• 제목/요약/키워드: standard of diagnosis

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미만성 침윤성 폐질환에 대한 비디오 흉강경 폐생검과 개흉 폐생검의 비교 (A Comparison of Thoracoscopic and Open Lung Biopsy for the Diffuse Infiltrative Lung Disease)

  • 이재익;김영태;성숙환;김주현
    • Journal of Chest Surgery
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    • 제32권2호
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    • pp.164-170
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    • 1999
  • 배경: 미만성 침윤성 폐질환의 확진을 위해 많은 환자들에게 폐생검이 시행되고 있다. 개흉 폐생검에서의 작은 절개로 얻을 수 있는 제한된 시야와는 달리, 흉강경을 통한 폐생검은거의 전 폐실질을 관찰한 후 생검할 수 있는 장점과 전통적인 개흉으로 생길 수 있는 유병률을 감소시킬 수 있다는 장점을 가지고 있다. 본 연구에서는 미만성 침윤성 폐질환의 진단에 있어, 흉강경 폐생검(TLB)과 개흉 폐생검(OLB)을 효율성과 안전성의 측면에서 비교하였다. 대상 및 방법: 1993년 3월부터 1997년 8월까지 81명의 환자에게 폐생검을 시행하였으며, 이 중 51명에게 기존의 개흉 폐생검을, 30명에게는 비디오 흉강경 폐생검을 시행하였다. 결과:수술 시간은 TLB에서 63분, OLB에서 79분이었고(p=0.04), 생검 조직 절편의 크기(TLB 7.8 cm3, OLB 6.9 cm3 : p=0.72)와 진단률(TLB 100%, OLB 96%)은 두 군간의 차이가 없었다. 술후 재원 일수는 TLB에서 OLB보다 유의하게 짧았고(TLB 13일, OLB 22일 : p=0.01), 흉관 거치일, 진통제 투여 횟수는 차이가 없었으나 진통제 투여 기간은 TLB에서 유의하게 짧았다(TLB 2.5일, OLB 5.2일, p=0.05). 합병증은 TLB에서 2례(6.67%), OLB에서 4례(7.84%)가 있었으며, 두 군 모두에서 수술로 인한 사망례는 없었다. 결론: 흉강경 폐생검이 미만성 침윤성 폐질환의 진단에 있어서, 기존의 개흉 폐생검의 훌륭한 대안이 될 수 있다고 생각한다.

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Current Status of the Diagnosis and Management of Pancreatic Neuroendocrine Tumors in Japan

  • Tetsuhide Ito;Masami Miki;Keijiro Ueda;Lingaku Lee;Ken Kawabe;Hisato Igarashi;Nao Fujimori;Kazuhiko Nakamura;Kohei Yasunaga;Robert T. Jensen;Takao Ohtsuka;Yoshihiro Ogawa
    • Journal of Digestive Cancer Research
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    • 제4권2호
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    • pp.51-57
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    • 2016
  • The epidemiology of pancreatic neuroendocrine neoplasms (PNENs) in Asia has been clarified through epidemiological studies, including one conducted in Japan, and subsequently another in South Korea. As endoscopic ultrasonography (EUS) has become more widely accessible, endoscopic ultrasound-fine needle aspiration (EUS-FNA) has been performed in pancreatic tumors for which the clinical course was only monitored previously. This has enabled accurate diagnosis of pancreatic tumors based on the 2010 WHO classification; as a result, the number of patients with an accurate diagnosis has increased. Although surgery has been the standard therapy for PNENs, new treatment options have become available in Japan for the treatment of advanced or inoperable PNENs; of particular note is the recent introduction of molecular target drugs (such as everolimus and sunitinib) and streptozocin. Treatment for progressive PNENs needs to be selected for each patient with consideration of the performance status, degree of tumor differentiation, tumor mass, and proliferation rate. Somatostatin receptor (SSTR)-2 is expressed in many patients with neuroendocrine tumor. Somatostatin receptor scintigraphy (SRS), which can visualize SSTR-2 expression, has been approved in Japan. The SRS will be a useful diagnostic tool for locating neuroendocrine neoplasms, detecting distant metastasis, and evaluating therapy outcomes. In this manuscript, we review the latest diagnostic methods and treatments for PNENs.

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필댐 하류사면 자생식물의 습생지수 결정 (Determination of Hydrophyte Index of Native Plant on the Downstream Slope of Earth Fill Dam)

  • 김현수;류범희;박승기
    • 한국농공학회논문집
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    • 제61권1호
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    • pp.131-144
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    • 2019
  • The purpose of study was to determine the hygrophyte index of each plant(HIP) considering the moisture environment condition (MEC) of the native plants on the downstream slope of the fill dam and evaluate its applicability which to develop a method to search for leaks and saturated zones of the fill dam for status evaluation of precision safety diagnosis. The HIP was weighted average and consisted of 19 ranks. The weighted average was calculated according to the following three procedures: First, the linear assumption was made according to the actual habitat environmental conditions, the second one was weighted to 10% of the optimal habitat condition, and finally the average value of the distribution range values. The Hygrophyte index of vegetation at each plot (HIV) was obtained from the Sinheung reservoir (Yesan-gun, Chungcheongnam-do) using the results of vegetation survey of the Sinheung reservoir with precision safety diagnosis and suggested the use of the hygrophyte index of the cultivated vegetation. The average HIP range of plant species that emerged in 50 survey sites on the downstream slope of the Sinheung reservoir is 2.99 to 3.56. The coefficient of variation showed a large difference depending on the appearance of the leakage indicator plant(LIP) species. The range of HIV is 2.80 to 4.26, the mean value is 3.37, standard deviation is 0.37 and the coefficient of variation is 9.7%. As a result, the value of the coefficient of variation showed a large difference depending on the appearance of the plant species.

유방의 양성 엽상종양 및 섬유선종에 대한 세포학적 비교 검색 (Cytologic Features of Benign Phyllodes Tumors as Compared to Fibroadenomas of the Breast)

  • 서재희;공경엽;박정미;안세현;김온자
    • 대한세포병리학회지
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    • 제7권2호
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    • pp.151-156
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    • 1996
  • Phyllodes tumor(PT) is a rare distinctive fibroepithelial breast tumor that occasionally shows unpredictable clinical behavior. Wide excision should be the primary treatment of PT and enucleation, the standard procedure for fibroadenoma(FA), is proscribed due to high frequency of local recurrence. Therefore an accurate preoperative diagnosis of PT is essential in order to ensure proper surgical treatment. However, the differentiation between benign PT and FA is often difficult on the basis of cytologic findings. In an attempt to better understand the cytologic features of benign PT and possibly to differentiate PT from FA on the findings of fine needle aspiration(FNA) smears, we reviewed cytologic smears from 22 histologically diagnosed cases each of benign PT and FA, respectively. The cytologic features assessed were cellularity and atypia of both epithelial and stromal components, and shape of epithelial cell clusters. Atypia of stromal cells was more frequent in PT, while blunt branching pattern of epithelial cells was more frequent in FA. The specific cytologic diagnosis of PT is not possible in many cases, but the abundance of stromal cells with moderate nuclear atypia in the correct clinical setting such as older age and larger size(>4cm) allows the diagnosis.

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Identification of plasma miRNA biomarkers for pregnancy detection in dairy cattle

  • Lim, Hyun-Joo;Kim, Hyun Jong;Lee, Ji Hwan;Lim, Dong Hyun;Son, Jun Kyu;Kim, Eun-Tae;Jang, Gulwon;Kim, Dong-Hyeon
    • 한국동물생명공학회지
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    • 제36권1호
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    • pp.35-44
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    • 2021
  • A pregnancy diagnosis is an important standard for control of livestock's reproduction in paricular dairy cattle. High reproductive performance in dairy animals is a essential condition to realize of high life-time production. Pregnancy diagnosis is crucial to shortening the calving interval by enabling the farmer to identify open animals so as to treat or re-breed them at the earliest opportunity. MicroRNAs are short RNA molecules which are critically involved in regulating gene expression during both health and disease. This study is sought to establish the feasible of circulating miRNAs as biomarkers of early pregnancy in cattle. We applied Illumina small-RNA sequencing to profile miRNAs in plasma samples collected from 12 non-pregnant cows ("open" cows: samples were collected before insemination (non-pregnant state) and after pregnancy check at the indicated time points) on weeks 0, 4, 8, 12 and 16. Using small RNA sequencing we identified a total of 115 miRNAs that were differentially expressed weeks 16 relative to non-pregnancy ("open" cows). Weeks 8, 12 and 16 of pregnancy commonly showed a distinct increase in circulating levels of miR-221 and miR-320a. Through genome-wide analyses we have successfully profiled plasma miRNA populations associated with pregnancy in cattle. Their application in the field of reproductive biology has opened up opportunities for research communities to look for pregnancy biomarker molecules in dairy cattle.

Elastography for Breast Cancer Diagnosis: a Useful Tool for Small and BI-RADS 4 Lesions

  • Liu, Xue-Jing;Zhu, Ying;Liu, Pei-Fang;Xu, Yi-Lin
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권24호
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    • pp.10739-10743
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    • 2015
  • The present study aimed at evaluating and comparing the diagnostic performance of B-mode ultrasound (US), elastography score (ES), and strain ratio (SR) for the differentiation of breast lesions. This retrospective study enrolled 431 lesions from 417 in-hospital patients. All patients were examined with both conventional ultrasound and elastography. Two experienced radiologists reviewed ultrasound and elasticity images. The histopathologic result obtained from ultrasound-guided core biopsy or operation excisions were used as the reference standard. Pathologic examination revealed 276 malignant lesions (64%) and 155 benign lesions (36%). A cut-off point of 4.15 (area under the curve, 0.891) allowed significant differentiation of malignant and benign lesions. ROC (receiver-operating characteristic) curves showed a higher value for combination of B-mode ultrasound and elastography for the diagnosis of breast lesions. Conventional ultrasound combined elastography showed high sensitivity, specificity, and accuracy for group II lesions (10mm${\leq}20mm$). Elastography combined with conventional ultrasound show high specificity and accuracy for differentiation of benign and malignant breast lesions. Elastography is particularly important for the diagnosis of BI-RADS 4 and small breast lesions.

LED 광원을 이용한 디지털 혀 영상 촬영장치의 기구설계와 개발 (Mechanical Design and Development of a Digital Tongue Imaging System Equipped with LEDs)

  • 남동현;김지혜;이상석
    • 대한한의진단학회지
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    • 제16권3호
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    • pp.41-48
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    • 2012
  • Objectives: The aims of this study are to design a optimized mechanical structure of digital tongue imaging system (DTIS) equipped with LEDs in aspects of object distance and camera angle of coverage. Methods and Results: We tried to find optimized object distance while recording a rectangular object of common tongue size. In case object distance is 22 cm or less, edge of the rectangle was not taken beyond the shooting range. In contrast, if object distance is 40 cm or more, the rectangle image was too small. Therefore when considering the variation of subjects, we selected distance of 35-40 cm as appropriate object distance for the DTIS. We also tried to find optimized angle between camera view axis and horizontal line. We photographed from the side of the face of 7 adults with exposed tongue. We drew an exposed tongue lines to connect the tongue tip points and the tongue root points by using the photos acquired from the side faces. And then we calculated the tongue exposure angles between the vertical line and the exposed tongue lines. Mean tongue exposure angle was $28.3^{\circ}$ when tongue was lightly exposed and $13.3^{\circ}$ when maximally. So we determined $73^{\circ}$ as appropriate slope angle of part in contact with face of the DTIS and by considering that the standard variation was great, we designed control gears to adjust the slope of the camera view axis and to regulate the object distance. Conclusions: We designed a optimized mechanical structure in object distance and slope angle of part in contact with face of the DTIS.

Tumoral Accumulation of Long-Circulating, Self-Assembled Nanoparticles and Its Visualization by Gamma Scintigraphy

  • Cho, Yong-Woo;Kim, Yoo-Shin;Kim, In-San;Park, Rang-Woon;Oh, Seung-Jun;Moon, Dae-Hyuk;Kim, Sang-Yoon;Kwon, Ick-Chan
    • Macromolecular Research
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    • 제16권1호
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    • pp.15-20
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    • 2008
  • The enhanced permeability and retention (EPR) effect is used extensively for the passive targeting of many macromolecular drugs for tumors. Indeed, the EPR concept has been a gold standard in polymeric anticancer drug delivery systems. This study investigated the tumoral distribution of self-assembled nanoparticles based on the EPR effect using fluorescein and radio-labeled nanoparticles. Self-assembled nanoparticles were prepared from amphiphilic chitosan derivatives, and their tissue distribution was examined in tumor-bearing mice. The size of the nanoparticles was controlled to be 330 run, which is a size suited for opening between the defective endothelial cells in tumors. The long-circulating polymer nanoparticles were allowed to gradually accumulate in the tumors for 11 days. The amount of nanoparticles accumulated in the tumors was remarkably augmented from 3.4%ID/g tissue at 1 day to 25.9%ID/g tissue at 11 days after i.v. administration. The self-assembled nanoparticles were sustained at a high level throughout the 14 day experimental period, indicating their long systemic retention in the blood circulation. The ${\gamma}$-images provided clear evidence of selective tumor localization of the $^{131}I$-labeled nanoparticles. Confocal microscopy revealed the fluorescein-labeled nanoparticles to be preferentially localized in the perivascular regions, suggesting their extravasation to the tumors through the hyperpermeable angiogenic tumor vasculature. This highly selective tumoral accumulation of nanoparticles was attributed to the leakiness of the blood vessels in the tumors and their long residence time in the blood circulation.

Diagnostic Potential of Strain Ratio Measurement and a 5 Point Scoring Method for Detection of Breast Cancer: Chinese Experience

  • Parajuly, Shyam Sundar;Lan, Peng Yu;Yun, Ma Bu;Gang, Yang Zhi;Hua, Zhuang
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권4호
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    • pp.1447-1452
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    • 2012
  • Aim: To evaluate the differential diagnostic potential of lesion stiffness assessed by the sonoelastographic strain index ratio (SR) and elastographic color scoring system (UE) for breast lesions. Materials and Methods: Three hundred and forty two breast masses (158 benign and 184 malignant) from 325 consecutive patients (mean age 44.2 years; range 16-81)who had been scheduled for a sonographically guided core biopsy were examined proposed by Itoh et al, with scoring 1-3=benign and 4-5=malignant. Strain and area ratios of each lesion were calculated within the same machine. Histological diagnosis was used as the reference standard. The area under the curve (AUC) and cut-off point were obtained by receiver operating curve and the cross table Fischer Test was carried out for assessing diagnostic value. Sensitivity, specificity, PPV, NPV, accuracy and false-discovery rates were compared. Results: The mean strain ratios for benign and malignant lesions were 1.87 and 7.9 respectively. (P<0.0001). When a cutoff point of 3.54 was used, SR had a sensitivity of 94.6%, a specificity 94.3%, a PPV of 95.1%, an NPV of 93.7% and an accuracy of 94.4%. The AUC values were 0.90 for the 5 point scoring system (UE) and 0.96 for the strain index ratio. The overall diagnostic performance was SR method was better (P<0.05). Conclusions: Strain ratio measurement could be another effective predictor in elastography imaging besides 5 the point scoring system for differential diagnosis of breast lesions.

Comparison of 99mTc-DMSA Renal Scan and Power Doppler Ultrasonography for the Detection of Acute Pyelonephritis and Vesicoureteral Reflux

  • Bae, Hee Jung;Park, Yong-Hoon;Cho, Jae Ho;Jang, Kyung Mi
    • Childhood Kidney Diseases
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    • 제22권2호
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    • pp.47-51
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    • 2018
  • Purpose: Urinary tract infection (UTI) is one of the common infectious diseases in children. Several imaging modalities can be used to confirm the presence of acute pyelonephritis (APN). Among them the 99mTcdimercaptosuccinic acid renal scan (DMSA scan) is used as a gold standard for diagnosis. Ultrasonography technology is evolving. Therefore, in this study, we investigated the sensitivity and specificity of Power Doppler ultrasonography (PDU) compared to the results from the previous study. Methods: There were 260 patients included in this study, aged between 1 and 12 months old. The patients were admitted to the Yeungnam University Medical Center between January 2008 and December 2015. All patients underwent both DMSA scan and PDU within 5days of admission. Voiding cystourethrography (VCUG) was performed in 195 patients with abnormal DMSA scan or PDU. Results: The diagnostic sensitivity of APN using PDU was 45.5% and specificity was 85.5% in 260 patients following detection of a defect on DMSA scan that was defined as APN. The diagnostic sensitivity and specificity of PDU for VUR were 65.5 % and 60.1%, respectively. The diagnostic sensitivity and specificity of DMSA scan for VUR were 95.7% and 14.1%, respectively. Conclusion: PDU has a high specificity but low sensitivity, so there are limitations in using it to replace a DMSA scan for the diagnosis of APN in children. DMSA scan and PDU have different sensitivity and specificity in diagnosis of VUR, respectively. Therefore, we suggest that the sensitivity and specificity of each test can be helpful in diagnosing APN and VUR when used in conjunction.