• 제목/요약/키워드: Clinical Diagnosis

검색결과 7,076건 처리시간 0.035초

Computer-aided polyp characterization in colonoscopy: sufficient performance or not?

  • Natalie Halvorsen;Yuichi Mori
    • Clinical Endoscopy
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    • 제57권1호
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    • pp.18-23
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    • 2024
  • Computer-assisted polyp characterization (computer-aided diagnosis, CADx) facilitates optical diagnosis during colonoscopy. Several studies have demonstrated high sensitivity and specificity of CADx tools in identifying neoplastic changes in colorectal polyps. To implement CADx tools in colonoscopy, there is a need to confirm whether these tools satisfy the threshold levels that are required to introduce optical diagnosis strategies such as "diagnose-and-leave," "resect-and-discard" or "DISCARD-lite." In this article, we review the available data from prospective trials regarding the effect of multiple CADx tools and discuss whether they meet these thresholds.

악하부종괴에 대한 임상적 연구 (CLINICAL STUDY ON SUBMANDIBULAR MASSES)

  • 장현석;유준영
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제18권4호
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    • pp.701-705
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    • 1996
  • There are many kind of diagnostic entities in submandibular or neck masses, and we can set up treatment plan and estimate treatment result, prognosis by accurate diagnosis. By reasoning medical and dental history, physical examination, anatomical consideration of masses in submandibular or neck area, location of masses, laboratory and radiographic studies, we can formulate a clinical diagnosis or differential diagnosis. Although a clinical diagnosis might suffice in some instances, a definitive(microscopic) diagnosis is frequently required for proper treatment. In order to get some information about making accurate diagnosis and setting up appropriate treatment plan, we did clinical study and histopathologic classification of 82 patients who visited and were operated for submandibular masses at Department of Oral and Maxillofacial Surgery in Seoul National University Hospital from 1988 to 1992. The result were as follows : 1. Submandibular masses occured most frequently in forties and fifties, and there was no sex predilection. 2. Chief complaints were in order of mass, swelling, pain and consistency were soft mass, mobile hard mass, firm mass, diffuse swelling in descending order. 3. Most frequent pathologic finding was lymphadenitis. 4. Site of submandibular masses were submandible, neck, submental, retromandible in descending order, and there was no predilection between left and right side. 5. Accuracy rate between clinical impression and result was 51.2%.

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Laboratory Diagnosis of Invasive Candidiasis

  • Ellepola Arjuna N.B.;Morrison Christine J.
    • Journal of Microbiology
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    • 제43권spc1호
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    • pp.65-84
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    • 2005
  • Invasive candidiasis is associated with high morbidity and mortality. Clinical diagnosis is complicated by a lack of specific clinical signs and symptoms of disease. Laboratory diagnosis is also complex because circulating antibodies to Candida species may occur in normal individuals as the result of commensal colonization of mucosal surfaces thereby reducing the usefulness of antibody detection for the diagnosis of this disease. In addition, Candida species antigens are often rapidly cleared from the circulation so that antigen detection tests often lack the desired level of sensitivity. Microbiological confirmation is difficult because blood cultures can be negative in up to 50% of autopsy-proven cases of deep-seated candidiasis or may only become positive late in the infection. Positive cultures from urine or mucosal surfaces do not necessarily indicate invasive disease although can occur during systemic infection. Furthermore, differences in the virulence and in the susceptibility of the various Candida species to antifungal drugs make identification to the species level important for clinical management. Newer molecular biological tests have generated interest but are not yet standardized or readily available in most clinical laboratory settings nor have they been validated in large clinical trials. Laboratory surveillance of at-risk patients could result in earlier initiation of antifungal therapy if sensitive and specific diagnostic tests, which are also cost effective, become available. This review will compare diagnostic tests currently in use as well as those under development by describing their assets and limitations for the diagnosis of invasive candidiasis.

의사결정나무법을 이용한 설문지의 응답특성에 대한 임상적 검토 (The Characteristics of Questionnaire Response Using decision tree method)

  • 최재영;박성식
    • 사상체질의학회지
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    • 제15권3호
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    • pp.177-186
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    • 2003
  • Objectives: This paper was for studying the constitutional differences between questionnaire and clinical diagnosis, and to be helpful to make a diagnosis Sasang constitution. Using the result of this study, it will be helpful to diagnose a Sasang constitution. Methods: There were 331 patients(135 men and 196 women) who answered questionnaire and were diagnosed by the Sasang constitution specialist at constitutional clinic of Dongguk Bundang Oriental Hospital. Using the response of questionnaire and several statistical techniques, we tried to find the characteristics of questionnaire response among each constitution and consistency between questionnaire and clinical diagnosis. Results: As a result of the analysis of the consistency between clinical diagnosis and questionnaire, the consistency was low degree(kappa value = 0.320) and Taeumin and Soeumin had more consistency than Soyangin.

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한의사의 진단, 설문지, 맥진을 이용한 미병 관리에 관한 관찰적 임상연구 (Observational Clinical Study on Mibyeong Based on Korean Medicine Diagnosis, Questionnaire, and Radial Artery Tonometry)

  • 문희영;김민수;임수현;채윤병;이인선
    • Korean Journal of Acupuncture
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    • 제40권2호
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    • pp.44-53
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    • 2023
  • Objectives : This study was conducted to reveal the relationship between multiple factors of traditional Korean Medicine diagnosis and consider the further probabilities of treating people with physical and mental problems not defined as diseases, which is called 'Mibyeong' in traditional Korean Medicine. Methods : 40 healthy participants were included in the observational clinical trial. The participants were asked to complete health questionnaires (e.g. State-Trait Anxiety Inventory, Pittsburgh Sleep Quality Index, Stress Response Inventory) and they went through a traditional diagnosis process, including four stages of diagnosis (looking, listening/smelling, inquiring, and pulse taking), by a Korean Medicine doctor. Both the Korean Medicine doctor and an artery tonometry device performed the pulse diagnosis. Results : Although all participants were healthy people with no history of disease, more than half of participants had a problem related with severe level of fatigue (n=19), sleep disturbance (n=26) and stress (n=27) status according to the related questionnaires. Participants diagnosed with phlegm syndrome by the Korean Medicine doctor showed significantly greater score in phlegm pattern questionnaires than participants who were not. However, there was little agreement between the doctor's pulse diagnosis and radial artery tonometry results. Conclusions : We conducted a pulse diagnosis and measured health-related information along with the traditional Korean Medicine diagnose procedure, including four stages of diagnosis, and we found a linkage between diagnosis of phlegm and the phlegm pattern questionnaire score. The results suggest that a number of healthy participants, with no disease diagnosed, have Mibyoung symptoms which need further clinical management. Thus, we suggest that Mibyoung management programs based on qualified diagnosis tools and traditional Korean medicine diagnosis procedures be developed, and that future research using various diagnostic tools be carried out on a large population.

안면형상을 활용한 사상체질 진단 연구에 관한 체계적 고찰 (Systematic Review on Researches of Sasang Constitution Diagnosis Using Facial Feature)

  • 이선영;고병희;이의주;이준희;황민우
    • 사상체질의학회지
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    • 제24권4호
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    • pp.17-27
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    • 2012
  • Objectives : This study proposes developing Sasang Medical Diagnosis Program using Facial form for increase in Sasang Constitution Diagnosis objectivity and putting the Diagnosis Program into practical use. The author presents a review of extant research on Sasang constitution diagnosis utilizing facial feature analysis and suggests an agenda for further research. Methods : For this thesis, a collection of dissertations on the subject of 'Usage of facial form for constitution diagnosis' published until September of 2012 such as RISS4U, OASIS, KISTI, Korean TK were reviewed. The final 33 dissertations were classified into two categories, basic or clinical research and then analyzed. Results : 9 out of 33 dissertations were of basic research and 24 were of clinical research. 1) As result of review of references, a uniform tendency was found in facial form according to Sasang Constitution. 2) In the grade of practical use, facial element is repeatedly used and the facial element of important use has constitutional differences. 3) Standard faces per Sasang Constitution were derived as result of 2-dimensional research. 4) 3-dimensional research focused on improvement of accuracy and reliability of 3D-AFRA, and there has been an attempt to develop a prototype for identification. Conclusions : For practical use of facial feature in Sasang Constitution Diagnosis, 1) Standardization of diagnosis through establishing Sasang Medical Diagnosis clinical protocol must be preceded. After the standardization, practical purpose and direction of facial form in general may be decided. 2) Information on high quality facial form of constitutional and conditional patients must be collected to form extensive database. 3) Subdivided symptomatology, as well as Sasang Constitution must be considered for diagnosis in order for diagnosis technique to acquire clinical practicality.

한방비만병증 설문지를 바탕으로 증상 척도에 따른 변증진단 비교 (The Comparison of Pattern Identification Diagnosis According to Symptom Scale Based on Obesity Pattern Identification Questionnaire)

  • 강경원;문진석;강병갑;김보영;신미숙;최선미
    • 한방비만학회지
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    • 제9권1호
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    • pp.37-44
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    • 2009
  • The study was to investigate the distribution for the diagnosis of pattern identification questionnaire and agreement rate between diagnosis of pattern identification based on obesity pattern identification questionnaire and the clinical diagnosis of pattern' identification by medical specialist. The distribution for the diagnosis of pattern identification based on obesity pattern identification questionnaire was shown in order of stagnation of liver Gi, retention of undigested food, deficiency of Yang at scale of 5, 3, 2 score and the diagnosis rate of single pattern identification at scale of 5, 3, 2 score was 89.96%, 79.33%, 54.64%, respectively the agreement rate between the diagnosis of pattern identification based on obesity pattern identification questionnaire and the clinical diagnosis of pattern identification by medical specialist was 0.1013. Therefore, the complementary management in CRF questionnaires with consultation from experts and the study for score difference of pattern identification will improve the accuracy and agreement rate, which will will be helpful for pattern identification of obesity by clinical experts.

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Cardiocirculatory, biochemical and hemostatic evaluation of dogs with hyperadrenocorticism at diagnosis and after treatment

  • Soares, Frederico Aecio Carvalho;Matheus, Juliana Pereira;Carvalho, Guilherme Luiz;Neuwald, Elisa Barp;Poppl, Alan Gomes;Valle, Stella Faria;Gonzalez, Felix Hilario Diaz
    • 대한수의학회지
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    • 제56권3호
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    • pp.161-166
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    • 2016
  • Hyperadrenocorticism (HAC) is a common endocrinopathy among dogs that causes multisystemic signs. This study was conducted to evaluate cardiocirculatory, biochemical, and hemostatic parameters in dogs with HAC at diagnosis, in addition to verifying whether abnormal parameters could be controlled by initial treatment with trilostane. Fifteen dogs with HAC were assessed by systolic blood pressure measurement, electrocardiography, Doppler echocardiography, serum concentration of troponin I, and biochemical and hemostatic profile at diagnosis and after trilostane therapy. Unlike biochemical parameters, hemostatic and cardiocirculatory parameters were not significantly influenced by the onset of treatment. The authors believe that clinical treatment with trilostane for 3 to 4 months might not be sufficient for the stabilization of cardiocirculatory abnormalities such as hypertension. Therefore, dogs with HAC must receive cardiocirculatory monitoring at diagnosis and during drug treatment.

Prenatal Diagnosis of Mucolipidosis Type II: Comparison of Biochemical and Molecular Analyses

  • Kosuga, Motomichi;Okada, Michiyo;Migita, Osuke;Tanaka, Toju;Sago, Haruhiko;Okuyama, Torayuki
    • Journal of mucopolysaccharidosis and rare diseases
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    • 제2권1호
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    • pp.19-22
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    • 2016
  • Purpose: Mucolipidosis type II (ML II), also known as I-cell disease is an autosomal recessive inherited disorder of lysosomal enzyme transport caused by a deficiency of the uridine diphosphate (UDP)-N-acetylglucosamine:lysosomal enzyme N-acetylglucosamine-1-phosphotransferase (GlcNAc-phosphotransferase). Clinical manifestations are skeletal abnormalities, mental retardation, cardiac disease, and respiratory complications. A severely and rapidity progressive clinical course leads to death before 10 years of age. Methods/Results: In this study we diagnosed three cases of prenatal ML II in two different at-risk families. We compared two procedures -biochemical analysis and molecular analysis - for the prenatal diagnosis of ML II. Both methods require an invasive procedure to obtain specimens for the diagnosis. Biochemical analysis requires obtaining cell cultures from amniotic fluid for more than two weeks, and would result in a late diagnosis at 19 to 22 weeks of gestation. Molecular genetic testing by direct sequence analysis is usually possible when mutations are confirmed in the proband. Molecular analysis has an advantage in that it can be performed during the first-trimester. Conclusion: Molecular diagnosis is a preferable method when a prompt decision is necessary.

당뇨병성 다발신경병증의 조기 진단에서 신경전도검사의 유용성에 관한 논란: 긍정적인 관점에서 (Controversies on the Usefulness of Nerve Conduction Study in the Early Diagnosis of Diabetic Polyneuropathy: Pros)

  • 권오현
    • Annals of Clinical Neurophysiology
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    • 제10권1호
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    • pp.29-32
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    • 2008
  • Although various criteria on the diagnosis of diabetic neuropathy are applied from trial to trial, being tailored in concert with its purpose, the utmost evidences of the diagnosis are subjective symptoms and objective signs of neurologic deficit. The application and interpretation of auxiliary electrophysiological test including nerve conduction study (NCS) should be made on the context of clinical pictures. The evaluation of the functions of small, thinly myelinated or unmyelinated nerve fibers has been increasingly stressed recently with the advent of newer techniques, e.g., measurement of intraepidermal fiber density, quantitative sensory testing, and autonomic function test. And the studies with those techniques have shed light to the nature of the evolution of diabetic neuropathy. The practical application of these techniques to the diagnosis of diabetic neuropathy in the individual patients, however, should be made cautiously due to several shortcomings: limited accessibility, wide overlapping zone between norm and abnormality with resultant unsatisfactory sensitivity and specificity, difficulty in performing subsequent tests, unproven quantitative correlation with clinical deficit, and invasiveness of some technique. NCS, as an extension of clinical examination, is still the most reliable electrophysiological test in evaluating neuropathy and gives the invaluable information about the nature of neuropathy, whereas the newer techniques need more refinement of the procedure and interpretation, and the accumulation of large scaled data of application to be considered as established diagnostic tools of peripheral neuropathy.

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