• Title/Summary/Keyword: diagnostic significance

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Heavily T2-Weighted Magnetic Resonance Myelography as a Safe Cerebrospinal Fluid Leakage Detection Modality for Nontraumatic Subdural Hematoma

  • An, Sungjae;Jeong, Han-Gil;Seo, Dongwook;Jo, Hyunjun;Lee, Si Un;Bang, Jae Seung;Oh, Chang Wan;Kim, Tackeun
    • Journal of Korean Neurosurgical Society
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    • v.65 no.1
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    • pp.13-21
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    • 2022
  • Objective : Nontraumatic subdural hematoma (SDH) is a common disease, and spinal cerebrospinal fluid (CSF) leakage is a possible etiology of unknown significance, which is commonly investigated by several invasive studies. This study demonstrates that heavily T2-weighted magnetic resonance myelography (HT2W-MRM) is a safe and clinically effective imaging modality for detecting CSF leakage in patients with nontraumatic SDH. Methods : All patients who underwent HT2W-MRM for nontraumatic SDH workup at our institution were searched and enrolled in this study. Several parameters were measured and analyzed, including patient demographic data, initial modified Rankin Scale (mRS) score upon presentation, SDH bilaterality, hematoma thickness upon presentation, CSF leakage sites, treatment modalities, follow-up hematoma thickness, and follow-up mRS score. Results : Forty patients were identified, of which 22 (55.0%) had CSF leakage at various spinal locations. Five patients (12.5%) showed no change in mRS score, whereas the remaining (87.5%) showed decreases in follow-up mRS scores. In terms of the overall hematoma thickness, four patients (10.0%) showed increased thickness, two (5.0%) showed no change, 32 (80.0%) showed decreased thickness, and two (5.0%) did not undergo follow-up imaging for hematoma thickness measurement. Conclusion : HT2W-MRM is not only safe but also clinically effective as a primary diagnostic imaging modality to investigate CSF leakage in patients with nontraumatic SDH. Moreover, this study suggests that CSF leakage is a common etiology for nontraumatic SDH, which warrants changes in the diagnosis and treatment strategies.

Definition, Role and Method of Yinyang Pattern Differentiation (음양변증(陰陽辨證)의 정의와 기능 및 판별방법 연구)

  • Chi, Gyoo-yong;Park, Shin-hyung
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.35 no.2
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    • pp.47-55
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    • 2021
  • In order to ensure the fact that eight principle pattern differentiation is used clinically as a basic guideline for Korean medicine practice, the definition, role and method of yin-yang pattern differentiation with its case report were explored at first. Yinyang Pattern Differentiation is a method of discriminating human tendencies or morbidity based on the yin and yang characteristics expressed in living bodies. And yin and yang are the two contrasting characteristics and aspects of the interaction when certain physical conditions that have a lasting effect on the human physiological metabolic function are correlated with the morbidity. Specific methods of yinyang pattern differentiation can be divided into several types of yin and yang indicators. First, time and space factors like day and night, hot and cold seasons, above and below, topographical districts. Second, colors and pulse and their/or relative clearness and muddiness, hardness and softness, moving and resting. Third, diagnose yin and yang patterns through distinguishing the true and false of a fever and cold in an emergency phase such as increase of brain pressure and shock state. Fourth, general characteristics of the propensity and constitution of a subject such as body type, speech, behavior, and physiological metabolism. And for clinical use, these were summarized again as a symptom indicators of physical signs and color, pulse, tongue and questionnaire indicators of propensity, body type, and space-time characteristics. Conclusively, it was confirmed that yinyang pattern differentiation has its own diagnostic significance which is distinct from exterior-interior, cold-heat and deficiency-excess pattern differentiation.

Association of Hemodialysis and Sarcopenia : A systematic review (혈액투석과 근감소증의 연관성에 관한 문헌고찰)

  • Kyoung-Wook Choi;Hwa-Gyeong Lee;Soo-Ah Kim;Yun-Jae Oh
    • Journal of The Korean Society of Integrative Medicine
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    • v.11 no.3
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    • pp.185-194
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    • 2023
  • Purpose : This study aimed to investigate the relationship between the characteristics of hemodialysis patients and the occurrence of sarcopenia through a comprehensive literature review. Methods : A systematic literature search was conducted to identify eligible studies in the Cochrane library, PubMed and Embase. In this review, we included all papers published since the initiative's inception and summarized results as of december 2022. Studies that investigated association between sarcopenia diagnosis and hemodialysis patients (aged≥18 years) were included. Ultimately, 16 studies met our selection criteria. The risk of bias was assessed using the Newcastle-Ottawa scale. Results : Fourteen of the sixteen studies (88 %) reported that significant association between sarcopenia diagnosis and hemodialysis patients. However, two studies reported no association between sarcopenia diagnosis and hemodialysis patients. As a factor statistically related to sarcopenia in hemodialysis patients, Mortality (6 studies, 38 %), age (5 studies, 31 %), body composition (4 studies, 25 %), physical activity (2 studies, 13 %), diabetes (2 studies, 13 %), cardiovascular abnormalities (1 studies, 6 %), nutritional status (3 studies, 19 %), and gender (3 studies, 19 %). Conclusion : Our findings highlight the necessity of developing a physical therapy program that accurately reflects the health status of hemodialysis patients. To further investigate the association between the diagnosis of sarcopenia and hemodialysis patients, it is recommended to conduct large-scale longitudinal studies using standardized diagnostic criteria and evaluation methods, as well as analyze potential risk factors. Consequently, this study emphasizes the importance and potential of developing physical therapy programs that effectively address the health consequences associated with hemodialysis. The significance of this research lies in its ability to provide valuable insights and lay the foundation for future studies focused on developing preventive and therapeutic interventions targeting muscle wasting syndrome resulting from hemodialysis.

Molecular methods for diagnosis of microbial pathogens in muga silkworm, Antheraea assamensis Helfer (Lepidoptera: Saturniidae)

  • Gangavarapu Subrahmanyam;Kangayam M. Ponnuvel;Kallare P Arunkumar;Kamidi Rahul;S. Manthira Moorthy;Vankadara Sivaprasad
    • International Journal of Industrial Entomology and Biomaterials
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    • v.47 no.1
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    • pp.1-11
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    • 2023
  • The Indian golden muga silkworm, Antheraea assamensis Helfer is an economically important wild silkworm endemic to Northeastern part of India. In recent years, climate change has posed a threat to muga silk production due to the requirement that larvae be reared outdoors. Since the muga silkworm larvae are exposed to the vagaries of nature, the changing climate has increased the incidence of microbial diseases in the rearing fields. Accurate diagnosis of the disease causing pathogens and its associated epidemiology are prerequisites to manage the diseases in the rearing field. Although conventional microbial culturing methods are widely used to identify pathogenic bacteria, they would not provide meaningful information on a wide variety of silkworm pathogens. The information on use of molecular diagnostic tools in detection of microbial pathogens of wild silk moths is very limited. A wide range of molecular and immunodiagnostic techniques including denaturing gradient gel electrophoresis (DGGE), random amplified polymorphism (RAPD), 16S rRNA/ITSA gene sequencing, multiplex polymerase chain reaction (M-PCR), fluorescence in situ hybridization (FISH), immunofluorescence, and repetitive-element PCR (Rep-PCR), have been used for detecting and characterizing the pathogens of insects with economic significance. Nevertheless, the application of these molecular tools for detecting and typing entomopathogens in surveillance studies of muga silkworm rearing is very limited. Here, we discuss the possible application of these molecular techniques, their advantages and major limitations. These methods show promise in better management of diseases in muga ecosystem.

Effect of cone-beam computed tomography metal artefact reduction on incomplete subtle vertical root fractures

  • Andrea Huey Tsu Wang;Francine Kuhl Panzarella;Carlos Eduardo Fontana;Jose Luiz Cintra Junqueira;Carlos Eduardo da Silveira Bueno
    • Imaging Science in Dentistry
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    • v.53 no.1
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    • pp.11-19
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    • 2023
  • Purpose: This study compared the accuracy of detection of incomplete vertical root fractures (VRFs) in filled and unfilled teeth on cone-beam computed tomography images with and without a metal artefact reduction (MAR) algorithm. Materials and Methods: Forty single-rooted maxillary premolars were selected and, after endodontic instrumentation, were categorized as unfilled teeth without fractures, filled teeth without fractures, unfilled teeth with fractures, or filled teeth with fractures. Each VRF was artificially created and confirmed by operative microscopy. The teeth were randomly arranged, and images were acquired with and without the MAR algorithm. The images were evaluated with OnDemand software (Cybermed Inc., Seoul, Korea). After training, 2 blinded observers each assessed the images for the presence and absence of VRFs 2 times separated by a 1-week interval. P-values<0.05 were considered to indicate significance. Results: Of the 4 protocols, unfilled teeth analysed with the MAR algorithm had the highest accuracy of incomplete VRF diagnosis (0.65), while unfilled teeth reviewed without MAR were associated with the least accurate diagnosis (0.55). With MAR, an unfilled tooth with an incomplete VRF was 4 times more likely to be identified as having an incomplete VRF than an unfilled tooth without this condition, while without MAR, an unfilled tooth with an incomplete VRF was 2.28 times more likely to be identified as having an incomplete VRF than an unfilled tooth without this condition. Conclusion: The use of the MAR algorithm increased the diagnostic accuracy in the detection of incomplete VRF on images of unfilled teeth.

Texture analysis in cone-beam computed tomographic images of medication-related osteonecrosis of the jaw

  • Polyane Mazucatto Queiroz;Karolina Castilho Fardim;Andre Luiz Ferreira Costa;Ricardo Alves Matheus;Sergio Lucio Pereira Castro Lopes
    • Imaging Science in Dentistry
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    • v.53 no.2
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    • pp.109-115
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    • 2023
  • Purpose: The aim of this study was to evaluate changes in the trabecular bone through texture analysis and compare the texture analysis characteristics of different areas in patients with medication-related osteonecrosis of the jaw (MRONJ). Materials and Methods: Cone-beam computed tomographic images of 16 patients diagnosed with MRONJ were used. In sagittal images, 3 regions were chosen: active osteonecrosis(AO); intermediate tissue (IT), which presented a zone of apparently healthy tissue adjacent to the AO area; and healthy bone tissue (HT) (control area). Texture analysis was performed evaluating 7 parameters: secondary angular momentum, contrast, correlation, sum of squares, inverse moment of difference, sum of entropies, and entropy. Data were analyzed using the Kruskal-Wallis test with a significance level of 5%. Results: Comparing the areas of AO, IT, and HT, significant differences (P<0.05) were observed. The IT and AO area images showed higher values for parameters such as contrast, entropy, and secondary angular momentum than the HT area, indicating greater disorder in these tissues. Conclusion: Through texture analysis, changes in the bone pattern could be observed in areas of osteonecrosis. The texture analysis demonstrated that areas visually identified and classified as IT still had necrotic tissue, thereby increasing the accuracy of delimiting the real extension of MRONJ.

Zygomaticotemporal suture maturation evaluation in Chinese population using cone-beam computed tomography images

  • Yifan Li;Ruomei Li;Jiajun Shi;Yuhua Shan;Zhenqi Chen
    • The korean journal of orthodontics
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    • v.53 no.4
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    • pp.232-240
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    • 2023
  • Objective: This study aimed to evaluate the zygomaticotemporal suture (ZTS) maturation, analyze the age distribution patterns of ZTS maturation stages, and investigate the relationship between ZTS and cervical vertebral maturation (CVM). Methods: A total of 261 patients who underwent cone-beam computed tomography (112 males, mean age, 13.1 ± 3.3 years; 149 females, mean age, 13.7 ± 3.1 years) were examined to evaluate the ZTS stages. The ZTS stages were defined based on a modified method from previous studies on zygomaticomaxillary sutures. Differences between groups and correlations between indicators were analyzed using the Spearman correlation test, intraclass coefficient of correlation (ICC), one-way analysis of variance and rank sum test. Statistical significance was set at p < 0.05. The diagnostic value of CVM stages in identifying ZTS maturation stages was evaluated using positive likelihood ratios (LRs). Results: A positive relationship was found between the ZTS and CVM stage (r = 0.747, ICC = 0.621, p < 0.01) and between the ZTS stage and chronological age (r = 0.727, ICC = 0.330, p < 0.01). Positive LRs > 10 were found for several cervical stages (CSs), including CS1 and CS2 for the diagnosis of stage B, CS1 to CS3 for the diagnosis of stages B and C, and CS6 for the diagnosis of stages D and E. Conclusions: The ZTS maturation stage may be more relevant to the CVM stage than to the chronological age. The CVM stages can be good indicators for clinical decisions regarding maxillary protraction, except for CS4 and CS5.

An Efficiency Analysis of an Artificial Intelligence Medical Image Analysis Software System : Focusing on the Time Behavior of ISO/IEC 25023 Software Quality Requirements (인공지능 기술 기반의 의료영상 판독 보조 시스템의 효율성 분석 : ISO/IEC 25023 소프트웨어 품질 요구사항의 Time Behavior를 중심으로)

  • Chang-Hwa Han;Young-Hwang Jeon;Jae-Bok Han;Jong-Nam Song
    • Journal of the Korean Society of Radiology
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    • v.17 no.6
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    • pp.939-945
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    • 2023
  • This study analyzes the 'performance efficiency' of AI-based reading assistance systems in the field of radiology by measuring their 'time behavior' properties. Due to the increase in medical images and the limited number of radiologists, the adoption of AI-based solutions is escalating, stimulating a multitude of studies in this area. Contrary to the majority of past research which centered on AI's diagnostic precision, this study underlines the significance of time behavior. Using 50 chest X-ray PA images, the system processed images in an average of 15.24 seconds, demonstrating high consistency and reliability, which is on par with leading global AI platforms, suggesting the potential for significant improvements in radiology workflow efficiency. We expect AI technology to play a large role in the field of radiology and help improve overall healthcare quality and efficiency.

Ultrasonographic evaluation of the masseter muscle in patients with temporomandibular joint degeneration

  • Busra Arikan;Numan Dedeoglu;Aydin Keskinruzgar
    • Imaging Science in Dentistry
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    • v.53 no.4
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    • pp.355-363
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    • 2023
  • Purpose: Sonographic elastography can be used to evaluate the hardness of muscle tissue through the application of compression. Strain elastography gauges hardness through the comparison of echo sets before and after compression. This study utilized ultrasonography to measure the thickness and hardness of the masseter muscle in individuals with temporomandibular joint(TMJ) osteoarthritis. Materials and Methods: This study included 40 patients who presented with joint pain and were diagnosed with TMJ osteoarthritis via diagnostic cone-beam computed tomography, along with 40 healthy individuals. The thickness and hardness of each individual's masseter muscle were evaluated both at rest and at maximum bite using ultrasonography. The Mann-Whitney U test and the chi-square test were employed for statistical analysis, with the significance level set at P<0.05. Results: The mean thickness of the resting masseter muscle was 0.91 cm in patients with osteoarthritis, versus 1.00 cm in healthy individuals. The mean thickness of the masseter muscle at maximum bite was 1.28 cm in osteoarthritis patients and 1.36 cm in healthy individuals. The mean masseter elasticity index ratio at maximum bite was 4.51 in patients with osteoarthritis and 3.16 in healthy controls. Significant differences were observed between patients with osteoarthritis and healthy controls in both the masseter muscle thickness and the masseter elasticity index ratio, at rest and at maximum bite (P<0.05). Conclusion: The thickness of the masseter muscle in patients with TMJ osteoarthritis was less than that in healthy controls. Additionally, the hardness of the masseter muscle was greater in patients with TMJ osteoarthritis.

Computed tomographic evaluation of portal vein indices in cats with the extrahepatic portosystemic shunts

  • Eunji Jeong;Jin-Young Chung;Jin-Ok Ahn;Hojung Choi;Youngwon Lee;Kija Lee;Sooyoung Choi
    • Journal of Veterinary Science
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    • v.25 no.3
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    • pp.37.1-37.10
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    • 2024
  • Importance: The portal vein to aorta (PV/Ao) ratio is used to assess the clinical significance of extrahepatic portosystemic shunt (EHPSS). Previous studies using computed tomography (CT) were conducted in dogs but not in cats. Objective: This study aimed to establish normal reference values for PV indices (PV/Ao ratio and PV diameter) in cats and determine the usefulness of these for predicting symptomatic EHPSS. Methods: This study included 95 dogs and 114 cats that underwent abdominal CT. The canine normal (CN) group included dogs without EHPSS. The cats were classified into feline normal (FN, 88/114), feline asymptomatic (FA, 16/114), and feline symptomatic (FS, 10/114) groups. The PV and Ao diameters were measured in axial cross-sections. Results: The group FN had a higher PV/Ao ratio than the group CN (p < 0.001). Within the feline groups, the PV indices were in the order FN > FA > FS (both p < 0.001). The mean PV diameter and PV/Ao ratio for group FN were 5.23±0.77 mm and 1.46±0.19, respectively. The cutoff values between groups FN and FS were 4.115 mm for PV diameter (sensitivity, 100%; specificity, 97.7%) and 1.170 for PV/Ao ratio (90%, 92.1%). The cutoff values between group FA and FS were 3.835 mm (90%, 93.8%) and 1.010 (70%, 100%), respectively. Conclusions and Relevance: The results demonstrated significant differences in PV indices between dogs and cats. In cats, the PV/Ao ratio demonstrated high diagnostic performance for symptomatic EHPSS. The PV diameter also performed well, in contrast to dogs.