• The Korean Journal of Pain
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• v.14 no.1
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• pp.26-31
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• 2001

Background: Sympathetic blocks with local anesthetics are used to differentiate sympathetically- maintained pain (SMP) from sympathetically-independent pain (SIP). However, systemic lidocaine is also used in the management of neuropathic pain. Therefore, there may be possibility of a false positive response in relieving their pain by systemic absorption of lidocaine following a diagnostic sympathetic block in patients with SIP. In this study, we measured the plasma lidocaine concentrations after a stellate ganglion block (SGB) using three volumes of 1% lidocaine. Methods: This prospective, crossover study was performed in 3 patients who experience sudden hearing loss and in 4 volunteers. Each person received SGB three times using three different volumes (6 ml, 12 ml and 16 ml) of 1% lidocaine at one week intervals. SGB was performed using a 23 G butterfly needle via a paratracheal approach by two persons. Two ml of venous blood was obtained from a prepared contra-lateral sided venous route at 1, 3, 5, 7, 10, 20 and 60 min after SGB. Plasma lidocaine level was analyzed by immunoassay. Results: Mean plasma lidocaine concentrations correlated well with the volumes of 1% lidocaine used in SGB; larger volumes showed higher concentrations (P < 0.01). Mean peak plasma concentrations were $1.08{\pm}0.18$ in 6 ml, $1.90{\pm}0.47$ in the 12 ml and $2.74{\pm}0.67{\mu}g/ml$ in the 16 ml groups (P < 0.01). The mean time to reach peak plasma concentration was not significantly different between the three groups. Conclusions: The peak plasma lidocaine concentrations in SGB using large volume were found to be similar to that of IV lidocaine infusion in the management of neuropathic pain. These data suggest that diagnostic sympathetic block may result in many false positive responses for SMP. Part of its effect may be related to systemic local anesthetic absorption and not to a sympathetic block. Therefore, physicians may be required to use optimal volumes and minimal concentration of local anesthetic in diagnostic sympathetic block procedures and also make a careful assessment of the performance of a permanent sympathetic block.

• Imaging Science in Dentistry
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• v.47 no.4
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• pp.233-239
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• 2017

Purpose: This study was performed to quantify the repeat rate of imaging acquisitions based on different clinical examinations, and to assess the prevalence of error types in intraoral bitewing and periapical imaging using a digital complementary metal-oxide-semiconductor(CMOS) intraoral sensor. Materials and Methods: A total of 8,030 intraoral images were retrospectively collected from 3 groups of undergraduate clinical dental students. The type of examination, stage of the procedure, and reasons for repetition were analysed and recorded. The repeat rate was calculated as the total number of repeated images divided by the total number of examinations. The weighted Cohen's kappa for inter- and intra-observer agreement was used after calibration and prior to image analysis. Results: The overall repeat rate on intraoral periapical images was 34.4%. A total of 1,978 repeated periapical images were from endodontic assessment, which included working length estimation (WLE), trial gutta-percha (tGP), obturation, and removal of gutta-percha (rGP). In the endodontic imaging, the highest repeat rate was from WLE (51.9%) followed by tGP (48.5%), obturation (42.2%), and rGP (35.6%). In bitewing images, the repeat rate was 15.1% and poor angulation was identified as the most common cause of error. A substantial level of intra- and inter-observer agreement was achieved. Conclusion: The repeat rates in this study were relatively high, especially for certain clinical procedures, warranting training in optimization techniques and radiation protection. Repeat analysis should be performed from time to time to enhance quality assurance and hence deliver high-quality health services to patients

• Imaging Science in Dentistry
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• v.44 no.4
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• pp.301-305
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• 2014

Purpose: The purpose of this study was to compare the accuracy of postoperative maxillary cyst (POMC) diagnosis by panoramic radiographs versus computed tomography (CT) and by oral and maxillofacial radiologists versus non-specialists. Materials and Methods: Sixty-five maxillary sinuses with POMCs and 63 without any lesion were assessed using panoramic radiographs and CT images by five oral and maxillofacial radiologists and five non-specialists on a five-point scale. The areas under receiver operating characteristic (ROC) curves were analyzed to determine the differences in diagnostic accuracy between the two imaging modalities and between the two groups of observers. The intra-observer agreement was determined, too. Results: The diagnostic accuracy of CT images was higher than that of panoramic radiographs in both groups of observers (p<0.05). The diagnostic accuracy of oral and maxillofacial radiologists for each method was higher than that of non-specialists (p<0.05). Conclusion: The use of CT improves the diagnosis of POMC, and radiological training and experience leads to more accurate evaluation.

• Journal of Korean Neurosurgical Society
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• v.52 no.5
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• pp.472-475
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• 2012

Objective : The aim of this study is to establish the value of hand elevation test as a reproducible provocative test for the diagnosis of carpal tunnel syndrome (CTS). Methods : We had a prospective study of 45 hands of 38 patients diagnosed with CTS between April 2005 and February 2009. The diagnosis of CTS was based on the American Academy of Neurology clinical diagnostic criteria. Experimental and control group patients underwent Tinel's test, Phalen's test, carpal compression test and hand elevation test as provocative tests for CTS. Results : We used chi-square analysis to compare Tinel's test and Phalen's test, carpal compression test with hand elevation test. The sensitivity and specificity of the hand elevation test is 86.7% and 88.9% each. Tinel's test had 82.2% sensitivity and 88.9% specificity. Phalen's test had 84.4% sensitivity and 86.7% specificity. Carpal compression test had 84.4% sensitivity 82.2% specificity. Comparisons of sensitivity and specificity between hand elevation test and Tinel's test, Phalen's test, and carpal compression test had no statistically significant differences. To compare the diagnostic accuracies of four tests, the area under the non-parametric receiver operating character curve was applied. Conclusion : The hand elevation test has higher sensitivity and specificity than Tinel's test, Phalen's test, and carpal compression test. Chi-square statistical analysis confirms the hand elevation test is not ineffective campared with Tinel's test, Phalen's test, and carpal compression test.

• Imaging Science in Dentistry
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• v.31 no.1
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• pp.51-55
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• 2001

Purpose : This study was performed to compare the diagnostic ability of conventional intraoral radiographs with that of digital subtraction image and to assess the quantifying ability of digital subtraction image for simulated apical root resorption Materials and Methods : Conventional intraoral radiographs and digital images of ten sound maxillary central incisors and those with simulated apical root resorption were taken with varying horizontal and vertical angulations of the x-ray beam. The diagnostic accuracy to detect the lesion was evaluated on conventional intraoral radiographs and digital subtraction images by ROC analysis. The amount of simulated apical root resorption was also estimated on the reconstruction images by Emago/sup (R)/ and compared with actual amount of tooth loss using paired t-test. Results: The diagnostic accuracy of conventional intraoral radiographs to detect the apical root resorption was low (ROC area = 0.6446), and the sensitivity and the specificity of digital subtraction images were 100%, respectively. The calculated amounts of apical root resorption showed no statistically significant difference with the actual amounts of the lesion (p>0.05). Conclusion: Digital subtraction radiography is powerful tool to detect the small apical root resorption, and quantitative analysis of small amounts of the lesion can be evaluated by digital subtraction radiography.

• Journal of the Korean Institute of Illuminating and Electrical Installation Engineers
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• v.23 no.6
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• pp.104-108
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• 2009

The insulation aging characteristics and structural analysis test were performed to analyze the correlations among the insulation deterioration, diagnostic results and the breakdown strength for the underground power cables. From the results of the degree of crosslinking test, hot-oil test etc., it could be confirmed that there were no manufacturing defects in the power cables under test. From the results of the water tree test and chemical structural analysis, it could be confirmed that the aging status of cable under test were very poor, especially for B-Phase and the degree of aging was increased in the orders of A, C and B-phase. From the above results, it could be concluded that the insulation aging characteristic analysis results were well consistent with the diagnostic and breakdown test results, and also confirmed that the diagnostic system under consideration was successful to discriminate the bad cables which is likely to cause cable system failure.

• Journal of the Korean Society of Radiology
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• v.12 no.7
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• pp.807-812
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• 2018

In this study, we investigated the conditions used in setting the recommendation level of general radiography diagnostic reference and tried to evaluate the effective dose and biological evaluation using PCXMC v2.0 program. As a result based on the effective dose of male in ICRP 60, the highest Pelvis AP was 0.794 mSv. The lowest Chest PA was 0.050 mSv. In the case of ICRP 103, the highest T-Spine AP was 0.906 mSv The lowest Chest PA was 0.052 mSv. For 40 years old male and female adults, effective doses of general radiography were evaluated and even if the medical exposures are not subject to the limit of dose, efforts should be made to reduce the medical exposures of the people by keeping the dose below the recommended amount in order to minimize the probable effect of radiation hazard.

• Journal of Yeungnam Medical Science
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• v.36 no.3
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• pp.231-240
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• 2019

Background: We sought to determine the value of combining diffusion-weighted (DW) and perfusion-weighted (PW) sequences with a conventional magnetic resonance (MR) sequence to assess solid components of borderline ovarian tumors (BOTs) and stage I carcinomas. Methods: Conventional, DW, and PW sequences in the tumor imaging studies of 70 patients (BOTs, n=38; stage I carcinomas, n=32) who underwent surgery with pathologic correlation were assessed. Two independent radiologists calculated the parameters apparent diffusion coefficient (ADC), $K^{trans}$ (vessel permeability), and $V_e$ (cell density) for the solid components. The distribution on conventional MR sequence and mean, standard deviation, and 95% confidence interval of each DW and PW parameter were calculated. The inter-observer agreement among the two radiologists was assessed. Area under the receiver operating characteristic curve (AUC) and multivariate logistic regression were performed to compare the effectiveness of DW and PW sequences for average values and to characterize the diagnostic performance of combined DW and PW sequences. Results: There were excellent agreements for DW and PW parameters between radiologists. The distributions of ADC, $K^{trans}$, and $V_e$ values were significantly different between BOTs and stage I carcinomas, yielding AUCs of 0.58 and 0.68, 0.78 and 0.82, and 0.70 and 0.72, respectively, with ADC yielding the lowest diagnostic performance. The AUCs of the DW, PW, and combined PW and DW sequences were $0.71{\pm}0.05$, $0.80{\pm}0.05$, and $0.85{\pm}0.05$, respectively. Conclusion: Combining PW and DW sequences to a conventional sequence potentially improves the diagnostic accuracy in the differentiation of BOTs and stage I carcinomas.

• Journal of Korean Medicine for Obesity Research
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• v.18 no.2
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• pp.144-151
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• 2018

Objectives: The purpose of this study is to evaluate the quality of case reports of the Journal of Korean Medicine for Obesity Research by the Case Report (CARE) guidelines. Methods: Case reports published in the Journal of Korean Medicine for Obesity Research from January 2013 to July 2018 were searched from Oriental Medicine Advanced Searching Integrated System (OASIS). We assessed the quality of reporting based on CARE guidelines. Results: A total of 8 case reports were finally included for the assessment. There was a deviation in the sub-item reporting rate by a maximum 75% and a minimum 57.14% in case reports. The 10 sub-items mentioned below, such as 'Timeline', 'Diagnostic challenges', 'Diagnostic reasoning including other diagnoses considered', 'Prognostic characteristics', 'Changes in intervention', 'Important follow-up diagnostic evaluations and other test results', 'Intervention adherence and tolerability', 'Adverse and unanticipated events', 'Patient perspective' and 'Informed consent' were reported below 30%. Conclusions: Efforts to diversify the subject of the case study and to apply appropriate reporting guidelines are needed to improve the quality of the case report contributed to the Journal of Korean Medicine for Obesity Research.

• Journal of Sasang Constitutional Medicine
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• v.32 no.4
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• pp.45-64
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• 2020

Purpose This study was to develop and study 'Diagnostic Index for the Ordinary Symptom of Soyangin'. Methods The main diagnosis and evaluation index symptoms of Soyangin were extracted based on 『Donguisusebowon』 and Clinical Practice Guidelines for Sasang Constitutional Medicine Symptomatology; CPG for soyangin. The selected ordinary symptoms were divided into 4 categories such as Exterior-Cold ordinary symptom (表寒素證), Exterior-Disease unfavorable's ordinary symptom (表病逆證素證), Interior-Heat ordinary symptom (裏熱素證), Interior-Disease unfavorable's ordinary symptom (裏病逆證素證) of Soyangin and translated into Korean. And the inclusion, importance and translation validity of major diagnosis and assessment indicators of Soyangin were surveyed online by a group of Sasang constitutional experts. Results & Conclusions 29 ordinary symptoms and pathological mechanism were selected from references and translated into 51 Korean symptoms. After inclusion yes or no survey by expert group, 45 symptoms were selected. The importance survey showed that 'Have a soft stool' of Exterior-Cold ordinary symptom indication, '(If you're stressed, if you're not in good health) Have a soft stool or diarrhea' of Exterior-Disease unfavorable's ordinary symptom, 'The feces harden easily' of Interior-Heat ordinary symptom and '(If you're stressed, if you're not in good health) Have an upset stomach' of Interior-Disease unfavorable's ordinary symptom were the most important. Finally, [Diagnostic Index for the Ordinary Symptom of Soyangin] was completed after survey of translation validity, reflection of individual opinions by the expert committee, and application of weighted value calculated from the importance survey.