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( Lauren M. Ladd ),( Temel Tirkes ),( Mark Tann ),( David M Agarwal ),( Matthew S Johnson ),( Bilal Tahir ),( Kumaresan Sandrasegaran ) 대한간학회 2016 Clinical and Molecular Hepatology(대한간학회지) Vol.22 No.4
Background/Aims: The diagnosis and treatment plan for hepatocellular carcinoma (HCC) can be made from radiologic imaging. However, lesion detection may vary depending on the imaging modality. This study aims to evaluate the sensitivities of hepatic multidetector computed tomography (MDCT), magnetic resonance imaging (MRI), and digital subtraction angiography (DSA) in the detection of HCC and the consequent management impact on potential liver transplant patients. Methods: One hundred and sixteen HCC lesions were analyzed in 41 patients who received an orthotopic liver transplant (OLT). All of the patients underwent pretransplantation hepatic DSA, MDCT, and/or MRI. The imaging results were independently reviewed retrospectively in a blinded fashion by two interventional and two abdominal radiologists. The liver explant pathology was used as the gold standard for assessing each imaging modality. Results: The sensitivity for overall HCC detection was higher for cross-sectional imaging using MRI (51.5%, 95% confidence interval [CI]=36.2-58.4%) and MDCT (49.8%, 95% CI=43.7-55.9%) than for DSA (41.7%, 95% CI=36.2-47.3%) (P=0.05). The difference in false-positive rate was not statistically significant between MRI (22%), MDCT (29%), and DSA (29%) (P=0.67). The sensitivity was significantly higher for detecting right lobe lesions than left lobe lesions for all modalities (MRI: 56.1% vs. 43.1%, MDCT: 55.0% vs. 42.0%, and DSA: 46.9% vs. 33.9%; all P<0.01). The sensitivities of the three imaging modalities were also higher for lesions ≥2 cm vs. <2 cm (MRI: 73.4% vs. 32.7%, MDCT: 66.9% vs. 33.8%, and DSA: 62.2% vs. 24.1%; all P<0.01). The interobserver correlation was rated as very good to excellent. Conclusions: The sensitivity for detecting HCC is higher for MRI and MDCT than for DSA, and so cross-sectional imaging modalities should be used to evaluate OLT candidacy. (Clin Mol Hepatol 2016;22:450-457)
Social Competence: An Important Educational Objective?
Gary W. Ladd 환태평양유아교육연구학회 2007 Asia-Pacific journal of research in early childhoo Vol.1 No.1
Abstract. Because early childhood educators have been entrusted with the responsibility of promoting children S social competence, it is important to consider the meaning of this concept and its value as an educational objec - tive. Accordingly, three principal themes are addressed in this article. First, the construct of social competence is examined with the aim of explicating assumptions about its locus, its modes of expression or manifestations, and the conditions under which children s performance can be considered competent. Second, the value of social competence as an educational objective is appraised in light of what has been learned, empirically, about its role in chil - dren s development. Third, findings from research on the precursors of social competence are reviewed as a means of identifYing resources that may useful for promoting social competence in young children.