• Title/Summary/Keyword: median approach

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Early hypopharyngeal cancer treated with different therapeutic approaches: a single-institution cohort analysis

  • Kim, Nalee;Lee, Jeongshim;Kim, Kyung Hwan;Park, Jong Won;Lee, Chang Geol;Keum, Ki Chang
    • Radiation Oncology Journal
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    • v.34 no.4
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    • pp.280-289
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    • 2016
  • Purpose: Early hypopharyngeal squamous cell carcinoma (HPSCC) is a rarely diagnosed disease, for which the optimal treatment has not been defined yet. We assessed patterns of failure and outcomes in early HPSCC treated with various therapeutic approaches to identify its optimal treatment. Materials and Methods: Thirty-six patients with stage I (n = 10) and II (n = 26) treated between January 1992 and March 2014 were reviewed. Patients received definitive radiotherapy (RT) (R group, n = 10), surgery only (S group, n = 19), or postoperative RT (PORT group, n = 7). All patients in both the R and PORT groups received elective bilateral neck irradiation. In the S group, 7 patients had ipsilateral and 8 had bilateral dissection, while 4 patients had no elective dissection. Results: At a median follow-up of 48 months, the 5-year locoregional control (LRC) rate was 65%. Six patients had local failure, 1 regional failure (RF), 3 combined locoregional failures, and 2 distant failures. There was no difference in 5-year LRC among the R, S, and PORT groups (p = 0.17). The presence with a pyriform sinus apex extension was a prognosticator related to LRC (p = 0.01) in the multivariate analysis. Patients with a bilaterally treated neck showed a trend toward a lower RF rate (p = 0.08). Conclusion: This study shows that patients with early stage HPSCC involving the pyriform sinus apex might need a tailored approach to improve LRC. Additionally, our study confirms elective neck treatment might have an efficacious role in regional control.

Small Target Detection using Morphology and Gaussian Distance Function in Infrared Images (적외선 영상에서 모폴로지와 가우시안 거리함수를 이용한 소형표적 검출)

  • Park, Jun-Jae;Ahn, Sang-Ho;Kim, Jong-Ho;Kim, Sang-Kyoon
    • Journal of Korea Society of Industrial Information Systems
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    • v.17 no.4
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    • pp.61-70
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    • 2012
  • We propose a method that finds candidate targets based on morphology and detects a small target from them using modified gaussian distance function. The existing small target detection methods use predictive filters or morphology. The methods using predictive filters take long to approach least errors. The methods using morphology are weak at clutters and need to consider size of a small target when selecting size of structure elements. We propose a robust method for small target detection to complete the existing methods. First, the proposed method deletes clutters using a median filter. Next, it does closing and opening operation using various size of structure elements, and figures target candidate pixels with subtraction operation between the results of closing and opening operation. It detects an exact small target using a gaussian distance function from the candidates target areas. The proposed method is less sensitive to clutters, and shows a detection rate of 98%.

Aortic Valve Replacement for Aortic Stenosis in Elderly Patients (75 Years or Older)

  • Sohn, Bongyeon;Choi, Jae Woong;Hwang, Ho Young;Kim, Kyung Hwan;Kim, Ki-Bong
    • Journal of Chest Surgery
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    • v.51 no.5
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    • pp.322-327
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    • 2018
  • Background: This study evaluated the early and long-term outcomes of surgical aortic valve replacement (AVR) in elderly patients in the era of transcatheter aortic valve implantation. Methods: Between 2001 and 2018, 94 patients aged ${\geq}75years$ underwent isolated AVR with stented bioprosthetic valves for aortic valve stenosis (AS). The main etiologies of AS were degenerative (n=63) and bicuspid (n=21). The median follow-up duration was 40.7 months (range, 0.6-174 months). Results: Operative mortality occurred in 2 patients (2.1%) and paravalvular leak occurred in 1 patient. No patients required permanent pacemaker insertion after surgery. Late death occurred in 11 patients. The overall survival rates at 5 and 10 years were 87.2% and 65.1%, respectively. The rates of freedom from valve-related events at 5 and 10 years were 94.5% and 88.6%, respectively. The Society of Thoracic Surgeons (STS) score (p=0.013) and chronic kidney disease (p=0.030) were significant factors affecting long-term survival. The minimal p-value approach demonstrated that an STS score of 3.5% was the most suitable cut-off value for predicting long-term survival. Conclusion: Surgical AVR for elderly AS patients may be feasible in terms of early mortality and postoperative complications, particularly paravalvular leak and permanent pacemaker insertion. The STS score and chronic kidney disease were associated with long-term outcomes after AVR in the elderly.

Intradural Schwannoma Associated with Lumbar Spinal Stenosis: A Cese Report (요추부 척추관 협착증과 동반된 경막내 신경초종: 증례 보고)

  • Soh, Jae-Wan;Kim, Tae-Heon;Kwon, Sai-Won
    • The Journal of the Korean bone and joint tumor society
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    • v.17 no.2
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    • pp.106-110
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    • 2011
  • In the patient who has intradural mass associated with spinal stenosis, if the operation for spinal stenosis is performed alone, the symptom may remain. We report with literature review that we achieved the successful outcome after simultaneous decompression of spinal stenosis and space occupying mass removal in the case of intradural and extradural compression. A 71-year-old female patient suffering from low back pain and radiating pain of both lower extremities admitted. In magnetic resonance imaging, spinal stenosis on L4-5 and spondylolisthesis on L5-S1 compressed dural sac and intradural space occupying mass on L4 level compressed. By posterior approach, decompression and interbody fusion were carried out. Then mass was removed with median durotomy. Pathologic diagnosis was schwannoma and the symptom was improved remarkably.

Identification of M-1, S-1 Cortex Using Combined Intraoperative SEP and Cortical Stimulation - A Case Report - (수술중 체성감각 유발전위 및 대뇌피질 자극을 이용한 일차 운동피질영역과 일차 감각피질영역의 확인 - 증례보고 -)

  • Lee, Jae-Uhn;Son, Byung-Chul;Kim, Moon-Chan;Kang, Joon-Ki
    • Journal of Korean Neurosurgical Society
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    • v.29 no.7
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    • pp.954-958
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    • 2000
  • In the removal of small subcortical lesion in the eloquent area like sensory-motor cortex, the prevention of neurologic deficit is important. We present our technique of identification of M-1, S-1 cortex in a case of subcortical granuloma located in sensorymotor cortex. To accurately localize mass, stereotactic craniotomy was planned. At the beginning of procedure, functional MRI of motor cortex was done with stereotactic headframe in place. Next, the stereotactic craniotomy about 4 cm was done under propofol anesthesia for cortical mapping. After reflection of dura, central sulcus was identified with phase-reversal response of intraoperative SEP(somatosensory evoked potential) of contralateral median nerve. Then the patient was awakened, and direct cortical stimulation was done. We observed the muscle contractions of elbow, hand and fingers and the paresthesia over forearm, hand, fingers on the M-1 and S-1 cortex. Through cortical mapping and stereotactic guidance, we concluded that the mass lie immediately posterior to central sulcus, then the mass was carefully removed through small transsulcal approach, opening about 1 cm of rolandic sulcus.

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Cardiac Rupture after Blunt Chest Trauma (흉부 둔상에 의한 심장파열)

  • 김태이;정태은;이동협;이정철;한승세
    • Journal of Chest Surgery
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    • v.31 no.3
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    • pp.255-261
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    • 1998
  • A clinical evaluation was performed on 11 cases of the cardiac rupture by blunt chest trauma at the department of thoracic and cardiovascular surgery, Yeungnam University Hospital during the period from July, 1993 to May, 1995. The results were as follows ; The sex distribution was 8 mem and one women, and mean age was 41 years old. The causes of accident was traffic accident in most cases. And then one case was cultivator accident and another one was fall down. The average times from trauma to admission was 139 minutes and the patients that transferred via other hospitals have relatively long average times to 227 minutes. The average times from admission to operation was 117 minutes and we consumed 25 minutes for the preoperative preparation. The sites of injury were 7 cases in the right heart and 3 cases in the left heart. There were symptoms and signs of the cardiac tamponade(dyspnea, chest pain, nausea/vomitus, neck vein distention & hypovolemic shock) at admission and in most of them typical symptoms and signs of a tamponade appeared. Surgical approach was performed with median sternotomy in 10 cases. Subxiphoid pericardial window was created in one case. Another case which was very difficult in surgical procedure was operated under cardiopulmonary bypass and the result was good.

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A Study on the Minimum Flow Frequency Analysis by SMEMAX Transformation (SMEMAX변환에 의한 온수빈도분석에 관한 연구)

  • 이순혁;박명근
    • Magazine of the Korean Society of Agricultural Engineers
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    • v.29 no.3
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    • pp.138-144
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    • 1987
  • This study was conducted to pursue the normalization of frequency distribution by making approach the coefficient of skewness to nearly zero tbrough SMEMAX transformation and to get probable minimum flows can be acquired by means of transforrnation equation which has been derivated by SMEMAX method to the annual minimum flow series of five watersheds along Geum river basin. The results obtained through SMEMAX method were compared with probable minimum flows according to return periods by Type III extremal distribution which has been determined as the best fitted one among probablility distributions for the analysis of minimum flow. All the results obtained through this study are summarized as follows. 1.SMEMAX transformation based on median value was proved to be the best method when the coefficient of skewness has less reliability because of the short duration for the observation and were not affected by accidental outliers. 2.SMEMAX transformation has found to be the best one for the coefficient of skewness to be made nearly zero in comparison with log and cubic root transformation. 3.Probable minimum flows according to the return periods were derivated by transformation equations obtained through theoretical analysis of SMEM AX transformation. 4.In general, probable minimum flows by SMEMAX method were appeared as higher values in the range of five and twenty years and as lower ones in the range of below than five and more than fifty years in return periods respectively, in comparison with the results of type III extremal distribution. 5.Relative errors in the probable minimum flows of SMEMAX method to the results of type III extremal distribution were shown to be within ten percent except those of one hundred years in return periods. 6.SMEMAX method was also confirmed to be useful for the analysis of minimum flow frequency as well as flood frequency analysis.

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Cross Correlation based Signal Classification for Monitoring System of Abnormal Respiratory Status (상관관계 기반 신호 분류를 이용한 비정상 호흡 상태 모니터링 시스템)

  • Lee, Deokwoo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.5
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    • pp.7-13
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    • 2020
  • This paper focuses on detecting abnormal patterns of respiration of humans. In this study, a contact-based device was used to acquire both normal and abnormal respiration signals. To this end, this paper reports the development of a monitoring system to investigate the respiratory status of humans in a normal environment. This work aims to classify the respiratory status, i.e., normal and abnormal status, quantitatively. The respiration signal is acquired using a contact-based medical device (BIOBPAC), and noise reduction is carried out before classifying the respiratory status. To reduce noise, a mixed filter that combines the Savitzky-Golay filter and Median filter is applied to the acquired respiration signals. The inter-class distance is maximized, and the intra-class distance is minimized. The proposed algorithm is straightforward and can be applied to a practical environment. In addition, the experimental results are provided to substantiate the proposed approach.

Persistent Trigeminal Artery Variant Detected by Conventional Angiography and Magnetic Resonance Angiography -Incidence and Clinical Significance-

  • Rhee, Sun-Joo;Kim, Myoung-Soo;Lee, Chae-Heuck;Lee, Ghi-Jai
    • Journal of Korean Neurosurgical Society
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    • v.42 no.6
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    • pp.446-449
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    • 2007
  • Objective : Persistent trigeminal artery variant (PTAV) is an anastomosis between the internal carotid artery (ICA) and the cerebellar artery without any interposing basilar artery segment. We discuss its probable embryological origin and emphasize clinical implications. Methods : Retrospectively 1250 conventional cerebral angiograms and 2947 cranial magnetic resonance angiographies (MRAs) were evaluated for the patients with PTAV. Results : Five patients (four men and one woman, 23 to 76 years of age, median age 65 years) had a PTAV. Three patients who underwent MRA had a PTAV (3/2947=0.1%). Four of the patients who underwent cerebral angiography had a PTAV (4/1250=0.32%). Two of 143 patients who underwent both conventional angiography and cranial MRA showed PTAV. The PTAV was an incidental finding in all five patients. The PTAV originated from the cavernous segment of the left ICA in four patients and from the cavernous segment of the right ICA in one patient. The terminal branch of the PTAV was the anterior inferior cerebellar artery (AICA) and superior cerebellar artery (SCA) in two patients and the AICA only in the other three patients. Conclusion : Neurosurgeons should be aware of possible presence of PTAV. Manipulation of this vessel during a surgical approach to the parasellar region and percutaneous gasserian ganglion procedure may result in hemorrhage or ischemia.

Trust-Based Filtering of False Data in Wireless Sensor Networks (신뢰도 평가를 통한 무선 센서 네트워크에서의 거짓 데이타 제거)

  • Hur, Jun-Beom;Lee, Youn-Ho;Yoon, Hyun-Soo
    • Journal of KIISE:Information Networking
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    • v.35 no.1
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    • pp.76-90
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    • 2008
  • Wireless sensor networks are expected to play a vital role in the upcoming age of ubiquitous computing such as home environmental, industrial, and military applications. Compared with the vivid utilization of the sensor networks, however, security and privacy issues of the sensor networks are still in their infancy because unique challenges of the sensor networks make it difficult to adopt conventional security policies. Especially, node compromise is a critical threat because a compromised node can drain out the finite amount of energy resources in battery-powered sensor networks by launching various insider attacks such as a false data injection. Even cryptographic authentication mechanisms and key management schemes cannot suggest solutions for the real root of the insider attack from a compromised node. In this paper, we propose a novel trust-based secure aggregation scheme which identifies trustworthiness of sensor nodes and filters out false data of compromised nodes to make resilient sensor networks. The proposed scheme suggests a defensible approach against the insider attack beyond conventional cryptographic solutions. The analysis and simulation results show that our aggregation scheme using trust evaluation is more resilient alternative to median.