• 제목/요약/키워드: Aspiration Levels

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Pleural Space Elastance and Its Relation to Success Rates of Pleurodesis in Malignant Pleural Effusion

  • Masoud, Hossam Hosny;El-Zorkany, Mahmoud Mohamed;Ahmed, Azza Anwar;Assal, Hebatallah Hany
    • Tuberculosis and Respiratory Diseases
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    • 제84권1호
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    • pp.67-73
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    • 2021
  • Background: Pleurodesis fails in 10%-40% of patients with recurrent malignant pleural effusions malignant pleural effusion and dyspnea. This study aimed to assess the values of pleural elastance (PEL) after the aspiration of 500 mL of pleural fluid and their relation to the pleurodesis outcome, and to compare the pleurodesis outcome with the chemical characteristics of pleural fluid. Methods: A prospective study was conducted in Kasr El-Aini Hospital, Cairo University, during the period from March 2019 to January 2020. The study population consisted of 40 patients with malignant pleural effusion. The measurement of PEL after the aspiration of 500 mL of fluid was done with "PEL 0.5" (cm H2O/L), and the characteristics of the pleural fluid were chemically and cytologically analyzed. Pleurodesis was done and the patients were evaluated one month later. The PEL values were compared with pleurodesis outcomes. Results: After 4-week of follow-up, the success rate of pleurodesis was 65%. The PEL 0.5 was significantly higher in failed pleurodesis than it was in successful pleurodesis. A cutoff point of PEL 0.5 >14.5 cm H2O/L was associated with pleurodesis failure with a sensitivity and specificity of 93% and 100%, respectively. The patients with failed pleurodesis had significantly lower pH levels in fluid than those in the successful group (p<0.001). Conclusion: PEL measurement was a significant predictor in differentiating between failed and successful pleurodesis. The increase in acidity of the malignant pleural fluid can be used as a predictor for pleurodesis failure in patients with malignant pleural effusion.

인간난자의 체외수정 및 배아의 자궁내이식 후 황체기 혈청 난포호르몬 및 황체호르몬의 변동에 관한 연구 (Luteal Phase Serum Estradiol and Progesterone in In Vitro Fertilization and Embryo Transfer)

  • 이진용;김학순;김정구;문신용;장윤석
    • Clinical and Experimental Reproductive Medicine
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    • 제14권2호
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    • pp.127-137
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    • 1987
  • Steroid hormone profiles during luteal phases after in vitro fertilization(IVF) and embryo transfer(ET) have been evaluated in 83 cycles stimulated by pure follicle-stimulating hormone/human menopausal gonadotropin/human chorionic gonadotropin, in which 13 patients became pregnant. Serum estradiol($E_2$) and progesterone($P_4$) levels were determined on days 2, 5, 7 and 9 after laparoscopic follicle aspiration. The follicular $E_2$ peak was slightly higher in pregnancies than in failures. Positive correlations were observed between the follicular $E_2$ peaks and the $P_4$ levels on days 5 and 7 of the luteal phase in pregnancies, but no correlation was found in failures. The $E_2$ and $P_4$ levels on days 5 and 7 of the luteal phase were significantly higher in pregnancies than in failures, but not different on days 2 and 9. Values of the $P_4/E_2$ ratio were similar between the two groups. The luteal phase durations were 12 to 19 days and no correlation was observed between the lengths of luteal phase and the luteal $E_2$ or $P_4$ concentrations. These data suggest that high $P_4$ levels in the mid-luteal phase, which have positive correlations with the follicular $E_2$ peaks, might have a favorable influence on the pregnancy success in human IVF.

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A Fuzzy Multi-Objective Linear Programming Model: A Case Study of an LPG Distribution Network

  • Ozyoruk, Bahar;Donmez, Nilay
    • Industrial Engineering and Management Systems
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    • 제13권3호
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    • pp.319-329
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    • 2014
  • Supply chain management is a subject that has an increasing importance due to the developments in the global markets and technology. In this paper, a fuzzy multi-objective linear programming model is developed for the supply chain of a company dealing with procurement, storage, filling, and distribution of liquefied petroleum gas (LPG) in Turkey. The model intends to determine the quantities of LPG to be procured, stored, filled to cylinders, and transported between the plants and demand centers for six planning periods. In this model, which aims to minimize both total costs (sum of procurement, storage, filling, and transportation costs) and total transportation distances, demand quantities of the main demand centers and decision maker's aspiration levels about objective functions are fuzzy. After comparing the results obtained from the model with those obtained by using different methods, it is concluded that the proposed method can be applied to real world problems practically and it may be used in this type of problems in order to generate an efficient solution.

Transabdominal follicular aspiration in an in vitro fertilization cycle: experiences with an unusual but necessary intervention in a resource-limited setting

  • Osemwenkha, Abieyuwa;Osaikhuwuomwan, James
    • Clinical and Experimental Reproductive Medicine
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    • 제43권1호
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    • pp.54-57
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    • 2016
  • Controlled ovarian hyperstimulation is one of the major steps of in vitro fertilization. The inaccessibility or non-visualization of developing follicles on transvaginal sonography (the preferred imaging method) may be misjudged as a poor response, resulting in cycle cancellation. It is necessary to scrupulously appraise proxy indicators for ovarian response, such as estradiol levels, endometrial thickness, and other individual clinical characteristics. This can prompt meticulous transabdominal ultrasound follicular monitoring and oocyte retrieval with the goal of averting cycle cancellation and improving treatment outcomes.

Empty follicle syndrome

  • Kim, Jee Hyun;Jee, Byung Chul
    • Clinical and Experimental Reproductive Medicine
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    • 제39권4호
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    • pp.132-137
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    • 2012
  • Empty follicle syndrome (EFS) is a condition in which no oocytes are retrieved after an apparently adequate ovarian response to stimulation and meticulous follicular aspiration. EFS can be classified into 'genuine' and 'false' types according to hCG levels. It is a rare condition of obscure etiology. The existence of genuine EFS has been questioned and is still controversial. The limitation around EFS is that the definition of EFS is obscure. Management of patients with EFS is a challenge to physicians. No single treatment is known to be universally effective. However, patients should be adequately informed regarding the importance of correct hCG administration because improper hCG administration is a common and preventable cause of EFS. EFS is a syndrome that deserves additional study because such investigation could lead to a further understanding of ovarian biology and infertility.

거래의 경제적 차원과 관계적 차원이 경로구성원의 이탈성향에 미치는 영향

  • 이찬;임영균
    • 한국유통학회지:유통연구
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    • 제2권1호
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    • pp.115-141
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    • 1997
  • This study examines the effects of economic and relational dimensions of supplier-distributor relationship on distributors intents to leave. A survey of 121 computer hardware distributors revealed that distributors commitment to the relationship and their transaction-specific investment would decrease directly the level of withdrawal intention. Other relational dimensions such as the procedural and distributive fairness, the morality of aspiration, and economic dimensions such as the transaction-specific investment made by the supplier and distributors expectations fo future performance increase indirectly the level of withdrawal intension via affecting either trust or commitment. The present study also found that perceived uncertainty and relative dependence might moderate the effects the economic and relational dimensions on distributors intents to leave. Relational dimensions, when compared to economic dimensions, tend to have stronger impacts on withdrawal intentions under high levels of uncertainty and relative dependence.

Double-ply로 구성된 타이어 측벽형상 최적설계를 위한 GUI기반 프로그램 개발 (Development of GUI-based Program for Optimum Design of Double-ply Tire Sidewall Contour)

  • 손정삼;조진래;유완석
    • 대한기계학회:학술대회논문집
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    • 대한기계학회 2004년도 춘계학술대회
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    • pp.525-530
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    • 2004
  • In this paper, the optimum design of tire sidewall contour consisted of double plies for improving automobile maneuverability and tire durability is considered and a GUI program is developed for the purpose of the practical design. Each improvement of maneuverability and durability depends on the cord tension and strain energy distribution of tire sidewall. Satisfing trade-off method, which requires the judgment of aspiration levels, is used for the multi-objective optimization problem. Also, this paper presents the application to the practical sidewall contour design with the GUI program developed using visual Fortran.

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Exploring the Role of Preference Heterogeneity and Causal Attribution in Online Ratings Dynamics

  • Chu, Wujin;Roh, Minjung
    • Asia Marketing Journal
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    • 제15권4호
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    • pp.61-101
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    • 2014
  • This study investigates when and how disagreements in online customer ratings prompt more favorable product evaluations. Among the three metrics of volume, valence, and variance that feature in the research on online customer ratings, volume and valence have exhibited consistently positive patterns in their effects on product sales or evaluations (e.g., Dellarocas, Zhang, and Awad 2007; Liu 2006). Ratings variance, or the degree of disagreement among reviewers, however, has shown rather mixed results, with some studies reporting positive effects on product sales (e.g., Clement, Proppe, and Rott 2007) while others finding negative effects on product evaluations (e.g., Zhu and Zhang 2010). This study aims to resolve these contradictory findings by introducing preference heterogeneity as a possible moderator and causal attribution as a mediator to account for the moderating effect. The main proposition of this study is that when preference heterogeneity is perceived as high, a disagreement in ratings is attributed more to reviewers' different preferences than to unreliable product quality, which in turn prompts better quality evaluations of a product. Because disagreements mostly result from differences in reviewers' tastes or the low reliability of a product's quality (Mizerski 1982; Sen and Lerman 2007), a greater level of attribution to reviewer tastes can mitigate the negative effect of disagreement on product evaluations. Specifically, if consumers infer that reviewers' heterogeneous preferences result in subjectively different experiences and thereby highly diverse ratings, they would not disregard the overall quality of a product. However, if consumers infer that reviewers' preferences are quite homogeneous and thus the low reliability of the product quality contributes to such disagreements, they would discount the overall product quality. Therefore, consumers would respond more favorably to disagreements in ratings when preference heterogeneity is perceived as high rather than low. This study furthermore extends this prediction to the various levels of average ratings. The heuristicsystematic processing model so far indicates that the engagement in effortful systematic processing occurs only when sufficient motivation is present (Hann et al. 2007; Maheswaran and Chaiken 1991; Martin and Davies 1998). One of the key factors affecting this motivation is the aspiration level of the decision maker. Only under conditions that meet or exceed his aspiration level does he tend to engage in systematic processing (Patzelt and Shepherd 2008; Stephanous and Sage 1987). Therefore, systematic causal attribution processing regarding ratings variance is likely more activated when the average rating is high enough to meet the aspiration level than when it is too low to meet it. Considering that the interaction between ratings variance and preference heterogeneity occurs through the mediation of causal attribution, this greater activation of causal attribution in high versus low average ratings would lead to more pronounced interaction between ratings variance and preference heterogeneity in high versus low average ratings. Overall, this study proposes that the interaction between ratings variance and preference heterogeneity is more pronounced when the average rating is high as compared to when it is low. Two laboratory studies lend support to these predictions. Study 1 reveals that participants exposed to a high-preference heterogeneity book title (i.e., a novel) attributed disagreement in ratings more to reviewers' tastes, and thereby more favorably evaluated books with such ratings, compared to those exposed to a low-preference heterogeneity title (i.e., an English listening practice book). Study 2 then extended these findings to the various levels of average ratings and found that this greater preference for disagreement options under high preference heterogeneity is more pronounced when the average rating is high compared to when it is low. This study makes an important theoretical contribution to the online customer ratings literature by showing that preference heterogeneity serves as a key moderator of the effect of ratings variance on product evaluations and that causal attribution acts as a mediator of this moderation effect. A more comprehensive picture of the interplay among ratings variance, preference heterogeneity, and average ratings is also provided by revealing that the interaction between ratings variance and preference heterogeneity varies as a function of the average rating. In addition, this work provides some significant managerial implications for marketers in terms of how they manage word of mouth. Because a lack of consensus creates some uncertainty and anxiety over the given information, consumers experience a psychological burden regarding their choice of a product when ratings show disagreement. The results of this study offer a way to address this problem. By explicitly clarifying that there are many more differences in tastes among reviewers than expected, marketers can allow consumers to speculate that differing tastes of reviewers rather than an uncertain or poor product quality contribute to such conflicts in ratings. Thus, when fierce disagreements are observed in the WOM arena, marketers are advised to communicate to consumers that diverse, rather than uniform, tastes govern reviews and evaluations of products.

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Thyroid Nodules with Atypia or Follicular Lesions of Undetermined Significance (AUS/FLUS): Analysis of Variables Associated with Outcome

  • Kayilioglu, Selami Ilgaz;Dinc, Tolga;Sozen, Isa;Senol, Kazim;Katar, Kagan;Karabeyoglu, Melih;Tez, Mesut;Coskun, Faruk
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권23호
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    • pp.10307-10311
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    • 2015
  • Background: The Bethesda System for Reporting Thyroid Cytopathology is one of the main classification systems for thyroid nodules. It expects that 7% of all fine needle aspiration biopsies will be reported as atypia or follicular lesions of undetermined significance, and 5-15% of these undetermined nodules are malignant. Our study is a retrospective analysis of variables that may be associated with outcome in patients with indeterminate thyroid nodules. Materials and Methods: Patients who underwent thyroidectomy in our institution between 2010 and 2014 were retrieved from the institutional records database. Patient demographics and medical histories were recorded. All ultrasonography reports were examined for nodule features and biochemical blood levels, hormone levels and complete blood counts were recorded. Results: A total of 103 patient cytopathology reports were regarded as belonging to the undetermined category. Some 35% of patients had malignant nodules. Median preoperative red cell distribution width (RDW) level was 13.6 inthe benign group, while it was 14.3 in patients with malignancy, demonstrating a significant correlation (p=0.003). Only calcification presence was significantly different between benign and malignant groups on ultrasonography (p=0.034). Conclusions: Ultrasonography is one of the primary tools for this matter. RDW levels may become another promising tool to predict malignancy.

개의 신장에 있어서 Ascorbic Acid에 의한 허혈/재관류 손상의 감소에 관한 연구 (Attenuation of Renal Ischemia-Reperfusion (I/R) Injury by Ascorbic Acid in the Canine Nephrotomy)

  • 김종만;이재연;정성목;박창식;김명철
    • 한국임상수의학회지
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    • 제27권5호
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    • pp.553-558
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    • 2010
  • 본 연구의 목적은 개의 신장 절개술 모델에서 ascorbic acid를 전처치 하거나 관주 및 흡인시에 있어서, 허혈/재관류 손상의 감소와 신장 기능의 회복에 대한 효과를 평가하는데 있다. 성숙 잡종견 9두에서 신장절개술을 실시하였으며, hepa-saline 관주 및 흡인군와 ascorbic acid로 전처치 한 후 hepa-saline 관주 및 흡인한 군을 각각 실험군 1, 2로 놓았다. 신기능 검사와 항산화 효소 검사를 위해 신장절개술 후 0, 1, 3, 5, 7일에 혈액 샘플을 채취하였다. 그리고 7일 후 TNF-alpha, INF-gamma 검사를 위해 신장을 적출 보관하였다. 신장의 기능 검사에서 처치군 1과 2는 재관류 후 3, 5 그리고 7일째에 대조군과 비교하여 유의성 있게 감소 하였으며(p < 0.05), 처치군 2는 재관류 후 3일째에서 처치군 1과 비교하여 유의성있게 감소하였다(p < 0.05). 혈장에서의 항산화 효소의 활성치는 처치군 1과 2는 재관류 후 3, 5 그리고 7일째에 대조군과 비교하여 유의성 있게 증가 하였으며(p < 0.05), 처치군 2는 재관류 후 3일째에서 처치군 1과 비교하여 유의성있게 증가하였다(p < 0.05). TNF-alpha는 감소하고, INF-gamma는 증가하였다. 본 연구의 결과 신장의 관주 및 흡인의 과정은 신장의 관주 및 흡인의 과정은 신장의 허혈 및 재관류 손상을 감소 시키는 데에 효과가 있음을 시사하며, 또한, 외인성 ascorbic acid의 투여는 개의 신장 절개술에서 허혈 및 재관류의 손상을 감소시키며 신기능의 회복에 효과가 있음을 시사한다.