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Comparative Efficacy and Safety of Radiofrequency Ablation and Microwave Ablation in the Treatment of Benign Thyroid Nodules: A Systematic Review and Meta-Analysis

  • Hendra Zufry;Timotius Ivan Hariyanto
    • Korean Journal of Radiology
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    • v.25 no.3
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    • pp.301-313
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    • 2024
  • Objective: The current body of evidence lacks clarity regarding the comparative efficacy and safety of radiofrequency ablation (RFA) and microwave ablation (MWA) as minimally invasive treatments for benign thyroid nodules. The primary objective of this study is to clarify these concerns. Materials and Methods: A comprehensive search was conducted using the Cochrane Library, Scopus, Europe PMC, and Medline databases until October 10th, 2023, using a combination of relevant keywords. This study incorporated literature that compared RFA and MWA for benign thyroid nodules. The primary outcome was the volume reduction ratio (VRR) from baseline to follow-up. Secondary outcomes were symptom score, cosmetic score, ablation time, major complications rate, hemorrhage, hoarseness, skin burn, cough, and sympathetic nerve injury. We used Risk of Bias in Non-randomized Studies - of Interventions (ROBINS-I) tool to assess the risk of bias in the included studies. We employed random effects models to analyze the standardized mean difference (SMD) and odds ratio for the presentation of outcomes. Results: Nine studies with 2707 nodules were included. The results of our meta-analysis indicated similar efficacy between RFA and MWA in terms of VRR during the 1 (SMD 0.06; 95% confidence interval [CI]: -0.13 to 0.26; P = 0.52) and 3 (SMD 0.11; 95% CI: -0.03 to 0.25; P = 0.12) months of follow-up. VRR was significantly higher in RFA than in MWA at the 6 (SMD 0.25; 95% CI: 0.06-0.43; P = 0.008) and 12 month of follow-up (SMD 0.38; 95% CI: 0.17 to 0.59; P < 0.001). There were no significant differences between RFA and MWA in symptom scores, cosmetic scores, or the incidence of complications, including hemorrhage, hoarseness, skin burn, cough, and sympathetic nerve injury. Conclusion: RFA showed a higher VRR than MWA at 6 and 12-month follow-ups, with a comparable safety profile.

Efficacy and safety of low-dose naltrexone for the management of fibromyalgia: a systematic review and meta-analysis of randomized controlled trials with trial sequential analysis

  • Akhil Deepak Vatvani;Pratik Patel;Timotius Ivan Hariyanto;Theo Audi Yanto
    • The Korean Journal of Pain
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    • v.37 no.4
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    • pp.367-378
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    • 2024
  • Background: Fibromyalgia is characterized by the presence of chronic widespread pain that may impair patient's quality of life. Currently, the use of naltrexone as a therapeutic agent for fibromyalgia is not supported by enough evidence, especially from randomized controlled trials (RCTs). This study aims to analyze the efficacy and safety of low-dose naltrexone (LDN) for the management of fibromyalgia. Methods: A comprehensive search was conducted on the Scopus, Medline, ClinicalTrials.gov, and Cochrane Library databases up until May 20th, 2024. This review incorporates RCTs that examine the comparison between LDN and placebo in fibromyalgia patients. We employed random-effect models to analyze the odds ratio and mean difference (MD) for presentation of the outcomes. Results: A total of 4 RCTs with 222 fibromyalgia patients were incorporated. The results of our meta-analysis showed a significant reduction in pain scores (MD: -0.86, 95% confidence interval [CI]: -1.20, -0.51, P < 0.001, I2 = 33%) and higher increment in pressure pain threshold (MD: 0.17, 95% CI: 0.08, 0.25, P < 0.001, I2 = 0%) among fibromyalgia patients who received LDN than those who only received a placebo. The fibromyalgia impact questionnaire revised and pain catastrophizing scale did not differ significantly between the two groups. LDN was also associated with higher incidence of vivid dreams and nausea, but showed no significant difference with the placebo in terms of serious adverse events, headache, diarrhea, and dizziness. Conclusions: This study suggests the efficacy of LDN in mitigating pain symptoms for fibromyalgia patients with a relatively good safety profile.

Effective 3-D GPR Survey for the Exploration of Old Remains (유적지 발굴을 위한 효율적 3차원 GPR 탐사)

  • Kim, Jung-Ho;Yi, Myeong-Jong;Son, Jeong-Sul;Cho, Seong-Jun;Park, Sam-Gyu
    • Geophysics and Geophysical Exploration
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    • v.8 no.4
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    • pp.262-269
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    • 2005
  • Since the buried cultural relics are three-dimensional (3-D) objects in nature, 3-D survey is more preferable in archeological exploration. 3-D Ground Penetrating Radar (GPR) survey based on very dense data in principle, however, might need much higher cost and longer time of exploration than other geophysical methods commonly used for the archeological exploration, such as magnetic and electromagnetic methods. We developed a small-scale continuous data acquisition system which consists of two sets of GPR antennas and the precise positioning device tracking the moving-path of GPR antenna automatically and continuously. Since the high cost of field work may be partly attributed to establishing many profile lines, we adopted a concept of data acquisition at arbitrary locations not along the pre-established profile lines. Besides this hardware system, we also developed several software packages in order to effectively process and visualize the 3-D data obtained by the developed system and the data acquisition concept. Using the developed system, we performed 3-D GPR survey to investigate the possible historical remains of Baekje Kingdom at Buyeo city, South Korea, prior to the excavation. Owing to the newly devised system, we could obtain 3-D GPR data of this survey area having areal extent over about $17,000m^2$ within only six-hours field work. Although the GPR data were obtained at random locations not along the pre-established profile lines, we could obtain high-resolution 3-D images showing many distinctive anomalies, which could be interpreted as old agricultural lands, waterways, and artificial structures or remains. This cast: history led us to the conclusion that 3-D GPR method is very useful not only to examine a small anomalous area but also to investigate the wider region of the archeological interests.

Technological Synergy Effect of Business Portfolio : Panel Data Analysis on 50 Largest Chaebols in Korea (사업포트폴리오의 기술시너지효과 :50대 재벌의 패널자료분석)

  • 김태유;박경민
    • Proceedings of the Technology Innovation Conference
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    • 1996.12a
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    • pp.265-295
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    • 1996
  • This paper investigates empirically the relationship between various business portfolio properties (particularly technological properties) and chaebol′s performance using data on the 50 largest chaebols in Korea. In addition to the traditional indexes to measure diversification such as entropy index we calculated inter-industry technological similarity using R&D expenditure data by industry and 1990 Input-output Table in Korea, and obtained chaebol-level technological relatedness and internal transaction proportion from chaebols′business profile, inter-industry technological similarity and 1990 input-output table. We applied factor analysis on 13 business portfolio property indexes and showed that they could be grouped into 3 dimensions, diversification scope, inter-business relatedness and degree of vertical integration. In this paper, using 50 largest chaebols′financial data (1989-1994), we analyzed empirically the effect of business portfolio properties on ROS (Return On Sales) which is conventional index for firm performance and on TFP(Total Factor Productivity) growth which is a pure measure of firm performance. To utilize the advantage of panel data, FEM(Fixed Effect Model) and REM(Random Effect Model) were used. The empirical result shows that the entropy index as a measurement of inter-business relatedness is not significant but technological relatedness index is significant. OLS estimates on pooled data were considerably different from FEM or REM estimates on panel data. By introducing interaction effect among the three variables for business portfolio properties, we obtained three findings. First, only VI (Vertical integration) has a significant positive correlation with ROS. Second, when using TFP growth as an dependent variable, both TR(Technological Relatedness) and f[ are significant and positively related to the deepened variable. Third, the interaction term between TR and VI is significant and negatively affects TFP growth, meaning that TR and VI are substitutes. These results suggest strategic directions on restructuring business portfolio. As VI is increased, chaebols will get more profit. A higher level of either TR or W will increase TFP growth rate. but increase in both TR and VI will have a negative effect on TFP growth. To summarize, certain business portfolio properties such as VI and TR can be considered "resources" themselves since they can affect profit rate and productivity growth. VI and TR have a synergy effect of change in profit rate and productivity growth. VI increases ROS and productivity growth, while TR increases productivity growth representing a technological synergy effect.

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Mband characterization of a cultivar "DanBi 5Ho" with a long shelf life (큰느타리버섯 단핵균주 간 교잡에 의한 저장우수형 품종 "단비5호" 육성 및 특성)

  • Lee, Young-Han;Kim, Ya-El;Seuk, Su-Won;Jeong, Jeong-Min;Ryu, Jae-San;Heo, Jae-Young;Kim, Hee-Dae;Choe, Yong-Jo;Kim, Min-Keun
    • Journal of Mushroom
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    • v.14 no.2
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    • pp.64-69
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    • 2016
  • Pleurotus eryngii is one of the most widely cultivated and important edible mushrooms. However, the shelf life of the fruiting body is short, which. To solve this problem, a new cultivar, DanBi 5Ho, of Pleurotus eryngii was developed by mono-mono crossing between monokaryotic strains derived from KNR2598 and KNR2610. The optimum temperature formycelial growth was 25 and that forfruiting body development was 15-16. The quality did not change after a period of 40.0 d at 4. This result was significantly different compared to that ofthe control strain Knneuari 2 Ho. Analysis of genetic characteristics of the new hybrid strain DanBi 5Ho revealeda different profile thanthat of the parental and control strains when random amplification of polymorphic DNA (RAPD) primers we used. The results obtained from this study show that DanBi 5Ho is a new hybrid strain, characterized by improved storability after harvesting.

Effect of Conjugated Linoleic Acid Feeding on the Growth Performance and Meat Fatty Acid Profiles in Broiler: Meta-analysis

  • Cho, Sangbuem;Ryu, Chaehwa;Yang, Jinho;Mbiriri, David Tinotenda;Choi, Chang-Weon;Chae, Jung-Il;Kim, Young-Hoon;Shim, Kwan-Seob;Kim, Young Jun;Choi, Nag-Jin
    • Asian-Australasian Journal of Animal Sciences
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    • v.26 no.7
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    • pp.995-1002
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    • 2013
  • The effect of conjugated linoleic acid (CLA) feeding on growth performance and fatty acid profiles in thigh meat of broiler chicken was investigated using meta-analysis with a total of 9 studies. Overall effects were calculated by standardized mean differences between treatment (CLA fed) and control using Hedges's adjusted g from fixed and random effect models. Meta-regression was conducted to evaluate the effect of CLA levels. Subgroups in the same study were designated according to used levels of CLA, CP levels or substituted oils in diets. The effects on final body weight, weight gain, feed intake and feed conversion ratio were investigated as growth parameters. Total saturated and unsaturated fatty acid concentrations and C16:0, C18:0, C18:2 and C18:3 concentrations in thigh meat of broiler chicken were used as fatty acid profile parameters. The overall effect of CLA feeding on final weight was negative and it was only significant in fixed effect model (p<0.01). Significantly lower weight gain, feed intake and higher feed conversion ratio compared to control were found (p<0.05). CLA feeding on the overall increased total saturated fatty acid concentration in broilers compared to the control diet (p<0.01). Total unsaturated fatty acid concentration was significantly decreased by CLA feeding (p<0.01). As for individual fatty acid profiles, C16:0, C18:0 and C18:3 were increased and C18:2 was significantly decreased by CLA feeding (p<0.01). In conclusion, CLA was proved not to be beneficial for improving growth performance, whereas it might be supposed that CLA is effective modulating n-6/n-3 fatty acids ratio in thigh meat. However, the economical compensation of the loss from suppressed growth performance and increased saturated fatty acids with the benefit from enhanced n-6/n-3 ratio should be investigated in further studies in order to propose an appropriate use of dietary CLA in the broiler industry.

Characterization of a New Cultivar "Dan Bi" by Mono-mono Hybridization in Pleurotus eryngii (단핵균주간 교잡에 의한 큰느타리버섯 신품종 "단비"의 특성)

  • Kim, Min-Keun;Ryu, Jae-San;Yoo, Young-Bok
    • The Korean Journal of Mycology
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    • v.39 no.1
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    • pp.39-43
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    • 2011
  • A new cultivar "Dan Bi" of Pleurotus eryngii was developed by the method of mono-mono crossing between monokaryotic strains derived from KNR2312 and KNR2596. The parental strains, KNR2312 and KNR2596, are characterized by the property of high quality and a small number of primordia formation, respectively. The optimum temperature of mycelial growth was 25 and that of fruiting body development was $15{\sim}16^{\circ}C$. The period of harvesting including primordia formation was 0.7~1.3 days later than that of control strain Knneutari No. 3 in the culling cultivation. The color of pileus and stipe surface was neutral-brown and pure white, respectively. The shape of pileus was dome and has a scale like as cobweb. The yield was $93{\pm}9.7$ g per 850 cc of plastic bottle. Analysis of the genetic characteristics of the new commercial variety "Dan Bi" showed a different profile as that of the control strain, Knneutari No. 3, when RAPD (Random Amplified Polymorphic DNA) primer #8005 was used. This new variety "Dan Bi" of Pleurotus eryngii is characterized by a small number of primordia formation after scratching.

Characterization of a new variety Auricularia polytricha (Mont.) Sacc.'Geoni' (털목이 신품종 '건이')

  • Kim, Kil-Ja;Lee, Sook-Jae;Kim, Myeong-Seok;An, Ho-Sub;Kim, Dong-Gwan;Kwon, Oh-Do;Park, Heung-Gyu
    • Journal of Mushroom
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    • v.14 no.4
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    • pp.211-214
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    • 2016
  • Geoni, a new variety of Auricularia polytricha, was bred in JARES(Jeollanamdo Agricultural Research and Extension Services) in 2012. Geoni was selected through the monospore hybridization with JNM21008 and JNM21014 in 2010. Based on a performance test conducted from 2011 to 2012, the Geoni was selected from a line showing an excellent light brown pileus and strong pest resistance. Geoni has a favorable chewiness, light brown and smooth pileus. In addition, Geoni was rich in dietary fiber. MCM(mushroom complete medium), Malt and PDA(Potato Dextrose Agar) mediums were suitable for cultivating the Geoni. The number of effective stipes was 39 ea/0.9 kg and minor axis and major axis of pileus were 6.9 cm and 8.7 cm respectively. The yield of Geoni was 291 g/0.9 kg in plastic bag. Geoni was required 40~54 days for culture at $20^{\circ}C$ and 24days for the primordia and growth period, which is longer than that of the control(Pung-un). Somatic incompatibility was formed between parental strains and Geoni. Analysis of the genetic diversity of the new variety "Geoni"revealed a different profile from the parental strains when RAPD(random Amplified Polymorphic DNA) primers were used.

Creation of an Environmental Forest as an Ecological Restoration

  • Lee, Chang-Seok;You, Young-Han
    • The Korean Journal of Ecology
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    • v.24 no.2
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    • pp.101-109
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    • 2001
  • We created an environmental forest on the basis of ecological design around the incineration plant of Jindo Engineering and Construction Co., Ltd., which is located in Jeongwang-dong, Siheung-si, Kyunggi-do. To get ecological information of this site, physico-chemical properties of soil on salt marsh, which is located close to the syudy site and of forest soil transported from other sites for ecological restoration were analyzed. Texture of salt marsh and transported soils were loam and sandy loam, respectively. pH, organic matter, T-N, available P, and exchangeable K and Na contents of salt marsh and transported forest soils were 6.7 and 5.4, 4.1 and 0.4%, 1.0 and 0.3mg/g, 46.7 and 6.8ppm, 521 and 207ppm, and 3.8 and 0.5mg/g, respectively. Introduced plants were selected among the dominant species of forests and the species composing the potential natural vegetation around the present study site. Those plants were selected again by considering the tolerances to air pollution and to salt, and their availability. Selected trees were Pinus thunbergii, Sophora japonica, Celtis sinensis, Quercus aliena, Q. serrata, Q. dentata, and Q. acutissima. Selected sub-trees were Albizzia julibrissin, Koelreuteria poniculata, and Styrax japonica and shrubs were Rhododendron yedoense var. poukhanense, R. mucronulatum, Callicarpa japonica, Euonymus alatus, E. japonica, and R. schlippenbachii. On the other hand, introduction of herbs was not considered except for Liriope platyphylla, which was ornamentally planted in one site. Planting bed of mound type was adopted to provide the fine drainage system. Mound was designed to furnish litter, A, B, and C layers simuating the profile of forest soil. Slope of mound was mulched by rice straw of 2cm in thickness to prevent for sliding of litter and soil in cases of strong wind or heavy rain. Height of mound was designed to secure more than 1 m by combining A and B layers. Narrow zones, in which mound with stable slope degree cannot be prepared, was designed to equip the standard soil depth with the introduction of stone for supporting. On the other hand, plants with shallow root system were arranged in some zones, in which satisfactory soil depth cannot be ensured. Plants were arranged in the order of tree, sub-tree, and shrub from center to edge on the mound to make a mature forest of a dome shape in the future. Dispersion of plants was designed to be random pattern rather than clumped one. Problems on creation of the environmental forest by such ecological design were found to be management or inspection by non-specialized project operators and inspecting officers, and regulations for construction without ecological background. Alternative plans to solve such problems were suggested.

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Dynamic Control Allocation for Shaping Spacecraft Attitude Control Command

  • Choi, Yoon-Hyuk;Bang, Hyo-Choong
    • International Journal of Aeronautical and Space Sciences
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    • v.8 no.1
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    • pp.10-20
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    • 2007
  • For spacecraft attitude control, reaction wheel (RW) steering laws with more than three wheels for three-axis attitude control can be derived by using a control allocation (CA) approach.1-2 The CA technique deals with a problem of distributing a given control demand to available sets of actuators.3-4 There are many references for CA with applications to aerospace systems. For spacecraft, the control torque command for three body-fixed reference frames can be constructed by a combination of multiple wheels, usually four-wheel pyramid sets. Multi-wheel configurations can be exploited to satisfy a body-axis control torque requirement while satisfying objectives such as minimum control energy.1-2 In general, the reaction wheel steering laws determine required torque command for each wheel in the form of matrix pseudo-inverse. In general, the attitude control command is generated in the form of a feedback control. The spacecraft body angular rate measured by gyros is used to estimate angular displacement also.⁵ Combination of the body angular rate and attitude parameters such as quaternion and MRPs(Modified Rodrigues Parameters) is typically used in synthesizing the control command which should be produced by RWs.¹ The attitude sensor signals are usually corrupted by noise; gyros tend to contain errors such as drift and random noise. The attitude determination system can estimate such errors, and provide best true signals for feedback control.⁶ Even if the attitude determination system, for instance, sophisticated algorithm such as the EKF(Extended Kalman Filter) algorithm⁶, can eliminate the errors efficiently, it is quite probable that the control command still contains noise sources. The noise and/or other high frequency components in the control command would cause the wheel speed to change in an undesirable manner. The closed-loop system, governed by the feedback control law, is also directly affected by the noise due to imperfect sensor characteristics. The noise components in the sensor signal should be mitigated so that the control command is isolated from the noise effect. This can be done by adding a filter to the sensor output or preventing rapid change in the control command. Dynamic control allocation(DCA), recently studied by Härkegård, is to distribute the control command in the sense of dynamics⁴: the allocation is made over a certain time interval, not a fixed time instant. The dynamic behavior of the control command is taken into account in the course of distributing the control command. Not only the control command requirement, but also variation of the control command over a sampling interval is included in the performance criterion to be optimized. The result is a control command in the form of a finite difference equation over the given time interval.⁴ It results in a filter dynamics by taking the previous control command into account for the synthesis of current control command. Stability of the proposed dynamic control allocation (CA) approach was proved to ensure the control command is bounded at the steady-state. In this study, we extended the results presented in Ref. 4 by adding a two-step dynamic CA term in deriving the control allocation law. Also, the strict equality constraint, between the virtual and actual control inputs, is relaxed in order to construct control command with a smooth profile. The proposed DCA technique is applied to a spacecraft attitude control problem. The sensor noise and/or irregular signals, which are existent in most of spacecraft attitude sensors, can be handled effectively by the proposed approach.