• 대한의용생체공학회:의공학회지
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• 제32권2호
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• pp.134-143
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• 2011

The selection of meaningful clinical tests and its reference values from a high-dimensional clinical data with imbalanced class distribution, one class is represented by a large number of examples while the other is represented by only a few, is an important issue for differential diagnosis between similar diseases, but difficult. For this purpose, this study introduces methods based on the concepts of both discernibility matrix and function in rough set theory (RST) with two discretization approaches, equal width and frequency discretization. Here these discretization approaches are used to define the reference values for clinical tests, and the discernibility matrix and function are used to extract a subset of significant clinical tests from the translated nominal attribute values. To show its applicability in the differential diagnosis problem, we have applied it to extract the significant clinical tests and its reference values between normal (N = 351) and abnormal group (N = 101) with either cholecystitis or cholelithiasis disease. In addition, we investigated not only the selected significant clinical tests and the variations of its reference values, but also the average predictive accuracies on four evaluation criteria, i.e., accuracy, sensitivity, specificity, and geometric mean, during l0-fold cross validation. From the experimental results, we confirmed that two discretization approaches based rough set approximation methods with relative frequency give better results than those with absolute frequency, in the evaluation criteria (i.e., average geometric mean). Thus it shows that the prediction model using relative frequency can be used effectively in classification and prediction problems of the clinical data with imbalanced class distribution.

• Clinical and Experimental Pediatrics
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• 제61권5호
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• pp.160-166
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• 2018

Purpose: This study aimed to analyse laboratory values according to fever duration, and evaluate the relationship across these values during the acute phase of Kawasaki disease (KD) to aid in the early diagnosis for early-presenting KD and incomplete KD patients. Methods: Clinical and laboratory data of patients with KD (n=615) were evaluated according to duration of fever at presentation, and were compared between patients with and without coronary artery lesions (CALs). For evaluation of the relationships across laboratory indices, patients with a fever duration of 5 days or 6 days were used (n=204). Results: The mean fever duration was $6.6{\pm}2.3days$, and the proportions of patients with CALs was 19.3% (n=114). C-reactive proteins (CRPs) and neutrophil differential values were highest and hemoglobin, albumin, and lymphocyte differential values were lowest in the 6-day group. Patients with CALs had longer total fever duration, higher CRP and neutrophil differential values and lower hemoglobin and albumin values compared to patients without CALs. CRP, albumin, neutrophil differential, and hemoglobin values at the peak inflammation stage of KD showed positive or negative correlations each other. Conclusion: The severity of systemic inflammation in KD was reflected in the laboratory values including CRP, neutrophil differential, albumin, and hemoglobin. Observing changes in these laboratory parameters by repeated examinations prior to the peak of inflammation in acute KD may aid in diagnosis of early-presenting KD patients.

• 음성과학
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• 제12권3호
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• pp.19-33
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• 2005

Tremor is a main factor of parkinsonism. Voice tremor may be the first, later or the only symptom of a neurological disease and its frequency, amplitude, and regularity may differ among the diseases of different neural subsystems. Differential diagnosis between idiopathic Parkinson's disease (IPD) and multiple system atrophy (MSA) has been difficult. This study included three groups: (1) 6 IPD patients; (2) 6 MSA patients; and (3) 20 ageand sex-matched normal controls. The MDVP (Multidimensional Voice Program) was used to analyze the sustained /a/phonation. The results were as follows: (1) frequency perturbation parameters (jitter, sPPQ, Vf0) and FTRI of tremor parameter of two patient groups were statistically different from those of the controls (p < .01); (2) measures were higher in short-term and long-term f0 and amplitude perturbation in MSA than IPD; (3) however, any acoustic parameters between IPD and MSA were not statistically different; except for the rate of frequency tremor, 4$\sim$5 Hz in IPD, 5$\sim$11 Hz in MSA and (4) the pattern of regularity for voice tremor through histogram indicated that amplitude of IPD was irregular while both f0 and amplitude of MSA were irregular. In conclusion, F0, rate of frequency tremor, and pattern of f0 regularity may be predictors for differential diagnosis. These findings might signify that voice tremor of parkinsonism was resulted from modulation of f0.

• Asian Pacific Journal of Cancer Prevention
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• 제15권3호
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• pp.1269-1274
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• 2014

Breast tubular adenomas are rare benign breast tumors and detailed descriptions of their sonographic appearance are necessary for differential diagnosis from fibroadenomas or breast cancers. This study investigated twenty-one histology-proved tubular adenomas in 17 patients and also included 48 fibroadenomas in 35 patients as a control group. There was no significant difference between the two groups with clinical presentation, which was age, tumor location, tumor number (p>0.05). Statistic analysis showed three significant factors in the differential diagnosis of tubular adenomas and fibroadenomas, including macro-lobulation (p=0.01), "tiny branch like" patterns (p=0.001) and vascularity (p=0.02). Other ultrasonographic features such as echogenicity, border, uniformity of echotexture, posterior acoustic enhancement, lateral wall shadowing were of no clinical significance (p>0.05). Calcifications were seen in three tubular adenomas which were different from those of carcinomas. Although tubular adenomas have some typical characteristics on sonography, surgery and core needle biopsy are still needed for complex cases to exclude progress to malignancy.

• 치과방사선
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• 제29권1호
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• pp.241-254
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• 1999

The purpose of this study was to investigate whether a radiometric analysis of radicular cysts and periapical granulomas is useful in the differential diagnosis. In this experiment, twenty-nine periapical radiographs of the radicular cyst and those periapical granuloma were used. The periapical radiography was taken by intraoral paralleling device. The X-ray film was digitized and digitally filtered to reduce film-grain noise. We estimated density difference of the inner/outer area, roundness or circularity, bone profile or scan line of the margin and cumulative percentage frequency curve of radicular cyst & periapical granuloma. The obtained results were as follows; 1. The differences in density between ROIs of inner and outer area of radicular cysts were smaller than those of periapical granulomas. 2. The equivalent circular diameter was over 6.3mm, there was significant difference between periapical cyst and periapical granuloma. 3. In differential diagnosis of radicular cyst and periapical granuloma using bone profile. sensitivity. specificity and accuracy were considerably high(0.83. 0.86. 0.86) respectively. 4. Cumulative percentage frequency curve of the radicular cyst was closer to the pseudo-pixel value of 50 than average curve, whereas periapical granuloma was closer to that of 0. Hence we conclude that digital radiometric features might be useful in the differential diagnosis between radicular cyst and periapical granuloma.

• 대한치과의사협회지
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• 제40권7호통권398호
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• pp.542-547
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• 2002

This study was aimed to help diagnose the vertical root fractures in endodontically and in nonendodontically treated teeth. This was a study about mine teeth with a vertical root fractures. Four cases were nonendodontically treated teeth and five cases were endodontically treated teeth. A collection of information including past dental history, periodontal probing, and X-ray was gathered on each case. One of the endodontic cases had no periodontal pocket depth and was in acute pain. It was confusing to find whether causes were because of endodontic failure or vertical root fractures. Most of the vertical root fractures were found in patients aged between 50 and 60. Vertical root fractures were found in the molar and premolar of maxillary and mandibular teeth. The second molars repecially, which had C shaped roots had vertical root fractures with apical propagation type. The apical propagation type means that vertical root fracture initiates in root apex and propagate to coronal root. The teeth with vertical root fractures of the apical propagation type, which was in acute pain, were very difficult in differential diagnosis of periodontal lesion and endodontic failure. Therefore, the dental history was very important to make a differential diagnosis. Past pain history repeated uncomfortable symptoms in bite was a key of differential diagnosis.

• 동의생리병리학회지
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• 제26권5호
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• pp.621-629
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• 2012

This study aimed to examine the possibility of data from pulse diagnosis device to be used for diagnosis of Sasang constitution. Systematic searches of 5 major Korean medical database were conducted for articles published up to May 2012. Searching key word was "Sasang" or "Constitution". Studies dealt with correlation between Sasang constitution and the pulse wave data from pulse diagnosis machine were included. Totally 2886 studies are searched and 3 studies are added from references of evaluated articles. Among them, 12 studies were met our inclusion criteria (2 Xishu Mac, 2 Self-made pulse diagnosis machine, 8 3D-Mac). Three of the eight 3D-Mac studies intended to develop a formula of constitutional differential diagnosis, 2 studies compared variables by Sasang constitution in healthy group and 3 studies compared variables by Sasang constitution in healthy group and special disease group. They all reported some significant variables, however results are not consistent between studies. The accuracy of the formula of constitutional differential diagnosis using 3D-Mac pulse diagnosis devices is 46.0% by now. Improvements in measuring pulse are required to achieve more accurate result and be used for diagnosis of Sasang constitution. Compensating B.M.I. among Sasang constitutional groups and separating constitutional pulse factors from acquired characteristics are also needed in further study.

• Investigative Magnetic Resonance Imaging
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• 제23권2호
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• pp.100-113
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• 2019

Sarcoidosis is a multisystem disease characterized by noncaseating granulomas. Cardiac involvement is known to have poor prognosis because it can manifest as a serious condition such as the conduction abnormality, heart failure, ventricular arrhythmia, or sudden cardiac death. Although early diagnosis and early treatment is critical to improve patient prognosis, the diagnosis of CS is challenging in most cases. Diagnosis usually relies on endomyocardial biopsy (EMB), but its diagnostic yield is low due to the incidence of patchy myocardial involvement. Guidelines for the diagnosis of CS recommend a combination of clinical, electrocardiographic, and imaging findings from various modalities, if EMB cannot confirm the diagnosis. Especially, the role of advanced imaging such as cardiac magnetic resonance (CMR) imaging and positron emission tomography (PET), has shown to be important not only for the diagnosis, but also for monitoring treatment response and prognostication. CMR can evaluate cardiac function and fibrotic scar with good specificity. Late gadolinium enhancement (LGE) in CMR shows a distinctive enhancement pattern for each disease, which may be useful for differential diagnosis of CS from other similar diseases. Effectively, T1 or T2 mapping techniques can be also used for early recognition of CS. In the meantime, PET can detect and quantify metabolic activity and can be used to monitor treatment response. Recently, the use of a hybrid CMR-PET has introduced to allow identify patients with active CS with excellent co-localization and better diagnostic accuracy than CMR or PET alone. However, CS may show various findings with a wide spectrum, therefore, radiologists should consider the possible differential diagnosis of CS including myocarditis, dilated cardiomyopathy (DCM), hypertrophic cardiomyopathy, amyloidosis, and arrhythmogenic right ventricular cardiomyopathy. Radiologists should recognize the differences in various diseases that show the characteristics of mimicking CS, and try to get an accurate diagnosis of CS.

• Journal of Oral Medicine and Pain
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• 제47권2호
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• pp.87-94
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• 2022

Purpose: This study aimed to evaluate the differences between clinical and quantitative sensory testing (QST) results among persistent idiopathic dentoalveolar pain (PIDP), inflammatory dental pain, and control group subjects to identify discriminative clinical features for differential diagnosis. Methods: Thirty-three patients (5 PIDP-a without surgical procedures 10 PIDP-b with surgical procedures, 8 dental pain patients, and 10 controls) were evaluated for clinical features and QST results. Cold pain threshold, heat pain threshold, mechanical pain threshold (MPT), mechanical pain sensitivity, and pressure pain threshold (PPT) were performed. Psychological factors were assessed using Symptom Checklist-90-Revision (SCL-90-R) and a chart review was conducted to evaluate additional discriminative clinical features such as pain quality and treatment prognosis. Results: The dental pain group had lower PPT than the PIDP-b and the control group. The PIDP-a group showed higher MPT and PPT than the PIDP-b and dental pain group but the difference was not statistically significant. Differences in SCL-90-R SOM (Somatization), O-C (obsessive-compulsive), ANX (anxiety), and PSY (Psychoticism) values were statistically significant among groups. PIDP-a and PIDP-b groups showed remaining symptoms after treatment and the pain tended to spread widely, whereas, in toothache patients, symptoms disappeared after treatment. However, factors that confound the diagnosis, such as an increase in pain during chewing and a decrease in the pain threshold at the affected site, could also be identified. Conclusions: PIDP and dental pain groups have distinct clinical symptoms, but there are also factors that cause confusing in diagnosis. Therefore, various clinical examination results should be carefully reviewed and comprehensively evaluated in the differential diagnosis process.

• Journal of the Korean Data and Information Science Society
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• 제18권2호
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• pp.429-438
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• 2007

Headache is one of the most common reasons for neurological consultation. Headache as many causes and symptoms. Therefore, screening method using questionaire is helpful in diagnosis of headache. This paper is to propose a medical diagnostic method to grasp patient's diseases using the relations between symptoms and diseases. For this purpose, we develop an interview chart assigned IF(intuitionistic fuzzy) grade with the relation among symptoms and three labels of headache. The method can be used to classify patient's tone of diseases with certain degrees of belief and its concerned symptoms.