• 제목/요약/키워드: False-negative results

검색결과 302건 처리시간 0.031초

유방암 환자에서 $^{99m}Tc$-Antimony Trisulfide Colloid, $^{99m}Tc$-Tin Colloid, $^{99m}Tc$-Human Serum Albumin을 이용한 감시림프절 매핑 성적의 비교 (Comparison of the Results for Sentinel Lymph Node Mapping in the Breast Cancer Patients using $^{99m}Tc$-Antimony Trisulfide Colloid, $^{99m}Tc$-Tin Colloid, and $^{99m}Tc$-Human Serum Albumin)

  • 장성준;문승환;김석기;김범산;김석원;정기욱;강건욱;이은숙
    • Nuclear Medicine and Molecular Imaging
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    • 제41권6호
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    • pp.546-552
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    • 2007
  • 목적: 유방암 환자에게 불필요한 액와림프절 전절제술을 예방하기 위해서는 감시림프절을 절제하여 전이 여부를 평가하는 것이 중요하다. 감시림프절 매핑을 위한 방사성교질중 antimony trisulfide colloid (ASC), tin colloid (TC), human serum albumin (HSA) 이상의 3가지 교질에 $^{99m}Tc$을 표지하여 각각에서 림포신티그라피, 감시림프절 매핑의 성적을 비교하였다. 대상 및 방법: 2001년 10월부터 2006년 12월까지 임상적으로 액와림프절 전이가 없는 조기 유방암 환자 총 397명에게 시행한 림포신티그라피와 수술 중 감시림프절 절제 동결절편 검사, 및 수술 후 병리 소견을 후향적으로 평가하였다. 림포신티그라피 영상 소견을 분석하고, 감시림프절의 발견율(identification rate)과 위음성율(false negative rate), 그리고 음성예측도(negative predictive value)를 구하여 각 군의 자료에 대해 Fisher 직접확률법으로 비교하였다. 결과: 202명에게는 $^{99m}Tc$ ASC를, 120명에게는 $^{99m}Tc$-TC를, 75명에게는 $^{99m}Tc$-HSA를 사용하였으며 평균 연령, 병기, 원발 종양의 크기 등에서는 각 군별 환자들 사이에 유의한 차이가 없었다. ASE는 59명에게는 유륜부 피내 혹은 피하주사법을 사용했으며 136명에게는 종양주위 주사를, 그리고 7명의 환자에게는 두 가지를 병용하였다. TC와 HSA를 사용한 환자들에게는 모두 피내 혹은 피하주사하였다. 액와림프절 전이는 ASE사용 군에서 33.2%, TC 사용군에서 31.7%, HSA 사용 군에서 22.7%였으며 통계적으로 유의한 차이는 없었다. 감시 림프절 발견율(IR) 과 위음성율(FNR) 그리고 음성예측도(NPV) 는 사용한 교질 ASC/TC/HSA 각각에 대해 99.0%, 21.5%, 90.5% / 96.7%, 20.5%, 90.7% / 94.7%, 17.7%, 94.7%로 사용한 교질의 종류에 따라 통계적으로 유의한 차이가 없었다. 감시림프절 매핑 성적은 방사성교질의 주사방법에 따라서 유의한 차이를 보이지 않았다. 림포신티그라피의 영상에서 감시림프절이 명확히 구분된 경우는 ASC에서 79.6%, TC 에서 92.5%, HSA에서 88.6%였다. 림프관이 관찰된 비율은 ASC에서 43.6%, TC에서 0.8%, HSA 에서 96.8%이었다. 림포신티그라피에서 관찰된 감시림프절의 개수는 HSA가 가장 많았지만 통계적으로 유의한 차이는 없었다. 결론: ASC, TC 및 HSA등의 방사성교질을 이용한 감시림프절 매핑 성적은 서로 유의한 차이를 보이지 않았다.

Use of Sentinel Lymph Node Biopsy after Neoadjuvant Chemotherapy in Patients with Axillary Node-Positive Breast Cancer in Diagnosis

  • Choi, Hee Jun;Kim, Isaac;Alsharif, Emad;Park, Sungmin;Kim, Jae-Myung;Ryu, Jai Min;Nam, Seok Jin;Kim, Seok Won;Yu, Jonghan;Lee, Se Kyung;Lee, Jeong Eon
    • Journal of Breast Cancer
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    • 제21권4호
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    • pp.433-4341
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    • 2018
  • Purpose: This study aimed to evaluate the effects of sentinel lymph node biopsy (SLNB) on recurrence and survival after neoadjuvant chemotherapy (NAC) in breast cancer patients with cytology-proven axillary node metastasis. Methods: We selected patients who were diagnosed with invasive breast cancer and axillary lymph node metastasis and were treated with NAC followed by curative surgery between January 2007 and December 2014. We classified patients into three groups: group A, negative sentinel lymph node (SLN) status and no further dissection; group B, negative SLN status with backup axillary lymph node dissection (ALND); and group C, no residual axillary metastasis on pathology with standard ALND. Results: The median follow-up time was 51 months (range, 3-122 months) and the median number of retrieved SLNs was 5 (range, 2-9). The SLN identification rate was 98.3% (234/238 patients), and the false negative rate of SLNB after NAC was 7.5%. There was no significant difference in axillary recurrence-free survival (p=0.118), disease-free survival (DFS; p=0.578) or overall survival (OS; p=0.149) among groups A, B, and C. In the subgroup analysis of breast pathologic complete response (pCR) status, there was no significant difference in DFS (p=0.271, p=0.892) or OS (p=0.207, p=0.300) in the breast pCR and non-pCR patients. Conclusion: These results suggest that SLNB can be feasible and oncologically safe after NAC for cytology-determined axillary node metastasis patients and could help reduce arm morbidity and lymphedema by avoiding ALND in SLN-negative patients.

자궁경부암 선별 검사에서 자궁경부 확대 촬영술의 이용 (Cervicography as a Screening Test for Cervical Cancer)

  • 이두진;이승호
    • Journal of Yeungnam Medical Science
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    • 제16권2호
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    • pp.169-180
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    • 1999
  • 우리 나라 여성암 중에서 가장 높은 발생률을 보이고 있는 자궁경부암의 선별 검사로서 자궁경부 확대 촬영술의 가능성을 검토하기 위하여 1998년 3월 1일부터 1999년 10월 31일 사이에 자궁암 검진 목적으로 자궁경부 확대 촬영을 시행한 482명의 여성 중에서 310명을 대상으로 한 연구에서 다음과 같은 결과를 얻었다. 대상 환자의 평균 산과력은 임신 4.4회, 분만 2.6회, 유산 1.9회였고 검진의 목적은 정기 검진이 164명으로 가장 많았다. 연령별로는 35-39세 군이 가장 많았고 다음으로 40-44세군, 45-49세군의 순이었으며 마지막 세포진 검사와의 검진 간격은 평균 17.1개월이었고 지금까지 한 번도 검사를 받지 않았던 여성은 64명이었다. 310명의 여성 중 정상으로 판단된 254명을 제외한 56명에서 질확대경 조준 하 생검을 시행하였으며 생검 소견은 만성 자궁경부염 26례, 경증 이형증 4례, 중등도 이형증 6례, 중증 이형증 2례, 자궁경부 상피내암 14례 및 침윤암 4례였다. 세포진 검사 결과와 자궁 경부 확대 촬영술의 결과는 비교적 잘 일치하였다. 세포진 검사 결과가 LSIL 이상일 때를 비정상으로 판정했을 때의 민감도와 특이도는 각각 86.7% 및 76.9%였고, 양성 예측률과 음성 예측률은 각각 81.3% 및 83.3%였으며 위양성률과 위음성률은 각각 23.1%와 13.3%였다. 자궁 경부 확대 촬영에서 의증(S2) 이상일 때를 비정상으로 판정했을 때 민감도와 특이도는 각각 56.7% 및 96.2%였고, 양성 예측률과 음성 예측률은 각각 94.4% 및 65.8%였으며 위양성률과 위음성률은 각각 3.8%와 43.3%였다. 자궁경부 확대 촬영술의 민감도는 세포진 검사에 비해 매우 낮았으나 특이도는 훨씬 높았고 서로 보완관계가 있음을 나타내었다. 또 자궁경부 확대 촬영술에서 위음성률이 높았으나 위양성률은 낮은 결과를 보였다. 본 연구의 결과 자궁 경부 확대 촬영은 단독으로 선별검사에 사용하는 것보다는 세포진 검사와의 상호 보완적인 방법으로 사용되어야 할 것으로 생각되었고 세포진 검사의 단점을 보완하는 자궁경부암의 집단 검진 방법으로 가능성이 높을 것으로 예상되었다.

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악성 침샘종양의 세침흡인 세포검사의 정도관리 (Quality Assuarance on Fine Needle Aspiration Cytology of Malignant Salivary Gland Neoplasms)

  • 오영륜;고영혜
    • 대한세포병리학회지
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    • 제15권1호
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    • pp.40-44
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    • 2004
  • To evaluate the quality of fine needle aspiration cytology diagnosis on malignant salivary gland neoplasms, cytologic findings were correlated with histologic diagnosis of 56 surgically removed malignant salivary gland tumors. Seven cases (12.5%) were insufficient, 23 cases (41.1%) were diagnosed as malignant, 17 (30.4%) cases were accurately diagnosed by histologic subtype, and 9 cases (16%) were diagnosed as benign. Five out of 9 false negative cases were misdiagnosed as pleomorphic adenomas. Except the cases with insufficient specimen, overall sensitivity was 81.6%, and the sensitivity varied according to the histologic subtype; 91% in salivary duct carcinoma, 100% in carcinoma ex pleomorphic adenoma, 50% in mucoepidermoid carcinoma, 63% in adenoid cystic carcinoma, and 50% in acinic cell carcinoma. The diagnostic accuracy differed among cytopathologists irrespective of periods after acquisition of board of pathologists. These results confirm that salivary gland neoplasm can be easily misdiagnosed in fine needle aspiration cytology and a great caution should be given in diagnosing the benign appearing salivary aspirates to avoid under-diagnosis of malignant neoplasm with low grade cytologic atypia.

Application of Bovine Viral Diarrhoea Virus as an Internal Control in Nucleic Acid Amplification Tests for Hepatitis C Virus RNA in Plasma-Derived Products

  • Yoo Si Hyung;Hong Seung Hee;Jung Sa Rah;Park Su Jin;Lee Nam Kyung;Kim Soon Nam;Kang Sang Mo;Min Hong Ki;Park Sue Nie;Hong Seung Hwa
    • Journal of Microbiology
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    • 제44권1호
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    • pp.72-76
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    • 2006
  • Plasma-derived products are produced from plasma via fractionation and chromatography techniques, but can also be produced by other methods. In the performance of nucleic acid amplification tests (NAT) with plasma-derived products, it is necessary to include an internal control for the monitoring of all procedures. In order to avoid false negative results, we confirmed the usefulness of the bovine viral diarrhoea virus (BVDV) for use as an internal control in the detection of hepatitis C virus (HCV) RNA in plasma-derived products. These products, which were spiked with BVDV, were extracted and then NAT was performed. Specificity and sensitivity were determined via the adjustment of primer concentrations and annealing temperatures. BVDV detection allows for validation in the extraction, reverse transcription, and amplification techniques used for HCV detection in plasma-derived products.

백혈병 환자에서 골수주사를 이용한 골수침범 유무의 평가 (Evaluation of Bone Marrow Involvement in Leukemic Patients using Bone Marrow Scan)

  • 조재현;김명준;이종두;박창윤;김길영;김용수
    • 대한핵의학회지
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    • 제27권2호
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    • pp.298-304
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    • 1993
  • To estimate the bone marrow involvement of leukemia, we peformed scintigraphies using $^{99m}Tc$ antimony sulfide colloid and Gallium-67. Total 13 patients were included and obtained 14 study sets of $^{99m}Tc$ antimony sulfide colloid and gallium-67 and compared with bone marrow aspiration biopsy and clinicolaboratory datas. $^{99m}Tc$ Antimony scan showed localized defect in 4 patients who had relapse. No false positive or negative results were observed. Gallium 67 showed localized increased uptake in 2 of 4 relapsed patients. Therefore, bone marrow scan is useful for the evaluation of marrow infiltration in ieukemic patients.

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Walker와 Avant 기법을 활용한 원불교 마음공부집단상담 프로그램에서의 마음공부의 개념 분석 (The Concept Analysis of Won-Buddhism's Maumgongbu in Group Counseling based on Walker and Avant's Strategy)

  • 양경희
    • 동의신경정신과학회지
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    • 제24권3호
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    • pp.229-244
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    • 2013
  • Objectives : The purpose of this study was to provide information about Maumgongbu to meet the needs of people by analysing the concept of Maumgongbu in group counseling. Methods : This study was conducted using Walker and Avant's Concept Analysis Strategy. Dictionaries, Wonbuddhism's Kyunjions and literatures, and participants' journals were reviewed after enrolling in Onsarm maumgongbu group counseling. Results : The attributes of the Maumgongbu include emotion, object, self-reflection, attribution, and creativity. The antecedents of "Maumgongbu" are the conditions arising from negative emotions. The Maumgongbu helps people find the emotional causality of their inner self by self-reflecting, getting out of false belief, restoring positive emotions, maintaining healthy and warm relationships with oneself, family, friends and society. Above all, the Maumgongbu makes people experience tranquility and true happiness and activate their positive energy or power. Conclusions : If there is a clear indication of linkage to principles, attributions, precedents and consequences, and empirical referents to any of Maumgongbu programs, there is no doubt that our understanding of the human mind and lives will be greatly enriched. Furthermore, self-discipline and steadfast complements give us calmness, peacefulness and better quality of life.

A Method for Service Evaluation Based on Fuzzy Theory for Cloud Computing

  • Guo, Liangmin;Luo, Yonglong;He, Xiaokang;Hu, Guiyin;Dong, Yan
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • 제11권4호
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    • pp.1820-1840
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    • 2017
  • Aiming at the phenomenon of false information issued by service providers in cloud computing environment, a method for service evaluation based on fuzzy theory is put forward in this paper. According to the quality of services provided by cloud service providers and their behavior during interactions, a trust relationship between cloud service providers and cloud service consumers is established, which can be quantified by using fuzzy theory. The quality of services is evaluated by drawing on the trust relationship. In our method, the recommendation credibility of a cloud service consumer is determined through behavior similarity with evaluators and a praise factor. The introduction of the praise factor better suits the phenomenon of a high-quality service getting more repeat customers. The negative impact of dishonest customers is reduced, and the accuracy of trust and cloud service quality evaluation is improved by introducing a confidence factor that can be dynamically adjusted. The experimental results show that our method can effectively and accurately evaluate the trust value and service quality of providers, while weakening the influence of dishonest consumers, and quickly detect dishonest service providers. This is beneficial for consumers trying to find high quality service providers for similar services.

구강암 환자에서 경부 임파절 평가에 대한 $^{18}F$-FDG PET(Fluorine 18-Labelled Deoxyglucose Positron Emission Tomography)의 유용성 (DIAGNOSTIC ACCURACY OF $^{18}F$-FDG IN NODAL NEGATIVE ORAL SQUAMOUS CELL CARCINOMA)

  • 최은주;강상훈;김기호;남웅;김형준;차인호
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제33권6호
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    • pp.597-600
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    • 2007
  • PET is one of the most widely used verification methods for evaluation of metastasis on the lymph nodes of the neck in oral cancer patients. The purpose of this study was to assess the correlation between PET findings and histopathologic findings in patients who had been diagnosed as squamous cell carcinoma and performed neck dissection. Thirty-four necks in 25 patients had been evaluated on pathologic lymph nodes and the data were compared with preoperative PET scan. The sensitivity of PET at the level of the neck was 72.7%, specificity was 60%, and accuracy was 79.2%. Since FDG-PET show high false-positive results, it should be used with other diagnostic tools for evaluation of lymph node metastasis.

단일 모동맥에서의 다발성 뇌동맥류 (Multiple Cerebral Aneurysms on Single Parent Artery)

  • 서의교;안정용;주진양
    • Journal of Korean Neurosurgical Society
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    • 제29권12호
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    • pp.1592-1599
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    • 2000
  • Objective : Multiple cerebral aneurysms reportedly account for 14-33% of all cerebral aneurysms. However, multiple separate aneurysms on single parent artery are uncommon. The majority of these are found on middle cerebral artery(MCA). Multiple aneurysms arising from anterior communicating artery(ACoA) are rare. We report 5 cases of multiple aneurysms developed separately on single artery and describe angiographic and operative findings of these lesions. Materials and Methods : Among 127 patients of cerebral aneurysms operated in our hospital, only 5 had multiple aneurysms on single parent artery. Results : Among 5 cases, 4 were diagnosed preoperatively and the only one was found intraoperatively. Two were found on MCA bifurcation, one on M2 and two on ACoA. All separate aneurysms developed on single parent artery were treated successfully with multiple clipping. Conclusion : Multiple cerebral aneurysms, developed separately on single parent artery, are uncommon. Furthermore, those arising from ACoA are very rare. Despite the advanced technology in radiological examinations, multiple cerebral aneurysms may not be detected on preoperative study only. Close proximity or smaller size of the lesion may be responsible for the preoperative false negative angiographic findings.

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