• 제목/요약/키워드: Systematic diagnosis

검색결과 471건 처리시간 0.028초

The Nevus Lipomatosus Superficialis of Face: A Case Report and Literature Review

  • Jae-Won Yang;Mi-Ok Park
    • Archives of Plastic Surgery
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    • 제51권2호
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    • pp.196-201
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    • 2024
  • Nevus lipomatosus superficialis (NLS) is a hamartoma of adipose tissue, rarely reported in the past 100 years. We treated one case, and we conducted a systematic review of the literature. A 41-year-old man presented with a cutaneous multinodular lesion in the posterior region near the right auricle. The lesion was excised and examined histopathologically. To review the literature, we searched PubMed with the keyword "NLS." The search was limited to articles written in English and whose full text was available. We analyzed the following data: year of report, nation of corresponding author, sex of patient, age at onset, duration of disease, location of lesion, type of lesion, associated symptoms, pathological findings, and treatment. Of 158 relevant articles in PubMed, 112 fulfilled our inclusion criteria; these referred to a total of 149 cases (cases with insufficient clinical information were excluded). In rare cases, the diagnosis of NLS was confirmed when the lesion coexisted with sebaceous trichofolliculoma and Demodex infestation. Clinical awareness for NLS has increased recently. NLS is an indolent and asymptomatic benign neoplasm that may exhibit malignant behavior in terms of huge lesion size and specific anatomical location. Early detection and curative treatment should be promoted.

Influence of biliary stents on the diagnostic outcome of endoscopic ultrasound-guided tissue acquisition from solid pancreatic lesions: a systematic review and meta-analysis

  • Suprabhat Giri;Shivaraj Afzalpurkar;Sumaswi Angadi;Jijo Varghese;Sridhar Sundaram
    • Clinical Endoscopy
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    • 제56권2호
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    • pp.169-179
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    • 2023
  • Background/Aims: This meta-analysis analyzed the effect of an indwelling biliary stent on endoscopic ultrasound (EUS)-guided tissue acquisition from pancreatic lesions. Methods: A literature search was performed to identify studies published between 2000 and July 2022 comparing the diagnostic outcomes of EUS-tissue acquisition (TA) in patients with or without biliary stents. For non-strict criteria, samples reported as malignant or suspicious for malignancy were included, whereas for strict criteria, only samples reported as malignant were included in the analysis. Results: Nine studies were included in this analysis. The odds of an accurate diagnosis were significantly lower in patients with indwelling stents using both non-strict (odds ratio [OR], 0.68; 95% confidence interval [CI], 0.52-0.90) and strict criteria (OR, 0.58; 95% CI, 0.46-0.74). The pooled sensitivity with and without stents were similar (87% vs. 91%) using non-strict criteria. However, patients with stents had a lower pooled sensitivity (79% vs. 88%) when using strict criteria. The sample inadequacy rate was comparable between groups (OR, 1.12; 95% CI, 0.76-1.65). The diagnostic accuracy and sample inadequacy were comparable between plastic and metal biliary stents. Conclusions: The presence of a biliary stent may negatively affect the diagnostic outcome of EUS-TA for pancreatic lesions.

Research on the educational management model for the interplay of structural damage in buildings and tunnels based on numerical solutions

  • Xiuzhi Wei;Zhen Ma;Jingtao Man;Seyyed Rohollah Taghaodi;H. Xiang
    • Geomechanics and Engineering
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    • 제37권1호
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    • pp.21-29
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    • 2024
  • The effective management of damage in tunnels is crucial for ensuring their safety, longevity, and operational efficiency. In this paper, we propose an educational management model tailored specifically for addressing damage in tunnels, utilizing numerical solution techniques. By leveraging advanced computational methods, we aim to develop a comprehensive understanding of the factors contributing to tunnel damage and to establish proactive measures for mitigation and repair. The proposed model integrates principles of tunnel engineering, structural mechanics, and numerical analysis to facilitate a systematic approach to damage assessment, diagnosis, and management. Through the application of numerical solution techniques, such as finite element analysis, we demonstrate the efficacy of the proposed model in simulating various damage scenarios and predicting their impact on tunnel performance. Additionally, the educational component of the model provides valuable insights and training opportunities for tunnel management personnel, empowering them to make informed decisions and implement effective strategies for ensuring the structural integrity and safety of tunnel infrastructure. Overall, the proposed educational management model represents a significant advancement in tunnel management practices, offering a proactive and knowledge-driven approach to addressing damage and enhancing the resilience of tunnel systems.

대학생의 비교과 만족도, 진로결정 자기효능감이 진로준비행동에 미치는 영향 (The impact of college students' Extracurricular Curriculum satisfaction and career decision self-ef icacy on career preparation behavior)

  • 권영애;이효숙
    • 디지털산업정보학회논문지
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    • 제20권1호
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    • pp.99-107
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    • 2024
  • This study conducted a survey of 330 students participating in the extracurricular curriculum program at K University in Chungcheongbuk-do to analyze the impact of extracurricular satisfaction and career decision self-efficacy on career preparation behavior. The main results and implications are as follows. First, the positive perception of participation in extracurricular curriculum programs had a significant impact on career preparation behavior. Second, high career decision self-efficacy was related to active career preparation behavior. It is necessary to provide continuous career program support, provide counseling tailored to the needs of each student, and establish a systematic career diagnosis system. This study is limited to extracurricular curriculum program participants and has limitations in generalization. Comparative and analytical research is needed by measuring the performance of various educational programs conducted in universities. It is necessary to support the development and operation of various extracurricular curriculum programs that reflect the needs of society and students and to prepare continuous quality management measures.

A machine learning informed prediction of severe accident progressions in nuclear power plants

  • JinHo Song;SungJoong Kim
    • Nuclear Engineering and Technology
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    • 제56권6호
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    • pp.2266-2273
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    • 2024
  • A machine learning platform is proposed for the diagnosis of a severe accident progression in a nuclear power plant. To predict the key parameters for accident management including lost signals, a long short term memory (LSTM) network is proposed, where multiple accident scenarios are used for training. Training and test data were produced by MELCOR simulation of the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident at unit 3. Feature variables were selected among plant parameters, where the importance ranking was determined by a recursive feature elimination technique using RandomForestRegressor. To answer the question of whether a reduced order ML model could predict the complex transient response, we performed a systematic sensitivity study for the choices of target variables, the combination of training and test data, the number of feature variables, and the number of neurons to evaluate the performance of the proposed ML platform. The number of sensitivity cases was chosen to guarantee a 95 % tolerance limit with a 95 % confidence level based on Wilks' formula to quantify the uncertainty of predictions. The results of investigations indicate that the proposed ML platform consistently predicts the target variable. The median and mean predictions were close to the true value.

예비보건의료인을 위한 결핵 교육 모형 구축 (Development of Tuberculosis Education Model for Junior Health Care Professionals)

  • 백설향;이지수;이현정
    • 한국콘텐츠학회논문지
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    • 제18권5호
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    • pp.432-445
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    • 2018
  • 예비보건의료인들을 포함한 보건 의료인들은 결핵에 노출될 위험이 상대적으로 높기 때문에 이들이 적절한 수준의 지식과 예방행위를 구비하는 것이 중요하다. 예비보건의료인들을 위한 결핵 교육 모형을 구축함에 있어서 문헌고찰을 실시함과 동시에 129명의 예비 보건 의료인과 14인의 의료인들을 대상으로 설문조사와 전화 인터뷰를 실시하였다. 그 결과는 다음과 같다.; 첫째, 문헌 고찰에 근거하여 결핵의 역학, 결핵의 전파 및 병태생리, 검사와 진단, 잠복결핵, 결핵의 치료, 그리고 결핵의 예방 등을 포함한 총 6개의 교육 주제가 파악되었다. 둘째, 예비보건의료인들은 결핵의 역학, 전파 및 병태생리, 잠복결핵 분야에 대해 상대적으로 낮은 지식수준을 보였다. 그러므로 교육과정을 계획할 때, 이러한 지식이 낮은 영역에 더 많은 시간이 할애되어야 할 것이다. 셋째, 의료인들은 결핵역학 교육 시, 결핵의 정의와 유형이 잘 포함되어야 한다고 강조하였으며, 결핵의 전파와 병태생리를 교육할 때에는 병원감염과 감염회로에 관한 내용이 포함되어야 된다고 답변하였다. 이에 덧붙여, 의료인들은 결핵의 진단과 집단검진을 강조하였으며, 잠복결핵 교육 시에는 개인보호장구 착용에 관한 내용이 포함되어야 한다고 반응하였다. 또한, 결핵의 치료에 대한 교육 시, 환자 교육 및 결핵약의 부작용에 대한 내용이 포함되어야 하며, 덧붙여 예비보건의료인들의 자기건강증진 행위 및 체계적인 결핵 교육이 결핵 예방의 중요한 수단이라고 정의하였다. 이러한 결과는 제한된 수의 응답자들과 표집 오차를 포함하고 있기에 결과를 일반화하는데 신중을 기해야 한다. 그러므로 더 큰 연구집단을 이용한 후속 연구를 통해 결핵 교육 모형을 개발하는 것이 필요하다.

Immunoblot법을 이용한 낭미충증(囊尾蟲症)진단에 있어서 각종 항원(抗原)의 적용가능성(適用可能性) 검토(檢討)에 관한 연구(硏究) (Studies on the Applicability of Various Antigen Preparations in the Immunoblot Diagnosis of Cysticercosis)

  • 고영태;주경환;정명숙;임한종
    • 농촌의학ㆍ지역보건
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    • 제16권1호
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    • pp.79-89
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    • 1991
  • A systematic study was conducted to identify and isolate a serologically pertinent antigen with high specific activity and low cross reactivity from Cysticercus parenchymal antigen. Differential centrifugation of the homogenate yield three particulate and one soluble fractions ; the $480{\times}G$ pellets($CyL_2$), the $7650{\times}G$ pellet($CyL_3$), the $100000{\times}G$ pellet($CyL_4$), and $100000{\times}G$ supernatant($CyL_6$). We compared antigenicity of these antigens to that or cystic fluid antigens($CyF_1$), saline extract of cystic wall($CyL_1$), and n-butanol treated $GyL_4$ antigen ($CyL_6$) based on SDS-PAGE and immunoblot techniques. The data obtained were as follows : 1) The ratio of O.D. value of ELISA against cysticercosis positive pool sera to that of negative pool sera was highest when using $CyF_1$ as antigen. However the ratio was relatively low in case of $CyL_{3.4}$ and $CyL_5$. 2) We have noted in previous paper that most strong antigenic activities are present in 63Kd band with low cross reactivities. An effective serologic reagent must contain components that are recognized by most infected sera. 63Kd band met this criteria and could be considered as a reliable band for the diagnosis of cysticercosis. As far as 63Kd band concern, $CyL_5$ showed most strong activities without disturbance of cross reaction by EITB in spite of low applicability to microplate ELISA. 3) $CyL_5$ could detect the serum antibody of cysticercosis even in very low titers, around cut-off values of microplate ELISA, by immunoblot. It also could detect the cross reactivities of Echinococcus species, which showed high absorbance value in micro plate ELISA and some sparganosis cases. Further purification of this antigen will be able to represents a antigen that can be used in the diagnosis of cysticercosis.

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Association of Knowledge and Cultural Perceptions of Malaysian Women with Delay in Diagnosis and Treatment of Breast Cancer: a Systematic Review

  • Khan, Tahir Mehmood;Leong, Jamie Pik Yan;Ming, Long Chiau;Khan, Amer Hayat
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권13호
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    • pp.5349-5357
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    • 2015
  • Background: Breast cancer is the most common cancer and the leading cause of cancer mortality among women of all ethnic and age groups in Malaysia. Delay in seeking help for breast cancer symptoms is preventable and by identifying possible factors for delayed diagnosis, patient prognosis and survival rates could be improved. Objectives: This narrative review aimed to understand and evaluate the level of in-depth breast cancer knowledge in terms of clinical breast examination and breast self-examination, and other important aspects such as side-effects and risk factors in Malaysian females. Since Malaysia is multicultural, this review assessed social perceptions, cultural beliefs and help-seeking behaviour in respect to breast cancer among different ethnic groups, since these may impinge on efforts to 'avoid' the disease. Materials and Methods: A comprehensive literature search of seven databases was performed from December 2015 to January 2015. Screening of relevant published journals was also undertaken to identify available information related to the knowledge, perception and help-seeking behaviour of Malaysian women in relation to breast cancer. Results: A total of 42 articles were appraised and included in this review. Generally, women in Malaysia had good awareness of breast cancer and its screening tools, particularly breast self-examination, but only superficial in-depth knowledge about the disease. Women in rural areas had lower levels of knowledge than those in urban areas. It was also shown that books, magazines, brochures and television were among the most common sources of breast cancer information. Delay in presentation was attributed mainly to a negative social perception of the disease, poverty, cultural and religion practices, and a strong influence of complementary and alternative medicine, rather than a lack of knowledge. Conclusions: This review highlighted the need for an intensive and in-depth breast cancer education campaigns using media and community health programmes, even with the existing good awareness of breast cancer. This is essential in order to avoid misconceptions and to frame the correct mind-set about breast cancer among women in Malaysia. Socio-cultural differences and religious practices should be taken into account by health care professionals when advising on breast cancer. Women need to be aware of the risk factors and symptoms of breast cancer so that early diagnosis can take place and the chances of survival improved.

Risk of Breast Cancer and Total Malignancies in Rheumatoid Arthritis Patients Undergoing TNF-α Antagonist Therapy: a Meta-analysis of Randomized Control Trials

  • Liu, Yang;Fan, Wei;Chen, Hao;Yu, Ming-Xia
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권8호
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    • pp.3403-3410
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    • 2014
  • Context: Interest exits in whether TNF-alpha antagonists increase the risk of breast cancer and total malignancies in patients with rheumatoid arthritis (RA). Objectives: To analyze the risk of malignancies, especially breast cancer, in patients with RA enrolled in randomized control trials (RCTs). Methods: A systematic literature search for RCTs from 1 January 1998 to 1 July 2013 from online databases, such as PubMed, WILEY, EMBASE, ISI web of knowledge and Cochrane Library was conducted. Studies included RCTs that compared the safety of at least one dose of the five TNF-${\alpha}$ antagonists with placebo or methotrexate (MTX) (or TNF-${\alpha}$ antagonists plus MTX vs placebo plus MTX) in RA patients for more than 24 weeks and imported all the references into document management software EndNote${\times}6$. Two independent reviewers selected studies and extracted the data about study design, patients' characteristics and the type, number of all malignancies. Results: 28 RCTs from 34 records with 11,741 patients were analyzed. Of the total, 97 developed at least one malignancy during the double-blind trials, and breast cancer was observed in 17 patients (17.5% of total malignancies). However, there was no statistically significant increased risk observed in either the per protocol (PP) model (OR 0.65, 95%CI [0.22, 1.93]) or the modified intention to treat (mITT) model (OR 0.75, 95%CI [0.25, 2.21]). There were also no significant trend for increased risk of total malignancies on anti-TNF-${\alpha}$ therapy administered at approved doses in either model (OR, 1.06, 95%CI [0.64, 1.75], and OR, 1.30, 95%CI [0.80, 2.14], respectively). As to the two models, modified intention to treat model analysis led to higher estimation than per protocol model analysis. Conclusions: This study did not find a significantly increased risk of breast cancer and total malignancies in adults RA patients treated with TNF-${\alpha}$ antagonists at approved doses. However, it cannot be ignored that more patients developed malignancies with TNF-${\alpha}$ antagonists therapy compared with patients with placebo or MTX, in spite of the lack of statistical significance, so that more strict clinical trials and long-term follow-up are needed, and both mITT and PP analyses should be used in such safety analyses.

어린이 성장판 영상화를 위한 초음파와 X-선 방식의 비교 평가 (Comparison Between Ultrasonic and X-ray Methods for Imaging the Children′s Growth Plate)

  • 김상후;김형준;한은옥;한승무
    • 대한의용생체공학회:의공학회지
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    • 제25권6호
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    • pp.551-556
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    • 2004
  • 본 연구에서는 진단 방법의 정확성이 아직까지 구체적으로 규명되지 않고 있는 어린이의 성장 발육을 체계적이고 과학적으로 측정할 수 있는 방법을 제시하고자 시도하였다. 현재 많이 이용되고 있는 성장 진단 방법은 X-ray 영상을 이용한 각 관절 부위의 성장판의 개폐 분석이다. 그러나 X-ray 방식은 성장 진단에서 요구되는 주기적이고 반복적인 측정을 하지 못함과 동시에 방사선 노출이라는 단점을 가지고 있다. 따라서 인체에 무해한 초음파 영상을 이용한 성장판 개폐 분석 대체 가능성을 평가하기 위해 종골의 초음파 광역 감쇄 영상을 이용한 프로파일 분석 및 성장판 영상 분석 알고리즘을 제시하였다. 본 연구에서는 7세~16세의 어린이 269명에 대해서 X-ray를 이용하여 무릎, 손가락, 종골에서의 성장판 영상을 얻었다. 또한 초음파 방식을 이용하여 종골의 성장판 영상을 얻었다. 각 관절에서의 성장판 개폐 유무 시기는 각 개인별로 측정 방법에 따라 조금의 차이는 있으나 전반적으로 일치하였다. 또한. X-ray방식과 초음파 방식에 의한 성장판 영상을 비교한 결과 상호 높은 연관성을 나타내었다. 이와 같이 성장판을 정확하게 측정하기 위해 도입된 초음파 프로파일 분석 알고리즘은 기존의 X-ray 영상 방식에 의한 성장판의 측정을 대체할 수 있을 것으로 사료된다.