• Title/Summary/Keyword: diagnostic process

Search Result 691, Processing Time 0.02 seconds

Differential Diagnosis of Metastatic Bone Disease and Benign Bone Disease on Spine SPECT in Patients with Low Back Pain (요통 환자의 척추골 SPECT에서 골전이 병변과 양성골질환의 섭취 양상 분석을 통한 감별진단이 가능한가)

  • Lee, Seung-Hun;Choi, Yun-Young;Cho, Suk-Shin
    • The Korean Journal of Nuclear Medicine
    • /
    • v.35 no.6
    • /
    • pp.371-377
    • /
    • 2001
  • Purpose: One or more abnormal vertebrae detected on bone scintigraphy is a common finding in clinical practice, and it could pose a diagnostic dilemma especially in cancer patients. as either metastasis or benign disease may cause scintigraphic abnormality. The purpose of this study was to determine whether additional spine SPECT has a role in differentiating malignant from benign lesions in patients with back pain. Materials and Methods: We reviewed spine SPECT studios obtained over a three-year period in 108 patients. Among them, forty-five patients with abnormal SPECT and clinically followed records were evaluated (20 cancer patients were included). Uptake patterns were classified as follows: 1. Body: diffusely increased uptake, linear increased uptake of end plate, segmental increased uptake, and cold defect, 2. Posterior element: posterior to body (pedicle), posterior to Intervertebral disc space (facet joint), and spinous process. Lesions were correlated with radiological findings and with final diagnosis. Results: Sixty-nine bone lesions were detected on SFECT images, including 18 metastases, 28 degenerative diseases and 21 compression fractures. Cold defect (6) and segmental increased uptake (5) were dominant findings in metastasis; linear increased uptake (12), and facet joint uptake (15) were in degenerative change; and diffuse increased uptake (9), and linear increased uptake (9) were in compression fracture. Conclusion: Cold defect and segmental increased uptake of body were characteristic findings of metastasis, but care should be taken because compression fracture also shows segmental increased uptake in some cases. Degenerative disease was easily diagnosed because of the typical finding of linear increased uptake of end plate and facet joint. Therefore, additional bone SPECT after planar bone scan would be helpful for differentiating metastasis from benign condition in cancer patients.

  • PDF

A Study on the Standardization of QSCCII (Questionnaire for the Sasang Constitution Classification II) (사상체질분류검사지(四象體質分類檢査紙)(QSCC)II의 표준화(標準化) 연구(硏究) -각(各) 체질집단(體質集團)의 군집별(群集別) Profile 분석(分析)을 중심(中心)으로-)

  • Kim, Sun Ho;Go, Byeong-Hui;Song, Il-Byeong
    • Journal of Sasang Constitutional Medicine
    • /
    • v.8 no.1
    • /
    • pp.187-246
    • /
    • 1996
  • The purpose of this study is to evaluate and standardize the four scales of Questionnaire for the Sasang Constitution ClassificationII (QSCCII). QSCCII is newly prepared by statistical item analysis and is designed to examine its diagnostic discriminability. QSCCII is administered to 1366 random informants. From the survey, we could get the data for the standardization. The criteria of standardization are based on the data from 265 informants who are examined by professionals. Collected data are analyzed by internal consistency, variation analysis(ANOVA), Duncan test and discrimination analysis of SPSS PC+ V4.0 program. The results are as follows 1) The reliability of four scales for QSCCII is relatively valid. The internal consistency of Tae-yang(太陽) scale is Cronbach's ${\alpha}=0.5708$. That of So-yang(少陽) scale is ${\alpha}=0.5708$. That of Tae-eum(太陰) scale is ${\alpha}=0.5922$. That of So-eum(少陰) scale is ${\alpha}=0.6319$. 2) There is a significant difference between each group through variation analysis of four scales. 3) The process of standardization is based on the average value and standard deviation with respect to age and sex difference of each criteria. 4) This study suggests a source of standardization of Sasang Constitution Classification by providing norms in which the differences of age, sex, and number of items are taken into deep consideration. QSCCII, therefore, can be applied to every age(the 10's to the 60's) and sex groups. 5) The recalculation of the raw-score to standard value (T-score) shows that the diagnostic discriminability (Hit-ratio : 70.08%) of QSCCII brings about 37% improvement than proportional chance criteria(33.33%). Especially, Hit-ratios of Tae-eum In(74.5%) and So-eum In(70.8%) are higher than that of So-yang In(60.0%). 6) QSCC has discriminability only to male informants. Compared with QSCC, however, QSCCII has relatively efficient discriminability both to male and female informants. 7) These results would be a demonstration of the fact that the QSCCII could be used as a tool for sasang constitution classification.

  • PDF

From the Onset of Panic Symptoms to Getting to a Psychiatric Treatment : The Change by Improved Public Awareness of Panic Disorder in Korea (증상의 발현부터 치료의 시작까지 : 한국인의 공황장애 인식도 변화가 치료적 접근에 미친 영향)

  • Choi, Yong-Won;Seo, Ho-Jun;Han, Sang-Woo;Hong, Jin-Pyo;Lee, Kyoung-Uk;Kim, Se-Joo;Lim, Se-Won;Lee, Sang-Hyuk;Yang, Jong-Chul;Lee, Seung-Jae;Park, Seon-Cheol;Gim, Min-Sook;Chae, Jeong-Ho
    • Anxiety and mood
    • /
    • v.15 no.2
    • /
    • pp.61-67
    • /
    • 2019
  • Objective : This study aimed to investigate the general process from the symptom onset to the psychiatric treatment in Korean panic patients and the effect of improved public awareness on it. Methods : This study has a retrospective design. The subjects were the new patients with panic disorder who visited the psychiatric outpatient clinic in twelve university-affiliated hospitals all across Korea. The medical chart was reviewed retrospectively and the data were collected including chief complaints of symptoms, recent stressors, the time to visit the psychiatric outpatient clinic, and visit of other departments and diagnostic approaches for their symptoms. Results : A total of 814 participants were included in the study. The most common department other than psychiatry the panic patients visited were cardiology (28.3%), general internal medicine (16.0%) and neurology (11.4%). The most frequently used diagnostic tests were a echocardiography (17.9%), 24-hour Holter monitoring (11.2%), and brain MRI (8.2%). Only 37.3% of participants visited psychiatric clinic directly. About 80% of participants visited psychiatric department within 1 year after their first panic symptoms and it took $13.8{\pm}13.7weeks$ on average. Comparing before and after 2012, the number of participants increased who visit directly the psychiatric clinic without visiting other departments (p=0.002) and without visiting emergency room (p<0.001). Conclusions : Our results suggest that a substantial number of patients visit departments other than psychiatry when they experience first panic symptoms. However, most patients begin psychiatric treatment within 1 year after their first symptoms and the number of patient are increasing who visit psychiatric department directly without visiting other departments.

Understanding the Legal Structure of German Human Gene Testing Act (GenDG) (독일 유전자검사법의 규율 구조 이해 - 의료 목적 유전자검사의 문제를 중심으로 -)

  • Kim, Na-Kyoung
    • The Korean Society of Law and Medicine
    • /
    • v.17 no.2
    • /
    • pp.85-124
    • /
    • 2016
  • The Human gene testing act (GenDG) in Germany starts from the characteristic features of gene testing, i.e. dualisting structure consisted of anlaysis on the one side and the interpretation on the other side. The linguistic distincion of 'testing', 'anlaysis' and 'judgment' in the act is a fine example. Another important basis of the regulation is the ideological purpose of the law, that is information autonomy. The normative texts as such and the founding principle are the basis of the classification of testing types. Especially in the case of gene testing for medical purpose is classified into testing for diagnostic purpose and predictive purpose. However, those two types are not always clearly differentiated because the predictive value of testing is common in both types. In the legal regulation of gene testing it is therefore important to manage the uncertainty and subjectivity which are inherent in the gene-analysis and the judgment. In GenDG the system ensuring the quality of analysis is set up and GEKO(Commity for gene tisting) based on the section 23 of GenDG concretes the criterium of validity through guidelines. It is also very important in the case of gene testing for medical purpose to set up the system for ensurement of procedural rationality of the interpretation. The interpretation of the results of analysis has a wide spectrum because of the consistent development of technology on the one side and different understandings of different subjects who performs gene testings. Therefore the process should include the communication process for patients in oder that he or she could understand the meaning of gene testing and make plans of life. In GenDG the process of genetic counselling and GEKO concretes the regulation very precisely. The regulation as such in GenDG seems to be very suggestive to Korean legal polic concerning the gene testing.

  • PDF

A Study on the Establishment and Operation of a Regulatory Response Framework in connection with the Regulatory Strength of the Licensing Policy for New Medical Devices -Focusing on the Application of FMEA- (의료기기 신제품의 인허가정책 규제강도에 연계한 규제대응 프레임워크 수립 및 운영에 관한 연구 - FMEA 적용을 중심으로 -)

  • Kim, Gyosu;Ru, Gyuha;Kim, Yeonhee
    • Journal of Technology Innovation
    • /
    • v.28 no.4
    • /
    • pp.1-26
    • /
    • 2020
  • Due to the spread of Corona 19 around the world, Infectious Disease Medicine and New Medical Devices such as Diagnostic Agent are being rapidly developed and launched, and for the fast supply and demand of these, each country has eased import regulations or has implemented policies for fast approval(NIDS, 2020). On the other hand, New Developed Medical Devices that are not related to New Infectious Diseases, they are still entering the market through strict licensing and licensing regulations, such as delay and cancellation in the test inspection process, etc. Therefore, This Study specialized in the government-managed laws encountered when New Medical Devices enter the market, derive Factors influencing the Strength of Regulations, analyzes the Strength of Regulations, and proposes a Regulatory Response Framework. The Research Method was conducted by Literature Research, was applied by Failure Mode and Effects Analysis(FMEA) Method, Expert Interview(1st): Idea Collection, Expert Interview(2nd): Validation, and Priority through the Application Process of FMEA Method. A Method of Quantifying the Intensity of Regulation was proposed by multiplying the Impact of the Influencing Factors for each stage of regulation and the Burden Impact for each type of Regulatory Affairs to find the Importance of the Regulatory Factors and multiplying the Severity of the Regulatory Impact. The Implications are that major overseas countries and the Korean government are actively responding with Special Regulatory Policies and Mitigation Policies for fast licensing of New Developed Medical Devices in accordance with Corona 19. It is expected that the direction for improvement of regulations and measures to respond to regulations will be implemented so that a more proactive and preemptive response to the regulatory process of the licensing policy for New Devices can be achieved.

The Korean Practice Parameter for the Treatment of Attention - Deficit Hyperactivity Disorder(II) - Diagnosis and Assessment - (주의력결핍 과잉행동장애 한국형 치료 권고안(II) - 진단 및 평가 -)

  • Cheon, Keun-Ah;Kim, Ji-Hoon;Kang, Hwa-Yeon;Kim, Bung-Nyun;Shin, Dong-Won;Ahn, Dong-Hyun;Yang, Su-Jin;Yoo, Han-Ik;Yoo, Hee-Jeong;Hong, Hyun-Ju
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
    • /
    • v.18 no.1
    • /
    • pp.10-15
    • /
    • 2007
  • Probably the three most important components to a comprehensive evaluation of patients with attention-deficit hyperactivity disorder (ADHD) are the clinical interview, the medical examination, and the completion and scoring or behavior rating scales. Teachers and other school personnel are often the first to recognize that a child or adolescent might have ADHD, and often play an important role in the help-seeking/referral process. A diagnostic evaluation for ADHD should include questions about ADHD symptoms, other problems including alcohol and drug use, family history of ADHD, prior evaluation and treatment for ADHD. Screening interview or rating scales as well as interviews should be used. When it is feasible, clinicians may wish to supplement these components of the evaluation with objective assessments of the ADHD symptoms, such as psychological tests. These tests are not essential to reaching a diagnosis, however, or to treatment planning, but they may yield further information about the presence and severity of cognitive impairments that could be associated with some cases of ADHD. Screening for intellectual ability and academic achievement skills is also important in determining the presence of comorbid developmental delay or loaming disabilities. The number and type of symptoms required for a diagnosis of ADHD vary depending on the specific subtype. To receive a diagnosis of ADHD, the person must be experiencing significant distress or impairment in daily functioning, and must not meet criteria for other mental disorders which might better account for the observed symptoms such as mental retardation, autism or other pervasive developmental disorders, mood disorders, anxiety disorders. This report aims to suggest a practice guideline of assessment and diagnosis for children and adolescents with ADHD in Korea.

  • PDF

Improvement of Tentative Korean Standard Differentiation of the Symptoms and Signs for Stroke for Clinical Application (중풍변증표준안 진료기록부 임상적용을 위한 증례기록부와 표준작업지침서의 개선과정)

  • Lee, Min-Goo;Kang, Byeong-Kab;Kim, Bo-Young;Ko, Ho-Yeon;Choi, Sun-Mi;Seol, In-Chan;Jo, Hyun-Kyung;Yun, Jong-Min;Moon, Byung-Soon;Lee, In
    • Journal of Physiology & Pathology in Korean Medicine
    • /
    • v.21 no.1
    • /
    • pp.347-351
    • /
    • 2007
  • This study was done to report the improvement of second case report form(CRF) and standard operating procedure(SOP) of Tentative Korean Standard Differentiation of the Symptoms and Signs for Stroke. We were in charge of developing case report form(CRF) and educating the investigators. In the process of this project, we needed to develop standard operating procedure(SOP) for this CRF. So we made Tentative Korean Standard Differentiation of the Symptoms and Signs for Stroke and tried clinical application at Department of Oriental Internal Medicine of Wonkwang University and Daejeon University in 2005. And in this pilot study we can find out some problems and need to improve it. We strengthen the incision and exclusion criteria of CRF We canceled the Chief complains entry for efficiency. We reflected the decision of Stroke standard committee. We reduced the differentiation index of CRF to promote efficiency and accuracy. We rearranged the order of the differentiation index to promote rationality and practicality. We regulated detail item belonging to Differentiation index. We used a colloquialism in question. We inserted flow chart in SOP. We inserted picture of diagnostic index.

Visual detection of porcine circovirus 2 by loop-mediated isothermal amplification (LAMP) with hydroxynaphthol blue dye (육안 판독 등온증폭법을 이용한 돼지 써코바이러스 2형 신속 진단법)

  • Kong, Ho-Chul;Kim, Eun-Mi;Jeon, Hyo-Sung;Kim, Ji-Jung;Kim, Hee-Jung;Park, Yu-Ri;Kang, Dae-Young;Kim, Young-Hwa;Park, Jun-Cheol;Lee, Chang-hee;Yeo, Sang-Geon;Park, Choi-Kyu
    • Korean Journal of Veterinary Service
    • /
    • v.38 no.3
    • /
    • pp.145-153
    • /
    • 2015
  • In this study, we developed a loop-mediated isothermal amplification (LAMP) with hydroxynaphtol blue dye (HNB) for rapid and direct visual detection of porcine circovirus 2 DNA with high sensitivity and specificity. The LAMP was completed in 40 min at $63^{\circ}C$, and the results of the LAMP can be confirmed by naked eye without any detection process. The sensitivity of the LAMP was 10-fold higher than that of the commercial PCR (cPCR) and real time PCR (rPCR) previously reported. In clinical application, the PCV2 detection rate of the LAMP was the same on porcine tissue samples (75.0%, 36/48) between porcine blood samples (75.0%, 39/52). The PCV2 detection rate (75.0%) of LAMP was higher than those of the cPCR and rPCR (67.3%, 35/52) in blood samples. In conclusion, the LAMP developed in the study could be an useful alternative method for the detection of PCV2 in the swine disease diagnostic laboratories.

How Does Technostress Influence Employees' Role and Performance in An Organization?: The Moderating Effect of Innovation Support (조직 내 기술스트레스가 역할과 성과에 미치는 영향: 혁신지원의 조절효과)

  • Kim, Geuna;Kim, Sanghyun
    • Information Systems Review
    • /
    • v.16 no.2
    • /
    • pp.97-124
    • /
    • 2014
  • This study applies the concepts of sociotechnical theory and role theory in order to verify the effects of stress (that is, technostress) created from information and computer technology (ICT) concerning role stress and performance. We suggest diverse perspectives concerning the elements leading to technostress along with the stress-creating process of ICT among organizational members. The following four major hypotheses are proposed: (1) Technostress is positively related to role stress (e.g., conflict and overload of roles), adverse psychological outcomes, and adverse IS use related outcomes, (2) Role conflict is positively related to adverse psychological outcomes and adverse IS use related outcomes, (3) Role overload is positively related to adverse psychological outcomes and adverse IS use related outcomes, and (4) Innovation support will play as a moderator between technostress, roles tress, adverse psychological outcomes and adverse IS use related outcomes. A partial least square (PLS) with data gathered data from ICT users of organizations was used to verify the proposed hypotheses. The results supported our claims excluding the hypothesis associated to the relationship between technostress and role stress. We suggest a theoretical implication based on the verification of technostress related to the current concept of stress experienced by individuals within organizations. We also propose that a practical implication concerning the opposite effect of technostress, can be utilized as a method of reducing role stress, and suggests a diagnostic tool for assessing the degree of technostress within organizations.

Implant-supported maxillary full-arch fixed prosthesis opposing mandibular natural dentition: A clinical report (하악 자연치열에 대합되는 상악 임플란트 전악 수복 증례)

  • Kim, In-Ju;Park, Jong-Hee;Park, Ju-Mi;Song, Kwang-Yeob;Ahn, Seung-Geun;Seo, Jae-Min
    • The Journal of Korean Academy of Prosthodontics
    • /
    • v.53 no.1
    • /
    • pp.51-57
    • /
    • 2015
  • When an implant-supported maxillary full-arch fixed prosthesis is planned for patients with the horizontal and vertical bone resorption induced by periodontal disease, it is necessary to consider the masticatory function, esthetics and phonetics when placing implants. For this reason, thorough clinical and radiological diagnosis is necessary. Extensive bone and soft tissue grafting may be required as well. Since there is no clear guideline for proper number of implants, segment or splinting of substructure and method of retaining prosthesis, these should be considered during diagnostic process. This clinical report describes a patient who has experienced several tooth extractions and periodontal treatment due to severe periodontitis on maxilla and mandible. With bone and soft tissue graft before dental implant placement, the patient have satisfactory result in esthetic and functional aspect with the implant-supported maxillary full-arch fixed prosthesis opposing mandibular natural dentition.