• 제목/요약/키워드: conventional medicine

검색결과 2,833건 처리시간 0.032초

MRI Predictors of Malignant Transformation in Patients with Inverted Papilloma: A Decision Tree Analysis Using Conventional Imaging Features and Histogram Analysis of Apparent Diffusion Coefficients

  • Chong Hyun Suh;Jeong Hyun Lee;Mi Sun Chung;Xiao Quan Xu;Yu Sub Sung;Sae Rom Chung;Young Jun Choi;Jung Hwan Baek
    • Korean Journal of Radiology
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    • 제22권5호
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    • pp.751-758
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    • 2021
  • Objective: Preoperative differentiation between inverted papilloma (IP) and its malignant transformation to squamous cell carcinoma (IP-SCC) is critical for patient management. We aimed to determine the diagnostic accuracy of conventional imaging features and histogram parameters obtained from whole tumor apparent diffusion coefficient (ADC) values to predict IP-SCC in patients with IP, using decision tree analysis. Materials and Methods: In this retrospective study, we analyzed data generated from the records of 180 consecutive patients with histopathologically diagnosed IP or IP-SCC who underwent head and neck magnetic resonance imaging, including diffusion-weighted imaging and 62 patients were included in the study. To obtain whole tumor ADC values, the region of interest was placed to cover the entire volume of the tumor. Classification and regression tree analyses were performed to determine the most significant predictors of IP-SCC among multiple covariates. The final tree was selected by cross-validation pruning based on minimal error. Results: Of 62 patients with IP, 21 (34%) had IP-SCC. The decision tree analysis revealed that the loss of convoluted cerebriform pattern and the 20th percentile cutoff of ADC were the most significant predictors of IP-SCC. With these decision trees, the sensitivity, specificity, accuracy, and C-statistics were 86% (18 out of 21; 95% confidence interval [CI], 65-95%), 100% (41 out of 41; 95% CI, 91-100%), 95% (59 out of 61; 95% CI, 87-98%), and 0.966 (95% CI, 0.912-1.000), respectively. Conclusion: Decision tree analysis using conventional imaging features and histogram analysis of whole volume ADC could predict IP-SCC in patients with IP with high diagnostic accuracy.

Diagnostic Efficacy and Safety of Low-Contrast-Dose Dual-Energy CT in Patients With Renal Impairment Undergoing Transcatheter Aortic Valve Replacement

  • Suyon Chang;Jung Im Jung;Kyongmin Sarah Beck;Kiyuk Chang;Yaeni Kim;Kyunghwa Han
    • Korean Journal of Radiology
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    • 제25권7호
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    • pp.634-643
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    • 2024
  • Objective: This study aimed to evaluate the diagnostic efficacy and safety of low-contrast-dose, dual-source dual-energy CT before transcatheter aortic valve replacement (TAVR) in patients with compromised renal function. Materials and Methods: A total of 54 consecutive patients (female:male, 26:38; 81.9 ± 7.3 years) with reduced renal function underwent pre-TAVR dual-energy CT with a 30-mL contrast agent between June 2022 and March 2023. Monochromatic (40- and 50-keV) and conventional (120-kVp) images were reconstructed and analyzed. The subjective quality score, vascular attenuation, contrast-to-noise ratio (CNR), and signal-to-noise ratio (SNR) were compared among the imaging techniques using the Friedman test and post-hoc analysis. Interobserver reliability for aortic annular measurement was assessed using the intraclass correlation coefficient (ICC) and Bland-Altman analysis. The procedural outcomes and incidence of post-contrast acute kidney injury (AKI) were assessed. Results: Monochromatic images achieved diagnostic quality in all patients. The 50-keV images achieved superior vascular attenuation and CNR (P < 0.001 in all) while maintaining a similar SNR compared to conventional CT. For aortic annular measurement, the 50-keV images showed higher interobserver reliability compared to conventional CT: ICC, 0.98 vs. 0.90 for area and 0.97 vs. 0.95 for perimeter; 95% limits of agreement width, 0.63 cm2 vs. 0.92 cm2 for area and 5.78 mm vs. 8.50 mm for perimeter. The size of the implanted device matched CT-measured values in all patients, achieving a procedural success rate of 92.6%. No patient experienced a serum creatinine increase of ≥ 1.5 times baseline in the 48-72 hours following CT. However, one patient had a procedural delay due to gradual renal function deterioration. Conclusion: Low-contrast-dose imaging with 50-keV reconstruction enables precise pre-TAVR evaluation with improved image quality and minimal risk of post-contrast AKI. This approach may be an effective and safe option for pre-TAVR evaluation in patients with compromised renal function.

분자생물학과 면역학적 방법에 의한 소 요네병 진단의 연구 (Studies on Molecular Biological and Immunological Diagnosis of Johne's Disease)

  • 김태종;김윤식;김재천;윤화중;이원창
    • 대한수의학회지
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    • 제37권2호
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    • pp.349-358
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    • 1997
  • Mycobacterium paratuberculosis is the etiologic agent of Johne's disease, a chronic inflammatory bowel syndrome in ruminants. The attempts to control or eradicate the disease were severely hampered by the inadequacies of present diagnostic methods. The first purpose of this study was to detect Johne's disease out of 577 cows in the province of Kyunggi, Chungchong, Gangweon and the second purpose was to compare the results of non-absorbed ELISA, absorbed ELISA, PCR, and conventional culture methods. The third purpose was to increase diagnostic specificity, accuracy and rapidity. When non-absorbed ELISA test was conducted with Mycobacterium paratuberculosis antigen, the prevalence of positive was 10.9%. To increase diagnostic specificity, absorbed ELISA test with Mycobacterium phlei was used. In this test, the positive prevalence was 1.7%. For the specific detection of Mycobacterium paratuberculosis, PCR was applied to bacterial culture obtained from fecal samples of cattle. The DNA sequences derived from IS900 were used to prepare DNA primers for detection and identification of Mycobacterium paratuberculosis by PCR. PCR for M paratuberculosis isolated from fecal cultures amplified specific target DNA. PCR was much more rapid than that obtained by conventional culture technique in diagnosis of Johne's disease.

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Spinal Cord Partial Block Technique Using Dynamic MLC

  • Cho, Sam-Ju;Yi, Byong-Yong;Back, Geum-Mun;Lee, Sang wook;Ahn, Seung-Do;Kim, Jong-Hoon;Kwon, Soo-Il;Park, Eun-Kyung
    • 한국의학물리학회:학술대회논문집
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    • 한국의학물리학회 2002년도 Proceedings
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    • pp.138-140
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    • 2002
  • The spinal cord dose is the one of the limiting factor for the radiation treatment of the head & neck (H&N) or the thorax region. Due to the fact that the cord is the elongated shaped structure, it is not an easy task to maintain the cord dose within the clinically acceptable dose range. To overcome this problem, the spinal cord partial block technique (PBT) with the dynamic Multi-Leaf Collimator (dMLC) has been developed. Three dimension (3D) conformal beam directions, which minimize the coverage of the normal organs such as the lung and the parotid gland, were chosen. The PBT field shape for each field was designed to shield the spinal cord with the dMLC. The transmission factors were determined by the forward calculation method. The plan comparisons between the conventional 3D conformal therapy plan and the PTB plan were performed to evaluate the validity of this technique. The conformity index (CI) and the dose volume histogram (DVH) were used as the plan comparison indices. A series of quality assurance (QA) was performed to guarantee the reliable treatment. The QA consisted of the film dosimetry for the verification of the dose distribution and the point measurements. The PBT plan always generated better results than the conventional 3D conformal plan. The PBT was proved to be useful for the H&N and thorax region.

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

  • 이민경;최승홍;정근화;윤태진;김지훈;손철호;장기현
    • Investigative Magnetic Resonance Imaging
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    • 제16권2호
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    • pp.142-151
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    • 2012
  • 목적: 간질중첩증의 동맥 스핀 라벨링 자기공명영상 소견을 알아보고자 한다. 대상과 방법: 본 기관에 내원한 환자들을 대상으로 후향적으로 검색하여 중 간질중첩증으로 임상적으로 진단받았으면서 동맥 스핀 라벨링을 포함한 자기공명영상검사를 받은 환자들을 찾아 이미지를 분석 하였다. 결과: 총 여섯명의 간질중첩증 환자들이 검색되었으며 이 환자들은 모두 EEG에서 이상소견이 나타난 부위에 국소적 CBF증가 소견을 보였다. 특히 두 명의 환자에서는 DWI를 포함한 고식적 자기공명영상 시퀀스에서 모두 특이 소견 보이지 않았으나 동맥 스핀 라벨링 이미지에서만 국소적으로 증가된 CBF를 보였다. 결론: 간질중첩증 환자들의 진단에 있어서 동맥 스핀 라벨링은 기존 영상검사에 더하여 추가적인 역할을 할 수 있을 것으로 기대된다.

Co-amplification at Lower Denaturation-temperature PCR Combined with Unlabled-probe High-resolution Melting to Detect KRAS Codon 12 and 13 Mutations in Plasma-circulating DNA of Pancreatic Adenocarcinoma Cases

  • Wu, Jiong;Zhou, Yan;Zhang, Chun-Yan;Song, Bin-Bin;Wang, Bei-Li;Pan, Bai-Shen;Lou, Wen-Hui;Guo, Wei
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권24호
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    • pp.10647-10652
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    • 2015
  • Background: The aim of our study was to establish COLD-PCR combined with an unlabeled-probe HRM approach for detecting KRAS codon 12 and 13 mutations in plasma-circulating DNA of pancreatic adenocarcinoma (PA) cases as a novel and effective diagnostic technique. Materials and Methods: We tested the sensitivity and specificity of this approach with dilutions of known mutated cell lines. We screened 36 plasma-circulating DNA samples, 24 from the disease control group and 25 of a healthy group, to be subsequently sequenced to confirm mutations. Simultaneously, we tested the specimens using conventional PCR followed by HRM and then used target-DNA cloning and sequencing for verification. The ROC and respective AUC were calculated for KRAS mutations and/or serum CA 19-9. Results: It was found that the sensitivity of Sanger reached 0.5% with COLD-PCR, whereas that obtained after conventional PCR did 20%; that of COLD-PCR based on unlabeled-probe HRM, 0.1%. KRAS mutations were identified in 26 of 36 PA cases (72.2%), while none were detected in the disease control and/or healthy group. KRAS mutations were identified both in 26 PA tissues and plasma samples. The AUC of COLD-PCR based unlabeled probe HRM turned out to be 0.861, which when combined with CA 19-9 increased to 0.934. Conclusions: It was concluded that COLD-PCR with unlabeled-probe HRM can be a sensitive and accurate screening technique to detect KRAS codon 12 and 13 mutations in plasma-circulating DNA for diagnosing and treating PA.

Impact of irregular marital cohabitation on quality of life and sexual dysfunction in infertile men from upper Egypt

  • Taha, Emad Abdelrhim;Sabry, Mohamed;Abdelrahman, Islam Fathy Soliman;Elktatny, Hossam;Hosny, Ahmed
    • Clinical and Experimental Reproductive Medicine
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    • 제47권1호
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    • pp.77-82
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    • 2020
  • Objective: Irregular patterns of marital cohabitation are a common problem in upper Egypt due to employment conditions. The objective of this study was to investigate the effect of irregular marital cohabitation on the quality of life and sexual function of infertile men. Methods: In total, 208 infertile men were included and divided into two groups. The first group included 134 infertile men with an irregular pattern of marital cohabitation and the second group included 74 infertile men with a regular pattern of marital cohabitation. All subjects were assessed through a clinical evaluation, conventional semen analysis, the fertility quality of life (FertiQoL) questionnaire, the International Index of Erectile Function (IIEF-5) score, and the premature ejaculation diagnostic tool (PMEDT). Results: The two groups were compared in terms of conventional semen parameters, FertiQoL, IIEF-5 score, and PMEDT. Infertile men with an irregular pattern of marital cohabitation had significantly lower subscale and total FertiQoL and IIEF-5 scores. Additionally, they had significantly higher PMEDT scores. Erectile dysfunction and premature ejaculation were more common in them than in infertile men with a regular pattern of marital cohabitation. Conclusion: Irregular patterns of marital cohabitation had an adverse effect on quality of life and sexual function in infertile men.

지백지황환·대보음환 병용투여를 통한 성조숙증 치료에 대한 체계적 문헌고찰 및 메타분석 (Jibaekjihwang-hwan and Daeboeum-hwan Combination Therapy on Precocious Puberty: a Systematic Review and Meta-Analysis)

  • 강소현;서지혜;허다희;이동녕;김형준
    • 대한한방부인과학회지
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    • 제34권2호
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    • pp.124-141
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    • 2021
  • Objectives: The purpose of this study is to assess the efficacy of Jibaekjihwang-hwan and Daeboeum-hwan combination therapy for the treatment of precocious puberty. Methods: 6 databases were searched from the date of inception until April 2021 for relevant studies. We included randomized controlled trials (RCTs) and non-randomized controlled trials (nRCTs) which focused on effects of Jibaekjihwang-hwan and Daeboeum-hwan on precocious puberty. Results: Total 8 literatures were included in qualitative analysis and meta analysis on results was conducted on 4 synthesizable studies. The response rate was significantly higher in Jibaekjihwang-hwan and Daeboeum-hwan combination group than in conventional therapy group. Also, serum estradiol and follicle stimulating hormone (FSH) level were significantly lower in Jibaekjihwang-hwan and Daeboeum-hwan combination group than in conventional therapy group. Conclusions: It seems that combination therapy of Jibaekjihwang-hwan and Daeboeum-hwan can effectively reduce serum estradiol and FSH level while increasing response rate significantly. Further high quality studies are needed to supplement the efficacy and safety of combination therapy of Jibaekjihwang-hwan and Daeboeum-hwan on precocious puberty.

빈혈에 대한 보중익기탕 및 그 가미방의 효과: 체계적 문헌고찰과 메타분석 (Effects of Bojungikgi-tang and its modifications for Anemia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials)

  • 김미경;한창호
    • 대한한의학회지
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    • 제44권2호
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    • pp.181-200
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    • 2023
  • Objectives: This study aimed to evaluate the efficacy and safety of Bojungikgi-tang (BJIG) and its modifications for patients with anemia. Methods: The subject of analysis of this study was a parallel design randomized controlled trial in which BJIG or its modifications was administered orally to patients who met the World Health Organization's anemia criteria and the efficacy and safety were prospectively measured. Electronic databases were searched to retrieve eligible literature published from 1 January 2000 to 12 February 2023. A meta-analysis was conducted, and the risk of bias (RoB) and level of evidence of the included studies was assessed using the Cochrane RoB 2 tool and GRADE method, respectively. Results: Five studies were included in the meta-analysis. When BJIG or its modifications was administered to anemia patients receiving conventional treatment, additional benefits compared to the non-administered group were found in terms of an increase in red blood cell count (mean difference (MD) 0.46 × 1012/L, 95% confidence interval (CI) 0.17 to 0.74), hemoglobin concentration (MD 9.28 g/L, 95% CI 6.06 to 12.51), hematocrit (MD 2.57%, 95% CI 1.76 to 3.38), total effective rate (odds ratio 5.29, 95% CI 2.05 to 13.68), and traditional Chinese medicine symptom scores (standardized MD -1.51, 95% CI -2.79 to -0.24). Conclusions: This study demonstrated the clinical potential of BJIG and its modifications to provide additional benefits to patients with anemia receiving conventional treatment.