• 제목/요약/키워드: standard of diagnosis

검색결과 1,197건 처리시간 0.024초

당뇨병성 족부 궤양 환자의 진단 1년 내의 절단율 및 위험 인자의 분석 (The Amputation Rate and Associated Risk Factors within 1 Year after the Diagnosis of Diabetic Foot Ulcer)

  • 천동일;전민철;최성우;김용범;노재휘;원성훈
    • 대한족부족관절학회지
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    • 제20권3호
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    • pp.121-125
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    • 2016
  • Purpose: This study investigates the amputation rate within 1 year after the diagnosis of diabetic foot ulcer and its associated risk factors. Materials and Methods: This study enrolled 60 patients with diabetic foot ulcer. The mean and standard deviation age was $64.4{\pm}12.8years$ (range, 32~89 years); the mean and standard deviation prevalence period for diabetes mellitus was $21.0{\pm}7.5years$ (range, 0.5~36 years). The amputation rate was evaluated by dividing the subjects into two groups - the major and minor amputation groups - within 1 year following the initial diagnosis of diabetic foot ulcer. Multivariate Cox proportional hazards regression analysis was used to identify the risk factors for amputation. Results: The total amputation rate of 38.3% (n=23) was comprised of the amputation rate for the major amputation group (10.0%) and rate for the minor amputation group (23.8%). There was a high correlation between peripheral artery disease (toe brachial pressure index <0.7) and amputation (hazard ratio [HR] 5.81, confidence interval [CI] 2.09~16.1, p<0.01). Nephropathy was significantly correlated with the amputation rate (HR 3.53, CI 1.29~9.64, p=0.01). Conclusion: Clinicians who treat patients with diabetic foot complications must understand the fact that the amputation rate within 1 year is significant, and that the amputation rate of patients with peripheral artery disease or nephropathy is especially high.

Agreement between Colposcopic Diagnosis and Cervical Pathology: Siriraj Hospital Experience

  • Tatiyachonwiphut, Molpen;Jaishuen, Atthapon;Sangkarat, Suthi;Laiwejpithaya, Somsak;Wongtiraporn, Weerasak;Inthasorn, Perapong;Viriyapak, Boonlert;Warnnissorn, Malee
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권1호
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    • pp.423-426
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    • 2014
  • Aim: To evaluate the agreement between colposcopic diagnosis and cervical pathology a retrospective chart review was performed. Materials and Methods: This study included 437 patients who underwent colposcopy and cervical biopsy or conization at Siriraj Hospital from October 2010 - December 2012. The patient clinical characteristics, cervical cytology results, colposcopic diagnoses, cervical pathology results were recorded and correlations between variables were analyzed. Results: Agreement of colposcopic diagnosis and cervical pathology was matched in 253 patients (57.9%). The strength of agreement with weighted Kappa statistic was 0.494 (p<0.001). Colposcopic diagnoses more often overestimated (31.1%) than underestimated (11%) the cervical pathology. Agreement of colposcopic diagnosis and cervical pathology within 1 grade was found in 411 patients (94.1%). Positive predictive value (PPV) of high grade colposcopy or more was 75.5%, whereas the negative predictive value (NPV) of insignificant and low grade colposcopy was 83.8%. False positives of high grade colposcopy or more were 21%. False negatives of insignificant or low grade colposcopy were 19.1%. Conclusions: Strength of agreement between colposcopic diagnosis and cervical pathology was found to be only moderate. A biopsy at colposcopy should be performed at a gold standard level to detect high grade lesions.

제조업 특성을 반영한 스마트공장 진단모델 개발 및 중소기업 맞춤형 적용사례 (Development of Smart Factory Diagnostic Model Reflecting Manufacturing Characteristics and Customized Application of Small and Medium Enterprises)

  • 김현득;김동민;이경근;윤제환;염세경
    • 산업경영시스템학회지
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    • 제42권3호
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    • pp.25-38
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    • 2019
  • This study is to develop a diagnostic model for the effective introduction of smart factories in the manufacturing industry, to diagnose SMEs that have difficulties in building their own smart factory compared to large enterprise, to identify the current level and to present directions for implementation. IT, AT, and OT experts diagnosed 18 SMEs using the "Smart Factory Capacity Diagnosis Tool" developed for smart factory level assessment of companies. They analyzed the results and assessed the level by smart factory diagnosis categories. Companies' smart factory diagnostic mean score is 322 out of 1000 points, between 1 level (check) and 2 level (monitoring). According to diagnosis category, Factory Field Basic, R&D, Production/Logistics/Quality Control, Supply Chain Management and Reference Information Standardization are high but Strategy, Facility Automation, Equipment Control, Data/Information System and Effect Analysis are low. There was little difference in smart factory level depending on whether IT system was built or not. Also, Companies with large sales amount were not necessarily advantageous to smart factories. This study will help SMEs who are interested in smart factory. In order to build smart factory, it is necessary to analyze the market trends, SW/ICT and establish a smart factory strategy suitable for the company considering the characteristics of industry and business environment.

토마토 생육 진단 시스템 개발에 관한 연구 (A study on the growth diagnosis system for tomato)

  • 이창열
    • 한국산학기술학회논문지
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    • 제16권12호
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    • pp.8673-8678
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    • 2015
  • 본 논문은 토마토 생육 진단 시스템 개발에 관한 것이다. 토마토 생육 진단을 위하여 우선 생육에 영향을 미치는 주요 지표를 정의하였고, 이 지표를 이용하여 토마토 생육 상태에 대한 진단과 이에 따른 조치 정보를 제공한다. 생육에 대한 지표는 지속적인 관찰을 통하여 생육 상태를 확인하는 측정 지표(Measure Index; MI)와 현재 토마토가 영영생장 단계인지 또는 생식생장 단계인지를 판단하는 단계 지표(Period Index; PI)로 구성되었다. 본 시스템의 관찰일지는 MI와 PI에 대한 기록 정보를 입력하는 기능을 제공하고 있다. MI인 경우, 진단은 관찰일지에 기록된 데이터와 미리 정의된 해당 지표에 대한 정상 기준(표준) 값을 비교한 결과이다. PI인 경우 미리 정의된 영양 생장 지표와 생식 생장 지표에 체크를 하여 어느 부분에 치우쳤는지 판단하도록 만들어졌다. 진단 결과 정의된 조치를 수행하는 기능을 서비스한다. 본 시스템은 타 작물로 서비스 확장을 고려하여 구현되었다. 본 시스템을 이용하면 농가에게 정확한 생육 진단과 그에 따른 조치 정보를 제공할 수 있기 때문에 농가의 생산성 향상에 기여할 것을 기대하고 있다.

전기적 자극방식 삼킴 보조 치료기의 장비관리/안전진단 매뉴얼 개발 (Development of Device Management and Safety Diagnosis Manual for Electrical Stimulating Swallowing-Assist Equipments)

  • 허서윤;최봉근;이근민
    • 재활복지공학회논문지
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    • 제8권2호
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    • pp.79-88
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    • 2014
  • 국내에서 전기적 자극방식 삼킴 보조 치료기는 높은 보급률과 사용빈도를 가진 전문 의료기기임에도 불구하고 기기에 대한 관리체계가 전무하여 유지 보수의 측면에 있어서도 매우 큰 취약성을 노출해 왔다. 이에 본 연구는 전기적 자극방식 삼킴 보조 치료기의 장비관리 및 안전진단 매뉴얼 개발에 목적을 두고 프로그램을 개발하였다. 이를 위하여 국제전기기술위원회(International Electrotechnical Commission, IEC)등의 기관에서 공시한 표준화된 프로그램 수집과 문헌고찰을 통해 매뉴얼 개발의 근거를 마련하고, 프로토콜을 개발하여 제시하였다. 완성된 알고리즘과 프로토콜, 지표 등의 자료를 전문가 및 현장 실무자의 자문을 통하여 수정 및 보완하고 유지보수 워크시트(Maintenance Worksheet)의 5지표 18항목, 삼킴 보조 전자 의료기기 장비관리/안전진단 절차 매뉴얼(Equipment Procedure Manual)에서 4개 지표 32항목으로 구성된 점검 매뉴얼을 최종적으로 완성하였다. 완성된 지표는 장비의 고장률을 줄이고 의료기록 문서화의 체계성 제고에 도움을 줄 것이며, 의료서비스의 효율성, 적절성을 유지하는데 기여할 수 있을 것이라 생각된다.

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초음파 기관지 내시경 세침흡인을 이용하여 진단한 폐 사르코이드증 (Pulmonary Sarcoidosis Diagnosed by Endobronchial Ultrasound Fine Needle Aspiration)

  • 김원영;장유진;류지원;박영수;장세진;송진우;오연목;심태선;이상도;김우성;김동순;최창민
    • Tuberculosis and Respiratory Diseases
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    • 제68권5호
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    • pp.267-272
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    • 2010
  • Background: Pulmonary sarcoidosis often involves mediastinal or hilar lymph nodes in the lung parenchyma. Mediastinoscopy is the gold standard for diagnosis, but it is invasive and expensive. Transbronchial needle aspiration using conventional bronchoscope is less invasive than mediastinoscopy, but its diagnostic accuracy is in question due to the blind approach to targeting lymph nodes. Transbronchial needle aspiration (TBNA) via endobronchial ultrasound (EBUS) has high diagnostic value due to direct visualization of lymph nodes and to its relatively safeness. The purpose of this study was to assess the usefulness of EBUS-TBNA in the diagnosis of pulmonary sarcoidosis. Methods: Twenty-five patients with symptoms of sarcoidosis were enrolled into this study. Core tissue was obtained for a definitive diagnosis. Endobronchial biopsy, transbronchial lung biopsy, and bronchoalveolar lavage were performed to verify diagnosis. For patients without a confirmed diagnosis after the above procedures were performed, the additional procedures of mediastinoscopy or video-associated thoracoscopic surgery were performed to confirm a final diagnosis. Results: A total 25 EBUS procedures were done and 50 lymph nodes were aspirated. Thirty-three (37) out of 50 lymph nodes were consistent with non-caseating granuloma, confirming sarcoidosis as the final diagnosis. Sarcoidosis was the final diagnosis for all 25 patients, and 21 required EBUS-TBNA for a final diagnosis. There were no complications associated with the procedure. Conclusion: EBUS-TBNA is already a well-known procedure for diagnosing mediastinal or hilar lymphadenopathy. We used EBUS-TBNA for the diagnosis of pulmonary sarcoidosis and our results showed 84% diagnostic accuracy and no complications related to the procedure. EBUS-TBNA is a reliable and practical diagnostic modality in the diagnosis of pulmonary sarcoidosis.

"난경(難經)" 맥진조(脈診條)중 십육난(十六難)~ 이십이난(二十二難)의 영역(英譯) 연구(硏究) (An English Translation Study on the Sixteenth to Twenty-second Issue concerning Pulse Diagnosis of "Classic of Difficult Issues(難經)")

  • 강혜원;김재균;백진웅
    • 대한한의학원전학회지
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    • 제24권1호
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    • pp.57-71
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    • 2011
  • Although there have been many endeavors aimed at the standardization and globalization of Korean medicine over a long period of time, the access to information on Oriental medical classics has been relatively poor due to the lack of appropriate translation methodology and standard terminology. In order to overcome existing barriers, continuous effort towards precise translation adopting a standard terminology should be maintained. As a part of this procedure, we planned to publish a part of "Classic of difficult issues(難經)" in three sections, and the first two studies have already been published. Based on the methodology and approaches of previous studies, this third study aims to translate parts of "Classic of difficult issues(難經)" into English, beginning with "The Sixteenth Question", and adopting "WHO-IST" terminology. The outcomes of this study are presented as follows: First, based on the result of existing translation studies and the outcome of "WHO-IST", English translation of "Classic of difficult issues(難經)" from "the Sixteenth Question" to "The Twenty-second Question" is offered, hoping to set a model of translation study which can be communicated universally. Second, in order to pave the way for future success in establishing translation studies, it is natural to verify the effectiveness and practicality of standard terminologies including the outcome of "WHO-IST". Continuous translation studies will be required in order to obtain constant feedback and adopt more suitable guidelines during the standardization process. Taking this into consideration, further translation studies of Oriental medical classics including "Classic of difficult issues(難經)" should be continued.

한국표준건강분류(KCF)로 평가한 척수경색 환자의 한의 치료 전후 변화 증례 보고 (A case report of a patient with spinal cord infarction treated by Korean medicine combined with conventional medicine: An evaluation using Korean Standard Classification of Functioning, Disability and Health (KCF))

  • 김미경
    • 대한한의학회지
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    • 제39권3호
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    • pp.89-100
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    • 2018
  • Objectives: Korean Standard Classification of Functioning, Disability and Health (KCF), a useful tool for a comprehensive consideration of the health-related overall implications, might be also promising way to validate the effectiveness of Korean medicine. This study reports the change of pre- and post-hospitalization using the KCF in a patient with spinal cord infarction who underwent rehabilitation plus Korean medicine treatment. This study aims to apply the KCF to this case, evaluate its applicability, and review its expected benefits and obstacles in the clinical practice of Korean medicine. Methods: The changes in the overall health status of the patient were assessed by the KCF as well as the chief complaints, diagnosis, neurological deficits, and activities of daily living (ADL), impairment scale etc. before and after admission to a Korean medicine hospital were investigated. Results: Most of the chief complaints of the patient were improved enough to perform her daily routine activities independently. These improvements were reflected in the neurological function and ADL scores, but could not change the diagnosis according to the Korean Standard Classification of Diseases nor the impairment scale. The KCF, on the other hand, was able to grasp the changes of the patient in various aspects in terms of body function, body structure, activity and participation, and environmental factors. Conclusions: Through this case, we found the applicability of the KCF in clinical practice of Korean medicine and the possibility that the KCF can be a promising tool to show the effectiveness and benefits of Korean medicine.

뇌경색 시기별 MR영상의 정량적 분석 (Quantitative Analysis of MR Image in Cerebral Infarction Period)

  • 박병래;하광;김학진;이석홍;전계록
    • 대한방사선기술학회지:방사선기술과학
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    • 제23권1호
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    • pp.39-47
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    • 2000
  • In this study, we showed a comparison and analysis making use of DWI(diffusion weighted image) using early diagnosis of cerebral Infarction and with the classified T2 weighted image, FLAIR images signal intensity for brain infarction period. period of cerebral infarction after the condition of a disease by ischemic stroke. To compare 3 types of image, we performed polynomial warping and affined transform for image matching. Using proposed algorithm, calculated signal intensity difference between T2WI, DWI, FLAIR and DWI. The quantification values between hand made and calculated data are almost the same. We quantified the each period and performed pseudo color mapping by comparing signal intensity each other according to previously obtained hand made data, and compared the result of this paper according to obtained quantified data to that of doctors decision. The examined mean and standard deviation for each brain infarction stage are as follows ; the means and standard deviations of signal intensity difference between DWI and T2WI for each period are $197.7{\pm}6.9$ in hyperacute, $110.2{\pm}5.4$ in acute, and $67.8{\pm}7.2$ in subacute. And the means and standard deviations of signal intensity difference between DWI and FLAIR for each period are $199.8{\pm}7.5$ in hyperacute, $115.3{\pm}8.0$ in acute, and $70.9{\pm}5.8$ in subacute. We can quantificate and decide cerebral infarction period objectively. According to this study, DWI is very exact for early diagnosis. We classified the period of infarction occurrence to analyze the region of disease and normal region in DW, T2WI, FLAIR images.

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Evaluation of Invasive and Noninvasive Methods for the Diagnosis of Helicobacter Pylori Infection

  • Cosgun, Yasemin;Yildirim, Abdullah;Yucel, Mihriban;Karakoc, Ayse Esra;Koca, Gokhan;Gonultas, Alpaslan;Gursoy, Gul;Ustun, Huseyin;Korkmaz, Meliha
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권12호
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    • pp.5265-5272
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    • 2016
  • Objective: The present study was conducted to evaluate invasive and noninvasive diagnostic methods for detection of Helicobacter pylori (H. pylori) in patients admitted with dyspeptic complaints and to compare sensitivities and specificities. Method: Sets of four gastric biopsy specimens were obtained from a total of 126 patients included in the study. The presence of H. pylori was determined by invasive tests including culture, rapid urease test, polymerase chain reaction (PCR) and histopathology. Among noninvasive tests, urea breath test, serological tests and enzyme-linked immunosorbent assay (ELISA) were performed. Results: H. pylori was isolated in 79 (62.7%) gastric biopsy cultures, whereas positivity was concluded for 105 (83.3%) patients by rapid urease test, for 106 (84.1%) by PCR, for 110 (87.3%) by histopathology, for 119 (94.4%) by urea breath test, and for 107 (84.9%) by ELISA. In the present study, the culture findings and histopathological examination findings were accepted as gold standard. According to the gold standard, urea breath test had the highest sensitivity (96.5%) and the lowest specificity (30%), whereas culture and histopathology had the highest specificities (100%). Conclusion: The use of PCR invasively with gastric biopsy samples yielded parallel results with the gold standard. PCR can be recommended for routine use in the diagnosis of H. pylori.