• Korean Journal of Radiology
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• 제23권2호
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• pp.280-288
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• 2022

Objective: To compare core needle biopsy (CNB) and repeat fine-needle aspiration (rFNA) to reduce the rate of diagnostic surgery and prevent unnecessary surgery in nodules initially diagnosed as atypia/follicular lesions of undetermined significance (AUS/FLUS). Materials and Methods: This study included 231 consecutive patients (150 female and 81 male; mean age ± standard deviation, 51.9 ± 11.7 years) with 235 thyroid nodules (≥ 1 cm) initially diagnosed as AUS/FLUS, who later underwent both rFNA and CNB. The nodules that required diagnostic surgery after the biopsy were defined using three different scenarios according to the rFNA and CNB results: criterion 1, surgery for low-risk indeterminate (categories I and III); criterion 2, surgery for high-risk indeterminate (categories IV and V); and criterion 3, surgery for all indeterminate nodules (categories I, III, IV, and V). We compared the expected rates of diagnostic surgery between CNB and rFNA in all 235 nodules using the three surgical criteria. In addition, the expected rates of unnecessary surgery (i.e., surgery for benign pathology) were compared in a subgroup of 182 nodules with available final diagnoses. Results: CNB showed significantly lower rates of nondiagnostic, AUS/FLUS, and suspicious for malignancy diagnoses (p ≤ 0.016) and higher rates of follicular neoplasm or suspicious for a follicular neoplasm (p < 0.001) and malignant diagnoses (p = 0.031). CNB showed a significantly lower expected rate of diagnostic surgery than rFNA for criterion 1 (29.8% vs. 48.1%, p < 0.001) and criterion 3 (46.4% vs. 55.3%, p = 0.029), and a significantly higher rate for criterion 2 (16.6% vs. 7.2%, p = 0.001). CNB showed a significantly lower expected rate of unnecessary surgery than rFNA for criterion 1 (18.7% vs. 29.7%, p = 0.024). Conclusion: CNB was superior to rFNA in reducing the rates of potential diagnostic surgery and unnecessary surgery for nodules initially diagnosed as AUS/FLUS in a scenario where nodules with low-risk indeterminate results (categories I and III) would undergo surgery.

• Korean Circulation Journal
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• 제54권7호
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• pp.382-394
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• 2024

Background and Objectives: Fractional flow reserve (FFR) is an invasive standard method to identify ischemia-causing coronary artery disease (CAD). With the advancement of technology, FFR can be noninvasively computed from coronary computed tomography angiography (CCTA). Recently, a novel simpler method has been developed to calculate onsite CCTA-derived FFR (CT-FFR) with a commercially available workstation. Methods: A total of 319 CAD patients who underwent CCTA, invasive coronary angiography, and FFR measurement were included. The primary outcome was the accuracy of CT-FFR for defining myocardial ischemia evaluated with an invasive FFR as a reference. The presence of ischemia was defined as FFR ≤0.80. Anatomical obstructive stenosis was defined as diameter stenosis on CCTA ≥50%, and the diagnostic performance of CT-FFR and CCTA stenosis for ischemia was compared. Results: Among participants (mean age 64.7±9.4 years, male 77.7%), mean FFR was 0.82±0.10, and 126 (39.5%) patients had an invasive FFR value of ≤0.80. The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of CT-FFR were 80.6% (95% confidence interval [CI], 80.5-80.7%), 88.1% (95% CI, 82.4-93.7%), 75.6% (95% CI, 69.6-81.7%), 70.3% (95% CI, 63.1-77.4%), and 90.7% (95% CI, 86.2-95.2%), respectively. CT-FFR had higher diagnostic accuracy (80.6% vs. 59.1%, p<0.001) and discriminant ability (area under the curve from receiver operating characteristic curve 0.86 vs. 0.64, p<0.001), compared with anatomical obstructive stenosis on CCTA. Conclusions: This novel CT-FFR obtained from an on-site workstation demonstrated clinically acceptable diagnostic performance and provided better diagnostic accuracy and discriminant ability for identifying hemodynamically significant lesions than CCTA alone.

• 한국광학회:학술대회논문집
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• 한국광학회 2009년도 동계학술발표회 논문집
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• pp.357-358
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• 2009

• 대한디지털의료영상학회논문지
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• 제9권1호
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• pp.7-15
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• 2007

고정식 초점형 격자가 적용된 비정질 실리콘 평판형 검출기에서 초점-격자간 중심변위와 두부 팬텀의 검출기내 위치 변위가 영상 특성에 미치는 영향을 조사하여, 디지털 의료영상 장비의 올바른 사용 방법을 제안하고자 한다. 고정식 초점형 격자를 적용한 비정질 실리콘 평판형 검출기에서 두부 팬텀을 사용하여 초점-격자간 중심 변위와 두부 팬텀의 위치 변위에 따라 영상을 획득 하였다. 획득된 영상을 NIH(Image J) 영상 분석 프로그램을 이용하여 동일 영역에서의 픽셀값(Pixel value), 히스토그램(Histogram), 도면형상(plot profile), 표면도(Surface plot)등을 분석하고, 표준 촬영 영상과 비교 하였다. 초점-격자간 측 방향 중심 변위와 초점-격자와 두부 팬텀의 이중 변위는 수평, 대각선으로 증가할수록 픽셀의 평균값과 표준편차값이 비례적으로 감소하였다. 또한 높은 픽셀값의 빈도수가 상당히 감소하여 영상의 대조도를 저하시켰고, 변위가 증가할수록 영상 왜곡현상도 증가하였다. 다음으로 두부 팬텀 위치 변위의 픽셀 평균값은 큰 변화가 없었으나 수평, 대각선으로 증가할수록 높은 픽셀값의 빈도수가 감소하는 양상을 보여 영상의 대조도가 저하 되었다. 디지털 검출기의 넓은 관용도와 후처리 능력은 영상의 화소 잡음이 증가하여도 방사선사들이 인지하지 못할 수 있다. 따라서 방사선사는 격자가 장착된 디지털 검출기에서 화소 잡음을 증가시키는 촬영 요인들을 정확히 인지하여 검사에 임해야 할 것이다.

• 한국산림과학회지
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• 제104권3호
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• pp.488-494
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• 2015

경영 표준진단표를 통해 재배자 스스로 경영 진단을 할 수 있도록 하고 이를 참고하여 임가 경영 개선에 도움이 되고자 떫은감 경영 표준진단표를 개발하여 주산단지의 임가를 대상으로 적용하였다. 떫은감 경영 표준진단표는 임가 일반 현황과 경영 성과 지표, 그리고 경영 진단을 위한 3개의 대분류 항목과 18개의 중분류 항목으로 구성되어 있다. 떫은감 경영 표준진단표 작성을 위해 떫은감 주산단지 10개 시 군 241임가의 경영 실태 조사를 실시하였으며 경영수준 진단을 위해서 18개 중분류 항목의 점수를 합산하여 총점을 산출하였다. 조사 결과 241임가의 평균 점수는 57.4점이었으며 전체 임가의 62%가 40점 이상 60점 미만에 해당하는 것으로 나타났다. 세부 진단항목 결과를 살펴보면 경영기반 지표에서는 나무높이 항목의 점수가 충남 지역에서만 평균 점수보다 현저히 낮은 점수를 나타냈는데 이는 조사 지역의 나무가 30년 이상 된 고령목들이 많아 영향을 준 것으로 생각된다. 생산기술 지표에서 결실조절 항목의 전국 평균 점수는 1.96점으로 상당히 낮은데 떫은감은 단감과 달리 적뢰 적과를 거의 하지 않고 자연 낙과를 통해 스스로 조절하는 경우가 많기 때문이다. 경영 및 판매능력 지표의 자재구입 항목에서는 전국 평균 점수가 2.01점으로 조사 임가의 60% 이상이 대부분의 자재를 개별적으로 선택하고 협상하여 구입한다고 응답하였다. 공동으로 구입한다고 응답한 임가들은 대부분 작목반 단체로 구입하는 경우인 것으로 나타났다.

• 인터넷정보학회논문지
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• 제8권2호
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• pp.67-76
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• 2007

SFPI 모듈은 $SFP-MSA^2$ 규격에 의해 A0 및 A2의 메모리 영역에 데이터들이 저장된다 본 논문에서는 공장 자동화를 위하여 프로그래밍 언어 중 AGILENT의 $VEE^3$를 이용하였으며, SFP모듈의 광학 특성 및 SFP-MSA 규정에 따라 Digital Diagnostic Monitoring Interface가 가능하도록 LD Driver IC 내부에 $RS232^4$ 통신을 이용하여 해당 레지스터 번지에 정확한 값을 입력하도록 프로그램을 설계하고 개발하여 생산현장에 적용하였으며 6-시그마 이상의 효율을 갖는 시스템을 구축하였다.

• 사상체질의학회지
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• 제24권3호
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• pp.1-16
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• 2012

Objectives For the methodological review on the accuracy study of questionnaire for Sasang constitution diagnosis, we searched the various diagnostic accuracy study of the questionnaires for Sasang constitution. Methods We searched MEDLINE, the Cochrane Library, KISS, and DBPIA. Additionally, We hand-searched the main oriental medical journals. All articles were independently reviewed and selected by two evaluators. And selected articles were assessed by "Quality Assessment of Diagnostic Accuracy Studies Tool"(QUADAS Tool) for the methodological review. Results The twenty eight studies initially identified studies were included in the methodological review. The part of "Acceptable reference standard", "Uninterpretable results reported" and "Withdrawals explained" was very weak in the risk of bias. The part of "Representative spectrum", "Acceptable delay between tests", "Incorporation avoided", "Reference standard results blinded", "Index test results blinded" was unclear in the description. Conclusions For the further study on the accuracy study of Sasang constitution diagnosis, we have to improve the aforementioned errors. Additionally, the checklist for the description of study might be needed.

• 대한한방체열의학회지
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• 제3권1호
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• pp.15-19
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• 2004

Cold hypersensitivity means a condition feeling cold at a temperature when one should not feel so. Cold hypersensitivity has been diagnosed based on the patient's subjective complaints. But these days, cold hypersensitivity can be diagnosed by the help of D.I.T.I.(Digital Infrared Thermal Imaging) This study is designed to verify the validity of diagnosis of cold hypersensitivity by D.I.T.I. Thermographic findings of 100 outpatients who visited the Kangnam Korean Hospital, KyungHee University, Seoul, Korea, from June 2000 to November 2000 were analyzed. The experimental group consisted of 50 patients who complained cold hypersensitivity, and for the control group, 50 patients who did not complain cold hypersensitivity. For the diagnosis of cold hypersensitivity of the hands, thermographic measurements were performed on two pairs of areas(palm-upper arm and back of hand-upper arm). And for that of the feet, other two pairs of areas(anterior thigh-top of the feet and posterior thigh-heel). When the criterion for thermal deviation between the palm and the upper arm was appointed as higher than $0.3^{\circ}C$, the sensitivity was 94.0% and the specificity, 90.0%. And when the criterion for that between the anterior thigh and the top of feet was appointed higher than $2.0^{\circ}C$, the sensitivity was 94.0% and the specificity, 76.0%. Through this study, the diagnostic standard for cold hypersensitivity of hands and feet could be presented.

• Journal of Digestive Cancer Research
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• 제9권2호
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• pp.57-59
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• 2021

Carcinoid tumor is called as neuroendocrine tumor and is classified into neuroendocrine tumor Grade 1, neuroendocrine tumor Grade 2, and neuroendocrine carcinoma based on the differentiation of tumors. Recently, the incidence of rectal carcinoid tumor has been increasing probably due to the increased interest on screening colonoscopy and the advancement of endoscopic imaging technology. As the rectal carcinoid shows a wide range of clinical characteristics such as metastasis and long-term prognosis depending on the size and histologic features, it is a challenge to give a consistent diagnostic code in patients with the rectal carcinoid. If the rectal carcinoid tumor is less than 1 cm in size, it can be given as the code of definite malignancy or the code of uncertain malignant potential according to International Classification of Diseases for Oncology (ICD-O) by World Health Organization (WHO). Because patients get different amount of benefit from the insurance company based on different diagnostic codes, this inconsistent coding system has caused a significant confusion in the clinical practice. In 2019, WHO updated ICD-O and Statistics Korea subsequently changed Korean Standard Classification of Diseases (KCD) including the code of rectal carcinoid tumors. This review will summarize what has been changed in recent ICD-O and KCD system regarding the rectal carcinoid tumor and surmise its clinical implication.

• Asian Pacific Journal of Cancer Prevention
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• 제15권22호
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• pp.10039-10043
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• 2014

Background: In Pakistan thyroid cancer is responsible for 1.2% cases of all malignant tumors. Ultrasonography (US) is helpful in detecting cancerous thyroid nodules on basis of different features like echogenicity, margins, microcalcifications, size, shape and abnormal neck lymph nodes. We therefore aimed to calculate diagnostic accuracy of ultrasound in detection of carcinoma in thyroid nodules taking fine needle aspiration cytology as the reference standard. Materials and Methods: A cross-sectional analytical study was designed to prospectively collect data from December 2010 till December 2012 from the Department of Radiology in Aga Khan University Hospital, Karachi, Pakistan. A total of 100 patients of both genders were enrolled after informed consent via applying non-probability consecutive sampling technique. Patients referred to Radiology department of Aga Khan University to perform thyroid ultrasound followed by fine-needle aspiration cytology of thyroid nodules were included. They were excluded if proven for thyroid malignancy or if their US or FNAC was conducted outside our institution. Results: The subjects comprised 76 (76%) females and 24 males. Mean age was $41.8{\pm}SD$ 12.3 years. Sensitivity and specificity with 95%CI of ultrasound in differentiating malignant thyroid nodule from benign thyroid nodule calculated to be 91.7% (95%CI, 0.72-0.98) and 78.94% (0.68-0.87) respectively. Reported positive predictive value and negative PV were 57.9% (0.41-0.73) and 96.8% (0.88-0.99) and overall accuracy was 82%. Likelihood ratio (LR) positive was computed to be 4.3 and LR negative was 0.1. Conclusions: Ultrasonography has a high diagnostic accuracy in detecting malignancy in thyroid nodules on the basis of features like echogenicity, margins, micro calcifications and shape.