• Title/Summary/Keyword: definite diagnosis

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Inclusion Body Myositis : Clinical Features and Electrophysiological Findings (봉입체 근염 : 임상과 전기생리학 소견)

  • Kim, Kwang-Kuk
    • Annals of Clinical Neurophysiology
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    • v.8 no.1
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    • pp.16-22
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    • 2006
  • Sporadic inclusion body myositis (s-IBM) is an aquired slowly progressive inflammatory myopathy with unknown etiology. Although light microscopic abnormalities and characteristic histopathology on muscle biopsy distinguishes from other inflammatory myopathies, vacuolated muscle fibers, intracellular amyloid deposits or tubulofilaments in electromicroscopic findings are not definite in some patients. This review shows the prominently involved muscles in s-IBM and specific or nonspecific electrophysiologic manifestations from reported data for helping the diagnosis of definite-or probable-IBM patients. In lower limbs, the quadriceps is predominantly involved, as is iliopsoas, and tibialis anterior is common. In the upper limbs, the greatest weakness is in forearm finger flexors. Finger extensors, biceps and triceps also are moderately to prominently involved. The majority of patients demonstrate polyphasic MUAPs that are short in duration. An additional striking feature is the concomitant documentation of long-duration, large-amplitude, polyphasic MUAPs. In spite of the frequent mixed myopathic-neurogenic electromyographic findings of IBM, just like that of chronic myositis, asymmetric, slowly progressive weakness of flexor digitorum profundus or quadriceps femoris muscles after age of 50 is very necessary condition for the diagnosis of IBM.

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Diagnostic Performance of 2018 KLCA-NCC Practice Guideline for Hepatocellular Carcinoma on Gadoxetic Acid-Enhanced MRI in Patients with Chronic Hepatitis B or Cirrhosis: Comparison with LI-RADS Version 2018

  • Sang Min Lee;Jeong Min Lee;Su Joa Ahn;Hyo-Jin Kang;Hyun Kyung Yang;Jeong Hee Yoon
    • Korean Journal of Radiology
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    • v.22 no.7
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    • pp.1066-1076
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    • 2021
  • Objective: To evaluate the performance of the 2018 Korean Liver Cancer Association-National Cancer Center (KLCA-NCC) Practice Guidelines (hereafter, PG) for the diagnosis of hepatocellular carcinoma (HCC) using gadoxetic acid-enhanced MRI, compared to the Liver Imaging-Reporting and Data System (LI-RADS) version 2018 (hereafter, v2018). Materials and Methods: From January 2013 to October 2015, treatment-naïve hepatic lesions (≥ 1 cm) on gadoxetic acid-enhanced MRI in consecutive patients with chronic hepatitis B or cirrhosis were retrospectively evaluated. For each lesion, three radiologists independently analyzed the imaging features and classified the lesions into categories according to the 2018 KLCA-NCC PG and LI-RADS v2018. The imaging features and categories were determined by consensus. Generalized estimating equation (GEE) models were used to compare the per-lesion diagnostic performance of the 2018 KLCA-NCC PG and LI-RADS v2018 using the consensus data. Results: In total, 422 lesions (234 HCCs, 45 non-HCC malignancies, and 143 benign lesions) from 387 patients (79% male; mean age, 59 years) were included. In all lesions, the definite HCC (2018 KLCA-NCC PG) had a higher sensitivity and lower specificity than LR-5 (LI-RADS v2018) (87.2% [204/234] vs. 80.8% [189/234], p < 0.001; 86.2% [162/188] vs. 91.0% [171/188], p = 0.002). However, in lesions of size ≥ 2 cm, the definite HCC had a higher sensitivity than the LR-5 (86.8% [164/189] vs. 82.0 (155/189), p = 0.002) without a reduction in the specificity (80.0% [48/60] vs. 83.3% [50/60], p = 0.15). In all lesions, the sensitivity and specificity of the definite/probable HCC (2018 KLCA-NCC PG) and LR-5/4 did not differ significantly (89.7% [210/234] vs. 91.5% [214/234], p = 0.204; 83.5% [157/188] vs. 79.3% [149/188], p = 0.071). Conclusion: For the diagnosis of HCC of size ≥ 2 cm, the definite HCC (2018 KLCA-NCC PG) had a higher sensitivity than LR-5, without a reduction in specificity. The definite/probable HCC (2018 KLCA-NCC PG) had a similar sensitivity and specificity to that those of the LR-5/4.

One-class Classification based Fault Classification for Semiconductor Process Cyclic Signal (단일 클래스 분류기법을 이용한 반도체 공정 주기 신호의 이상분류)

  • Cho, Min-Young;Baek, Jun-Geol
    • IE interfaces
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    • v.25 no.2
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    • pp.170-177
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    • 2012
  • Process control is essential to operate the semiconductor process efficiently. This paper consider fault classification of semiconductor based cyclic signal for process control. In general, process signal usually take the different pattern depending on some different cause of fault. If faults can be classified by cause of faults, it could improve the process control through a definite and rapid diagnosis. One of the most important thing is a finding definite diagnosis in fault classification, even-though it is classified several times. This paper proposes the method that one-class classifier classify fault causes as each classes. Hotelling T2 chart, kNNDD(k-Nearest Neighbor Data Description), Distance based Novelty Detection are used to perform the one-class classifier. PCA(Principal Component Analysis) is also used to reduce the data dimension because the length of process signal is too long generally. In experiment, it generates the data based real signal patterns from semiconductor process. The objective of this experiment is to compare between the proposed method and SVM(Support Vector Machine). Most of the experiments' results show that proposed method using Distance based Novelty Detection has a good performance in classification and diagnosis problems.

Diagnostic Efficacy of Fine Needle Aspiration Cytology, Frozen section Biopsy and Ultrasonography for a Palpable Thyroid Mass (갑상선 촉지 종괴에서 시행한 세침흡인세포검사법, 동결절편검사법 및 초음파검사법의 진단적 유용성)

  • Lee Byoung-Kil;Jung Sung-Hoo
    • Korean Journal of Head & Neck Oncology
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    • v.18 no.2
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    • pp.168-172
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    • 2002
  • Objectives: This study was done to determine the diagnostic efficacy of fine needle aspiration cytology (FNA), frozen section biopsy (FSx) and ultrasonography in a palpable thyroid mass. Materials and Methods: During the period from July 1999 to March 2002, the medical records of 98 patients who underwent a thyroidectomy for thyroid mass, at the Department of Surgery, Chonbuk National University Hospital, were reviewed retrospectively. Ninety eight cases were classified according to whether the FNA cytological diagnosis inadequate, benign, suspicious, or malignant and the FSx diagnosis benign or malignant and the ultrasonographic examination was benign, suspicious, or malignant. The diagnostic correlations of ultrasonography, FNA cytology, frozen section, and both FNA cytology and frozen section with definite histologic diagnosis were evaluated. Results: According to the FNA cytological interpretation, 76 cases were diagnosed as benign, 6 cases suspicious, 13 cases malignant, and 3 cases inadequate. The sensitivity and specificity for FNA were 86.3% and 95.9% and for FSx 95.5% and 100% respectively. The diagnostic accuracy of FNA and FSx were 93.5% and 98.9% respectively. Based on a definite histologic diagnosis, the ultrasonographic examination had a sensitivity and a specificity of 77.2% and 78.9%. Conclusion: The results confirm that FNA cytology is a reliable and useful tool in the initial evaluation of a palpable thyroid mass compared to the ultrasonographic examination. Intraoperative FSx is a valuable diagnostic procedure to confirm the cytological diagnosis with undetermined or unsatisfactory cytological diagnosis.

A case study on robust fault diagnosis and fault tolerant control (강인한 고장진단과 고장허용저어에 관한 사례연구)

  • Lee, Jong-Hyo;Yoo, Jun
    • 제어로봇시스템학회:학술대회논문집
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    • 2000.10a
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    • pp.130-130
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    • 2000
  • This paper presents a robust fault diagnosis and fault tolerant control lot the actuator and sensor faults in the closed-loop systems affected by unknown inputs or disturbances. The fault diagnostic scheme is based on the residual set generation by using robust Parity space approach. Residual set is evaluated through the threshold test and then fault is isolated according to the decision logic table. Once the fault diagnosis module indicates which actuator or sensor is faulty, the fault magnitude is estimated by using the disturbance-decoupled optimal state estimation and a new additive control law is added to the nominal one to override the fault effect on the system. Simulation results show that the method has definite fault diagnosis and fault tolerant control ability against actuator and sensor faults.

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Diagnosis of Pulmonary Tuberculosis and Nontuberculous Mycobacterial Lung Disease in Korea

  • Kwon, Yong Soo;Koh, Won-Jung
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.1
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    • pp.1-5
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    • 2014
  • The recovery of nontuberculous mycobacteria (NTM) from respiratory specimens and the number of patients with NTM lung disease have been rapidly increasing in Korea. An early differential diagnosis of NTM lung disease from pulmonary tuberculosis (TB) is important, as the therapeutic regimen differs from that of pulmonary TB, and it is not necessary to track the contacts of patients with NTM lung disease. However, differentiating NTM lung disease from pulmonary TB remains difficult, because the clinical presentations of the two diseases are similar and a definite diagnosis of NTM lung disease based on sputum culture takes time. This review focuses on the changing epidemiology, clinical and radiographic manifestation, and laboratory diagnosis of pulmonary TB and NTM lung disease in Korea.

Megaoesophagus Seconday to Myasthenia Gravis in Three Dogs (중증근무력증에 의한 개의 거대식도증 3례)

  • Lee, Hee-Chun;Jeon, Joon-Hyeok;Cho, Kyu-Woan;Kang, Byeong-Teck;Jung, Dong-In
    • Journal of Veterinary Clinics
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    • v.29 no.1
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    • pp.107-111
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    • 2012
  • Three dogs (An 8 years-old intact female Poodle, a 7 years-old intact male Schunauzer, and an 8 yearsold Golden Retriever) were presented due to acute vomiting, dyspnea, and generalized weakness. Megaesophagus was confirmed through radiographic examination in all 3 dogs. Relative oesophageal diameter (ROD) was measured and results of ROD measurements showed the possibility of megaesophagus secondary to myasthenia gravis in three dogs. Thus we performed anticholinesterase test as screening test for myasthenia gravis. In all three dogs, esophageal diameter was reduced after neostigmine methylsulfate administration. For definite diagnosis of acquired myasthenia gravis, serum acetylcholine receptor antibody titer was measured, but definite diagnosis was confirmed only in one case. However, based on history, radiographic findings, anticholinesterase test, ROD measurement, other two cases were still suspected as megaesophagus secondary to myasthenia gravis. Treatment with pyridostigmine bromide was initiated in all dogs, and improvement of esophageal diameter was shown in all dogs. One dog was successfully managed for 15 months after initial treatment and, is still alive, but other two dogs were died shortly after initial treatment, because of severe aspiration pneumonia.

Accuracy of Preoperative Urinary Symptoms, Urinalysis, Computed Tomography and Cystoscopic Findings for the Diagnosis of Urinary Bladder Invasion in Patients with Colorectal Cancer

  • Woranisarakul, Varat;Ramart, Patkawat;Phinthusophon, Kittipong;Chotikawanich, Ekkarin;Prapasrivorakul, Siriluck;Lohsiriwat, Varut
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.17
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    • pp.7241-7244
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    • 2014
  • Background: To determine the accuracy of preoperative urinary symptoms, urinalysis, computed tomography (CT) and cystoscopic findings for the diagnosis of urinary bladder invasion in patients with colorectal cancer. Materials and Methods: Records of patients with colorectal cancer and a suspicion of bladder invasion, who underwent tumor resection with partial or total cystectomy between 2002 and 2013 at the Faculty of Medicine Siriraj Hospital, were reviewed. Correlations between preoperative urinary symptoms, urinalysis, cystoscopic finding, CT imaging and final pathological reports were analyzed. Results: This study included 90 eligible cases (71% male). The most common site of primary colorectal cancer was the sigmoid colon (44%), followed by the rectum (33%). Final pathological reports showed definite bladder invasion in 53 cases (59%). Significant features for predicting definite tumor invasion were gross hematuria (OR 13.6, sensitivity 39%, specificity 73%), and visible tumor during cystoscopy (OR 5.33, sensitivity 50%, specificity 84%). Predictive signs in CT imaging were gross tumor invasion (OR 7.07, sensitivity 89%, specificity 46%), abnormal enhancing mass at bladder wall (OR 4.09, sensitivity 68%, specificity 66%), irregular bladder mucosa (OR 3.53, sensitivity 70%, specificity 60% ), and loss of perivesical fat plane (OR 3.17, sensitivity 81%, specificity 43%). However, urinary analysis and other urinary tract symptoms were poor predictors of bladder involvement. Conclusions: The present study demonstrated that the most relevant preoperative predictors of definite bladder invasion in patients with colorectal cancer are gross hematuria, a visible tumor during cystoscopy, and abnormal CT findings.

Optimal Shoulder Position for Visualization of SLAP Ⅱ lesion on MR-Arthrography (SLAP Ⅱ 병변의 진단을 위한 관절 조영 자기 공명 영상에서 견관절 위치에 따른 비교)

  • Lee Young-Soo;Shin Dong-Bae;Park Soo-Jin;Kim Jin-Yong;Kim Hee-Sang;Ha Du-Hae
    • Clinics in Shoulder and Elbow
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    • v.3 no.2
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    • pp.95-101
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    • 2000
  • Purpose : The purpose of this study was to evaluate the efficacy of oblique coronal MR images, oblique axial images of neutral, internal rotation and external rotation positions in the diagnosis of SLAP Ⅱ lesion. Materials and Methods: MR arthrography of the glenohumeral joint was evaluated retrospectively in 16 patients(16 shoulders) who underwent arthroscopic surgery(mean age; 38 years old, Male; 13, Female; 3). Oblique coronal fat-suppressed Tl-weighted spin echo images were performed with each shoulder in the neutral position of the arm and oblique axial images were performed in neutral, internal and external rotations of the arm respectively. The preoperative findings of MR were classified as definite tear, possible tear and no tear. Arthroscopic findings were correlated with MR findings of several different position of the arm. Results: Arthroscopic surgery revealed 8 SLAP Ⅱ lesion, 2 SLAP I lesion, and 6 normal superior labrum respectively. The accuracy of diagnosis in the 8 SLAP Ⅱ lesion were high on oblique axial image in external rotation which were interpreted as 8 definite tear, to compare with oblique axial images in neutral position which were interpreted as 4 definite tear, 3 possible tear, 1 no tear. The 6 normal superior labrum lesion were interpreted as no tear in all three position. The 2 SLAP I lesion were interpreted as 1 definite tear, 1 no tear on oblique axial image in neutral position and 1 definite tear, 1 possible tear on oblique axial image in external rotation. Conclusion: This study showed that axial MR images in external rotation of the arm combined with oblique coronal images have proved to be effective to detect SLAP Ⅱ lesion, and should be considered in imaging protocol for MR arthrography of the SLAP Ⅱ lesion.

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Unifocal Langerhans Cell Histiocytosis of Frontal Bone in a Child (소아 전두골에 발생한 랑게르한스세포 조직구증)

  • Hong, Seong Jae;Cho, Sang Hun;Eo, Su Rak
    • Archives of Craniofacial Surgery
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    • v.14 no.1
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    • pp.69-72
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    • 2013
  • Lateral eyebrow mass with primary skull lesion are rare in pediatric population. Although epidermoid cyst and dermoid cyst are the most commonly encountered skull lesions in pediatric population, Langerhans cell histiocytosis (LCH) is rarely reported. We report a case of LCH arising from the lateral eyebrow with osteolytic lesion involving the frontal bone. A 5-year-old boy was presented with a hard, fixed mass in his lateral eyebrow. Contrast magnetic resonance imaging revealed inhomogeneous enhancement of the mass with direct invasion of the frontal bone and adjacent dura mater. Under general anesthesia, linear incision at the lateral eyebrow region was made. Intraoperative evaluation revealed hard, fixed and well-defined soft tissue mass. The final extirpated mass was $2.5{\times}2.4cm$ in size, and was accompanied by a $1{\times}1cm$ sized defect on the frontal bone with intact dura mater. The surgical wound was closed primarily by a layer-by-layer fashion. Histologic examination was later performed for definite diagnosis. The histologic examination revealed abnormal proliferation of Langerhans cell with granuloma formation. Radionuclide bone scan and positron emission tomography was taken and revealed free of multi-organ involvement. At 3 months after surgery, natural looking contour at the lateral eyebrow region was observed with no tumor recurrence. Differential diagnosis of the hard and fixed mass at the lateral eyebrow region affecting the primary skull lesion from pediatric population includes epidermoid cyst, dermoid cyst and LCH. Generally, brief physical examination with plain X-ray view can be performed for clinical evaluation, but for a definite diagnosis, contrast MRI may be helpful.