• 제목/요약/키워드: diagnostic approach

검색결과 582건 처리시간 0.026초

공간 통계 활용에 따른 소지역 추정법의 평가 (Evaluations of Small Area Estimations with/without Spatial Terms)

  • 신기일;최봉호;이상은
    • 응용통계연구
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    • 제20권2호
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    • pp.229-244
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    • 2007
  • 국내외에서 소지역 추정에 관한 많은 연구가 진행되고 있다. 보조 자료가 충분히 있는 경우 모형기반 추정법을 사용하는 것이 일반적이며 이 중에서 계층적 베이지안(Hierarchical Bayesian: HB) 추정법이 가장 좋은 것으로 알려져 있다. 그러나 보조 자료가 충분하지 않은 경우에는 모형 기반 추정법의 사용은 제한적이다. 최근 충분한 보조 자료가 없는 경우 공간 정보를 보조 자료로 사용하는 방법이 제안되었다. 본 논문에서는 공간통계량과 베이즈 접근방법을 활용한 모형기반의 소지역 통계량들을 모형 검진방법(Diagnostic method)들을 이용하여 비교 분석하였다. 분석에 사용된 자료는 2005년도 경제활동인구 조사이며 소지역(시,군,구)통계를 추정하여 비교하였다.

학습장애의 조기 발견을 위한 소아과적 접근 (Pediatric approach to early detection of learning disabilities)

  • 성인경
    • Clinical and Experimental Pediatrics
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    • 제51권9호
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    • pp.911-921
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    • 2008
  • Learning disabilities (LD) are heterogeneous group of disorders with evidences of genetic or familial trait, intrinsic to the individual and presume to be due to central nervous dysfunction. Learning disabilities and attention deficit hyperactivity disorder (ADHD) are the two of the most common disorders in the population of school-age children. Typically academic achievements in children with learning disabilities are significantly lower than expected by their normal or above normal range of IQ. Although academic and cognitive deficits are hallmarks of children with LD, those children are also at risk for a broad range of behavioral and emotional problems. Almost all cases meet criteria for at least one additional diagnosis such as ADHD, developmental coordination disorder, depression, anxiety, obsessive compulsive disorder, tic disorder, among which ADHD is particularly predominant. Because of the response to the therapeutic intervention program is promising and positive when applied early, it is critical to recognize patients as early as possible. Pediatricians often are the first to hear from parents worried about a childs academic progress. It is not the responsibility of pediatrician to make a diagnosis, referring children for a diagnostic evaluation of LD is a reasonable first step. Pediatricians can make early referral of suspicious children by asking some serial short questions about basic and processing skills. With a basic knowledge about the clinical characteristics, diagnostic and therapeutic procedures of LD, pediatricians also can provide primary counseling and education for parents at their outpatient clinical settings.

혈관신생 분자핵의학 영상 (Molecular Nuclear imaging of Angiogenesis)

  • 이경한
    • 대한핵의학회지
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    • 제38권2호
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    • pp.171-174
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    • 2004
  • Angiogenesis, the formation of new capillaries from existing vessels, increases oxygenation and nutrient supply to ischemic tissue and allows tumor growth and metastasis. As such, angiogenesis targeting provides a novel approach for cancer treatment with easier drug delivery and less drug resistance. Therapeutic anti-angiogenesis has shown impressive effects in animal tumor models and are now entering clinical trials. However, the successful clinical introduction of this new therapeutic approach requires diagnostic tools that can reliably measure angiogenesis in a noninvasive and repetitive manner. Molecular imaging is emerging as an exciting new discipline that deals with imaging of disease on a cellular or genetic level. Angiogenesis imaging is an important area for molecular imaging research, and the use of radiotracers offers a particularly promising technique for its development. While current perfusion and metabolism radiotracers can provide useful information related to tissue vascularity, recent endeavors are focused on the development of novel radioprobes that specifically and directly target angiogenic vessels. Presently available proges include RGD sequence containing peptides that target ${\alpha}_v\;{\beta}_3$ integrin, endothelial growth factors such as VEGF or FGF, metalloptoteinase inhibitors, and specific antiangiogenic drugs. It is now clear that nuclear medicine techniques have a remarkable potential for angiogenesis imaging, and efforts are currently continuing to develop new radioprobes with superior imaging properties. With future identification of novel targets, design of better probes, and improvements in instrumentation, radiotracer angiogenesis imaging promises to play an increasingly important role in the diagnostic evaluation and treatment of cancer and other angiogenesis related diseases.

Autoimmune encephalitis and epilepsy: evolving definition and clinical spectrum

  • Seo, Joo Hee;Lee, Yun-Jin;Lee, Ki Hyeong;Gireesh, Elakkat;Skinner, Holly;Westerveld, Michael
    • Clinical and Experimental Pediatrics
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    • 제63권8호
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    • pp.291-300
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    • 2020
  • Advances in autoimmune encephalitis studies in the past 10 years have led to the identification of new syndromes and biomarkers that have transformed the diagnostic approach to the disorder. The disorder or syndrome has been linked to a wide variety of pathologic processes associated with the neuron-specific autoantibodies targeting intracellular and plasma membrane antigens. However, current criteria for autoimmune encephalitis are quite dependent on antibody testing and responses to immunotherapy, which might delay the diagnosis. This form of encephalitis can involve the multifaceted presentation of seizures and unexpected behavioral changes. The spectrum of neuropsychiatric symptoms in children is less definitive than that in adults, and the incorporation of clinical, immunological, electrophysiological, and neuroradiological results is critical to the diagnostic approach. In this review, we document the clinical and immunologic characteristics of autoimmune encephalitis known to date, with the goal of helping clinicians in differential diagnosis and to provide prompt and effective treatment.

이하선 Warthin 종양의 세침흡인검사 후 발생한 육아종성 괴사 1예 (A Case of Parotid Warthin Tumor with Granulomatous Necrosis After Fine-Needle Aspiration)

  • 오현식;이은섭;조용태;권민수
    • 대한두경부종양학회지
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    • 제34권2호
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    • pp.57-60
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    • 2018
  • Fine needle aspiration is usually performed as a preoperative cytologic evaluation in salivary gland tumors, and complications of the lesion after fine needle aspiration are scarcely developed. The secondary change of tissue by fine needle aspiration can make the diagnostic and subsequent therapeutic difficulties for clinicians and require a careful approach. Fine needle aspiration can cause variety of changes in Warthin tumor, and it is presumed that those changes are mainly caused by the infarction of the mass due to vascular injury and following inflammatory reactions. We would introduce our experience of granulomatous and necrotic change after fine needle aspiration on parotid Warthin tumor with consequent difficulties in diagnostic and surgical approach to the patient.

수족냉증을 호소하는 소양인 비수한표한병 환자의 증례보고 7례 (A Case Series of Cold Hypersensitivity in Hands and Feet in Soyangin Cold Pattern Patients)

  • 이지연;황민우
    • 사상체질의학회지
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    • 제35권3호
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    • pp.12-28
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    • 2023
  • Introduction This study reports case series of Soyangin patients with coldness in hands and feet using Sasang constitutional medicine approach. This study suggests a value of using constitutional medicine indicators as both prognostic and diagnostic tools. Methods Among patients who visited an outpatient clinic, 7 patients were selected based on the criteria. These selected patients were exclusively treated with herbal medicine and monitored every 2 to 4 weeks retrospectively. Results The average treatment period was 8 weeks. Patients with a favorable pattern showed the improvement within 8 weeks, while those with an unfavorable pattern required more time. Discussion This study confirms the significance of Sasang constitutional medicine approach in Soyangin exterior cold syndrome with coldness in hands and feet. It also validates the current coldness in hands and feet as meaningful diagnostic indicator of Soyangin exterior cold syndrome. Furthermore, it highlights the value of original symptoms as prognostic tools.

Artificial Intelligence-Based Breast Nodule Segmentation Using Multi-Scale Images and Convolutional Network

  • Quoc Tuan Hoang;Xuan Hien Pham;Anh Vu Le;Trung Thanh Bui
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • 제17권3호
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    • pp.678-700
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    • 2023
  • Diagnosing breast diseases using ultrasound (US) images remains challenging because it is time-consuming and requires expert radiologist knowledge. As a result, the diagnostic performance is significantly biased. To assist radiologists in this process, computer-aided diagnosis (CAD) systems have been developed and used in practice. This type of system is used not only to assist radiologists in examining breast ultrasound images (BUS) but also to ensure the effectiveness of the diagnostic process. In this study, we propose a new approach for breast lesion localization and segmentation using a multi-scale pyramid of the ultrasound image of a breast organ and a convolutional semantic segmentation network. Unlike previous studies that used only a deep detection/segmentation neural network on a single breast ultrasound image, we propose to use multiple images generated from an input image at different scales for the localization and segmentation process. By combining the localization/segmentation results obtained from the input image at different scales, the system performance was enhanced compared with that of the previous studies. The experimental results with two public datasets confirmed the effectiveness of the proposed approach by producing superior localization/segmentation results compared with those obtained in previous studies.

개에서 Helicobacter균 감염을 검출하기 위한 urease 검사와 PCR 검사의 진단적 정확도 (Diagnostic Accuracy of Urease and Polymerase Chain Reaction to Detect Helicobacter Species Infection in Dogs)

  • Pak, Son-Il;Oh, Tae-Ho
    • 한국임상수의학회지
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    • 제18권4호
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    • pp.329-333
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    • 2001
  • 새로 개발되거나 혹은 기존의 어떤 진단검사를 다양한 임상상황에 적용하기 위해서는 먼저 이들 검사법의 진단적 정확도를 추정하는 연구가 반드시 선행되어야 한다. 진단의 정확도에 대한 추정치를 모른다면 검사결과를 해석하는 것이 불가능하기 때문이다. 특히 동일한 개체에서 감염부위별로 3개 이상의 시료를 얻어 진단검사를 적용하는 경우 각 시료의 검사결과는 독립적인 측정시료가 아니라 개체내에서 연관성이 매우 높은 종속적인 시료에 해당 한다. 즉 동일한 개체에서 얻은 시료일수록 검사결과에서 유사한 반응을 보이며 이 경우 분석의 단위는 각각의 개체가 아니라 검사부위가 되는데 이는 의학연구에서 매우 흔하다. 본 연구에서는 Helicobacter 균에 의한 감염을 검출하기 위하여 동일한 개로부터 위의 해부학적 구조상 pyloric antrum, body 및 cardia의 생검시료에 대하여 urease 검사와 PCR 검사를 적용하여 각 검사의 진단적 정확도를 추정하였다. urease 검사의 민감도와 특이도는 0.74 (95% 신뢰구간: 0.64-0.84)와 0.87 (95% 신뢰구간: 0.67-1.00)이었으며 PCR 검사의 민감도와 특이도는 0.95 (95% 신뢰구간: 0.89-1.00)와 0.90 (95% 신뢰구간: 0.70-1.00)로 두 검사의 특이도는 높은 것으로 나타났다. 그러나 PCR 검사에 비하여 urease 검사의 경우 가음성 (false negative)의 가능성이 높기 때문에 진단결과에 대한 신중한 해석이 요구된다.

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Critical Evaluation of Fine Needle Aspiration Cytology as a Diagnostic Technique in Bone Tumors and Tumor-like Lesions

  • Chakrabarti, Sudipta;Datta, Alok Sobhan;Hira, Michael
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권7호
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    • pp.3031-3035
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    • 2012
  • Background: Though open surgical biopsy is the procedure of choice for the diagnosis of bone tumors, many disadvantages are associated with this approach. The present study was undertaken to evaluate the role of fine needle aspiration cytology (FNAC) as a diagnostic tool in cases of bony tumors and tumor-like lesions which may be conducted in centers where facilities for surgical biopsies are inadequate. Methods: The study population consisted of 51 cases presenting with a skeletal mass. After clinical evaluation, radiological correlation was done to assess the nature and extent of each lesion. Fine needle aspiration was performed aseptically and smears were prepared. Patients subsequently underwent open surgical biopsy and tissue samples were obtained for histopathological examination. Standard statistical methods were applied for analysis of data. Results: Adequate material was not obtained even after repeated aspiration in seven cases, six of which were benign. Among the remaining 44 cases, diagnosis of malignancy was correctly provided in 28 (93.3%) out of 30 cases and categorical diagnosis in 20 (66.67%). Interpretation of cytology was more difficult in cases of benign and tumor-like lesions, with a categorical opinion only possible in seven (50%) cases. Statistical analysis showed FNAC with malignant tumors to have high sensitivity (93.3%), specificity (92.9%) and positive predictive value of 96.6%, whereas the negative predictive value was 86.7%. Conclusion: FNAC should be included in the diagnostic workup of a skeletal tumor because of its simplicity and reliability. However, a definitive pathologic diagnosis heavily depends on compatible clinical and radiologic features which can only be accomplished by teamwork. The cytological technique applied in this study could detect many bone tumors and tumor-like conditions and appears particularly suitable as a diagnostic technique for rural regions of India as other developing countries.

Internal Amplification Control for a Cryptosporidium Diagnostic PCR: Construction and Clinical Evaluation

  • Hawash, Yousry;Ghonaim, M.M.;Al-Hazmi, Ayman S.
    • Parasites, Hosts and Diseases
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    • 제53권2호
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    • pp.147-154
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    • 2015
  • Various constituents in clinical specimens, particularly feces, can inhibit the PCR assay and lead to false-negative results. To ensure that negative results of a diagnostic PCR assay are true, it should be properly monitored by an inhibition control. In this study, a cloning vector harboring a modified target DNA sequence (${\approx}375bp$) was constructed to be used as a competitive internal amplification control (IAC) for a conventional PCR assay that detects ${\approx}550bp$ of the Cryptosporidium oocyst wall protein (COWP) gene sequence in human feces. Modification of the native PCR target was carried out using a new approach comprising inverse PCR and restriction digestion techniques. IAC was included in the assay, with the estimated optimum concentration of 1 fg per reaction, as duplex PCR. When applied on fecal samples spiked with variable oocysts counts, ${\approx}2$ oocysts were theoretically enough for detection. When applied on 25 Cryptosporidium-positive fecal samples of various infection intensities, both targets were clearly detected with minimal competition noticed in 2-3 samples. Importantly, both the analytical and the diagnostic sensitivities of the PCR assay were not altered with integration of IAC into the reactions. When tried on 180 randomly collected fecal samples, 159 were Cryptosporidium-negatives. Although the native target DNA was absent, the IAC amplicon was obviously detected on gel of all the Cryptosporidium-negative samples. These results imply that running of the diagnostic PCR, inspired with the previously developed DNA extraction protocol and the constructed IAC, represents a useful tool for Cryptosporidium detection in human feces.