• Title/Summary/Keyword: standard of diagnosis

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Clinical Value of Dual-phase 18F-FDG SPECT with Serum Procalcitonin for Identification of Etiology in Tumor Patients with Fever of Unknown Origin

  • Zhang, Qun;Shan, Chun;Wu, Pei;Huang, Xin-En
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.2
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    • pp.683-686
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    • 2014
  • Objective: The purpose of the study was to evaluate clinical value of dual-phase $^{18}F$-FDG SPECT with serum procalcitonin (PCT) in identifying cancers in patients with fever of unknown origin (FUO). Methods: PCT test and dual-phase $^{18}F$-FDG SPECT were sequentially performed on 50 consecutive patients with FUO. Two radiologists evaluated all $^{18}F$-FDG SPECT data independently. A consensus was reached if any difference of opinions existed. Final diagnosis was based on a comprehensive analysis of results for the PCT test, dual-phase $^{18}F$-FDG SPECT and bacterial cultivation, regarded as a gold standard. Results: Among 50 patients, 34 demonstrated PCT ${\geq}0.5{\mu}g/L$. Coincidence imaging showed in 37 patients with inflammatory lesions, and 13 with malignancy. Finally, 36 bacterial, 1 fungal and 1 viral infections, as well as 12 cancerous fevers were confirmed by dual-phase $^{18}F$-FDG SPECT with PCT, combined with bacterial cultivation and clinical follow-up. Conclusion: Our study demonstrated that dual-phase $^{18}F$-FDG SPECT in association with PCT could be a valuable tool for diagnosis in tumor patients with FUO.

Sarcopenia: Nutrition and Related Diseases

  • Du, Yang;No, Jae Kyung
    • Culinary science and hospitality research
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    • v.23 no.1
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    • pp.66-78
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    • 2017
  • "Sarcopenia", sarcopenia is an old age syndrome, and used to describe the reduction of skeletal muscle. Initially, it was thought that sarcopenia was only a senile disease characterized by degeneration of muscle tissue. However, its cause is widely regarded as multifactorial, with neurological decline, hormonal changes, inflammatory pathway activation, declines in activity, chronic illness, fatty infiltration, and poor nutrition, all shown to be contributing factors. Skeletal muscle mass can be measured by a variety of methods, currently, the commonly used methods are dual-energy X-ray scanning (DXA), computer tomography (CT), magnetic resonance imaging (MRI), etc. Muscular skeletal disorders can also be assessed by measuring appendicular skeletal muscle (ASM), particularly muscle tissue content. At the same time, sarcopenia refers to skeletal muscle cell denervation, mitochondrial dysfunction, inflammation, hormone synthesis and secretion changes and a series of consequences caused by the above process and is a progressive loss of skeletal muscle syndrome, which can lead to the decrease of muscle strength, physical and functional disorders, and increase the risk of death. Sarcopenia is mainly associated with the aging process, but also related to other causes such as severe malnutrition, neurodegenerative diseases, and disuse and endocrine diseases associated with muscular dystrophy, and it is the comprehensive results of multi-factors, so it is difficult to define that sarcopenia is caused by a specific disease. With the aging problem of the population, the incidence of this disease is increasingly common, and seriously affects the quality of the life of the elderly. This paper reviews the etiology and pathogenesis of myopathy, screening methods and diagnosis, the influence of eating habits, etc, and hopes to provide reference for the diagnosis and treatment of this disease. At present, adequate nutrition and targeted exercise remain the gold standard for the therapy of sarcopenia.

Ultrasonographic Diagnosis of Extensor Tenosynovitis Caused by Dorsal Screw Prominence after Volar Plate Fixation of Distal Radius Fracture: Case Report (원위 요골 골절의 수장측 금속판 고정술 후 발생한 신전건 활막염에 대한 초음파를 이용한 진단: 증례 보고)

  • Lim, Tae Kang;Kim, Sang Yeol;Kang, Hong Je;Hah, Dae Ho
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.6 no.2
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    • pp.60-64
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    • 2013
  • After volar locking plating of distal radius fracture, complications arising from unrecognized dorsally prominent screws penetrating the extensor compartments are increasingly reported. However, standard radiography and fluoroscopy may not adequately visualize screw lengths, because of complex shape of dorsal cortex of the distal radius. We presented case of ultrasonography diagnosis of extensor tenosynovitis caused by dorsal screw prominence after volar plate fixation of distal radius fracture.

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A Delphi Study of Korean Medicine for Anorexia in Children for Clinical Practice Guidelines (소아 식욕부진의 한의표준임상진료지침 개발을 위한 델파이 연구)

  • Bang Miran;Lee Sun Haeng;Chang Gyu Tae
    • The Journal of Pediatrics of Korean Medicine
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    • v.38 no.2
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    • pp.21-31
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    • 2024
  • Objectives This study aimed to develop consensus-based recommendations for establishing standard clinical practice guidelines for pediatric anorexia through the utilization of a Delphi study. Methods We analyzed existing randomized controlled trials for pediatric anorexia treatment using the Delphi method-a structured process for achieving consensus among a panel of experts. A questionnaire was distributed among a select panel of nine specialists in the field. Results The initial Delphi round led to consensus on 30 distinct recommendations; however, consensus was not reached for 19 other recommendations, prompting a second Delphi round. In the subsequent round, adjustments were made based on feedback from the initial round, and deliberations were held on recommendations that previously lacked consensus. Following these adjustments, consensus was achieved on all recommendations. Additionally, a third Delphi iteration was conducted to address three specific queries that required amendment due to a reevaluation of the evidence levels of certain recommendations. In total, three Delphi rounds were carried out to produce informed recommendations related to the diagnosis, treatment, and general management of anorexia. Conclusions This investigation successfully generated evidence-based recommendations for the diagnosis and treatment of pediatric anorexia. The recommendations encompassed various practices, including herbal medicine, acupuncture, moxibustion, cupping, and Chuna manual therapy, which can be integrated into clinical settings.

Diagnosis of Vertebral Artery Ostial Stenosis on Contrast-Enhanced MR Angiography: Usefulness of a Thin-Slab MIP Technique (조영 증강 MR 혈관 조영 영상에서 척추동맥 기시부 협착의 진단: Thin-Slab MIP technique의 유용성)

  • Kim, Sun-Mi;Lee, Deok-Hee;Choi, Jin-Woo;Choi, Byung-Se;In, Hyun-Sin
    • Investigative Magnetic Resonance Imaging
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    • v.15 no.1
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    • pp.77-81
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    • 2011
  • It is a well-known clinical fact that contrast-enhanced magnetic resonance angiography exaggerates vertebral arterial ostial stenosis and sometimes shows pseudostenosis. Considering the clinical significance of a lesion in the posterior circulation ischemia, the importance of an accurate imaging diagnosis of ostial stenosis should not be underestimated. We were able to differentiate pseudo stenosis of the ostium from true stenosis using thin-slab maximum-intensity-projection(MIP) images which are thought to be helpful for minimizing standard full thickness MIP images.

A Study on Neuropsychiatric Symptoms and Signs of Disease Pattern in Korean Medicine (한의병증에 대한 신경정신과적 증상 기술 연구)

  • Jang, Jae-Soon;Kim, Ka-Na;Cho, Seung-Hun
    • Journal of Oriental Neuropsychiatry
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    • v.27 no.4
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    • pp.249-259
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    • 2016
  • Objectives: This study aimed to develop a standard understanding of neuropsychiatric symptoms and signs of Disease Pattern Identification/syndrome in Korean Medicine. Methods: We investigated various published articles, and the proposals are based on a comparative analysis between Korean medicine literature and DSM5, ICD-10. To improve our understanding, we engaged in a consultation through discussions with the advisory committee. Results: We describe the physical and neuropsychiatric symptoms in a modern sense of the major disease Pattern in Korean Medicine. We also proposed a profound understanding of the neuropsychiatric symptoms and signs of Disease Pattern Identification/syndrome in Korean Medicine. Conclusions: Compared with DSM5, ICD-10, the system of neuropsychiatric diagnosis in Korean medicine, could be profoundly organized into a system in a modern sense. It would be helpful to apply this understanding to clinical practices. There are several points of consideration in this study. The system of neuropsychiatric diagnosis in Korean medicine cannot be a perfect match for DSM5 or ICD-10. In addition, we could not reach a complete consensus on the disease pattern. Although there are some limitations to this study, it is meaningful to have an understanding of the neuropsychiatric symptoms and signs in Korean medicine through discussions with the advisory committee. This trial is expected to be applicable to related research in the future.

Usefulness of four commonly used neuropathic pain screening questionnaires in patients with chronic low back pain: a cross-sectional study

  • Gudala, Kapil;Ghai, Babita;Bansal, Dipika
    • The Korean Journal of Pain
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    • v.30 no.1
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    • pp.51-58
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    • 2017
  • Background: Recently symptoms-based screening questionnaires have gained attention for screening for a neuropathic pain component (NePC) in various chronic pain conditions. The present study assessed the usefulness of four commonly used NePC screening questionnaires including the Self-completed douleur neuropathique 4 (S-DN4), the ID Pain, the painDETECT questionnaire (PDQ), and the Self-completed Leeds Assessment of neuropathic Symptoms and Signs (S-LANSS) questionnaire in patients with chronic low back pain (CLBP) to assess the presence of NePC. Methods: This is a single-center cross-sectional study where patients with CLBP, with or without leg pain, were included. Participants were initially screened for NePC presence by a physician according to the regular practice, and later assessed using screening questionnaires. The diagnostic accuracy of these questionnaires was compared assuming the physician-made diagnosis as the gold standard. Results: A total of 215 patients with CLBP of which 164 (76.3%, 95% CI, 70.2-81.5) had a NePC were included. S-DN4, ID Pain, and PDQ have an area under the curve (AUC) > 0.8 indicating excellent discrimination. However, S-LANSS has an AUC of 0.69 (0.62-0.75), indicating low discrimination. S-DN4 has a significantly higher AUC as compared to ID Pain (d(AUC) = 0.063, P < 0.01) and S-LANSS (d(AUC) = 0.197, P < 0.01). But the AUC of S-DN4 does not significantly differ from that of PDQ (d(AUC) = 0.013, P = 0.62). Conclusions: S-DN4, ID Pain, and PDQ, but not S-LANSS, have good discriminant validity to screen for NePCs in patients with CLBP. Despite using all the tests, 20-30% of patients with an NePC were missed. Thus, these questionnaires can only be used as an initial clue in screening for NePCs, but do not replace clinical judgment.

High Expression of Lung Resistance Protein mRNA at Diagnosis Predicts Poor Early Response to Induction Chemotherapy in Childhood Acute Lymphoblastic Leukemia

  • Bhatia, Prateek;Masih, Shet;Varma, Neelam;Bansal, Deepak;Trehan, Amita
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6663-6668
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    • 2015
  • Background: Treatment failure in leukemia is due to either pharmacokinetic resistance or cell resistance to drugs. Materials and Methods: Gene expression of multiple drug resistance protein (MDR-1), multidrug resistance-related protein (MRP) and low resistance protein (LRP) was assessed in 45 pediatric ALL cases and 7 healthy controls by real time PCR. The expression was scored as negative, weak, moderate and strong. Results: The male female ratio of cases was 2.75:1 and the mean age was 5.2 years. Some 26/45 (58%) were in standard risk, 17/45(38%) intermediate and 2/45 (4%) in high risk categorie, 42/45 (93%) being B-ALL and recurrent translocations being noted in 5/45 (11.0%). Rapid early response (RER) at day 14 was seen in 37/45 (82.3%) and slow early response (SER) in 8/45 (17.7%) cases. Positive expression of MDR-1, LRP and MRP was noted in 14/45 (31%), 15/45 (33%) and 27/45 (60%) cases and strong expression in 3/14 (21%), 11/27 (40.7%) and 8/15 (53.3%) cases respectively. Dual or more gene positivity was noted in 17/45 (38%) cases. 46.5 % (7/15) of LRP positive cases at day 14 were in RER as compared to 100% (30/30) of LRP negative cases (p<0.05). All 8 (100%) LRP positive cases in SER had strong LRP expression (p=<0.05). Moreover, only 53.3% of LRP positive cases were in haematological remission at day 30 as compared to 100% of LRP negative cases (p=<0.05). Conclusions: Our study indicated that increased LRP expression at diagnosis in pediatric ALL predicts poor response to early treatment and hence can be used as a prognostic marker. However, larger prospective studies with longer follow up are needed, to understand the clinical relevance of drug resistance proteins.

Detecting Incipient Caries Using Front-illuminated Infrared Light Scattering Imaging

  • Kim, Ji-Young;Ro, Jung-Hoon;Jeon, Gye-Rok;Kim, Jin-Bom;Ye, Soo-Young
    • Transactions on Electrical and Electronic Materials
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    • v.13 no.6
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    • pp.310-316
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    • 2012
  • A new method for early caries diagnosis was proposed and tested through a home-made optical examination system that used quantitative light fluorescence (QLF) and digital imaging fiber optic transillumination (FOTI) (DIFOTI), with light sources across a wide spectral range, from 350 nm to 1,000 nm. The front-illuminated infrared light scattering image (FIR) showed similar diagnostic abilities to that of DIFOTI. The FIR method was invented based on the observation that caries lesions lose the high transmittance and low scattering properties of benign enamel tissue. There are various methods for the early diagnosis of caries, such as visual examination, exploration, X-ray radiography, QLF, FOTI, and infrared fluorescence (diagnodent). Among them, methods based on optical properties are regarded as having the most potential. A comparative study was performed between the FOTI, QLF, diagnodent, optical coherence tomography, and FIR scattering image methods, using 20 extracted teeth samples with early caries. A scale of lesion measurement based on optical image contrast was proposed. The statistical analysis showed a significant correlation between the DIFOTI and FIR methods (r = 0.35, p < 0.05). However, the QLF and diagnodent methods showed little association with FIR images, as they have different detection principles as compared with FIR. Tomographic images obtained by OCT, using 1,330 nm super luminescent LED as a gold standard of tooth structure, verified that the FOTI and FIR results correctly represented the lack of homogeneity in dental tissue. The newly proposed FIR method attained similar diagnostic results to those of FOTI, but with an easier approach.

COVID-19 Diagnosis from CXR images through pre-trained Deep Visual Embeddings

  • Khalid, Shahzaib;Syed, Muhammad Shehram Shah;Saba, Erum;Pirzada, Nasrullah
    • International Journal of Computer Science & Network Security
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    • v.22 no.5
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    • pp.175-181
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    • 2022
  • COVID-19 is an acute respiratory syndrome that affects the host's breathing and respiratory system. The novel disease's first case was reported in 2019 and has created a state of emergency in the whole world and declared a global pandemic within months after the first case. The disease created elements of socioeconomic crisis globally. The emergency has made it imperative for professionals to take the necessary measures to make early diagnoses of the disease. The conventional diagnosis for COVID-19 is through Polymerase Chain Reaction (PCR) testing. However, in a lot of rural societies, these tests are not available or take a lot of time to provide results. Hence, we propose a COVID-19 classification system by means of machine learning and transfer learning models. The proposed approach identifies individuals with COVID-19 and distinguishes them from those who are healthy with the help of Deep Visual Embeddings (DVE). Five state-of-the-art models: VGG-19, ResNet50, Inceptionv3, MobileNetv3, and EfficientNetB7, were used in this study along with five different pooling schemes to perform deep feature extraction. In addition, the features are normalized using standard scaling, and 4-fold cross-validation is used to validate the performance over multiple versions of the validation data. The best results of 88.86% UAR, 88.27% Specificity, 89.44% Sensitivity, 88.62% Accuracy, 89.06% Precision, and 87.52% F1-score were obtained using ResNet-50 with Average Pooling and Logistic regression with class weight as the classifier.