• 제목/요약/키워드: Screening Procedures

검색결과 207건 처리시간 0.027초

수핵성형술(Nucleoplasty)을 이용한 디스크 내장증(Internal Disc Disruption)의 치료 연구들의 의학적 논거에 대한 비판 (A Criticism Regarding the Medical Rationale of Nucleoplasty Studies for Internal Disc Disruption)

  • 홍영기
    • 한국콘텐츠학회논문지
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    • 제22권9호
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    • pp.570-582
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    • 2022
  • 수핵성형술은 경피적 디스크 감압술의 한 종류로 디스크 탈출증의 치료를 위해 개발된 시술법이다. 현재 몇몇 임상 현장에선 이 기술을 원래의 적응증인 디스크 탈출증을 지닌 환자들에 대해서 뿐 아니라, 디스크 내장증을 지닌 환자들에게도 사용하고 있다. 이 연구의 목적은 이와 같은 임상 현장에서의 수핵성형술의 적응증의 확대가 타당한 의학적 논리 위에서 수행된 것인지 평가하는 것이다. 그것을 위해 논자는 수핵성형술을 디스크 내장증 환자들에게 적용한 논문들을 분석하였다. 분석의 요점은 첫째, 연구자들이 제시하는 치료 근거의 타당성과 둘째, 환자 선별 기준의 적절성이다. 그 결과 수핵성형술을 디스크 내장증의 치료에 적용한 기존 논문들이 제시하는 치료 근거는 불분명하거나 일반적인 의학의 논리에 부합하지 않는 측면이 있는 것으로 판단되며, 환자 선별의 과정에선 경피적 감압술이 기능을 발휘할 수 있는 조건을 지닌 디스크를 찾기 위한 절차를 엄밀히 수행하지 않거나 경피적 감압술에 부적합한 것으로 판단될 수 있는 디스크도 시술 대상에 포함시킨 것으로 평가된다. 따라서 논자는 수핵성형술을 디스크 내장증 치료에 적용한 기존 연구들은 불필요하거나 잠재적 부작용을 발생시킬 수 있는 다소 모험적인 실험의 성격을 갖고 있다고 판단한다. 이 주제에 대한 연구과정에서 환자의 권익을 지키고 연구의 완성도를 높이기 위해선 현재의 이해 수준보다 선명한 치료적 근거의 확립과 이에 기반한 정교한 환자 선별 과정이 필수적으로 갖추어져야 할 것이라 생각한다.

갑상선 우연암종의 임상병리적 특성 (Clinicopathologic Characteristics of Incidentally Discovered Thyroid Carcinomas)

  • 정웅윤;정재호;장항석;박정수
    • 대한두경부종양학회지
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    • 제16권1호
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    • pp.64-68
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    • 2000
  • Objectives: With the recent advances and increasing use of imaging techniques in examination of the neck, the incidence of incidentally discovered thyroid carcinoma has been increasing. This study was carried out to evaluate the clinicopathologic characteristics of incidental thyroid carcinomas and to find optimal therapeutic strategies for these lesions. Materials & Methods: From Jan. 1988 to Aug. 1998, 1,053 patients were operated on for thyroid cancer, of whom 127(12.1%) had incidentally discovered thyroid cancers which were identified during routine health checkups(n=40), diagnostic procedures for unrelated medical conditions(n=39) and mass screening for thyroid cancer(n=48). The preoperative diagnosis was obtained by ultrasound-guided FNAB and the extent of surgery was determined based on frozen section examinations, as well as prognostic factors and gross findings at the time of surgery. Results: There were 6 men and 121 women with a mean age of 45.9 years. Histopathological diagnosis included papillary carcinomas(n=1l9), follicular carcinomas(n=6), poorly differentiated carcinoma(n=l) and medullary carcinoma(n=1). Thirty patients(23.6%) had multifocallesions. The mean diameter of the tumors was 1.1 cm(0.2-3.4 cm). Capsular invasions were found in 53 patients(41.7%) and nodal metastases in 41(32.3%). The surgical procedures used were: 90 less-than total thyroidectomies and 37 total thyroidectomies with central neck node dissection. Lateral neck dissection was added in 5 patients. According to TNM staging, 79 patients(63.2%) were at stage I, 15(12.0%) at stage II, 31(24.8%) at stage III and 0(0.0%) at stage IV. By AMES scoring system, 102 patients(81.6%) were in the low-risk group and 23(18.4%) in the high-risk group. And by MACIS scoring system, 103(86.6%) of 119 papillary thyroid cancer patients were less than 6. Conclusions: The clinicopathological characteristics of incidentally discovered thyroid carcinomas are similar to ordinary thyroid carcinomas. The treatment of choice should be individualized based on the particular clinical situation encountered, as in ordinary thyroid carcinomas.

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Stereotactic Vacuum-Assisted Core Biopsy Results for Non-Palpable Breast Lesions

  • Agacayak, Filiz;Ozturk, Alper;Bozdogan, Atilla;Selamoglu, Derya;Alco, Gul;Ordu, Cetin;Pilanci, Kezban Nur;Killi, Refik;Ozmen, Vahit
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권13호
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    • pp.5171-5174
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    • 2014
  • Background: The increase in breast cancer awareness and widespread use of mammographic screening has led to an increased detection of (non-palpable) breast cancers that cannot be discovered through physical examination. One of the methods used in the diagnosis of these cancers is vacuum-assisted core biopsy, which prevents a considerable number of patients from undergoing surgical procedures. The aim of this study was to present the results of stereotactic vacuum-assisted core biopsy for suspicious breast lesions. Materials and Methods: Files were retrospectively scanned and data on demographic, radiological and pathological findings were recorded for patients who underwent stereotactic vacuum-assisted core biopsy due to suspicious mammographic findings at the Interventional Radiology Centre of the Florence Nightingale Hospital between January 2010, and April 2013. Statistical analysis was carried out using Pearson's Chi-square, continuity correction, and Fisher's exact tests. Results: The mean age of the patients was 47 years (range: 36-70). Biopsies were performed due to BIRADS 3 lesions in 8 patients, BIRADS 4 lesions in 77 patients, and BIRADS 5 lesions in 3 patients. Mammography elucidated clusters of microcalcifications in 73 patients (83%) and focal lesions (asymmetrical density, distortion) in 15 patients (17%). In terms of complications, 1 patient had a hematoma, and 2 patients had ecchymoses (3/88; 3.3%). The histopathologic results revealed benign lesions in 63 patients (71.6%) and malignant lesions in 25 patients (28.4%). The mean duration of the procedure was 37 minutes (range: 18-55). Although all of the BIRADS 3 lesions were benign, 22 (28.6%) of the BIRADS 4 lesions and all of the BIRADS 5 lesions were malignant. Among the malignant cases, 80% were in situ, and 20% were invasive carcinomas. These patients underwent surgery. Conclusions: In cases where non-palpable breast lesions are considered to be suspicious in mammography scans, the vacuum-assisted core biopsy method provides an accurate histopathologic diagnosis thus preventing a significant number of patients undergoing unnecessary surgical procedures.

Development of Standard Operating Procedures (SOPs), Standardization, TLC and HPTLC Fingerprinting of a Polyherbal Unani Formulation

  • Naaz, Arjumand;Viquar, Uzma;Naikodi, Mohammad Abdul Rasheed;Siddiqui, Javed Inam;Zakir, Mohammad;Kazmi, Munawwar Husain;Minhajuddin, Ahmed
    • 셀메드
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    • 제11권4호
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    • pp.21.1-21.9
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    • 2021
  • Background: Unani System of Medicine (USM) has its origin to Greece. To ensure and develop the quality, authenticity of Unani drugs, standardization on modern analytical parameter is essential requirement for drugs. Objectives: The aimed of the present study was to develop a standard profile of "Qurṣ-e-Mafasil" by systematic study through authenticated ingredients, pharmacognostic identification followed by physicochemical, TLC, HPTLC fingerprinting analysis as per standard protocol. Material and Methods: In this study three batches of "Qurṣ-e-Mafasil" QM were prepared by standard method as per UPI had been followed by organoleptic properties of formulation such as appearance, color, odor, taste. Powder Microscopy and physicochemical studies were carried out such as Uniformity of weight, Friability, Disintegration time, hardness, LOD, ash vales and extractive values in like aqueous, alcohol & hexane. Further qualitative tests such as Thin-Layer Chromatography (TLC), and High-Performance Thin Layer Chromatography (HPTLC) studies were also carried out to develop fingerprint pattern of the alcoholic solvent extract of QM. Phytochemical screening was carried out in different solvent extracts such as alcoholic, aqueous and chloroform extracts to detect the presence phytoconstituents in the formulation QM. Heavy metals, Microbial Load Contamination and pesticidal residues were also determined. Results: Qurṣ-e-Mafasil showed tablet-like appearance, light brown colour, mild pungent odour and acrid taste. Uniformity of weight (mg), friability (rpm), and hardness (kg/cm) and disintegration time was ranged between (500 to 503), (0.0340 to 0.038), (8.40 to 8.67) and (4-5 minutes) respectively for the three batches. Loss in weight on drying at 105℃ was ranged between (8.3425 to 8.7346). Extracted values were calculated in distilled water ranged between (30.9091 to 31.4358), hexane (1.1419 to 1.4281), and alcohol (3.3352 to 3.3962). The ash values recorded were ranged between (3.7336 to 3.8378), and acid insoluble ash (0.5859 to 0.6112).

Free flap thrombosis in patients with hypercoagulability: A systematic review

  • Biben, Johannes Albert;Atmodiwirjo, Parintosa
    • Archives of Plastic Surgery
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    • 제46권6호
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    • pp.572-579
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    • 2019
  • Background Even with satisfactory anastomosis technique and adequate experience of the surgeon, flap loss due to thrombosis can still occur due to the patient's underlying condition. Patients with hypercoagulability due to etiologies such as malignancy, hereditary conditions, and acquired thrombophilia are among those who could benefit from free flap procedures. This review aimed to evaluate the risk of free flap thrombosis in patients with hypercoagulability and to identify the most effective thromboprophylaxis regimen. Methods This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. The PubMed, Embase, and Cochrane Library databases were explored. Types of free flaps, types of hypercoagulable states, thrombosis prevention protocols, thrombosis complication rates, and flap vitality outcomes were reviewed. Samples from the included studies were pooled to calculate the relative risk of free flap thrombosis complications in patients with hypercoagulability compared to those without hypercoagulability. Results In total, 885 articles underwent title, abstract, and full-text screening. Six articles met the inclusion criteria. The etiologies of hypercoagulability varied. The overall incidence of thrombosis and flap loss in hypercoagulable patients was 13% and 10.3%, respectively. The thrombosis risk was two times higher in hypercoagulable patients (P=0.074) than in controls. Thromboprophylaxis regimens were variable. Heparin was the most commonly used regimen. Conclusions Hypercoagulability did not significantly increase the risk of free flap thrombosis. The most effective thromboprophylaxis regimen could not be determined due to variation in the regimens. Further well-designed studies should be conducted to confirm this finding.

달천광산 주변 토양 내 비소의 존재형태 및 토양세척법에 의한 제거 (Fractionation and the Removal of Arsenic-Contaminated Soils Around Dalchĕn Mine Using Soil Washing Process)

  • 한경욱;신현무
    • 한국환경과학회지
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    • 제17권2호
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    • pp.185-193
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    • 2008
  • This study has been carried out to examine the feasibility of soil washing process for reducing arsenic contamination level of soil around $Dalch\hat{e}n$ Mine. The results of physicochemical tests of the target soil showed that pH was weak alkalic ($pH{\simeq}7.8$), soil texture was coarse sand, and organic contents (5.7%) and CEC (Cation exchange capacity; 21.5 meq/100 g) were similar with those of soils generally found in Korea. Contamination levels of arsenic were found to over 201 mg/kg which exceed the Korea standard levels of countermeasure and concern. To investigate chemical partitioning of heavy metals, sequential extraction procedures were adopted and it was found that arsenic was predominantly associated with the residual fraction among five fractional forms as much as over 85%, which is demonstrating that only less than 15% of all might be vulnerable to a selected washing agents. Among 6 kinds of washing agents applied on the screening for arsenic-contaminated soil, HCl and $H_3PO_4$ solution were selected as promising washing agents. In comparison with HCl and $H_3PO_4$ solutions for arsenic washing by kinetic experiment in the change of pH, soil-solution ratio, temperature, and washing solution concentration, $H_3PO_4$ solution was determined to best one of agents tested, which showed faster washing rate than HCl to accomplish regulatory goal.

성대내낭종에서 성대내바늘기법의 효과 (The Effects of Intralaryngeal Needle Technique in Intracordal Cyst)

  • 안철민
    • 대한후두음성언어의학회지
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    • 제27권1호
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    • pp.40-44
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    • 2016
  • Background and Objectives : Surgery is considered the primary treatment for intracordal cyst. However, patients who had undergone surgery are still subject to recurrence and continued voice changes. Intracordal cysts naturally disappear in some patient population. Cyst does not always recur in patients who had received partial surgical removal, too. Contradicting results raises a question whether complete surgical removal of intracordal cyst is necessary and demonstrate need for better treatment. Herein, the author proposes novel surgical method technique intralaryngeal needle technique (INT), a technique using surgical needle for not only injection but also for aspiration and excision of cyst. This study aims to examine the potential of intralaryngeal needle technique in treating intracordal cysts. Materials and Methods : Surgical procedures were done on in-patients diagnosed with intracordal cyst. 23 patients received follow-up screening after the surgery for one year. Patients' subjective satisfaction levels, acoustic measures, aerodynamic measures, laryngeal stroboscopic results were compared before and after the treatment. Results : Overall patients were satisfied with novel surgical excision method. In terms of aerodynamic measures, maximum phonation time, mean air flow rate improved after the surgery. In terms of acoustic measures, Jitter, Shimmer, NHR, and voice pitch changes after the treatment showed statistically significant differences. Laryngeal stroboscopy results showed significant decreases in cyst sizes. Post-surgery patients had improved mucosal waves and amplitudes values. Conclusion : The results show the validity of intralaryngeal needle technique in reducing intracordal cyst size by excision, aspiration, and injection. The author believes this novel technique can be used as an alternative surgical method for intracordal cysts.

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지적 영재유아 판별의 절차와 과제

  • 박혜원
    • 영재교육연구
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    • 제11권1호
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    • pp.99-117
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    • 2001
  • 본 연구에서는 만 6세 미만의 유아기 아동을 대상으로 영재판별의 필요성과 가능성을 살펴보고 지적 영재성을 진단할 수 있는 세부적인 방법들과 과제를 논의하였다. 6세미만의 유아기부터 지적 영재성은 더 나이든 아동의 특성과 유사한 행동특성으로 나타난다는 것이 부모의 관찰과 연구자들의 보고에 의해 밝혀져 있다. 단지 유아기에는 아동의 현재 수행보다 앞으로 보일 수행가능성 즉 잠재성의 측정이 중요하며 특히 유아의 여러 기능들이 서로 잘 분화되지 않은 점을 감안할 때 보다 과학적이고 포괄적인 판별이 필요하다는 것을 주장하였다. 구체적인 영재유아의 판별방법은 부모나 교사의 일상행동관찰에 의한 의뢰, 영재아 행동평가지, 간편 검사 그리고 개인별 세부 검사 등을 통한 종합적인 평가와 단계적 방법이 효율적임을 주장하였다. 특히 어린 유아의 경우 발달과정에서의 변이성이 크기 때문에 반복적 평가가 중요하다. 본 연구에서는 국내에서 사용하는 영재판별방법들의 종류와 검사자의 자질, 실시상의 주의점을 살펴보았으며 특히 영재아의 여러 특성을 올바로 진단할 수 있는 전문가와 다양한 검사방법이 개발이 중요하다는 것을 정리하였다. 끝으로 영재판별이 영재아에 대한 최적 교육환경의 제공이라는 점에서 조기 발견이 무엇보다 중요하다는 점을 강조하였다.

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연안준설 및 준설토 해양투기 해양환경평가 개선방안 (Improvement of the Marine Environmental Assessment for Dredging and Ocean Disposal of Coastal Sediment in Korea)

  • 이대인;박달수;엄기혁;김귀영;조현서;김종규;서영교;백근욱
    • 환경영향평가
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    • 제18권3호
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    • pp.131-141
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    • 2009
  • We studied improvement in marine environmental impact assessment and related management systems of coastal sediments that are dredged inshore but disposed offshore. After reviewing and diagnosing the existing assessment procedures and problems, we recommend to design the core assessment items and improve the reliability of assessment byenhancing the quality assurance/quality control (QA/QC) and verification processes. We proposed eco-friendly disposal plan for dredging sediment such as reuse system in land development was explored. A marine environmental database system was established to support the assessment processes. Guidelines for marine research and modelling were proposed for improving assessment of dredging and disposal of coastal sediment. Also, applying of screening and scoping for marine environmental assessment was reviewed.

흰쥐 조직에 존재하는 Inositol(1,4,5) triphosphate 3-Kinase의 면역학적 특성 (Immunological Gharacterization of Inositol(1,4,5) triphosphate 3-Kinase in Rat Tissues)

  • 김재웅;이서구
    • 한국식품영양학회지
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    • 제6권1호
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    • pp.37-46
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    • 1993
  • Brain, heart, liver, lung, kidney and thymus etc. 12 organs were removed and homogenized from Dawley-Sprague rats after suffocation. After fractionation of the tissue cytosols, enzymatic activities of the key enzymes in metabolic inositol phosphates cycle, PLC, IPSK and Ins(1,4,5) P35-phosphatase, were measured respectively. Hybridoma monoclones producing anti-lP3K murine monoclonal antibodies were obtained by the fusion of SP2/Ag 0-14 and spleen cells of mouse immunized with purified 53KDa IPSK, screening and cloning procedures. 18 cloned hybridoma cells were obtained, background due to nonspecific binding was very low with 10 clones. These Abs were purified from ascitic fluids by using affi-gel 15, and determined subtype of Abs. When immunoreactivities for rat tissues IP3K were exercised by adding the mixed Abs of 19Gl and 19G2b, they showed an overall similarity with noncompetitive inhibition. Brain tissue has high sensitivity for anti-lP3K Ab, whereas heart tissue has very low activity. In kinetic parameters Km value was 1.58 mM and Vmx value was 5.41umol/min/ml, respectively Only one form of 40 KDa IPSK was detected in heart tissues, however rat brain contains at least three immunologically distinct IP3K (53, 51 and 40 KDa) in western blot analysis. Of them 53 KDa protein was major enzyme in enzymatic activity. Northern blot analysis with 32P-labeled CDNA probe which encodes 1.8 Kb IPSK gene was performed. These results suggest that IPSK are regulated at transcriptional level during rat tissue development.

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