• Title/Summary/Keyword: Diagnosis agreement

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When Should Familial Hypercholesterolemia Be Suspected?: A Case of Dyslipidemia in Young Patient without Coronary Artery Disease (가족성 고콜레스테롤혈증은 언제 의심해야 할까?: 관상동맥 질환이 없는 젊은 이상지질혈증 환자 증례)

  • In Sun Ryou
    • Archives of Obesity and Metabolism
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    • v.2 no.1
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    • pp.29-35
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    • 2023
  • Familial hypercholesterolemia (FH) is a genetic disease that is not well known or diagnosed in Korea. This disease is associated with persistently high levels of low-density lipoprotein cholesterol (LDL-C), which increase the risk of coronary artery disease at a young age. Therefore, early diagnosis and treatment are important; however, there are no global consensus diagnostic criteria. In Korea, the Dutch Lipid Clinic Network diagnostic criteria, and the Simon Broome diagnostic criteria were used for diagnosis of FH according to the agreement announced at the Korean Society of Lipid and Atherosclerosis (KSoLA) in 2022. Recently, the absence of coronary artery calcification has been considered a good prognostic factor, even among patients with very high LDL-C levels who are considered to be at high risk for atherosclerotic cardiovascular disease. We describe throughout this paper the diagnosis and treatment of FH in a young male without coronary artery calcification.

Research of Yinyanmaisihou(陰陽脈死候) in medical books from Mawangdui Han dynasty tomb (마왕퇴(馬王堆) 출토(出土) 의서(醫書) 중(中) 《음양맥사후(陰陽脈死候)》에 관(關)한 연구(硏究))

  • Jung, Yong-rae;Hwang, Min-seob;Jo, Hyun-seog;Lee, Seong-deog;Kim, Kyung-ho;Yoon, Jong-hwa;Kim, Gap-sung
    • Journal of Acupuncture Research
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    • v.21 no.2
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    • pp.261-274
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    • 2004
  • Object : In this thesis we researched the transformation of five symptoms of final life stage from ${\ll}$Sumun(素問)${\gg}$, ${\ll}$Yingshu(靈樞)${\gg}$ and ${\ll}$Nanjing(難經)${\gg}$ and pulse diagnosis method. Method : We studied medical books from Mawangdui Han dynasty tomb Results and Conclusion : 1. The symptoms of final life stage according to Yinyanmaisihou(陰陽脈死候) is suggested by observation of symptoms introducting Yinyan five-elements theory. 2. The symptoms of final life stage according to Yinyanmaisihou(陰陽脈死候) and "Qijue(氣絶)" from ${\ll}$Lingshu(靈樞) Jingmai(經脈)${\gg}$ made use of twelve merdian bian(遍) diagnosis method and ${\ll}$Lingshu(靈樞) Zongshi(終始)${\gg}$, ${\ll}$Sumun(素問) Zhenyaojingzhonglun(診要經終論)${\gg}$ made use of twelve merdian biaoben(標本) diagnosis method. Afterward oriental medical biology which suggests agreement between outside and inside symptoms needs to be examined by use of science and medical theory to apply medical treatment .

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Accuracy of the 2008 Simplified Criteria for the Diagnosis of Autoimmune Hepatitis in Children

  • Arcos-Machancoses, Jose Vicente;Busoms, Cristina Molera;Tatis, Ecaterina Julio;Bovo, Maria Victoria;Bernabeu, Jesus Quintero;Goni, Javier Juamperez;Martinez, Vanessa Crujeiras;Martin de Carpi, Javier
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.2
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    • pp.118-126
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    • 2018
  • Purpose: Classical criteria for diagnosis of autoimmune hepatitis (AIH) are intended as research tool and are difficult to apply at patient's bedside. We aimed to study the accuracy of simplified criteria and the concordance with the expert diagnosis based on the original criteria. Methods: A cohort of children under study for liver disorder was selected through consecutive sampling to obtain the prevalence of AIH within the group of differential diagnoses. AIH was defined, based on classical criteria, through committee review of medical reports. Validity indicators of the simplified criteria were obtained in an intention to diagnose approach. Optimal cut-off and the area under the receiver operating characteristic (ROC) curve were calculated. Results: Out of 212 cases reviewed, 47.2% were AIH. For the optimal cut-off (6 points), the simplified criteria showed a sensitivity of 72.0% and a specificity of 96.4%, with a 94.7% positive and a 79.4% negative predictive value. The area under the ROC curve was 94.3%. There was a good agreement in the pre-treatment concordance between the classical and the simplified criteria (kappa index, 0.775). Conclusion: Simplified criteria provide a moderate sensitivity for the diagnosis of AIH, but may help in indicating treatment in cases under suspicion with 6 or more points.

A Study on Estimating Real-time Thermal Load During GHP Operation in Heating Mode (GHP 난방 모드 운전시 실시간 부하 추정방법에 관한 연구)

  • Seo, Jeong-A;Shin, Young-Gy;Oh, Se-Je;Jeong, Sang-Duck;Ji, Kyoung-Chul;Jeong, Jin-Hee
    • Korean Journal of Air-Conditioning and Refrigeration Engineering
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    • v.23 no.1
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    • pp.32-37
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    • 2011
  • The present study has been conducted to propose an algorithm regarding real-time load estimation of a gas engine-driven heat pump. In the study, thermal load of an indoor unit is estimated in terms of air-side and refrigerant-side. The air-side estimation is based on a typical heat exchanger model and is found to be in good agreement with experimental data. When it comes to the refrigerant-side load, a pressure difference across a valve must be estimated. For the estimation, it is assumed to be proportional to a bigger pressure difference that is available either by measurement or by estimation. Relative good agreement between the air- and refrigerant-sides suggests that the assumption may be plausible for the load estimation. The summed flow rate of all of indoor units is in good agreement with the throughput of the compressor which are calculated from the manufacturer's software. Accordingly, estimated thermal loads are also in good agreement. The proposed algorithm may be further developed for improved control algorithm and fault diagnosis.

Important Items Extracted through the Questionnaire of Cold and Heat Pattern Identification by the Experts' Agreement (전문가의 일치도를 통해 알아본 중요 한증, 열증 지표)

  • Bae, Kwang Ho;Park, Ki Hyun;Lee, Young Seop;Jang, Eun Su
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.30 no.6
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    • pp.466-473
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    • 2016
  • This study intended to find out the most substantial items in cold and heat pattern identification(CHPI) questionnaire based on usual symptoms through CHPI diagnosis and evaluation by experts. 120 participants, faculties of OO university, filled out CHPI questionnaire based on usual symptoms by the way of self-reporting. Then 2 Korean Medicine doctors independently diagnosed them whether they belonged to cold pattern identification(PI) or heat PI, and scored the result of it. Pearson correlation of 2 experts was 0.649 in cold PI and 0.605 in heat PI. Agreement was 75.8%(Kappa value 0.516) in cold PI and 74.2%(Kappa value 0.465) in heat PI. Pearson correlation of 2 experts was 0.649 in cold PI and 0.605 in heat PI. Agreement between two experts was 75.8%(Kappa value 0.516) in cold PI and 74.2%(Kappa value 0.465) in heat PI. Items of high correlation with experts' evaluation followed next: "do not usually like the cold", "usually like the warm", "usually feel cold" in cold PI and "do not usually like the hot", "usually feel hot", "usually feel burning sensation in the body" in heat PI. We could infer from that facts that experts give weight on 'subjective feeling of cold or heat in participants body' and 'preference on sensation of cold and heat'. We also expect this study to be an epidemiological foundation to disclose correlation between usual CHPI and diseases.

Medical Image Processing with Local Variati on of the Image Quality (화질의 국소적 변화를 고려한 의용화상처리)

  • 홍승홍
    • Journal of the Korean Institute of Telematics and Electronics
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    • v.12 no.1
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    • pp.1-6
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    • 1975
  • The boundary has been one of the most important information in radiographic images and the degrees of difficulty involved varies greatly with the quality of the picture. These Buantifications are the means to diagnoses. The purpose of this paper is to quantify intensity variation and the threshold decision which is based on statistical principles and is developed to detect limits in liver scintigrams the entire picture is devide4 into 64 small regions. The kurtosis and variances for each smal region are used as indications to select the histograms the thresholds are computed according to the method o(maximum likelihood which minimizes the probability o( misclassification. Therefore Ive have demonstrated the applicability of the boundary detection and proved good agreement with human recognition, and we can use it for the diagnosis data of liver disease.

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Development Cut-off Value for Yin-deficiency Questionnaire and Diagnostic Ability of Yin-deficiency in Xerostomia (구강건조증 환자에서 음허 측정 설문지 절단점 개발 및 진단능 평가)

  • Jang, Seung-Won;Kim, Jin-Sung
    • The Journal of Internal Korean Medicine
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    • v.35 no.4
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    • pp.483-497
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    • 2014
  • Objectives: The aims of study were developing cut-off value of Yin-deficiency questionnaire (YDQ) for diagnosis of Yin-deficiency (YD) and compare diagnostic ability between YDQ and Yin-deficiency scale score (YDS) in xerostomia patients. Methods: We recruited 58 xerostomia patients. They were diagnosed YD or non-YD by 3 Korean medicine doctors (KMD). We assessed YD using YDQ and YDS. We evaluated xerostomia using VAS, Dry Mouth Symptom Questionnaire (DMSQ), Salivary Flow Rate (SFR), oral moisture on buccal mucosa and tongue surface (OMB and OMT). We surveyed tongue coatings using Winkel Tongue Coating Index (WTCI). Results: We diagnosed 23 patients YD and 35 patients non-YD. There were no significant differences of age, sex and body mass index between the YD and non-YD groups. Using receiver operating characteristic curve analysis, the optimal cut-off value of YDQ was defined as 304. Sensitivity, specificity and Youden index of YDQ were 86.96%, 71.43% and 1.5839 respectively. Using Cohen's coefficient of agreement, we found that degree of agreement between KMD and YDQ diagnosis was moderate (${\kappa}$=0.524, p<0.001). Using Pearson's correlation analysis, we found concurrent validity of YDQ and YDS were significant correlated. Using area under curve value, we found diagnostic ability between YDQ and YDS were not significantly different (p=0.505), but there were more strong correlations between DMSQ-symptoms and YDQ (r=0.731, p<0.001) than correlations between DMSQ-symptoms and YDS (r=0.418, p<0.01). Conclusions: The cut-off value of YDQ can diagnose YD in xerostomia and diagnostic ability of YDQ in xerostomia is better than YDS.

Convergence of the Image Evaluation by BI-RADS Classification in Accordance with Algorithms in DR Mammography (디지털 유방촬영술에서 BI-RADS의 구분에 따른 알고리즘별 영상의 융복합적 평가)

  • Lee, Mi-Hwa
    • Journal of Digital Convergence
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    • v.13 no.9
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    • pp.489-495
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    • 2015
  • Image availability evaluated by the degree of agreement and sensitive using the process improve visualization according to the Algorithm modification in Image Post-Processing. Reliability measured by the Breast Imaging Reporting and Data System. 172 patients visit same period divided by BI-RADS, category five stages, and contents of breast parenchyma into Calcification, Nodule and Mass. Evaluated the TE/PV image reliability, visualization sensitive, agreement of diagnosis. Convergence analysis was an in various fields. According to the result of this research, PV has higher sensitive and accuracy about lesions than TE visual and there is a difference insensitive by contents of breast parenchyma. Therefore, practical use of Algorithm Modification(Tissue Equalization: TE, Premium View: PV) is expected to improve more accurate, useful diagnosis, which has not been easy until now.

The Korean version of Eating Disorder Diagnostic Scale DSM-5 (K-EDDS DSM-5) : A Reliability and Validity Study (한국판 DSM-5 섭식장애진단척도(Korean version of the Eating Disorder Diagnostic Scale DSM-5, K-EDDS DSM-5) : 신뢰도와 타당도 연구)

  • Bang, Eun Byul;Han, Cho Long;Joen, Yae Lim;Kim, Youl-Ri
    • Anxiety and mood
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    • v.14 no.2
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    • pp.127-134
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    • 2018
  • Objective : The aim of this study was to examine the psychometric features of the Korean version of the Eating Disorder Diagnostic Scale-the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (K-EDDS DSM-5). Methods : A total of 72 patients diagnosed with eating disorders participated in the study. The diagnosis was based on the Korean version of the Eating Disorder Examination (KEDE) interview. All participants completed the K-EDDS and the Eating Disorder Examination Questionnaire version 6.0 (EDE-Q 6.0) for this study. The psychometric features of the K-EDDS were examined using exploratory factor analysis, convergent validity of agreement between the K-EDDS and the KEDE, and internal consistency. Results : The exploratory factor analysis initially extracted 6-factor structures which were reconstructed into 4 factors of body dissatisfaction, binge behavior, binge frequency, and compensatory behavior based on appropriateness of the items. The internal consistency of the K-EDDS was fairly acceptable (Cronbach's alpha=0.72). The diagnostic agreement between the K-EDDS and the KEDE was high (98.61%). The 4 factors of the K-EDDS showed significant correlation with the 4 subscales of the EDE-Q 6.0. Conclusion : Our data suggests that the K-EDDS is a reliable and valid tool for the diagnosis of eating disorders based on the DSM-5.

Interobserver Reproducibility of Segmental Scoring of $^{99m}Tc$-MIBI Myocardial SPECT ($^{99m}Tc$-MIBI 심근 SPECT의 분절 육안 분석시 판독자간의 일치도)

  • Yeo, Jeong-Seok;Lee, Dong-Soo;Lee, Kyung-Han;Kim, Jong-Ho;Shon, Kyung-Soo;Cho, Sung-Wook;Kwark, Cheol-Eun;Chung, June-Key;Lee, Myung-Chul;Seo, Jeong-Don;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.3
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    • pp.317-325
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    • 1994
  • The accuracy of dipyridamole stress/rest $^{99m}Tc$-MIBI myocardial imaging for detection of ischemia depends on reproducible image interpretation. To evaluate the reproducibility of visual assessment, agreement in interpretation among two independent observers, blind-ed to clinical data, was evaluated in SPECT images of 131 patients (94 males, 38 females; mean age $58{\pm}7yr$) with suspected coronary artery disease who underwent both dipyridamole stress/rest $^{99m}Tc$-MIBI myocardial SPECT and coronary angiography. The left ventricle was divided into twenty-nine segments in stress and rest SPECT images and each segment was visually graded according to a five-point scale (segmental score : 0=normal, 1=equivocal, 2=mild decrease, 3=severe decrease and 4=absent uptake). Overall concordance of segmental scoring between the two observers was 80%. The Pear-son's correlation coefficient (r) of the segmental scores for stress and rest images were 0.67 and 0.65, respectively, while the difference in score between the two images showed a correlation of 0.45 (all p<0.001). Agreement between two observers in final SPECT diagnosis as absence or presence of disease was 93%. The degree of agreement in segmental scoring showed no difference between patients with or without agreement as to the presence of disease. Therefore it appeared that cases with inconcordant diagnosis between the 2 observers were mainly due to a difference in individual threshold for interpretating the significance of a particular decreased uptake area rather than to a difference in perceiving the degree of the hypoactivity Thus, establishment of individual optimum thresholds in visual interpretation of myocardial SPECT may be helpful to improve reproducibility and accuracy of scan diagnosis.

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