• Journal of Chest Surgery
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• 제16권1호
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• pp.138-145
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• 1983

The value of exfoliative sputum cytology in diagnosis of lung cancer has been accepted with bronchoscopic technique and results has been much improved by foreign investigators, but there was not presented accurate reports for sputum cytologic evaluation in Korea. We tried to find indicators of cytologic tests result in our hospital. During the period between May, 1980 and August, 1982, 400 patients, tested at Department of Thoracic and Cardiovascular Surgery of Kosin Medical College, had diagnostic bronchofiberscopic examination, and the cytologic study of sputum and bronchial secretions were performed. The sputum or bronchial secretion during bronchofiberscopic examination were obtained with various methods and the name of specimen were labeled as I, ASPIRATION SPUTUM, which was collected initially endobronchial sputum as introducing of scope, II, WASHING SPUTUM, which was collected washing bronchial secretion, III, BRUSHING SPUTUM, which was washing solution of brushing instrument and endobronchial sputum after brushing of lesions, IV, POST-SCOPIC SPUTUM, which was expectorated sputum as soon as removing of scopic instrument, V, ALL SPUTUM CYTOLOGY & CELL BLOCK, which was collected all specimen of above procedures. The diagnostic results of bronchofiberscopic examination was disclosed 174 cases [43.5%] of proved lung cancer, 47 cases [11.8%] of suspected lung cancer in grossly, and 179 cases [44.8%] of others finding except cancer. Patient with bronchofiberscopically grossly evidence of lung cancer which were not confirmed histologically or cytologically were excluded from this cytologic study. Histologic and cytologic correlation in proven lung cancer, 174 cases was revealed that number of cytologic positive patients were 45 cases [38.7%] among the 117 cases of proved squamous cell carcinoma, 12 cases [38.7%] among hislogically unknown cancer 34 cases and 6 cases [33.3%] among small cell undifferentiated carcinoma 18 Gases. Total cytologic positive result was presented as 67 cases [38.3%]. The other type of lung cancer, histologically, could not comparison because of small cases. The sequence of positive cytologic result in I-V specimen were disclosed as II, WASHING SPUTUM 57.6%, and V, ALL SPUTUM & CELL BLOCK 41.4%. The I, III & IV result were 28.6%, 22.2% and 26.1% respectively.

• Asian Pacific Journal of Cancer Prevention
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• 제15권24호
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• pp.10665-10673
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• 2015

Background: We wished to analyse patterns of use of needle biopsy procedures by BreastScreen Australia (BSA) accredited programs to identify areas for improvement. Design: BSA services provided anonymous data regarding percutaneous needle biopsy of screen detected lesions assessed between 2005-2009. Results: 12 services, from 5 of 7 Australian states and territories provided data for 18212 lesions biopsied. Preoperative diagnosis rates were 96.84% for lesion other than microcalcification (LOTM) and 93.21% for microcalcifications. At surgery 97.9% impalpable lesions were removed at the first procedure. Of 11548 Microcalcification (LOTM) biopsied, 46.9% were malignant. The final diagnosis was reached by conventional core biopsy (CCB) in 72.46%, FNAB in 21.33%, VACB in 1.69% and open biopsy in 4.52% of lesions. FNA is being limited to LOTM with benign imaging After FNAB, core biopsy was required for 38% of LOTM. In LOTM the mean false positive rate (FPR) was 0.36% for FNAB, 0.06% for NCB and 0% for VACB. Diagnostic accuracy was 72.75% for FNAB and 92.1% for core biopsies combined. Of 6441 microcalcifications biopsied 2305 (35.8%) were malignant. Microcalcifications are being assessed primarily by NCB but 6.57% underwent FNAB, 45.6% of which required NCB. False positive diagnoses were rare. FNR was 5% for NCB and 1.53% for VACB. Diagnostic accuracy was 73.52% for FNAB, 86.29% for NCB and 88.63% for VACB. Only 8 of 12 services had access to VACB facilities. Conclusions: BSA services are selecting lesions effectively for biopsy and are achieving high preoperative diagnosis rates. Gaps in the present accreditation standards require further consideration.

• 한국임상수의학회지
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• 제34권2호
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• pp.135-139
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• 2017

This study was performed to evaluate the clinical efficacy of alfaxalone for induction of inhalation anesthesia in small animal practice. Patient data were collected according to anesthetic records (136 dogs and 14 cats) presented to the Veterinary Medical Teaching Hospital of Seoul National University for surgeries and diagnostic imaging from July 2013 to March 2014. Anesthetic results included signalment, American Society of Anesthesiologists (ASA) grade, premedicated drugs, procedures, induction quality, and recovery after anesthesia. One hundred fifty anesthetic events were classified according to the ASA grade. Three patients were ASA grade I, 52 patients grade II, 86 patients grade III, and 9 patients grade IV, respectively. The most common premedication was midazolam and hydromorphone combination (n = 59, 39.3%) follow by acepromazine and hydromorphone combination (n = 22, 14.7%). The majority of anesthesia procedures were diagnostic imaging (n = 33, 22.0%) and ophthalmic surgeries (n = 31, 20.7%), followed by soft tissue surgeries (n = 27, 18.0%), and orthopedic surgeries (n = 20, 13.3%). Intravenous alfaxalone provided smooth induction for inhalation anesthesia in almost cases, but transient apnea and twitching/paddling were observed after induction and during recovery, respectively. In addition, alfaxalone did not show pain response during intravenous administration. Alfaxalone showed smooth induction of inhalation anesthesia in dogs and cats with mild to severe systemic disease (ASA 2-4). Alfaxalone was considered as an acceptable induction agent for patients with higher risk in small animal practice.

• Imaging Science in Dentistry
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• 제45권2호
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• pp.81-87
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• 2015

Purpose: Contrast, sharpness, enhancement, and density can be changed in digital systems. The important question is to what extent the changes in these variables affect the accuracy of caries detection. Materials and Methods: Forty eight extracted human posterior teeth with healthy or proximal caries surfaces were imaged using a photostimulable phosphor (PSP) sensor. All original images were processed using a six-step method: (1) applying "Sharpening 2" and "Noise Reduction" processing options to the original images; (2) applying the "Magnification 1:3" option to the image obtained in the first step; (3) enhancing the original images by using the "Diagonal/"option; (4) reviewing the changes brought about by the third step of image processing and then, applying "Magnification 1:3"; (5) applying "Sharpening UM" to the original images; and (6) analyzing the changes brought about by the fifth step of image processing, and finally, applying "Magnification 1:3." Three observers evaluated the images. The tooth sections were evaluated histologically as the gold standard. The diagnostic accuracy of the observers was compared using a chi-squared test. Results: The accuracy levels irrespective of the image processing method ranged from weak (18.8%) to intermediate (54.2%), but the highest accuracy was achieved at the sixth image processing step. The overall diagnostic accuracy level showed a statistically significant difference (p=0.0001). Conclusion: This study shows that the application of "Sharpening UM" along with the "Magnification 1:3" processing option improved the diagnostic accuracy and the observer agreement more effectively than the other processing procedures.

• Asian Pacific Journal of Cancer Prevention
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• 제16권18호
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• pp.8619-8623
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• 2016

Background: Breast cancer is a common disorder in women, constituting one of the main causes of death all over the world. The purpose of this study was to determine the diagnostic value of the breast tissue diseases by the help of thermography. Materials and Methods: In this paper, we applied non-contact infrared camera, INFREC R500 for evaluating the capabilities of thermography. The study was conducted on 60 patients suspected of breast disease, who were referred to Imam Khomeini Imaging Center. Information obtained from the questionnaires and clinical examinations along with the obtained diagnostic results from ultrasound images, biopsies and thermography, were analyzed. The results indicated that the use of thermography as well as the asymmetry technique is useful in identifying hypoechoic as well as cystic masses. It should be noted that the patient should not suffer from breast discharge. Results: The accuracy of asymmetry technique identification is respectively 91/89% and 92/30%. Also the accuracy of the exact location of identification is on the 61/53% and 75%. The approach also proved effective in identifying heterogeneous lesions, fibroadenomas, and intraductal masses, but not ISO-echoes and calcified masses. Conclusions: According to the results of the investigation, thermography may be useful in the initial screening and supplementation of diagnostic procedures due to its safety (its non-radiation properties), low cost and the good recognition of breast tissue disease.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권3호
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• pp.217-224
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• 2019

Purpose: Various publications on the use of sedation and anesthesia for diagnostic procedures in children have demonstrated that no ideal agent is available. Although propofol has been widely used for sedation during esophagogastroduodenoscopy in children, adverse events including hypoxia and hypotension, are concerns in propofol-based sedation. Propofol is used in combination with other sedatives in order to reduce potential complications. We aimed to analyze whether the administration of midazolam would improve the safety and efficacy of propofol-based sedation in diagnostic esophagogastroduodenoscopies in children. Methods: We retrospectively reviewed the hospital records of children who underwent diagnostic esophagogastroduodenoscopies during a 30-month period. Demographic characteristics, vital signs, medication dosages, induction times, sedation times, recovery times, and any complications observed, were examined. Results: Baseline characteristics did not differ between the midazolam-propofol and propofol alone groups. No differences were observed between the two groups in terms of induction times, sedation times, recovery times, or the proportion of satisfactory endoscopist responses. No major procedural complications, such as cardiac arrest, apnea, or laryngospasm, occurred in any case. However, minor complications developed in 22 patients (10.7%), 17 (16.2%) in the midazolam-propofol group and five (5.0%) in the propofol alone group (p=0.010). Conclusion: The sedation protocol with propofol was safe and efficient. The administration of midazolam provided no additional benefit in propofol-based sedation.

• Annals of Clinical Neurophysiology
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• 제24권1호
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• pp.7-16
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• 2022

Background: There is inadequate information on the validation of diabetic microvascular complications in the Korean National Health Insurance Service data set. We aimed to validate the diagnostic algorithms regarding the nephropathy, neuropathy, and retinopathy of diabetes. Methods: From various secondary and tertiary medical centers, we selected 6,493 patients aged ≥ 40 years who were diagnosed with diabetic microvascular complications more than once based on codes in the 10th version of the International Classification of Diseases (ICD-10). During 2019 and 2020, we randomly selected the diagnoses of 200 patients, 100 from each of two hospitals. The positive predictive value (PPV), negative predictive value, error rate, sensitivity, and specificity were determined for each diabetic microvascular complication according to the ICD-10 codes, laboratory findings, diagnostic studies, and treatment procedure codes. Results: Among the 200 patients who visited the hospital more than once and had the diagnostic codes of diabetic microvascular complications, 142, 110, and 154 patients were confirmed to have the gold standard of diabetic nephropathy (PPV, 71.0%), diabetic neuropathy (PPV, 55.0%), and diabetic retinopathy (PPV, 77.0%), respectively. The PPV and specificity of diabetic nephropathy (PPV, 71.0-81.4%; specificity, 10.3-53.4%), diabetic neuropathy (PPV, 55.0-81.3%; specificity, 66.7-76.7%) and diabetic retinopathy (PPV, 77.0-96.6%; specificity, 2.2-89.1%) increased after combining them with the laboratory findings, diagnostic studies, and treatment procedures codes. These change trends were observed similarly for both hospitals. Conclusions: Defining diabetic microvascular complications using ICD-10 codes and their related examination codes may be a feasible method for studying diabetic complications.

• Restorative Dentistry and Endodontics
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• 제45권4호
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• pp.48.1-48.11
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• 2020

Objectives: This systematic review aimed to identify mean oxygen saturation values (SpO₂) using pulse oximetry in permanent maxillary anterior teeth. Materials and Methods: The MEDLINE, Scientific Electronic Library Online, Cochrane Central Register of Controlled Trials, EMBASE, and Literatura Latino Americana em Ciências da Saúde electronic databases were searched. Combinations and variations of "oximetry" AND "dental pulp test" were used as search terms. Studies reporting means and standard deviations of SpO₂ values were included. Two reviewers independently extracted data following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Heterogeneity was assessed using the I² statistic, and all analyses were performed using R software. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool and the Newcastle-Ottawa scale. Results: Of the 251 studies identified, 19 met the eligibility criteria and were included (total sample, 4,541 teeth). In the meta-analysis, the mean SpO₂ values were 84.94% (95% confidence interval [CI], 84.85%-85.04%) for the central incisors, 89.29% (95% CI, 89.22%-89.35%) for the lateral incisors, and 89.20% (95% CI, 89.05%-89.34%) for the canines. The studies were predominantly low-quality due to the high risk of bias associated with the index test, unclear risk regarding patient selection, and concerns about outcome assessment. Conclusions: Although most studies were low-quality, the oxygen saturation levels in normal pulp could be established (minimum saturation, 77.52%). Despite the risk of bias of the included studies, the reference values reported herein are clinically relevant for assessments of changes in pulp status.

• 한국간담췌외과학회지
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• 제27권3호
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• pp.307-312
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• 2023

Hepatic arterioportal fistulae are abnormal communications between the hepatic artery and portal vein. They are reported to be congenital or acquired secondary to trauma, iatrogenic procedures, hepatic cirrhosis, and hepatocellular carcinoma, but less likely to occur spontaneously. Extrahepatic portal venous obstruction (EHPVO) can lead to pre-hepatic portal hypertension. A spontaneous superimposed hepatic arterioportal fistula can lead to pre-sinusoidal portal hypertension, further exacerbating its physiology. This report describes a young woman with long-standing EHPVO presenting with repeated upper gastrointestinal variceal bleeding and symptomatic hypersplenism. Computed tomography scan demonstrated a cavernous transformation of the portal vein and a macroscopic hepatic arterioportal fistula between the left hepatic artery and portal vein collateral in the central liver. The hepatic arterioportal fistula was associated with a flow-related left hepatic artery aneurysm and a portal venous collateral aneurysm proximal and distal to the fistula, respectively. Endovascular coiling was performed for the hepatic arterioportal fistula, followed by proximal splenorenal shunt procedure. This case illustrates an uncommon association of a spontaneous hepatic arterioportal fistula with EHPVO and the utility of a combined endovascular and surgical approach for managing multifactorial non-cirrhotic portal hypertension in such patients.

• Korean Journal of Radiology
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• 제2권3호
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• pp.151-158
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• 2001

Objective: To determine the ability of MR imaging to detect the pathological changes occurring in radiofrequency (RF) thermal lesions and to assess its accuracy in revealing the extent of tissue necrosis. Materials and Methods: Using an RF electrode, thermal lesions were created in the livers of 18 rabbits. The procedure involved three phases. In the acute phase, six animals were killed the day after performing thermal ablation with RF energy, and two on day 3. In the subacute and chronic phases, eight rabbits underwent percutaneous hepatic RF ablation. After performing MR imaging, two animals were sacrificed at 1, 2, 4, and 7 weeks after the procedure, and MRpathologic correlation was performed. Results: In the acute phase, the thermal ablation lesions appeared at gross examination as well-circumscribed, necrotic areas, representing early change in the coagulative necrosis seen at microscopic examination. They were hypointense on T2-weighted images, and hyperintense on T1-weighted images. Gadolinium-enhanced MR imaging showed that a thin hyperemic rim surrounded the central coagulative necrosis. In the subacute phase, ablated lesions also showed extensive coagulative necrosis and marked inflammation at microscopic examination. Beyond two weeks, the lesions showed gradual resorption of the necrotic area, with a peripheral fibrovascular rim. The size of lesions measured by MR imaging correlated well with the findings at gross pathologic examination. Conclusion: MR imaging effectively demonstrates the histopathological tissue change occurring after thermal ablation, and accurately determines the extent of the target area.