• Title/Summary/Keyword: Differential management

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Clinicoradiological Characteristics in the Differential Diagnosis of Follicular-Patterned Lesions of the Thyroid: A Multicenter Cohort Study

  • Jeong Hoon Lee;Eun Ju Ha;Da Hyun Lee;Miran Han;Jung Hyun Park;Ji-hoon Kim
    • Korean Journal of Radiology
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    • v.23 no.7
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    • pp.763-772
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    • 2022
  • Objective: Preoperative differential diagnosis of follicular-patterned lesions is challenging. This multicenter cohort study investigated the clinicoradiological characteristics relevant to the differential diagnosis of such lesions. Materials and Methods: From June to September 2015, 4787 thyroid nodules (≥ 1.0 cm) with a final diagnosis of benign follicular nodule (BN, n = 4461), follicular adenoma (FA, n = 136), follicular carcinoma (FC, n = 62), or follicular variant of papillary thyroid carcinoma (FVPTC, n = 128) collected from 26 institutions were analyzed. The clinicoradiological characteristics of the lesions were compared among the different histological types using multivariable logistic regression analyses. The relative importance of the characteristics that distinguished histological types was determined using a random forest algorithm. Results: Compared to BN (as the control group), the distinguishing features of follicular-patterned neoplasms (FA, FC, and FVPTC) were patient's age (odds ratio [OR], 0.969 per 1-year increase), lesion diameter (OR, 1.054 per 1-mm increase), presence of solid composition (OR, 2.255), presence of hypoechogenicity (OR, 2.181), and presence of halo (OR, 1.761) (all p < 0.05). Compared to FA (as the control), FC differed with respect to lesion diameter (OR, 1.040 per 1-mm increase) and rim calcifications (OR, 17.054), while FVPTC differed with respect to patient age (OR, 0.966 per 1-year increase), lesion diameter (OR, 0.975 per 1-mm increase), macrocalcifications (OR, 3.647), and non-smooth margins (OR, 2.538) (all p < 0.05). The five important features for the differential diagnosis of follicular-patterned neoplasms (FA, FC, and FVPTC) from BN are maximal lesion diameter, composition, echogenicity, orientation, and patient's age. The most important features distinguishing FC and FVPTC from FA are rim calcifications and macrocalcifications, respectively. Conclusion: Although follicular-patterned lesions have overlapping clinical and radiological features, the distinguishing features identified in our large clinical cohort may provide valuable information for preoperative distinction between them and decision-making regarding their management.

Comparative Assessment of Quantitative Methods determining the Amount of Calcium Carbonate Minerals derived from Biocalcification (생물학적 칼슘화에 의해 생성된 CaCO3 광물의 정량분석 방법 비교 평가)

  • Ahn, Chang-Min;Bae, Young-Shin;Ham, Jong-Heon;Cheon, Seung-Kyu;Kim, Chang-Gyun
    • Journal of Soil and Groundwater Environment
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    • v.18 no.5
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    • pp.1-6
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    • 2013
  • This study was performed to develop a method for quantitative analysis obtaining the amount of calcium carbonate minerals formed when Ca salts biomimetically reacted with carbon dioxide. There were two methods compared; 1) volumetric calcimeter method that determining the amount of released carbon dioxide after calcium carbonate minerals were acidified by 4N HCl and 2) Thermogravimetry-Differential Thermal Analysis (TG-DTA) adopting differential decomposition temperature breaking-up the structural link within calcium carbonate minerals. The comparisons were made by batch experiment (i.e., biocalcification process) along with control (i.e., nominal concentration of $CaCO_3$ prepared). For the control, TG-DTA took a minor root mean square deviation (RMSD) of 1.1~5.9 mg, whereas volumetric calcimeter exposed a greater RMSD of 28.3 mg. For the biocalcification, the amount of $CaCO_3$ was more precisely obtained for TG-DTA rather than that of volumetric calcimeter. It was decided that TG-DTA was more successfully used for quantitative analysis to observe the amount of calcium carbonate minerals derived from biocalcification.

A Study on Improvement of Large-size Hospital's Emergency Medical Service According to Patient's Viewpoint (환자관점에 따른 대형병원의 응급의료서비스 개선연구)

  • Cho, Chul-Ho;Lee, Eun-Ji
    • Journal of Korean Society for Quality Management
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    • v.41 no.4
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    • pp.541-553
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    • 2013
  • Purpose: This study intends to offer strategic implications that can be used in emergency medical service of large-size hospital through analysis of causal relationship among factors such as emergency medical service, patient value, patient satisfaction and reuse intention. Methods: Differential model was introduced to test causal relationship. Questionnaire was developed, and data was collected and analyzed with Structural Equation Modeling. Results: As a result of empirical analysis, we found that emergency medical service qualities of general hospital could be six components. Image of hospital, medical facilities, and attitude of medical staff are positively related to patient satisfaction and reuse intention. Conclusion: This study offers practical implications to relevant managers, at the same time it has limitations to be solved through additional study in future.

How to Reinvent Network Services for All (상이한 네트워크 서비스 어떻게 향상시킬까?)

  • Kim, Yong-J.;Lee, Seo-Jun;Lim, Jay-Ick
    • Korean Management Science Review
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    • v.25 no.3
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    • pp.87-99
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    • 2008
  • Besieged by needs for upgrading the current Internet, social pressures, and regulatory concerns, a network operator may be left with few options to Improve his services. Yet he can still consider a transition prioritizing network services. In this paper, we describe a transition from a non-priority system to a prioritized one, using non-preemptive M/G/1 model. After reviewing the constraints and theoretical results from past research, we describe steps making the transition Pareto-improving, which boils down to a multi-goal search for a Pareto-improving state. We use a genetic algorithm that captures actual transition costs along with incentive-compatible and Pareto-Improving constraints. Simulation results demonstrate that the initial post-transition solutions are typically Pareto-improving. for non Pareto-improving solutions, the heuristic quickly generates Pareto-improving and incentive-compatible solutions.

Image Improvement and Trust Building of Traditional Medical Service Considered Emotional Attachment (정서적 애착을 고려한 전통 의료서비스의 이미지개선 및 신뢰구축)

  • Cho, Chul-Ho
    • Journal of Korean Society for Quality Management
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    • v.41 no.2
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    • pp.261-276
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    • 2013
  • Purpose: This study intends to offer strategic implications that can be used in Korean medicine hospitals through analysis of causal relationship among factors focusing on image improvement and trust building. Methods: Differential model was introduced to test causal relationship. Questionnaire was developed, and data was collected and analyzed with Structural Equation Modeling. Results: Medical service has effects on image, trust, and CS. CS has an effect on trustworthiness, and trustworthiness has positive effect on loyalty intention and has negative effect on switching intention. Emotional attachment has moderating functions between trust and loyalty intention and between trust and switching intention. Conclusion: This study offers practical implications to relevant managers, at the same time it has limitations that omits relevant study of inducing factor for emotional attachment.

A Fairness Improvement Algorithm using Dynamic Threshold in ATM-GFR Service (ATM-GFR 서비스에서 동적 임계치를 이용한 공평성 향상 알고리즘)

  • Kim, Nam-Hee;Kim, Byun-Gon
    • The KIPS Transactions:PartC
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    • v.10C no.3
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    • pp.305-310
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    • 2003
  • The performance of various GFR implementations has been recently studied due to the interest to provide bandwidth guarantees with a simpler implementation than ABR in ATM networks. One of the important factors is buffer management for guaranteeing QoS in GFR service. An efficient buffer management algorithm is necessary to guarantee MCR for untagged cell in ATM switch. In this paper, we propose and evaluate a buffer management scheme to provide the GFR service guarantees. The proposed scheme can control the cell discarding for fairness in each VC, and compared with Double-EPD and DFBA. Our results show that the proposed buffer management with per-VC queuing achieves significant enhancement on goodputs and fairness index than those of existing methods.

The effect which the location of Partitioning Function causes in successful probability in Differential Power Analysis (차분 전력 분석에서 분류함수의 위치가 성공확률에 미치는 영향)

  • Kim, Sung-Kyoung;Kim, Hee-Seok;Kim, Tae-Hyun;Han, Dong-Guk;Ryoo, Jeong-Choon;Lim, Jong-In
    • Proceedings of the Korean Society of Broadcast Engineers Conference
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    • 2007.02a
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    • pp.112-115
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    • 2007
  • 최근 부채널 공격으로 스마트 카드 같은 장치의 비밀키를 알아낼 수 있음이 알려지면서 많은 알고리즘에 대한 부채널 공격과 대웅 방안이 연구되고 있다. 차분전력분석은 부채널 공격의 일종으로 암호화 연산 중 발생하는 전력 소모 곡선을 통계적으로 분석하여 키를 알아내는 공격이다. 본 논문에서는 Hocker 형태의 IC칩 차분전력분석공격에 대한 실험 분석 모델을 설정한 후 이를 검증하고자 축소형 모델로 실험한다 실험 분석을 위하여 선정된 장치에 DES 암호알고리즘을 어셈블리로 구현한 후 8비트 마이크로프로세서 형 칩에 탑재하여 암호 알고리즘 실행 시에 발생되는 차분 전력 신호를 분석한다. 그리고 차분전력분석 공격에서 중요한 기술인 분류함수 설정에 따른 분석 성공 여부에 따른 비교를 한다.

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The Development of Logistics Service Evaluation Model Considering Potential Customer Demand Improvement Index (잠재적고객요구개선지수와 기대손실을 고려한 물류서비스 평가모형 개발)

  • Chang, Yong-Hyuk;Cho, Yu-Jin;Kang, Kyung-Sik
    • Journal of the Korea Safety Management & Science
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    • v.21 no.1
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    • pp.9-16
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    • 2019
  • Logistics companies are worrying about securing of differential competitiveness so as to be competitive companies in keen logistics market. The ground is how users are satisfied by sell-established service system to respond not only economic feasibility of logistics costs but also diversity and advancement of logistics needs. The competitiveness of logistics companies is also caused by customer satisfaction of service and only companies finding and satisfying customer needs continuously may be more competitive. For the competitiveness, it's the most important to analyze demands of current and potential customers and their pursuing value properly. Therefore, this researcher grasped PSL for online logistics service users with 5-point Likert-scale and quality-level decision method that consider the weighted value based on Kano model, measured customer's potential Demand for service through PCDI, and suggested methodology for deciding the priority of the improvement with loss function of Taguchi.

Benign Osteoblastoma Located in the Parietal Bone

  • Lee, Yong-Gun;Cho, Chang-Won
    • Journal of Korean Neurosurgical Society
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    • v.48 no.2
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    • pp.170-172
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    • 2010
  • Benign osteoblastoma is an uncommon primary bone tumor, extremely rare in calvarium. We present a case of a 25-year-old female with an osteoblastoma of parietal bone which was totally resected. The authors discussed the clinical presentation, radiographic finding, differential diagnosis and management of the benign calvarial osteoblastoma with a review of the literature.

Nonepileptic paroxysmal disorders in childhood (소아에서의 유사 경련 질환)

  • Suh, Eun Sook
    • Clinical and Experimental Pediatrics
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    • v.49 no.4
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    • pp.364-367
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    • 2006
  • Epilepsy is the most common paroxysmal disorders seen in the childhood. But other nonepileptic paroxysmal events are confused with epileptic seizures or have unusual clinical features. Nonepileptic paroxysmal disorders tend to recur episodically. So differential diagnosis between epileptic and nonepileptic disorders in fundamental not only to allow correct management of patients and but also avoid of unnecessary antiepileptic medications. To accurate diagnosis of nonepileptic paroxysmal disorders, the patients' age and accurate description of the events are need.