• Title/Summary/Keyword: diagnostic procedures

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Consistency check algorithm for validation and re-diagnosis to improve the accuracy of abnormality diagnosis in nuclear power plants

  • Kim, Geunhee;Kim, Jae Min;Shin, Ji Hyeon;Lee, Seung Jun
    • Nuclear Engineering and Technology
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    • v.54 no.10
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    • pp.3620-3630
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    • 2022
  • The diagnosis of abnormalities in a nuclear power plant is essential to maintain power plant safety. When an abnormal event occurs, the operator diagnoses the event and selects the appropriate abnormal operating procedures and sub-procedures to implement the necessary measures. To support this, abnormality diagnosis systems using data-driven methods such as artificial neural networks and convolutional neural networks have been developed. However, data-driven models cannot always guarantee an accurate diagnosis because they cannot simulate all possible abnormal events. Therefore, abnormality diagnosis systems should be able to detect their own potential misdiagnosis. This paper proposes a rulebased diagnostic validation algorithm using a previously developed two-stage diagnosis model in abnormal situations. We analyzed the diagnostic results of the sub-procedure stage when the first diagnostic results were inaccurate and derived a rule to filter the inconsistent sub-procedure diagnostic results, which may be inaccurate diagnoses. In a case study, two abnormality diagnosis models were built using gated recurrent units and long short-term memory cells, and consistency checks on the diagnostic results from both models were performed to detect any inconsistencies. Based on this, a re-diagnosis was performed to select the label of the second-best value in the first diagnosis, after which the diagnosis accuracy increased. That is, the model proposed in this study made it possible to detect diagnostic failures by the developed consistency check of the sub-procedure diagnostic results. The consistency check process has the advantage that the operator can review the results and increase the diagnosis success rate by performing additional re-diagnoses. The developed model is expected to have increased applicability as an operator support system in terms of selecting the appropriate AOPs and sub-procedures with re-diagnosis, thereby further increasing abnormal event diagnostic accuracy.

Surgical Complications of Epilepsy Surgery Procedures : Experience of 179 Procedures in a Single Institute

  • Lee, Jun-Ho;Hwang, Yong-Soon;Shin, Jun-Jae;Kim, Tae-Hong;Shin, Hyung-Shik;Park, Sang-Keun
    • Journal of Korean Neurosurgical Society
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    • v.44 no.4
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    • pp.234-239
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    • 2008
  • Objective : There are a few reports on the complications of surgery for epilepsy. We surveyed our data to present complications of epilepsy surgeries from the neurosurgeon's point of view and compare our results with other previous reports. Methods : A total of 179 surgical procedures for intractable epilepsy (41 diagnostic, 138 therapeutic) were performed in 92 consecutive patients (10 adults, 82 children) during the last 9.2 years (February. 1997-April. 2006). Their medical records and radiological findings were reviewed to identify and analyze the surgical complications. Results : The diagnostic procedures encompassed various combinations of subdural grid, subdural strips, and depth electrodes. Four minor transient complications developed in 41 diagnostic procedures (4/41=9.8%). A total of 138 therapeutic procedures included 28 anterior temporal lobectomies, 21 other lobectomies, 6 lesionectomies, 21 topectomies, 13 callosotomies, 20 vagus nerve stimulations, 13 multiple subpial transections, and 16 hemispherectomies. Twenty-six complications developed in therapeutic procedures (26/138=18.8%). Out of the 26 complications, 21 complications were transient and reversible (minor; 21/138=15.2%), and 5 were serious complications (major; 5/138=3.6%). Five major complications were one visual field defect, two mortality cases and two vegetative states. There were 2 additional mortality cases which were not related to the surgery itself. Conclusion : Our results indicate that complication rate was higher than previous other reports in minor complications and was comparable in major complications. However, our results show relatively high frequency of mortality cases and severe morbidity case compared to other previous reports. The authors would like to emphasize the importance of acute postoperative care in young pediatric patients as well as meticulous surgical techniques to reduce morbidity and mortality in epilepsy surgery.

Are Women in Kuwait Aware of Breast Cancer and Its Diagnostic Procedures?

  • Saeed, Raed Saeed;Bakir, Yousif Yacoub;Ali, Layla Mohammed
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.15
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    • pp.6307-6313
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    • 2014
  • The aim of this study was to examine the knowledge and awareness of women in Kuwait with regard to risk factors, symptoms and diagnostic procedures of breast cancer. A total of 521 questionnaires were distributed among women in Kuwait. Results showed that 72% of respondents linked breast cancer factors to family history, while 69.7% scored abnormal breast enlargement as the most detectable symptom of the disease. Some 84% of participants had heard about self-examination, but knowledge about mammograms was limited to 48.6% and only 22.2% were familiar with diagnostic procedures. Some 22.9% of respondents identified the age over 40 years as the reasonable age to start mammogram screening. Risk factor awareness was independent on age groups (p>0.05), but both high education and family history increased the likelihood of postivie answers; the majority knew about a few factors such as aging, pregnancy after age 30, breast feeding for short time, menopause after age of 50, early puberty, and poor personal hygiene. In conclusion, 43.1% of participants had an overall good knowledge of breast cancer with regards to symptoms, risk factors and breast examination. Very highly significant associations (p<0.005) were evident for all groups except for respondents distributed by nationality (p=0.444). Early campaigns for screening the breast should be recommended to eliminate the confusion of wrong perceptions about malignant mammary disease.

A Study of Diagnostic Reference Levels for Coronary Angiography and Percutaneous Coronary Intervention in Gyeongsang Area (관상동맥 조영술 및 경피적 관상동맥 중재술에 대한 진단참고준위에 관한 연구; 경상도지역중심)

  • Si-Wang Lim;Jung-Su Kim;Pyong-Kon Cho
    • Journal of radiological science and technology
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    • v.46 no.2
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    • pp.123-129
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    • 2023
  • Interventional cardiology procedures can involve relatively high radiation doses compared to conventional radiography. During CAG, CAG + PCI and PCI the same area is exposed to radiation for a long period. In this study, radiation exposure data of 421 examinations in Gyeongsang area were collected, and the DRLs and ADs in actual medical practice for three types of interventional cardiology procedures in Korea were established. In CAG 286 case, 75th percentile DRLs and ADs of the total DAP were 55.89 Gy·cm2 and 37.47 Gy·cm2 , respectively. In CAG + PCI 92 case, those values were 222.84 Gy·cm2 and 117.51 Gy·cm2 respectively. In PCI 43 case, those values were 198.73 Gy·cm2 and 120.13 Gy·cm2 respectively. In this study, for the first time, the diagnostic reference level of interventional cardiology procedures in Gyeongsang area were established. Using the diagnostic reference level of interventional cardiology procedures derived from this study, it will help to identify and improve the level of exposure dose in the region and country.

Review of National Diagnostic Reference Levels for Interventional Procedures

  • Lee, Min Young;Kwon, Jae;Ryu, Gang Woo;Kim, Ki Hoon;Nam, Hyung Woo;Kim, Kwang Pyo
    • Progress in Medical Physics
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    • v.30 no.4
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    • pp.75-88
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    • 2019
  • Diagnostic reference level (DRL) is employed to optimize the radiation doses of patients. The objective of this study is to review the DRLs for interventional procedures in Korea and abroad. Literature review was performed to investigate radiation dose index and measurement methodology commonly used in DRL determination. Dose area product (DAP) and fluoroscopy time within each major procedure category were systematically abstracted and analyzed. A wide variation was found in the radiation dose. The DAP values and fluoroscopy times ranged 0.01-3,081 Gy·㎠ and 2-16,878 seconds for all the interventional procedures, 8.5-1,679 Gy·㎠ and 32-5,775 seconds for the transcatheter arterial chemoembolization (TACE), and 0.1-686 Gy·㎠ and 16-6,636 seconds for the transfemoral cerebral angiography (TFCA), respectively. The DRL values of the DAP and fluoroscopy time were 238 Gy·㎠ and 1,224 seconds for the TACE and 189 Gy·㎠ and 686 seconds for the TFCA, respectively. Generally, the DRLs of Korea were lower than those of other developed countries, except for the percutaneous transluminal angioplasty with stent in arteries of the lower extremity (LE PTA and stent), aneurysm coil embolization, and Hickman insertion procedures. The wide variation in the radiation doses of the different procedures suggests that more attention must be paid to reduce unnecessary radiation exposure from medical imaging. Furthermore, periodic nationwide survey of medical radiation exposures is necessary to optimize the patient dose for radiation protection, which will ultimately contribute to patient dose reduction and radiological safety.

Reference levels for patient Radiation Dose in interventional radiological procedures (중재적 방사선 시술 시 환자선량에 대한 참고 준위 비교)

  • Park, Hyeok;Kim, Yong-Wan;Jeon, Ju-Seob
    • Journal of the Korean Society of Radiology
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    • v.6 no.1
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    • pp.11-17
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    • 2012
  • The purpose of this study is to measure and evaluate radiation dose on patients in interventional radiological(IVR) procedures classified by each procedure, and aid as data for safety management. Fluroscopy time(F-time), dose area product(DAP) and number of acquired images from each kind of procedure was checked. Non-vascular procedures showed low value, and vascular procedure showed high value in all procedures except in IVC filter. F-time was longest in EVAR, which showed also the highest DAP value of all procedures. DAP-rate showed high value in TACE. By this result, we attempt to establish standard guideline of radiation dose on patients in IVR procedure.

Cone-Beam CT-Guided Percutaneous Transthoracic Needle Lung Biopsy of Juxtaphrenic Lesions: Diagnostic Accuracy and Complications

  • Wonju Hong;Soon Ho Yoon;Jin Mo Goo;Chang Min Park
    • Korean Journal of Radiology
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    • v.22 no.7
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    • pp.1203-1212
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    • 2021
  • Objective: To investigate the diagnostic accuracy and complications of cone-beam CT-guided percutaneous transthoracic needle biopsy (PTNB) of juxtaphrenic lesions and identify the risk factors for diagnostic failure and complications. Materials and Methods: In total, 336 PTNB procedures for lung lesions (mean size ± standard deviation [SD], 4.3 ± 2.3 cm) abutting the diaphragm in 326 patients (189 male and 137 female; mean age ± SD, 65.2 ± 11.4 years) performed between January 2010 and December 2014 were included. The accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the PTNB procedures for the diagnosis of malignancy were measured based on the intention-to-diagnose principle. The risk factors for diagnostic failures and complications were evaluated using logistic regression analysis. Results: The accuracy, sensitivity, specificity, PPV, and NPV were 92.7% (293/316), 91.3% (219/240), 91.4% (74/81), 96.9% (219/226), and 77.9% (74/95), respectively. There were 23 diagnostic failures (7.3%), and lesion sizes ≤ 2 cm (p = 0.045) were the only significant risk factors for diagnostic failure. Complications occurred in 98 cases (29.2%), including 89 cases of pneumothorax (26.5%) and 7 cases of hemoptysis (2.1%). The multivariable analysis showed that old age (> 65 years) (p = 0.002), lesion size of ≤ 2 cm (p = 0.003), emphysema (p = 0.006), and distance from the pleura to the target lesion (> 2 cm) (p = 0.010) were significant risk factors for complications. Conclusion: The diagnostic accuracy of cone-beam CT-guided PTNB of juxtaphrenic lesions for malignancy was fairly high, and the target lesion size was the only significant predictor of diagnostic failure. Complications of cone-beam CT-guided PTNB of juxtaphrenic lesions occurred at a reasonable rate.

The Development of Classification System of Medical Procedures in Korea (한국표준의료행위 분류체계 개발)

  • Park, Hyoung-Wook;Sohn, Myong-Sei;Kim, Han-Joong;Park, Eun-Cheol;Yu, Seung-Hum
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.4 s.55
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    • pp.877-897
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    • 1996
  • In recent years, the Korean Medical Association has undertaken the feat of establishing the Korean Standard Terminology of Medical Procedures with the dedicated help of 32 medical academic societies. However, because the project is being conducted by several different circles, it has yet to see a clear system of classification. This thesis, therefore, proposes the three principles of scientific properties, usefulness and ideology as the basis for classification system and has developed the Classification System of Medical Procedures in Korea upon their foundation. The methodology and organization of this thesis as follows. First, by adopting scientific classification system of Feinstein(1988), an analysis of the classification systems of the medical procedures in the United States, Japan, Taiwan, WHO was carried out to reveal the framework and the basic principles in each system. Second, the direction of classification system has been constructed by applying the normative principle of medical field in order to show the future direction of the medical field and realize its ideology. Third, a finalized framework for the classification system will be presented as based on the direction of classification system. Of the three basis principles mentioned above, the analysis on the principles of usefulness was left out of this thesis due to the difficulty of establishing specific standards of analysis. The results of the study are as follows. The overall structure of the thesis is aimed at showing the 'Prevention-Therapy-Rehabilitation' quality of comprehensive health care and consists of six chapters; I. Prevention and Health Promotion II. Evaluation and Management III. Diagnostic Procedures IV. Endoscopy V. Therapeutic Procedures VI. Rehabilitation Chapter three Diagnostic Procedures is divided into four parts : Functional Diagnosis, Visual Diagnosis, Pathological Diagnosis, Biopsy and Sampling. Chapter five Therapeutic Procedures is divided into Psychiatry, Non-Invasive Therapy, Invasive Therapy, Anaesthesia and Radiation Oncology. Of these sub-divisions, Functional Diagnosis, Biopsy and Sampling, Endoscopy and Invasive Therapy employs the anatomical system of classification. On the other hand, Visual Diagnosis, Pathological Diagnosis, Anesthesia and Diagnostic Radiology, namely those divisions in which there is little or no overlapping in services with other divisions, used the classification system of its own division. The classification system introduced in this thesis can be further supplemented through the use of the cluster analysis by incorporating the advice and assistance of other specialists.

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An Experimental Study on Hepatic Ablation using an Internally Cooled Needle Electrodes in Radiofrequency Ablation (고주파 열치료(Rodiofrequency ablotion)에 이용되는 내부 냉각 전극(Internally cooled needle electrodes)를 이용한 간 소작법의 유용성 실험)

  • Han Jung Hwan;Ahn Jung Hyun;Park Won Sik
    • Journal of The Korean Radiological Technologist Association
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    • v.30 no.1
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    • pp.58-62
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    • 2004
  • The purpose of this study was to determine the factors influencing on the size of Radiofrequency ablation using an internally cooled needle electrodes in cattle liver. Ablation procedures involved the use of cool-tip RF system generator and internally coo

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Aortopulmonary Fistula Presenting without an Endoleak after Thoracic Endovascular Aortic Repair

  • Sica, Giacomo;Rea, Gaetano;Bocchini, Giorgio;Lombardi, Romilda;Muto, Massimo;Valente, Tullio
    • Journal of Chest Surgery
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    • v.50 no.4
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    • pp.287-290
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    • 2017
  • Herein, we report the case of a 60-year-old man, a smoker with a history of arterial hypertension and diabetes mellitus. After computed tomography (CT) for an episode of hemoptysis, the patient underwent elective thoracic endovascular aortic repair (TEVAR) because of a degenerative aneurysm of the descending thoracic aorta. The area of perianeurysmal pulmonary atelectasis reported on the CT scan was not considered. Three months later, he developed an aortopulmonary fistula without endoleaks. Although TEVAR is a relatively safe procedure, no detail should be overlooked in the preoperative evaluation in order to avoid life-threatening complications. Further, the effectiveness and modality of prolonged antibiotic prophylaxis and/or preoperative respiratory physiotherapy should be assessed in such cases.