• Title/Summary/Keyword: Post-diagnosis

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Quantitative Analysis of Thyroid Blood Flow and Static Imaging in the Differential Diagnosis of Thyroid Nodules

  • Song, Li-Ping;Zhang, Wen-Hong;Xiang, Yang;Zhao, Na
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6331-6335
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    • 2013
  • Objective:To evaluate the performance of combined quantitative analysis of thyroid blood flow and static imaging data in the differential diagnosis of thyroid nodules. Method: Thyroid blood flow and static imaging were performed in 165 patients with thyroid nodules. Patients were divided into a benign thyroid nodule group (BTN, n=135) and a malignant thyroid nodule group (MTN, n=30) based on the results of post-surgical pathologic examination. Carotid artery thyroid transit times (CTTT), perfusion ratio of thyroid nodule blood/thyroid blood (TNB/TB), and perfusion ratio of thyroid nodule blood/carotid artery blood (TNB/CAB) were measured using thyroid blood flow imaging. The ratios between thyroid nodule and ipsilateral submandibular gland (TN/SG) and thyroid nodule and normal thyroid tissue (TN/T) were measured from thyroid static imaging. The differences between the BTN and MTN groups were compared. Results: 1) CTTT was markedly lower in the MTN group than the BTN group, the difference being statistically significant. 2) TNB/TB and TNB/CAB were both significantly higher in MTN than BTN groups. 3) TN/T was significantly lower in MTN group than BTN group. 4) TN/SG was lower in MTN group than BTN group, but the difference was not statistically significant. 5) Using the combination of CTTT and TN/T, the sensitivity, specificity and accuracy were 93.1%, 95.3% and 94.9% respectively for the diagnosis of MTN. Using the combination of CTTT, TNB/TB and TN/T, the sensitivity, specificity and accuracy changed to 89.7%, 100%, and 98.1% respectively. 6) Correlation analysis demonstrated a significant correlation between TN/T and TNB/TB (r=-0.384, P=0.036) and TNB/CAB (r=-0.466, P=0.009) in the MTN group. Conclusion: The combination of quantitative markers from thyroid blood flow and thyroid static imaging had high specificity and accuracy in differential diagnosis of benign and malignant thyroid nodules, thus providing an important imaging diagnostic approach.

Quantitative assessment of image artifacts from root filling materials on CBCT scans made using several exposure parameters

  • Rabelo, Katharina Alves;Cavalcanti, Yuri Wanderley;de Oliveira Pinto, Martina Gerlane;Melo, Saulo Leonardo Sousa;Campos, Paulo Sergio Flores;de Andrade Freitas Oliveira, Luciana Soares;de Melo, Daniela Pita
    • Imaging Science in Dentistry
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    • v.47 no.3
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    • pp.189-197
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    • 2017
  • Purpose: To quantify artifacts from different root filling materials in cone-beam computed tomography (CBCT) images acquired using different exposure parameters. Materials and Methods: Fifteen single-rooted teeth were scanned using 8 different exposure protocols with 3 different filling materials and once without filling material as a control group. Artifact quantification was performed by a trained observer who made measurements in the central axial slice of all acquired images in a fixed region of interest using ImageJ. Hyperdense artifacts, hypodense artifacts, and the remaining tooth area were identified, and the percentages of hyperdense and hypodense artifacts, remaining tooth area, and tooth area affected by the artifacts were calculated. Artifacts were analyzed qualitatively by 2 observers using the following scores: absence (0), moderate presence (1), and high presence (2) for hypodense halos, hypodense lines, and hyperdense lines. Two-way ANOVA and the post-hoc Tukey test were used for quantitative and qualitative artifact analysis. The Dunnet test was also used for qualitative analysis. The significance level was set at P<.05. Results: There were no significant interactions among the exposure parameters in the quantitative or qualitative analysis. Significant differences were observed among the studied filling materials in all quantitative analyses. In the qualitative analyses, all materials differed from the control group in terms of hypodense and hyperdense lines (P<.05). Fiberglass posts did not differ statistically from the control group in terms of hypodense halos(P>.05). Conclusion: Different exposure parameters did not affect the objective or subjective observations of artifacts in CBCT images; however, the filling materials used in endodontic restorations did affect both types of assessments.

Recurrent ST segment elevations in a patient with asymptomatic early repolarization during head and neck surgery: implications of vasospastic angina

  • Park, Se-Ung;Kim, Sung-Hoon;Kwon, Hye-Mee;Koh, Gi-Ho;Nam, Gi-Byoung;Karm, Myong-Hwan;Kim, Wook-Jong;Ku, Seung-Woo
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.18 no.3
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    • pp.189-193
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    • 2018
  • A 57-year-old woman scheduled for cochlear implant removal exhibited preoperative electrocardiographic findings of early repolarization (ER). Four episodes of transient ST segment elevations during surgery raised suspicion for vasospastic angina (VA). In the post-anesthetic care unit, the patient complained of chest discomfort and received sublingual nitroglycerin with uncertain effect. The patient refused to proceed with postoperative invasive coronary angiography, resulting in inconclusive diagnosis. Intraoperative circumstances limit the diagnosis of VA, which emphasizes the need for further testing to confirm the diagnosis. When VA is suspected in patients with underlying ER, it is reasonable to consider invasive examination to establish the diagnosis and prevent recurrence of VA. If ST changes are observed during surgery in patients with preoperative ER, careful monitoring is recommended. Due to general anesthesia, the absence of patient symptoms limits the definitive diagnosis of those with suspected VA. Therefore, additional postoperative surveillance is recommended.

Vertical root fracture diagnosis in teeth with metallic posts: Impact of metal artifact reduction and sharpening filters

  • Debora Costa Ruiz;Lucas P. Lopes Rosado;Rocharles Cavalcante Fontenele;Amanda Farias-Gomes;Deborah Queiroz Freitas
    • Imaging Science in Dentistry
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    • v.54 no.2
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    • pp.139-145
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    • 2024
  • Purpose: This study examined the influence of a metal artifact reduction (MAR) tool, sharpening filters, and their combination on the diagnosis of vertical root fracture (VRF) in teeth with metallic posts using cone-beam computed tomography (CBCT). Materials and Methods: Twenty single-rooted human premolars - 9 with VRF and 11 without - were individually placed in a human mandible. A metallic post composed of a cobalt-chromium alloy was inserted into the root canal of each tooth. CBCT scans were then acquired under the following parameters: 8 mA, a 5×5 cm field of view, a voxel size of 0.085 mm, 90 kVp, and with MAR either enabled or disabled. Five oral and maxillofacial radiologists independently evaluated the CBCT exams under each MAR mode and across 3 sharpening filter conditions: no filter, Sharpen 1×, and Sharpen 2×. The diagnostic performance was quantified by the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity. These metrics were compared using 2-way analysis of variance with a significance level of α=5%. Intra- and inter-examiner agreement were assessed using the weighted kappa test. Results: Neither MAR nor the application of sharpening filters significantly impacted AUC or specificity (P>0.05). However, sensitivity increased when MAR was combined with Sharpen 1× and Sharpen 2× (P=0.015). The intra-examiner agreement ranged from fair to substantial (0.34-0.66), while the inter-examiner agreement ranged from fair to moderate (0.27-0.41). Conclusion: MAR in conjunction with sharpening filters improved VRF detection; therefore, their combined use is recommended in cases of suspected VRF.

A Case Study of Improving Instruction by Utilizing Online Instruction Diagnosis Item Pool

  • SHIM, Mi-Ja
    • Educational Technology International
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    • v.6 no.2
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    • pp.23-41
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    • 2005
  • One of the main factors that determine the quality of instruction is the teaching ability of the instructor administering the class. To evaluate teaching ability, methods such as peer review, student feedback, and teaching portfolio can be used. Among these, because feedback from the students is directly associated with how well the students feel they have learned, it is essential to improving instruction and teaching ability. The principal aim of instruction evaluation lies in the evaluation of instructor's qualification and the improvement of instruction quality by enhancing professionalism. However, the mandatory instruction evaluations currently being carried out at the term's end in universities today have limitations in improving instruction in terms of its evaluation items and times. To improve the quality of instruction and raise teaching abilities, instruction evaluations should not stop at simply being carried out but also be utilized as useful data for students and teachers. In other words, they need to be used to develop teaching and improve instruction for teachers, and consequently, should also exert a positive influence on students' scholastic achievements and learning ability. The most important thing in evaluation is the acquisition of accurate information and how to utilize it to improve instruction. The online instruction diagnosis item pool is a more realistic feedback device developed to improve instruction quality. The instruction diagnosis item pool is a cafeteria-like collection of hundreds of feedback questions provided to enable instructors to diagnose their instruction through self-diagnosis or students' feedback, and the instructors can directly select the questions that are appropriate to the special characteristics of their instruction voluntarily make use of them whenever they are needed. The current study, in order to find out if the online instruction diagnosis item pool is truly useful in reforming and improving instruction, conducted pre and post tests using 256 undergraduate students from Y university as subjects, and studied the effects of student feedback on instructions. Results showed that the implementation of instruction diagnosis improved students' responsibility regarding their classes, and students had positive opinions regarding the usefulness of online instruction diagnosis item pool in instruction evaluation. Also, after instruction diagnosis, analyzing the results through consultations with education development specialists, and then establishing and carrying out instruction reforms were shown to be more effective. In order to utilize the instruction diagnostic system more effectively, from planning the execution of instruction diagnosis to analyzing the results, consulting, and deciding how those results could be utilized to instruction, a systematic strategy is needed. In addition, professors and students need to develop a more active sense of ownership in order to elevate the level of their instruction.

A Computed Tomographic Study on the Size and Bone Wall Thickness of the Maxillary Sinus in Normal, Preoperative and Postoperative Maxillary Sinusitis Patients (술전ㆍ후 상악동염환자와 정상인의 상악동 크기 및 골벽두께에 관한 전산화단층방사선학적 연구)

  • Choi Sun-Young;Lee Sang-Rae;Koh Kwang-Joon
    • Imaging Science in Dentistry
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    • v.30 no.2
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    • pp.109-116
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    • 2000
  • Purpose : To compare the size and bone wall thickness of the maxillary sinus in normal, preoperative and postoperative maxillary sinusitis patients. Materials and Methods : The author analyzed CT images of both left and right maxillary sinuses in 357 patients who visited Chonbuk National University Hospital between January 1997 and December 1998. The size and bone wall thickness of the maxillary sinus of normal, inflammatory and post-Caldwell-Luc groups were compared. Results: The significant differences of transverse, maximum medio-lateral, maximum supero-inferior dimensions and medio-lateral dimension at nasal floor level between normal and post-Caldwell-Luc groups were found (P<0.05). And the significant differences of antero-posterior dimensions between inflammatory and post-Caldwell-Luc group were found (P<0.05). But, no significant differences of vertical height dimensions between groups was found (P>0.05). The significant differences of postero-lateral, infero-lateral and medial wall thickness between normal and post-Caldwell-Luc groups were found (P<0.05). Conclusion : The results of this study will aid in the diagnosis and treatment of maxillary sinus diseases and post operative treatment planning.

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Reconstruction of Post Burn Auricular Defect (화상 후 이개부 결손의 재건)

  • Cho, Dong-Pill;Lee, Jong-Wook;Koh, Jang-Hyu;Seo, Dong-Kook;Choi, Jai-Koo;Jang, Young-Chul
    • Archives of Plastic Surgery
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    • v.37 no.4
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    • pp.421-426
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    • 2010
  • Purpose: Patients with serious burns are prone to chondritis due to lack of soft tissue in the auricle, which can cause severe defects in the auricular morphology. In addition, skin damage occurs frequently in the vicinity of post-burn wounds, presenting difficulties in reconstruction surgery. An auricular reconstruction has functional and cosmetic significance. The aim of this study is to develop appropriate reconstruction methods for auricular defects. Methods: Thirty seven patients, who were treated for auricular defects from 2005 to 2009, were enrolled in this study. A local flap, multiple regional flaps and cartilage framework with or without a temporal fascial flap were applied in reconstruction surgery according to the location of the auricular defect. Results: The age of the subjects ranged from 11 to 56. Some subjects had defects that cover more than half of the helical rim with most exhibiting post-burn scars in the vicinity, for whom a multiple regional flap was used. A single use of a tubed flap was sufficient for subjects with defects that covered less than half of the helical rim. A regional flap was also used for reconstruction in subjects with defects covering both the helical rim and antehelix. Conclusion: Achieving satisfactory results from the skin flaps and skin grafts for post-burn auricular defects in both functional and cosmetic aspects is a difficult task. Therefore, selecting an appropriate surgical method through proper diagnosis of the auricular defect and the state of the available skin in the vicinity is essential.

Influential Factors of Post-Traumatic Stress Disorder in Survivors of Intensive Care Units (중환자실 생존자의 외상 후 스트레스장애 발생정도와 영향요인)

  • Kim, So Hye;Ju, Hyeon Ok
    • Journal of Korean Clinical Nursing Research
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    • v.26 no.1
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    • pp.97-106
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    • 2020
  • Purpose: This study was conducted to investigate the incidence and associated factors with post-traumatic stress disorders (PTSD) in patients with intensive care units (ICU) admission experience. Methods: This study is a retrospective observational study using self-reporting questionnaire. Patients who were admitted to ICU more than 72 hours and agreed to participate were enrolled in this study. PTSD were assessed by Korean version of post-traumatic diagnosis scale, and PTSD was defined as 20 points or more. Medical records of participants were reviewed to identify influencing factors of PTSD. To analyzed the data, descriptive statistics, Mann-Whitney U test, Kruskal-Wallis test and gamma regression were utilized using SPSS/WIN 23.0 program. Results: A total of 128 patients participated in the study. Mean age of participants was 58.3±11.7 years and 50 patients (39.1%) were female. Mean duration of ICU stay was 8.43±8.09 days and PTSD was diagnosed in 12 patients (9.4%). In the results of a Gamma regression analysis, Psychiatric history (B=1.09, p=.002), APACHEII score (B=.04, p=.005), CPR experience (B=1.65, p=.017) and physical restraint (B=.68, p=.049) were independently associated with PTSD occurrence. Conclusion: The results of this study suggest that a various factors influencing PTSD should be identified to prevent PTSD in patients who requires ICU care. In addition, post-ICU care programs are required to assess and reduce PTSD.

Pulmonary Functions and Inflammatory Biomarkers in Post-Pulmonary Tuberculosis Sequelae

  • Shanmugasundaram, Kumar;Talwar, Anjana;Madan, Karan;Bade, Geetanjali
    • Tuberculosis and Respiratory Diseases
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    • v.85 no.2
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    • pp.175-184
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    • 2022
  • Background: Post-tuberculosis (TB) sequelae is a commonly encountered clinical entity, especially in high TB burden countries. This may represent chronic anatomic sequelae of previously treated TB, with frequent symptomatic presentation. This pilot study was aimed to investigate the pulmonary functions and systemic inflammatory markers in patients with post-TB sequelae (PTBS) and to compare them with post-TB without sequelae (PTBWS) participants and healthy controls. Methods: A total of 30 participants were enrolled, PTBS (n=10), PTBWS (n=10), and healthy controls (n=10). Pulmonary function tests included spirometry and measurement of airway impedance by impulse oscillometry. Serum levels of matrix metalloproteinase (MMP)-1, transforming growth factor-β, and interferon-γ were estimated. Results: Slow vital capacity (SVC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC, and peak expiratory flow were significantly lower in PTBS as compared to controls. SVC and FEV1 were significantly less in PTBS as compared to PTBWS. Total airway impedance (Z5), total airway resistance (R5), central airway resistance (R20), area of reactance (Ax), and resonant frequency (Fres) were significantly higher and respiratory reactance at 5 and 20 Hz (X5, X20) were significantly lower in PTBS as compared to PTBWS. Spirometry parameters correlated with impulse oscillometry parameters in PTBS. Serum MMP-1 level was significantly higher in PTBS as compared to other groups. Conclusion: Significant pulmonary function impairment was observed in PTBS, and raised serum MMP-1 levels compared with PTBWS and healthy controls. Follow-up pulmonary function testing is recommended after treatment of TB for early diagnosis and treatment of PTBS.

Development of Adaptive Noise Cancelling Algorithm for Post Processing of Biomedical Signals

  • Nam, Ji-Hyun;Yoon, Dal-Hwan
    • Proceedings of the IEEK Conference
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    • 2002.07a
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    • pp.500-503
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    • 2002
  • Biomedical signals are ubiquitously contaminated and degraded by background noise which span nearly all frequency bandwidths. This paper proposes the MADF (multiplication free adaptive digital filter) algorithm to cancel the noise. And the convergence characteristics of the algorithm is analyzed. In the experimental results, the MADF algorithm has the advantage in which has superior to a condition of low-frequency and slow data speed. This application gives an important significance in ensuring the objectivity of clinical information and in promoting the representation and the disease diagnosis.

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