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( Gwyneth Soon ),( Aileen Wee ) 대한간학회 2021 Clinical and Molecular Hepatology(대한간학회지) Vol.27 No.1
Nonalcoholic fatty liver disease/nonalcoholic steatohepatitis (NAFLD/NASH) is a major cause of liver fibrosis and cirrhosis. Accurate assessment of liver fibrosis is important for predicting disease outcomes and assessing therapeutic response in clinical practice and clinical trials. Although noninvasive tests such as transient elastography and magnetic resonance elastography are preferred where possible, histological assessment of liver fibrosis via semiquantitative scoring systems remains the current gold standard. Collagen proportionate area provides more granularity by measuring the percentage of fibrosis on a continuous scale, but is limited by the absence of architectural input. Although not yet used in routine clinical practice, advances in second harmonic generation/two-photon excitation fluorescence (SHG/TPEF) microscopy imaging show great promise in characterising architectural features of fibrosis at the individual collagen fiber level. Quantification and calculation of different detailed variables of collagen fibers can be used to establish algorithm-based quantitative fibrosis scores (e.g., qFibrosis, q-FPs), which have been validated against fibrosis stage in NAFLD. Artificial intelligence is being explored to further refine and develop quantitative fibrosis scoring methods. SHG-microscopy shows promise as the new gold standard for the quantitative measurement of liver fibrosis. This has reaffirmed the pivotal role of the liver biopsy in fibrosis assessment in NAFLD, at least for the near-future. The ability of SHG-derived algorithms to intuitively detect subtle nuances in liver fibrosis changes over a continuous scale should be employed to redress the efficacy endpoint for fibrosis in NASH clinical trials; this approach may improve the outcomes of the trials evaluating therapeutic response to antifibrotic drugs. (Clin Mol Hepatol 2021;27:44-57)
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#A little bird told me: birdcaging the message during the BP disaster
Gwyneth V.J. Howell,Rohan Miller,Georgina Rushbrook-House 한국마케팅과학회 2014 마케팅과학연구 Vol.24 No.2
The purpose of crisis planning is to prepare for the inevitable. This paper examinesBP’s crisis response following the Deepwater Horizon oil rig explosion and thesubsequent environmental disaster in the Gulf of Mexico. This event severely damagedBP’s corporate standing, and the company’s response and management of the crisis andcleanup exacerbated the damage to BP’s reputation. The company’s crisiscommunication strategies failed amid an onslaught of online and social mediacommentary from traditionally passive stakeholders and activists. The resultantdamage to the company’s reputation saw $95B wiped off the company’s equity valueand the CEO forced to resign. It is shown that crisis planning needs to be continuallyreviewed to take account of the evolving nature of social media during a crisis; in thisinstance, the use of Twitter proved particularly damaging to BP. Rolling crisis plansthat encompass all media are required to provide the conclusive and swift actionnecessary to minimise the impact of a crisis.
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Chun Han Nigel Tan,Gwyneth Shook Ting Soon,Wei Chieh Alfred Kow 한국간담췌외과학회 2017 Annals of hepato-biliary-pancreatic surgery Vol.21 No.3
Peliosis Hepatis (PH) is a rare vascular disorder of the liver, characterized by the presence of cystic blood-filled cavities distributed throughout the hepatic parenchyma. The pathogenesis of PH remains controversial. The preoperative diagnosis of PH is difficult, due to the non-specific imaging characteristics of PH and almost all cases are diagnosed on histology post resection. This study presents a case of PH masquerading as hepatocellular carcinoma (HCC). The patient is a 45-year old Chinese lady, who presented with transaminitis. She was found to be hepatitis B virus core total antibody-positive with an alpha-fetoprotein (AFP) of 29.4 ng/ml. Triphasic liver computed tomography showed several arterial hypervascular lesions and hypoenhancing lesions on the venous phase, particularly in the segments 6/7. Subsequently, a magnetic resonance imaging scan showed multiple lesions in the right hemiliver with an indeterminate enhancement patterns. Subsequently, she decided to undergo a resection procedure. Histopathology revealed findings consistent with PH with some unusual features. This case demonstrates a clinical conundrum, in which PH presented with a raised AFP, in a patient with risk factors for the development of HCC. The clinical suspicion of PH should be high in patients, who present with multiple hepatic lesions with variable enhancement patterns.
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