• Journal of Veterinary Clinics
• /
• v.25 no.3
• /
• pp.146-151
• /
• 2008

During the clinical decision making practitioners are often faced with performing diagnostic tests to solve the presenting problems seen in the patients. The diagnostic utility of a test has traditionally been described by technical terms such as sensitivity, specificity, and positive (PPV) and negative predictive value (NPV). Although well known, clinicians are frequently unclear about the concept and application of these terms in everyday evidence-based clinical decision making. Sensitivity and specificity, which are intrinsic properties of diagnostic tests, summarizes the characteristics of the test over a population. The PPV and NPV are greatly dependent on the population prevalence of disease, and thus they do not transferable to different patients or clinical settings. Besides, considering the fact that clinicians more often interested in knowing the extent to which a test result could confirm or exclude of a condition under consideration (posttest probability), these measures do not provide answers on this question. The likelihood ratios (LR) using the information contained in sensitivity and specificity are becoming increasingly popular for reporting the usefulness of diagnostic tests because this term provide an indication of posttest probability as a function of the pretest probability. In this article, clinical applications of LR are illustrated with some practical examples. Discussion is also included of the inherent limitations regarding diagnostic test characteristics.

• The Journal of the Korean dental association
• /
• v.55 no.11
• /
• pp.778-788
• /
• 2017

Ultrasound sonography(US) is used to evaluate various diseases of oral and maxillofacial region including salivary glands, soft tissue and jaw lesions because of easy accessibility and no hazard of ionizing radiation. Also, US can offer dynamic study showing real-time images during diagnostic or surgical procedure. US images provide accurate information about the internal features of lesions on the jaw prior to surgical treatment. Doppler images are used to visualize the vascular distribution of the lesions and to provide additional information to enhance diagnostic value. It is necessary to evaluate the diagnostic value of US and evaluate its usefulness by looking at clinical cases using US images. Therefore, US imaging may be recommended as an assistant image in evaluating jaw lesions. US images provided accurate information about the internal structure of lesions on the jaw prior to surgical treatment, and diagnostic value was enhanced by visualizing the vascular distribution of the lesion using doppler imaging. We report the protocol and suggest the effectiveness of US for various lesions and US-guided sialography.

• Journal of The Korean Radiological Technologist Association
• /
• v.27 no.2
• /
• pp.175-180
• /
• 2001

Ⅰ. Background and Objectives : Recently the percutaneous transradial approach for coronary angiography and angioplasty has been using. When the radial artery as a graft for coronary artery bypass surgery was used, pantency increased. Many examination and

• The Journal of the Society of Stroke on Korean Medicine
• /
• v.13 no.1
• /
• pp.63-70
• /
• 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.

• Korean Journal of Digital Imaging in Medicine
• /
• v.11 no.1
• /
• pp.27-33
• /
• 2009

In this study, we compared the alteration of test positions according to various test equipments when testing shoulder joint superoinferior axial to estimate the clinical usefulness of tiltable standing detector. Our objectives were patients who visited our hospital. Among them we chose patients who were prescribed to get a shoulder axial test, again we selected 30 patients whose abduction is more than 90 degree.(2008. Nov.$\sim$2009 Jan.) With the patients cooperation, we used CR(Agfa, Belgium), fixed-detector(Canon, japan), Tiltable-detector(Philips, Netherlands). Tested with only one equipment(tiltable detector), and posed with the other two. We surveyed 5 inspectors and 30 patients, asking them to rate the convenience of test position. Also, we checked how long it takes to have the image appear on screen after testing with the equipment We provided a standard for an assessment of the image to an expert in bone radiology, an orthopedist and a radiologist with 5 years experience. When the patients were asked about the convenience of the equipments, 15 people(50%) answered CR is convenient and 14 people(46.7%) answered the Tilting detector is convenient, showing not much difference. However, when the inspectors were asked the same question, 4people(80%) out of 5 answered that the Tilting detector is more convenient The time test showed that CR takes 2 minutes and 50 seconds, the Fixed detector 1minute and 48 seconds andor had no distortion showing the shoulder joint space. However, even though the Fixed detector showed ac the Tilting detector takes 1 minute and 43 seconds to bring the image to the screen after the position. The results of the value of image taken by each equipment, CR and the Tilting detectromion, coracoid process, due to the unstable pose, they were quite distorted and scored poor in observing glenoid fossa. By this study, we can see that testing the shoulder joint superoinferior axial projection with a detector that has a tilting device would be more convenient than testing it with a CR.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
• /
• v.29 no.1
• /
• pp.223-239
• /
• 1999

Purpose: to evaluate the usefulness of the panoramic radiography, generally used in dental clinic, for the detection of the maxillary sinus pathosis due to the inflammation and tumor, through the comparison with CT findings as the absolute standard. Materials & Methods: 150 maxillary sinuses of 75 patients with or without particular signs and symptoms and showing soft tissue lesions or destruction of maxillary sinus walls in at least one sinus in CT, were selected as subject samples, and the panoramic radiography of the same patients were interpretated by 3 dental radiologists and 3 non dental radiologist given no previous informations. Using the CT findings as the absolute standard, the diagnostic ability of panoraimc radiography in the mucosal thickening, maxillary sinus haziness, inferior wall destruction, medial wall destruction, posterolateral wall destruction and the superior wall destruction was evaluated using the ROC curve and the difference between dental radiologist group and non dental radiologist group was also evaluated. Results: 1. When dental radiologist group interpretated the destruction of inferior wall and posterolateral wall, the kappa value which shows interobserver's coincidence was above 0.75. 2. The diagnostic ability according to site of interpretation was the highest when the inferior wall was interpretated in both observer groups and there was a statistically significant difference between the dental radiologist group and non dental radiologist group in interpretating the mucosal thickening, haziness, destruction of the inferior and medial wall(p<0.05). 3. The diagnostic ability in detecting the destruction of the sinus walls was better than in soft tissue lesions in both groups and between the groups there was a statistically significant difference(p<0.05). Conclusion: When detecting the destruction of inferior and posterolateral wall of the maxillary sinus there was coincident with that of CT findings, and so it is considered that diagnostic ability of panoramic radiography is high in this point. But in interpretating the destruction of medial wall and soft tissue lesions, diagnostic ability of the panoramic radiography was relatively low and there was a significant difference between the dental radiologist group and non dental radiologist group. Therefore CT or other auxiliary diagnostic method will be necessary when evaluating thorough pathosis of maxillary sinus objectively.

• Annals of Clinical Neurophysiology
• /
• v.9 no.2
• /
• pp.63-68
• /
• 2007

The EEG plays an important diagnostic role in epilepsy and provides supporting evidence of a seizure disorder as well as assisting with classification of seizures and epilepsy syndromes. There are a variety of electroclinical syndromes that are really defined by the EEG such as Lennox-Gastaut syndrome, benign rolandic epilepsy, childhood absence epilepsy, juvenile myoclonic epilepsy and also for localization purposes, it is vitally important especially for temporal lobe epilepsy. The sensitivity of first routine EEG in diagnosis of epilepsy has been known about 20-50%, but this proportion rises to 80-90% if sleep EEG and repetitive recording should be added. Convincing evidences suggest that the EEG may also provide useful prognostic information regarding seizure recurrence after a single unprovoked attack and following antiepileptic drug (AED) withdrawal. Moreover, patterns in the EEG make it possible to disclose an ictal feature of nonconvulsive status epilepticus, separate epileptic from other non-epileptic episodes and clarify the clues predictive of the cause of the encephalopathy (i.e., triphasic waves in metabolic encephalopathy). Therefore, regardless of its low sensitivity and other pitfalls, EEG should be considered not only in the situation of new onset episode such as a newly developed, unprovoked seizure or a condition manifesting decreased mentality from obscure origin, but also as a barometer of the long-term outcome following AED withdrawal.

• The Korean Journal of Cytopathology
• /
• v.4 no.1
• /
• pp.9-15
• /
• 1993

The aim of the present study is to demonstrate the usefulness of intraoperative fine needle aspiration (FNA) of pancreatic lesions in 30 patients. A conclusive diagnosis was done in 27 patients and the diagnoses of three patients were deferred. No complications followed the procedure. Based on histologic findings of the resected specimens in 20 cases and of cell blocks in 10 cases, the final diagnoses were adenocarcinoma in 19 cases, chronic pancreatitis in nine cases and tuberculosis in two cases. The sensitivity, specificity and diagnostic accuracy were 95%, 100% and 96% resepectively and there were no false positives. The smear of aspirate was stained with toluidine blue and examined by light microscope. The presence of there-dimensional clusters of disoriented cells and the increased nuclear/cytoplasmic ratio with large prominent nucleoli were the most helpful criteria for a diagnosis of malignancy in the pancreas. The intraoperative FNA of pancreatic lesions was considered as a simple, safe, and highly specific and sensitive tool in differentiating benign from malignant lesions. The intraoperative FNA can be recommended as the first tool of choice of intraoperative diagnostic procedure in lesions of the pancreas.

• Journal of Veterinary Clinics
• /
• v.39 no.4
• /
• pp.177-184
• /
• 2022

Caval syndrome is a severe complication of canine heartworm disease in which affected dogs present with various clinical signs that are often life-threatening. In cases of severe infection, adulticidal treatment has numerous complications as a result of a marked immune response against dead worms. Therefore, several surgical and non-surgical methods, including interventional extraction, have been applied in veterinary medicine. Despite the usefulness and efficiency of conventional retrieval devices, a few associated limitations must be addressed to reduce their risks and increase their applicability. Herein, we introduced a case of treating three dogs with caval syndrome by applying a newly developed heartworm basket device. The dogs were diagnosed with heartworm disease by heartworm antigen testing and direct smear. Imaging findings revealed remarkable remodeling of the right heart and pulmonary vessels and the presence of heartworms in the right heart. Additionally, heartworms were confirmed in the distal part of the abdominal aorta and femoral arteries in one dog, indicating aberrant systemic migration of the worms. Under general anesthesia, the heartworm basket device was introduced into the right heart via femoral venotomy and arteriotomy in one dog and jugular venotomy in the other two dogs. Although the number of cases in this study was small, the basket device was successful in gradual and cautious extraction of the heartworms in all three dogs. They exhibited good prognosis of clinical symptoms as indicated by imaging analyses.

• Korean Journal of Psychosomatic Medicine
• /
• v.17 no.2
• /
• pp.75-81
• /
• 2009

Objectives : This study aimed to evaluate the clinical usefulness of Korean version of Strengths and Difficulties Questionnaire(SDQ-Kr) by comparing with Korean version of Childhood Behavior Checklist (K-CBCL). Methods : The parent version of SDQ-Kr and K-CBCL were administered to parents of 313 children in psychiatric clinic, 91 children referred for psychiatric consultation from pediatric clinic and 93 control children in pediatric clinic. All children aged 4-11 years old. Children in psychiatric clinic were diagnosed with one of followings;ADHD, emotional disorders and oppositional/conduct disorder. Mean scores were compared among three groups by gender. Coefficients were calculated for corresponding problem scales and total scores of both questionnaires. ROC analysis was performed for discriminant validity to distinguish psychiatry and pediatrics samples, and also to distinguish diagnostic groups of psychiatry sample. Results : The psychiatry sample showed highest means of problem scales and total scores, followed by consultation and control sample of pediatrics. SDQ-Kr and K-CBCL were significantly correlated, and equally able to distinguish those samples with SDQ-Kr showing better results. Within the psychiatry sample, SDQ-Kr had higher predictive power for all diagnostic groups. Conclusion : This study supports clinical usefulness of SDQ-Kr. We suggest that SDQ-Kr could be used not only as a diagnostic tool for children in psychiatric clinic but also as an effective and efficient screening instrument for children in need for psychiatric evaluation in pediatric clinic.