• Title/Summary/Keyword: Diagnostic rate

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Diagnostic Accuracy of Cervicovaginal Cytology in the Detection of Squamous Epithelial Lesions of the Uterine Cervix; Cytologic/Histologic Correlation of 481 Cases (자궁경부 편평상피병변에서 자궁경부질도말 세포검사의 진단정확도 : 481예의 세포-조직 상관관계)

  • Jin, So-Young;Park, Sang-Mo;Kim, Mee-Sun;Jeen, Yoon-Mi;Kim, Dong-Won;Lee, Dong-Wha
    • The Korean Journal of Cytopathology
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    • v.19 no.2
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    • pp.111-118
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    • 2008
  • Background : Cervicovaginal cytology is a screening test of uterine cervical cancer. The sensitivity of cervicovaginal cytology is less than 50%, but studies of cytologic/histologic correlation are limited. We analyzed the diagnostic accuracy of cervicovaginal cytology in the detection of the squamous epithelial lesions of the uterine cervix and investigate the cause of diagnostic discordance. Materials and Methods : We collected a total of 481 sets of cervicovaginal cytology and biopsies over 5 years. The cytologic diagnoses were categorized based on The Bethesda System and the histologic diagnoses were classified as negative, flat condyloma, cervical intraepithelial neoplasia (CIN) I, CIN II, CIN III, or squamous cell carcinoma. Cytohistologic discrepancies were reviewed. Results: The concordance rate between the cytological and the histological diagnosis was 79.0%. The sensitivity and specificity of cervicovaginal cytology were 80.6% and 92.6%, respectively. Its positive predictive value and negative predictive value were 93.7% and 77.7%, respectively. The false negative rate was 19.4%. Among 54 false negative cytology cases, they were confirmed by histology as 50 flat condylomas, 2 CIN I, 1 CIN III, and 1 squamous cell carcinoma. The causes of false negative cytology were sampling errors in 75.6% and interpretation errors in 24.4%. The false positive rate was 7.4%. Among 15 false positive cytology cases, they were confirmed by histology as 12 atypical squamous cells of undetermined significance (ASCUS) and 3 low grade squamous intraepithelial lesions (LSIL). The cause of error was interpretation error in all cases. The overall diagnostic accuracy of cervicovaginal cytology was 85.7%. Conclusions : Cervicovaginal cytology shows high overall diagnostic accuracy and is a useful primary screen of uterine cervical cancer.

Diagnostic Performance of the Modified Korean Thyroid Imaging Reporting and Data System for Thyroid Malignancy: A Multicenter Validation Study

  • Sae Rom Chung;Hye Shin Ahn;Young Jun Choi;Ji Ye Lee;Roh-Eul Yoo;Yoo Jin Lee;Jee Young Kim;Jin Yong Sung;Ji-hoon Kim;Jung Hwan Baek
    • Korean Journal of Radiology
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    • v.22 no.9
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    • pp.1579-1586
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    • 2021
  • Objective: To evaluate the diagnostic performance of the modified Korean Thyroid Imaging Reporting and Data System (K-TIRADS), and compare it with the 2016 version of K-TIRADS using the Thyroid Imaging Network of Korea. Materials and Methods: Between June and September 2015, 5708 thyroid nodules (≥ 1.0 cm) from 5081 consecutive patients who had undergone thyroid ultrasonography at 26 institutions were retrospectively evaluated. We used a biopsy size threshold of 2 cm for K-TIRADS 3 and 1 cm for K-TIRADS 4 (modified K-TIRADS 1) or 1.5 cm for K-TIRADS 4 (modified K-TIRADS 3). The modified K-TIRADS 2 subcategorized the K-TIRADS 4 into 4A and 4B, and the cutoff sizes for the biopsies were defined as 1 cm for K-TIRADS 4B and 1.5 cm for K-TIRADS 4A. The diagnostic performance and the rate of unnecessary biopsies of the modified K-TIRADS for detecting malignancy were compared with those of the 2016 K-TIRAD, which were stratified by nodule size (with a threshold of 2 cm). Results: A total of 1111 malignant nodules and 4597 benign nodules were included. The sensitivity, specificity, and unnecessary biopsy rate of the benign nodules were 94.9%, 24.4%, and 60.9% for the 2016 K-TIRADS; 91.0%, 39.7%, and 48.6% for the modified K-TIRADS 1; 84.9%, 45.9%, and 43.5% for the modified K-TIRADS 2; and 76.1%, 50.2%, and 40.1% for the modified K-TIRADS 3. For small nodules (1-2 cm), the diagnostic sensitivity of the modified K-TIRADS decreased by 5.2-25.6% and the rate of unnecessary biopsies reduced by 19.2-32.8% compared with those of the 2016 K-TIRADS (p < 0.001). For large nodules (> 2 cm), the modified K-TIRADSs maintained a very high sensitivity for detecting malignancy (98%). Conclusion: The modified K-TIRADSs significantly reduced the rate of unnecessary biopsies for small (1-2 cm) nodules while maintaining a very high sensitivity for malignancy for large (> 2 cm) nodules.

Cone-Beam CT-Guided Percutaneous Transthoracic Needle Lung Biopsy of Juxtaphrenic Lesions: Diagnostic Accuracy and Complications

  • Wonju Hong;Soon Ho Yoon;Jin Mo Goo;Chang Min Park
    • Korean Journal of Radiology
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    • v.22 no.7
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    • pp.1203-1212
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    • 2021
  • Objective: To investigate the diagnostic accuracy and complications of cone-beam CT-guided percutaneous transthoracic needle biopsy (PTNB) of juxtaphrenic lesions and identify the risk factors for diagnostic failure and complications. Materials and Methods: In total, 336 PTNB procedures for lung lesions (mean size ± standard deviation [SD], 4.3 ± 2.3 cm) abutting the diaphragm in 326 patients (189 male and 137 female; mean age ± SD, 65.2 ± 11.4 years) performed between January 2010 and December 2014 were included. The accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the PTNB procedures for the diagnosis of malignancy were measured based on the intention-to-diagnose principle. The risk factors for diagnostic failures and complications were evaluated using logistic regression analysis. Results: The accuracy, sensitivity, specificity, PPV, and NPV were 92.7% (293/316), 91.3% (219/240), 91.4% (74/81), 96.9% (219/226), and 77.9% (74/95), respectively. There were 23 diagnostic failures (7.3%), and lesion sizes ≤ 2 cm (p = 0.045) were the only significant risk factors for diagnostic failure. Complications occurred in 98 cases (29.2%), including 89 cases of pneumothorax (26.5%) and 7 cases of hemoptysis (2.1%). The multivariable analysis showed that old age (> 65 years) (p = 0.002), lesion size of ≤ 2 cm (p = 0.003), emphysema (p = 0.006), and distance from the pleura to the target lesion (> 2 cm) (p = 0.010) were significant risk factors for complications. Conclusion: The diagnostic accuracy of cone-beam CT-guided PTNB of juxtaphrenic lesions for malignancy was fairly high, and the target lesion size was the only significant predictor of diagnostic failure. Complications of cone-beam CT-guided PTNB of juxtaphrenic lesions occurred at a reasonable rate.

3D Segmentation of a Diagnostic Object in Ultrasound Images Using LoG Operator (초음파 영상에서 LoG 연산자를 이용한 진단 객체의 3차원 분할)

  • 정말남;곽종인;김상현;김남철
    • Journal of Biomedical Engineering Research
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    • v.24 no.4
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    • pp.247-257
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    • 2003
  • This paper proposes a three-dimensional (3D) segmentation algorithm for extracting a diagnostic object from ultrasound images by using a LoG operator In the proposed algorithm, 2D cutting planes are first obtained by the equiangular revolution of a cross sectional Plane on a reference axis for a 3D volume data. In each 2D ultrasound image. a region of interest (ROI) box that is included tightly in a diagnostic object of interest is set. Inside the ROI box, a LoG operator, where the value of $\sigma$ is adaptively selected by the distance between reference points and the variance of the 2D image, extracts edges in the 2D image. In Post processing. regions of the edge image are found out by region filling, small regions in the region filled image are removed. and the contour image of the object is obtained by morphological opening finally. a 3D volume of the diagnostic object is rendered from the set of contour images obtained by post-processing. Experimental results for a tumor and gall bladder volume data show that the proposed method yields on average two times reduction in error rate over Krivanek's method when the results obtained manually are used as a reference data.

International Health Project for Improving the Level of Mother and Child Health in Developing Countries: Focusing on KOICA CTS Cases in Vietnam (개발도상국 모자보건 수준 향상을 위한 국제보건사업: 베트남 KOICA CTS 사례를 중심으로)

  • Choung, Yoo-Chan;Shin, Jae-wan
    • Journal of Appropriate Technology
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    • v.6 no.1
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    • pp.45-50
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    • 2020
  • We developed the world's first wireless ultrasound diagnostic device. For the smooth delivery of pregnant women, the WHO requires four prior examinations, and the use of ultrasound diagnostic devices is essential for this purpose. However, income levels and medical facilities in developing countries are falling short. We conducted KOICA's CTS program in Vietnam using a self-developed radio ultrasound diagnostic device. We supplied Sonon300C, a portable wireless ultrasound diagnostic device, to health centers and hospitals in Huong-Hoa district, Vietnam, and conducted an outreach program in an effort to further enhance business performance. As a result, the rate of ultrasound diagnostics in the region reached 100% and the percentage of trained graduates increased to 59%.

Experiments and Assessment on Traditional Korean Medicine Diagnostic Support System (한의 진단 지원 시스템의 시험 수행 및 평가)

  • Cho, Woo-keun;Kim, Myung-ho;Lee, Sang-ah;Jang, Myung-woong;Choi, Dong-jun
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.13 no.1
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    • pp.63-70
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    • 2012
  • Object : Traditional Korean Medicine Diagnostic Support System(TKMDSS) is the diagnostic prescribing system based on ontology developed by Korea Institute of Oriental Medicine. We monitored and assessed its usefulness and searched for improvements. Methods : We collected 10 cases of stroke inpatients of Dongguk University Ilsan Oriental Hospital. They were diagnosed by primary care physician and another researcher who monitored using "TKMDSS" respectively. We compared the process and results of two diagnosis. Results : The diagnostic concordance rate between primary care physician and researcher were pretty high. Most of the problems were caused by expressions on symptoms inappropriate use of terminology. The severity of symptoms and vague symptoms which is hard to be diagnosed should be reflected and measured in this system. Conclusions : The problems were about terminology and definition. The terminology should be defined accurately and in-depth detail so that anyone can get the right information. If the problems were modified, "TKMMSS" could be utilized as supportive measures for oriental medicine doctors and students.

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A Study on the Correlation between the Patterns of the Zone 4 of Factor AA in 7-Zone-diagnostic System and Heart Rate Variability (7구역진단기의 Factor AA 제4구역 유형과 심박변이도(HRV)와의 상관성 연구)

  • Yu, Jung-Suk;Cho, Yi-Hyun;Lee, Jin-Seok;Lee, Hui-Yong;Song, Beom-Yong
    • Journal of Acupuncture Research
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    • v.25 no.4
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    • pp.71-80
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    • 2008
  • Objectives : The 7-zonediagnostic system is a diagnostic device to predetermine bodily locations by measuring the energy of body. This study was to investigate the relation between the different patterns of Zone 4 of Factor AA in VEGA DFM 722 (VEGA, Germany), 7-zone-diagnositic system and heart rate variability. Methods : We made three groups according to the Factor AA patterns of VEGA DFM 722. The Factor AA pattern of Group A is that the red bar graph of zone 4 was higher than the normal range. The Factor AA patterns of Group B was that the red bar graph of zone 4 was located at the normal range. The Factor AA patterns of Group C was that the red bar graph of zone 4 was lower than the normal range. We investigated how to difference of the index of heart rate variability(HRV, LX-3202, LAXTHA, Korea) according to each groups. Results : Complexity, HRV-index, RMSSD, SDSD values of Group B were higher than other Groups. pNN50 values of Group B were lower than other groups. And Ln(TP), Ln(VLF), Ln(LF), Ln(HF) values of Group B were higher than other groups. Conclusions : We presumed that Group B was healthier than other groups for the stress.

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The effects of diagnostic hysteroscopy on the reproductive outcomes of infertile women without intrauterine pathologies: a systematic review and meta-analysis

  • Yang, Soo Yeon;Chon, Seung-Joo;Lee, Seon Heui
    • Women's Health Nursing
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    • v.26 no.4
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    • pp.300-317
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    • 2020
  • Purpose: Hysteroscopy can be used both to diagnose and to treat intrauterine pathologies. It is well known that hysteroscopy helps to improve reproductive outcomes by treating intrauterine pathologies. However, it is uncertain whether hysteroscopy is helpful in the absence of intrauterine pathologies. This study aimed to confirm whether hysteroscopy improves the reproductive outcomes of infertile women without intrauterine pathologies. Methods: We conducted a systematic review of 11 studies retrieved from Ovid-MEDLINE, Ovid-Embase, and the Cochrane Library. Two independent investigators extracted the data and used risk-of-bias tools (RoB 2.0 and ROBINS-I) to assess their quality. Results: Diagnostic hysteroscopy prior to in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) was associated with a higher clinical pregnancy rate (CPR) and live birth rate (LBR) than non-hysteroscopy in patients with recurrent implantation failure (RIF) (odds ratio, 1.79 and 1.46; 95% confidence interval, 1.40-2.30 and 1.08-1.97 for CPR and LBR, respectively) while hysteroscopy prior to first IVF was ineffective. The overall meta-analysis of LBR showed statistically significant findings for RIF, but a subgroup analysis showed effects only in prospective cohorts (odds ratio, 1.40 and 1.47; 95% confidence interval, 0.62-3.16 and 1.04-2.07 for randomized controlled trials and prospective cohorts, respectively). Therefore, the LBR should be interpreted carefully and further research is needed. Conclusion: Although further research is warranted, hysteroscopy may be considered as a diagnostic and treatment option for infertile women who have experienced RIF regardless of intrauterine pathologies. This finding enables nurses to educate and support infertile women with RIF prior to IVF/ICSI.

Study on Multimedia Expert Diagnostic System of Chicken Diseases

  • Lu Changhua;Wang Lifang;Nong, Hu-Yi;Wang Qiming;Lu Qingwen
    • Proceedings of the Korea Inteligent Information System Society Conference
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    • 2001.01a
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    • pp.508-510
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    • 2001
  • Adopting the method of user weighting fuzzy mathematics, the author accomplished the subject title “Study on Expert System of Chicken\`s Common Diseases Diagnostics”, which could properly diagnose 30 kinds of chicken\`s common diseases and the accordance rate reached 80% verified through 244 disease cases. On the basis of the accomplishment, the multimedia technology was adopted further more to establish a system, which integrated with the input, display, query, and processing of sound, picture and text etc., combined with the previous chicken disease diagnostic expert system, make the output information of computer more rich and comprehensive, and the accordance rate of disease diagnosis could be improved. The system consists of database, knowledge base, graphics and picture base. This system is easy to operate and interface of which is vivid and intuitive. It could output diagnostic result and prescribe rapidly, so that, such a system is not only adapted to large, medium chicken farm but also to grass-roots veterinary station for developing health care and disease diagnosing. It is sure that the system could have side prospect of application.

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Application of PET in Breast Cancer (유방암에서 PET의 응용)

  • Noh, Dong-Young
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.1
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    • pp.34-38
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    • 2002
  • Positron emission tomography(PET) is an imaging method that employs radionuclide and tomography techniques. Since 1995, we applied PET not only to the diagnosis of breast cancer but also to the detection of abnormalities in the augmented breast and to the detection of metastasis. Until 2001, we evaluated 242 breast cases by PET at PET center of Seoul National University Hospital. Our group has reported serially at the international journals. In the first report, PET showed high sensitivity for detecting breast cancer, both the primary and axillary node metastasis. A total of 27 patients underwent breast operations based on PET results at Seoul National University Hospital from 1995 to 1996. The diagnostic accuracy of PET were 97% for the primary tumor mass and 96% for axillary lymph node metastasis. In case of the breast augmented, PET also showed excellent diagnostic results for primary breast cancer and axillary lymph node metastasis where mammography and ultrasound could not diagnose properly. PET also had outstanding results in the detection of recurrent or metastatic breast cancer(sensitivity 94%, specificity 80%, accuracy 89%). In addition, our study gave some evidence that PET could be applied further to evaluate the growth rate of tumors by measuring SUV, and finally to prognosticated the disease. PET could also be applied to evaluate the response after chemotherapy to measure its metabolic rate and size. In conclsion, PET is a highly sensitive, accurate diagnostic tool for breast cancer of primary lesion in various conditions including metastasis.