• Title/Summary/Keyword: Evaluation Procedures

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Comparison between Visual Inspection of Cervix and Cytology Based Screening Procedures in Bangladesh

  • Nessa, Ashrafun;Nahar, Khadiza Nurun;Begum, Shirin Akhter;Anwary, Shahin Ara;Hossain, Fawzia;Nahar, Khairun
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7607-7611
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    • 2013
  • Background: Cervical cancer continues to be a major problem in Bangladesh with approximately 18,000 new cases annually of which over 10,000 women die from it. Visual inspection of the cervix after 3-5% acetic acid (VIA) application is a simple and easy to learn method for cervical cancer screening, although cytology-based screening is more often applied in developed countries where it has successfully reduced the prevalence of cervical cancer. Objective: To compare the efficacy of VIA and cytology-based primary methods for cervical cancer screening in Bangladesh. Materials and Methods: This hospital based comparative study was conducted at the VIA centre and Colposcopy Clinic of Bangabandhu Sheikh Mujib Medical University (BSMMU) from October 2008 to October 2010. Results: Among 650 women, 74 (11.4%) were VIA+ve and 8 (1.2%) had abnormalities in their Pap smear reports. During colposcopy, 38 (7.7%) women had different grades of CIN and 4 (0.6%) had cervical cancer. The gold standard histology findings proved 20 women had CIN I, 14 had CIN II/II and 4 had cervical cancer. Among the 38 histology diagnosed abnormalities, VIA test could identify 30 abnormalities including two cervical cancers. However, Pap smear could detect only 8 cases of histological abnormalities (2 low grade and 6 had high grade lesion) and it missed all the cervical cancer cases. The sensitivity and specificity of VIA were 88.9% and 52.1%. The positive predictive value (PPV) and negative predictive value (NPV) were 41.0%, and 92.6% respectively. Moreover, the sensitivity, specificity, PPV and NPV of Pap smear were 33.3%, 95.8%, 75.0% and 79.3%, respectively. Conclusions: VIA test should be used as the primary screening tool even with its low sensitivity and specificity in low resource countries like Bangladesh. False positive results may be greater, but overtreatment can be minimized by colposcopy evaluation of the VIA positive women.

Review and Application of the Radioactive Waste Certification Program (방사성폐기물 인증프로그램의 검토 및 적용)

  • Chung Hee-Jun;Whang Joo-Ho;Lee Jae-Min;Kim Heon;Jeong Yi-Yeong
    • Proceedings of the Korean Radioactive Waste Society Conference
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    • 2005.11a
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    • pp.126-133
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    • 2005
  • Securing of radioactive waste disposal site and the related operations for disposal of low and intermediate level radioactive waste is being actively carried out in Korea. For disposal of radioactive wastes, physicochemical and radiological status and integrity of radioactive wastes must be secured first. Also, waste generators must provide this information to disposers. In addition, to secure the safety of waste disposal, waste acceptance criteria (WAC) and site specific waste acceptance criteria (SWAC) to consider characteristics of the disposal site are required. Radioactive wastes must be processed, generated, managed and transferred in accordance with these criteria. [1] For this, evaluation of properties on each of the radioactive wastes must be performed. However, in reality, atomic power plants are experiencing difficulties in relation to this due to the large quantity of radioactive waste generation. In order to solve this problem, IAEA and major overseas countries have developed, thus are using waste certification program (WCP) and quality assurance program (QAP) [2,3]. On the basis of these programs, radioactive waste certification program has been developed for safe disposal of radioactive wastes in Korea to satisfy the provisions specified in 'low and intermediate level radioactive waste transfer guidelines' of announcement No. 2005-18 from the Ministry of Science and Technology and specific site waste acceptance criteria (tentative plan). In addition, it is being planned to administer amendment on commercial atomic power plant related procedures and ensile staff training in order for early introduction and operation of radioactive waste certification system.

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Measurement and Estimation for the Clearance of Radioactive Waste with Patients of Thyroid Treatment (갑상선 진료환자 관련 방사성폐기물의 처분을 위한 방사능 측정 및 평가)

  • Kim, Chang-Bum;Jang, Seong-Joo
    • The Journal of the Korea Contents Association
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    • v.14 no.6
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    • pp.255-261
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    • 2014
  • The generation amount of radioactive waste has been rapidly increased by increase of the usage of radioisotope source in medical field. Especially, the use of the radioactive source of I-131 with short half-life of 8.02 days used in treatment of thyroid has been increased, and all of the wastes concerned have been disposed by means of the self-disposal method. IAEA proposed criteria for clearance level of waste which depends on the individual (10 ${\mu}Sv/y$) and collective dose (1 man-Sv/y), and concentration of each nuclide (IAEA Safety Series No 111-P-1.1, 1992 and IAEA RS-G-1.7, 2004). In this study, various radioactive wastes in medical fields are collected and measured for establishing the disposal methods and procedures of radioactive wastes. In addition, comparison evaluation of decay storage period between the half-life which was calculated by attenuation curve based on real measurement and analytical half-life is considered. With comparing the theoretical half-life and the effective half life(7.72 days) which was based on the decay equation of measured data, it is resulted in the theoretical half-life is longer than effective half-life. The storage period of radioactive waste for self-disposal may be curtailed. The result of this study will be proposed as ISO standard.

Preoperative Angiographic Value in Anterior Clinoidectomy for Surgery of Internal Carotid-Posterior Communicating Artery(IC-PC) Aneurysms (내경-후교통 동맥류 수술시 전 상상돌기 절제 유무에 대한 술전 혈관조영술의 의의)

  • Kim, Jae Hoon;Kim, Jae Min;Yi, Hyeong Joong;Bak, Koang Hum;Kim, Choong Hyun;Oh, Suck Jun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.9
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    • pp.1188-1194
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    • 2000
  • Objective : Internal carotid-posterior communicating artery(IC-PC) aneurysms can be clipped easily without any special preparations. Occasionally, however, it is difficult to clip the low-lying IC-PC aneurysms without some kinds of additional procedures. Clinical Material and Methods : We experienced four cases of low-lying IC-PC aneurysms, which the intradural anterior clinoidectomy and/or anterior petroclinoid fold(APF) resection was essential to expose the proximal side of the aneurysmal neck and/or proximal control. One patient harbored two low-lying IC-PC aneurysms bilaterally. The patients were divided into two groups according to the necessity of anterior clinoidectomy : Group I(n=4) that needed an intradural clinoidectomy and/or APF resection and Group II(n=29) that had IC-PC aneurysms, easily clipped without any special preparation. Also, various radiometric parameters were measured through the preoperative angiograms. Results : The incidence of such aneurysms was 12% among a total of thirty-three surgically treated IC-PC aneurysms during lasr 3 years. Among four cases, three cases presented with subarachnoid hemorrhage and all aneurysmal sac projected to postero-inferior direction. In our study, We initially considered the necessity of intraoperative anterior clinoid process(ACP) removal and/or resection of APF in cases of shorter distance less than 5.6mm between the proximal aneurysmal sac and tip of the ACP(p<0.001), and the proximal portion of aneurysmal neck has located below the interclinoid line(p=0.001). Conclusion : Through a careful preoperative evaluation, some radiometric parameters can be used to determine whether the ACP should be removed in clipping of the low-lying IC-PC aneurysms. Unlike to total removal of the ACP, the intradural partial anterior clinolidectomy and/or APF resection, which are more familiar to surgeons, reduce the risks of the premature rupture, operative time, and also contribute a more precise clip placement with proximal control than the extradural clinoidectomy.

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The Effect of Exercise Behavior Change of Casino Securities on Their Physical Self-description (카지노 시큐리티 종사자의 운동행동변화과정이 신체적 자기개념에 미치는 효과)

  • Chun, Yong-Tae
    • Proceedings of the Korea Contents Association Conference
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    • 2009.05a
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    • pp.597-601
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    • 2009
  • The purpose of this study is to closely examine the effect of exercise behavior change of casino securities on their physical self-description. This observation takes place in casino enterprises in Seoul, Busan, Kangwon and Jeju. Within these areas, we have selected companies with more than 30 securities. Among 450 persons sampling unit, we have excluded 77 copied which seem to be insincere, and actually used 373 copies in this study. Evaluation forms are used as a study method; each form consists of continuance 5 points Likert scales and nominal/proportional scaling and used after excluding a test through the analysis of validity and reliability. After encoding and inputting the framing completed data along with each purpose, it was computerized by computer process, making use of SPSS 15.0 version. Through the data analysis according to these methods and procedures, the result on this study is described below. First, the exercise behavior according to socio-demographic characteristics. Second, the decision-making balance according to socio-demographic characteristics. Third, the self-efficacy according to socio-demographic characteristics. Fourth, the physical self-concept according to socio-demographic characteristics. Fifth, the exercise behavior influence indirectly on the physical self-concept throughout the decision-making balance and self-efficacy.

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Tension Pneumothorax in a Dog with Diaphragmatic Hernia (횡격막허니아에 병발한 긴장성기흉 1례)

  • Kim, Hyunseok;Yun, Soo-kyung;Son, Won-gyun;Jang, Min;Hwang, Hyeshin;Jo, Sang-min;Shin, Chi Won;Kim, Wan Hee;Yoon, Junghee;Lee, Inhyung
    • Journal of Veterinary Clinics
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    • v.33 no.4
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    • pp.237-242
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    • 2016
  • A 1.86 kg, 3-year-old, female, Maltese was presented to the Veterinary Medical Teaching Hospital of Seoul National University after being hit by a car. The patient was diagnosed with urinary bladder rupture, diaphragmatic hernia and fracture of ilium, tibia and fibula. Repair surgery was performed after stabilizing treatment. During the surgery, hypoxia was identified and it worsened after positive pressure ventilation (partial pressure of oxygen in arterial blood ($PaO_2$): 52 mmHg, pulse oximetry ($SpO_2$): 87%, arterial hemoglobin oxygen saturation ($SpO_2$): 85.8%). In addition to hypoxia, blood pressure decreased to 30 mmHg. Positive pressure ventilation was discontinued because hypoxia and hypotension were aggravated. After suturing the diaphragm, air was withdrawn to form negative pressure within the thorax. However, negative pressure was not attained despite continuous withdrawal of air. A thoracostomy tube was placed because tension pneumothorax was strongly suspected. The patient recovered through close monitoring with the tube for 3 days. Due to limitation of evaluation of the lung, predicting occurrence of tension pneumothorax is difficult in patient of diaphragmatic hernia. Therefore, it is recommended that indicators of tension pneumothorax should be closely monitored during diagnosis and repair procedures of diaphragmatic hernia.

Quality Changes in Apple Juice Containing Pulp upon Sterilization by Hot Water (열수 살균 조건에 따른 과육 함유 사과주스의 품질 변화)

  • Park, Nan-Young;Kim, Jae-Whoa;Woo, Sang-Cheul;Jeong, Yong-Jin
    • Food Science and Preservation
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    • v.17 no.2
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    • pp.230-235
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    • 2010
  • We investigated the physicochemical quality characteristics of apple juice upon sterilization using hot water, and under various storage conditions. None of sugar content, acidity, or pH differed significantly among various sterilization conditions but chromaticity was considerably reduced in sterilized juice compared with control material. The chromaticity of non-sterilized juice decreased significantly after sterilization compared with material supplemented with vitamin C (0.1%, w/v). Fungi, yeast, and aerobic bacteria were detected in juice sterilized at $65^{\circ}C$ for 10 or 20 min, but no microorganisms were observed in juice sterilized by other procedures. Vitamin C content affected sterilization temperature to a greater extent than sterilization time. When juice was stored at $4^{\circ}C$ or $37^{\circ}C$ for 3 weeks after application of different sterilization conditions, almost no change in acidity, sugar content, or pH was observed, regardless of sterilization mode or storage period. However, chromaticity decreased with longer storage. Vitamin C levels were reduced by higher sterilization temperatures. However, longer storage periods had the greatest effect on reduction of vitamin C levels, which tended toward lower values regardless of differences in sterilization and storage conditions. In sensory evaluation tests, all of taste, color, and overall preference were highest for juice sterilized at $75^{\circ}C$ for 20 min. The ASC value was low at a storage temperature of $4^{\circ}C$ and at high sterilization temperatures, and a long storage period was associated with a greater ASC value. Thus, the quality of apple juice was excellent when juice was hot water-sterilized, with additional vitamin C, at $75^{\circ}C$ for 20 min, followed by storage at $4^{\circ}C$.

EXPERIMENTAL STUDY ON RELAPSE AFTER RAMAL LENGTHENING IN DIFFERENT SURGICAL METHODS - RADIOGRAPHIC EVALUATION (하악지 길이증가를 위한 수술방법들간의 회귀현상에 관한 실험적 연구)

  • Yi, Choong-Kook;Chang, Hyun-Ho;Park, Jung-Hyun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.6
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    • pp.636-643
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    • 2000
  • Facial asymmetry is the most frequent disease in craniofacial deformities. And the primary causing area of that is mostly placing in mandible. That is to say, it is known that primarily, mandible grows excessively or deficiently, and other facial region involving maxilla undergoes compensatory growth secondarily, so asymmetric face develops. In facial asymmetry, the surgical correction of undergrowth is more difficult than that of overgrowth and the reason of it is the postoperative relapse caused by stress of surrounding soft tissues. It means the stress of surrounding soft tissues occurring after bone lengthening and reducing above stress is the same meaning with reducing postoperative relapse. Among various areas, mandibular ramus is the most difficult area to lengthen vertically and maintain its length. The reason of it is considered by many authors as the stress of surrounding pterygomasseteric sling which is enveloping lower border of mandible and interrupting elongation of ramal height. So we applied two different surgical procedures in which pterygomasseteric slings have different stress respectively to monkeys which have similar masticatory function and anatomy to human being and compared relapse by radiographic film and observed periodically the histochemical change of masseteric muscle fiber. So we could see the following results. The relapse was less in EVRO group in which we separated pterygomasseric sling in inferior border and didn't approximate muscle sling after vertical lengthening to minimize the stress of soft tissues than IVRO group in which we elongated ramal height preserving pterygomassetric sling. Of course, we could see a problem in EVRO group such as bone resorption in inferior border caused by uncovering the periosteum of inferior border. But we expect that such problem will be solved by developing periosteum substitutes for covering the exposed bone and minimizing the surgical trauma. In histochemical study of masseteric muscle fiber, the fiber constituents of EVRO group in which we minimized soft tissue stress was changed immediately after operation and maintained it for 1 year, whereas that of IVRO group in which we preserved soft tissue stress was changed in more portion after operation and recovered it by 1 year. By the histochemical results, we can see that the recovery of fiber constituents reflect the recovery of muscle stress and it is closely related with relapse phenomenon.

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Evaluation of the course of the inferior alveolar canal in the mandibular ramus using cone beam computed tomography

  • Kwon, Kyung-Hwan;Sim, Kyu-Bong;Lee, Jae-Min
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.38 no.4
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    • pp.231-239
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    • 2012
  • Objectives: This study sought to provide guidelines in order to decrease the incidence of nerve injury during mandibular ramus bone harvesting, and to improve understanding of the anatomical structure of the inferior alveolar canal (IAC) to include its distance from the exterior buccal cortex. Materials and Methods: In January and February 2009, 20 patients who visited the Wonkwang University Department of Oral and Maxillofacial Surgery reporting various conditions underwent cone beam computed tomography and were included in this study. Patients with missing left or right mandibular first molars or incisors, or who had jaw fracture or bone pathologies, were excluded. The reference point (R point) was defined as the point where the occlusal plane reached the anterior ramus of the mandible. The position of the IAC in relation to the R point, the buccal bone width (BW), the alveolar crest distance (ACD), the distance from the alveolar crest to the occlusal plane (COD), and the distance from the IAC to the sagittal plane (CS) were determined using proprietary image analysis software which produced cross-sectional coronal and axial images. Results: The distance medially from the R point to the IAC along the axial plane was $6.19{\pm}1.21mm$. The HD from the R point, posteriorly to IAC, in the lateral view was $13.07{\pm}2.45mm$, the VD from the R point was $14.24{\pm}2.41mm$, and the ND from the R point was $10.12{\pm}1.76mm$. The pathway of the IAC was positioned almost in a straight line along a sagittal plane within $0.56{\pm}0.70mm$. The distance from the buccal bone surface to the IAC increased anteriorly from the R point. Conclusion: Marking osteotomy lines in the retromolar area in procedures involving bone harvesting should be discouraged due to the risk of damage to IAC structures. Our measurements indicated that the area from the R point in the ramus of the mandible to 10 mm anterior can be safely harvested for bone grafting purposes.

Conventional versus Doxorubicin-Eluting Beads Transarterial Chemoembolization for Unresectable Hepatocellular Carcinoma: a Tertiary Medical Centre Experience in Malaysia

  • Rahman, F Abdul;Naidu, J;Ngiu, CS;Yaakob, Y;Mohamed, Z;Othman, H;Jarmin, R;Elias, MH;Hamid, N Abdul;Mokhtar, N Mohd;Ali, RA Raja
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.8
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    • pp.4037-4041
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    • 2016
  • Background: Hepatocellular carcinoma (HCC) is a common cancer that is frequently diagnosed at an advanced stage. Transarterial chemoembolisation (TACE) is an effective palliative treatment for patients who are not eligible for curative treatment. The two main methods for performing TACE are conventional (c-TACE) or with drug eluting beads (DEB-TACE). We sought to compare survival rates and tumour response between patients undergoing c-TACE and DEB-TACE at our centre. Materials and Methods: A retrospective cohort study of patients undergoing either treatment was carried out from January 2009 to December 2014. Tumour response to the procedures was evaluated according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST). Kaplan-Meier analysis was used to assess and compare the overall survival in the two groups. Results: A total of 79 patients were analysed (34 had c-TACE, 45 had DEB-TACE) with a median follow-up of 11.8 months. A total of 20 patients in the c-TACE group (80%) and 12 patients in the DEB-TACE group (44%) died during the follow up period. The median survival durations in the c-TACE and DEB-TACE groups were $4.9{\pm}3.2$ months and $8.3{\pm}2.0$ months respectively (p=0.008). There was no statistically significant difference noted among the two groups with respect to mRECIST criteria. Conclusions: DEB-TACE demonstrated a significant improvement in overall survival rates for patients with unresectable HCC when compared to c-TACE. It is a safe and promising approach and should potentially be considered as a standard of care in the management of unresectable HCC.