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Matthias Rief,Fabian Stenzel,Anisha Kranz,Peter Schlattmann,Marc Dewey 대한영상의학회 2013 Korean Journal of Radiology Vol.14 No.1
Objective: We aimed to evaluate the time efficiency and diagnostic acObjective: We aimed to evaluate the time efficiency and diagnostic accuracy of automated myocardial computed tomography perfusion (CTP) image analysis software. Materials and Methods: 320-row CTP was performed in 30 patients, and analyses were conducted independently by three different blinded readers by the use of two recent software releases (version 4.6 and novel version 4.71GR001, Toshiba, Tokyo, Japan). Analysis times were compared, and automated epi- and endocardial contour detection was subjectively rated in five categories (excellent, good, fair, poor and very poor). As semi-quantitative perfusion parameters, myocardial attenuation and transmural perfusion ratio (TPR) were calculated for each myocardial segment and agreement was tested by using the intraclass correlation coefficient (ICC). Conventional coronary angiography served as reference standard. Results: The analysis time was significantly reduced with the novel automated software version as compared with the former release (Reader 1: 43:08 ± 11:39 min vs. 09:47 ± 04:51 min, Reader 2: 42:07 ± 06:44 min vs. 09:42 ± 02:50 min and Reader 3: 21:38 ± 3:44 min vs. 07:34 ± 02:12 min; p < 0.001 for all). Epi- and endocardial contour detection for the novel software was rated to be significantly better (p < 0.001) than with the former software. ICCs demonstrated strong agreement (≥ 0.75) for myocardial attenuation in 93% and for TPR in 82%. Diagnostic accuracy for the two software versions was not significantly different (p = 0.169) as compared with conventional coronary angiography. Conclusion: The novel automated CTP analysis software offers enhanced time efficiency with an improvement by a factor of about four, while maintaining diagnostic accuracy.
Matthias May,Hans-Martin Fritsche,Christian Gilfrich,Mirja Dombrowski,Odilo Maurer,Philipp Spachmann,Manju Ganesh Kumar,Marc Bjurlin,Maximilian Burger,Sabine Brookman-May 대한비뇨의학회 2018 Investigative and Clinical Urology Vol.59 No.3
Purpose: Smoking represents a primary risk factor for the development of urothelial carcinoma (UC) and a relevant factor impacting UC-specific prognosis. Data on the accordant knowledge of UC-patients in this regard and the significance of physicians in the education of UC-patients is limited. Materials and Methods: Eighty-eight UC-patients were enrolled in a 23-items-survey-study aimed to analyse patient knowledge and awareness of their tumor disease with smoking along with physician smoking cessation counselling. Results: The median age of the study patients was 69 years; 26.1% (n=23), 46.6% (n=41), and 27.3% (n=24), respectively, were non-smokers, previous, and active smokers. Exactly 50% of active smokers reported a previous communication with a physician about the association of smoking and their tumor disease; however, only 25.0% were aware of smoking as main risk factor for UC development. Merely 33% of the active smokers had been prompted directly by their physicians to quit smoking. About 42% of active smokers had received the information that maintaining smoking could result in a tumor-specific impairment of their prognosis. Closely 29% of active and about 5% of previous smokers (during the time-period of active smoking) had been offered support from physicians for smoking cessation. No association was found between smoking anamnesis (p=0.574) and pack-years (p=0.912), respectively, and tumor stage of UC. Conclusions: The results of this study suggest that the medical conversation of physicians with UC-patients about the adverse significance of smoking is limited. Implementation of structured educational programs for smoking cessation may be an opportunity to further enhance comprehensive cancer care.
Spinal Deformity Surgery: A Critical Review of Alignment and Balance
Matthias Pumberger,Hendrik Schmidt,Michael Putzier 대한척추외과학회 2018 Asian Spine Journal Vol.12 No.4
Correction of the overall coronal and/or sagittal plane deformities is one of the main predictors of successful spinal surgery. In routine clinical practice, spinal alignment is assessed using several spinal and pelvic parameters, such as pelvic incidence and tilt, sacral slope, lumbar lordosis, thoracic kyphosis, and sagittal vertical axis. Standard values have been defined for all these parameters, and the formulas of correction have been set for determining the surgical strategy. However, several factors can potentially bias these formulas. First, all standard values are measured using conventional plain radiographs and are, therefore, prone to bias. The radiologist, measuring surgeon, and patient are possible confounding influencing factors. Second, spino-pelvic compensatory effects and biomechanically relevant structures for the patient’s posture, including ligaments, tendons, and muscles, have received minimal consideration in the literature. Therefore, even in cases of appropriately planned deformity correction surgeries, complications, revision rates, and surgical outcomes significantly vary. This study aimed to illustrate the current clinical weaknesses of the assessment of spinal alignment and the importance of holistically approaching the musculoskeletal system for any spinal deformity surgery. We believe that our detailed insights regarding spinal, sagittal, and coronal alignments as well as the considerations of an individual’s spinal balance will contribute toward improvement in routine patient care.
Towards Gendering Northeast Asian Traditional Security: The Cases of the USS Pueblo and Juche Policy
Matthias Maass 한국국방연구원 2014 The Korean Journal of Defense Analysis Vol.26 No.2
Since the conclusion of the uneasy armistice that halted the Korean War in 1953, security on the Korean Peninsula has remained unsettled. This has negatively impacted regional security dynamics, too. A major problem has been North Korean military provocations. South Korean and U.S. responses to such maneuvers have further contributed to regional instability. Using the case of the 1968 Pueblo Incident, the paper examines the context of military provocation and reaction with the focus on a suspected gender-bias in regional security affairs. The paper investigates Pyongyang’s motivation for initiating a crisis and Washington’s and Seoul’s responses to the provocation and applies a branch of International Relations Theory, Gender Studies, as its analytical framework. The conclusion is that all actors involved in the 1968 Pueblo Incident, especially North Korea’s leadership, initiated or preferred actions that were heavily gender-biased. Demonstrations of strength, independence, and victory were seen as the only ones appropriate, while alternative policies were seen as weak and defeatist. In 1968, conflict and conflict resolution can be properly explained as heavily gender-biased, which sheds new light on our understanding of North Korea’s motivation for the provocation, and South Korean and American responses.
Matthias Zimmermann,Denise Traxler,Elisabeth Simader,Christine Bekos,Benjamin Dieplinger,Mitja Lainscak,Hendrik Jan Ankersmit,Thomas Mueller 대한진단검사의학회 2016 Annals of Laboratory Medicine Vol.36 No.4
The effects of storage temperatures, repeated freeze-thaw cycles, or delays in separating plasma or serum from blood samples are largely unknown for heat shock protein 27 (HSP27). We evaluated (1) the imprecision of the HSP27 assay used in this study; (2) the in vitro stability of HSP27 in blood samples stored at 4°C for up to 6 hr with immediate and delayed serum/plasma separation from cells; and (3) the in vitro stability of HSP27 in blood samples stored at -80°C after repeated freeze-thaw cycles. The ELISA to detect HSP27 in this study showed a within-run CV of <9% and a total CV of <15%. After 4-6 hr of storage at 4°C, HSP27 concentrations remained stable when using serum tubes irrespective of sample handling, but HSP27 concentrations decreased by 25-45% when using EDTA plasma tubes. Compared with baseline HSP27, one freeze-thaw cycle had no effect on serum concentrations. However, plasma concentrations increased by 3.1-fold after one freeze-thaw cycle and by 7.3-fold after five freeze-thaw cycles. In conclusion, serum is an appropriate biological sample type for use in epidemiological and large-scale clinical studies.