Purpose This study aimed to evaluate the efficacy and safety of transcatheter arterial embolization (TAE) for bleeding due to uterine body cancer. Materials and Methods In this retrospective study, six patients with varying types of uterine body cancer who underwent TAE for bleeding control were investigated. Angiographic findings, cross-sectional images, TAE details, and clinical outcomes were studied. Technical and clinical success rates were calculated. Results The identified patients had endometrioid adenocarcinoma, sarcoma, and gestational trophoblastic neoplasia, and most were patients with advanced-stage cancer. In four patients, tumor bleeding presented as vaginal bleeding. Technical success was achieved in all seven TAE procedures in six patients. Two patients with recurrent masses who had undergone hysterectomy presented with hematochezia, and TAE was able to provide technical success in these patients as well. The clinical success rate was 50%, indicating bleeding control for > 1 week. Rebleeding was directly associated with death in one patient. On the following day, mild fever was observed in one patient. Conclusion TAE can be considered an effective and safe method of bleeding control for uterine body cancer, especially during critical periods throughout the disease course of patients with inoperable, advanced-stage cancer.
Objectives: This study examined the intake of energy and macronutrients among elementary, middle, and high school students according to household income before the COVID-19 pandemic (2016-2019), during the social distancing period (2020-2021), and after the social distancing measures were lifted (2022). Methods: We included 5,217 students aged 5-18 from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted between 2016 and 2022. Dietary intake was assessed using one-day 24-hour dietary recalls. We estimated the least squares means (LS-means) of intake according to household income for each period using a weighted linear regression model, adjusted for age and sex. Differences in LS-means between the periods were analyzed using the t-test. Results: During the social distancing period, the LS-means of energy intake among students decreased significantly by 143.2 kcal/day compared to pre-pandemic levels (P < 0.001). Students from low-income households experienced a more pronounced decrease in energy intake (-379.1 kcal/day, P < 0.001) and macronutrient intake compared to those from other income groups. Energy intake at school significantly declined for all income groups during the social distancing period compared to before the pandemic. No significant changes in home energy intake were observed among low-income students, whereas there was an increase for students from higher-income groups. Before the pandemic, 8.5% of students from low-income households reported insufficient food due to economic difficulties; this figure rose to 21.3% during the pandemic. Conclusions: During the pandemic, students from low-income families experienced significantly lower intake of energy and macronutrients compared to pre-pandemic levels. The most substantial reductions were noted among low-income students, largely due to the lack of compensation for decreased school-based intake with increased intake at home.
Loi Van Le;Quang Van Vu;Thanh Van Le;Hieu Trung Le;Khue Kim Dang;Tuan Ngoc Vu;Anh Hoang Ngoc Nguyen;Thang Manh Tran
Annals of Hepato-Biliary-Pancreatic Surgery
/
v.28
no.1
/
pp.42-47
/
2024
Backgrounds/Aims: Hepatolithiasis and choledocholithiasis are frequent pathologies and unfortunately, with the current treatment strategies, the recurrence incidence is still high. This study aimed to assess the outcomes of laparoscopic choledochotomy using cholangioscopy via the percutaneous-choledochal tube for the treatment of hepatolithiasis and choledocholithiasis in Vietnamese patients. Methods: A cross-sectional study of patients with hepatolithiasis and/or choledocholithiasis who underwent laparoscopic choledochotomy using intraoperative cholangioscopy via percutaneous-choledochal tube at the Department of Hepatopancreatobiliary Surgery, 108 Military Central Hospital, from June 2017 to March 2020. Results: A total of 84 patients were analyzed. Most patients were females (56.0%) with a median age of 55.56 years. Among them, 41.8% of patients had previous abdominal operations, with 33.4% having choledochotomy. All patients underwent successful laparoscopic common bile duct exploration followed by T-tube drainage without needing to convert to open surgery. Most patients (64.3%) had both intrahepatic and extrahepatic stones. The rate of stones ≥ 10 mm in diameter was 64.3%. Biliary strictures were observed in 19.1% of patients during cholangioscopy. Complete removal of stones was achieved in 54.8% of patients. Intraoperative complications were encountered in two patients, but there was no need to change the strategy. The mean operating time was 121.85 ± 30.47 minutes. The early postoperative complication rate was 9.6%, and all patients were managed conservatively. The residual stones were removed through the T-tube tract by subsequent choledochoscopy in 34/38 patients, so the total success rate was 95.2%. Conclusions: Laparoscopic choledochotomy combined with cholangioscopy through the percutaneous-choledochal tube is a safe and effective strategy for hepatolithiasis and/or choledocholithiasis, even in patients with a previous choledochotomy.
Purpose: To date, there is no region-specific guideline for pediatric endoscopy training. This study aimed to illustrate the current status of pediatric endoscopy training in Asia-Pacific region and identify opportunities for improvement. Methods: A cross-sectional survey, using a standardized electronic questionnaire, was conducted among medical schools in the Asia-Pacific region in January 2024. Results: A total of 57 medical centers in 12 countries offering formal Pediatric Gastroenterology training programs participated in this regional survey. More than 75% of the centers had an average case load of <10 cases per week for both diagnostic and therapeutic endoscopies. Only 36% of the study programs employed competency-based outcomes for program development, whereas nearly half (48%) used volume-based curricula. Foreign body retrieval, polypectomy, percutaneous endoscopic gastrostomy, and esophageal variceal hemostasis, that is, sclerotherapy or band ligation (endoscopic variceal sclerotherapy and endoscopic variceal ligation), comprised the top four priorities that the trainees should acquire in the autonomous stage (unconscious) of competence. Regarding the learning environment, only 31.5% provided formal hands-on workshops/simulation training. The direct observation of procedural skills was the most commonly used assessment method. The application of a quality assurance (QA) system in both educational and patient care (Pediatric Endoscopy Quality Improvement Network) aspects was present in only 28% and 17% of the centers, respectively. Conclusion: Compared with Western academic societies, the limited availability of cases remains a major concern. To close this gap, simulation and adult endoscopy training are essential. The implementation of reliable and valid assessment tools and QA systems can lead to significant development in future programs.
Background/Aims: This study aims to compare polyp detection performance of "Deep-GI," a newly developed artificial intelligence (AI) model, to a previously validated AI model computer-aided polyp detection (CADe) using various false positive (FP) thresholds and determining the best threshold for each model. Methods: Colonoscopy videos were collected prospectively and reviewed by three expert endoscopists (gold standard), trainees, CADe (CAD EYE; Fujifilm Corp.), and Deep-GI. Polyp detection sensitivity (PDS), polyp miss rates (PMR), and false-positive alarm rates (FPR) were compared among the three groups using different FP thresholds for the duration of bounding boxes appearing on the screen. Results: In total, 170 colonoscopy videos were used in this study. Deep-GI showed the highest PDS (99.4% vs. 85.4% vs. 66.7%, p<0.01) and the lowest PMR (0.6% vs. 14.6% vs. 33.3%, p<0.01) when compared to CADe and trainees, respectively. Compared to CADe, Deep-GI demonstrated lower FPR at FP thresholds of ≥0.5 (12.1 vs. 22.4) and ≥1 second (4.4 vs. 6.8) (both p<0.05). However, when the threshold was raised to ≥1.5 seconds, the FPR became comparable (2 vs. 2.4, p=0.3), while the PMR increased from 2% to 10%. Conclusions: Compared to CADe, Deep-GI demonstrated a higher PDS with significantly lower FPR at ≥0.5- and ≥1-second thresholds. At the ≥1.5-second threshold, both systems showed comparable FPR with increased PMR.
Research into optical signal processing using photonic integrated circuits (PICs) has been actively pursued in various fields, including optical communication, optical sensors, and quantum optics. Among the materials used in PIC fabrication, polymers have attracted significant interest due to their unique characteristics. To fabricate polymer-based PICs, establishing an accurate manufacturing process for the cross-sectional structure of an optical waveguide is crucial. For stable device performance and high yield in mass production, a process with high reproducibility and a wide tolerance for variation is necessary. This study proposes an efficient method for fabricating polymer optical-waveguide devices by introducing the atomic layer deposition (ALD) process. Compared to conventional photoresist or metal-film deposition methods, the ALD process enables more precise fabrication of the optical waveguide's core structure. Polyimide optical waveguides with a core size of 1.8 × 1.6 ㎛2 are fabricated using the ALD process, and their propagation losses are measured. Additionally, a multimode interference (MMI) optical-waveguide power-splitter device is fabricated and characterized. Throughout the fabrication, no cracking issues are observed in the etching-mask layer, the vertical profiles of the waveguide patterns are excellent, and the propagation loss is below 1.5 dB/cm. These results confirm that the ALD process is a suitable method for the mass production of high-quality polymer photonic devices.
BACKGROUND/OBJECTIVES: The study examined the association between homocysteine and diabetes mellitus in patients with H-type hypertension and assessed the possible effect modifiers. SUBJECTS/METHODS: This cross-sectional study included 1,255 eligible participants in the 'H-type Hypertension Management and Stroke Prevention Strategic International Science and Technology Innovation Cooperation Project' among rural Chinese people with H-type hypertension. A multivariate logistic regression model was used to evaluate the relationship between homocysteine and diabetes mellitus. RESULTS: The mean level of total homocysteine (tHcy) in the diabetes mellitus population was 19.37 μmol/L, which was significantly higher than the non-diabetic patients (18.18 μmol/L). When tHcy was analyzed as a continuous variable, the odds ratio (OR) of diabetes was 1.17 (95% confidence interval [CI], 1.01-1.35; per interquartile range). When tHcy was stratified according to the quintile, the ORs for diabetes were 2.86 (95% CI, 1.22-6.69) in the highest quintile (tHcy ≥ 20.60 μmol/L) compared to the reference group (tHcy < 12.04 μmol/L). When tHcy was grouped by 15 μmol/L and 20 μmol/L, patients with tHcy ≥ 20 μmol/L had a significantly (P = 0.037) higher risk of diabetes (OR, 2.03; 95% CI, 1.04-3.96) than in those with tHcy < 15 μmol/L. Subgroup analysis showed that the tHcy-diabetes association was unaffected by other variables. CONCLUSION: In this study of rural Chinese people with H-type hypertension, the tHcy levels showed a positive association with diabetes mellitus. This independent association is unaffected by other potential risk factors.
The present study examines the dual mediating role of social support and self-esteem in the relationship between grit and life satisfaction among college students. Utilizing a cross-sectional design, we surveyed a sample of 326 undergraduates from one university in China by means of purposive sampling. The analyses were conducted using SPSS PC+ Win. ver. 25.0 and SPSS PROCESS macro ver. 4.2. Pearson's correlation analysis was performed to show the correlations among the variables, and Model 6 of the PROCESS macro for SPSS was used to verify dual mediation effects. First, correlation results indicated positive and significant correlations between grit, social support, self-esteem and life satisfaction. Second, the dual mediating role of social support and self-esteem in the relationship between grit and life satisfaction was proved. This study contributes to the literature by elucidating the psychological mechanisms through which grit operates to enhance life satisfaction. The results have implications for the development of interventions aimed at fostering grit and the enhancement of social support and self-esteem to improve life satisfaction. Suggestions for future studies were discussed in detail.
The objective of this study is to establish the number of erupted $1^{st}$ molar, the age. sex and somatic measures of weight and height in population of Chungcheongnam-do, South Korea based cross sectional study. The consistent and complete data were obtained from 441 children with age of six. SPSS 12.0 was used for various statistical analyses including descriptive, cross tabulation, correlation and regression. Results demonstrates that variation of the number of the erupted $1^{st}$ molar was explained by age($x^2$(df)=117.68), height($x^2$(df=59.74) and weight($x^2$(df)=31.69) of children (P<.001). The study also showed the strong correlation among erupted $1^{st}$ molar rate, age, height and weight (p<.01). Numerical values of correlation among those are following: r = .45 between Erupted $1^{st}$ molar rate and age; r = .31 between erupted $1^{st}$ molar rate and height; r = .24 between erupted $1^{st}$ molar rate and weight; r = .40 between age and weight; r = .24 between age and height; r = .54 between height and weight. It was concluded that above variables influences one another and the age of the children is the greatest variable that influences the number of erupted $1^{st}$ molar, followed by height and weight of the children.
Traffic accident fatalities in Korea in 2016 was 4,292 and 1,732 cases were deaths of elderly people. In spite of this, the researches on behaviors of the elderly when crossing roads, are rather limited. The purpose of this study is to investigate and analyze road crossing behavior characteristics of the elderly, when crossing roads, especially focusing on the characteristics of pedestrians and vehicles. Cross-sectional data was collected from six different sites in two regions and the following results was identified. First, at road crossings, 528 cases(84.3%) out of 626 conflict situations of the elderly and 303 cases(63.3%) out of 478 conflict situations of the non-elderly pedestrians were found to be dangerous, respectively. The elderly tend to face a statistically significant risk of 3.11 times higher than that of non-elderly people. Second, 519 cases(82.9%) of jaywalking occurred in 626 conflict cases of the elderly and 375 cases(78.5%) of jaywalking in 478 conflict events of non-elderly persons, which indicates the elderly's 1.34 times higher trend compared with the non-elderly's. Third, the pedestrian safety margin (PSM) analysis showed that the PSM of the elderly and the non-elderly were 3.33 seconds and 4.04 seconds respectively, which is 17.5% high. Fourth, the difference in pedestrian safety interval was examined by dividing the speed of approaching vehicle into less than 30km/h, above 30km/h and less than 50km/h, and over 50km/h. There was no significant difference between the PSM of coming vehicles with the speed less than 30km/h and the PSM of approaching with the speed 30km/h~50km/h, but the conflicts with vehicle of the speed above 50km/h show significantly lower PSM than with vehicle speed of 30km/h~50km/h. Finally, when the risk threshold is set to less than 2.5 seconds, the analysis shows that older pedestrians tend to cross roads dangerously 1.59~2.53 times than younger pedestrians. The results set forth here can be used as a basis for constructing the elderly safety measures at present and a potential basis for autonomous vehicle safety application in the future for solving the issue of the difference in crossing behavior between elderly and non-elderly pedestrians.
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