• Title/Summary/Keyword: Delay Risk

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SonazoidTM versus SonoVue® for Diagnosing Hepatocellular Carcinoma Using Contrast-Enhanced Ultrasound in At-Risk Individuals: A Prospective, Single-Center, Intraindividual, Noninferiority Study

  • Hyo-Jin Kang;Jeong Min Lee;Jeong Hee Yoon;Jeongin Yoo;Yunhee Choi;Ijin Joo;Joon Koo Han
    • Korean Journal of Radiology
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    • v.23 no.11
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    • pp.1067-1077
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    • 2022
  • Objective: To determine whether Sonazoid-enhanced ultrasound (SZUS) was noninferior to SonoVue-enhanced ultrasound (SVUS) in diagnosing hepatocellular carcinoma (HCC) using the same diagnostic criteria. Materials and Methods: This prospective, single-center, noninferiority study (NCT04847726) enrolled 105 at-risk participants (71 male; mean age ± standard deviation, 63 ± 11 years; range, 26-86 years) with treatment-naïve solid hepatic nodules (≥ 1 cm). All participants underwent same-day SZUS (experimental method) and SVUS (control method) for one representative nodule per participant. Images were interpreted by three readers (the operator and two independent readers). All malignancies were diagnosed histopathologically, while the benignity of other lesions was confirmed by follow-up stability or pathology. The primary endpoint was per-lesion diagnostic accuracy for HCC pooled across three readers using the conventional contrast-enhanced ultrasound diagnostic criteria, including arterial phase hyperenhancement followed by mild (assessed within 2 minutes after contrast injection) and late (≥ 60 seconds with a delay of 5 minutes) washout. The noninferiority delta was -10%p. Furthermore, different time delays were compared as washout criteria in SZUS, including delays of 2, 5, and > 10 minutes. Results: A total of 105 lesions (HCCs [n = 61], non-HCC malignancies [n = 19], and benign [n = 25]) were evaluated. Using the 5-minutes washout criterion, per-lesion accuracy of SZUS pooled across the three readers (72.4%; 95% confidence interval [CI], 64.1%-79.3%) was noninferior to that of SVUS (71.4%; 95% CI, 63.1%-78.6%), meeting the statistical criterion for non-inferiority (difference of 0.95%p; 95% CI, -3.8%p-5.7%p). The arterial phase hyperenhancement combined with the 5-minutes washout criterion showed the same sensitivity as that of the > 10-minutes criterion (59.0% vs. 59.0%, p = 0.989), and the specificities were not significantly different (90.9% vs. 86.4%, p = 0.072). Conclusion: SZUS was noninferior to SVUS for diagnosing HCC in at-risk patients using the same diagnostic criteria. No significant improvement in HCC diagnosis was observed by extending the washout time delay from 5 to 10 minutes.

Carotenoids: Functions and Recent Research Progress

  • Yeum, Kyung-Jin
    • Preventive Nutrition and Food Science
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    • v.1 no.2
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    • pp.256-261
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    • 1996
  • Carotenoids are abundant int he Korean food supply. The intake of foods rich in carotenoids appears to be associated with optimal health, and a reduction in the risk of cancer, cardiovascular disease, macular degeneration and cataract formation. Specific dietary carotenoids may be responsible for these specific protective effects. Hydrocarbon carotenoids such as $\alpha$-,$\beta$-carotenes and lycopene may reduce the risk of cancer and heart disease, whereas oxygenated carotenoids, such as lutein and zeaxanthin, may be important in protection of the eye. Dietary carotenoids, such as lutein, cryptoxanthin, $\alpha$-carotene, $\beta$-carotene and lycopene can be readily obtained from the diet, Green leafy vegetables, such as spinach and broccoli, contain both oxygenated and hydrocarbon carotenoids ; yellow or orange vegetables, such as carrots, have high levels of $\alpha$-carotene and $\beta$-carotene ; and tomatoes contain high amounts of lycopene. Besides being important vitamin A sources, provitamin A carotenoids such as $\alpha$-carotene, $\beta$-carotene and cryptoxanthin, participate in the cell defense systems that are associated with radical quenching. Non-provitamin A carotenoids, such as lutein and lycopene, major carotenoids in human plasma, have also been reported to possess strong antioxidant capability. The alteration of dietary sources of carotenoids can modify their levels in the circulation and target tissues, and thus prevent or delay the onset of these chronic diseases.

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Newborn heating screening (신생아 청력장애의 선별검사와 의의)

  • Kim, Lee-Suk
    • Clinical and Experimental Pediatrics
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    • v.50 no.1
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    • pp.7-13
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    • 2007
  • Hearing loss in newborns is the most frequently occurring birth defect. If hearing impaired children are not identified and managed early, it is difficult for many of them to acquire the fundamental language, social and cognitive skills that provide the foundation for later schooling and success in society. All newborns, both high and low risk, should be screened for hearing loss in the birth hospital prior discharge (Universal Newborn Heaing Screening, UNHS). Objective physiologic measures must be used to detect newborns and very young infants with hearing loss. Recent technological developments have produced screening methods and both evoked otoacoustic emission (EOAE) and auditory brainstem response (ABR) have been successfully implemented for UNHS. Audiologic evaluation should be carried out before 3 months of age and infants with confirmed hearing loss should receive intervention before 6 months of age. All infants who pass newborn hearing screening but who have risk indicators for other auditory disorders and/or speech and language delay receive ongoing audiologic surveillance and monitoring for communication development. Infants with sensorineural hearing loss are managed with hearing aids and receive auditory and speech-language rehabilitation therapies. Cochlear implants can be an outstanding option for certain children aged 12 months and older with severe to profound hearing loss who show limited benefit from conventional amplifications.

Corticosteroid-induced Avascular Necrosis of Talus after Cardiac Transplantation (심장이식 후 부신피질호르몬 투여로 인한 거골의 무혈성 괴사 - 1예 보고 -)

  • Park, Hong-Gi;Eom, Gi-Serk
    • Journal of Korean Foot and Ankle Society
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    • v.4 no.2
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    • pp.83-86
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    • 2000
  • A vascular necrosis of the talus has frequently been reported following trauma because talus has no muscle insertions, sixty percent of the surface of the talus is covered by hyaline cartilage, takes only a small area for entrance of a blood supply. Osteonecrosis is also associated with a variety of nontraumatic disorders. There are many indications for steroid usage, patient with rheumatoid arthritis, systemic lupus erythematosus, chronic obstructive pulmonary disease, and status- post renal or cardiac transplantation may be on long- term steroid usage, osteonecrosis may develop. A vascular necrosis of the talus secondary to chronic steroid usage is an unusual case. Delay in detection of osteonecrosis may lead to fragmentation and collapse of the talar body. When pain on range of motion is present and conservative treatment have been exhausted, surgical treatment is indicated, that is, fusion of the ankle joint. However it is important that conservative treatment may prevent its various sequelae with early diagnosis because steroid - treated patients have a more operative risk and increased risk for postoperative infection. We report a rare case of corticosteroid induced avascular necrosis of talus after cardiac transplantation.

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Epidemiology and Prevention of Prostate Cancer in Vietnam

  • Dong, Hoang Van;Lee, Andy H.;Nga, Nguyen Hoai;Quang, Nguyen;Chuyen, Vu Le;Binns, Colin W.
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.22
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    • pp.9747-9751
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    • 2014
  • Prostate cancer is the second most common cancer in men worldwide and a leading cause of mortality. Incidences continues to rise and vary substantially between populations. Although the prevalence of prostate cancer is relatively low in Vietnam, some hospital-based reports have shown an upward trend in recent years. While certain non-modifiable factors such as age, race and genetics are known to be mainly responsible, the literature has also suggested that environmental exposures can delay the onset of this disease. The present study provides a review of the epidemiology of prostate cancer in Vietnam by systematically searching several electronic databases. The results confirm an increasing trend of prostate cancer over the past decade, with age-standardised rate more than doubled from 2.2 per 100,000 men in 2000 to 4.7 per 100,000 men in 2010. However, no study has been found on modifiable risk factors, with the exception of one in vitro experiment that showed the inhibitory effect of garlic on the growth of prostate cancer cells. The lack of epidemiological information poses a difficulty to develop public health interventions to prevent this emerging malignant disease in Vietnam.

A Study on the Importer Security Filing and Additional Carrier Requirements(10+2 rule) in U.S. (미국 관세청의 선적전 추가 보안관련 정보 제출법안(10+2 Rule)에 관한 연구)

  • Song, Seon-Uk
    • International Commerce and Information Review
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    • v.10 no.4
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    • pp.395-416
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    • 2008
  • The advance information for oceangoing cargoes destined to th United States enable CBP to evaluate the potential risk of smuggling WMD and to facilitate the prompt release of legitimate cargo following its arrival in the Unites States. On January 1, 2008, CBP promulgate regulations, also known as 10+2 rule, to require the electronic transmission of additional data elements for improved high-risk targeting, including appropriate security elements of entry data for cargo destined to the United States by vessel prior to loading of such cargo on vessels at foreign seaports. The potential impact to an importer's international supply chain will be as follows ; Firstly, importers will take incremental supply chain costs and filing costs. Secondly, anticipate delay in shipment of containerized cargo. Thirdly, importers could be charged fines if they fail to file and file inaccurate or missing data. Companies exporting to the United States should be interested in 10+2 rule, analyze their current processes and procedures to ensure that they are prepared to handle the additional filing requirements of 10+2 rule. And they should focus on how 10+2 impacts their supply chain in terms of costs and sourcing. They will be necessary to revise service legal agreements with their forwarders, customs brokers or carriers in order to meet filing requirements of 10+2 rule.

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A review of herbal medicines for chemotherapy induced peripheral neuropathy (한약을 이용한 chemotherapy-induced peripheral neuropathy (CIPN) 치료 관련 무작위 배정 임상 시험에 대한 고찰)

  • Park, Bongki
    • Journal of Korean Traditional Oncology
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    • v.21 no.2
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    • pp.51-61
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    • 2016
  • Background : Chemotherapy-induced peripheral neuropathy (CIPN) is a common adverse effect in cancer patients who were exposed to chemotherapy. CIPN impacts on the quality of life and could delay chemotherapy. The aim of this review was to assess the therapeutic effectiveness of herbal medicine in CIPN patients. Methods : Randomized controlled trials (RCTs) were included in this review. We searched MEDLINE, Cochrane database, EMBASE, CNKI, Wanfang and four Korean databases without restrictions on time or language. The risk of bias was assessed using the Cochrane risk of bias tool. Results : Eleven RCTs involving 706 patients met the inclusion criteria. Eleven different herbal medicines were examined in the included trials. Almost RCTs showed insufficiency in the reporting randomization method and allocation concealment. One trial used allocation concealment and a double-blinding method. Five studies reported that participants dropped out of RCTs and conducted an 'as-treated analysis'. One trials reported adverse effects of herbal medicine. In ten of the eleven trials, the use of herbal medicine had shown significant differences in clinical symptoms or nerve conduction velocity. Conclusions : The use of herbal medicines for CIPN showed significant improvements in the management of CIPN. However, conclusions cannot be drawn because of the generally low quality of methodology and low quantity of data for each single herbal medicine. Further rigorous trials are needed.

Clinical Application of the Delayed Procedure in the Distally Based Sural Flap (원위기저비복피판에서 지연처치의 임상적 적용)

  • Yim, Hyung-Woo;Park, Yong-Joon
    • Archives of Plastic Surgery
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    • v.37 no.6
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    • pp.775-778
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    • 2010
  • Purpose: Reconstruction of soft tissue defects with osteomyelitis in the lower third of the leg represents a challenge to plastic surgeons. Moreover, it is more arduous in multimorbid patients. One excellent option for reconstruction of these defects is to use a delayed distally based sural flap. Methods: We successfully used delayed distally based sural flap with a two-step procedure. During the first operation, radical debridement and elevation of flap were performed. The raised flap was fixed again at the donor site. The delay period ranged from seven to ten days. Between August 2008 and July 2009, we underwent operations for five patients using this technique. The size of flap varied from $10{\times}6\;cm$ to $12{\times}14\;cm$. Results: All flaps successfully survived. Partial skin loss of the grafted site was seen in two patients but no further surgical procedure was required for wound healing. Complaints of hypoesthesia on the lateral part of the foot was observed. In a three month follow-up period, hypoesthesia was resolved spontaneously. Conclusion: Delayed procedure improves the viability of distally based sural flap in high risk, critically multimorbid patients. We recommend that, if a two-stage operative approach is required, the delayed procedure should be considered.

Risk Identification and Management Strategies for BIM Projects

  • Ng, Ron C.W.;Cheng, Jack C.P.;Das, Moumita
    • International conference on construction engineering and project management
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    • 2020.12a
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    • pp.103-113
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    • 2020
  • The construction industry is undergoing a digital transformation in which Building Information Modelling (BIM) is a key technology. The potential of BIM in several areas such as design optimization, time management, cost management, and asset management/facility management (AM/FM) is widely acknowledged by the AECO (Architecture, Engineering, Construction, and Operation) industry around the world. However, BIM implementation in construction projects is faced with problems such as project delay and cost overruns. The lack of identification of risks in BIM projects and standard guidelines on mitigation techniques furthers poor performance, dissatisfaction, and disputes between employers and project participants, which results in low BIM adoption rates. Therefore, the objective of this paper is to identify the potential risks in BIM implementation under the primary categories - (1) technical, (2) contractual, (3) management-related, and (4) personnel-related risks in BIM projects and present solutions to reduce, manage, and mitigate risks. To meet the objective of this paper, a survey was designed and conducted in the Hong Kong construction industry in which over 140 respondents from different disciplines, with experience in BIM projects, have participated. Based on the analysis of the survey data, the most severe and frequently occurring BIM risks and their potential mitigation strategies were identified and discussed in this paper.

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Management of Osteoporosis Medication after Osteoporotic Fracture

  • Young Kwang Oh;Nam Hoon Moon;Won Chul Shin
    • Hip & pelvis
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    • v.34 no.4
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    • pp.191-202
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    • 2022
  • The aim of this study was to provide helpful information for use in selection of an appropriate medication after osteoporotic fractures through conduct of a literature review. In addition, a review of the recommendations of several societies for prevention of subsequent fractures was performed and the appropriate choice of medication for treatment of atypical femur fractures was examined. Clinical perspective was obtained and an updated search of literature was conducted across PubMed and MEDLINE and relevant articles were selected. The articles were selected manually according to relevance, and the references for identified articles and reviews were also evaluated for relevance. The following areas are reviewed: Commonly prescribed osteoporosis medications: BPs (bisphosphonates), denosumab, and SERMs (selective estrogen receptor modulators) in antiresorptive medications and recombinant human parathyroid hormone teriparatide, recently approved Romosuzumab in anabolic agents, clinical practice guidelines for the management of osteoporosis, osteoporotic fracture, and atypical femur fracture. Most medications for treatment of osteoporosis do not delay fracture healing and the positive effect of teriparatide on fracture healing has been confirmed. In cases where an osteoporotic fracture is diagnosed, risk assessment should be performed for selection of very high-risk patients in order to prevent subsequent fractures, and administration of anabolic agents is recommended.