• 제목/요약/키워드: Missed diagnosis

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사람면역결핍바이러스 감염의 진단 (Diagnosis of Human Immunodeficiency Virus Infection)

  • 유시내
    • The Korean Journal of Medicine
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    • 제99권1호
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    • pp.32-36
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    • 2024
  • Early diagnosis and early treatment of human immunodeficiency virus (HIV) infection are essential for clinical and public health benefits. Diagnostic algorithms for early diagnosis are being emphasized, and rapid tests at the point of care have been expanded to improve voluntary testing rates. Despite advances in laboratory diagnostic tests, early HIV infection can still be missed due to window periods, and it is crucial to recognize the limitations of testing methods and the potential for false negative and false positive results.

Ultrasonographic Features of Triple-Negative Breast Cancer: a Comparison with Other Breast Cancer Subtypes

  • Yang, Qi;Liu, Hong-Yan;Liu, Dan;Song, Yan-Qiu
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권8호
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    • pp.3229-3232
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    • 2015
  • Background: Triple-negative breast cancer (TNBC) is known to be associated with aggressive biologic features and a poor clinical outcome. Therefore, early detection of TNBC without missed diagnosis is a requirement to improve prognosis. Preoperative ultrasound features of TNBC may potentially assist in early diagnosis as characteristics of disease. Purpose: To retrospectively evaluate the sonographic features of TNBC compared to ER (+) cancers which include HER(-) and HER2 (+), and HER2 (+) cancers which are ER (-). Materials and Methods: From June 2012 through June 2014, sonographic features of 321 surgically confirmed ER (+) cancers (n=214), HER2 (+) cancers (n=66), and TNBC (n=41) were retrospectively reviewed by two ultrasound specialists in consensus. The preoperative ultrasound and clinicopathological features were compared between the three subtypes. In addition, all cases were analyzed using morphologic criteria of the ACR BI-RADS lexicon. Results: Ultrasonographically, TNBC presented as microlobulated nodules without microcalcification (p=0.034). A lower incidence of ductal carcinoma in situ (p<0.001), invasive tumor size that is>2 cm (p=0.011) and BI-RADS category 4 (p<0.001) were significantly associated with TNBC. With regard to morphologic features of 41 TNBC cases, ultrasonographically were most likely to be masses with irregular (70.7%) microlobulated shape (48.8%), be circumscribed (17.1%) or have indistinct margins (17.1%) and parallel orientation (68.9%). Especially TNBC microlobulated mass margins were more more frequent than with ER (+) (2.0%) and HER2 (+) (4.8%) cancers. Conclusions: TNBC have specific characteristic in sonograms. Ultrasonography may be useful to avoid missed diagnosis and false-negative cases of TNBC.

Fault Feature Clarification in the Residual for Fault Detection and Diagnosis of Control Systems

  • Lee, Jonghyo;Joon Lyou
    • 제어로봇시스템학회:학술대회논문집
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    • 제어로봇시스템학회 2002년도 ICCAS
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    • pp.96.3-96
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    • 2002
  • A scheme of clarifying fault feature in the residual is given for model-based fault detection and diagnosis of control systems. It is based on the residual generation using a robust filter and the noise suppresion in test statistics of the residual by multi-scale discrete wavelet transform. By clarifying the fault feature in the residual, the difficulties of existing model based approaches via adopting a threshold can be overcomed and it has advantage of taking the false alarm and missed detection into acount at the same time, which can make the fault detection and diagnosis easy and correct. To show the effectiveness of our approach, the simulation results are illustrated for a linear syste...

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Cor Triatriatum Associated with Total Anomalous Pulmonary Venous Connection: A Rare but Plausible Combination

  • Lee, Jun Oh;Park, Chun Soo
    • Journal of Chest Surgery
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    • 제54권2호
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    • pp.143-145
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    • 2021
  • In a newborn in whom cor triatriatum was missed on echocardiography, infracardiac total anomalous pulmonary venous connection was successfully repaired with the aid of cardiac computed tomography (CT). In rare combinations, as in this case, an accurate diagnosis prior to surgery, which is of vital importance for successful repair, can be made through a high index of suspicion and the use of a supplemental imaging modality such as CT.

Lymphocytoma cutis: diagnostic enigma for the maxillofacial surgeon

  • Kale, Tejraj P.;Singh, Arjun Gurmeet;Shah, Pushpak
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제42권6호
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    • pp.379-382
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    • 2016
  • Cutaneous lymphoid hyperplasia (CLH) is a cutaneous pseudolymphoma with a worldwide distribution, equally affecting all races and ethnic groups. Due to its vast array of characteristics, it is most often missed in the differential diagnosis of firm to soft lumps on the head and neck. A systematic approach to the workup and diagnosis along with treatment of such lesions is discussed in this article. A 20-year-old Asian Indian female presented to our Oral and Maxillofacial unit with a lump on the left side of her forehead for 1 month. Local examination revealed a $2.5{\times}3.0cm^2$, well circumscribed swelling over the left para median region that was firm to doughy and non-tender. There was no other significant finding on general examination. Excisional biopsy of the lesion was performed, followed by histopathologic processing. The general etiology, pathogenesis, clinical presentation, differential diagnosis, clinical course, prognosis, treatment, and prevention have been discussed in line with the recent modalities of diagnosis and treatment of CLH. Due to the overlapping clinical and histological characteristics of CLH with many other lesions, it is important to consider this lesion in the differential diagnosis of cutaneous lesions.

경미한 외상을 받은 소아.청소년 환자의 지연 진단에 대한 고찰 (Analysis of Delayed Diagnosis of Pediatric and Adolescent Patients Injured by Minor Trauma)

  • 최지안;박원빈;김진주;조진성;김재광;임용수;현성열;정호성;양혁준;이근
    • Journal of Trauma and Injury
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    • 제22권2호
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    • pp.212-217
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    • 2009
  • Purpose: To analyze delayed diagnosis, we collected date on pediatric and adolescent patients who had been admitted to the Emergency Department with injuries due to minor trauma Methods: We retrospectively analyzed the age distribution, trauma mechanism, time interval for each affected body region at delayed diagnosis, hospital stay, and outcome for 161 pediatric and adolescent patients who had been admitted to the Emergent Department of Gachon University Gil Hospital from January 2006 to September 2008. Results: The incidence of delayed diagnosis in pediatric and adolescent trauma was 11.8% in our retrospective review of 161 pediatric and adolescent patients. Lengths of hospitalization were longer in patients with delayed diagnosis (p<0.05). Patients with delayed diagnosis were more often transferred to other hospitals than patients with non-delayed diagnosis (p<0.05). The time intervals for each different affected body regions at delayed diagnosis were significantly different, but the hospital stays were not. There were no statistical significance to age on affected body region. Conclusion: From this study, we found that admission result and hospital stay were statistically significant differences between the delayed-diagnosis patient group and the non-delayed-diagnosis patient group. Finally, we must follow up pediatric and adolescent patients with minor trauma, closely considering missed injuries.

Missing Elements in Surgical Pathology Reports: Breast, Colon and Stomach Cancers

  • Kadivar, Maryam;Rahimabad, Parnian Kheirkhah
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권3호
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    • pp.1469-1472
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    • 2016
  • Cancer pathology reports play an important role in choice of patient care. They provide crucial information concerning diagnosis, therapy options, and prognosis. Professional pathology institutions, such as the College of American Pathologists (CAP), have developed checklists to ensure the presence of all the required elements in reports. In this study, 438 surgical pathology reports of patients with breast (148), colon (147), and stomach cancer (143) were evaluated with respect to the presence of mandated elements according to CAP checklists. The most common missing element in all the three types of cancer was 'staging' (73.6, 53.1, and 56.6% in breast, colon, and stomach cancer reports missed 'staging', respectively). The second most missing element was 'tumor site' in breast (64.2%) and stomach cancer (30.1%), and 'procedure' in colon cancer (29.3%). 'Perineural invasion' was the third most missing element in the three types of cancer (25.7, 17.0, and 22.4% in breast, colon, and stomach cancer, respectively). Only 11.4% of reports included all key elements required by CAP. The use of checklists was associated with higher rate of completeness. This study demonstrates that the key elements requiring the information on the requisition forms from the clinicians are commonly missed, leading to ambiguity.

놓치기 쉬운 폐암: 흉부 X선 진단의 함정에 대한 이해와 다양한 폐암 영상 소견의 중요성 (Missed Lung Cancers on Chest Radiograph: An Illustrative Review of Common Blind Spots on Chest Radiograph with Emphasis on Various Radiologic Presentations of Lung Cancers )

  • 최고운;남보다;황정화;김기업;김현조;김동원
    • 대한영상의학회지
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    • 제81권2호
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    • pp.351-364
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    • 2020
  • 흉부 X선은 폐와 종격동 질환을 평가하는 데 있어 매우 중요한 일차 영상 검사이다. 초기 흉부 X선에서 놓친 폐암은 환자의 진단을 지연시키고 예후에 중요한 영향을 줄 수 있다. 저자들은 초기 흉부 X선에서 폐암의 중요한 진단적 오류를 피하기 위하여 비교적 흔히 접하게 되는 영상 진단의 함정에 대하여 다양한 증례를 통하여 검토하고 또한 폐암의 다양한 영상 소견의 중요성에 대하여 중점적으로 살펴보고자 한다.

Panic Disorder Intelligent Health System based on IoT and Context-aware

  • Huan, Meng;Kang, Yun-Jeong;Lee, Sang-won;Choi, Dong-Oun
    • International journal of advanced smart convergence
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    • 제10권2호
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    • pp.21-30
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    • 2021
  • With the rapid development of artificial intelligence and big data, a lot of medical data is effectively used, and the diagnosis and analysis of diseases has entered the era of intelligence. With the increasing public health awareness, ordinary citizens have also put forward new demands for panic disorder health services. Specifically, people hope to predict the risk of panic disorder as soon as possible and grasp their own condition without leaving home. Against this backdrop, the smart health industry comes into being. In the Internet age, a lot of panic disorder health data has been accumulated, such as diagnostic records, medical record information and electronic files. At the same time, various health monitoring devices emerge one after another, enabling the collection and storage of personal daily health information at any time. How to use the above data to provide people with convenient panic disorder self-assessment services and reduce the incidence of panic disorder in China has become an urgent problem to be solved. In order to solve this problem, this research applies the context awareness to the automatic diagnosis of human diseases. While helping patients find diseases early and get treatment timely, it can effectively assist doctors in making correct diagnosis of diseases and reduce the probability of misdiagnosis and missed diagnosis.

Photodynamic Diagnosis and Therapy for Peritoneal Carcinomatosis from Gastrointestinal Cancers: Status, Opportunities, and Challenges

  • Kim, Hyoung-Il;Wilson, Brian C.
    • Journal of Gastric Cancer
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    • 제20권4호
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    • pp.355-375
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    • 2020
  • Selective accumulation of a photosensitizer and the subsequent response in only the light-irradiated target are advantages of photodynamic diagnosis and therapy. The limited depth of the therapeutic effect is a positive characteristic when treating surface malignancies, such as peritoneal carcinomatosis. For photodynamic diagnosis (PDD), adjunctive use of aminolevulinic acid- protoporphyrin IX-guided fluorescence imaging detects cancer nodules, which would have been missed during assessment using white light visualization only. Furthermore, since few side effects have been reported, this has the potential to become a vital component of diagnostic laparoscopy. A variety of photosensitizers have been examined for photodynamic therapy (PDT), and treatment protocols are heterogeneous in terms of photosensitizer type and dose, photosensitizer-light time interval, and light source wavelength, dose, and dose rate. Although several studies have suggested that PDT has favorable effects in peritoneal carcinomatosis, clinical trials in more homogenous patient groups are required to identify the true benefits. In addition, major complications, such as bowel perforation and capillary leak syndrome, need to be reduced. In the long term, PDD and PDT are likely to be successful therapeutic options for patients with peritoneal carcinomatosis, with several options to optimize the photosensitizer and light delivery parameters to improve safety and efficacy.