• Title/Summary/Keyword: standard of diagnosis

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A Study of the Relationship to the Student's Health Behavior, Belief, Value and Health Service Utilization -With Emphasis on Family Structure and Other Variables- (학생(學生)의 건강행위(健康行爲), 신념(信念), 가치(價値) 및 보건의료(保建醫療) 이용(利用)에 미치는 영향(影響)에 관(關)한 연구 -가족(家族)의 형태(形態) 및 제특성(諸特性)을 중심(中心)으로-)

  • Chung, Yeon Kang
    • Journal of the Korean Society of School Health
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    • v.6 no.1
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    • pp.9-44
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    • 1993
  • An explorative and descriptive study in order to determine the effect of family structure and other socio-demographic variables on health behavior, belief, locus, and value and utilization of public health service was carried out. Data were collected from 1,653 subjects randomly sampled in three areas, Seoul, Kyunggi province, and Cheju province. From Seoul 849 subjects were selected, 397 subjects Kyunggi, and 407 subjects from Cheju, respectively. Self-reporting questionaires were administered during the period from March to June, 1992. The major findings were as follows: 1) The subjects visited herb-doctor's at irregular intervals mainly to have tonic medicine prepared. They preferred herb-doctor's rather than with doctors at clinics and hospitals. Statistically significant difference was found among the regions studied (p<0.05). 2) The reason for visiting hospitals was primarily for treatment of diseases. They preferred hospital because they felt that the hospitals offer much highly reliable treatment services as well as medical accessibility. For the purpose of hospital utilization, statistically significant differences existed among sex, educational level, family type and region. However, no significance was found among sex, educational level, and region (p<0.05). 3) The subjects utilized general hospitals mainly for diagnosis and treatment of diseases. They preferred general hospitals because of their much better facilities and reliability. Statistical significance was found among sex, educational level, and region (p<0.05). 4) The subjects visited dentist at irregular intervals basis. They visited once half a year or three to four months. their purpose of visit was mainly for diagnosis and treatment of diseases. Statistical significance differences were found among educational level, region and economic standard (p<0.05). 5) Whenever their illnesses were mild and the pharmacies was located in nearby they visited to pharmacies. They visited once a month and patient medicines. Statistically significant differences were found among sex, educational level and region (p<0.05). 6) The subjects believed that herb medicine was quite efficacious for treatment of some diseases, particularly by information handed down through time-honored tradition and experience. However, they recognized that the efficacy of folk medicine can vary with type and severity of diseases. Statistical significance was among sex, educational level, region and economic standard (p<0.05). 7) The reason why subjects believed that pray and superstition are effective for treatment of certain type of diseases, particularly in neuropathy, was the belief in God's almighty. Statistically significant differences were found among sex, educational level, regions and economic standard (p<0.05). 8) Most of subjects under same condition preferred western medicine because they believed that it is more scientific and prompts in showing therapeutic effect. Statistical significance was not found in the choice of type of public health service among, regions. But significant differences were found among sex, educational level and region (p<0.05). 9) The subjects looked for pharmacy if they thought the symptom was mild. However, they visited hospitals for chronic disease and general hospitals for emergency treatment. Statistical significances were found among educational level, region and economic standard (p<0.05). 10) Although most of students wanted to have a healthy life as for the component of health standard and value, they think that they are not healthy (p<0.05). As for the health behavior, significant difference was found in the proportion of smoking and drinking between educational level and region (p<0.05). The health locus was affected by educational level, and health behavior was influenced by region, sex and educational level. The utilization of type of public health service was influenced by family type and region, and health belief by region and educational level, and the health values by region and economic standard respectively, most of correlation showed statistical significance. Among them, the highest correlation was seen between locus of control and external/internal locus of control, which is quite obvious. The correlation between health belief and behavior was the next highest, but still low (0.343). All the other variables are low but significant except only a few of those. These findings indicate that health education should be incorporated into the curriculum so as to develop desirable health habit, and ability of self-control in accordance with their growth stages. A systematic and scientific understanding on the herb/folk medicine is needed, and greater reliability of the utilization of public health services are is still required. Health policy for equal distribution of health service throughout the country along the hierarchical health service system and complementary mutual assistance and cooperation among various health organizations are also required.

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Diagnosis of Ictal Hyperperfusion Using Subtraction Image of Ictal and Interictal Brain Perfusion SPECT (발작기와 발작간기 뇌 관류 SPECT 감산영상을 이용한 간질원인 병소 진단)

  • Lee, Dong Soo;Seo, Jong-Mo;Lee, Jae Sung;Lee, Sang-Kun;Kim, Hyun Jip;Chung, June-Key;Lee, Myung Chul;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.1
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    • pp.20-31
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    • 1998
  • A robust algorithm to disclose and display the difference of ictal and interictal perfusion may facilitate the detection of ictal hyperfusion foci. Diagnostic performance of localizing epileptogenic zones with subtracted SPECT images was compared with the visual diagnosis using ictal and interictal SPECT, MR, or PET. Ietal and interictal Tc-99m-HMPAO cerebral perfusion SPECT images of 48 patients(pts) were processed to get parametric subtracted images. Epileptogenic foci of all pts were diagnosed by seizure free state after resection of epileptogenic zones. In subtraction SPECT, we used normalized difference ratio of pixel counts(ictal-interictal)/interictal ${\times}100%$) after correcting coordinates of ictal and interictal SPECT in semi-automatized 3-dimensional fashion. We found epileptogenic zones in subtraction SPECT and compared the performance with visual diagnosis of ictal and interictal SPECT, MR and PET using post-surgical diagnosis as gold standard. The concordance of subtraction SPECT and ictal-interictal SPECT was moderately good(kappa=0.49). The sensitivity of ictal-interictal SPECT was 73% and that of subtraction SPECT 58%. Positive predictive value of ictal-interictal SPECT was 76% and that of subtraction SPECT was 64%. There was no statistical difference between sensitivity or positive predictive values of subtraction SPECT and ictal-interictal SPECT, MR or PET. Such was also the case when we divided patients into temporal lobe epilepsy and neocortical epilepsy. We conclude that subtraction SPECT we produced had equivalent diagnostic performance compared with ictal-interictal SPECT in localizing epileptogenic zones. Additional value of these subtraction SPECT in clinical interpretation of ictal and interictal SPECT should be further evaluated.

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Magnitude of beam-hardening artifacts produced by gutta-percha and metal posts on cone-beam computed tomography with varying tube current

  • Gaeta-Araujo, Hugo;Nascimento, Eduarda Helena Leandro;Fontenele, Rocharles Cavalcante;Mancini, Arthur Xavier Maseti;Freitas, Deborah Queiroz;Oliveira-Santos, Christiano
    • Imaging Science in Dentistry
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    • v.50 no.1
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    • pp.1-7
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    • 2020
  • Purpose: This study was performed to evaluate the magnitude of artifacts produced by gutta-percha and metal posts on cone-beam computed tomography (CBCT) scans obtained with different tube currents and with or without metal artifact reduction (MAR). Materials and Methods: A tooth was inserted in a dry human mandible socket, and CBCT scans were acquired after root canal instrumentation, root canal filling, and metal post placement with various tube currents with and without MAR activation. The artifact magnitude was assessed by the standard deviation (SD) of gray values and the contrast-to-noise ratio (CNR) at the various distances from the tooth. Data were compared using multi-way analysis of variance. Results: At all distances, a current of 4 mA was associated with a higher SD and a lower CNR than 8 mA or 10 mA (P<0.05). For the metal posts without MAR, the artifact magnitude as assessed by SD was greatest at 1.5 cm or less (P<0.05). When MAR was applied, SD values for distances 1.5 cm or closer to the tooth were reduced (P<0.05). MAR usage did not influence the magnitude of artifacts in the control and gutta-percha groups(P>0.05). Conclusion: Increasing the tube current from 4 mA to 8 mA may reduce the magnitude of artifacts from metal posts. The magnitude of artifacts arising from metal posts was significantly higher at distances of 1.5 cm or less than at greater distances. MAR usage improved image quality near the metal post, but had no significant influence farther than 1.5 cm from the tooth.

Manual Liquid Based Cytology in Primary Screening for Cervical Cancer - a Cost Effective Preposition for Scarce Resource Settings

  • Nandini, N.M.;Nandish, S.M.;Pallavi, P.;Akshatha, S.K.;Chandrashekhar, A.P.;Anjali, S.;Dhar, Murali
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.3645-3651
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    • 2012
  • Conventional pap smear (CPS) examination has been the mainstay for early detection of cervical cancer. However, its widespread use has not been possible due to the inherent limitations, like presence of obscuring blood and inflammation, reducing its sensitivity considerably. Automated methods in use in developed countries may not be affordable in the developing countries due to paucity of resources. On the other hand, manual liquid based cytology (MLBC) is a technique that is cost effective and improves detection of precursor lesions and specimen adequacy. Therefore the aim of the study was to compare the utility of MLBC with that of CPS in cervical cancer screening. A prospective study of 100 cases through MLBC and CPS was conducted from October 2009 to July 2010, in a Medical College in India, by two independent pathologists and correlated with histopathology (22 cases). Morphological features as seen through MLBC and CPS were compared. Subsequently, all the cases were grouped based on cytological diagnosis according to two methods into 10 groups and a subjective comparison was made. In order to compare the validity of MLBC with CPS in case of major diagnoses, sensitivity and specificity of the two methods were estimated considering histological examination as the gold standard. Increased detection rate with MLBC was 150%. The concordance rate by LBC/histopathology v/s CPS/histopathology was also improved (86% vs 77%) The percentage agreement by the two methods was 68%. MLBC was more sensitive in diagnosis of LSIL and more specific in the diagnosis of inflammation. Thus, MLBC was found to be better than CPS in diagnosis of precursor lesions. It provided better morphology with increased detection of abnormalities and preservation of specimen for cell block and ancillary studies like immunocytochemistry and HPV detection. Therefore, it can be used as alternative strategy for cervical cancer prevention in limited resource settings.

A Study on Characteristics of Jinsatak(陳士鐸)'s Clinic Theory (진사탁(陳士鐸) 임상 이론의 특징에 관한 연구)

  • Jeong, Kyung-Ho;Kim, Ki-Wook;Park, Hyun-Guk
    • Journal of Korean Medical classics
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    • v.22 no.3
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    • pp.31-51
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    • 2009
  • The characteristics of Jin's ideas on clinic theory can be arranged as follows. 1. Jin emphasized warming and tonifying[溫補] in treatment and the part that shows this the best is the taking care of[調理] the Vital gate[命門], kidney, liver, and spleen. His ideas were based on his understanding of a human life's origin, and was influenced by Seolgi(薛己), Joheon-ga(趙獻可) and Janggaebin(張介賓)'s Vital gate and source Gi theory(元氣說) so scholastically, he has that in common with them but was later criticized by later doctors such as Oksamjon(玉三尊) as an 'literary doctor(文字醫)' who followed the ideas of "Uigwan(醫貫)". 2. The warming and tonifying school[溫補學派], who were influenced by Taoism, said in their theory of disease outbreak[發病學說] that since one must not hurt one's Yin essence and Yang fire [陰精陽火] there is more deficiency than excess, so that was why they used tonifying methods. Jin was also like them and this point of view is universal in internal medicine, gynecology, pediatric medicine and surgery and so on. 3. Jin, who saw the negative form of pulse diagnosis[診脈] emphasized following symptoms over pulse diagnosis using the spirit of ‘finding truth based on truth[實事求是]' in "Maekgyeolcheonmi(脈訣闡微)", but emphasized 'the combination of pulse and symptoms[脈證合參]'. He understood pulse diagnosis as a defining tool for symptoms, and in "Seoksilbirok(石室秘錄)" simplified pulse diagnosis into 10 methods : floating/sunken(浮沉), slow/fast(遲數), large/fine(大小), vacuous/replete(虛實) and slippery/rough(滑澀). 4. Jin used 'large formulas(大方)' a lot that usually featured a large dose, and in " Bonchosinpyeon(本草新編)" he thought of the seven formulas(七方) and ten preparations(十劑) as the standard when using medicine. He did away with old customs and presented a 'new(新)' and 'extra(奇)' point of view. He especially used a lot of Insam(人蔘) when tonifying Gi and Geumeunhwa(金銀花) when treating sores and ulcers. 5. In the area of surgery Jin gave priority to the early finding and treatment of disease with internal treatment[內治] and was against the overuse of acupuncture. However records of surgical measures in a special situation like lung abscesses(肺癰) and liver abscesses(肝癰), and anesthetic measures using 'Manghyeongju(忘形酒)' and 'Singoiyak(神膏異藥)' and opening the abdomen or skull, and organ transplants using a dog's tongue are important data. 6. Jin stated the diseases of Gi and blood broadly. Especially in the principles of treating blood, blood diseases had to be forwarded[順] and Gi regulation[理氣] was the number one priority and stated the following two treatments. First, in "Jeonggiinhyeolpyeon(精氣引血篇)" of volume 6 of "Oegyeongmieon(外經微言)", for the rules for treating blood he stated the pattern identification of finding Gi in blood and blood in Gi. Second, he emphasized Gi regulation(理氣) in blood diseases and stated that the Gi must be tonifyed after finding the source of the loss of blood.

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Evaluation of Malignancy Risk of Ampullary Tumors Detected by Endoscopy Using 2-[18F]FDG PET/CT

  • Pei-Ju Chuang;Hsiu-Po Wang;Yu-Wen Tien;Wei-Shan Chin;Min-Shu Hsieh;Chieh-Chang Chen;Tzu-Chan Hong;Chi-Lun Ko;Yen-Wen Wu;Mei-Fang Cheng
    • Korean Journal of Radiology
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    • v.25 no.3
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    • pp.243-256
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    • 2024
  • Objective: We aimed to investigate whether 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (2-[18F]FDG PET/CT) can aid in evaluating the risk of malignancy in ampullary tumors detected by endoscopy. Materials and Methods: This single-center retrospective cohort study analyzed 155 patients (79 male, 76 female; mean age, 65.7 ± 12.7 years) receiving 2-[18F]FDG PET/CT for endoscopy-detected ampullary tumors 5-87 days (median, 7 days) after the diagnostic endoscopy between June 2007 and December 2020. The final diagnosis was made based on histopathological findings. The PET imaging parameters were compared with clinical data and endoscopic features. A model to predict the risk of malignancy, based on PET, endoscopy, and clinical findings, was generated and validated using multivariable logistic regression analysis and an additional bootstrapping method. The final model was compared with standard endoscopy for the diagnosis of ampullary cancer using the DeLong test. Results: The mean tumor size was 17.1 ± 7.7 mm. Sixty-four (41.3%) tumors were benign, and 91 (58.7%) were malignant. Univariable analysis found that ampullary neoplasms with a blood-pool corrected peak standardized uptake value in earlyphase scan (SUVe) ≥ 1.7 were more likely to be malignant (odds ratio [OR], 16.06; 95% confidence interval [CI], 7.13-36.18; P < 0.001). Multivariable analysis identified the presence of jaundice (adjusted OR [aOR], 4.89; 95% CI, 1.80-13.33; P = 0.002), malignant traits in endoscopy (aOR, 6.80; 95% CI, 2.41-19.20; P < 0.001), SUVe ≥ 1.7 in PET (aOR, 5.43; 95% CI, 2.00-14.72; P < 0.001), and PET-detected nodal disease (aOR, 5.03; 95% CI, 1.16-21.86; P = 0.041) as independent predictors of malignancy. The model combining these four factors predicted ampullary cancers better than endoscopic diagnosis alone (area under the curve [AUC] and 95% CI: 0.925 [0.874-0.956] vs. 0.815 [0.732-0.873], P < 0.001). The model demonstrated an AUC of 0.921 (95% CI, 0.816-0.967) in candidates for endoscopic papillectomy. Conclusion: Adding 2-[18F]FDG PET/CT to endoscopy can improve the diagnosis of ampullary cancer and may help refine therapeutic decision-making, particularly when contemplating endoscopic papillectomy.

The Research on the Classification of Soeumin Symptomatology and the Standardized Symptom (소음인(少陰人) 병증(病證) 분류체계와 표준증후 연구)

  • Song, Eun-Young;Park, Byung-Joo;Song, An-Na;Lee, Eui-Ju;Koh, Byung-Hee;Lee, Jun-Hee
    • Journal of Sasang Constitutional Medicine
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    • v.23 no.4
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    • pp.429-444
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    • 2011
  • 1. Objective This study is aimed to present the effective classification of Soeumin symptomatology and the standardized signs for classification which can be applied for KCD, ICD and the insurance codification system. 2. Methods 1) Differentiate Soeumin symptomatology based on exterior-interior patterns, favorable-unfavorable patterns, and mild-severe-dangerous-urgent patterns. 2) Investigate the standard signs and symptoms to claasify Soeumin symptomatology based on exterior-interior patterns, favorable-unfavorable patterns, and mild-severe-dangerous-urgent patterns. 3. Results and Conclusions 1) The diagnosis criteria for Soeumin exterior-interior disease is based upon signs & symptoms of cold/heat, condition of stool, state of digestive system(such as digestion and appetite)among others. 2) The diagnosis criteria for Soeumin favorable-unfavorable disease is generally based upon whether the vital force of the spleen is damaged or not. More specifically, for the exterior disease, whether or not sweating is present. For the interior disease, whether or not dry mouth, body ache(a main symptom of the exterior state), and anxiousness are present. 3) For the Soeumin Wool-gwang disease, the diagnosis criteria of mild-severe disease is whether or not chills is present and the degree of body fever. 4) For Soeumin Mang-yang disease, the diagnosis criteria of dangerous-urgent disease is whether or not chills is, the degree of sweating and urine condition. 5) For the Soeumin Greater-Yin disease, Abdominal-pain bowel irritability pattern and Epigastric discomfort pattern are early state signs, Jaundice pattern is mild-state sign, edema & Greater-Yang disease Yin-toxin pattern are terminal state signs. 6) For the Soeumin interior disease, Abdominal-pain bowel irritability pattern and Epigastric discomfort pattern are of the dangerous state pattern, Jang-gual and Exuberant-Yin-repelling-Yang pattern are of the urgent state patterns.

Efficacy of Fine Needle Aspiration Biopsy in Parotid Gland Tumors (이하선 종양에서 세침흡인검사의 유용성)

  • Lee, Chang-Hee;Lee, Hyun-Sub;Jin, Sung-Min;Lee, Sang-Hyuk;Pyo, Jung-Soo;Sohn, Jin-Hee
    • Korean Journal of Head & Neck Oncology
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    • v.27 no.2
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    • pp.204-209
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    • 2011
  • Background and Objectives : The usefulness of fine needle aspiration biopsy(FNAB) for diagnosis of parotid gland tumors is controversial, because of the generalized belief requiring surgery for most parotid tumors. The aim of this study was to evaluate the efficacy of FNAB for diagnosis in parotid gland tumors. Material and Methods : FNAB was performed in 91 patients who underwent parotid surgery at Kangbuk Samsung Hospital from January 2007 to December 2010. The result of FNAB, 11 malignancies and 75 benign tumors and 5 non-neoplasms were analyzed and compared with the final histopathologic diagnoses. Sensitivity, specificity, accuracy, positive predictive value(PPV), and negative predictive value(NPV) were calculated using final histopathologic diagnosis of the surgical specimen as the standard diagnostic reference for comparative analysis. Results : 86 specimens(94.5%) were suitable for evaluation. We compared the result of FNAB and the final histopathology in 79(89.4%) cases. The sensitivity, specificity, accuracy, PPV, and NPV of FNAB for detecting pleomorphic adenoma was 95.8%, 88.4%, 92.3%, 90.2%, and 95.0%. In Warthin's tumor, results were 86.4%, 94.2%, 92.3%, 82.6%, and 95.6%. Among 11 patients who were diagnosed with malignancy on final histopathologic report, only 3(30%) patients were diagnosed with the same as on FNAB, the other 8 patients were initially diagnosed incorrectly as benign tumors in FNAB. There were no complications related to FNAB. Conclusion : Diagnostic accuracy for FNAB in benign parotid tumors was high. However, in malignant tumors, FNAB shows low diagnostic usefulness compared with benign tumors. FNAB can be effective and safe diagnostic technique for evaluating the benign parotid glands tumors.

An Experimental Study on the Application of LIBS for the Diagnosis of Concrete Deterioration (콘크리트 열화 진단의 LIBS 적용을 위한 실험적 연구)

  • Woo, Sang-Kyun;Chu, In-Yeop;Youn, Byong-Don
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.21 no.6
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    • pp.140-146
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    • 2017
  • It is laser induced breakdown spectroscopy(LIBS) that enables qualitative and quantitative analysis of the elements contained in unknown specimen by comparing the wavelength characteristics of each element obtained from the spectral analysis of the standard specimen with the wavelength analysis results from unknown specimens. In this study, the applicability of LIBS to the analysis of major deterioration factors affecting concrete durability was experimentally analyzed. That is, the possibility of applying LIBS to the diagnosis of concrete deterioration by studying the quantitative detection of harmful deteriorating factors on chloride, sulfate and carbonated mortar specimens using LIBS was studied. As a result of LIBS test for each chloride and sulfate specimen, the LIBS spectral wavelength intensity of chlorine and sulfur ions increased linearly with increasing concentration. Carbon ion LIBS spectral wave intensities of carbonated specimens increased nonlinearly over the duration of carbonation exposure. From the above results, it can be partially confirmed that LIBS can be applied to the diagnosis of concrete deterioration. In case of concrete carbonation, it is presumed that carbon content is contained in the cement itself and is different from the detection of chloride and sulfate specimen. Therefore, it is considered that more various parameter studies should be performed to apply LIBS to concrete carbonation.

Near Infrared Spectroscopy for Diagnosis: Influence of Mammary Gland Inflammation on Cow´s Milk Composition Measurement

  • Roumiana Tsenkova;Stefka Atanassova;Kiyohiko Toyoda
    • Near Infrared Analysis
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    • v.2 no.1
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    • pp.59-66
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    • 2001
  • Nowadays, medical diagnostics is efficiently supported by clinical chemistry and near infrared spectroscopy is becoming a new dimension, which has shown high potential to provide valuable information for diagnosis. The investigation was carried out to study the influence of mammary gland inflammation, called mastitis, on cow´s milk spectra and milk composition measured by near infrared spectroscopy (NIRS). Milk somatic cell counts (SCC) in milk were used as a measure of mammary gland inflammation. Naturally occurred variations with milk composition within lactation and in the process of milking were included in the experimental design of this study. Time series of unhomogenized, raw milk spectral data were collected from 3 cow along morning and evening milking, for 5 consecutive months, within their second lactation. In the time of the trial, the investigated cows had periods with mammary gland inflammation. Transmittance spectra of 258 milk samples were obtained by NIRSystem 6500 spectrophotometer in 1100-2400 nm region. Calibration equations for the examined milk components were developed by PLS regression using 3 different sets of samples: samples with low somatic cell count (SCC), samples with high SCC and combined data set. The NIR calibration and prediction of individual cow´s milk fat, protein, and lactose were highly influenced by the presence of mil samples from animals with mammary gland inflammation in the data set. The best accuracy of prediction (i.e. the lower SEP and the higher correlation coefficient) for fat, protein and lactose was obtained for equations, developed when using only “healthy” samples, with low SCC. The standard error of prediction increased and correlation coefficient decreased significantly when equations for low SCC milk were used to predict examined components in “mastitis” samples with high SCC, and vice versa. Combined data set that included samples from healthy and mastitis animals could be used to build up regression models for screening. Further use of separate model for healthy samples improved milk composition measurement. Regression vectors for NIR mild protein measurement obtained for “healthy” and “mastitic” group were compared and revealed differences in 1390-1450 nm, 1500-1740 nm and 1900-2200 nm regions and thus illustrated post-secretory breakdown of milk proteins by hydrolytic enzymes that occurred with mastitis. For the first time it has been found that monitoring the spectral differences in water bands at 1440 nm and 1912 nm could provide valuable information for inflammation diagnosis.