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Current Status of Endoscopic Gallbladder Drainage
Joey Ho Yi Chan,Anthony Yuen Bun Teoh 대한소화기내시경학회 2018 Clinical Endoscopy Vol.51 No.2
The gold standard for treatment of acute cholecystitis is laparoscopic cholecystectomy. However, cholecystectomy is often not suitablefor surgically unfit patients who are too frail due to various co-morbidities. As such, several less invasive endoscopic treatmentmodalities have been developed to control sepsis, either as a definitive treatment or as a temporizing modality until the patient is stableenough to undergo cholecystectomy at a later stage. Recent developments in endoscopic ultrasound-guided gallbladder drainage (EUSGBD)with EUS-specific stents having lumen-apposing properties have demonstrated potential as a definitive treatment modality. Furthermore, advanced gallbladder procedures can be performed using the stents as a portal. With similar effectiveness as percutaneoustranshepatic cholecystostomy and lower rates of adverse events reported in some studies, EUS-GBD has opened exciting possibilities inbecoming the next best alternative in treating acute cholecystitis in surgically unfit patients. The aim of this review article is to providea summary of the various methods of GBD with particular focus on EUS-GBD and the many new prospects it allows.
Measurement of Clavicle Fracture Shortening Using Computed Tomography and Chest Radiography
Reza Omid,Chris Kidd,Anthony Yi,Diego Villacis,Eric White 대한정형외과학회 2016 Clinics in Orthopedic Surgery Vol.8 No.4
Background: Nonoperative management of midshaft clavicle fractures has resulted in widely disparate outcomes and there is growing evidence that clavicle shortening poses the risk of unsatisfactory functional outcomes due to shoulder weakness and nonunion. Unfortunately, the literature does not clearly demonstrate the superiority of one particular method for measuring clavicle shortening. The purpose of this study was to compare the accuracy of clavicle shortening measurements based on plain radiographs with those based on computed tomography (CT) reconstructed images of the clavicle. Methods: A total of 51 patients with midshaft clavicle fractures who underwent both a chest CT scan and standardized anteroposterior chest radiography on the day of admission were included in this study. Both an orthopedic surgeon and a musculoskeletal radiologist measured clavicle shortening for all included patients. We then determined the accuracy and intraclass correlation coefficients for the imaging modalities. Bland-Altman plots were created to analyze agreement between the modalities and a paired t-test was used to determine any significant difference between measurements. Results: For injured clavicles, radiographic measurements significantly overestimated the clavicular length by a mean of 8.2 mm (standard deviation [SD], ± 10.2; confidence interval [CI], 95%) compared to CT-based measurements (p < 0.001). The intraclass correlation was 0.96 for both plain radiograph- and CT-based measurements (p = 0.17). Conclusions: We found that plain radiograph-based measurements of midshaft clavicle shortening are precise, but inaccurate. When clavicle shortening is considered in the decision to pursue operative management, we do not recommend the use of plain radiograph-based measurements.
Diana Wai-Lam Ho,Anthony Pak-Hin Kong,Olivia Ho-Yi Yeung,Samson Wai Yeung 한국언어재활사협회 2020 Clinical Archives of Communication Disorders Vol.5 No.1
Purpose: The study aimed at developing and determining the preliminary reliability and validity of a new screening form for use by laypersons to refer individuals with neurogenic communication disorders to speech-language pathologists. Methods: Thirty-two native Cantonese speakers with neurogenic communication disorders were tested with the proposed screening form by fourteen volunteer raters and well-established speech and language tests for aphasia, dysarthria and apraxia of speech (AOS) by ten speech-language pathology students. Results: Statistical analyses showed that the internal consistency and inter-rater reliability were high in all the tasks for aphasia and most of the tasks for dysarthria and AOS of the proposed screening form. It was further identified that some of the tasks for aphasia, dysarthria, and AOS would be valid for laypersons to identify individuals with communications disorders. Conclusions: The results indicated that the tasks for screening aphasia, dysarthria, and AOS should be carefully selected so that untrained laypersons would be able to make correct judgements. Further investigations involving a larger sample size are needed to determine areas to enhance the sensitivity and discriminating power of the current screener to be used by laypersons without a clinical background.
Fuzzy AHP Approach to TQM Strategy Evaluation
Tseng, Ming-Lang,Lin, Yuan-Hsu,Chiu, Anthony SF,Chen, Chia Yi Korean Institute of Industrial Engineers 2008 Industrial Engineeering & Management Systems Vol.7 No.1
In recent years, many electronics producing firms have looked upon total quality management (TQM) strategy as a means by which they could maintain competitive advantage. This empirical research evaluates TQM strategic factors in order to determine the critical success factors in environmental uncertainty. Fuzzy analytic hierarchy process (FAHP) is the proposed research methodology to discuss and tackle the different decision criteria like effective leadership, people management, customer focus, strategic plan and process management, being involved in identifying the TQM strategic critical success factors with uncertainty. The result shows that effective leadership is the most critical success factor in TQM strategy.
Fuzzy AHP Approach to TQM Strategy Evaluation
Ming-Lang Tseng,Yuan-Hsu Lin,Anthony SF Chiu,Chia Yi Chen 대한산업공학회 2008 Industrial Engineeering & Management Systems Vol.7 No.1
In recent years, many electronics producing firms have looked upon total quality management (TQM) strategy as a means by which they could maintain competitive advantage. This empirical research evaluates TQM strategic factors in order to determine the critical success factors in environmental uncertainty. Fuzzy analytic hierarchy process (FAHP) is the proposed research methodology to discuss and tackle the different decision criteria like effective leadership, people management, customer focus, strategic plan and process management, being involved in identifying the TQM strategic critical success factors with uncertainty. The result shows that effective leadership is the most critical success factor in TQM strategy.
Acute Compartment Syndrome after Non-Contact Peroneus Longus Muscle Rupture
Jarrad Merriman,Diego Villacis,Curtis Kephart,Anthony Yi,Russ Romano,George F. Rick Hatch 대한정형외과학회 2015 Clinics in Orthopedic Surgery Vol.7 No.4
This case demonstrates a rare variation in the pattern of injury and the presentation of acute lateral compartment syndrome of the leg. Although uncommon, lateral compartment syndrome of the leg after an ankle inversion leading to peroneus longus muscle rupture has been previously documented. This case was unusual because there was no overt ankle injury and the patient was able to continue physical activity, in spite of a significant rupture of the peroneus longus muscle that was determined later. This case highlights the necessary vigilance clinicians must maintain when assessing non-contact injuries in patients with possible compartment syndrome.
Insights from a Prospective Follow-up of Thyroid Function and Autoimmunity among COVID-19 Survivors
David Tak Wai Lui,Chi-Ho Lee,Wing-Sun Chow,Alan Chun Hong Lee,Anthony Raymond Tam,Carol Ho Yi Fong,Chun Yiu Law,Eunice Ka Hong Leung,Kelvin Kai Wang To,Kathryn Choon Beng Tan,Yu-Cho Woo,Ching Wan Lam 대한내분비학회 2021 Endocrinology and metabolism Vol.36 No.3
Background: The occurrence of Graves’ disease and Hashimoto thyroiditis after coronavirus disease 2019 (COVID-19) raised concerns that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may trigger thyroid autoimmunity. We aimed to address the current uncertainties regarding incident thyroid dysfunction and autoimmunity among COVID-19 survivors. Methods: We included consecutive adult COVID-19 patients without known thyroid disorders, who were admitted to Queen Mary Hospital from July 21 to September 21, 2020 and had serum levels of thyroid-stimulating hormone, free thyroxine, free triiodothyronine (fT3), and anti-thyroid antibodies measured both on admission and at 3 months. Results: In total, 122 patients were included. Among 20 patients with abnormal thyroid function tests (TFTs) on admission (mostly low fT3), 15 recovered. Among 102 patients with initial normal TFTs, two had new-onset abnormalities that could represent different phases of thyroiditis. Among 104 patients whose anti-thyroid antibody titers were reassessed, we observed increases in anti-thyroid peroxidase (TPO) (P<0.001) and anti-thyroglobulin (P<0.001), but not anti-thyroid stimulating hormone receptor titers (P=0.486). Of 82 patients with negative anti-TPO findings at baseline, 16 had a significant interval increase in anti-TPO titer by >12 U, and four became anti-TPO-positive. Worse baseline clinical severity (P=0.018), elevated C-reactive protein during hospitalization (P=0.033), and higher baseline anti-TPO titer (P=0.005) were associated with a significant increase in anti-TPO titer. Conclusion: Most patients with thyroid dysfunction on admission recovered during convalescence. Abnormal TFTs suggestive of thyroiditis occurred during convalescence, but infrequently. Importantly, our novel observation of an increase in anti-thyroid antibody titers post-COVID-19 warrants further follow-up for incident thyroid dysfunction among COVID-19 survivors.