5.The Effect of Mental Rotation on Surgical Pathological Diagnosis.
Heejung PARK ; Hyun Soo KIM ; Yoon Jin CHA ; Junjeong CHOI ; Yangki MINN ; Kyung Sik KIM ; Se Hoon KIM
Yonsei Medical Journal 2018;59(3):445-451
PURPOSE: Pathological diagnosis involves very delicate and complex consequent processing that is conducted by a pathologist. The recognition of false patterns might be an important cause of misdiagnosis in the field of surgical pathology. In this study, we evaluated the influence of visual and cognitive bias in surgical pathologic diagnosis, focusing on the influence of “mental rotation.” MATERIALS AND METHODS: We designed three sets of the same images of uterine cervix biopsied specimens (original, left to right mirror images, and 180-degree rotated images), and recruited 32 pathologists to diagnose the 3 set items individually. RESULTS: First, the items found to be adequate for analysis by classical test theory, Generalizability theory, and item response theory. The results showed statistically no differences in difficulty, discrimination indices, and response duration time between the image sets. CONCLUSION: Mental rotation did not influence the pathologists' diagnosis in practice. Interestingly, outliers were more frequent in rotated image sets, suggesting that the mental rotation process may influence the pathological diagnoses of a few individual pathologists.
Bias (Epidemiology)
;
Cervix Uteri
;
Diagnosis*
;
Diagnostic Errors
;
Discrimination (Psychology)
;
Female
;
Pathology
;
Pathology, Surgical
7.The Significance of Cervical Erosion with Benign Cellular Change on Papanicolaou Smear.
Mee Jeong JOENG ; Kum Ja PARK ; Kook Young YOO
Korean Journal of Obstetrics and Gynecology 1997;40(10):2241-2245
The significance of cervical erosion with benign cellular change on Papanicolaou smear has not been evaluated. A retrospective review of 430 coloscopically directed punch biopsies performed over 15 months revealed 206 cases who had a benign cellular change on cytologic smear. Of these 206 smears, 48(23%) had clear cervix without erosion, 99(48%) had mild erosion on cervix, 41(20%) had moderate cervical erosion and 18(9%) had severe cervical erosion. The false negative rate that revealed more than mild dysplasia on histologic diagnosis was 2% in patients without cervical erosion, 3% in patients with mild cervical erosion, 5 % in patients with moderate cervical erosion, and 11% in patients with severe cervical er- osion. Koilocytotic change that suggested human papilloma virus infection was 17% in each group regardless cervical erosion. In conclusion, benign cellular change on Pap smears in patients with severe cervical erosion may be associated with significant cervical cancer pathology.
Biopsy
;
Cervix Uteri
;
Diagnosis
;
Female
;
Humans
;
Papanicolaou Test*
;
Papilloma
;
Pathology
;
Retrospective Studies
;
Uterine Cervical Neoplasms
9.Preoperative Staging of Endometrial Carcinoma by MRI.
See Hyung KIM ; Jae Ho CHO ; Bok Hwan PARK
Yeungnam University Journal of Medicine 2002;19(2):116-125
BACKGROUND: In patients with endometrial carcinoma, preoperative evaluation of exact staging has important prognostic and therapeutic implications. The incidence of pelvic and aortic lymph node involvement in endometrial carcinoma depends on grade of tumor differentiation and depth of myometrial invasion. MATERIAL AND METHOD: To evaluate whether MRI provides a preoperative assessment for staging of endometrial carcinoma, MRI was undertaken in 28 patients, a few weeks before operation. Myometrial invasion was devided in three categories, and involvement of cervix, adnexa, and pelvic cavity were classified. RESULTS: The results of MR imaging were compared with these of pathology. The preoperative MRI staging of endometrial carcinoma was correct in 22 out of 28 patients. In the evaluation of myometrial invasion, the MR imaging underestimated in 4 cases and overestimated in 1 case. CONCLUSION: In patients with endometrial carcinoma, MR imaging is very useful in the assessment of the depth of myometrial invasion, stromal invasion of cevix, lymphatic & pelvic metastases and extent of the lesion.
Cervix Uteri
;
Endometrial Neoplasms*
;
Female
;
Humans
;
Incidence
;
Lymph Nodes
;
Magnetic Resonance Imaging*
;
Neoplasm Metastasis
;
Pathology
10.Value of lymphography before and after radical hysterectomy in carcinoma of the uterine cervic
Choon Yul KIM ; Yung Ho OH ; Woo Jin YANG ; Yong Whee BAHK
Journal of the Korean Radiological Society 1983;19(3):616-625
Radiological demonstration of lymph vessels and lymph nodes may be achieved only by direct lymphography, whichis perfomred by injecting contrast material directly into the lymph vessels. lymph nodes, or occasionally intolymph cysts. Clinical lymphography is performed essentially according to the direct technique of Kinmonth(1952 &1954). Lymphography has become a routine procedure in patients with carcinoma of the uterine cervix. Thoroughassessment of the extent of carcinoma of the uterine cervix is necessary to the intellignet management of anypatient with uterine carcinoma. This presentation is to outline the technique of lymphangio-adenography(lymphography), lymphographic finding and diagnostic criteria of the cervical carcinoma, and evaluation of theaccuracy of lymphographic diagnosis in cervical carcinoma. A retrospective reivew of the lymphograms of 145patients with carcinoma of the uterine cercix was undertaken. All lymphograms were performed at Kang Nam St.Mary's and St. Mary's Hospitals, Catholic Medical College form 1975 to 1982. Of thse patients 87 were got radicalhysterectomy and lymphographic diagnosis was compared with tissue pathology of the nodes removed, and determinedthe diagnostic accuracy of lymphography. Lymphography can make a significant contribution in the pretreatmentassessment of patients with carcinoma of the uterine cervix. Strict adherence to rigid criteria will yieldexcellent pathologic correlation in the event of a positive radiographic diagnosis of metastatic carcinoma. Once apositive diagnosis is made, it should influence the management of the cancer patients. The results were as follow;1. The accuracy of lymphography in diagnosing lymph node metastasis of carcinoma of the uterine cervix was 85.1%,82.4% in sensitivity and 86.8% in specificity. 2. Metastic lymph nodes were moderately to markedly enlarged andirregular in shape and shown motheaten marginal filling defects in 92.7%. Theses ranged from 3mm to 20mm in thegreatest diameter. 3. Metastatic lymph nodes showed a tendency to get increased in size, inproportion to the sizeof marginal filling defect. 4. The size of filling defect of metastatic lymph nodes was not correlated to theclinical stage of carcinoma of the uterine cervix. 5. Lymph node metastasis was confirmed in 6 patients of 10patients who were got lymphography in 2 to 5 years after radical hysterectomy. 6. Many collateral lymphatics andlymphatic cysts were found out in the lymphography after radical hysterectomy in carcioma of the uterine cerix.
Cervix Uteri
;
Diagnosis
;
Female
;
Humans
;
Hysterectomy
;
Lymph Nodes
;
Lymphography
;
Neoplasm Metastasis
;
Pathology
;
Retrospective Studies
;
Sensitivity and Specificity