• Title/Summary/Keyword: Large change sensitivity

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Sonographic Diagnosis of Cervical Lymph Node Metastasis in Patients with Thyroid Cancer and Comparison of European and Korean Guidelines for Stratifying the Risk of Malignant Lymph Node

  • Sae Rom Chung;Jung Hwan Baek;Yun Hwa Rho;Young Jun Choi;Tae-Yon Sung;Dong Eun Song;Tae Yong Kim;Jeong Hyun Lee
    • Korean Journal of Radiology
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    • v.23 no.11
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    • pp.1102-1111
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    • 2022
  • Objective: To evaluate the ultrasonography (US) features for diagnosing metastasis in cervical lymph nodes (LNs) in patients with thyroid cancer and compare the US classification of risk of LN metastasis between European and Korean guidelines. Materials and Methods: From January 2014 to December 2018, US-guided fine-needle aspiration was performed on 836 LNs from 714 patients for the preoperative nodal staging of thyroid cancer. The US features of LNs were retrospectively reviewed for the following features: size, presence of hilum, margin, orientation, cystic change, punctate echogenic foci (PEF), large echogenic foci, eccentric cortical thickening, abnormal vascularity, and cortical hyperechogenicity. A multiple logistic regression analysis was performed to identify the independent US features for the diagnosis of metastatic LNs. The diagnostic performance of independent US features was subsequently evaluated. LNs were categorized according to the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) and European Thyroid Association (ETA) guidelines, and the correlation between the two sets of classifications was assessed. Results: Absence of the hilum, presence of cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity were independent US features of metastatic LNs. Cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity showed high specificity (86.8%-99.6%). The absence of the hilum had the highest sensitivity yet low specificity (66.4%). When LNs were classified according to the ETA guidelines and K-TIRADS, they yielded similar categorizations of malignancy risks and were strongly correlated (Spearman coefficient, 0.9766 [95% confidence interval, 0.973-0.979]). According to the ETA guidelines, 9.8% (82/836) of LNs were classified as "not specified." Conclusion: Absence of hilum, cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity were independent US features suggestive of metastatic LNs in thyroid cancer. Both K-TIRADS and the ETA guidelines provided similar risk stratification for metastatic LNs with a high correlation; however, the ETA guidelines failed to classify 9.8% of LNs into a specific risk stratum. These results may provide a basis for revising LN classification in future guidelines.

Sensitivity of NOx Removal on Recycled TiO2 in Cement Mortar (재생 이산화티탄을 혼입한 모르타르의 NOx 저감률 민감도 분석)

  • Rhee, Inkyu;Kim, Jin-Hee;Kim, Jong-Ho;Roh, Young-Sook
    • Journal of the Korean Recycled Construction Resources Institute
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    • v.4 no.4
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    • pp.388-395
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    • 2016
  • This paper explores the photocatalytic sensitivity of cement mortar incorporated with recycled $TiO_2$ from waste water sludge. Basically, $TiO_2$ cluster sank down slowly to the bottom of cement mortar specimen before setting and hardening process. This leads the mismatch of $TiO_2$ concentration on the top and the bottom faces of a specimen. This poorly dispersed $TiO_2$-cement mortar naturally exhibits poor NOx removal efficiency especially on the top of cementitious structure. In architectural engineering application such as building or housing structures, one can simply filp over from the bottom so that more $TiO_2$ concentrated surface can be placed outward into the air. However, in highway pavement case, this could not be applicable due to in-situ installation of concrete pavement. Hence, the dispersion of $TiO_2$ cluster inside the cementitous material is getting important issue onto road construction application. To elaborate this issue, according to our results, silica fume, high-ranged water reducer, viscosity agent, blast furnace slag were not enhanced much of dispersion characteristics of $TiO_2$ cluster. The combination of foaming agent and accelerator of hardening with viscosity agent and small grain size of fine aggregate may help the dispersion of $TiO_2$ inside cementitious materials. Even though the enhanced dispersion were applied to the specimen, NOx removal efficiency doest not change much for the top surface of the specimen. This concurrently affected by the presence of tiny air voids and the dispersion of $TiO_2$ in that these voids could easily adsorbed NOx gas with the aid of large surface area.

Radioimmunoassay Reagent Survey and Evaluation (검사별 radioimmunoassay시약 조사 및 비교실험)

  • Kim, Ji-Na;An, Jae-seok;Jeon, Young-woo;Yoon, Sang-hyuk;Kim, Yoon-cheol
    • The Korean Journal of Nuclear Medicine Technology
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    • v.25 no.1
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    • pp.34-40
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    • 2021
  • Purpose If a new test is introduced or reagents are changed in the laboratory of a medical institution, the characteristics of the test should be analyzed according to the procedure and the assessment of reagents should be made. However, several necessary conditions must be met to perform all required comparative evaluations, first enough samples should be prepared for each test, and secondly, various reagents applicable to the comparative evaluations must be supplied. Even if enough comparative evaluations have been done, there is a limit to the fact that the data variation for the new reagent represents the overall patient data variation, The fact puts a burden on the laboratory to the change the reagent. Due to these various difficulties, reagent changes in the laboratory are limited. In order to introduce a competitive bid, the institute conducted a full investigation of Radioimmunoassay(RIA) reagents for each test and established the range of reagents available in the laboratory through comparative evaluations. We wanted to share this process. Materials and Methods There are 20 items of tests conducted in our laboratory except for consignment tests. For each test, RIA reagents that can be used were fully investigated with the reference to external quality control report. and the manuals for each reagent were obtained. Each reagent was checked for the manual to check the test method, Incubation time, sample volume needed for the test. After that, the primary selection was made according to whether it was available in this laboratory. The primary selected reagents were supplied with 2kits based on 100tests, and the data correlation test, sensitivity measurement, recovery rate measurement, and dilution test were conducted. The secondary selection was performed according to the results of the comparative evaluation. The reagents that passed the primary and secondary selections were submitted to the competitive bidding list. In the case of reagent is designated as a singular, we submitted a explanatory statement with the data obtained during the primary and secondary selection processes. Results Excluded from the primary selection was the case where TAT was expected to be delayed at the moment, and it was impossible to apply to our equipment due to the large volume of reagents used during the test. In the primary selection, there were five items which only one reagent was available.(squamous cell carcinoma Ag(SCC Ag), β-human chorionic gonadotropin(β-HCG), vitamin B12, folate, free testosterone), two reagents were available(CA19-9, CA125, CA72-4, ferritin, thyroglobulin antibody(TG Ab), microsomal antibody(Mic Ab), thyroid stimulating hormone-receptor-antibody(TSH-R-Ab), calcitonin), three reagents were available (triiodothyronine(T3), Tree T3, Free T4, TSH, intact parathyroid hormone(intact PTH)) and four reagents were available are carcinoembryonic antigen(CEA), TG. In the secondary selection, there were eight items which only one reagent was available.(ferritin, TG, CA19-9, SCC, β-HCG, vitaminB12, folate, free testosterone), two reagents were available(TG Ab, Mic Ab, TSH-R-Ab, CA125, CA72-4, intact PTH, calcitonin), three reagents were available(T3, Tree T3, Free T4, TSH, CEA). Reasons excluded from the secondary selection were the lack of reagent supply for comparative evaluations, the problems with data reproducibility, and the inability to accept data variations. The most problematic part of comparative evaluations was sample collection. It didn't matter if the number of samples requested was large and the capacity needed for the test was small. It was difficult to collect various concentration samples in the case of a small number of tests(100 cases per month or less), and it was difficult to conduct a recovery rate test in the case of a relatively large volume of samples required for a single test(more than 100 uL). In addition, the lack of dilution solution or standard zero material for sensitivity measurement or dilution tests was one of the problems. Conclusion Comparative evaluation for changing test reagents require appropriate preparation time to collect diverse and sufficient samples. In addition, setting the total sample volume and reagent volume range required for comparative evaluations, depending on the sample volume and reagent volume required for one test, will reduce the burden of sample collection and planning for each comparative evaluation.

Dynamic Equilibrium Position Prediction Model for the Confluence Area of Nakdong River (낙동강 합류부 삼각주의 동적 평형 위치 예측 모델: 감천-낙동강 합류점 중심 분석 연구)

  • Minsik Kim;Haein Shin;Wook-Hyun Nahm;Wonsuck Kim
    • Economic and Environmental Geology
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    • v.56 no.4
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    • pp.435-445
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    • 2023
  • A delta is a depositional landform that is formed when sediment transported by a river is deposited in a relatively low-energy environment, such as a lake, sea, or a main channel. Among these, a delta formed at the confluence of rivers has a great importance in river management and research because it has a significant impact on the hydraulic and sedimentological characteristics of the river. Recently, the equilibrium state of the confluence area has been disrupted by large-scale dredging and construction of levees in the Nakdong River. However, due to the natural recovery of the river, the confluence area is returning to its pre-dredging natural state through ongoing sedimentation. The time-series data show that the confluence delta has been steadily growing since the dredging, but once it reaches a certain size, it repeats growth and retreat, and the overall size does not change significantly. In this study, we developed a model to explain the sedimentation-erosion processes in the confluence area based on the assumption that the confluence delta reaches a dynamic equilibrium. The model is based on two fundamental principles: sedimentation due to supply from the tributary and erosion due to the main channel. The erosion coefficient that represents the Nakdong River confluence areas, was obtained using data from the tributaries of the Nakdong River. Sensitivity analyses were conducted using the developed model to understand how the confluence delta responds to changes in the sediment and water discharges of the tributary and the main channel, respectively. We then used annual average discharge of the Nakdong River's tributaries to predict the dynamic equilibrium positions of the confluence deltas. Finally, we conducted a simulation experiment on the development of the Gamcheon-Nakdong River delta using recorded daily discharge. The results showed that even though it is a simple model, it accurately predicted the dynamic equilibrium positions of the confluence deltas in the Nakdong River, including the areas where the delta had not formed, and those where the delta had already formed and predicted the trend of the response of the Gamcheon-Nakdong River delta. However, the actual retreat in the Gamcheon-Nakdong River delta was not captured fully due to errors and limitations in the simplification process. The insights through this study provide basic information on the sediment supply of the Nakdong River through the confluence areas, which can be implemented as a basic model for river maintenance and management.