• Title/Summary/Keyword: diagnostic approach

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Treatment of a Carotid-Cavernous Sinus Fistula via the Superior Ophthalmic Vein Approach: A Case Report (상안정맥을 이용한 해면정맥동루의 색전술 치험례)

  • Moon, In-Sun;Shin, Han-Kyung;Kim, Dong-Il
    • Archives of Craniofacial Surgery
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    • v.11 no.2
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    • pp.116-119
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    • 2010
  • Purpose: Arteriovenous fistulas that involve the cavernous sinus often produce ophthalmologic symptoms and signs. Transvenous endovascular access is the method of choice for a carotid-cavernous sinus fistula. The superior ophthalmic vein is a safe and reasonable alternative route for the transvenous embolization of carotid-cavernous sinus fistula. We report a case of the embolization of a carotid-cavernous sinus fistula using the superior ophthalmic vein approach. Methods: A 58 year old female had conjunctival congestion, periocular pain and diplopia with a 2 month duration. Diagnostic orbital CT, brain MRI and cerebral angiography revealed a carotid-cavernous sinus fistula. The fistula occlusion was treated by coil embolization using the superior ophthalmic vein approach. Results: The initial presenting symptoms, conjunctival congestion, periocular pain and diplopia, decreased after surgery. Coil embolization via the superior ophthalmic vein approach was difficult because of the venous tortuosity and friability. During the follow up period, the patient was in a good condition without complications. Conclusion: Surgical exposure of the superior ophthalmic vein provides direct venous access to the cavernous sinus as well as an effective and safe treatment approach. The cooperation of the plastic surgeon and interventionist is a factor in successful treatment.

Clinical Trials and Accuracy of Diagnostic Tests (진단법의 임상시험연구와 진단정확도)

  • Lee, You-Kyoung;Lee, Sang-Moo
    • Journal of Genetic Medicine
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    • v.8 no.1
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    • pp.28-34
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    • 2011
  • Most clinicians understand clinical trials as the evaluation process for new medicine before their use. However, clinical trials can also be applied to laboratory diagnostic tests (LDTs) to verify diagnostic accuracy and efficacy before their clinical laboratory implementation for patients. The clinical trial of LDT has two distinctive characteristics that are different from the case of pharmaceuticals and thus worth special consideration. One of them is the level of evidence. The well-designed randomized controlled trials (RCTs) are known to provide the best evidence to prove the clinical efficacy of any pharmaceutical products. However, RCTs lose practicality when applied to LDTs due to various issues including ethical complications. For this reason, comparative study format is considered more feasible approach for LDTs. In addition pharmaceuticals and LDTs are different in that the user's intervention is not required for the former but critical to the latter. Moreover, in the case of pharmaceuticals, end-products are produced by manufacturers before being used by clinicians. However, in LDTs, once reagents and instruments are provided by manufacturers, they are first utilized by clinical laboratories to produce test results in order for clinicians to use them later. In other words, when it comes to LDTs, clinical laboratories play the role of manufacturers, providing reliable test results with improved quality assurance. Considering the distinctive characteristics of LDTs, we would like to offer detailed suggestions to successfully perform clinical trials in LDTs, which include analytical performance measures, clinical test performance measures, diagnostic test accuracy measures, clinical effectiveness measures, and post-implementation surveillance.

Quality of Same-Day Sputum Smears Microscopy and Presumptive Tuberculosis Patients Drop-out at Health Facilities of Addis Ababa, Ethiopia

  • Taddese, Boja Dufera;Misganaw, Abay Sisay
    • Tuberculosis and Respiratory Diseases
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    • v.83 no.1
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    • pp.89-95
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    • 2020
  • Background: Same-day sputum microcopy is recommended in areas where sputum smear microscopy external quality assessment (EQA) is effectively implemented and sturdy. In Addis Ababa, the status of EQA and drop-out of same-day sputum smear microcopy has not yet been assessed. The objective of this study was to assess the quality of same-day sputum smear microscopy and diagnostic drop-out of presumptive tuberculosis (TB) patients in health facilities (HFs) across Addis Ababa, Ethiopia. Methods: Amulti-analysis was conducted from September 2016 to July 2017 to determine the status of external quality assessment and diagnostic drop-out of presumptive TB patients registered for same-day sputum smear microscopy. Data was coded and entered in Microsoft Excel, and subsequently transferred and analyzed using SPSS version 20.0. Results: The drop-out of same-day sputum smear microscopy was 209 (6.2%). More than 33% of the specimens collected for purposes of same-day sputum smears were of poor quality. Among the selected HFs for the study: 13 (46.4%) used filter reagents prior to sputum smear staining while 75% of the selected HFs for the study used smear microscopy services interruption in a year. The sensitivity and specificity of the HFs participating in regional quality assessment scheme for the diagnosis of TB was 97.4% and 99.6%, respectively. Conclusion: The diagnostic drop-out of same-day sputum smear microscopy was high in Addis Ababa. Strengthening EQA, competency-based laboratory professionals training on sputum smear microscopy might reduce the reading errors in sputum smear. Awareness creation of the community on the benefits gained from completion of specimen provision for the same-day approach decreases diagnostic drop-out and enhances TB control program.

Assessing the Potential of Thermal Imaging in Recognition of Breast Cancer

  • Zadeh, Hossein Ghayoumi;Haddadnia, Javad;Ahmadinejad, Nasrin;Baghdadi, Mohammad Reza
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8619-8623
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    • 2016
  • Background: Breast cancer is a common disorder in women, constituting one of the main causes of death all over the world. The purpose of this study was to determine the diagnostic value of the breast tissue diseases by the help of thermography. Materials and Methods: In this paper, we applied non-contact infrared camera, INFREC R500 for evaluating the capabilities of thermography. The study was conducted on 60 patients suspected of breast disease, who were referred to Imam Khomeini Imaging Center. Information obtained from the questionnaires and clinical examinations along with the obtained diagnostic results from ultrasound images, biopsies and thermography, were analyzed. The results indicated that the use of thermography as well as the asymmetry technique is useful in identifying hypoechoic as well as cystic masses. It should be noted that the patient should not suffer from breast discharge. Results: The accuracy of asymmetry technique identification is respectively 91/89% and 92/30%. Also the accuracy of the exact location of identification is on the 61/53% and 75%. The approach also proved effective in identifying heterogeneous lesions, fibroadenomas, and intraductal masses, but not ISO-echoes and calcified masses. Conclusions: According to the results of the investigation, thermography may be useful in the initial screening and supplementation of diagnostic procedures due to its safety (its non-radiation properties), low cost and the good recognition of breast tissue disease.

Diagnostic X-ray from the Perspective of Chuna Manual Medicine, Based on the Listing System of Spinal and Pelvic Subluxation (단순 방사선 영상 검사를 통한 추나의학적 진단 방법 - 척추.골반변위 명명체계를 중심으로 -)

  • Lee, Jin-Hyun;Kim, Chang-Gon;Jo, Dong-Chan;Moon, Su-Jeong;Park, Tae-Young;Ko, Youn-Suk;Nam, Hang-Woo;Lee, Jung-Han
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.9 no.1
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    • pp.1-14
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    • 2014
  • Objective : The purpose of this study is to offer a new approach to diagnostic X-ray in perspective of Chuna manual medicine for clinical application. Methods : Characteristics of each malposition in X-ray were analyzed comprehensively, based on the listing system. By verifying these results, find out the methods of X-ray diagnosis according to the each malposition. Results : 1. Vertebral malposition can be explained by alignment and relative position of vertebral body in the X-ray. To obtain more accurate estimation of subluxation, features of other structures should be considered, such as spinous process, intervertebral foramen and disc space. 2. Pelvic malposition can be determined by relative location of anterior superior iliac spine (ASIS) and posterior superior iliac spine (PSIS) in the X-ray. Also other pelvic parameters should be utilized to make a diagnosis of sacral malposition. Conclusions : Diagnostic X-ray should be applied to many clinicians for reasonable Chuna manual medicine application. And further studies are needed to use the diagnostic X-ray in the perspective of Chuna manual medicine.

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Application of Receiver Operating Characteristics (ROC) Curves for Clinical Diagnostic Tests (임상진단 검사에서 ROC 곡선의 응용)

  • Pak, Son-Il;Koo, Hee-Seung;Hwang, Cheol-Yong;Youn, Hwa-Young
    • Journal of Veterinary Clinics
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    • v.19 no.3
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    • pp.312-315
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    • 2002
  • Diagnostic tests often require the determination of cut-off values that discriminate uninfected from infected individuals. The receiver operating characteristic (ROC) curve has been frequently used to attain this purpose and gives a representation of diagnostic accuracy (sensitivity and specificity) of a prediction model when varying the cut-point of a decision rule on a whole spectrum. We have written and tested a visual basic application program in EXCEL for maximum likelihood estimation of a binormal ROC curve, which also computes univariate statistics of a diagnostic test employed. Examples applying for computed tomographic images in radiology and methicillin-resistant Staphylococcus aureus research are given to illustrate this approach. This stand-alone module is available from the first author on request.

Recent Research Trends on Hypertension in Traditional Chinese Medicine (현대 중의학 관점의 고혈압 연구동향 분석)

  • Kim, Chang-Seok;Song, Mi-Young;Yang, Chang-Sop;Kim, Young-Eun;Yea, Sang-Jun;Kim, Chul
    • The Journal of Korean Medical History
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    • v.26 no.1
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    • pp.107-132
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    • 2013
  • Objectives : This study was performed to investigate the research trends of hypertension in Traditional Chinese Medicine(TCM), and it aims to promote hypertension research in Korean Medicine. Methods : We first collected more than 1,900 papers about hypertension research, and finally selected 108 papers related to this study. They were analyzed by the annul situation, the subject of the study, the perspective of TCM, the study stream, the research fields, the diagnostic patterns, and the distinguishing treatments of TCM. Results : The first review about hypertension in TCM was performed in 1963, and the number of studies has increased since 2000s. Doctors and researchers in China tried various diagnostic patterns to treat the patient because the diagnostic patterns were not unified. For this reason, most researches were reported to the diagnostic patterns and the treatments. Also we have discovered the diversity in treatments methods such as not only the typical herbal medicine, acupuncture, and Qigong but also specific treatments like Chuna, herbal acupoints stimulation, footbath, and pillow. Conclusions : Based on the results of this study, it can be proposed as follows : First, the various approach about hypertension in Korean Medicine is required. Second, the domestic research is needed to be extended to the external treatments as the distinguishing treatments of TCM.

A Study on Multi Fault Detection for Turbo Shaft Engine Components of UAV Using Neural Network Algorithms

  • Kong, Chang-Duk;Ki, Ja-Young;Kho, Seong-Hee;Lee, Chang-Ho
    • Proceedings of the Korean Society of Propulsion Engineers Conference
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    • 2008.03a
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    • pp.187-194
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    • 2008
  • Because the types and severities of most engine faults are various and complex, it is not easy that the conventional model based fault detection approach like the GPA(Gas Path Analysis) method can monitor all engine fault conditions. Therefore this study proposed newly a diagnostic algorithm for isolating and diagnosing effectively the faulted components of the smart UAV propulsion system, which has been developed by KARI(Korea Aerospace Research Institute), using the fuzzy logic and the neural network algorithms. A precise performance model should be needed to perform the model-based diagnostics. The based engine performance model was developed using SIMULINK. For the work and mass flow matching between components of the steady-state simulation, the state-flow library was applied. The proposed steady-state performance model can simulate off-design point performance at various flight conditions and part loads, and in order to evaluate the steady-state performance model their simulation results were compared with manufacturer's performance deck data. According to comparison results, it was confirm that the steady-state model well agreed with the deck data within 3% in all flight envelop. The diagnosis procedure of the proposed diagnostic system has the following steps. Firstly after obtaining database of fault patterns through performance simulation, then secondly the diagnostic system was trained by the FFBP networks. Thirdly after analyzing the trend of the measuring parameters due to fault patterns, then fourthly faulted components were isolated using the fuzzy logic. Finally magnitudes of the detected faults were obtained by the trained neural networks. Because the detected faults have almost same as degradation values of the implanted fault pattern, it was confirmed that the proposed diagnostic system can detect well the engine faults.

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Performance Evaluation of Biozentech Malaria Scanner in Plasmodium knowlesi and P. falciparum as a New Diagnostic Tool

  • Firdaus, Egy Rahman;Park, Ji-Hoon;Muh, Fauzi;Lee, Seong-Kyun;Han, Jin-Hee;Lim, Chae-Seung;Na, Sung-Hun;Park, Won Sun;Park, Jeong-Hyun;Han, Eun-Taek
    • Parasites, Hosts and Diseases
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    • v.59 no.2
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    • pp.113-119
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    • 2021
  • The computer vision diagnostic approach currently generates several malaria diagnostic tools. It enhances the accessible and straightforward diagnostics that necessary for clinics and health centers in malaria-endemic areas. A new computer malaria diagnostics tool called the malaria scanner was used to investigate living malaria parasites with easy sample preparation, fast and user-friendly. The cultured Plasmodium parasites were used to confirm the sensitivity of this technique then compared to fluorescence-activated cell sorting (FACS) analysis and light microscopic examination. The measured percentage of parasitemia by the malaria scanner revealed higher precision than microscopy and was similar to FACS. The coefficients of variation of this technique were 1.2-6.7% for Plasmodium knowlesi and 0.3-4.8% for P. falciparum. It allowed determining parasitemia levels of 0.1% or higher, with coefficient of variation smaller than 10%. In terms of the precision range of parasitemia, both high and low ranges showed similar precision results. Pearson's correlation test was used to evaluate the correlation data coming from all methods. A strong correlation of measured parasitemia (r2=0.99, P<0.05) was observed between each method. The parasitemia analysis using this new diagnostic tool needs technical improvement, particularly in the differentiation of malaria species.

Spontaneous hepatic arterioportal fistula in extrahepatic portal vein obstruction: Combined endovascular and surgical management

  • Ananya Panda;Durgadevi Narayanan;Arjunlokesh Netaji;Vaibhav Kumar Varshney;Lokesh Agarwal;Pawan Kumar Garg
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.3
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    • pp.307-312
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    • 2023
  • Hepatic arterioportal fistulae are abnormal communications between the hepatic artery and portal vein. They are reported to be congenital or acquired secondary to trauma, iatrogenic procedures, hepatic cirrhosis, and hepatocellular carcinoma, but less likely to occur spontaneously. Extrahepatic portal venous obstruction (EHPVO) can lead to pre-hepatic portal hypertension. A spontaneous superimposed hepatic arterioportal fistula can lead to pre-sinusoidal portal hypertension, further exacerbating its physiology. This report describes a young woman with long-standing EHPVO presenting with repeated upper gastrointestinal variceal bleeding and symptomatic hypersplenism. Computed tomography scan demonstrated a cavernous transformation of the portal vein and a macroscopic hepatic arterioportal fistula between the left hepatic artery and portal vein collateral in the central liver. The hepatic arterioportal fistula was associated with a flow-related left hepatic artery aneurysm and a portal venous collateral aneurysm proximal and distal to the fistula, respectively. Endovascular coiling was performed for the hepatic arterioportal fistula, followed by proximal splenorenal shunt procedure. This case illustrates an uncommon association of a spontaneous hepatic arterioportal fistula with EHPVO and the utility of a combined endovascular and surgical approach for managing multifactorial non-cirrhotic portal hypertension in such patients.