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Ultrasound-guided percutaneous nephrolithotomy: Advantages and limitations
Foo Cheong Ng,Wai Loon Yam,Tze Ying Benjamin Lim,Jin Kiat Teo,Kok Kit Ng,Sey Kiat Lim 대한비뇨의학회 2017 Investigative and Clinical Urology Vol.58 No.5
Purpose: The use of ultrasound in percutaneous nephrolithotomy (PCNL) has not been shown to translate to better clinical and stone outcomes. To compare the operative outcomes, postoperative outcomes and complication rates of ultrasound-guided access PCNL (USGA-PCNL) versus fluoroscopy-guided access PCNL (FGA-PCNL). Materials and Methods: A total of 184 consecutive patients who underwent PCNL from July 2008 to September 2014 were identified from our PCNL database. Seventy-two patients underwent USGA-PCNL and 112 FGA-PCNL. Results: The patients were similar in age, sex, race, American Society of Anesthesiologists physical status classification, mean largest stone diameters, side of PCNL, number of stones and the degree of hydronephrosis between both groups. There were higher rates of upper pole (5.6% vs. 3.6%), mid pole (8.3% vs. 2.7%) and multiple pole punctures (4.2% vs. 0%) in USGA-PCNL compared to FGA-PCNL (p=0.027). There was no difference in the stone free rates of both groups in univariate analysis. Those who had FGA-PCNL were 2.26 (95% confidence interval, 1.09–4.75; p=0.029) times more likely to require a second-look procedure compared to USGA-PCNL on univariate analysis but not on multivariate analysis. There were no differences in Clavien-Dindo complications. No patient in the USGA-PCNL group experienced organ injuries during puncture compared to 1 patient in the FGA-PCNL group who had pneumothorax requiring urgent chest tube insertion. Conclusions: The use of ultrasonography to guide access puncture during PCNL eliminates the risk of inadvertent organ injuries. Similar operative and stone outcomes show that the learning curve for USGA is minimal compared to conventional FGA.
Pek-Ing Au,Benjamin Foo,Yee-Kwong Leong,Wen Ling Zhang,최형진 한국공업화학회 2015 Journal of Industrial and Engineering Chemistry Vol.21 No.1
Based on flow curve of graphene oxide coated polymeric microsphere based electrorheological (ER) fluid,model independent yield stress and shear rate, g˙ ðtÞ, were determined using a Tikhonov regularizationtechnique developed to solve the inverse problem of the shear rate in Couette flow viscometry. Themodel independent yield stress data were compared with that extracted from yield stress fluidmodels ofBingham plastic and Cho-Choi-Jhon (CCJ) used to fit the g˙ ðtÞ data. The agreement between modelindependent and Bingham yield stress was excellent, while the CCJ model yield stresses are generallyslightly higher.
Therapeutic Misconception in Psychiatry Research: A Systematic Review
Ivan SK Thong,Meng Yee Foo,Min Yi Sum,Benjamin Capps,Tih-Shih Lee,Calvin Ho,Kang Sim 대한정신약물학회 2016 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.14 No.1
Therapeutic misconception (TM) denotes the phenomenon in which research subjects conflate research purpose, protocols and procedures with clinical treatment. We examined the prevalence, contributory factors, clinical associations, impact, and collated solutions on TM within psychiatric research, and made suggestions going ahead. Literature search for relevant empirical research papers was conducted until February 2015. Eighty-eight reports were extracted, of which 31 were selected, summarised into different headings for discussion of implications and collated solutions of TM. We found variable and high rates of TM (ranging from 12.5% to 86%) in some psychiatry research populations. Contributory factors to TM included perceived medical roles of researchers, media, research setting and subject factors. Greater TM in affective, neurodevelopmental and psychotic spectrum conditions were associated with demographic variables (such as lower education, increased age), clinical factors (such as poor insight, cognitive deficits, increased symptoms, poorer self-rated quality of health), and social functioning (such as decreased independence). Inattention to TM may lead to frustration, negative impression and abandonment of participation in psychiatry research. Strategies such as the employment of a neutral educator during the informed consent process and education modules may be effective in addressing TM. Further research is warranted to examine the different TM facets, specific clinical correlates and more effective management strategies.