Although the dermoscopy had very long history since its introduction in 17th century, only recently it has been possible to see the widespread application of dermoscopy in the dermatology clinic. One of the most promising areas where the dermoscopy can be applied is the diagnosis of skin cancer, especially malignant melanoma. Due to its inherent limitation to obtain in-depth information-literally, from more than skin-deep and more importantly, from microscopic structures-of skin cancers, dermoscopy cannot replace the present gold-standard 'biopsy' in the diagnosis of skin cancer. However, several advantages of dermoscopy over biopsy merit further considerations. For example, as a non-invasive tool, dermoscopy is best suited for the follow-up of suspicious skin lesions, and as an all-at-a-glance tool, dermoscopy can aid the selection of the best biopsy-site to obtain the most meaningful pathological information from the minimal tissue specimen. There goes a saying that 'it takes two to tango,' similarly, we might need the two (biopsy and dermoscopy) to cope rhythmically with the varying tempos of everprogressing skin tumorigenesis and to reveal the true face of skin cancers usually hidden in various disguises.
Transitional cell carcinoma of the urinary bladder is common in the genitourinary tract. The gold standard for the diagnosis of bladder cancer has been cystoscopy, along with urine cytology. Cystoscopy is an invasive and relatively expensive technique. By comparison, urine cytology is easy to perform and specific for a diagnosis of bladder cancer, although less sensitive, especially in low-grade tumors. For this reason, there has been a need for superior noninvasive technology to increase our confidence in being able to detect bladder cancer. There are many reports of the various urinary tests that are available to facilitate the diagnosis. In this article, I reviewed the literature on urinary markers and tests that may be clinically useful, including fluorescence in situ hybridization, uCyt+/Immunocyte, the $BTA^{(R)}$ test, the NMP 22TM, the $FDP^{(R)}$ test, the telomerase activity test, the HA and HAse tests, and flow cytometry. Most of these tests have a higher sensitivity and specificity than cytology. However, urine cytology has the highest specificity, especially in individuals with a high-grade tumor. We conclude that no urinary markers or tests can replace the role of cystoscopy along with cytology in the diagnosis of transitional cell carcinoma of the bladder. However, some markers could be used adjunctively to increase the diagnostic accuracy during screening or during the postoperative follow-up examination of patients with bladder cancer.
Park, Hyoung-Wook;Sohn, Myong-Sei;Kim, Han-Joong;Park, Eun-Cheol;Yu, Seung-Hum
Journal of Preventive Medicine and Public Health
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v.29
no.4
s.55
/
pp.877-897
/
1996
In recent years, the Korean Medical Association has undertaken the feat of establishing the Korean Standard Terminology of Medical Procedures with the dedicated help of 32 medical academic societies. However, because the project is being conducted by several different circles, it has yet to see a clear system of classification. This thesis, therefore, proposes the three principles of scientific properties, usefulness and ideology as the basis for classification system and has developed the Classification System of Medical Procedures in Korea upon their foundation. The methodology and organization of this thesis as follows. First, by adopting scientific classification system of Feinstein(1988), an analysis of the classification systems of the medical procedures in the United States, Japan, Taiwan, WHO was carried out to reveal the framework and the basic principles in each system. Second, the direction of classification system has been constructed by applying the normative principle of medical field in order to show the future direction of the medical field and realize its ideology. Third, a finalized framework for the classification system will be presented as based on the direction of classification system. Of the three basis principles mentioned above, the analysis on the principles of usefulness was left out of this thesis due to the difficulty of establishing specific standards of analysis. The results of the study are as follows. The overall structure of the thesis is aimed at showing the 'Prevention-Therapy-Rehabilitation' quality of comprehensive health care and consists of six chapters; I. Prevention and Health Promotion II. Evaluation and Management III. Diagnostic Procedures IV. Endoscopy V. Therapeutic Procedures VI. Rehabilitation Chapter three Diagnostic Procedures is divided into four parts : Functional Diagnosis, Visual Diagnosis, Pathological Diagnosis, Biopsy and Sampling. Chapter five Therapeutic Procedures is divided into Psychiatry, Non-Invasive Therapy, Invasive Therapy, Anaesthesia and Radiation Oncology. Of these sub-divisions, Functional Diagnosis, Biopsy and Sampling, Endoscopy and Invasive Therapy employs the anatomical system of classification. On the other hand, Visual Diagnosis, Pathological Diagnosis, Anesthesia and Diagnostic Radiology, namely those divisions in which there is little or no overlapping in services with other divisions, used the classification system of its own division. The classification system introduced in this thesis can be further supplemented through the use of the cluster analysis by incorporating the advice and assistance of other specialists.
The diagnosis and treatment of early gastrointestinal cancers is the gastroenterologists' mission because of national cancer screening program in South Korea. The detection of early cancers is emphasized, because these were previously treated with surgical treatment can be currently cured with endoscopic treatment. Gastroenterologists who achieved at least on some level can make an exact diagnosis regardless of what type of endoscopy, but generally, there are some required conditions for an optimal diagnosis. First, clinically important lesions have to be detected easily. Second, the border and morphology of lesions have to be characterized easily. Third, lesions have to be diagnosed exactly. Precancers and early cancers are often subtle and can pose a challenge to gastroenterologists to visualize using standard white light endoscopy. The use of dye solutions aids the diagnosis of early gastrointestinal cancers, however, it is a quite cumbersome to use dye solutions all the time and the solution often bothers the exact observation by pooling into the depression or ulceration of the lesion. To overcome this weakness, newer endoscopes are now developed so called "image enhanced endoscopy" using optical and/or electronic methods such as narrow band imaging (NBI), autofluorescence imaging (AFI), i-scan, flexible spectral imaging color enhancement (FICE) and confocal endomicroscopy (CLE).
Open lung biopsy was performed in thirty patients for the diagnosis and staging evaluation of interstitial lung disease during the period from January 1987 until December 1992. The age of the patients ranged from 14 to 71 years [mean 48 years], and the patients consisted of 14 males and 16 females. Preoperative FEV1`s were from 0.80 liter to 3.88 liters [mean 1.66]. Other non-invasive diagnostic studies such as PCNA, bronchoalveolar lavage, TBLB, and gallium scan were also done in addition to X-ray and high-resolution chest CT. Tweaty-eight were correctly diagnosed and 2 cases were not [diagnostic yield rate 93.3%]. Among the 28 cases,pathologic diagnosis influenced further treatment regimens and prognostic expectations in 23 cases [82.1%]. The diagnostic non-invasive studies other than open lung biopsy yielded a correct diagnosis without staging only in 5 cases. There was no mortality and only one complication, ARDS ; however, the patient recovered after 5 days ventilator support. Open lung biopsy, which is the gold standard for the diagnosis and staging evaluation of interstitial lung disease can be done safely and has value in clinical decision making. Also knowledge of the involvement of the lesion is important for proper selection of the biopsy site.
Park Sang-Wook;Heo Min-Suk;Lee Sam-Sun;Choi Soon-Chul;Park Tae-Won;You Dong-Soo
Journal of Korean Academy of Oral and Maxillofacial Radiology
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v.29
no.1
/
pp.149-159
/
1999
Purpose: The purpose of this study was to evaluate cervical lymph node metastasis of oral squamous cell carcinoma patients by MRI film and neural network system. Materials and Methods: The oral squamous cell carcinoma patients(21 patients. 59 lymph nodes) who have visited SNU hospital and been taken by MRI. were included in this study. Neck dissection operations were done and all of the cervical lymph nodes were confirmed with biopsy. In MR images. each lymph node were evaluated by using 6 MR imaging criteria(size. roundness. heterogeneity. rim enhancement. central necrosis, grouping) respectively. Positive predictive value. negative predictive value. and accuracy of each MR imaging criteria were calculated. At neural network system. the layers of neural network system consisted of 10 input layer units. 10 hidden layer units and 1 output layer unit. 6 MR imaging criteria previously described and 4 MR imaging criteria (site I-node level II and submandibular area. site II-other node level. shape I-oval. shape II-bean) were included for input layer units. The training files were made of 39 lymph nodes(24 metastatic lymph nodes. 10 non-metastatic lymph nodes) and the testing files were made of other 20 lymph nodes(10 metastatic lymph nodes. 10 non-metastatic lymph nodes). The neural network system was trained with training files and the output level (metastatic index) of testing files were acquired. Diagnosis was decided according to 4 different standard metastatic index-68. 78. 88. 98 respectively and positive predictive values. negative predictive values and accuracy of each standard metastatic index were calculated. Results: In the diagnosis of using single MR imaging criteria. the rim enhancement criteria had highest positive predictive value (0.95) and the size criteria had highest negative predictive value (0.77). In the diagnosis of using single MR imaging criteria. the highest accurate criteria was heterogeneity (accuracy: 0.81) and the lowest one was central necrosis (accuracy: 0.59). In the diagnosis of using neural network systems. the highest accurate standard metastatic index was 78. and that time. the accuracy was 0.90. Neural network system was more accurate than any other single MR imaging criteria in evaluating cervical lymph node metastasis. Conclusion: Neural network system has been shown to be more useful than any other single MR imaging criteria. In future. Neural network system will be powerful aiding tool in evaluating cervical node metastasis.
Globalization describes a process by which regional cultures have become integrated through a global network of communication. In order to communicate among different cultural groups, standardization of terminology is one of the most important steps among its processes. In the field of oriental medicine, there have been continuous efforts to communicate through various methods. Translation of oriental medical classics is one of the significant approaches in terms of transmitting medical theories and clinical experiences of thousands of years to the people of different cultural backgrounds. However, previous translation studies have had difficulties in delivering its underlying principles and assumptions due to lack of standardization of terminology. "WHO International Standard Terminologies on Traditional Medicine in the Western Pacific Region(WHO-IST)" is the outcome of developing standard terminologies on oriental medicine based on mutual agreement of researchers of Korea, China and Japan. As a movement to find more efficient methodology for communication between heterogeneous communities, this study aims to translate parts of "Classic of difficult issues(難經)" into English adopting "WHO-IST" hoping to set a model of translation study.
The globalization of oriental medicine can be interpreted as the work of making its own contents able to be communicated among global heterogeneous cultural groups. In the field of oriental medical classics the work is to translate its classics into English and introduce them to researchers of oriental medicine in the world, which is essential in order to stimulate global academic communication in that the classics are the prototype as well as the source of oriental medical knowledge for thousands of years. Previous English translation studies have had limits in that terms used were not based on mutual agreement. Now "WHO International Standard Terminologies on Traditional Medicine in the Western Pacific Region(WHO-IST)" is the outcome of developing standard terminologies on oriental medicine contributed by researchers of Korea, China and Japan. The study aims to translate parts of "Classic of difficult issues(難經)" into English adopting "WHO-IST" hoping to set a model of translation study which can be communicated universally.
This study analyzes the management performance of environmentally-friendly rice farms using GCM method based on the multifaceted approach. This approach compares the management performance of GCM farms before and after the introduction of GCM, as well as the performance of GCM farms with the performance of conventional farms. It also compares the technical and managerial competence level of surveyed GCM farms with that of conventional farms based on the standard diagnosis table developed by Rural Development Adminstration. Results showed that average income has increased after the introduction of the GCM method and the average income of GCM farms was higher than that of conventional farms, while the level of rice production in farms using GCM method was lower than that of conventional farms. In addition, the technical and managerial competence score of surveyed farms using GCM method was higher than that of conventional farms. These results implies that the higher management performance of GCM farms compared to the conventional farms is attributed to not only the GCM method but also the competence level of farms using GCM method.
Abbasi, Mohammad Reza;Mirsaeed, Seyedeh Masoumeh Ghazi;Alizadeh, Amir Houshang Mohammad
Asian Pacific Journal of Cancer Prevention
/
v.17
no.10
/
pp.4563-4566
/
2016
Background/Objective: The aim of this study was to perform a comparative evaluation of the yields of conventional brush cytology and brush cytology with negative pressure in the diagnosis of malignant biliary strictures. Methods: A total of 132 consecutive patients undergoing endoscopic were identified. Of these, 88.0 had brush cytology after ERCP and 44 were Brush cytology with negative pressure. Retrograde cholangiopancreatography (ERCP) including brush cytology and brush cytology with negative pressure in patients with biliary strictures between 2012-2015. Endoscopic retrograde cholangiography was performed with a standard videoduodenoscope Olympus TFJ 160-R (Olympus, Hamburg, Germany) and brush cytology with a Cook medical Double Lumen Biliary BrushTM (Cytology). Means and standard frequencies were used to calculate variables. Results: Positive results for malignancy were obtained in 22 of 88 patients (25%) by brush cytology and 31 of 44 patients (70.4 %) by brush cytology with negative pressure. Conclusions: Sensitivity of cytology sampling could be maximized by negative pressure during ERCP.
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