• 제목/요약/키워드: Regional Diagnostic

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Utility of Spinal Injury Diagnosis Using C-Spine Lateral X-Ray and Chest, Abdomen and Pelvis Computed Tomography in Major Trauma Patients with Impaired Consciousness

  • Jang, Yoon Soo;So, Byung Hak;Jeong, Won Jung;Cha, Kyung Man;Kim, Hyung Min
    • Journal of Trauma and Injury
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    • v.31 no.3
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    • pp.151-158
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    • 2018
  • Purpose: The regional emergency medical centers manage the patients with major blunt trauma according to the process appropriate to each hospital rather than standardized protocol of the major trauma centers. The primary purpose of this study is to evaluate the effectiveness and influence on prognosis of additional cervical-thoracic-lumbar-spine computed tomography (CTL-spine CT) scan in diagnosis of spinal injury from the victim of major blunt trauma with impaired consciousness. Methods: The study included patients visited the urban emergency medical center with major blunt trauma who were over 18 years of age from January 2013 to December 2016. Data were collected from retrospective review of medical records. Sensitivity, specificity, positive predictive value, and negative predictive value were measured for evaluation of the performance of diagnostic methods. Results: One hundred patients with Glasgow coma scale ${\leq}13$ underwent additional CTL-spine CT scan. Mechanism of injury was in the following order: driver, pedestrian traffic accident, fall and passenger accident. Thirty-one patients were diagnosed of spinal injury, six of them underwent surgical management. The sensitivity of chest, abdomen and pelvis CT (CAP CT) was 72%, specificity 97%, false positive rate 3%, false negative rate 28% and diagnostic accuracy 87%. Eleven patients were not diagnosed of spinal injury with CAP CT and C-spine lateral view, but all of them were diagnosed of stable fractures. Conclusions: C-spine CT scan be actively considered in the initial examination process. When CAP CT scan is performed in major blunt trauma patients with impaired consciousness, CTL-spine CT scan or simple spinal radiography has no significant effect on the prognosis of the patient and can be performed if necessary.

Infantile Colic: A Survey of Physicians in Pakistan

  • Muhammad Saif Jalal;Syed Zafar Mehdi;Jalal Uddin Akber;Murtaza Ali Gowa;Carlos Lifschitz
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.27 no.3
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    • pp.186-195
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    • 2024
  • Purpose: Infantile colic diagnostic criteria were established by Rome IV. A universally accepted management remains to be established. We aimed to evaluate diagnostic criteria, management strategies, and perceived regional prevalence of infantile colic in Pakistan, as well as its effect on physicians and parents. Methods: A questionnaire was distributed amongst 1,256 physicians. Results: We received 800 replies. Wessel and Rome IV criteria were used by most physicians for diagnosis; however, the response "any infant who cries a lot" was selected by older physicians (48% of those over 60 years), physicians in rural areas (32%), physicians practicing in private clinics (27%), and general physicians (30%). Estimated prevalence of infantile colic ranges from 21-40%. Reassurance was the most widely recommended management strategy followed by herbal teas (51%), switching to a different formula (49%), probiotics (28%) and antibiotics (26%), discontinuation of breastfeeding (14%), elimination of dairy products from the breastfeeding mothers' diet (6%), and the administration of colic drops (1%). Most physicians considered the negative impact of colic on their personal lives and the parents as mild-to-moderate. Notably, 38% of percent of physicians routinely screened for maternal depression, and 45% of physicians were aware of the association between infantile colic and shaken baby syndrome. Conclusion: Most physicians in Pakistan diagnose and manage infantile colic according to the established guidelines. However, the guidelines pertaining to treatment planning are not followed. Educational efforts directed toward general physicians and doctors practicing in rural areas and clinics must be implemented to avoid unnecessary testing and treatment burden.

Automatic detection of periodontal compromised teeth in digital panoramic radiographs using faster regional convolutional neural networks

  • Thanathornwong, Bhornsawan;Suebnukarn, Siriwan
    • Imaging Science in Dentistry
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    • v.50 no.2
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    • pp.169-174
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    • 2020
  • Purpose: Periodontal disease causes tooth loss and is associated with cardiovascular diseases, diabetes, and rheumatoid arthritis. The present study proposes using a deep learning-based object detection method to identify periodontally compromised teeth on digital panoramic radiographs. A faster regional convolutional neural network (faster R-CNN) which is a state-of-the-art deep detection network, was adapted from the natural image domain using a small annotated clinical data- set. Materials and Methods: In total, 100 digital panoramic radiographs of periodontally compromised patients were retrospectively collected from our hospital's information system and augmented. The periodontally compromised teeth found in each image were annotated by experts in periodontology to obtain the ground truth. The Keras library, which is written in Python, was used to train and test the model on a single NVidia 1080Ti GPU. The faster R-CNN model used a pretrained ResNet architecture. Results: The average precision rate of 0.81 demonstrated that there was a significant region of overlap between the predicted regions and the ground truth. The average recall rate of 0.80 showed that the periodontally compromised teeth regions generated by the detection method excluded healthiest teeth areas. In addition, the model achieved a sensitivity of 0.84, a specificity of 0.88 and an F-measure of 0.81. Conclusion: The faster R-CNN trained on a limited amount of labeled imaging data performed satisfactorily in detecting periodontally compromised teeth. The application of a faster R-CNN to assist in the detection of periodontally compromised teeth may reduce diagnostic effort by saving assessment time and allowing automated screening documentation.

Intestinal Helminthic Infections Diagnosed by Colonoscopy in a Regional Hospital during 2001-2008

  • Do, Kyong-Rock;Cho, Young-Seok;Kim, Hyung-Keun;Hwang, Byung-Hee;Shin, Eun-Jung;Jeong, Hae-Bin;Kim, Sung-Soo;Chae, Hiun-Suk;Choi, Myung-Gyu
    • Parasites, Hosts and Diseases
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    • v.48 no.1
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    • pp.75-78
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    • 2010
  • The present study investigated characteristics of 24 parasite infection cases detected during colonoscopy in a regional hospital from January 2001 to December 2008. Sixteen patients were confirmed with Trichuris trichiura infection, 6 patients were with Ascaris lumbricoides infection, 1 patient with Enterobius vermicularis infection, and 1 patient with Anisakis infection. Among them, 7 patients (43.8%) were asymptomatic. Colonoscopy findings were normal in 18 patients (75.0%). Among the patients with T. trichiura infection, colonoscopy showed several erosions in 2 patients (8.3%) and non-specific inflammation of the affected segment of the colon in 3 patients (12.5%). In 1 patient with anisakiasis, colonoscopy revealed a markedly swollen colonic wall. Stool examinations were performed before treatment in 7 patients (29.2%) and were all negative for parasite eggs or worms. These results suggest that colonoscopy is a useful diagnostic approach for parasitic infections even for asymptomatic patients and for patients with negative stool examinations.

Comparative serology of human brucellosis in Korea

  • Lee, Sung-Il;Choi, Min-Jung;Hur, Jin;Islam, Md Ariful;Khatun, Mst Minara;Baek, Byeong-Kirl;Lee, Chang-Seup;Kakoma, Ibulaimu;Bolye, Stephen M;Srirangananathan, Nammalwar;Young, Edward John
    • Korean Journal of Veterinary Service
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    • v.31 no.3
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    • pp.331-338
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    • 2008
  • The study was carried out to evaluate the diagnostic efficacy of the tube agglutination test (TAT), enzyme-linked immunosorbent assay (ELISA) and the 2-Mercaptoethanol agglutination test (2-MAT) to detect human brucellosis patients in Korea. We examined 87 serum samples of people in the rural farm areas where bovine brucellosis had been reported. People in this study were divided into seven groups- farmers and their families, veterinarians, veterinary quarantine workers, livestock health control officers, artificial inseminators, livestock traders and healthy control individuals. Among 87 people, 65 were males and 22 were females ranging in age from 13 to 72 years. Of 87 serum samples, ELISA detected 21.84%, TAT detected 11.50% and 2-MAT detected 8.05% Brucella positive sera. Brucella specific IgG ELISA antibody titer was recorder higher in the individuals between the ages of 50 and 65 years. The highest prevalence rate of brucellosis(29.4%) was recorded in the cattle farmers and their family members followed by quarantine veterinary office workers (25%) and practicing veterinarians 01.1%). The majority of the Brucella sero-positive individuals in this study had a history of direct contact with animals.

Risk Factors for Poorer Breast Cancer Outcomes in Residents of Remote Areas of Australia

  • Roder, David;Zorbas, Helen;Kollias, James;Pyke, Chris;Walters, David;Campbell, Ian;Taylor, Corey;Webster, Fleur
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.1
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    • pp.547-552
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    • 2013
  • To investigate patient, cancer and treatment characteristics in females with breast cancer from more remote areas of Australia, to better understand reasons for their poorer outcomes, bi-variable and multivariable analyses were undertaken using the National Breast Cancer Audit database of the Society of Breast Surgeons of Australia and New Zealand. Results indicated that patients from more remote areas were more likely to be of lower socio-economic status and be treated in earlier diagnostic epochs and at inner regional and remote rather than major city centres. They were also more likely to be treated by low case load surgeons, although this finding was only of marginal statistical significance in multivariable analysis (p=0.074). Patients from more remote areas were less likely than those from major cities to be treated by breast conserving surgery, as opposed to mastectomy, and less likely to have adjuvant radiotherapy when having breast conserving surgery. They had a higher rate of adjuvant chemotherapy. Further monitoring will be important to determine whether breast conserving surgery and adjuvant radiotherapy utilization increase in rural patients following the introduction of regional cancer centres recently funded to improve service access in these areas.

Navel Orangeworm (Lepidoptera: Pyralidae) Intercepted on Fresh Oranges from the USA at the Korean Port of Entry (미국산 오렌지 생과실에서 검출된 Navel Orangeworm (나비목: 명나방과))

  • Hong, Ki-Jeong;Hong, Seong-Wook;Ryu, Chang-Seok;Lee, Yong-Hyun
    • Korean journal of applied entomology
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    • v.51 no.3
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    • pp.295-297
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    • 2012
  • Navel orangeworm, Amyelois transitella (Walker) was intercepted at the Korean port of entry. It was detected by an inspection for a consignment of fresh oranges from the USA by the Busan Newport District Office, Yeongnam regional office, Animal Plant and Fisheries Quarantine and Inspection Agency on January 31, 2012. This is the first time that the larvae of this pest species has been detected on fresh oranges, although it has been occasionally detected on walnuts. This report aims to ensure biosecurity by providing diagnostic characters to identify the caterpillars and conducting an imported risk analysis on fresh oranges from the USA.

Pseudo Continuous Arterial Spin Labeling MR Imaging of Status Epilepticus (간질중첩증의 동맥 스핀 라벨링 자기공명영상)

  • Yi, Min-Kyung;Choi, Seung-Hong;Jung, Keun-Hwa;Yoon, Tae-Jin;Kim, Ji-Hoon;Sohn, Chul-Ho;Chang, Kee-Hyun
    • Investigative Magnetic Resonance Imaging
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    • v.16 no.2
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    • pp.142-151
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    • 2012
  • Purpose : The purpose of this study was to describe arterial spin labeling MR image findings of status epilepticus. Materials and Methods: A retrospective chart review within our institute revealed six patients who had been clinically diagnosed as status epilepticus and had also undergone MR imaging that included ASL in addition to routine sequences. Results: Six patients with status epilepticus were studied by conventional MR and arterial spin labeling imaging. All patients showed increased regional CBF correlating with EEG pathology. Notably, in two patients, conventional MRI and DWI showed no abnormal findings whereas pCASL demonstrated regional increased CBF in both patients. Conclusion: Arterial spin labeling might offer additional diagnostic capabilities in the evaluation of patients with status epilepticus.

A Study on the Left Ventricular Wall Motion with EKG Gated Cardiac Blood Pool Scan (방사성동위원소(放射性同位元素) gated cardiac blood pool scan을 이용(利用)한 좌심실벽(左心室壁) 운동(運動)에 관(關)한 연구(硏究))

  • Ahn, Yong-Tae;Kim, Byung-Tae;Park, Young-Bae;Lee, Myung-Chul;Cho, Bo-Youn;Seo, Jung-Don;Lee, Young-Woo;Koh, Chang-Soon;Lee, Mun-Ho
    • The Korean Journal of Nuclear Medicine
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    • v.17 no.2
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    • pp.25-33
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    • 1983
  • Left ventricular wall motion was observed with EKG gated cardiac blood pool scan in 71 various cardiac diseases and 10 normal controls to evaluate its diagnostic and clinical significance in them. 1) In the presence of left ventricular dysfunction, visual evaluation of the left ventricular wall motion was useful to determine whether it was due to localized or diffuse abnormalities. In cardiomyopathy, marked left ventricular dilatation and severe hypokinesia were noted. 2) In myocardial infarction, regional wall motion abnormalities well represented the location of infarcted areas in majority of cases. Patients with inferior wall infarction had smaller decrease of the left ventricular ejection fraction and wall motion grade than anterior or combined groups. In whom persistent left ventricular failure was present, wall motion analysis with gated cardiac scan provided valuable information for the detection of ventricular aneurysms. 3) Evaluation of the left ventricular wall motion and its grading provided a reliable estimate of the left ventricular function. In conclusion, visual evaluation of left ventricular wall motion and its grading provided valuable information for analyzing the characteristics of regional and global left ventricular dysfunction.

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Breast Cancer Scenario in a Regional Cancer Centre in Eastern India over Eight Years - Still a Major Public Health Problem

  • Datta, Karabi;Choudhuri, Maitrayee;Guha, Subhas;Biswas, Jaydip
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.3
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    • pp.809-813
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    • 2012
  • In spite of screening and early diagnostic tests, the upward trend of breast cancer has become a matter of great concern in both developed and developing countries. The data collected by Population Based Cancer Registry in Chittaranjan National Cancer Institute, a regional cancer centre in Kolkata, from 1997 to 2004 gives an insight about the scenario of Breast Cancer in this part of Eastern India.The total no of female breast cancer cases were steadily increasing from 1997 to 2001 and only slightly lower from 2002 to 2004. and majority were in the 40-49 year old age group during this period. The next most commonly affected age group was 50-59 years. Regarding the distribution according to treatment, the main modality was surgery and radiotherapy followed by combined surgery, chemotherapy and radiotherapy and then combined surgery and chemotherapy. The commonest type was ductal followed by lobular cancer. In this eight year study in CNCI, status of patients on last day of the respective year was assessed. Number of patients alive was 43.5% in 1997. The percentage gradually increased up to 2000 and then gradually decreased to 47.4% in 2004. Also with every passing year, percentage mortality gradually decreased from 25.7% in 1997 to 16.8% in 2004. Better pattern of care (diagnosis and treatment) was reflected in this picture. However, lost to follow up, which also implies non compliance to treatment, increased to 30.8% in 1997 to 35.8% in 2004. Due to the small number of male breast cancers, only female cases were considered. In conclusion, breast cancer continues to be a major problem in Kolkata, India.