ray shield must placed in case of examine different location excluding operation room, emergency room, intensive care unit. But, radiogical technologist is having a lot of difficulties to examine with mobile x-ray generator, diagnostic x-ray shield partition, image plate and lead apron. So, when we use x-ray generator, we manufacture shield tools can be attached to the mobile x-ray generator On behalf of x-ray shield partition and conduct analysis and in comparison to part of body and distribution of dose rate and find way to reduce radiation exposure through distribution of dose rate of patient within the radiogical technologist, medical team. Mobile x-ray generator aimed at SHIMADZU inc. R-20, We manufactured equipment for shielding x-ray scattered x-ray by installing shielding wall from side to side based on support beam on the mobile x-ray generator. Shielding wall when moving can be folded and designed to expand when examine. Experiment measured five times in each by an angle for dose rate of eyes, thyroid, breast, abdomen and gonad on exposure condition of upper and lower extremity, chest, abdomen which is examined many times by mobile x-ray generator. We used dosimeter RSM-100 made by IJRAD and measured a horizontal dose rate by body part. The result of an experiment, shielding decreasing rate of the front and the rear showed 77 ~ 98.7%. Therefore using self-production shielding wall reduce scattered x-ray occurrence rate and confirm can decrease exposure dose consequently. Therefore, through this study, reduction result which is used shielding wall of self-production will be a role of shielding optimization and it could be answer about reduction of medical exposure recommended by ICRP 103.

Radiographic Status of the Visited Patients at University Hospital Emergency Room (한 대학병원 응급실 내원환자의 방사선촬영 실태)

  • Ahn, Byeoung-Ju
    • Journal of the Korean Society of Radiology
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    • v.5 no.2
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    • pp.81-92
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    • 2011
  • This study was carried out to improve service efficiency and to cope with a emergency situation in emergency radiography, through analysis of the radiographic distriution and literature cited about emergency care. Data collection of radiographic distribution was surveyed for 1270 emergency outpatients who visit during JAN, 2009at ER of the general hospital in Gwang city. The results is as follows : Emergency radiography rate of simple radiography was 56.6%, special radiography 2. 5%, CT 34.2%, and ultrasonography 6.7%, In simple radiography rate. a high rate was distributed on male(63.6%), thoracicsurgery part(90.0%), admission patient(77.9%), and long stayed patient at ER. In special raiography rate, a high rate was obsurved in urologic part(28.6%), and in CT rate, observed neurosurgerty part(49.2%) and neurologic part(36.7%). Ultrasonography rate was high for female(8.8%) and internal medicine part(15.9%). There are distributed regional radiography rate in radio-graphic type that chest(55.3%) is high in the simple radiography, urinary system(1.2%) in the special study, and brain(40.0%) in the CT. Regional radiography rate according to diagnostic department also was showed highly for head(64.6%) in neuro surgery, chest(90.0%) in thoracic surgery, abdomen(58.0%) in general surgery, spine(40.0%) in neuro surgery, and pelvis(15.9%), upper extrimity(20.5%), and lower extrimity(31.8%) in orthopedic surgery each. Mean radiographic case number per patient of simple radiography was sinificant on sex, age, transfer relation in both total and radiopraphic patients(p<0.05). Mean radiographic case number was highly distributed on male(2.2 case number) in sex, on thirties(2.7) in age, transferred patient(2.7) in patient type, and on nurosurgery(3.4) in diagnostic charged part. Total radiographic case number in regional party was highly distributed on chest(998 case number.) Considering the above results, emergency radiographer should take care of the elder patient in emergency radiography and get hold of injury mechanism to decrease possible secondary injury during radiography. Because of high radiography rate of urinary system in special study, related instrument. All radiographer who take charge emergency patient should cope with a emergency situation during radiography. Because head trauma patients is very important in patient care, especilly in CT at night, charged doctor should be always sitted with CT room and monitoring patient. Radiography was reqested by many diagnostic department in ER. Considering that rate of simple radiography is high, special room for emergency radiopraphy should be established in ER area, and the radioprapher of this room should be stationed radiologic technician who is career and can implement emergency patient care and The disposition of men which is appropriate with emergency patient increase is necessary.

Some Clinical Aspects of Dysarthria (마비성 조음장애의 임상적 양상에 관한 고찰)

  • Kim, H.G.;Kim, W.H.;Seo, J.H.;Hong, K.H.;Shin, H.K.;Ko, D.H.
    • Speech Sciences
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    • v.3
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    • pp.38-49
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    • 1998
  • Dysarthrias are a sort of neuromotor disorders because of the weakness of neuromotor controls. They are classified in six types on the basis of Mayo clinic research: flaccid, spastic, ataxic, hypokinetic, hypekinetic and mixed types. Five dysarthria types are investigated in this study. MRI, EMG, neuropathological tests are essential diagnostic processing. Visi-Pitch and Spectrgraphy, CSL are used for assessing dysarthria speech. Maximum phonation time, diadochokinetic rate, Voice Onset Time and substitution rate are the speech evaluation parameters. Maximum phonation time and diadochokinetic rates are the lowest in case of spastic and ataxic dysarthrias. Spastic dysarthria shows the substituted glottalized consonants. However, flaccid, ataxic and hypokinetic dysarthrias show the substituted aspirated consonants. VOT is the longest for hypokinetic dysarthria and the shortest for ataxic dysarthria. Jitter shows higher percentage in comparison with control group. Speech evaluation using experimental phonetic instruments help create on international standardization of speech evaluation for speech disorders.

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High Resolution Melting Analysis for Epidermal Growth Factor Receptor Mutations in Formalin-fixed Paraffin-embedded Tissue and Plasma Free DNA from Non-small Cell Lung Cancer Patients

  • Jing, Chang-Wen;Wang, Zhuo;Cao, Hai-Xia;Ma, Rong;Wu, Jian-Zhong
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6619-6623
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    • 2013
  • Background:The aim of the research was to explore a cost effective, fast, easy to perform, and sensitive method for epidermal growth factor receptor (EGFR) mutation testing. Methods: High resolution melting analysis (HRM) was introduced to evaluate the efficacy of the analysis for dectecting EGFR mutations in exons 18 to 21 using formalin-fixed paraffin-embedded (FFPE) tissues and plasma free DNA from 120 patients. Results: The total EGFR mutation rate was 37.5% (45/120) detected by direct sequencing. There were 48 mutations in 120 FFPE tissues assessed by HRM. For plasma free DNA, the EGFR mutation rate was 25.8% (31/120). The sensitivity of HRM assays in FFPE samples was 100% by HRM. There was a low false-positive mutation rate but a high false-negative rate in plasma free DNA detected by HRM. Conclusions: Our results show that HRM analysis has the advantage of small tumor sample need. HRM applied with plasma free DNA showed a high false-negative rate but a low false-positive rate. Further research into appropriate methods and analysis needs to be performed before HRM for plasma free DNA could be accepted as an option in diagnostic or screening settings.

The fabrication and evaluation of CdS sensor for diagnostic x-ray detector application (진단 X선 검출기 적용을 위한 CdS 센서 제작 및 성능 평가)

  • Park, Ji-Koon;Lee, Mi-Hyun;Choi, Young-Zoon;Jung, Bong-Zae;Choi, Il-Hong;Kang, Sang-Sik
    • Journal of the Korean Society of Radiology
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    • v.4 no.2
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    • pp.21-25
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    • 2010
  • Recently, various semiconductor compounds as radiation detection material have been researched for a diagnostic x-ray detector application. In this paper, we have fabricated the CdS detecton sensor that has good photosensitivity and high x-ray absorption efficiency among other semiconductor compounds, and evaluated the application feasibility by investigating the detection properties about energy range of diagnostic x-ray generator. We have fabricated the line voltage selector(LCV) for a signal acquisition and quantities of CdS sensor, and designed the voltage detection circuit and rectifying circuit. Also, we have used a relative relation algorithm according to x-ray exposure condition, and fabricated the interface board with DAC controller. Performance evaluation was investigated by data processing using ANOVA program from voltage profile characteristics according to resistive change obtained by a tube voltage, tube current, and exposure time that is a exposure condition of x-ray generator. From experimental results, an error rates were reduced according to increasing of a tube voltage and tube current, and a good properties of 6%(at 90 kVp) and 0.4%(at 320 mA) ere showed. and coefficient of determination was 0.98 with relative relation of 1:1. The error rate according to x-ray exposure time showed exponential reduction because of delayed response velocity of CdS material, and the error rate has 2.3% at 320 msec. Finally, the error rate according to x-ray dose is below 10%, and a high relative relation was showed with coefficient of determination of 0.9898.

Autonomic Conditions in Allergic Rhinitis Depending on Various Pattern Identifications (알레르기 비염 환자의 변증별 자율신경계 특성 분석 연구)

  • Choi, Eun-Ji;Jang, Soobin;Lee, Kyu-Jin;Yun, Young-Hee;Choi, In-Hwa;Ko, Seong-Gyu
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.27 no.4
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    • pp.110-120
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    • 2014
  • Objectives : We performed a clinical study to investigate autonomic conditions in persistent allergic rhinitis depending on various pattern identifications and the availability of heart rate variability (HRV) as a pattern identification diagnostic tool. Methods : 32 patients with persistent allergic rhinitis were asked to interview with doctor of Korean Medicine and perform the four pattern questionnaires (Cold-Heat Pattern, Phlegm Pattern, Yin Deficiency pattern, bloodstasis pattern). Then, they were examined their autonomic conditions with heart rate variability test. Results : Patients were classified as three pattern groups (Lung-stomach heat, Lung qi deficiency cold, Lung-spleen qi deficiency) by doctor. In the Lung qi deficiency cold group, Total power of the HRV (TP) and the power of the low frequency component (LF) significantly higher than in the Lung-stomach heat or Lung-spleen qi deficiency group (P < 0.05). Also, Patients were classified as 8 pattern groups (Cold/Heat, Phlegm/Non-phlegm, Yin deficiency/Non-yin deficiency, Bloodstasis/Non-bloodstasis) by four pattern questionnaires. Only in the Yin deficiency group, the power of the low frequency component (LF) significantly lower than in the Non-yin deficiency group (P < 0.05). There were not any significant differences in the rest groups. Conclusions : The result may provide that HRV doesn't reflect well the differences in the various pattern groups, and the HRV's availability is low. Continuous studies are needed to develop the objective and standardized pattern identification diagnostic tool for allergic rhinitis.

Improvement Way for Mobile X-ray Examinations by Rule Revision about Safety Management of Diagnosis Radiation Occurrence System (진단용방사선발생장치의 안전관리에 관한 규칙 개정에 따른 이동형 방사선검사의 개선방안)

  • Choi, Jun-Gu;Kim, Gyeong-Su;Kim, Byeong-Gi;Ahn, Nam-Jun;Kim, Hyeong-Sun;Kim, Sang-Geon;Lim, Si-Eun
    • Journal of radiological science and technology
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    • v.30 no.1
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    • pp.53-59
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    • 2007
  • A safety management rule of the diagnosis radiation system which opened a court 2006 February 10th was promulgated for safety of the radiation worker, patients and patients' family members. The purpose of this study is to minimize injury by radiation that can happen to patients and people around a sick ward when managing mobile X-ray system. This study analyzed sickroom environment of mobile X-ray examination and the statistical data of the Konkuk medical Information System(KIS) and the Picture Archiving Communication System(PACS). This study also investigated patient conditions, infection, relation information and related data, when the sickroom mobile X-ray examination is used. Through data analysis, many problems were expected such as restriction of space side, manpower and expense of business side, satisfaction degree decline of patient and protector of operation side. Therefore, we tried to restrict examination of multi bed sickroom, and to use treatment room in each ward to solve problem mentioned. As a result, the whole sickroom mobile X-ray examination rate decreased to near 50%, and mobile X-ray examination rate for inpatients decreased to more than 85%. This study shows that several attempts we did should be helpful for manpower, patients satisfaction and expenses. Also, they should protect patients in sickroom from unnecessary radiation exposure and could minimize inconvenience of patients and their family members from x-ray examination.

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Comparison of Thallium-201, Tc-99m MIBI and I-131 Scan in the Follow-up Assessment after I-131 Ablative Therapy in Differentiated Thyroid Cancer (방사성 옥소 치료 후 분화된 갑상선암 추적관찰에서 Thallium-201 스캔, Tc-99m MIBI 스캔과 I-131 스캔 검사 결과의 비교)

  • Kwon, Jae-Sung;Lee, Sung-Keun;Kim, Doe-Min;Park, Sae-Jong;Jang, Kyong-Sun;Kim, Eun-Sil;Kim, Chong-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.6
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    • pp.493-501
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    • 1999
  • Purpose: We conducted a comparative study to evaluate the diagnostic values of T1-201, Tc-99m MIBI and I-131 scans in the follow-up assessment after ablative I-131 therapy in differentiated thyroid cancer. Materials and Methods: The study population consisted of 20 patients who underwent surgical removal of thyroid cancer and ablative radioactive iodine therapy, and followed by one or mote times of I-131 retreatments (33 cases). In all patients, T1-201, Tc-99m MIBI, diagnostic and therapeutic I-131 scans were performed and the results were analyzed retrospectively. Also serum thyroglobulin levels were measured in all patients. The final diagnosis of recurrent or metastatic thyroid cancer was determined by clinical, biochemical, radiologic and/or biopsy findings. Results: Positive rates (PR) of Tc-99m MIBI, T1-201, diagnostic and therapeutic I-131 scans in detecting malignant thyroid tissue lesions were 70% (19/27), 54% (15/28), 35% (17/48) and 63% (30/48), respectively. The PR in the group of 20 cases (28 lesions) who underwent concomitant T1-201 and I-131 scans were in the order of therapeutic 131 scan 71%, T1-201 scan 54% and diagnostic I-131 scan 36%. There was no statistically significant difference between T1-201 and diagnostic I-131 scans (p>0.05). In the group of 20 cases (27 lesions) who underwent concomitant Tc-99m MIBI and I-131 scans, the PR were in the order of Tc-99m MIBI scan 70%, I-131 therapeutic scan 52% and I-131 diagnostic scan 33%. The PR of Tc-99m MIBI was significantly higher than that of diagnostic I-131 scan (p<0.05). Conclusion: Tc-99m MIBI scan is superior to diagnostic I-131 scan in detecting recurrent or metastatic thyroid cancer following ablation therapy in patients with differentiated thyroid cancer. T1-201 scan did not showed significantly higher positive rate than diagnostic I-131 scan. Instead of diagnostic I-131 scan before the I-131 retreatment, Tc-99m MIBI scan without discontinuing thyroid hormone replacement would be a prudent and effective approach in the management of these patients.

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Computed Radiography 환경에서의 REPEAT 유형변화에 대한 고찰

  • An, Mi-Seop;Jang, Gwang-Hyeon;Mun, Hui-Seok;Jeong, Hwan
    • Korean Journal of Digital Imaging in Medicine
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    • v.3 no.1
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    • pp.52-58
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    • 1997
  • Before entering 21st Century, modern medical science is requiring more precise display which is highly estimated in diagnostic value as radial science technology is achieving sharp development. And it is also trying to contribute to improve national health and to offer better service by reducing radial exposure. General projection and Fluoroscopy which are most difficult to be displayed in digital tend to change their way ; from analog to digital with development of Electronic Engineering and Computer Technology, Introducing to CR system in 1994, SMC have displayed General projection and Fluoroscopy 100% in digital using CR system. This study searched differences between repeat rate, repeat type in the exam using Film/Screen and those in the exam using CR system. According to the analysis of repeat types and repeat rate of Film which was reused by using CR system in general projection room and Fluoroscopy room of SMC, we found that total 192,813 films were used and 2,097 films, 1.09% of total were reused. However, actual repeat covers 0.76% to 1,461 sheets with the exception of 636sheets. As above, display process using CR system is 0.76% much lower than general repeat rate 2$\sim$4% of Film/Screen exam. Besides decreased under/over exposure, it is appeared that position failure rate in repeat rate 0.76% covers relatively high 31%. Noticing that repeat caused unskilled devices handing was found many times, sufficient understanding seems to be required to reduce repeat.

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