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An analysis of 77 cases of pancreatic injuries at a level one trauma center: Outcomes of conservative and surgical treatments

  • Harbi Khalayleh;Ashraf Imam;Oded Cohen-Arazi;Pikkel Yoav;Brigitte Helou;Bala Miklosh;Alon J. Pikarsky;Abed Khalaileh
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.2
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    • pp.190-198
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    • 2022
  • Backgrounds/Aims: Traumatic pancreatic injury (TPI) is rare as an isolated injury. There is a trend to perform conservative treatment even in patients with complete duct dissection and successful treatment. This study reviewed our 20 years of experience in the management of TPI and assessed patient outcomes according to age group and treatment strategy. Methods: A retrospective analysis of patients diagnosed and treated with TPI at a level-I trauma center from 2000-2019. Patients were divided into two groups: adults and pediatrics. Conservative treatment cases were subjected to subgroup analysis. Level of evidence: IV. Results: Of a total of 77 patients, the mean age was 24.89 ± 15.88 years. Fifty-six (72.7%) patients had blunt trauma with motor vehicle accident. Blunt trauma was the predominant mechanism in 42 (54.5%) patients. Overall, 38 (49.4%) cases had grade I or II injury, 24 (31.2%) had grade III injury, and 15 (19.5%) had grade IV injury. A total of 30 cases had non-operative management (NOM). Successful NOM was observed in 16 (20.8%) cases, including eight (32.0%) pediatric cases and eight (15.4%) adult cases. Higher American association for the surgery of trauma (AAST) grade of injury was associated with NOM failure (16.7% for grade I/II, 100% for grade III, and 66.7% for grade IV injury; p = 0.001). An independent factor for NOM failure was female sex (69.2% in females vs. 29.4% in males; p = 0.03). Conclusions: High AAST grade TPI is associated with a high rate of NOM failure in both pediatric and adults.

Fetal Interventricular Septum Volume Evaluated by Three-Dimensional Ultrasound Using Spatiotemporal Image Correlation and Virtual Organ Computer-Aided Analysis in Fetuses From Pre-Gestational Diabetes Mellitus Pregnant Women

  • Nathalie Jeanne Bravo-Valenzuela;Alberto Borges Peixoto;Rosiane Mattar;Edward Araujo Junior
    • Journal of Cardiovascular Imaging
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    • v.30 no.2
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    • pp.125-134
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    • 2022
  • BACKGROUND: To assess the interventricular septum (IVS) volume of fetuses from pre-gestational diabetes mellitus (DM) pregnant women by 3-dimensional ultrasound using spatiotemporal image correlation (STIC) and virtual organ computer-aided analysis (VOCAL) methods. METHODS: This was a prospective cross-sectional study of 45 fetuses from pre-gestational DM and 45 fetuses from healthy pregnant women (controls). Only singleton pregnancies between 20 and 34 + 6 weeks of gestation were included. The fetal IVS volumes were obtained off-line using STIC and VOCAL methods. To analyze differences among variables, the Student's t-test and Mann-Whitney U test were used. The correlation among continuous variables was determine using Spearman's correlation test (r). RESULTS: The median of fetal IVS volume was significantly higher in pre-gestational DM than in healthy pregnant women (0.3 cm3 vs. 0.2 cm3, p = 0.032). A strong positive correlation was observed between fetal IVS volume and gestational age at the time of ultrasound examination (r = 0.75, R2 = 0.48, p < 0.0001) and between fetal IVS volume and estimated fetal weight (r = 0.63, R2 = 0.37, p < 0.0001). No significant correlation was noted between fetal IVS volume and glycated hemoglobin levels (r = -0.16, R2 = 0.01, p = 0.540) in the pre-gestational DM pregnant women. CONCLUSIONS: Significant differences were observed in fetal IVS volumes between pre-gestational and healthy mothers, with higher values in the fetuses of pre-gestational DM pregnant women.

A Nomogram Using Imaging Features to Predict Ipsilateral Breast Tumor Recurrence After Breast-Conserving Surgery for Ductal Carcinoma In Situ

  • Bo Hwa Choi;Soohee Kang;Nariya Cho;Soo-Yeon Kim
    • Korean Journal of Radiology
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    • v.25 no.10
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    • pp.876-886
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    • 2024
  • Objective: To develop a nomogram that integrates clinical-pathologic and imaging variables to predict ipsilateral breast tumor recurrence (IBTR) in women with ductal carcinoma in situ (DCIS) treated with breast-conserving surgery (BCS). Materials and Methods: This retrospective study included consecutive women with DCIS who underwent BCS at two hospitals. Patients who underwent BCS between 2003 and 2016 in one hospital and between 2005 and 2013 in another were classified into development and validation cohorts, respectively. Twelve clinical-pathologic variables (age, family history, initial presentation, nuclear grade, necrosis, margin width, number of excisions, DCIS size, estrogen receptor, progesterone receptor, radiation therapy, and endocrine therapy) and six mammography and ultrasound variables (breast density, detection modality, mammography and ultrasound patterns, morphology and distribution of calcifications) were analyzed. A nomogram for predicting 10-year IBTR probabilities was constructed using the variables associated with IBTR identified from the Cox proportional hazard regression analysis in the development cohort. The performance of the developed nomogram was evaluated in the external validation cohort using a calibration plot and 10-year area under the receiver operating characteristic curve (AUROC) and compared with the Memorial Sloan-Kettering Cancer Center (MSKCC) nomogram. Results: The development cohort included 702 women (median age [interquartile range], 50 [44-56] years), of whom 30 (4%) women experienced IBTR. The validation cohort included 182 women (48 [43-54] years), 18 (10%) of whom developed IBTR. A nomogram was constructed using three clinical-pathologic variables (age, margin, and use of adjuvant radiation therapy) and two mammographic variables (breast density and calcification morphology). The nomogram was appropriately calibrated and demonstrated a comparable 10-year AUROC to the MSKCC nomogram (0.73 vs. 0.66, P = 0.534) in the validation cohort. Conclusion: Our nomogram provided individualized risk estimates for women with DCIS treated with BCS, demonstrating a discriminative ability comparable to that of the MSKCC nomogram.

Preparation of sputter-deposited CuOx thin film with p-type conductivity and application as thin film transistor

  • So Jeong Park;Eui-Jung Yun
    • Journal of the Korean Physical Society
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    • v.81
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    • pp.867-875
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    • 2022
  • This paper explored the effect of deposition conditions on the characteristics of copper oxide (CuOx) thin films prepared by direct current (DC) magnetron sputtering. X-ray diffraction exhibited that CuO with n-type conductivity was the main composition regardless of the DC magnetron sputtering power whereas the phase transition from n-type CuO to p-type Cu2O was observed with decreasing the oxygen pressure (OP) from 40 to 20%. The optical band gap ranges of 1.6-1.9 eV, which are characteristic of n-type CuO, were determined for samples prepared with OPs of 30-40% while the optical band gap of 2.3 eV, which is characteristic of p-type Cu2O, was measured for samples prepared with an OP of 20%. In addition, only Cu+ X-ray photoelectron spectroscopy (XPS) peak at the ~932.6 eV position exists in the films deposited with an OP of 20%, whereas only Cu2+ XPS peaks at ~934.2 eV and in the range of 940-945 eV are observed in the films deposited with an OP of 40%. Furthermore, as a result of XPS depth profile analysis, it was confirmed that the composition ratio of the sample prepared at an OP of 20% was Cu2O, whereas the composition ratio of the sample prepared at an OP of 40% was CuO. These suggest that the CuOx thin films could be constantly converted from n-type CuO to p-type Cu2O by decreasing the oxygen partial pressure. Thin film transistors with Cu2O deposited at 20% OP revealed p-type characteristics such as onset voltage (VON) of -3 V, saturated hole mobility of 8 cm2/Vs at VGS = -28 V, subthreshold swing of 0.86 V/decade at VGS-VON = -0.5 V, and on/off ratio of 1.14 × 103.

Comparison of Effect of Hip-dominant vs Knee-dominant Hamstring Strengthening Exercises on the Muscle Strength, Range of Movement, and Functional Performance Level: A Randomized Intervention Trial (엉덩관절-우세 넙다리뒤근 운동과 무릎관절-우세 넙다리뒤근 운동이 넙다리뒤근 근력과 관절가동범위, 기능적 수행 수준에 미치는 영향 비교: 무작위 중재 시험)

  • Hyun Kim;Jin-taek Kim;Suhn-yeop Kim
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.30 no.2
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    • pp.13-26
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    • 2024
  • Background: The most common form of injury in soccer is a hamstring strain. Eccentric bias exercises are crucial for reducing injury risk and improving sprinting performance. The purpose of this study was to compare a 4-week hip-dominant hamstring strengthening exercise program (HDE) with a knee-dominant hamstring strengthening exercise program (KDE) in youth soccer players. Method: The sample (n=31) was randomly divided into two groups: HDE (n=17) and KDE (n=14), with soccer players in HDE performing hip joint-dominant hamstring strengthening exercises and those in KDE performing knee joint-dominant hamstring strengthening exercises. Each intervention was conducted three times per week for four weeks. The outcome measures included the hamstring strength test (isometric strength test, eccentric strength test), knee joint range of motion (90/90 active knee extension; AKE) test, lower limb function test Y-balance test and Agility T-test. Results: Following the intervention, both groups showed significant improvement in isometric and eccentric hamstring strength on both dominant and non-dominant sides (p<.05). The AKE test showed significant improvement in the dominant leg (p<.05) and non-dominant leg only in KDE. The agility test significantly improved in HDE (p<.05). There was a slight improvement in the Y-balance test score; however, the difference was not statistically significant. There were no differences between the two groups in the values before, and after the intervention for all items. Conclusion: The hip-dominant and knee-dominant hamstring strengthening exercise should be coordinated and used based on the environment during hamstring injury prevention training.

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Prophylactic endoscopic transpapillary gallbladder stenting to prevent acute cholecystitis induced after metallic stent placement for malignant biliary strictures: a retrospective study in Japan

  • Fumisato Kozakai;Yoshihide Kanno;Shinsuke Koshita;Takahisa Ogawa;Hiroaki Kusunose;Toshitaka Sakai;Keisuke Yonamine;Kazuaki Miyamoto;Haruka Okano;Yuto Matsuoka;Kento Hosokawa;Hidehito Sumiya;Kei Ito
    • Clinical Endoscopy
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    • v.57 no.5
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    • pp.647-655
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    • 2024
  • Background/Aims: Endoscopic biliary drainage using self-expandable metallic stents (SEMSs) for malignant biliary strictures occasionally induces acute cholecystitis (AC). This study evaluated the efficacy of prophylactic gallbladder stents (GBS) during SEMS placement. Methods: Among 158 patients who underwent SEMS placement for malignant biliary strictures between January 2018 and March 2023, 30 patients who attempted to undergo prophylactic GBS placement before SEMS placement were included. Results: Technical success was achieved in 21 cases (70.0%). The mean diameter of the cystic duct was more significant in the successful cases (6.5 mm vs. 3.7 mm, p<0.05). Adverse events occurred for 7 patients (23.3%: acute pancreatitis in 7; non-obstructive cholangitis in 1; perforation of the cystic duct in 1 with an overlap), all of which improved with conservative treatment. No patients developed AC when the GBS placement was successful, whereas 25 of the 128 patients (19.5%) without a prophylactic GBS developed AC during the median follow-up period of 357 days (p=0.043). In the multivariable analysis, GBS placement was a significant factor in preventing AC (hazard ratio, 0.61; 95% confidence interval, 0.37-0.99; p=0.045). Conclusions: GBS may contribute to the prevention of AC after SEMS placement for malignant biliary strictures.

Timed barium esophagography to predict recurrent achalasia after peroral endoscopic myotomy: a retrospective study in Thailand

  • Tharathorn Suwatthanarak;Chainarong Phalanusitthepa;Chatbadin Thongchuam;Thawatchai Akaraviputh;Vitoon Chinswangwatanakul;Thikhamporn Tawantanakorn;Somchai Leelakusolvong;Monthira Maneerattanaporn;Piyaporn Apisarnthanarak;Jitladda Wasinrat
    • Clinical Endoscopy
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    • v.57 no.5
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    • pp.610-619
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    • 2024
  • Background/Aims: Achalasia is a rare esophageal motility disease, for which peroral endoscopic myotomy (POEM) has emerged as a promising treatment option; however, recurrence remains a challenge. Timed barium esophagography (TBE) is a useful diagnostic tool and potential outcome predictor of achalasia. This study aimed to determine predictive tools for recurrence after POEM. Methods: This retrospective study enrolled achalasia patients who underwent POEM between January 2015 and December 2021. Patients were categorized into two groups using the 1-month post-POEM Eckardt scores and TBE: the discordant group (Eckardt score improved >50%, TBE decreased <50%) and the concordant group (both Eckardt score and TBE improved >50%). Recurrence was defined as a reincrease in the Eckardt score to more than three during follow-up. Results: Complete medical records were available in 30 patients who underwent POEM. Seventeen patients (56.7%) were classified into the discordant group, while 13 patients (43.3%) were in the concordant group. The overall recurrence rate was 11.9% at 1-year, increasing to 23.8% during the extended follow-up. The discordant group had a 6.87 fold higher recurrence rate than the concordant group (52.9% vs. 7.7%, p=0.017). Conclusions: These results strongly suggest that combining the Eckardt score with TBE can effectively predict recurrent achalasia after POEM. Patients in the discordant group had an elevated risk.

Analysis of Sexual Behaviors among Adults in Korea: Results from the "Korean National Survey on Sexual Consciousness"

  • Sun Tae Ahn;Jong Wook Kim;Hong Seok Park;Hyun Jung Kim;Heung Jae Park;Hyeong Sik Ahn; Sung Won Lee;Du Geon Moon
    • The World Journal of Men's Health
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    • v.39 no.2
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    • pp.366-375
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    • 2021
  • Purpose This study aimed to understand the characteristics of sexual behaviors among Korean adults to facilitate the development of strategies and policies focused on sexual health in groups categorized by sociodemographic characteristics. Materials and Methods A nationally representative probability sample of 2,500 individuals (1,273 men and 1,227 women) aged 18-69 years obtained using a stratified multiple-stage sampling method based on Statistics Korea (KOSTAT) participated in a cross-sectional online survey. The survey consisted of structured questionnaires comprising questions on demographic information, lifetime sexual behavior, and sexual behavior in the previous 12 months. The mean age at first sexual intercourse was lower in men than in women (21.9±4.4 vs. 24.1±4.4 years, p=0.001). The overall prevalence rate of sexual events with casual partners within previous 12 months was 13.1% (95% confidence interval [CI], 11.6%-14.5%). It was found to more commonly exist among lower age groups and men. The overall regular condom use rates with relationship partner and casual partner were 14.8% (95% CI, 13.2%-16.4%) and 39.6% (95% CI, 33.9%-45.3%), respectively. Condom use rate with casual partners among 20s and 30s men was 51.2%. Overall, only 10.4% of the respondents had received sexual education about sexually transmitted infections. This study provided contemporary sexual behaviors in Korean adults, and identified socio-demographic factors that seem to influence sexual behaviors. Low condom use rates and low rate of receiving sexual education were concerns. The result of this study would be useful to health professionals to formulate policies and strategies related to sexual health.

Effects of postpartum fatigue, parenting stress, and family support on postpartum depression in Chinese first-time mothers: a cross-sectional study

  • Feiyan Yi;Sukhee Ahn
    • Women's Health Nursing
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    • v.30 no.3
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    • pp.226-237
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    • 2024
  • Purpose: This study aimed to explore the levels of postpartum fatigue, parenting stress, family support, and postpartum depression (PPD) experienced by first-time Chinese mothers and to investigate their impact on PPD. Methods: This cross-sectional survey involved 150 primigravida women attending postnatal checkups in Hebi City, Henan Province, China. Demographic data and information on environmental variables (living conditions, family relationships), postpartum fatigue, parenting stress, family support (expected vs. actual level), and PPD were collected. Results: The average age of the women was 26.25 years (SD, ±3.90), with 78.7% at risk for PPD (score ≥10). Significant correlations were found between PPD and postpartum fatigue (r=.63, p<.001), parenting stress (r=.59, p<.001), and family support (r=.40, p<.001). In model 1, which examined the influence of women's demographic variables on PPD, significant factors included a poor relationship with parents (β=.24, p=.001), a poor relationship with parents-in-law (β=.18, p=.029), and a poor relationship with the husband (β=.20, p=.013). When the three research variables were incorporated into model 2, the factors contributing to a higher level of PPD included a poor relationship with parents-in-law (β=.14, p=.033), increased postpartum fatigue (β=.37, p<.001), increased parenting stress (β=.33, p<.001), and less family support than expected (β=.12, p=.048). Conclusion: The most critical factors influencing PPD include postpartum fatigue, parenting stress, poor relationships with parents-in-law, and low family support among Chinese primiparas. To mitigate PPD levels, healthcare professionals should screen mothers for depression in outpatient clinics and offer education and counseling to both mothers and their families or companions regarding PPD.

Association between antioxidant vitamin intake and obesity among Korean women: using the Korea National Health and Nutrition Examination Survey 2007 ~ 2016 (우리나라 성인 여성의 항산화비타민 섭취량과 비만의 연관성 : 2007 ~ 2016년 국민 건강영양조사 자료를 이용하여)

  • Ham, Dongwoo;Kim, Seong-Ah;Jun, Shinyoung;Kang, Min-Sook;Joung, Hyojee
    • Journal of Nutrition and Health
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    • v.51 no.5
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    • pp.400-413
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    • 2018
  • Purpose: This study examined the association between the antioxidant vitamin intake and obesity in Korean women. Methods: Adult women aged ${\geq}19years$ who completed a health examination and nutrition survey from the Korea National Health and Nutrition Examination Survey between 2007 ~ 2016 were selected for the study (n = 30,425). A BMI ${\geq}25kg/m^2$ and waist circumference ${\geq}85cm$ were defined as obesity and abdominal obesity, respectively. The individual antioxidant vitamin intake was estimated by linking the antioxidant vitamin composition database of commonly consumed foods and the subjects' 24-hour recall food consumption data. Carotenoids, retinol, vitamin A (retinol activity equivalent), vitamin C, tocopherols, and vitamin E (${\alpha}$-tocopherol equivalent) were included in the analysis. Each vitamin intake was converted to the nutrient density per 1,000 kcal. Odds ratio (ORs) and 95% confidence interval (CI) for obesity according to each tertile of the nutrient density was obtained from multiple logistic regression adjusted for age, household income, education level, smoking, alcohol consumption, and physical activity. Results: The mean intake of ${\alpha}$-carotene, retinol, vitamin E, ${\alpha}$-tocopherol, and ${\gamma}$-tocopherol per 1,000 kcal was significantly lower in the obese group than in the normal group. A higher intake of lycopene was inversely associated with obesity (highest vs. lowest; OR = 0.89, 95% CI: 0.83-0.96) and abdominal obesity (highest vs. lowest; OR = 0.88, 95% CI: 0.81-0.95). Higher intakes of ${\alpha}$-carotene, total carotenoids, vitamin A, and ${\gamma}$-tocopherol also had a negative relationship with abdominal obesity. The antioxidant vitamin intakes from eggs, milk and dairy products, seasoning, and grains were significantly lower in the obese group than in the normal group. Conclusion: This study showed that the dietary intake of antioxidant vitamins was inversely associated with obesity and abdominal obesity among Korean women. Further study will be needed to examine the causal relationship between the antioxidant vitamin and obesity.