• Title/Summary/Keyword: Noninvasive diagnosis

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Ultrasonographic Evaluation in Patients with Inguinal Hernia (서혜부 탈장에서의 초음파 조영술)

  • Kwon, Oh-Kyoung;Jung, Jin-Hyang;Park, Jin-Young;Chang, Soo-Il
    • Advances in pediatric surgery
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    • v.8 no.1
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    • pp.16-22
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    • 2002
  • Between March 1999 and January 2000, 82 boys with the diagnosis of inguinal hernias (12 bilateral and 70 unilateral hernias), underwent Ultrasound (US) examination of both sides of the groin, a total of 164 inguinal imaging prior to surgery. The patients ages ranged from 3 days to 12 years with a mean of 32.6 months. Ninty four examinations were on the clinically symptomatic side and 70 were on the asymptomatic side. The US criteria for the diagnosis of an inguinal hernia were as follows: 1) visceral hernia, the presence of bowel loops, or omentum in the inguinal canal, 2) communicating hydrocele, the presence of fluid in the processus vaginalis, 3) widening of patent processus vaginalis at the level of internal inguinal ring. The width of patent processus vaginalis at the level of internal inguinal ring over 4 mm is considered an occult hernia. Among the 94 symptomatic groins, US findings showed 31 (33%) visceral hernias, 18 (19%) communicating hydroceles, and 38 (41%) widening of the internal inguinal ring, and 7 (7%) groins without abnormalities. In 70 asymptomatic groins, there were 4 (6%) visceral hernias, 5 (7%) communicating hydroceles, 11 (16%) widening of the internal inguinal ring, and 50 (70%) groins without abnormalities. Among the 70 asymptomatic groins there were US abnormalities in 20 (28%). One hundred and seven groins with positive US findings were surgically explored. Among 107 operated sites, the operative findings were compatible with the US diagnosis in 104, a sensitivity for US of 97.2%. In patients with US findings of widening of internal inguinal ring (>4 mm), there was patent processus vaginalis in 36 out of 38 symptomatic groins and 10 of 11 asymptomatic groins. The sensitivity of US to the operative findings in widening of internal inguinal ring was 93.8%. For visceral hernia and communicating hydrocele, the sensitivity of positive US findings was 100%. Ultrasonography for inguinal hernias appears to be a rapid, reliable, and noninvasive screening diagnostic tool with high positive specificity. Therefore, we recommend the use of US as a routine diagnostic tool in pediatric patients with inguinal hernias and hydroceles.

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Comparison of Four Commercial ELISA Kits and In-House Immunoblotting for Diagnosis of Helicobacter pylori Infection

  • Jeong, Hoar Lim;Jung, Yang-Sook;Jun, Jin-Su;Yeom, Jung Sook;Park, Ji Sook;Seo, Ji-Hyun;Lim, Jae-Young;Park, Chan-Hoo;Woo, Hyang-Ok;Youn, Hee-Shang;Ko, Gyung-Hyuck;Baik, Seung-Chul;Lee, Woo-Kon;Cho, Myung-Je;Rhee, Kwang-Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.15 no.2
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    • pp.85-90
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    • 2012
  • Purpose: Commercial enzyme-linked immunosorbent assay (ELISA) kits have been considered less reliable for children than for adults. The aim of this study was to compare four ELISA kits and in-house immunoblotting based on the analysis of anti-H. pylori-IgG antibody reactivity. Methods: A total of 399 serum samples were collected at the GNU Hospital during 1998-1999. All sera were tested using ELISA and immunoblotting. Statistically significant differences were determined by the $x^2$ test. Results: The overall seropositivity rates using GAP IgG, Genedia IgG, HM-CAP, Pyloriset EIA-G, and immunoblotting were 13.0%, 25.1%, 18.3%, 15.8%, and 62.9%, respectively. Immunoblotting showed a higher seropositivity rate than did all four ELISA kits in all age groups. Genedia IgG had the highest seropositivity among the ELISA kits. The seropositivity rate for children aged 13 to 18 months was lowest, and that of children aged 15 years was highest (90.0%). The seropositivity rate for children aged 7 months to 5 years was significantly lower than that for children aged 6 to 15 years among the four ELISA kits (p<0.0001) and immunoblotting (p=0.02). Conclusion: Immunoblotting is the most sensitive test for detection of anti-Helicobacter pylori IgG antibodies among the serological tests in this study. These results emphasize the need for standardization when commercial ELISA tests are used in different nations or in young age groups. Immunoblotting could be a suitable noninvasive assay for serodiagnosis and seroepidemiologic study of H. pylori infection in Korean children.

Reliability Improvement of Automatic Basal Cell Carcinoma Classifier with an Ambiguous Pattern Class (모호한 패턴 클래스 도입을 통한 기저 세포암 분류기의 신뢰도 향상)

  • Park, Aa-Ron;Baek, Seong-Joon;Jung, In-Wook;Song, Min-Gyu;Na, Seung-Yu
    • Journal of the Institute of Electronics Engineers of Korea CI
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    • v.44 no.1
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    • pp.64-70
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    • 2007
  • Raman spectroscopy is known to have strong potential for providing noninvasive dermatological diagnosis of skin cancer. According to the previous work, various well known methods including maximum a posteriori probability (MAP) and multilayer perceptron networks (MLP) showed competitive results. Since even the small errors often leads to a fatal result, we investigated the method that reduces classification error perfectly by screening out some ambiguous patterns. Those ambiguous patterns can be examined by routine biopsy. We incorporated an ambiguous pattern class in MAP, linear classifier using minimum squared error (MSE), MLP and reduced coulomb energy networks (RCE). The experiments involving 216 confocal Raman spectra showed that every methods could perfectly classify BCC by screening out some ambiguous patterns. The best results were obtained with MSE. According to the experimental results, MSE gives perfect classification by screening out 8.8% of test patterns.

Noninvasive Evaluation of Coronary Artery Bypass Graft Patency by Electron Beam Tomography (전자선 단층 촬영을 이용한 관상동맥 우회로 개존의 비침습적 평가)

  • 최규옥;김호석;조범구
    • Journal of Chest Surgery
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    • v.32 no.8
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    • pp.693-701
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    • 1999
  • Recently non-invasive diagnostic imaging replaced the invasive catheter angiography in the diagnosis of vascular disease. Catheter methods are now almost confined to the purpose of intervention. Coronary artery or coronary artery bypass graft still needs catheter technique because of small diameter and the cardiac motion. The last challenge for radiologists in this domain is to obtain a non-invasive imaging. Electron beam tomography(EBT) for high temporal resolution is able to obtain a coronary arteriogram or coronary artery bypass graft (CABG), of which CABG imaging is quite useful for the evaluation of patency. In our experience as well as others, the accuracy of EBT angiogram in evaluating CABG patency revealed that the accuracy of patency of saphenous vein grafts(SVG) is high due to relatively wide lumen, short and straight course and less influence from cardiac motion. The sensitivity and specificity of patency of SVGs were 92%, 97% respectively in the prospective evaluat on and 100% each in the retrospective evaluation. A false positive and a false negative case are rudimentary errors in the initial learing period. In contrast the analysis of left internal mammary artery(LIMA) graft was difficult due to the inherent small size and the adjacent surgical clips provoking beam-hardening artifact; therefore, the method of combining 3 dimensional reconstruction and flow mode study was important in improving the accuracy of LIMA patency. The sensitivity and specificity of LIMA patency were 100% and 80% in both prospective and retrospective evaluation. Therefore, EBT angiography is an accurate non-invasive diagnostic modality for evaluating the patency of CABG, particularly in SVGs. The accuracy can be improved with the improvement of the EBT and the development of the image reconstruction software.

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A Case Report of the Primary Lung Lymphoma (폐 종괴로 발현한 원발성 폐림프종 치험 1예)

  • Kim, Ye-Ree;Youn, Seong-Yuk;Yoo, Kwang-Ha;Ahn, Chul-Min;Kim, Hyung-Joong;Jin, Choon-Jo
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.2
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    • pp.272-278
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    • 1999
  • The primary lymphoma in the lung is very rare. Moot of the primary pulmonary lymphomas, which represent 3-4 % of extra-nodal lymphomas, are low-grade B-cell lymphoma. The low-grade B-cell lymphomas progress slowly and the prognosis of these are more favorable than that of the nodal lymphomas. However, high-grade forms progress rapidly with more severe course. The diagnosis of primary pulmonary lymphomas generally relies on the histopathologic findings of lung specimens obtained by surgical excision of the lesions or open-lung biopsy. Recently, less aggressive biopsies(transbronchial, transthoracic) and/or immunocyto-chemical, immunochemical and gene rearrangement studies on materials obtained by bronchoalveolar lavage have been used occasionally. The treatment of the primary pulmonary lymphomas has not been precisely codified. Several clinical data suggest that limited surgery or non-aggressive chemotherapy can provide long-term survival in patients with such slowly developing neoplasm, and demonstrated the need for the development of noninvasive diagnootic methods. In this study, we report a case of high-grade B-cell lymphoma of the lung which was treated with combination chemotherapy.

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Sensitive and Noninvasive Detection of Aberrant SFRP2 and MGMT-B Methylation in Iranian Patients with Colon Polyps

  • Naini, M Alizade;Mokarram, P;Kavousipour, S;Zare, N;Atapour, A;Zarin, M Hassan;Mehrabani, G;Borji, M
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.2185-2193
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    • 2016
  • Background: The pathogenesis of sporadic colorectal cancer (CRC) is influenced by the patient genetic background and environmental factors. Based on prior understanding, these are classified in two major pathways of genetic instability. Microsatellite instability (MSI) and CPG island methylator phenotype (CIMP) are categorized as features of the hypermethylated prototype, and chromosomal instability (CIN) is known to be indicative of the non-hypermethylated category. Secreted frizzled related protein 2 (SFRP2), APC1A in WNT signaling pathway and the DNA repair gene, O6-methylguanine-DNA methyltransferase (MGMT), are frequently hypermethylated in colorectal cancer. Detection of methylated DNA as a biomarker by easy and inexpensive methods might improve the quality of life of patients with CRC via early detection of cancer or a precancerous condition. Aim: To evaluate the rate of SFRP2 and MGMT hypermethylation in both polyp tissue and serum of patients in south Iran as compared with matched control normal population corresponding samples. Materials and Methods: Methylation-specific PCR was used to detect hypermethylation in DNA extracted from 48 polypoid tissue samples and 25 healthy individuals. Results: Of total polyp samples, 89.5% had at least one promoter gene hypermethylation. The most frequent methylated locus was SFRP2 followed by MGMT-B (81.2 and 66.6 percent respectively). Serologic detection of hypermethylation was 95% sensitive as compared with polyp tissue. No hypermethylation was detected in normal tissue and serum and its detection in patients with polyps, especially of serrated type, was specific. Conclusions: Serologic investigation for detection of MGMT-B, SFRP2 hypermethylation could facilitate prioritization of high risk patients for colonoscopic polyp detection and excision.

Comparison of Multidetector Computed Tomography with Coronary Angiography for Evaluation of Coronary Artery Bypass Grafts (관상동맥조영술과 MDCT를 이용한 관상동맥 이식편의 비교평가)

  • Yoo, Byung-Su;Shin, Yoon-Cheol;Kim, Kun-Il;Kim, Eung-Jung;Chee, Hyun-Keun
    • Journal of Chest Surgery
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    • v.39 no.1 s.258
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    • pp.42-47
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    • 2006
  • Background: The new Multidetector Computed Tomography (MDCT) is useful in visualization of complex coronary artery anatomy. We investigated usefulness comparing of invasive coronary angiography with noninvasive MDCT in judgment of functional degree of coronary arteries grafts after coronary artery bypass graft operation. Material and Method: We analyzed the patency of 52 conduits from 15 patients whom consented to take both 32 Channel MDCT and coronary angiography from November 2003 to November 2004. Comparisons were performed for sensitivity, specificity, positive prediction value and negative prediction value between coronary angiography and 3 dimensional reconstruction image using MDCT. Result: The average graft used was 3.4 $\pm$ 0.8 per patient. Average heart rate during MDCT was 86/minute (Range, 60$\∼$110/minute) without administration of $\beta$-blocker. All patients could hold breath as much as necessary. The average graft patency obtained through corollary angiography was 96.2$\%$. In MDCT group, the sensitivity, the specificity, the positive predictive value and the negative predictive value for diagnosis was 100$\%$, 98.0$\%$, 100$\%$ and 66.6$\%$ respectively. Conclusion: The effectiveness of 32 Channel MDCT may be compared to coronary angiography in grasping about patency and bloodstream of graft conduits after coronary artery bypass graft. Also MDCT has the advantage of noninvasiveness and inexpensiveness compared to coronary angiography.

Scintigraphic Features of Choledochal Cyst Using Technetium-99m-DISIDA Hepatobiliary Scan (총담관낭종의 $^{99m}Tc$-DISIDA 간담도 스캔)

  • Choi, Chung-Il;Kim, Jeong-Gyun;Bae, Sun-Kun;Kwak, Dong-Suk;Chung, Byung-Cheon;Lee, Jae-Tae;Lee, Kyu-Bo;Zeon, Seok-Kil;Lee, Hyung-Woo
    • The Korean Journal of Nuclear Medicine
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    • v.27 no.1
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    • pp.71-80
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    • 1993
  • In order to evaluate the scintigraphic features of choledochal cyst and these diagnostic value, authors investigated the findings of fourteen patients with choledochal cyst undergone hepatobiliary scan with $^{99m}Tc$-DISIDA before surgery. Five cases demonstrated the decreased hepatic uptake at 5-minute image of which four cases revealed severe jaundice. Seven cases demonstrated visualization of the cystic dilated common bile duct within 1 hour after injection. Two cases showed the cyst activity between 1 and 12 hours, but the cyst activity was not visible in five cases. Nonvisualization of the gall bladder was noted in ten cases, while four cases demonstrated visualization of the gall bladder within 1 hour. The time of visualization of gut activity was variably delayed. The intestinal activity was found in three cases within 1 hour and appeared in three cases between 1 and 2 hours and eight cases showed no visible gut activity. In four cases, intrahepatic ductal prominence was visible on the scintigram. Seven cases showed early and persistent accumulation of tracer in the common bile duct. Three cases showed persistent photon-deficient area in the gall bladder region. Two cases showed early photon-deficient area around gall bladder region with progressive accumulation of tracer in the same region. Two cases showed no evidence of activity in the biliary tract but noted late excretion into the small intestine. We concluded that hepatobiliary scan using $^{99m}Tc$-DISIDA is a noninvasive test useful in the evaluation and the diagnosis of choledochal cyst.

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Development of an Measuring System for Pulse Wave Corresponding to Different Radial Artery Diameters Caused by Indentation (요골동맥 직경 변화에 따른 맥파 측정 시스템 개발)

  • Lee, Jeon;Woo, Young-Jae;Jeon, Young-Ju;Lee, Yu-Jung;Kim, Jong-Yeol
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.57 no.12
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    • pp.2351-2357
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    • 2008
  • Noninvasive radial artery pulse wave has been widely used not only for the pulse wave analysis(PWA) itself but also for assessment of arterial stiffness with estimated aortic pulse wave from peripheral pulse wave. However, it has been found that the deformation of pulse shape can be caused readily by changing measuring position, indentation pressure, and so on. So, in this study, we have developed a system which can measure radial pulse wave and skin displacement simultaneously while the indentation body goes down to occlude subject's radial artery. This system can be divided into a measuring apparatus part, an indentation control hardware part, a data acquisition part and a control and computation part. And, the measuring apparatus consists of an arm-rest, a step motor, an indentation body, a laser displacement sensor(LK-G30, Keyence Co.) and pulse wave sensor. Under load-free condition and radial artery loaded condition, the evaluation of developed system has been performed. From these results, we can conclude: 1) The developed system can control the indentation body quantitatively and the adopted laser displacement sensor shows linear output characteristic even with skin as a reflector. 2) This system can measure the pulse wave and the displacement of indentation body, that is, skin displacement simultaneously at each specific level of indentation body. 3) This system can provide the number of motor steps used to get down the indentation body, the measured skin displacement, the calculated indentation pressure, the calculated pulse pressure and the pulse waveform as well as the information generated by combining these with each others. 4) This system can reveal the relationship between the morphological changes of pulse wave and the estimated displacement of radial artery wall by indentation. Consequently, the developed system can furnish more abundant information on radial artery than previous diagnosis systems based on tonometric measurement. In further study, we expect to setup the standard measuring process and to concrete the algorithm for the estimation of radial artery's diameter and of displacement of radial artery's wall. Furthermore, with well designed clinical studies, we hope to turn out the usefulness of developed system in the field of cardiovascular system evaluation.

Synthesis of (4-$[^{18}F]$Fluorophenyl)triphenylphosphonium as a Mitochondrial Voltage Sensor for PET (PET영상용 미토콘드리아 막전위 감지기 (4-$[^{18}F]$Fluorophenyl)triphenylphosphonium의 합성)

  • Kim, Dong-Yeon;Yu, Kook-Hyun;Bom, Hee-Seung;Min, Jung-Joon
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.6
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    • pp.561-565
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    • 2007
  • Purpose: Lipophilic cations including tetraphenylphosphonium (TPP) salts penetrate the hydrophobic barriers of the plasma and mitochondrial membranes, resulting in accumulation in mitochondria in response to the negative inner transmembrane potentials. The development of radiolabeled phosphonium cations as a noninvasive imaging agent may serve as a new molecular "voltage sensor" probe to investigate the role of mitochondria in the pathophysiology and diagnosis of cancer. Materials and Methods: We have synthesized a reference compound (4-fluorophenyl)triphenylphosphonium (TPP) and a labeled compound $[^{18}F]$TPP via two step nucleophilic substitution of no-carrier-added $[^{18}F]$fluoride with the precursor, 4-iodophenyltrimethylammonium iodide, in the presence of Kryptofix-2.2.2 and $K_2CO_3$. Result: The reference compound (4-fluorophenyl)triphenylphosphonium (TPP) was synthesized in 60% yield. The radiolabeled compound $[^{18}F]$TPP was synthesized in $10\sim15%$ yield. The radiochemical purity of the $[^{18}F]$TPP was $95.57{\pm}0.51%$ (n=11). Conclusion: $[^{18}F]$TPP was successfully synthesized that might have a potential to be utilized as a novel myocardial or cancer imaging agent for PET. However, it is required to improve the radiochemical yield to apply $[^{18}F]$TPP in preclinical or clinical researches.