• Title/Summary/Keyword: diagnostic procedures

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The Extended Indications of Endoscopic Submucosal Dissection (ESD) for Early Gastric Cancer Are Thus Not Entirely Safe

  • Lee, Ju-Hee;Kim, Hyung-Ho
    • Journal of Gastric Cancer
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    • v.10 no.3
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    • pp.87-90
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    • 2010
  • Early gastric cancer (EGC) is defined as tumor invasion confined to the mucosa or submucosa, regardless of the presence of regional lymph node metastasis. Lymph node metastasis is the most powerful and important prognostic factor for gastric cancer. Based on the risk of lymph node metastasis in EGC obtained from a large number of surgical cases in Japan, it was suggested that the criteria for endoscopic mucosal resection (EMR) and endoscopic submucosal resection (ESD) as local treatment for EGC might be extended. However, extending the indications for EMR and ESD remains controversial because the long-term outcomes of these procedures have not been fully documented, and there is a risk for lymph node metastasis. Furthermore, current diagnostic imaging techniques are unsatisfactory for accurately predicting metastasis to lymph nodes. Moreover, the long-term results of standard radical gastrectomy including minimally invasive procedures for stage IA have been increasing and have reached 99 to 100%. To determine the true efficacy of endoscopic resection of EGC, we need more evidence of long-term follow-up, standardization of techniques, and pathological interpretation.

An Easy Detection Method of Fasciola Eggs by Kim's Sedimental Tube (K-식(式) 침전관(沈澱管)에 의한 간질충란(肝蛭蟲卵) 간이검사법(簡易檢査法))

  • Kim, Kyo-Joon;Kim, Sang-Keun;Hu, Min-Do
    • Korean Journal of Veterinary Research
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    • v.23 no.1
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    • pp.105-110
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    • 1983
  • The studies carried out to investigate the detection method of Fasciola eggs from positive cattle feces in the intradermal reaction method with laborsaving composition of sieves and Kim's sedimental tube method. The results obtained are summarized as follows: 1. The detection method of Fasciola eggs was improved by 3 meshes (100mesh, 150mesh, 250mesh) for filteration of fecal fluid contained Fasciola eggs. 2. Third type of tube in the 3 kinds of sedimental tube had the highest recovers rate of Fasciola eggs. Thus, this type of tube was selected and called as Kim's sedimental tube. 3. A-II, A-III, B-III and C-III type by Kim's sedimental tube method had the recovery rates of eggs in the 1st drop as ranged 99 to 100% and, A-I, B-II, C-II as 71 to 91%. 4. These Type of tubes were useful to detect Fasciola eggs and to shorten the time of the diagnostic procedures. 5. The Kim's sedimental tube method showed high recovery rates and convenient procedures as compared with other detection methods reported. In addition, the EPG value can also be obtained by this method. Therefore, it is desirable that the Kim's sedimental tube method could be recommended to clinicians.

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Heterogeneous Computation on Mobile Processor for Real-time Signal Processing and Visualization of Optical Coherence Tomography Images

  • Aum, Jaehong;Kim, Ji-hyun;Dong, Sunghee;Jeong, Jichai
    • Current Optics and Photonics
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    • v.2 no.5
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    • pp.453-459
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    • 2018
  • We have developed a high-performance signal-processing and image-rendering heterogeneous computation system for optical coherence tomography (OCT) on mobile processor. In this paper, we reveal it by demonstrating real-time OCT image processing using a Snapdragon 800 mobile processor, with the introduction of a heterogeneous image visualization architecture (HIVA) to accelerate the signal-processing and image-visualization procedures. HIVA has been designed to maximize the computational performances of a mobile processor by using a native language compiler, which targets mobile processor, to directly access mobile-processor computing resources and the open computing language (OpenCL) for heterogeneous computation. The developed mobile image processing platform requires only 25 ms to produce an OCT image from $512{\times}1024$ OCT data. This is 617 times faster than the naïve approach without HIVA, which requires more than 15 s. The developed platform can produce 40 OCT images per second, to facilitate real-time mobile OCT image visualization. We believe this study would facilitate the development of portable diagnostic image visualization with medical imaging modality, which requires computationally expensive procedures, using a mobile processor.

Robotics for Advanced Therapeutic Colonoscopy

  • Wong, Jennie YY;Ho, Khek Yu
    • Clinical Endoscopy
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    • v.51 no.6
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    • pp.552-557
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    • 2018
  • Although colonoscopy was originally a diagnostic imaging procedure, it has now expanded to include an increasing range of therapeutic interventions. These procedures require precise maneuvers of instruments, execution of force, efficient transmission of force from the operator to the point of application, and sufficient dexterity in the mobilization of endoscopic surgical instruments. The conventional endoscope is not designed to support technically demanding endoscopic procedures. In case of colonoscopy, the tortuous anatomy of the colon makes inserting, moving, and orientating the endoscope difficult. Exerting excessive pressure can cause looping of the endoscope, pain to the patient, and even perforation of the colon. To mitigate the technical constraints, numerous technically enhanced systems have been developed to enable better control of instruments and precise delivery of force in the execution of surgical tasks such as apposing, grasping, traction, counter-traction, and cutting of tissues. Among the recent developments are highly dexterous robotic master and slave systems, computer-assisted or robotically enhanced conventional endoscopes, and autonomously driven locomotion devices that can effortlessly traverse the colon. Developments in endoscopic instrumentations have overcome technical barriers and opened new horizons for further advancements in therapeutic interventions. This review describes examples of some of these systems in the context of their applications to advanced therapeutic colonoscopy.

Diagnostic Usefulness of N-Terminal Probrain-type Natriuretic Peptide to Detect Congestive Heart Failure Patients (울혈성 심부전 환자에서 N-Terminal Probrain-type Natriuretic Peptide의 진단적 유용성)

  • Son, Gye-Sung
    • Korean Journal of Clinical Laboratory Science
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    • v.37 no.2
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    • pp.88-95
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    • 2005
  • Even though the echocardiograph has been recognized as the method of choice among various diagnostic tools to detect congestive heart failure (CHF), there were some limitations in relation to the consumption of time, labor and process. We analyzed results of N-terminal probrain-type natriuretic peptide (NT-proBNP) and various parameters of the echocardiographic findings to clarify the diagnostic usefulness of NT-proBNP in detecting patients with CHF. We analyzed the sera from total of 242 cases from in-patients and out-patients, which were requested from the cardiovascular section of department of Internal Medicine at Chungnam National University Hospital from March 2003 to May 2004. The procedures were performed in order as shown below; sampling, NT-proBNP analysis, data acquisition and data analysis. All data including personal information and echocardiographic findings ware acquired by medical record review. When classifying the study population into six groups according to the degree of left ventricular ejection fraction (LVEF), the serum level of NT-proBNP was higher in the group with 51-60% of LVEF (P=0.023). There were low correlation between the serum level of NT-proBNP and various parameters of the echocardiographic findings with LVESD (r=0.1513), LVEDD (r=0.0831), LVEF (r=0.2035), IVST (r=0.03) and LVPWT (r=0.0728), respectively. When comparing NT-proBNP with atrial and/or ventricular enlargement, the patient group with both left atrial and left ventricular enlargement (p=0.186) or only left atrial (p=0.105) or only left ventricular enlargement (p=0.256) showed higher level of NT-proBNP without statistical significance than patient group with no enlargement. Searching the optimal cutoff of the serum level of NT-proBNP, the sensitivity (98.9%) and the specificity (100%) was highest at the cutoff of 300 pg/mL than any other cutoffs. These findings suggested that the analysis of NT-proBNP in serum might detect the patients with CHF earlier than with the echocardiograph, especially in patients with asymptomatic or mild symptomatic CHF. In conclusion, NT-proBNP test was proved to be clinically useful to diagnose CHF patients.

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Application of MMP-7 and MMP-10 in Assisting the Diagnosis of Malignant Pleural Effusion

  • Cheng, Daye;Liang, Bin;Li, Yun-Hui
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.2
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    • pp.505-509
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    • 2012
  • Background: Matrix metalloproteinases (MMP) are proteolytic enzymes that are essentially involved in turnover of the extracellular matrix (ECM). The aim was to investigate the diagnostic value of MMP-7 and MMP-10 as tumor markers in pleural effusion (PE) and evaluate the value of combining MMP-7, MMP-10 and carcinoembryonic antigen (CEA) assays as diagnostic aids for malignant cells. Materials and Methods: A total of 179 patients with PE (87 malignant and 92 benign) were included in this study. The levels of MMP-7 and MMP-10 were measured using ELISA. Results: Values for MMP-7 and MMP-10 were significantly higher in malignant PE than those in benign PE (P<0.01). Among all variables evaluated, logistic regression found that MMP-7 and MMP-10 were significantly correlated with the presence of malignant disease (P<0.01). Analysis of receiver operating characteristics (ROC) curves showed that the area under the curve of MMP-10 (0.806) was significantly larger than that of MMP-7 (0.771) and CEA (0.789) (P<0.01). With parallel interpretation, the combination of MMP-10 and CEA achieved the higher sensitivity of 94.6%. The combination of MMP-7 and CEA in serial interpretation was able to boost the specificity to 95.7%. The combination of MMP-7, MMP-10 and CEA produced better sensitivity, specificity, PPV and NPV than MMP-7 and MMP-10 alone. Conclusion: MMP-7 and MMP-10 in PE may represent helpful adjuncts to conventional diagnostic tools in ruling out malignancy as a probable diagnosis, thus guiding the selection of patients who might benefit from further invasive procedures.

Use of Digital Smile Design in esthetic restoration in anterior teeth: A case report (전치부의 심미 수복을 위하여 Digital Smile Design을 적용한 증례)

  • Shin, Sejun;Noh, Kwantae;Kwon, Kung-Rock;Kim, Hyeong-Seob
    • The Journal of Korean Academy of Prosthodontics
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    • v.55 no.2
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    • pp.164-170
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    • 2017
  • When restoring their anterior dentition, patients become more demanding on esthetics compared to posterior region during treatment planning phase. Digital Smile Design (DSD) procedure is performed in presentation software and digital photographs. This can widen diagnostic visualization and aid in transferring information between clinician, patient, and technician. This case presented is that of patient with dissatisfaction of his anterior old restoration. Retreatment procedures were carried out in two different manners: (1) using DSD protocol for diagnosis, smile simulation, communication and fabricating interim and definitive prosthesis by totally digitized workflow. (2) Using diagnostic wax-up for smile design and fabricating restorations by conventional workflow. Comparing two methods, DSD was easier to communicate between the dental team than the diagnostic wax-up method. But the final result obtained failed to meet total esthetic factors. Therefore, to obtain predictable esthetic results, more advanced design tool would be needed, including consideration of various esthetic factors besides successful communications.

Chronic Compartment Syndrome and Stress Fracture (만성구획증후군 및 스트레스 골절)

  • Choi, Chang-Hyuk;Baek, Seung-Hoon;Jang, Il-Woong
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.9 no.1
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    • pp.16-21
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    • 2010
  • The prevalence of overuse syndrome in the lower extremity including chronic compartment syndrome and stress fracture is increasing with popularity of sports activities. Chronic compartment syndrome is defined as elevation of the interstitial pressure during exertional activities in a closed osseofascial compartment that results in microvascular compromise and operative procedures can be necessary if conservative treatments fail. Stress fracture can be classified as fatigue and insufficiency fracture; stress fracture occurs by repeated strain under abnormal conditions from the patient's activity whereas insufficiency fracture does by those from a process intrinsic to the bone. Most stress fractures occur in the lower extremity, most commonly in the tibial region. Fatigue fractures begin in athletes with the change in their training programs. The radiographic findings are usually diagnostic or at least strongly suggestive and MRI has proven to be a beneficial diagnostic tool for difficult diagnostic cases. Fatigue fractures are treated with a decrease in activity, but surgical procedure may be necessary in those in anterior cortex of the tibial diaphysis.

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Changes of Plasma Lidocaine Concentrations after Stellate Ganglion Block according to Volume-changes of 1% Lidocaine (성상신경절차단시 주입된 1% Lidocaine 양에 따른 혈중 Lidocaine 농도 변화)

  • Song, Sun-Ok;Suh, Yung-Ho
    • The Korean Journal of Pain
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    • v.14 no.1
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    • pp.26-31
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    • 2001
  • Background: Sympathetic blocks with local anesthetics are used to differentiate sympathetically- maintained pain (SMP) from sympathetically-independent pain (SIP). However, systemic lidocaine is also used in the management of neuropathic pain. Therefore, there may be possibility of a false positive response in relieving their pain by systemic absorption of lidocaine following a diagnostic sympathetic block in patients with SIP. In this study, we measured the plasma lidocaine concentrations after a stellate ganglion block (SGB) using three volumes of 1% lidocaine. Methods: This prospective, crossover study was performed in 3 patients who experience sudden hearing loss and in 4 volunteers. Each person received SGB three times using three different volumes (6 ml, 12 ml and 16 ml) of 1% lidocaine at one week intervals. SGB was performed using a 23 G butterfly needle via a paratracheal approach by two persons. Two ml of venous blood was obtained from a prepared contra-lateral sided venous route at 1, 3, 5, 7, 10, 20 and 60 min after SGB. Plasma lidocaine level was analyzed by immunoassay. Results: Mean plasma lidocaine concentrations correlated well with the volumes of 1% lidocaine used in SGB; larger volumes showed higher concentrations (P < 0.01). Mean peak plasma concentrations were $1.08{\pm}0.18$ in 6 ml, $1.90{\pm}0.47$ in the 12 ml and $2.74{\pm}0.67{\mu}g/ml$ in the 16 ml groups (P < 0.01). The mean time to reach peak plasma concentration was not significantly different between the three groups. Conclusions: The peak plasma lidocaine concentrations in SGB using large volume were found to be similar to that of IV lidocaine infusion in the management of neuropathic pain. These data suggest that diagnostic sympathetic block may result in many false positive responses for SMP. Part of its effect may be related to systemic local anesthetic absorption and not to a sympathetic block. Therefore, physicians may be required to use optimal volumes and minimal concentration of local anesthetic in diagnostic sympathetic block procedures and also make a careful assessment of the performance of a permanent sympathetic block.

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Repeat analysis of intraoral digital imaging performed by undergraduate students using a complementary metal oxide semiconductor sensor: An institutional case study

  • Yusof, Mohd Yusmiaidil Putera Mohd;Rahman, Nur Liyana Abdul;Asri, Amiza Aqiela Ahmad;Othman, Noor Ilyani;Mokhtar, Ilham Wan
    • Imaging Science in Dentistry
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    • v.47 no.4
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    • pp.233-239
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    • 2017
  • Purpose: This study was performed to quantify the repeat rate of imaging acquisitions based on different clinical examinations, and to assess the prevalence of error types in intraoral bitewing and periapical imaging using a digital complementary metal-oxide-semiconductor(CMOS) intraoral sensor. Materials and Methods: A total of 8,030 intraoral images were retrospectively collected from 3 groups of undergraduate clinical dental students. The type of examination, stage of the procedure, and reasons for repetition were analysed and recorded. The repeat rate was calculated as the total number of repeated images divided by the total number of examinations. The weighted Cohen's kappa for inter- and intra-observer agreement was used after calibration and prior to image analysis. Results: The overall repeat rate on intraoral periapical images was 34.4%. A total of 1,978 repeated periapical images were from endodontic assessment, which included working length estimation (WLE), trial gutta-percha (tGP), obturation, and removal of gutta-percha (rGP). In the endodontic imaging, the highest repeat rate was from WLE (51.9%) followed by tGP (48.5%), obturation (42.2%), and rGP (35.6%). In bitewing images, the repeat rate was 15.1% and poor angulation was identified as the most common cause of error. A substantial level of intra- and inter-observer agreement was achieved. Conclusion: The repeat rates in this study were relatively high, especially for certain clinical procedures, warranting training in optimization techniques and radiation protection. Repeat analysis should be performed from time to time to enhance quality assurance and hence deliver high-quality health services to patients