• Title/Summary/Keyword: Diagnostic usefulness

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Controversies on the Usefulness of Nerve Conduction Study in the Early Diagnosis of Diabetic Polyneuropathy (당뇨병성 다발신경병증의 조기 진단에서 신경전도검사의 유용성에 관한 논란)

  • Joo, In-Soo
    • Annals of Clinical Neurophysiology
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    • v.10 no.1
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    • pp.25-28
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    • 2008
  • Diabetic polyneuropathy (DPN) is the most frequently encountered form of neuropathy in diabetic patients, and it either relentlessly progresses or remains relatively stable for many years, not showing any trend towards improvement. From this point of view, early detection of DPN is very important to prevent the irreversible change of the peripheral nerve from diabetic insults. Although a number of clinical symptoms and/or deficit scales have been developed for clinical or research purposes, nerve conduction study (NCS) has been known one of the most objective and sensitive tools to detect peripheral nerve dysfunctions in diabetic patients. NCS, however, also have several shortcomings. The next two consecutive articles will focus on debates about diagnostic usefulness of NCS and on recent updates of other diagnostic tests including quantitative sensory testings and skin biopsy in the field of diabetic polyneuropathy.

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Diagnostic Usefulness of N-Terminal Probrain-type Natriuretic Peptide to Detect Congestive Heart Failure Patients (울혈성 심부전 환자에서 N-Terminal Probrain-type Natriuretic Peptide의 진단적 유용성)

  • Son, Gye-Sung
    • Korean Journal of Clinical Laboratory Science
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    • v.37 no.2
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    • pp.88-95
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    • 2005
  • Even though the echocardiograph has been recognized as the method of choice among various diagnostic tools to detect congestive heart failure (CHF), there were some limitations in relation to the consumption of time, labor and process. We analyzed results of N-terminal probrain-type natriuretic peptide (NT-proBNP) and various parameters of the echocardiographic findings to clarify the diagnostic usefulness of NT-proBNP in detecting patients with CHF. We analyzed the sera from total of 242 cases from in-patients and out-patients, which were requested from the cardiovascular section of department of Internal Medicine at Chungnam National University Hospital from March 2003 to May 2004. The procedures were performed in order as shown below; sampling, NT-proBNP analysis, data acquisition and data analysis. All data including personal information and echocardiographic findings ware acquired by medical record review. When classifying the study population into six groups according to the degree of left ventricular ejection fraction (LVEF), the serum level of NT-proBNP was higher in the group with 51-60% of LVEF (P=0.023). There were low correlation between the serum level of NT-proBNP and various parameters of the echocardiographic findings with LVESD (r=0.1513), LVEDD (r=0.0831), LVEF (r=0.2035), IVST (r=0.03) and LVPWT (r=0.0728), respectively. When comparing NT-proBNP with atrial and/or ventricular enlargement, the patient group with both left atrial and left ventricular enlargement (p=0.186) or only left atrial (p=0.105) or only left ventricular enlargement (p=0.256) showed higher level of NT-proBNP without statistical significance than patient group with no enlargement. Searching the optimal cutoff of the serum level of NT-proBNP, the sensitivity (98.9%) and the specificity (100%) was highest at the cutoff of 300 pg/mL than any other cutoffs. These findings suggested that the analysis of NT-proBNP in serum might detect the patients with CHF earlier than with the echocardiograph, especially in patients with asymptomatic or mild symptomatic CHF. In conclusion, NT-proBNP test was proved to be clinically useful to diagnose CHF patients.

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Diagnostic Usefulness of Fine Needle Aspiration Cytology on Lymphadenopathy (림프절종대의 세침흡인 세포검사의 진단적 유용성 - 림프절의 세침흡인 세포검사 1,216예의 분석 -)

  • Kim, Dong-Won;Jin, So-Young;Lee, Dong-Hwa;Lee, Chan-Soo
    • The Korean Journal of Cytopathology
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    • v.8 no.1
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    • pp.11-19
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    • 1997
  • Clinical lymphadenopathies are subjected to fine needle aspiration cytology(FNAC) for diagnosing not only benign lesions but also malignant ones, as the first diagnostic procedure. While the diagnostic reliability in metastatic carcinoma is high, it is difficult to differentiate malignant lymphoma from reactive conditions. We evaluated the diagnostic reliability of FNAC in lymphadenopathy, and discuss the diagnostic limitation and its place in clinical practice in this study, Over 8 years from January 1988, FNAC of 1,216 lymphadenopathies were analyzed and among them 170 cases were compared with histopathology. The results are as follows. 1. Of ail the cases, 890 cases(73.2%) were diagnosed cytologically as benign, 312 cases(25.7%) as malignant, and 14 cases(1.1%) as unsatisfactory material. Reactive hyperplasia was diagnosed in 585 cases(65.7%) of the benign lesions, and among the malignant diseases, metastatic carcinoma was diagnosed in 248 cases(79.5%), and malignant lymphoma in 62 cases(19.9%). 2. The overall diagnostic accuracy was 89.2%, and no false positive case and 9 false negative results were observed among 170 cases which were proven by histopathology. Six cases of sampling error of false negative diagnoses included 3 of metastatic carcinomas and 3 of malignant lymphomas. The causes were difference between aspiration and biopsy site, poor fixation, or scanty cellularity with bloody smear. All 3 cases of misinterpretation error were malignant lympliomas, one of mixed type on biopsy which was diagnosed as reactive hyperplasia cytologically. In summary, FNAC technique is thought to be useful in the initial diagnosis of lymphadenopathies as well as in the follow-up of patients with known malignancy. Although the results of malignant lymphoma was less accurate than other malignant lesions, the application of strict cytologic criteria or lymphoid marker studies of aspiration material will reduce the false negative rate.

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Diagnostic Usefulness of CISS Image in Preoperative Evaluation of Trigeminal Neuralgia and Hemifacial Spasm (삼차신경통과 반측안면경련에서 CISS 영상의 진단적 유용성)

  • Lee, Dong Hoon;Lee, Sang Weon;Choi, Chang Hwa
    • Journal of Korean Neurosurgical Society
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    • v.30 no.2
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    • pp.186-193
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    • 2001
  • Objectives : Trigeminal neuralgia and hemifacial spasm are caused by vascular compression of the REZ(root entry or exit zone) of the 5th and the 7th cranial nerve. Preoperative detection of neurovascular compression is essential for accurate diagnosis, appropriate treatment, and the good operative results. Three dimensional Fourier Transformation-Constructive Interference in Steady State(3DFT-CISS) images are known to give good contrast between CSF, nerve, and vessels. We applied a 3DFT-CISS imaging technique for the preoperative evaluation of patients with these diseases and estimated the diagnostic accuracy and usefulness of this study. Methods : A series of 71 patients with trigeminal neuralgia and hemifacial spasm were treated by microvascular decompression. Among them 34 patients with trigeminal neuralgia and 24 patients with hemifacial spasm had preoperative CISS images. We compared the radiologic finding with the operative finding, and analysed the diagnostic usefulness of 3DFT-CISS imaging. Results : The sensitivity of CISS images of detecting the neurovascular compression was 90.3% in trigeminal neuralgia and 100% in hemifacial spasm. There were one false-positive and three false-negative cases in trigeminal neuralgia, and one false-positive case in hemifacial spasm. The accuracy in diagnosing the causative vessel was 73.5% in trigeminal neuralgia and 83.3% in hemifacial spasm. Conclusion : CISS image is very useful diagnostic tool for preoperative evaluation of neurovascular compression in patients with trigeminal neuralgia and hemifacial spasm. No additional neuroradiologic examination other than CISS image and MRA is needed for preoperative evaluation of patients with trigeminal neuralgia and hemifacial spasm.

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Diagnostic Usefulness and Limitation of Fine Needle Aspiration Cytology of Lymph Node - Analysis of 176 Cases Confirmed by Biopsy - (림프절 세침흡인 세포검사의 진단적 유용성과 한계 - 생검으로 확진한 176 예의 분석 -)

  • Kim, Hee-Sung;Kim, Dae-Soo;Oh, Young-Lyun;Ko, Young-Hyeh;Ree, Howe-J.
    • The Korean Journal of Cytopathology
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    • v.10 no.1
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    • pp.35-42
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    • 1999
  • The accuracy of fine needle aspiration cytology(FNAC) of the lymph node was investigated through a review of 176 FNAC cases and the corresponding biopsies. We chose 157 FNAC cases after the exclusion of 19 inadequate ones. Sensitivity of malignancy was 94.0%, specificity 100%, false negativity 6.0%, and false positivity 0.0%. The overall diagnostic accuracy was 96.8%. Sensitivity of metastatic carcinoma was 98.0% and that of malignant lymphoma was 87.9%. False negative cases included one metastatic carcinoma and four malignant lymphomas. The aspirates of metastatic carcinoma with false negativity exhibited a diffuse smear of keratin debris without viable cells, which led to the difficulty in differentiation from benign epithelial cyst. The cases of malignant lymphoma with false negative diagnosis were two Hodgkin diseases, one Lennert's lymphoma, and one peripheral T cell lymphoma in the histologic sections. On the analysis of 39 cases of tuberculosis, 17 cases(43.6%) were diagnosed as tuberculosis, 4(10.3%) as granulomatous lymphadenitis, 3(7.7%) as necrotizing lymphadenitis, and 15(38.5%) as reactive hyperplasia or pyogenic inflammation. Sensitivity of tuberculosis was 53.9%. In conclusion, lymph node FNAC is an excellent non-invasive diagnostic tool for the diagnosis of metastatic carcinoma. The diagnostic accuracy of malignant lymphoma could be improved with flow cytometry or polymerase chain reaction for antigen receptor genes. For the FNAC diagnosis of tuberculosis, AFB stain, culture, and PCR would be helpful as adjuvant techniques.

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Diagnostic Value of p53 Expression in the Evaluation of Effusions (체강삼출액의 진단에 있어서 p53 단백의 유용성)

  • Lee, Ji-Shin;Park, Chang-Soo
    • The Korean Journal of Cytopathology
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    • v.7 no.2
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    • pp.138-143
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    • 1996
  • The diagnostic accuracy of routine cytological preparations from effusions ranges from 60% to 70%. Immunohistochemical markers, especially tumor-associated antigens, have been successfully employed to increase diagnostic sensitivity in effusion cytology. However, more than two different antibodies in diagnosis of effusions are needed. In the view of prevalence of abnormalities of p53 gene in human malignancies we investigated the diagnostic usefulness of demonstration of p53 protein immunoreactivity in distinguishing benign changes versus malignant processes in effusions. p53 protein expression was studied immunohistochemically in 76 effusions(28 malignant and 48 benign) using anti-human p53 antibody p53 immunoreactivity was identified in 19 of 28(67.9%) malignant effusions. In contrast, no p53 immunoreactivity was observed in all benign effusions. A specificity of 100% and a sensitivity of 67.9% were observed. These results suggest that immunohistochemical detection of p53 protein seems to be helpful in distinguishing benign changes versus malignant processes in effusions, although its principal limitation is its relatively low sensitivity.

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Diagnostic Usefulness of High Resolution Cross Sectional MRI in Symptomatic Middle Cerabral Arterial Dissection

  • Lee, Hai-Ong;Kwak, Hyo-Sung;Chung, Gyung-Ho;Hwang, Seung-Bae
    • Journal of Korean Neurosurgical Society
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    • v.49 no.6
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    • pp.370-372
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    • 2011
  • Dissection of the middle cerebral artery (MCA) is less frequent compared with dissection of the vertebrobasilar system or carotid artery. Recently, high-resolution cross sectional MR imaging (HRMRI) has emerged as a potential technique for atherosclerotic plaque imaging in MCA, We introduce the findings of HRMRI in a 56-year-old woman with traumatic MCA dissection, HRMRI showed an intimal flap and tapered pseudolumen with intra-luminal hemorrhage, We performed stent deployment about MCA dissection after failed medical treatment Three months later, there was no in-stent restenosis and no further neurological deficit were noted.

Cytologic Features of Cancers Metastatic to the Lung and Diagnostic Usefulness of Immunohistochemistry : Distinction Between Primary and Secondary Lung Tumors (전이성 폐종양의 세포소견과 면역조직화학적 검사의 유용성)

  • Oh, Young-Lyun
    • The Korean Journal of Cytopathology
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    • v.19 no.1
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    • pp.16-26
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    • 2008
  • The lungs are one of the most common visceral sites for metastatic disease. The identification of a metastasis from a second primary lung tumor is clinically important for patients with pulmonary metastases of an extrathoracic origin. Although the cytologic features of metastatic tumors involving the lung have been extensively described, making the cytologic diagnosis is usually not easy in the absence of clinical information. However, the immunohistochemical staining for many tumor markers and the different expressions of cytokeratin 7 and 20 are very useful in the diagnosis. This review presents the cytomorphological spectrum of metastatic tumors along with the immunohistochemical findings.

Digital Image Processing for Dynamic Color Images of Laryngeal Lesions Obtained With Electronic Videoendoscopy

  • Kawaida, Masahiro
    • Proceedings of the KSLP Conference
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    • pp.192-193
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    • 1998
  • Introduction : Laryngeal lesions were observed using the OLYMPUS EVIS-200 electronic videoendoscope system attached to the OLYMPUS ENF-200 rhinolarynx endoscope portion. This endoscope portion can be introduced into the laryngeal cavity by inserting it through the nasal passages. Since it is also possible to connect the OLYMPUS EVIP-230 digital image processor capable of processing dynamic images in real time to this system, an attempt has also been made to process the dynamic color images of laryngeal lesions obtained with the electronic videoendoscope system. Structure enhancement and color enhancement were peformed as processing images. The images of laryngeal lesions obtained with this system and the processed images are presented and described from the standpoint of diagnostic usefulness (omitted)

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