• Title/Summary/Keyword: Diagnostic usefulness

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The Usefulness of Fine Needle Aspiration Cytology of Bone Lesions (골 병변에서 세침흡인 세포검사의 유용성)

  • Kim, Bohng-Hee;Gong, Gyung-Yub
    • The Korean Journal of Cytopathology
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    • v.13 no.2
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    • pp.51-59
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    • 2002
  • To determine the usefulness on fine needle aspiration cytology(FNAC) of bone lesions and the complementary role of FNAC and percutaneous needle biopsy, 75 cases of FNAC taken from bone lesions were analyzed. Correlations with histopathology were possible in 47 cases, including 14 cases of simultaneous core biopsy and 33 cases of subsequent open biopsy due to inadequate aspirates. Among 75 cases, 4 cases were benign tumors and tumor-like lesion, 11 cases were malignant primary bone tumors, 17 cases were metastatic tumors, and 43 cases were nonneoplastic bone lesions. The aspirates were adequate in 35 cases(46.7%), in all of which the discrimination between benignancy and malignancy was possible. The main reason for Inadequate aspirates was due to hypocellularity. In the cases of aspiration and core biopsy simultaneously done, the diagnostic accuracy of aspiration, core biopsy, and both were 57%(8/14), 78.6%(11/14), and 92.9%(13/14), respectively. We conclude that a final diagnosis based on cytology is possible with the adequate aspirates and the clinical and radiological findings. Also we confirm the complementary role between FNAC and core biopsy in bone lesions.

Controversies in Usefulness of EEG for Clinical Decision in Epilepsy: Cons. (간질 치료에서 뇌파의 임상적 유용성에 관한 논란: 부정적 관점에서)

  • Lee, Seo-Young;Lee, Sang-Kun;Kim, Nam Hee
    • Annals of Clinical Neurophysiology
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    • v.9 no.2
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    • pp.69-74
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    • 2007
  • Electroencephalogram (EEG) is a representative diagnostic tool in epilepsy. However, there are several points of debate on the role of EEG in diagnosis and management of epilepsy. We suggest that EEG has some limitations for differential diagnosis from nonepileptic episodic diseases, classification of epilepsy, prediction of recurrence, and evaluation of treatment response. Interictal EEG cannot diagnose or exclude epilepsy because interictal epileptic discharge (IED) is frequently absent in epilepsy and can appear in nonepileptic conditions. Although EEG is helpful in classification of epilepsy, focal spikes in generalized epilepsy and secondary bilateral synchrony in localization related epilepsy cause interrater disagreement. It is controversial whether EEG predicts recurrence after the first seizure in adults. The predictive value of EEG in antiepileptic drug (AED) withdrawal is not absolute. The prognosis after AED withdrawal depends on epilepsy syndrome. Many studies could not confirm the value of EEG in assessing the treatment response. After all, epilepsy is clinically diagnosed and assessed. Interictal EEG alone does not provide decisive information and routine follow-up of EEG is not recommended.

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The Usefulness of Three-Dimensional Imaging with Spiral CT for Evaluation of the Upper Airway Lesions (상부기도병변의 평가에 있어 나선식컴퓨터단층촬영술을 이용한 3차원적 영상의 유용성)

  • 김진환;김현웅;소상훈;노영수;임현준;윤대영
    • Korean Journal of Bronchoesophagology
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    • v.4 no.1
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    • pp.43-51
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    • 1998
  • Background: Three-dementional imaging with spiral CT(3D spiral CT) is a well established imaging modality which has been investigated in various clinical settings. However the 3D spiral CT in upper airway disease is rarely reported and its results are still obscure. Objectives: To access the usefulness of 3D spiral CT imaging in patients with upper airway diseases. Materials and Methods We performed 3D spiral CT in fourteen patients In whom upper airway diseases were clinically suspected. Nine of these patients had upper airway stenosis, two had laryngeal cartilage fracture, and three had laryngo-hypopharyngeal cancer. For evaluation of location and extent of the lesions, we compared the findings of 3D imaging with those of air tracheogram, conventional 2D CT images, endoscopic and operative findings. Results: In case of stenosis, 3D spiral CT provide significant useful information, particularly the site and length of the stenotic segment. But, it was difficult to define the fracture of the laryngeal framework and to detect the cartilagenous invasion by head and neck cancer using the 3D imaging. Conclusion : The 3D spiral CT was an useful adjunctive method to assess some kind of upper airway disease but not in others. So, we should compare the findings of 3D images with those of other diagnostic tools for accurate diagnosis of the upper airway disease.

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The Usefulness of Whole-blood Interferon-gamma Release Assay for the Diagnosis of Extra-pulmonary Tuberculosis (폐외 결핵에서 전혈 인터페론 감마 측정법의 진단적 유용성)

  • Lee, Hye-Min;Cho, Sung Gun;Kang, Hyung Koo;Park, Sung Woon;Lee, Byung Ook;Lee, Jae Hee;Jeon, Eun Ju;Choi, Jae Chol
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.4
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    • pp.331-337
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    • 2009
  • Background: The whole-blood interferon-gamma release assay (QuantiFERON-TB Gold [QFT-G]: Cellestis, Carnegie, Victoria, Australia) has been studied primarily for the use of diagnosing active pulmonary tuberculosis (TB) or latent TB. In the present study, the usefulness of QFT-G was evaluated for the diagnosis of extra-pulmonary tuberculosis (EP-TB). Methods: From June 2006 to February 2009, we evaluated the usefulness of QFT-G in patients (n=65) suspected with EP-TB, retrospectively. The diagnostic sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the QFT-G assay were analyzed. Results: EP-TB was diagnosed in 33 (51%) participants. The overall sensitivity, specificity, PPV, and NPV of the QFT-G assay for EP-TB were 78%, 79%, 81%, and 77%, respectively. Of the 33 with EP-TB, 14 (42%) were diagnosed with TB pleurisy, 7 (21%) with TB lymphadenitis, 7 (21%) with intestinal TB, and 5 (15%) with EP-TB in other sites. In subgroup analyses according by site of infection, the QFT-G showed 86% sensitivity, 64% specificity, and 78% NPV in TB pleurisy. On the other hand, the sensitivity, specificity, and NPV of the assay were 71%, 83% and 71%, respectively in TB lymphadenitis, and 86%, 100% and 88%, respectively in intestinal TB. Among the patients with suspected alternative site EP-TB, the sensitivity, specificity, and NPV of the assay were 50%, 80% and 67%, respectively. Conclusion: The QFT-G assay showed moderate diagnostic accuracy in EP-TB. However, negative QFT-G assay does not exclude EP-TB because of the low NPV of this assay.

A USEFULNESS OF KEDI-INDIVIDUAL BASIC LEARNING SKILLS TEST AS A DIAGNOSTIC TOOL OF LEARNING DISORDERS (학습 장애아 진단 도구로 기초 학습 기능 검사의 유용성에 관한 연구)

  • Kim, Ji-Hae;Lee, Myoung-Ju;Hong, Sung-Do;Kim, Seung-Tai
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.8 no.1
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    • pp.101-112
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    • 1997
  • The purpose of this study was to examine usefulness of KEDI-Individual Basic Learning Skills Test as a diagnostic tool of learning disorders(LD). Learning disorder group consisted of two subgroups, verbal learning disorder group(VLD, n=34) and nonverbal learning disorder group(NVLD, n=14). Comparison group consisted of Dysthymia Disorder subgroup(n=11) and Normal subgroup(n=20). Performance of intelligence test and achievement test was examined in all 4 subgroups. In KEDI-WISC, VLD subgroup revealed primary problems in vocabulary, information and verbal-auditory attention test. NVLD group revealed primary problems in almost all performance tests such as visual acuity, psycho-motor coordination speed and visual-spatial organizations ability subtest. In KEDI-Individual Basic Learning Test, VLD group revealed primary problems in phonological coding process, word recognition and mathematics. For successful classification of LD children, the importance of achievement test and intelligence test was discussed by discriminant analysis and factor analysis. The results indicate that KEDI-Individual Basic Learning Skills is of considerable usefulness in diagnosing LD, but must be used in subtests, and additional tests must be conducted for thorough exploration of LD.

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Diagnostic Usefulness of Tc-99m Tetrofosmin Scintimnmmography in Patients with Primary Breast Cancer (유방암 환자에서 Tc-99m Tetrofosmin Scintimammography의 진단적 유용성)

  • Park, Ki-Han;Kim, Chang-Guhn;Yoon, Kwon-Ha;Choi, Si-Sung;Lee, Jong-Deok;Lee, Kwang-Man;Won, Jong-Jin
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.5
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    • pp.452-460
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    • 1999
  • Purpose: The purpose of this study was to evaluate the diagnostic usefulness of scintimammography per-formed with Tc-99m tetrofosmin in the detection of primary breast cancer Materials and Methods: Sixty-one patients underwent Tc-99m tetrofosmin scintimammography, plain-film mammography and ultrasonography. After intravenous injection of Tc-99m tetrofosmin (740 MBq), prone lateral and anterior scintimammograms were obtained. Scintimammogram was visually interpreted as positive, probably positive, probably negative and negative for malignancy. The tumor to background count ratio (T/B) was measured at 5 minutes and 1 hour. Plain-film mammogram was interpreted as one of 5 categories. Final diagnosis was achieved by surgical histology (58/61) or fine needle aspiration (3/61). Of 61 patients, 44 had cancer and 17 had benign lesion. Tumor size of malignant and benign lesions on ultrasonogram were $2.51{\pm}1.30cm$ (range 1-8 cm), $2.50{\pm}1.35cm$ (range 0.96-6 cm), respectively. Results: The sensitivity of plain-film mammography was 88.6%, specificity 58.8%, positive predictive value 84.7%, and negative predictive value 66.7% The sensitivity of Tc-99m tetrofosmin scintimammography was 90.9%; specificity, 88.2%; positive predictive value, 94.9%, negative predictive value, 18.9%. Of 25 patients with indeterminate degree of suspicion for malignancy on plain-film mammogram, 23 were correctly diagnosed by scintimammography. The T/B at 5 minutes and 1 hour were $3.78{\pm}2.21$, $3.25{\pm}1.80$ respectively. The T/B was decreased significantly at 1 hour (p<0.001). Conclusion: Tc-99m tetrofosmin scintimammography was useful dia-gnostic procedure in the detection of primary breast cancer, especially in patients with indeterminate degree of suspicion for malignancy on plain-film mammogram.

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The Usefulness of Serologic Diagnosis for Tuberculosis with Two Rapid Immunochromatographic Assay Devices (혈청학적 방법을 이용한 결핵 진단 방법의 효용성)

  • Kim, Deog-Kyeom;Kwon, Sung-Youn;Lee, Suk-Young;Park, Gye-Young;Jung, Kyung-Hae;Lee, Chun-Taek;Yoo, Churl-Gyoo;Kim, Young-Whan;Han, Sung-Koo;Shim, Yong-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.5
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    • pp.586-597
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    • 1999
  • Background: Many diagnostic tests have developed to diagnose tuberculosis and other mycobacterial diseases but the diagnosis of tuberculosis relies largely on radiological findings and acid-fast staining of sputum and/or culture. Recently, new serologic diagnostic methods, which are safe and easy to use have been introduced into Korea. In this study, the usefulness of serologic diagnosis for tuberculosis and the disease pattern induced variation of the test were evaluated. Methods: Serological assay was performed upon 108 patients with two test kits, the ICT tuberculosis and the BioSign$^{TM}$TB, which are based upon a rapid immunochromatographic assay technique, capable of being interpreted within 15 minutes. The case groups consisted of 61 patients with active pulmonary tuberculosis(36 patients), extrapulmonary tuberculosis(3 patients), or both(22 patients). Control groups consisted of 47 patients with inactive old pulmonary tuberculosis(17 patients), nontuberculous pulmonary disease(16 patients) and nonpulmonary cardiac disease(14 patients). Results : The diagnostic sensitivity, specificity, positive predictive value(PPV) and negative predictive value(NPV) of the ICT tuberculosis were 64.3%, 91.5%, 90.0% and 68.3% respectively. The diagnostic sensitivity, specificity, PPV and NPV of the BioSign$^{TM}$TB were 76.5%, 95.3%, 94.1 % and 78.8% respectively. Differences in sensitivity were not significant between patients with previous history of tuberculosis or patients without prior history of tuberculosis. The ICT tuberculosis test showed higher sensitivity in pulmonary tuberculosis patients(76.5%) than extrapulmonary tuberculosis patients(33.3%). There was no difference in sensitivity between patients with or without cavitary lesion by chest X-ray. Conclusion: Considering high specificity and PPV, serologic diagnosis using a rapid immunochromatographic assay device is another helpful diagnostic method in the diagnosis of tuberculosis, when combined with previous diagnostic methods such as chest X-ray, microbiologic study but it has limitation in terms of confirming the diagnosis for tuberculosis as the only diagnostic method because of relatively low sensitivity and NPV.

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Usefulness Evaluation 'Ankle Stress View Compared with MRI scan' of Subacute Ankle Sprain (아급성기 발목염좌에 대한 Stress View와 MRI검사 대비 유용성 평가)

  • Ahn, Byeoung-Ju
    • Journal of the Korean Society of Radiology
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    • v.5 no.4
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    • pp.201-205
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    • 2011
  • Subacute Ankle Sprain patients, 3 tests have been acknowledge for diagnostic precision and thus most commonly used to test their soft tissues, muscles, and ligaments: ankle stress-valgus test, anterior-draw test, and MRI scan. Although not much different from the rest two in its diagnostic value, MRI costs patients some money and time. Also, we have reached the conclusion through an experiment with a group of patients in a certain hospital that the rest two methods is as efficient and useful as MRI in diagnosing ankle joint patients.

Immunocytochemical Expression of E-cadherin in Cell Blocks of Serous Effusions (장액성 삼출액의 세포블록에서 E-cadherin의 면역세포화학적 발현)

  • Kim, Byung-Heon;Kwon, O-Jun
    • The Korean Journal of Cytopathology
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    • v.12 no.2
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    • pp.81-87
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    • 2001
  • The differentiation between reactive mesothelial and carcinoma cells in serous effusion cytology can be a diagnostic challenge based on morphology alone. The expression of some cell adhesion molecules may be helpful in the differential diagnosis. This study evaluated the usefulness of E-cadherin Immunocytochemistry for discrimination of carcinoma cells from reactive mesothelial cells. Alcohol fixed, paraffin embedded cell blocks taken from 42 reactive and 102 malignant serous effusions with histologically confirmed diagnoses were immunostained with monoclonal antibody to E-cadherin by LSAB method. E-cadherin expression was identified in only 2 benign reactive serous effusions(5%) whereas 91 malignant serous effusions(89%) expressed E-cadherin The differences in immunostaining for E-cadherin between reactive and malignant serous effusions were statistically significant(p < 0.001). The sensitivity and specificity of the E-cadherin immunostaining for carcinoma cells were 89% and 95%, respectively. In conclusion, E-cadherin is a useful diagnostic adjunct for differentiation between reactive mesothelial and carcinoma cells in serous effusions.

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Usefulness of Brushing Cytology in the Diagnosis of the Patients with the Stricture of Biliary Tree (담도계 협착 환자의 진단에 솔질 세포검사의 유용성)

  • Park, Mi-Ok
    • The Korean Journal of Cytopathology
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    • v.11 no.1
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    • pp.11-18
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    • 2000
  • Pancreaticobiliary tract strictures are frequent Indications for endoscopic retrograde cholangiopancreatography(ERCP). We have investigated the brushing cytology in order to determine its efficacy for diagnosis of pancreaticobiliary malisnancies. Brushing cytology during ERCP was evaluated in 56 patients with biliary tract stricture presenting to the Catholic Hospital of Taegu-Hyosung from April 1997 to August 1999. A comparison was made between the cytologic and histologic diagnoses on 32 cases from 30 patients. A diagnosis of malignancy was establishied in 78.1%, benign in 15.6%, and inadequate in 6.3% of the cases. Statistical data on cytologic diagnoses in strictures of the bile duct were as follows; specificity and sensitivity of blushing procedure was 100% & 83.3%, respectively: sensitivity of interpretation was 89.3%: with no false positive cases and 3 false negative cases: predictive value for malignancy was 100% & 100%, respectively: predictive value for benign was 28.6% & 40%,, respectively: overall diagnostic efficiency was 84.4%. It is concluded that brush cytology is a diagnostically reliable, highly specific technique for malignant lesions encounted at ERCP, although a negative result does not rule out the diagnosis of malignancy.

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