• 제목/요약/키워드: standard of diagnosis

검색결과 1,186건 처리시간 0.026초

Quantification of three-dimensional facial asymmetry for diagnosis and postoperative evaluation of orthognathic surgery

  • Cao, Hua-Lian;Kang, Moon-Ho;Lee, Jin-Yong;Park, Won-Jong;Choung, Han-Wool;Choung, Pill-Hoon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제42권
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    • pp.17.1-17.11
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    • 2020
  • Background: To evaluate the facial asymmetry, three-dimensional computed tomography (3D-CT) has been used widely. This study proposed a method to quantify facial asymmetry based on 3D-CT. Methods: The normal standard group consisted of twenty-five male subjects who had a balanced face and normal occlusion. Five anatomical landmarks were selected as reference points and ten anatomical landmarks were selected as measurement points to evaluate facial asymmetry. The formula of facial asymmetry index was designed by using the distances between the landmarks. The index value on a specific landmark indicated zero when the landmarks were located on the three-dimensional symmetric position. As the asymmetry of landmarks increased, the value of facial asymmetry index increased. For ten anatomical landmarks, the mean value of facial asymmetry index on each landmark was obtained in the normal standard group. Facial asymmetry index was applied to the patients who had undergone orthognathic surgery. Preoperative facial asymmetry and postoperative improvement were evaluated. Results: The reference facial asymmetry index on each landmark in the normal standard group was from 1.77 to 3.38. A polygonal chart was drawn to visualize the degree of asymmetry. In three patients who had undergone orthognathic surgery, it was checked that the method of facial asymmetry index showed the preoperative facial asymmetry and the postoperative improvement well. Conclusions: The current new facial asymmetry index could efficiently quantify the degree of facial asymmetry from 3D-CT. This method could be used as an evaluation standard for facial asymmetry analysis.

한의 진찰항목 표준화를 위한 실태 및 수요조사 (Survey for Standardization of Medical Examination Items in Oriental Medicine)

  • 문진석;박세욱;강병갑;김보영;강경원;최선미
    • 대한한의학회지
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    • 제28권3호통권71호
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    • pp.23-36
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    • 2007
  • Objective : To poll oriental medical doctors on their opinions about the necessity of standard medical charts and of detailed items in their development. Currently, oriental medical institutions use their own medical charts, but a standard medical chart is necessary for medical information sharing. Methods : Report by 912 of the 10,490 oriental medical doctors surveyed on their general aspects, actual conditions, and requirements. Results : The oriental medical doctors surveyed who worked in oriental medicine clinics, oriental medicine hospitals, and public health centers said medical examination programs should consist of chief complaints (said by 814 respondents or 89.25%), history (792 or 86.84%), ordinal symptoms (753 or 82.57%), diet (727 or 79.71%), emotions and overstrain (654 or 71.71%), side effects and allergies (622 or 68.20%), improvement of symptoms (605 or 66.34%), a questionnaire on particular diseases (558 or 61.18%), social aspects (523 or 57.35%), a physical examination (520 or 57.02%), a questionnaire on syndrome differentiation (514 or 56.36%), diagnosis using medical devices and laboratory tests (471 or 51.64%), and Sasang constitution (357 or 39.14%). Ninety-one percent of the respondents said they intended to use a standard chart, and 82.19% agreed to share patient information with medical institutions. Conclusions : Over 90 percent of the oriental medical doctors surveyed said they need a standard medical examination program. Oriental medical examination items that correspond with the opinions of the oriental medical doctors surveyed and of experts will thus be developed, and the draft chart will be distributed to oriental medical institutions with the developed medical forms and electronic medical chart.

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의료과오사건에서 의사의 과실을 인정하기 위한 요건 - 대법원 2006. 10. 26. 선고 2004도486 판결 - (Requirements to accept the doctor's mistake in the medical malpractice case - Sentenced by October 26, 2006, by The Supreme Court, Precedent case no. 2004Do486 -)

  • 범경철
    • 의료법학
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    • 제8권1호
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    • pp.215-234
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    • 2007
  • The mission of the doctors is to take care of human life, body and health through the medical behaviors such as diagnosis and treatment. Under this job propensity, the doctors have care duty to take the best actions required to prevent the risk according to the patients' specific disease status. Such care duty of the doctor may be evaluated based on the medical behavior level at the medical institution and clinical medical study field. Such medical level should be understood in the normative level, considering the treatment environment, condition and specialty of the behavior, because it means the medical common sense known and acknowledged to the normal doctors. While the criminal suit requires the evidence for no doubt conviction, the civil suit requires more eased different standard. The results between the criminal and civil sentence may be different, because the confirmed former case may lead to long-term imprisonment and even death penalty, while the latter case puts only monetary penalty on the defeated party.

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블레이드 각속도 통계 정보 기반 풍력 발전기 고장 진단 모니터링 시스템 (Statistical Blade Angular Velocity Information-based Wind Turbine Fault Diagnosis Monitoring System)

  • 김병진;강석주;박준영
    • KEPCO Journal on Electric Power and Energy
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    • 제2권4호
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    • pp.619-625
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    • 2016
  • 본 논문에서는 풍력 발전 시스템에서 발생 가능한 고장 중 블레이드에 대한 고장 진단 방법으로 자이로 센서를 이용한 각속도 측정을 통해 고장 진단용 모니터링 시스템을 제안한다. 제안하는 방법은 우선 손상이 발생하지 않은 상태의 블레이드 회전에 대한 각속도 dataset을 구성한다. 블레이드 상태 판별을 위한 dataset 구성이 되었다면, 임의의 상태에 대한 블레이드가 부착된 풍력 발전기를 일정한 힘을 가해 회전시킨 후 최종적으로 블레이드의 손상 정도에 따라 발생하는 각속도의 차이를 비교하여 블레이드의 고장 진단에 대해 판단한다. 실험 결과 정상 상태의 블레이드는 초당 1회 (초당 $360^{\circ}$) 이상의 속도로 회전을 진행하며, 손상 상태의 블레이드는 초당 1회 미만의 속도로 회전하며 표준 편차가 급격히 증가하는 것을 확인할 수 있었다.

수소충전소 내 연료전지용 수소연료 품질 관리 및 표준화 동향 (Current Status of Standardization for Quality Control of Hydrogen Fuel in Hydrogen Refueling Stations for Fuel Cell Electric Vehicles)

  • 김동겸;임정식;이정순
    • 한국수소및신에너지학회논문집
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    • 제33권4호
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    • pp.284-292
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    • 2022
  • Hydrogen is promising a candidate for energy supporting the carbon neutrality policy for greenhouse gas reduction, which is being promoted in several countries, including Korea. Although challenging efforts-such as lowering the costs of green hydrogen production and fuel cells-remain, hydrogen fuel cell electric vehicles (FCEVs) are expected to play a significant role in the energy transition from fossil fuels to renewable energy. In line with this objective, the hydrogen FCEV working group in the International Organization for Standardization (ISO) compiled and revised international standards related to hydrogen refueling stations as of 2019. A well-established hydrogen quality management system based on the standard documents will increase the reliability of hydrogen charging stations and accelerate the use of FCEVs. In this study, among the published ISO standards and other references, the main requirements for managing charging stations and developing related techniques were summarized and explained. To respond preemptively to the growing FCEV market, a continuous hydrogen quality monitoring method suitable for use at hydrogen charging stations was proposed.

선천성 부신 과형성증(21-hydroxylase 결핍)의 신생아 선별 검사 후 진단 알고리즘 (A Diagnostic Algorithm after Newborn Screening for 21-hydroxylase Deficiency)

  • 조성윤;고정민;이경아
    • 대한유전성대사질환학회지
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    • 제16권2호
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    • pp.70-78
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    • 2016
  • 선천성 부신 과형성증 중 가장 흔한 21-hydroxy-lase deficiency (21-OHD)는 신생아 선별검사에서 17-hydroxyprogesterone (17-OHP)의 증가로 조기 진단이 가능하다. 17-OHP가 애매하게 증가되는 경우에는 ACTH 자극 검사가 필요하며, 이 검사는 nonclassical (NC형) 21-OHD 진단의 gold standard이다. 전형적인 임상 증상이 없는 경우, 예를 들어 남성화가 심하지 않은 여아, 경한 simple virilizing (SV)형 남아나 신생아 선별 검사에서 발견되지 않을 수 있는 NC형 환자의 경우, 분자유전학적 검사가 진단에 도움을 줄 수 있으며, 이는 예후 에측 및 유전 상담에도 도움이 된다. 미숙아와 저체중 출생아의 경우는 17-OHP가 위양성을 보이기 쉬우므로 출생 주수나 출생 체중에 따른 cutoff 값 설정이 필요하다. 높은 위양성률을 극복하기 위해 기존 RIA방법에 비해 최근 LC-MS/MS가 민감도와 특이도를 높이는 검사로 주목 받고 있다. 21-OHD 신생아 선별 검사의 효율성을 높이기 위해서는 SW형 남아를 조기에 발견하고, 여아에서 성별 결정을 조기에 올바르게 하고, NC형 환자를 찾아내고, 미숙아/저체중 출생아/아픈 신생아에서 위양성률을 낮추어서 불필요한 재검 및 경제적/심리적 부담을 최소화 하기 위한 노력이 필요하다. 무엇보다 21-OHD가 임상적으로 확실하게 의심되는 경우에는 확진 검사에 앞서 적절한 치료가 조기에 시작되어야 한다. 저자들은 본 종설에서 21-OHD의 신생아 선별 검사 후 진단 알고리즘에 대해 최신 문헌들에 근거하여 가이드라인을 제시하는 바이다.

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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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