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Comparison of the Therapeutic Efficacy and Technical Outcomes between Conventional Fixed Electrodes and Adjustable Electrodes in the Radiofrequency Ablation of Benign Thyroid Nodules

  • Jae Ho Shin;Minkook Seo;Min Kyoung Lee;So Lyung Jung
    • Korean Journal of Radiology
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    • v.25 no.2
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    • pp.199-209
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    • 2024
  • Objective: This study aimed to compare therapeutic efficacy and technical outcomes between adjustable electrode (AE) and conventional fixed electrode (FE) for radiofrequency ablation (RFA) of benign thyroid nodules. Materials and Methods: Between 2013 and 2021, RFA was performed on histologically proven benign thyroid nodules. For the AE method, AE length ≥ 1 cm with higher power and < 1 cm with lower power were utilized for ablating feeding vessels and nodules, especially those near anatomical structures, respectively. The therapeutic efficacy (volume reduction rate [VRR], complication rate, and regrowth rate) and technical outcomes (total energy delivery, ablated volume/energy, RFA time, and ablated volume/time) of FE and AE were compared. Continuous parameters were compared using a two-sample t-test or Mann-Whitney U test, and categorical parameters were compared using a chi-squared test or Fisher's exact test. Results: A total of 182 nodules (FE: 92 vs. AE: 90) in 173 patients (mean age ± standard deviation, 47.0 ± 14.7 years; female, 90.8% [157/173]; median follow-up, 726 days [interquartile range, 441-1075 days]) were analyzed. The therapeutic efficacy was comparable, whereas technical outcomes were more favorable for AE. Both electrodes demonstrated comparable overall median VRR (FE: 92.4% vs. AE: 84.9%, P = 0.240) without immediate major complications. Overall regrowth rates were comparable between the two groups (FE: 2.2% [2/90] vs. AE: 1.1% [1/90], P > 0.99). AE demonstrated a shorter median RFA time (FE: 811 vs. AE: 627 seconds, P = 0.009). Both delivered comparable median energy (FE: 42.8 vs. AE: 29.2 kJ, P = 0.069), but AE demonstrated higher median ablated volume/energy and median ablated volume/time (FE: 0.2 vs. AE: 0.3 cc/kJ, P < 0.001; and FE: 0.7 vs. AE: 1.0 cc/min, P < 0.001, respectively). Conclusion: Therapeutic efficacy between FE and AE was comparable. AE demonstrated better technical outcomes than FE in terms of RFA time, ablated volume/energy, and ablated volume/time.

Various Pathologic Conditions of Sinus Tarsi Syndrome Assessed by Imaging and Arthroscopic Findings (영상학적 및 관절경적 소견으로 평가한 족근동 증후군의 다양한 병적 상태)

  • Jeong Jin Park;Seung Jae Cho;Seong Hyeon Jo;Chul Hyun Park
    • Journal of Korean Foot and Ankle Society
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    • v.28 no.2
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    • pp.60-67
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    • 2024
  • Purpose: Sinus tarsi syndrome (STS) is caused by various pathologies. However, the exact etiology of STS remains controversial. This study evaluated the imaging and arthroscopic findings of patients who underwent surgical treatment after conservative treatment for STS failed. Materials and Methods: Between December 2014 and August 2018, 20 patients (21 cases) who underwent surgical treatment for STS were included in the study. The clinical results were analyzed using the visual analog scale (VAS) and the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot functional scale. The radiographic results were analyzed using Meary's angle, calcaneal pitch angle, and hindfoot alignment angle. The pathologic conditions of sinus tarsi were confirmed by magnetic resonance imaging (MRI) and subtalar arthroscopy. Synovitis, bone edema, and accessory anterolateral talar facet (AALTF) were evaluated on MRI. Synovial thickening, cartilage damage, interosseous talocalcaneal ligament (ITCL) and cervical ligament rupture, soft tissue impingement, AALTF, and accessory talar facet impingement (ATFI) were evaluated by subtalar arthroscopy. Results: The mean duration of symptoms was 28.7 months (4~120). All patients showed significant improvement in the VAS and AOFAS ankle-hindfoot scale. Significant improvements in hindfoot alignment angle and Meary's angle postoperatively were noted in patients who underwent medial displacement calcaneal osteotomy. MRI confirmed synovitis in all patients, AALTF in 19 cases (90.5%), and ATFI with bone edema in seven cases (33.3%). In subtalar arthroscopy, pathologic conditions were observed in the following order: synovitis in 21 cases (100%), AALTF in 20 cases (95.2%), ITCL partial rupture in nine cases (42.9%), and soft tissue impingement in seven cases (33.3%). All cases had two or more pathological conditions, and 15 (71.4%) had three or more. Conclusion: In cases of STS that do not respond to conservative treatment, a comprehensive examination of the lesions of the tarsal sinus and lesions around the subtalar joint is essential.

Optimizing cone-beam computed tomography exposure for an effective radiation dose and image quality balance

  • Ananda Amaral Santos;Brunno Santos de Freitas Silva;Fernanda Ferreira Nunes Correia;Eleazar Mezaiko;Camila Ferro de Souza Roriz;Maria Alves Garcia Silva;Deborah Queiroz Freitas;Fernanda Paula Yamamoto-Silva
    • Imaging Science in Dentistry
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    • v.54 no.2
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    • pp.159-169
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    • 2024
  • Purpose: The aim of this study was to evaluate the influence of different cone-beam computed tomography (CBCT) acquisition protocols on reducing the effective radiation dose while maintaining image quality. Materials and Methods: The effective dose emitted by a CBCT device was calculated using thermoluminescent dosimeters placed in a Rando Alderson phantom. Image quality was assessed by 3 experienced evaluators. The relationship between image quality and confidence was evaluated using the Fisher exact test, and the agreement among raters was assessed using the kappa test. Multiple linear regression analysis was performed to investigate whether the technical parameters could predict the effective dose. P-values<0.05 were considered to indicate statistical significance. Results: The optimized protocol (3 mA, 99 kVp, and 450 projection images) demonstrated good image quality and a lower effective dose for radiation-sensitive organs. Image quality and confidence had consistent values for all structures (P<0.05). Multiple linear regression analysis resulted in a statistically significant model. The milliamperage (b=0.504; t=3.406; P=0.027), kilovoltage peak (b=0.589; t=3.979; P=0.016) and number of projection images (b=0.557; t=3.762; P=0.020) were predictors of the effective dose. Conclusion: Optimized CBCT acquisition protocols can significantly reduce the effective radiation dose while maintaining acceptable image quality by adjusting the milliamperage and projection images.

Organic solvent exposure for the chronic kidney disease: updated systematic review with meta-analysis

  • Chaeseong Lim;Hyeoncheol Oh
    • Annals of Occupational and Environmental Medicine
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    • v.35
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    • pp.11.1-11.17
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    • 2023
  • Background: Studies on the relationship between organic solvent exposure and chronic kidney disease (CKD) have presented inconsistent results. Definition of CKD has changed in 2012, and other cohort studies have been newly published. Therefore, this study aimed to newly confirm the relationship between organic solvent exposure and CKD through an updated meta-analysis including additional studies. Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The search was conducted on January 2, 2023 using Embase and MEDLINE databases. Case-control and cohort studies on the relationship between organic solvent exposure and CKD were included. Two authors independently reviewed full-text. Results: Of 5,109 studies identified, a total of 19 studies (control studies: 14 and cohort studies: 5) were finally included in our meta-analysis. The pooled risk of CKD in the organic solvent exposed group was 2.44 (1.72-3.47). The risk of a low-level exposure group was 1.07 (0.77-1.49). The total risk of a high-level exposure group was 2.44 (1.19-5.00). The risk of glomerulonephritis was 2.69 (1.18-6.11). The risk was 1.46 (1.29-1.64) for worsening of renal function. The pooled risk was 2.41 (1.57-3.70) in case-control studies and 2.51 (1.34-4.70) in cohort studies. The risk of subgroup classified as 'good' by the Newcastle Ottawa scale score was 1.93 (1.43-2.61). Conclusions: This study confirmed that the risk of CKD was significantly increased in workers exposed to mixed organic solvents. Further research is needed to determine the exact mechanisms and thresholds. Surveillance for kidney damage in the group exposed to high levels of organic solvents should be conducted.

Follow-Up Intervals for Breast Imaging Reporting and Data System Category 3 Lesions on Screening Ultrasound in Screening and Tertiary Referral Centers

  • Sun Huh;Hee Jung Suh;Eun-Kyung Kim;Min Jung Kim;Jung Hyun Yoon;Vivian Youngjean Park;Hee Jung Moon
    • Korean Journal of Radiology
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    • v.21 no.9
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    • pp.1027-1035
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    • 2020
  • Objective: To assess the appropriate follow-up interval, and rate and timepoint of cancer detection in women with Breast Imaging Reporting and Data System (BI-RADS) 3 lesions on screening ultrasonography (US) according to the type of institution. Materials and Methods: A total of 1451 asymptomatic women who had negative or benign findings on screening mammogram, BI-RADS 3 assessment on screening US, and at least 6 months of follow-up were included. The median follow-up interval was 30.8 months (range, 6.8-52.9 months). The cancer detection rate, cancer detection timepoint, risk factors, and clinicopathological characteristics were compared between the screening and tertiary centers. Nominal variables were compared using the chi-square or Fisher's exact test and continuous variables were compared using the independent t test or Mann-Whitney U test. Results: In 1451 women, 19 cancers (1.3%) were detected; two (0.1%) were diagnosed at 6 months and 17 (1.2%) were diagnosed after 12.3 months. The malignancy rates were both 1.3% in the screening (9 of 699) and tertiary (10 of 752) centers. In the screening center, all nine cancers were invasive cancers and diagnosed after 12.3 months. In the tertiary center, two were ductal carcinomas in situ and eight were invasive cancers. Two of the invasive cancers were diagnosed at 6 months and the remaining eight cancers newly developed after 13.1 months. Conclusion: One-year follow-up rather than 6-month follow-up may be suitable for BI-RADS 3 lesions on screening US found in screening centers. However, more caution is needed regarding similar findings in tertiary centers where 6-month follow-up may be more appropriate.

A Study on Forecasting Demand and Supply of Marine Officer for Korean Ocean-Going Merchant Vessels (외항 상선 해기사 인력 수요 및 공급 예측에 관한 연구)

  • Sang-hoon Shin;Yong-John Shin
    • Journal of Navigation and Port Research
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    • v.48 no.1
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    • pp.7-16
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    • 2024
  • Although the number of ocean-going merchant ships is increasing, the number of Korean marine officers is decreasing. This manpower shortage problem is becoming more serious. This study objectively measured factors determining the demand and supply of ocean-going merchant ship officers and forecasted the exact manpower demand and supply. Demand was predicted by applying the number of ship officers required for each ship size to the number of ships forecasted. The supply was predicted by segmenting by position and age using the Markov model, reflecting increase/decrease factors such as promotion, turnover, retirement, and new entry by year. The demand for ocean-going merchant ship officers will increase from 11,638 in 2023 to 13,879 in 2030 while the supply will decrease from7,006 in 2023 to 6,426 in 2030, with the shortage expected to exceed 10,000 in 2040. This study can be used as a reference to solve the problem of manpower shortage for ocean-going merchant ship officers by improving the accuracy of predictions through objective data, scientific analysis methods, and logical reasoning.

Nonlocal bending, vibration and buckling of one-dimensional hexagonal quasicrystal layered nanoplates with imperfect interfaces

  • Haotian Wang;Junhong Guo
    • Structural Engineering and Mechanics
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    • v.89 no.6
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    • pp.557-570
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    • 2024
  • Due to interfacial ageing, chemical action and interfacial damage, the interface debonding may appear in the interfaces of composite laminates. Particularly, the laminates display a side-dependent effect at small scale. In this work, a three-dimensional (3D) and anisotropic thick nanoplate model is proposed to investigate the effects of imperfect interface and nonlocal parameter on the bending deformation, vibrational response and buckling stability of one-dimensional (1D) hexagonal quasicrystal (QC) layered nanoplates. By combining the linear spring model with the transferring matrix method, exact solutions of phonon and phason displacements, phonon and phason stresses of bending deformation, the natural frequencies of vibration and the critical buckling loads of 1D hexagonal QC layered nanoplates are derived with imperfect interfaces and nonlocal effects. Numerical examples are illustrated to demonstrate the effects of the imperfect interface parameter, aspect ratio, thickness, nonlocal parameter, and stacking sequence on the bending deformation, the vibrational response and the critical buckling load of 1D hexagonal QC layered nanoplate. The results indicate that both the interface debonding and nonlocal effect can reduce the stiffness and stability of layered nanoplates. Increasing thickness of QC coatings can enhance the stability of sandwich nanoplates with the perfect interfaces, while it can reduce first and then enhance the stability of sandwich nanoplates with the imperfect interfaces. The biaxial compression easily results in an instability of the QC layered nanoplates compared to uniaxial compression. QC material is suitable for surface layers in layered structures. The mechanical behavior of QC layered nanoplates can be optimized by imposing imperfect interfaces and controlling the stacking sequence artificially. The present solutions are helpful for the various numerical methods, thin nanoplate theories and the optimal design of QC nano-composites in engineering practice with interfacial debonding.

Analysis of eating behavior of Indonesian women from multicultural and non-multicultural families

  • Ulya Ardina;Su-In Yoon;Jin Ah Cho
    • Journal of Nutrition and Health
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    • v.57 no.2
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    • pp.228-243
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    • 2024
  • Purpose: This study aimed to identify the distinctions in dietary and health-related behaviors among Indonesian women who marry Koreans or into multicultural families (MF) and those who marry Indonesians living in Korea (IK) and in Indonesia (II). Methods: The study was performed with 192 subjects using an online questionnaire regarding food choice, dietary and health behavior, and nutrition quotient (NQ). The analysis used Pearson's chi-squared test, the Fisher's exact test, multinomial logistic regression, and the general linear model. Results: The MF group consumed Korean food more than once a day and Indonesian food 1-2 times monthly (p < 0.001). The main challenge for the IK and II groups in consuming Korean food was the presence of pork and the different food flavors (p < 0.001). The MF group tended to have normal body mass index, consumed more vitamin and mineral supplements (p = 0.014), and exercised regularly ≥150 min/week compared to the IK and II groups (p < 0.001). However, the MF group had the highest rate of skipping breakfast (p = 0.040). When evaluating the NQ of the participants, the MF group consumed more vegetables (p = 0.026), mixed grains (p = 0.031), and spicy and salt soups (p = 0.006). The II group consumed more fish (p = 0.005), beans (p = 0.009), and nuts (p = 0.003). The IK group checked the nutrition labels the most (p = 0.005), while their consumption of vegetables, fish, beans, and nuts was lowest. The MF group had a higher balance score, which resulted in a substantially more nutritious food intake compared to the other two groups (p = 0.037). Conclusion: The MF group consumed more vegetables and mixed grains, adequate fish, beans, and nuts, and engaged in longer daily physical activity. However, the IK group had a relatively low-quality diet and nutritional intake status compared to the other two groups, and this needs to be improved in the future.

Impact of an Integrated Infection Control Education Program on Caregivers in Long-Term Care Facilities (장기요양시설 요양보호사를 위한 통합적 감염관리 교육프로그램의 효과)

  • Lee, Gyeong Mi;Jun, Eun-Young
    • Journal of Home Health Care Nursing
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    • v.31 no.1
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    • pp.77-88
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    • 2024
  • Purpose: This study aimed to develop and assess the impact of an integrated infection control education program on the awareness, attitudes, and performance of infection control among caregivers in long-term care facilities. Methods: Participants were recruited from two long-term care facilities with 25 caregivers in both the experimental group and the control group. This study used non-equivalent control group quasi-experimental pre-post design. The effectiveness of a developed Integrated Infection Control Education Program was evaluated based on infection control awareness, attitudes, and performance. Data were analyzed using SPSS/WIN 28.0 through descriptive statistics, chi-square tests, Fisher's exact tests, and independent t-tests. Results: There was a statistically significant difference in the degree of awareness (t=-5.00, p<.001), attitude (t=-4.91, p<.001), and performance (t=-6.66, p<.001) of infection control between the two groups. Conclusion: Given these results, the integrated infection control education program significantly improved infection control awareness, attitudes, and performance among caregivers in long-term care facilities. This study is noteworthy because it provided comprehensive education on infection control practices to caregivers in environments that are particularly susceptible to infections, especially following COVID-19. This educational program is actively utilized and validated in practice, it would enhance the infection control performance of caregivers, thereby reducing infection rates within facilities, shortening the length of stay for elderly residents in long term care facilities, and contributing to the reduction of healthcare costs.

Surgical treatment of feline intracranial meningiomas: a retrospective study of 26 cases

  • Charles Porsmoguer;Margaux Blondel;Pierre H. M. Moissonnier
    • Journal of Veterinary Science
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    • v.25 no.2
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    • pp.25.1-25.12
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    • 2024
  • Background: Surgical excision is the treatment of choice for feline intracranial meningioma. Objectives: To report clinical findings, complications, and outcomes following surgery for feline intracranial meningioma. Methods: Medical records (01/2000-01/2017) of cats that underwent surgical excision of an intracranial meningioma at our institution were reviewed. Patient data included signalment, clinical signs, surgical technique, complications, histopathologic diagnosis, survival time, and owners' answers to a satisfaction questionnaire. Survival was assessed using the Kaplan-Meier method and log-rank test. Results: Twenty-six cats were included in this study. The exact cause of death was known in 17 cases and was not related to meningioma in 9/17 cases. Overall median survival time was 881 days (95% confidence interval 518; 1248). The age of the cat did not influence survival (p = 0.94) or the occurrence of complications (p = 0.051). Complications occurred in 13/24 cats, including dramatic complications in 4/24 cats. Most complications appeared in the first 24 hours post-surgery (12/13). Males had more postoperative complications (p = 0.042), including more seizures (p = 0.016). Cats with cranioplasty had fewer complications (p = 0.021). Clinical recurrence was confirmed in 3 out of 17 cats. Recurrence-free survival time was 826 days. Most owners (12/14) were satisfied with the outcome. Conclusions: Surgical treatment of intracranial meningioma in cats was associated with a long median survival time but also with a high rate of minor and major postoperative complications, including early postoperative seizures. Cranioplasty may reduce complications. Age at the time of surgery had no effect on outcomes.