• 제목/요약/키워드: Low risk criteria

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Histomorphology and Immunohistochemistry of Gastrointestinal Stromal Tumors in a Malaysian Population

  • Kkrishnappa, Purushotham;Loh, Eu Jhin;Mohamad, Ibtisam Binti;Tata, Mahadevan Deva;Akhilesh, Meenakshi;Palayan, Kandasami
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.6
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    • pp.2795-2799
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    • 2016
  • Purpose: To study histomorphological and immunohistochemical patterns of gastro-intestinal stromal tumours (GISTs) in Malaysia. Materials and Methods: A total of 29 GIST cases from Hospital Tuanku Ja'afar, Seremban, were studied retrospectively over a period of 10 years from January 2002 to December 2011. Patient demographic data like age, sex and etnicity were collected. Tumour characteristics like site, maximum dimension and specimen type were analysed. Evaluation was according to established criteria into very low, low, intermediate and high-risk categories. Immunohistochemical characteristics were also analysed. Results: The mean age of patients was 59.7 years. Males (59%) were found to be more commonly affected than females (41%). The Chinese (45%) were commonly affected than Malays (41%), and Indians (10%). The most common symptom was pain in the abdomen (13.8%). More than half of the cases were seen in stomach (53%). The tumour size ranged from 1.5 cm to 17 cm with a mean of 6.94cm. Microscopic findings revealed that the spindle cell type was the most common (76%). It was observed that the majority of the cases (48%) were categorised in the intermediate risk group. Immunohistochemical staining showed positivity for CD117 (78.6%), CD34 (71.4%), vimentin (86.2%), S-100 (27.6%), SMA (35.7%), PKC THETA (46.4%) and PDGRFA (67.9%).

Reference values for pulp oxygen saturation as a diagnostic tool in endodontics: a systematic review and meta-analysis

  • Paula Lambert;Sergio Augusto Quevedo Miguens Jr;Caroline Solda;Juliana Tomaz Sganzerla;Leandro Azambuja Reichert;Carlos Estrela;Fernando Branco Barletta
    • Restorative Dentistry and Endodontics
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    • v.45 no.4
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    • pp.48.1-48.11
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    • 2020
  • Objectives: This systematic review aimed to identify mean oxygen saturation values (SpO2) using pulse oximetry in permanent maxillary anterior teeth. Materials and Methods: The MEDLINE, Scientific Electronic Library Online, Cochrane Central Register of Controlled Trials, EMBASE, and Literatura Latino Americana em Ciências da Saúde electronic databases were searched. Combinations and variations of "oximetry" AND "dental pulp test" were used as search terms. Studies reporting means and standard deviations of SpO2 values were included. Two reviewers independently extracted data following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Heterogeneity was assessed using the I2 statistic, and all analyses were performed using R software. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool and the Newcastle-Ottawa scale. Results: Of the 251 studies identified, 19 met the eligibility criteria and were included (total sample, 4,541 teeth). In the meta-analysis, the mean SpO2 values were 84.94% (95% confidence interval [CI], 84.85%-85.04%) for the central incisors, 89.29% (95% CI, 89.22%-89.35%) for the lateral incisors, and 89.20% (95% CI, 89.05%-89.34%) for the canines. The studies were predominantly low-quality due to the high risk of bias associated with the index test, unclear risk regarding patient selection, and concerns about outcome assessment. Conclusions: Although most studies were low-quality, the oxygen saturation levels in normal pulp could be established (minimum saturation, 77.52%). Despite the risk of bias of the included studies, the reference values reported herein are clinically relevant for assessments of changes in pulp status.

Comparison of Core Needle Biopsy and Repeat Fine-Needle Aspiration in Avoiding Diagnostic Surgery for Thyroid Nodules Initially Diagnosed as Atypia/Follicular Lesion of Undetermined Significance

  • Leehi Joo;Dong Gyu Na;Ji-hoon Kim;Hyobin Seo
    • Korean Journal of Radiology
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    • v.23 no.2
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    • pp.280-288
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    • 2022
  • Objective: To compare core needle biopsy (CNB) and repeat fine-needle aspiration (rFNA) to reduce the rate of diagnostic surgery and prevent unnecessary surgery in nodules initially diagnosed as atypia/follicular lesions of undetermined significance (AUS/FLUS). Materials and Methods: This study included 231 consecutive patients (150 female and 81 male; mean age ± standard deviation, 51.9 ± 11.7 years) with 235 thyroid nodules (≥ 1 cm) initially diagnosed as AUS/FLUS, who later underwent both rFNA and CNB. The nodules that required diagnostic surgery after the biopsy were defined using three different scenarios according to the rFNA and CNB results: criterion 1, surgery for low-risk indeterminate (categories I and III); criterion 2, surgery for high-risk indeterminate (categories IV and V); and criterion 3, surgery for all indeterminate nodules (categories I, III, IV, and V). We compared the expected rates of diagnostic surgery between CNB and rFNA in all 235 nodules using the three surgical criteria. In addition, the expected rates of unnecessary surgery (i.e., surgery for benign pathology) were compared in a subgroup of 182 nodules with available final diagnoses. Results: CNB showed significantly lower rates of nondiagnostic, AUS/FLUS, and suspicious for malignancy diagnoses (p ≤ 0.016) and higher rates of follicular neoplasm or suspicious for a follicular neoplasm (p < 0.001) and malignant diagnoses (p = 0.031). CNB showed a significantly lower expected rate of diagnostic surgery than rFNA for criterion 1 (29.8% vs. 48.1%, p < 0.001) and criterion 3 (46.4% vs. 55.3%, p = 0.029), and a significantly higher rate for criterion 2 (16.6% vs. 7.2%, p = 0.001). CNB showed a significantly lower expected rate of unnecessary surgery than rFNA for criterion 1 (18.7% vs. 29.7%, p = 0.024). Conclusion: CNB was superior to rFNA in reducing the rates of potential diagnostic surgery and unnecessary surgery for nodules initially diagnosed as AUS/FLUS in a scenario where nodules with low-risk indeterminate results (categories I and III) would undergo surgery.

Slope Stability Assessment on a Landslide Risk Area in Ulsan During Rainfall (울산 산사태 위험지역의 강우 침투 안정성 평가)

  • Kim, Jinwook;Shin, Hosung
    • Journal of the Korean Geotechnical Society
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    • v.32 no.6
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    • pp.27-40
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    • 2016
  • Conventional warning criteria for landslides due to rainfall in broad regions have limitations, because they did not have proper reflection of topography, forest physiognomy, and unsaturated soil properties, et al. This study suggested a new stability model for unsaturated slope analyses during rainfall, considering rainfall pattern, geomorphological characteristics (slope angle, soil depth), engineering properties of unsaturated soils, and tree surcharge and root reinforcement. Stability analysis not considering root reinforcement and tree surcharge tends to over-predict a factor of safety in unsaturated slopes. Developed slope stability model was used to build database on the factor of safety in unsaturated slopes during rainfall, and it was integrated with GIS to do quantitative risk analysis in landslide risk areas specified in Ulju. Landslide risk areas were located at downstream of the point with sudden drop in safety factor, as well as at regions with low safety factor during rainfall.

Priority Setting for Occupational Cancer Prevention

  • Peters, Cheryl E.;Palmer, Alison L.;Telfer, Joanne;Ge, Calvin B.;Hall, Amy L.;Davies, Hugh W.;Pahwa, Manisha;Demers, Paul A.
    • Safety and Health at Work
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    • v.9 no.2
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    • pp.133-139
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    • 2018
  • Background: Selecting priority occupational carcinogens is important for cancer prevention efforts; however, standardized selection methods are not available. The objective of this paper was to describe the methods used by CAREX Canada in 2015 to establish priorities for preventing occupational cancer, with a focus on exposure estimation and descriptive profiles. Methods: Four criteria were used in an expert assessment process to guide carcinogen prioritization: (1) the likelihood of presence and/or use in Canadian workplaces; (2) toxicity of the substance (strength of evidence for carcinogenicity and other health effects); (3) feasibility of producing a carcinogen profile and/or an occupational estimate; and (4) special interest from the public/scientific community. Carcinogens were ranked as high, medium or low priority based on specific conditions regarding these criteria, and stakeholder input was incorporated. Priorities were set separately for the creation of new carcinogen profiles and for new occupational exposure estimates. Results: Overall, 246 agents were reviewed for inclusion in the occupational priorities list. For carcinogen profile generation, 103 were prioritized (11 high, 33 medium, and 59 low priority), and 36 carcinogens were deemed priorities for occupational exposure estimation (13 high, 17 medium, and 6 low priority). Conclusion: Prioritizing and ranking occupational carcinogens is required for a variety of purposes, including research, resource allocation at different jurisdictional levels, calculations of occupational cancer burden, and planning of CAREX-type projects in different countries. This paper outlines how this process was achieved in Canada; this may provide a model for other countries and jurisdictions as a part of occupational cancer prevention efforts.

The Assessment of Risk of Bias on Randomised Controlled Trials of Oriental Medicine in Korea (한의학 관련 무작위배정비교임상연구의 비뚤림 위험 평가)

  • Lee, Yoon-Jae;Jang, Bo-Hyoung;Go, Ho-Yeon;Hyun, Min-Kyung;Park, Sun-Young;Lee, Chang-Hoon;Kim, Jin-Sung;Cho, Ki-Ho
    • The Journal of Korean Obstetrics and Gynecology
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    • v.24 no.4
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    • pp.105-113
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    • 2011
  • Objectives: To examine the current status of clinical research in oriental medicine, and to assess 'risk of bias'(ROB) of randomized clinical trials(RCTs) in oriental medicine in Korea. Methods: Special committee for EBM, KOMS(Korean Oriental Medicine Society) reviewed 17 journals related to oriental medicine in Korea (from the first issue to May 2010), the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 2, 2010), and PubMed (1966 to May 2010). Then we selected eligible RCTs in terms of oriental medicine, and assessed 'risk of bias'. Results: We reviewed 12,653 articles from the 17 journals, and 41 articles from CENTRAL and PubMed. After non-clinical articles were excluded, 1,004 articles were left. Among them, the number of eligible studies in terms of oriental medicine was 306. In these eligible studies, 130 were RCTs. Of RCTs, 69 were on acupuncture, 25 on herbal medicine. The proportion of 'unclear' is high in the criteria of 'Allocation concealment', 'Blinding of participants and personnel', 'Blinding of outcome assessment' and 'Other bias'. On the other hand, 'low' has high in the criteria of 'Incomplete outcome data' and 'Selective reporting'. Conclusions: Risk of bias on oriental medicine is unclear in terms of 'allocation concealment' and 'blinding'. For high-quality research in oriental medicine, further research should be needed on randomization and blinding in the RCTs.

Highway flood hazard mapping in Thailand using the Multi Criteria Analysis based the Analytic Hierarchy Process

  • Budhakooncharoen, Saisunee;Mahadhamrongchai, Wichien;Sukolratana, Jiraroth
    • Proceedings of the Korea Water Resources Association Conference
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    • 2015.05a
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    • pp.236-236
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    • 2015
  • Flood is one of the major natural disasters affecting millions of people. Thailand also, frequently faces with this type of disaster. Especially, 2011 mega flood in Central Thailand, inundated highway severely attributed to the failure of national economic and risk to life. Lesson learned from such an extreme event caused flood monitoring and warning becomes one of the sound mitigations. The highway flood hazard mapping accomplished in this research is one of the strategies. This is due to highway flood is the potential risk to life and limb, and potential damage to property. Monitoring and warning therefore help reducing live and property losses. In this study, degree of highway flood hazard was assessed by weighting factors for each cause of the highway flood using Multi Criteria Analysis (MCA) based Analytic Hierarchy Process (AHP). These weighting factors are the essential information to classify the degree of highway flood hazard to enable pinpoint on flood monitoring and flood warning in hazard areas. The highway flood causes were then investigated. It was found that three major factors influence to the highway flood are namely the highway characteristics, the hydrological characteristics and the land topography characteristics. The weight of importance for each cause of the highway flood in the whole country was assessed by weighting 3 major factors influence to the highway flood. According to the result of MCA analysis, the highway, the hydrological and the land topography characteristics were respectively weighted as 35, 35 and 30 percent influence to the cause of highway flood. These weighting factors were further utilized to classify the degree of highway flood hazard. The Weight Linear Combination (WLC) method was used to compute the total score of all highways according to each factor. This score was later used to categorize highway flood as high, moderate and low degree of hazard levels. Highway flood hazard map accomplished in this research study is applicable to serve as the handy tool for highway flood warning. However, to complete the whole warning process, flood water level monitoring system for example the camera gauge should be installed in the hazard highway. This is expected to serve as a simple flood monitor as part of the warning system during such extreme or critical event.

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A Systematic Review and Quality Assessment of Scalp Acupuncture for Musculoskeletal Diseases: Focused on Randomized Controlled Trials (근골격계 질환의 두침치료에 대한 체계적 문헌 고찰과 질 평가: 무작위 배정 대조 임상연구를 중심으로)

  • Do-Hun Kong;Byung-Cheul Shin
    • Journal of Korean Medicine Rehabilitation
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    • v.33 no.4
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    • pp.61-78
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    • 2023
  • Objectives This systematic review aimed to analyze the effectiveness, safety and the reporting quality of scalp acupuncture (SA) treatment for musculoskeletal disease (MSD). Methods Eleven databases were systematically searched up to July 12th 2023. Randomized controlled trials (RCTs) of SA treatment for MSD were selected manually by the inclusion criteria. The risk of bias of RCTs was assessed using the Cochrane's Risk of Bias (RoB) 1.0 and the reporting quality of studies was evaluated using Consolidated Standards of Reporting Trials (CONSORT) 2010 statement and Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) 2010 checklist. Results Ten clinical studies were met the inclusion criteria. Most of studies reported SA treatment significantly alleviated pain and functional disability of MSD patients and no serious adverse effects were reported. In RoB assessment, blinding of participants and personnel was found to have the highest RoB and allocation concealment was found to have the most unclear RoB. In CONSORT 2010 statement evaluation, all studies reported 15.3 items (41.4%) on average. In STRICTA 2010 checklist evaluation, all studies reported 11.2 items (65.9%) on average. Conclusions The systematic review found that SA treatment may alleviate pain and functional disability of MSD patients and have little severe adverse effect. The reporting quality of included studies was mainly low, therefore, further studies with strict adherence to the CONSORT and STRICTA checklist should be encouraged.

Investigation on Status of Musculoskeletal Disorders for Industrial Safety Managers (우리나라 근골격계질환의 추이와 산업체 안전담당자의 인식 실태 조사)

  • Gi, Do-Hyeong
    • Journal of the Ergonomics Society of Korea
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    • v.22 no.4
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    • pp.79-90
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    • 2003
  • The purposes of this study are to compare data for work-related musculoskeletal disorders(WMSDs) between Korea and USA, and to investigate status of WMSDs for industrial safety managers. The first part of this study was based on statistical data annually published by Minister of Labor of Korea and Bureau of Labor Statistics of USA. The latter was performed by using questionnaire survey for industrial safety managers in two regions. The results showed that the WMSDs incidence rate was significantly lower in Korea than in USA, and that there is big difference in the distribution of occupational illness by category of illness between Korea and USA. The questionnaire survey revealed that knowledge level about WMSDs was significantly affected depending upon corresponding companies' location and size, and that the low back pain was the most prevalent illness among varying WMSDs symptoms, followed by tendonitis/tenosynovitis, carpal tunnel syndrome, and tennis elbow. Based on this study, it is recommended that the future education/training for WMSDs focus on their preventative measures, methods/tools for identifying their risk factors, and diagnostic criteria for judging suspicious symptoms for industrial accidents, and that the governmental policy for WMSDs be changed towards financial supporting for preventive facilities, establishing objective diagnostic criteria and training for WMSDs.

Analysis of necrotizing enterocolitis and transfusion of red blood cell in very low birth weight preterm infants

  • Bak, Seon-Yeong;Lee, Sihyoung;Park, Jae-Hong;Park, Kyu-Hee;Jeon, Ji-Hyun
    • Clinical and Experimental Pediatrics
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    • v.56 no.3
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    • pp.112-115
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    • 2013
  • Purpose: To investigate the association between necrotizing enterocolitis (NEC) and red blood cell transfusions in very low birth weight (VLBW) preterm infants. Methods: We studied were 180 VLBW preterm infants who were admitted to the neonatal intensive care unit of CHA Gangnam Hospital from January of 2006 to December of 2009. The subjects were divided into 2 groups: an NEC group (greater than stage II on the modified Bell's criteria) and a control group (less than stage II on the modified Bell's critieria). We defined red blood cell transfusion before NEC diagnosis as the frequency of transfusion until NEC diagnosis (mean day at NEC diagnosis, day 18) in the NEC group and the frequency of transfusion until 18 days after birth in the control group. Results: Of the 180 subjects, 18 (10%) belonged to the NEC group, and 14 (78%) of these 18 patients had a history of transfusion before NEC diagnosis. The NEC group received $3.1{\pm}2.9$ transfusions, and the control group received $1.0{\pm}1.1$ transfusions before the NEC diagnosis (P=0.005). In a multivariate logistic regression corrected for gestational age, Apgar score at 1 minute, the presence of respiratory distress syndrome, patent ductus arteriosus, premature rupture of membrane, disseminated intravascular coagulopathy and death were confounding factors. The risk of NEC increased 1.63 times (95% confidence interval, 1.145 to 2.305; P=0.007) with transfusion before the NEC diagnosis. Conclusion: The risk for NEC increased significantly with increased transfusion frequency before the NEC diagnosis.