• 제목/요약/키워드: clinical examination experience

검색결과 147건 처리시간 0.03초

위암에서 인공지능의 응용 (Application of Artificial Intelligence in Gastric Cancer)

  • 이정인
    • Journal of Digestive Cancer Research
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    • 제11권3호
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    • pp.130-140
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    • 2023
  • Gastric cancer (GC) is one of the most common malignant tumors worldwide, with a 5-year survival rate of < 40%. The diagnosis and treatment decisions of GC rely on human experts' judgments on medical images; therefore, the accuracy can be hindered by image condition, objective criterion, limited experience, and interobserver discrepancy. In recent years, several applications of artificial intelligence (AI) have emerged in the GC field based on improvement of computational power and deep learning algorithms. AI can support various clinical practices in endoscopic examination, pathologic confirmation, radiologic staging, and prognosis prediction. This review has systematically summarized the current status of AI applications after a comprehensive literature search. Although the current approaches are challenged by data scarcity and poor interpretability, future directions of this field are likely to overcome the risk and enhance their accuracy and applicability in clinical practice.

Job Analysis by Department in Clinical Practice for Realization of Legal Scope of Dental Hygienists: Focusing on Conservation, Pediatric Dentistry, Prosthodontics, Oral and Maxillofacial Surgery, and Implant Departments

  • Yoon, Mi-Sook
    • 치위생과학회지
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    • 제20권4호
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    • pp.230-244
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    • 2020
  • Background: The objective of the present study was to specifically divide the various work performed by dental hygienists in clinical practice for legal amendments regarding problems associated with conflict between job roles and illegal delegation to establish key basic data for legislation and policy utilization for realization of legal scope of dental hygienists. Methods: The study used work reports drafted based on research methods in the "Second Job Analysis Report on Dental Hygienists" researched by the Korean Health Personnel Licensing Examination Institute in 2012 and "Opinions of Dentists on Actual and Legal Work of Dental Hygienists," a report published by the Korean Dental Hygienists Association. Of these, the study focused on conservation dentistry, pediatric dentistry, prosthodontics, oral and maxillofacial surgery, and dental implant treatment, which make up some of the fields covered by dental hygiene practice, to investigate and analyzed work performed by clinical experience. Results: Analysis of work actually performed in dental practice showed that for work related to 33 items presented in the study methods, the participants responded that they are currently performing such work or are likely to perform such work in the future, although there were differences by year. Investigation by type of workplace showed that dental hygienists working in university hospitals could perform the work presented if they had ≥5 years of dental hygienist experience, whereas dental hygienists working in dental clinics or hospitals could perform simple duties in their first year and performed more diverse duties with greater degree of difficulty after their second to fourth year. Conclusion: The reality that medical assistance during surgical operations and various procedures that is still being performed is no longer legally protected directly contradicts the needs in dental practice, and thus, there is the need to amend laws that are realistic by clearly recognizing the work of dental hygienists.

18F-FDG PET-CT 검사에서 췌장암, 췌장염, 정상 췌장에 대한 최대 표준섭취계수의 임상적 기준 설정 (Clinical Reference of the Maximum Standardized Uptake Values to the Pancreatic Cancer, Pancreatitis and Normal Pancreas in the 18F-FDG PET-CT)

  • 이재승;권대철
    • 대한의용생체공학회:의공학회지
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    • 제39권2호
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    • pp.80-86
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    • 2018
  • The aim of this study were to establish the clinical references and guidelines for the maximum standardized uptake ($SUV_{max}$) value of pancreatic cancer, pancreatitis, and normal pancreas in $^{18}F-FDG$ PET-CT examinations for pancreatic disease. For this purpose, we performed the statistical analysis on the descriptive statistics, percentiles and inter quartiles range (IQR), normal distribution, and using the probability density function for pancreatic cancer, pancreatitis, and normal pancreas. As a result, the clinical reference of $SUV_{max}$ for the pancreatic cancer, pancreatitis, and normal pancreas was more than 3.45, 1.91 to 2.62, and less than 1.91, respectively. Also, optimal cut-off value for applying the dual time point PET-CT examination was determined to be 2.62. The results of this study are summarized as follows: first, we suggests the clinical reference and guideline for the pancreatic cancer, pancreatitis, and normal pancreas, and second, suggests a scientific approach to improve diagnostic accuracy of pancreatic disease by deviating from an approximate experience approach.

임상신경생리 분야에서의 신경생리적 검사법의 응용 (Application of Neurophysiological Studies in Clinical Neurology)

  • 이광우;박경석
    • Annals of Clinical Neurophysiology
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    • 제1권1호
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    • pp.1-9
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    • 1999
  • Since Hans Berger reported the first paper on the human electroencephalogram in 1920s, huge technological advance have made it possible to use a number of electrophysiological approaches to neurological diagnosis in clinical neurology. In majority of the neurology training hospitals they have facilities of electroencephalography(EEG), electromyography(EMG), evoked potentials(EP), polysomnography(PSG), electronystagmography(ENG) and, transcranial doppler(TCD) ete. Clinicials and electrophysiologists should understand the technologic characteristics and general applications of each electrophysiological studies to get useful informations with using them in clinics. It is generally agreed that items of these tests are selected under the clinical examination, the tests are performed by the experts, and the test results are interpretated under the clinical background. Otherwise these tests are sometimes useless and lead clinicians to misunderstand the lesion site, the nature of disease, or the disease course. In this sense the clinical utility of neurophysiological tests could be summerized in the followings. First, the abnormal functioning of the nervous system and its environments can be demonstrated when the history and neurological examinations are equivocal. Second, the presence of clinically unsuspected malfunction in the nervous system can be revealed by those tests. Finally the objective changes can be monitored over time in the patient's status. Also intraoperative monitoring technique becomes one of the important procedures when the major operations in the posterior fossa or in the spinal cord are performed. In 1996, the Korean Society for Clinical Neurophysiology(KSCN) was founded with the hope that it will provide the members with the comfortable place for discussing their clinical and academic experience, exchanging new informations, and learning new techniques of the neurophysiological tests. The KSCN could collaborate with the International Federation of Clinical Neurophysiology(IFCN) to improve the level of the clinical neurophysiologic field in Korea as will as in Asian region.1 In this paper the clinical neurophysiological tests which are commonly used in clinical neurology and which will be delt with and educated by the KSCN in the future will be discussed briefly in order of EEG, EMG, EP, PSG, TCD, ENG, and Intraoperative monitoring.

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귀 연골조직에서 발생한 부분적 골화 (A Case Report of Focal Ossification of the Auricular Cartilage)

  • 서현우;김효성;하기영;한은미;김부영
    • 대한두개안면성형외과학회지
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    • 제12권1호
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    • pp.58-62
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    • 2011
  • Purpose: The focal ossification of auricular cartilage is an unusual clinical entity in which the ear becomes partially or totally rigid and immalleable. This condition may result from cold injury, local trauma, inflammation, or various systemic diseases. Patients may feel mild discomfort, but there are usually no other serious symptoms. We present a case of focal ossification of auricular cartilage in which the cause is unknown. Methods: A healthy 58-year-old man presented with a 2-year history of hard mass of right posterior auricular area. He denied any precipitating historical events like cold injury and inflammation. Routine testing did not demonstrate systemic abnormalities. Ultrasonographic examination revealed a $22{\times}10{\times}11mm$ sized heterogenous isoechoic mass showing an acoustic shadow. Results: Excisional biopsy was performed under local anesthesia. Histological examination revealed the ossification with deposition of trabecular bone in normal elastic cartilage. The patient was healed without any problems and satisfied with the result. Conclusion: We report clinical experience of focal ossification of auricular cartilage, which is quite a rare clinical entity. It should be considered that there is the possibility of ossification of cartilage when it meets the benign mass of the ear.

국내 뜸 요법 임상 실태 파악을 위한 전화조사 (Telephone survey for grasping clinical actual stage of moxibustion therapeutics in Korea)

  • 한창현;신미숙;신선화;강경원;박선희;최선미
    • Korean Journal of Acupuncture
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    • 제24권3호
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    • pp.17-31
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    • 2007
  • Objectives : Moxibustion therapeutics is one of the most popular oriental treatments in Korea. In this study, we operate the Telephone Survey for grasping clinical actual state moxibustion therapeutics in Korea. Methods : Survey questions were developed based on consensus of acupuncture professors. The list of the Korean medical doctors with experiences more than 10 years is provided by the Association of the Korean Oriental Medicine. A stratified random sample of Korean medical doctors is drawn for the telephone interviews. We choose a bound on the error of estimation equal to 6.5 percentage, and the sample size is 260 for the national sample. Telephone interviews with them were conducted by the well-trained interviewers of Korea Institute of Oriental Medicine in Medical researcher from 26th March 2007 to 6th April 2007. Results : Ninty -four percents of Korean oriental medical doctors were male and most commonly, clinical experience of doctors were 20-29 years(47.3%). Sixty-seven percent of Korean oriental medical doctors used moxibustion therapeutics. The most common treatment disease was Musculo-skeletal disorder(38.3%), Digestive disorder(28.6%), Gynecology(14.1%). Indirect moxibustion were as frequent as 65.5% of moxibustion method. The most common reason of unused respondents was 'Lots of smell and smoke'(28.3%), 'The wound left a scar'(20.8%), 'Less effects'(20%), etc. Eighty-three percents Korean oriental medical doctors were against that moxibustion therapy used without doctor's examination Conclusions : This survey provides unique insight into the perception of the Korea medical doctor at moxibustion therapeutics. Future research need to provide more in-depth insight into doctor views of the experience.

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치주 큐렛의 절단 연 마모도 평가 (Evaluation of the wear of the periodontal curet's cutting edge)

  • 박응준;임성빈;정진형
    • Journal of Periodontal and Implant Science
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    • 제27권3호
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    • pp.575-584
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    • 1997
  • The quality of periodontal instrument cutting edge is a basic element of effective root planing procedure. Using instruments, the sharp edge is changed into blunt or beveled edge. With the blunt instrument, the periodontal treatment can't be carried into accuracy and effective. The study on the wear of periodontal curet is insufficient, there are few publications about the change of sharpness of cutting egde after using instrument and a certen reports were published on the study of scanning electron microscope(SEM) examination. In this study, to declare the number of strokes for sharpening of instruments, the changes of cutting edge is measured by the clinical methods, tactile sensitivity examination and refraction light-white line test after scaling strokes and root planing strokes. SEM test was added for defined the changes of cutting edges. The 7/8 Gracey curets that have been never used was tested. Maxillary molars which were extracted from the School of Dental Medicine, Dankook University was used. Subjected teeth had attachment loss more than 6 mm in bucca-lingual surface and sufficient calculus of a band type in cervical area. The strokes of curet were executed 3, 5, 7, 9, 11, 13 times on scaling stroke and 10, 15, 20, 25, 30, 35 times on root planing stroke. A resident has periodontal experience over 3 years carried out the clinical examinations those tactile sensitivity examination and refraction light-white line test 5 times. The case there being tactile sensitivity certenly is 2, the case being felt tactile sensitivity is 1, and the case there not being tactile sensitivity is 0. The visual examination was recorded as following. The case that refracted white line is not recognised is 2, the case that uncerten is 1, and the case that acknowledged is 0. The results were obtained as follows. 1. After scaling strokes, the tactile sensitivity was reduced after 11 strokes and disappeared in 13 strokes. 2. In tactile sensitivity after root planing procedures, sensitivity was reduced after 25 strokes and disappeared in 35 strokes. 3. In case of visual examination, the detection of refracted white line was increased after 9 strokes of scaling procedures and the accuracy of wear wasn't showed after root planing procedures. 4. In SEM, metal projection was observed on new periodontal curet cutting edge and it was disappeared after scaling procedures. 5. In SEM, the cutting edge was showed changing linear into an aspect of the surface after 5 strokes of scaling procedures and 10 strokes of root planing procedures and showed beveled edge in 11 strokes of scaling procedures, 25 strokes of root planing procedures. The results of 3-type examination indicated that the sharpening of curet should be performed after 11 strokes of scaling procedures and 25 strokes of root planing procedures.

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Analysis of dental hygiene assessment data of recall patients (mainly 20s age)

  • Choi, Hye-Jung;Woo, Hee-Sun
    • 한국컴퓨터정보학회논문지
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    • 제27권6호
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    • pp.131-137
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    • 2022
  • 연령이 증가함에 따라 구강 즉, 치아와 치주도 노화가 시작되어 그에 따른 준비 과정이 필요하다. 그 준비과정은 20대부터 지식, 태도, 행동으로 이루어지는 구강보건교육이 이루어져 구강건강관리가 계속적으로 시작되어야 하는 중요한 시기이다. 이에 경기도에는 있는 한 치과의원에 내원하여 치료 후 구강건강관리실에서 계속관리를 받고 있는 환자들을 연구대상으로 임상치위생과정을 설계하기 위하여 치위생사정의 데이터 분석을 하고자 하였다. 치위생사정 도구로는 인적사항 및 전신병력을 기본으로 하여 치과방문경험, 치주검사(bleeding on probing; BOP), 구취검사, 위상차현미경으로 구강 세균 관찰, 치면세균막 검사(O'Leary index)를 시행하였다. 대상자의 치과방문 경험이 있는 대상자는 75.4%이고, 경험이 없는 경우는 24.6%로 나타났고, 치주검사 결과는 전반적으로 출혈이 있는 경우가 76.3%로 나타났다. 예방적 구강관리에서 20대의 치위생사정 단계는 중요한 첫 단추이다. 이 때 부터 본인의 구강상태를 스스로 책임질 수 있도록 체계적으로 습관화되어야 하는 중요한 연령이다. 따라서 본 연구에서는 20대 대상자의 구강검사를 통해 치위생사정 결과를 도출해 보고 그에 따른 구강보건교육 및 구강건강 관리에 있어서 임상치위생과정 중 치과위생사의 치위생수행 능력 역량 개발에 대한 기초자료로 제시하고자 한다.

Diagnostic Accuracy of Magnetic Resonance Imaging versus Clinical Staging in Cervical Cancer

  • Shirazi, Ahmad Soltani;Razi, Taghi;Cheraghi, Fatemeh;Rahim, Fakher;Ehsani, Sara;Davoodi, Mohammad
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권14호
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    • pp.5729-5732
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    • 2014
  • Background: Cervical cancer is the third most common gynecological cancer and a widespread malignancy in women, accounting for a large proportion of the cancer burden in developing countries. We compared accuracy of MRI staging with clinical staging and also concordance between the two methods for newly diagnosed patients with cervical cancer, using clinical staging as the reference. Materials and Methods: This prospective study was conducted on 27 newly diagnosed patients with cervical cancer from Imam Khomeini hospital from June 2012 to Feb 2014. New cases of cervical cancer with positive PAP test were staged separately with a clinical exam based on the FIGO system by a gynecologist, oncologist and also with MRI by an expert radiologist. Then we compared the predicted stage for each patient with the two methods. Results: Based on clinical staging 9 patients (33%) were observed at stage 1. MRI staging was in coordination with clinical staging in eight of them and for one patient MRI accorded stage 2B (88% concordance). Conclusions: MRI is a reliable noninvasive method with high accuracy for cervical cancer staging. Also presently it is easily obtainable, so we recommend using this technique along with clinical examination for staging cervical cancer patients. We also recommend to radiologists and residents of radiology to get experience with this method of staging.

좌측 하악골에 생긴 골육종(Osteosarcoma) 1예 (A Case of Osteosarcoma of the Mandible)

  • 김찬종;이재동;남순열
    • 대한두경부종양학회지
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    • 제19권2호
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    • pp.179-183
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    • 2003
  • Osteosarcoma is one of the most frequently occurring malignant bone tumor except for multiple myeloma. However, osteosarcoma of the mandible is rare and aggressive malignancy constituting about 5% to 13% of all cases of skeletal osteosarcoma. The authors experienced a case of osteosarcoma of the mandible in a 31-years old male patient. He visited our outpatient clinic with painless mass of the cheek. On the basis of the clinical and imaging findings, the differential diagnosis included giant cell tumor, histiocytosis and malignant bone tumor. In the first operation, the mass of the mandible was excised. Intraoperative microscopic examination of a frozen section did not yield a diagnosis: however, the final definitive histologic examination revealed osteoblastic osteosarcoma. After 15days, wide excision with hemimandibulectomy was completed followed by postoperative radiotherapy and chemotherapy. With our experience, we report the progression of diagnosis and management for mandibular osteosrcoma.