• Title/Summary/Keyword: Acceptable risk

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TiN 코팅된 지대주 나사의 반복 착탈 후 표면 변화와 적합도에 관한 연구 (SURFACE CHANGE AND FIT OF TIN-COATED ABUTMENT SCREW AFTER REPEATED CLOSING AND OPENING)

  • 김종남;정재헌;김희중
    • 대한치과보철학회지
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    • 제45권1호
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    • pp.119-130
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    • 2007
  • Statement of problem: A few dry lubricants were applied to abutment screws for the improvement of joint stability. Purpose: The purpose of this study was to evaluate the surface change and fit of TiN-Coated abutment screw through the examination of tested screws in the field emission scanning electron microscope(FE-SEM;Netherland, Phillips co., model:XL 30 SFEG) after repeated closing and opening. Materials and method: Titanium(3i/implant Innovations Inc, USA) and Gold-Tite abutment screws(3i/implant Innovations Inc, USA) were selected for Group A and C respectively. TiN coated titanium abutment screws were also divided into two groups, Group B and D. Abutment screws of each group and the fit of abutment screw/implant fixture/abutment were observed on FE-SEM after repeated closing and opening test respectively. Results: 1. The abutment screws of TiN coated groups(Group B and D) showed more remarkable wear resistance in the threads of the screw than those of the other group(Group A and C). 2. There were more severe wear and defect of TiN coating in Group D tightened to 32 Ncm than Group B to 20 Ncm. 3. There was no difference in the fit of abutment screw/fixture/abutment among four groups, Group A, Group B, Group C and Group D. Conclusion: Under the conditions of this study, it is suggested that TiN coating of abutment screw be clinically acceptable and be expected to reduce the risk of abutment screw loosening. TiN coating of abutment screw showed good resistance against wear and the adequate fit of abutment screw/implant fixture/abutment.

Application of Data Mining Techniques to Explore Predictors of HCC in Egyptian Patients with HCV-related Chronic Liver Disease

  • Omran, Dalia Abd El Hamid;Awad, AbuBakr Hussein;Mabrouk, Mahasen Abd El Rahman;Soliman, Ahmad Fouad;Aziz, Ashraf Omar Abdel
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권1호
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    • pp.381-385
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    • 2015
  • Background:Hepatocellular carcinoma (HCC) is the second most common malignancy in Egypt. Data mining is a method of predictive analysis which can explore tremendous volumes of information to discover hidden patterns and relationships. Our aim here was to develop a non-invasive algorithm for prediction of HCC. Such an algorithm should be economical, reliable, easy to apply and acceptable by domain experts. Methods: This cross-sectional study enrolled 315 patients with hepatitis C virus (HCV) related chronic liver disease (CLD); 135 HCC, 116 cirrhotic patients without HCC and 64 patients with chronic hepatitis C. Using data mining analysis, we constructed a decision tree learning algorithm to predict HCC. Results: The decision tree algorithm was able to predict HCC with recall (sensitivity) of 83.5% and precession (specificity) of 83.3% using only routine data. The correctly classified instances were 259 (82.2%), and the incorrectly classified instances were 56 (17.8%). Out of 29 attributes, serum alpha fetoprotein (AFP), with an optimal cutoff value of ${\geq}50.3ng/ml$ was selected as the best predictor of HCC. To a lesser extent, male sex, presence of cirrhosis, AST>64U/L, and ascites were variables associated with HCC. Conclusion: Data mining analysis allows discovery of hidden patterns and enables the development of models to predict HCC, utilizing routine data as an alternative to CT and liver biopsy. This study has highlighted a new cutoff for AFP (${\geq}50.3ng/ml$). Presence of a score of >2 risk variables (out of 5) can successfully predict HCC with a sensitivity of 96% and specificity of 82%.

Gemcitabine Alone or in Combination with Cisplatin for Advanced Biliary Tract Carcinomas: an Overview of Clinical Evidence

  • Sun, Tian-Tian;Wang, Ji-Lin;Fang, Jing-Yuan
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권2호
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    • pp.877-883
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    • 2013
  • Background and Objective: There has been no universally agreed standard chemotherapy regimen for patients with advanced biliary tract carcinomas (BTC). We aimed to fully display and evaluate the clinical evidence for gemcitabine or gemcitabine-cisplatin combination for advanced BTC. Methods: Systematic searches were performed to identify relevant randomized controlled trials (RCTs) and uncontrolled trials. Overall survival (OS), progression-free survival (PFS), overall response rates (ORR), tumor control rates (TCR), and toxicity were evaluated. Evidence levels of the results were evaluated with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results: Results of the eleven gemcitabine-cisplatin trials and ten gemcitabine trials showed both chemotherapy regimens had benefits with reference to mean OS (8.63 vs. 8.79 months), mean PFS (4.86 vs. 4.72 months), pooled ORR (25.3% vs. 19.6%) and TCR (55.2% vs. 53.1%). Two RCTs showed the gemcitabine-cisplatin combination to prolong the mean PFS (mean difference [MD] 2.57, 95%CI 1.69 3.45), substantially increasing the mean OS (MD 3.59, 95% CI 3.48 3.71), and producing a similar effect in ORR (risk ratio [RR] 1.59, 95%CI 1.04 2.43), increasing TCR (RR 1.15, 95%CI 1.02 1.31) compared with gemcitabine alone, with generally manageable grade 3 or 4 adverse events. The evidence level of OS was moderate, and other outcomes (ORR, PFS, TCR, anaemia, neutropenia) were at low evidence levels. Conclusion: Available evidence was limited with low quality, which showed that both gemcitabine-cisplatin and gemcitabine alone had clinical activity with acceptable safety profiles, and gemcitabine-cisplatin appeared to be more useful for advanced BTC patients than gemcitabine alone.

Radiotherapy for locally recurrent rectal cancer treated with surgery alone as the initial treatment

  • Tanaka, Hidekazu;Yamaguchi, Takahiro;Hachiya, Kae;Okada, Sunaho;Kitahara, Masashi;Matsuyama, Katsuya;Matsuo, Masayuki
    • Radiation Oncology Journal
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    • 제35권1호
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    • pp.71-77
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    • 2017
  • Purpose: Although the technical developments of radiotherapy have been remarkable, there are currently few reports on the treatment results of radiotherapy for local recurrence of rectal cancer treated with surgery alone as initial treatment in this three-dimensional conformal radiotherapy era. Thus, we retrospectively evaluated the treatment results of radiotherapy for local recurrence of rectal cancer treated with surgery alone as the initial treatment. Materials and Methods: Thirty-two patients who underwent radiotherapy were enrolled in this study. The dose per fraction was 2.0-3.5 Gy. Because the treatment schedule was variable, the biological effective dose (BED) was calculated. Results: Local control (LC) and overall survival (OS) rates from the completion of radiotherapy were calculated. The 1-, 2-, 3-, 4-, and 5-year LC rates were 51.5%, 24.5%, 19.6%, 19.6%, and 13.1%, respectively. LC rates were significantly higher for the high BED group (${\geq}75Gy_{10}$) than for the lower BED group (<$75Gy_{10}$). All patients who reported pain achieved pain relief. The duration of pain relief was significantly higher for the high BED group than for the lower BED group. The 1-, 2-, 3-, 4-, and 5-year OS rates were 82.6%, 56.5%, 45.2%, 38.7%, and 23.2%, respectively. There was a trend toward higher OS rates in with higher BED group compared to lower BED group. Conclusion: For patients with unresectable locally recurrent rectal cancer treated with surgery alone, radiotherapy is effective treatment. The prescribed BED should be more than $75Gy_{10}$, if the dose to the organ at risk is within acceptable levels.

Surgical Treatment for Non-Small Cell Lung Cancer in Patients on Hemodialysis due to Chronic Kidney Disease: Clinical Outcome and Intermediate-Term Results

  • Park, Byung Jo;Shin, Sumin;Kim, Hong Kwan;Choi, Yong Soo;Kim, Jhingook;Shim, Young Mog
    • Journal of Chest Surgery
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    • 제48권3호
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    • pp.193-198
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    • 2015
  • Background: Patients on dialysis undergoing surgery belong to a high-risk group. Only a few studies have evaluated the outcome of major thoracic surgical procedures in dialysis patients. We evaluated the outcomes of pulmonary resection for non-small cell lung cancer (NSCLC) in patients on hemodialysis (HD). Methods: Between 2008 and 2013, seven patients on HD underwent pulmonary resection for NSCLC at our institution. We retrospectively reviewed their surgical outcomes and prognoses. Results: The median duration of HD before surgery was 55.0 months. Five patients underwent lobectomy and two patients underwent wedge resection. Postoperative morbidity occurred in three patients, including pulmonary edema combined with pneumonia, cerebral infarction, and delirium. There were no instances of in-hospital mortality, although one patient died of intracranial bleeding 15 days after discharge. During follow-up, three patients (one patient with pathologic stage IIB NSCLC and two patients with pathologic stage IIIA NSCLC) experienced recurrence and died as a result of the progression of the cancer, while the remaining three patients (with pathologic stage I NSCLC) are alive with no evidence of disease. Conclusion: Surgery for NSCLC in HD patients can be performed with acceptable perioperative morbidity. Good medium-term survival in patients with pathologic stage I NSCLC can also be expected. Pulmonary resection seems to be the proper treatment option for dialysis patients with stage I NSCLC.

체중 3kg 이하 소아에서의 개심술 (Open Heart Surgery in Infants Weighing Less than 3kg)

  • 이창하
    • Journal of Chest Surgery
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    • 제33권8호
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    • pp.630-637
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    • 2000
  • Backgroud: There are well-known problems in the management of low weight neonates or infants with congenital heart defects. In the past, because of a perceived high risk of operations using cardiopulmonary bypass(CPB) in these patients, there was a tendency for staged palliation without the use of CPB. However, the recent trend has been toward early reparative surgery using CPB, with acceptable mortality and good long-term survival. Therefore we reviewed our results of the operations in infants weighing less than 3kg and considered the technical aspect of conducting the CPB including myocardial protection. Material and Method: Between Jan. 1995 and Jul. 1998, 28 infants weighing less than 3kg underwent open heart surgery for many cardiac anomalies with a mean body weight of 2.7kg(range; 1.9-3.0kg) and a mean age of 41days(range; 4-110days). Preoperative management in the intensive care unit was needed in 20 infants and preoperative ventilator support therapy in 11. Total correction was performed in 23 infants and the palliative procedure in 5. Total circulatory arrest was needed in 11 infants(39%). Result: There were seven hospital deaths(25%) caused by myocardial failure(n=3), surgical failure(n=2), multiorgan failure(n=1), and sudden death(n=1). The median duration of hospital stay and intensive care unit stay were 13days(range; 6-93days) and 6days(range; 2-77days) respectively. The follow-up was achieved in 21 patients and showed three cases of late mortality(15%) and a one-year survival rate of 62%. No neurologic complications such as clinical seizure and intracranial bleeding were noticed immediately after surgery and during follow-up. Conclusion: The early and late mortality rate of open heart surgery in our infants weighing less than 3 kg stood relatively high, but the improved outcomes are expected by means of the delicate conduct of cardiopulmonary bypass including myocardial protection as well as the adequate perioperative management. Also, the longer follow-up for the neurologic development and complications are needed in infants undergoing circulatory arrest and continuous low flow CPB.

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여자 청소년 음식 기반 권장식사패턴의 제안과 이를 적용하여 작성한 식단의 평가 (Proposition and Application of a Dish-Based Target Pattern for Korean Adolescent Girls)

  • 박미진;김영남
    • 대한지역사회영양학회지
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    • 제20권2호
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    • pp.87-95
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    • 2015
  • Objectives: Maintaining a balanced diet and thus health is crucial for adolescents, and the first step for balanced diet practice is meal planning. Adolescents, however, find it difficult to plan their meals. This study thus was set out to design an easier way of planning meals for adolescent girls. Methods: A dish-based target pattern for adolescent girls was tabulated, and validity of this was examined. Meal plan applying a dish-based target pattern was prepared by 150 female middle school students, and nutritional adequacies of those meal plans were examined. Validity and adequacy were tested by energy content, energy contribution ratio, nutrient adequacy ratio (NAR), probability of nutrient inadequacy, index of nutritional quality (INQ) calculation. Results: A dish-based target pattern with 11 dish groups was validated for nutritional adequacy. Though the NAR of calcium was 0.96, the INQ of calcium was 1.00. The average energy supply from the meal plans was 2,379 kcal, higher than the estimated energy requirement of a female middle school student, but the energy contribution ratio of carbohydrates, proteins, and fats were all adequate according to the acceptable macronutrient distribution range (AMDR). NAR of all nutrients examined were 1.0, except for calcium. The NAR and INQ of calcium were 0.87 and 0.75, respectively, and the meal plans at risk for calcium inadequacy was 19.30%. Conclusions: A dish-based target pattern proposed for adolescent girls was valid, but the meal plan prepared by female middle school students using this approach was high in energy and low in calcium supply. To cut down the energy supply from the meal plan, it is necessary to recommend dishes low in fat and use low fat cooking methods. To increase the calcium supply, it is important to recommend seaweed and legume group dishes with higher Ca INQ food items.

Does intrauterine injection of low-molecular-weight heparin improve the clinical pregnancy rate in intracytoplasmic sperm injection?

  • Kamel, Ahmed Mohamed;El-Faissal, Yahia;Aboulghar, Mona;Mansour, Ragaa;Serour, Gamal I;Aboulghar, Mohamed
    • Clinical and Experimental Reproductive Medicine
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    • 제43권4호
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    • pp.247-252
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    • 2016
  • Objective: Heparin can modulate proteins, and influence processes involved in implantation and trophoblastic development. This study aimed to assess the improvement of clinical pregnancy and implantation rates after local intrauterine injection of low-molecular-weight heparin (LMWH) in patients undergoing intracytoplasmic sperm injection (ICSI). Methods: A randomised case/control design was followed in women scheduled for ICSI. The study arm was injected with intrauterine LMWH during mock embryo transfer immediately following the ovum pickup procedure, while the control arm was given an intrauterine injection with a similar volume of tissue culture media. Side effects, the clinical pregnancy rate, and the implantation rate were recorded. Results: The pregnancy rate was acceptable (33.9%) in the LMWH arm with no significant reported side effects, confirming the safety of the intervention. No statistically significant differences were found in the clinical pregnancy and implantation rates between both groups (p= 0.182 and p= 0.096, respectively). The odds ratio of being pregnant after intrauterine injection with LMWH compared to the control group was 0.572 (95% confidence interval [CI], 0.27-1.22), while the risk ratio was 0.717 (95% CI, 0.46-1.13; p= 0.146). No statistical significance was found between the two groups in other factors affecting implantation, such as day of transfer (p= 0.726), number of embryos transferred (p= 0.362), or embryo quality. Conclusion: Intrauterine injection of LMWH is a safe intervention, but the dose used in this study failed to improve the outcome of ICSI. Based on its safety, further research involving modification of the dosage and/or the timing of administration could result in improved ICSI success rates.

철도안전도 평가지표 개발에 관한 연구 (A Study on Development of Safety Index for Evaluating Railway Safety)

  • 송보영;문대섭;이동훈
    • 한국철도학회논문집
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    • 제12권4호
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    • pp.443-449
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    • 2009
  • 국가에서는 철도운영 및 시설기관에 산재되어 있는 철도안전정보를 수집하여 분석할 수 있는 철도안전정보 종합관리시스템을 구축하야 철도안전관리를 효율적으로 수행하기 위하여 노력하고 있다. 매년 철도안전도를 평가하기 위하여 철도사고 자료를 분석하여 사망자 및 부상자 수를 산출하고 있으며 사고 원인 및 위험발생 경위를 규명하여 사고를 최소화 할 수 있도록 여러 안잔정책 및 안전관리방안을 시행하고 있다. 따라서 보다 선진적인 안전정책 수립 및 안전관리를 위해 철도안전도를 입체적으로 그리고 정량적으로 표현할 수 있는 방안이 필요하며 이를 위해서는 안전에 대한 주요 영향요소가 무엇인지를 파악해야 하며 선정된 개발적 요소들에 대한 정량적 철도안전지수(Railway Safety Index)를 개발해야 한다. 본 연구에서는 철도안전도를 정량적으로 평가할 수 있는 안전도 평가지표를 개발하여 안전목표 수립 및 관리 등 철도안전향상를 위한 전략적 방향 및 정책수립 과정에서 활용할 수 있는 모델을 제공하고자 한다.

Is the diagnosis of calcified laryngeal cartilages on panoramic radiographs possible?

  • Cagirankaya, Leyla Berna;Akkaya, Nursel;Akcicek, Gokcen;Dogru, Hatice Boyacioglu
    • Imaging Science in Dentistry
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    • 제48권2호
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    • pp.121-125
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    • 2018
  • Purpose: Detecting laryngeal cartilages (triticeous and thyroid cartilages) on panoramic radiographs is important because they may be confused with carotid artery calcifications in the bifurcation region, which are a risk factor for stroke. This study assessed the efficiency of panoramic radiography in the diagnosis of calcified laryngeal cartilages using cone-beam computed tomography (CBCT) as the reference standard. Materials and Methods: A total of 312 regions(142 bilateral, 10 left, 18 right) in 170 patients(140 males, 30 females) were examined. Panoramic radiographs were examined by an oral and maxillofacial radiologist with 11 years of experience. CBCT scans were reviewed by 2 other oral and maxillofacial radiologists. The kappa coefficient(${\kappa}$) was calculated to determine the level of intra-observer agreement and to determine the level of agreement between the 2 methods. Diagnostic indicators(sensitivity, specificity, accuracy, and false positive and false negative rates) were also calculated. P values <.05 were considered to indicate statistical significance. Results: Eighty-two images were re-examined to determine the intra-observer agreement level, and the kappa coefficient was calculated as 0.709 (P<.05). Statistically significant and acceptable agreement was found between the panoramic and CBCT images (${\kappa}=0.684$ and P<.05). The sensitivity, specificity, diagnostic accuracy rate, the false positive rate, and the false negative rate of the panoramic radiographs were 85.4%, 83.5%, 84.6%, 16.5%, and 14.6%, respectively. Conclusion: In most cases, calcified laryngeal cartilages could be diagnosed on panoramic radiographs. However, due to variation in the calcifications, diagnosis may be difficult.