• Korean Journal of Radiology
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• v.22 no.8
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• pp.1323-1331
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• 2021

Objective: To identify the association between renal tumor complexity and pathologic renal sinus invasion (RSI) and evaluate the usefulness of computed tomography tumor features for predicting RSI in patients with renal cell carcinoma (RCC). Materials and Methods: This retrospective study included 276 consecutive patients who underwent radical nephrectomy for RCC with a size of ≤ 7 cm between January 2014 and October 2017. Tumor complexity and anatomical renal sinus involvement were evaluated using two standardized scoring systems: the radius (R), exophytic or endophytic (E), nearness to collecting system or sinus (N), anterior or posterior (A), and location relative to polar lines (RENAL) nephrometry and preoperative aspects and dimensions used for anatomical classification (PADUA) system. CT-based tumor features, including shape, enhancement pattern, margin at the interface of the renal sinus (smooth vs. non-smooth), and finger-like projection of the mass, were also assessed by two independent radiologists. Univariable and multivariable logistic regression analyses were performed to identify significant predictors of RSI. The positive predictive value, negative predictive value (NPV), accuracy of anatomical renal sinus involvement, and tumor features were evaluated. Results: Eighty-one of 276 patients (29.3%) demonstrated RSI. Among highly complex tumors (RENAL or PADUA score ≥ 10), the frequencies of RSI were 42.4% (39/92) and 38.0% (71/187) using RENAL and PADUA scores, respectively. Multivariable analysis showed that a non-smooth margin and the presence of a finger-like projection were significant predictors of RSI. Anatomical renal sinus involvement showed high NPVs (91.7% and 95.2%) but low accuracy (40.2% and 43.1%) for RSI, whereas the presence of a non-smooth margin or finger-like projection demonstrated comparably high NPVs (90.0% and 91.3% for both readers) and improved accuracy (67.0% and 73.9%, respectively). Conclusion: A non-smooth margin or the presence of a finger-like projection can be used as a preoperative CT-based tumor feature for predicting RSI in patients with RCC.

• Journal of Gastric Cancer
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• v.17 no.1
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• pp.21-32
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• 2017

Purpose: Perioperative chemotherapy improves survival outcomes in locally advanced (LA) gastric cancer. Materials and Methods: We retrospectively analyzed patients with LA gastric cancer who were offered perioperative chemotherapy consisting of epirubicin, oxaliplatin, and capecitabine (EOX) from May 2013 to December 2015 at Tata Memorial Hospital in Mumbai. Results: Among the 268 consecutive patients in our study, 260 patients (97.0%) completed neoadjuvant chemotherapy, 200 patients (74.6%) underwent D2 lymphadenectomy, and 178 patients (66.4%) completed adjuvant chemotherapy. The median follow-up period was 17 months. For the entire cohort, the median overall survival (OS), 3-year OS rate, median progression-free survival (PFS), and 3-year PFS rate were 37 months, 64.4%, 31 months, and 40%, respectively. PFS and OS were significantly inferior in patients who presented with features of obstruction than in those who did not (P=0.0001). There was no difference in survival with respect to tumor histology (well to moderately differentiated vs. poorly differentiated, signet ring vs. non-signet ring histology) or location (proximal vs. distal). Survival was prolonged in patients with an early pathological T stage and a pathological node-negative status. In a multivariate analysis, postoperative pathological nodal status and gastric outlet obstruction on presentation significantly correlated with survival. Conclusions: EOX chemotherapy with curative resection and D2 lymphadenectomy is a suggested alternative to the existing perioperative regimens. The acceptable postoperative complication rate and relatively high resections, chemotherapy completion, and survival rates obtained in this study require further evaluation and validation in a clinical trial.

• Journal of Korean Neurosurgical Society
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• v.61 no.5
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• pp.625-632
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• 2018

Objective : Because the anatomical structure of the brachial plexus is very complex, surgical treatment of tumors in this region is challenging. Therefore, a lot of clinical and surgical experience is required for successful treatment; however, many neurosurgeons have difficulty accumulating this experience owing to the rarity of brachial plexus tumors. The purpose of this report is to share our surgical experience with brachial plexus tumor with other neurosurgeons. Methods : The records of 18 consecutive patients with brachial plexus tumors who underwent surgical treatment between January 2010 and December 2017 in a single institution were retrospectively reviewed. The surgical approach was determined according to the tumor location and size, and intraoperative neurophysiological monitoring (IONM) was used in most of cases to prevent iatrogenic nerve injury during surgery. In addition, to evaluate the differences in tumor characteristics according to pathologic diagnosis, the tumors were divided twice into two groups, based on two separate classifications, and statistical analysis was performed. Results : The 18 brachial plexus tumors comprised 15 (83.3%) benign peripheral nerve sheath tumors including schwannoma and neurofibroma, one (5.6%) malignant peripheral nerve sheath tumor, one (5.6%) benign tumor of non-neural sheath origin (neurogenic cyst), and one (5.6%) metastatic tumor (papillary carcinoma). The authors analyzed relationship between tumor size/location and tumor characteristic parameters such as age, size, right-left, and pathology. There were no statistically significant differences except a tendency of bigger tumor size in young age. Conclusion : For a successful surgical outcome, an appropriate surgical approach is essential, and the appropriate surgical approach is determined by the location and size of the tumor. Furthermore, applying IONM may prevent postoperative complications and it is favorable option for brachial plexus tumors surgery.

• Journal of Institute of Control, Robotics and Systems
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• v.20 no.8
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• pp.875-881
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• 2014

The redundancy resolution of the seven DOF (Degree of Freedom) upper limb exoskeleton is key to the synchronous motion between a robot and a human user. According to the seven DOF human arm model, positioning and orientating the wrist can be completed by multiple arm configurations that results in the non-unique solution to the inverse kinematics. This paper presents analysis on the kinematic and dynamic aspect of the human arm movement and its effect on the redundancy resolution of the seven DOF human arm model. The redundancy of the arm is expressed mathematically by defining the swivel angle. The final form of swivel angle can be represented as a linear combination of two different swivel angles achieved by optimizing two cost functions based on kinematic and dynamic criteria. The kinematic criterion is to maximize the projection of the longest principal axis of the manipulability ellipsoid of the human arm on the vector connecting the wrist and the virtual target on the head region. The dynamic criterion is to minimize the mechanical work done in the joint space for each of two consecutive points along the task space trajectory. The contribution of each criterion on the redundancy was verified by the post processing of experimental data collected with a motion capture system. Results indicate that the bimodal redundancy resolution approach improved the accuracy of the predicted swivel angle. Statistical testing of the dynamic constraint contribution shows that under moderate speeds and no load, the dynamic component of the human arm is not dominant, and it is enough to resolve the redundancy without dynamic constraint for the realtime application.

• The Journal of the Acoustical Society of Korea
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• v.20 no.6
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• pp.87-93
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• 2001

As a new type of a linear decorrelating receiver, the Pseudo-Decorrelator was presented for asynchronous code division multiple access systems by the author. In this paper, the concept of the Pseudo-Decorrelator is extended to derive a receiver for WCDMA uplink systems over an additive white Gaussian noise channel. Starting with the analysis of the multiple access components of the decision statistics, a non-square cross-correlation matrix for each bit is obtained. This cross-correlation matrix is then inverted, and the inverted matrix is applied to the decision statistics obtained from a conventional receiver. In this receiver, the detection process can be started after the first three consecutive bits are received. Simulation results are presented for K-user systems over an additive white Gaussian noise channel under the circumstances in which synchronization errors, including time delay errors and carrier phase errors exist. It is shown that the proposed receiver performs better than a conventional receiver and parallel interference canceller.

• Physical Therapy Korea
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• v.4 no.3
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• pp.70-83
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• 1997

The purpose of this study was to determine the effects of transcutaneous electrical nerve stimulation(TENS) on delayed onset muscle soreness(DOMS). Twenty males performed eccentric exercise of the elbow flexor. Subjects were randomly assigned to one of three groups: 1) a group ($n_1$=7) that received low frequency TENS (7 Hz), 2) a group ($n_2$=7) that received high frequency TENS (500 Hz), 3) a control group ($n_3$=6) that received no treatment. DOMS was induced in a standardised fashion in the non-dominant elbow flexor of all subjects by repeated eccentric exercise. Treatments were applied immediately following exercise and again at 24 hours and at 48 hours after. Subjects attended on three consecutive days for treatment and measurement of elbow flexion, extension and resting angle(universal goniometer), and pain(Visual Analogue Scale; VAS) on a daily basis. Measurements were taken after treatment. Analysis of results using repeated measures analysis of variance(ANOVA) and post hoc tests were as follows: 1) there were between groups differences in pain value at 48 hours after (p<0.05), 2) one-way ANOVA with repeated measurement for pain, resting angle, flexion angle and extension angle revealed significant differences within low frequency TENS group, 3) one-way ANOVA with repeated measurement for flexion angle revealed significant difference within high frequency TENS group.

• Archives of Plastic Surgery
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• v.46 no.3
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• pp.204-213
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• 2019

Background In implant-based breast reconstruction, acellular dermal matrix (ADM) is essential for supporting the inferolateral pole. Recent studies have compared non-sterilized freeze-dried ADM and sterilized pre-hydrated ADM, but have not assessed whether differences were attributable to factors related to sterile processing or packaging. This study was conducted to compare the clinical outcomes of breast reconstruction using two types of sterile-processed ADMs. Methods Through a retrospective chart review, we analyzed 77 consecutive patients (85 breasts) who underwent tissue expander/implant breast reconstruction with either freeze-dried ADM (35 breasts) or pre-hydrated ADM (50 breasts) from March 2016 to February 2018. Demographic variables, postoperative outcomes, and operative parameters were compared between freeze-dried and pre-hydrated ADM. Biopsy specimens were obtained for histologic analysis. Results We obtained results after adjusting for variables found to be significant in univariate analyses. The total complication rate for freeze-dried and pre-hydrated ADMs was 25.7% and 22.0%, respectively. Skin necrosis was significantly more frequent in the freeze-dried group than in the pre-hydrated group (8.6% vs. 4.0%, P=0.038). All other complications and operative parameters showed no significant differences. In the histologic analysis, collagen density, inflammation, and vascularity were higher in the pre-hydrated ADM group (P=0.042, P=0.006, P=0.005, respectively). Conclusions There are limited data comparing the outcomes of tissue expander/implant breast reconstruction using two types of sterile-processed ADMs. In this study, we found that using pre-hydrated ADM resulted in less skin necrosis and better integration into host tissue. Pre-hydrated ADM may therefore be preferable to freeze-dried ADM in terms of convenience and safety.

• Journal of Chest Surgery
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• v.29 no.1
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• pp.14-23
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• 1996

Circulatory arrest under deep hypothermia is an important auxiliary means for cardiac surgery, especially useful in pediatric patients. However, its clinical safety, particularly with regard to the neurologic outcome after long duration of circulatory arrest, is still not established. This study is a review of the eight years'clinical experience of hypothermic circulatory arrest at the Seoul national University Children's Hospital. During an eight-year period from January 1986 through December 1993, a total of 589 consecutive cardiac operations were done using circulatory arrest under deep hypothermia. Among them, 434 consecutive patients, in whom the duration of arrest was 20 minutes or more, are the subject of this study. The duration of arrest ranged from 20 minutes to 82 minutes (mean = 38.7 minutes) under rectal temperature in the range from 12.5$^{\circ}C$ to 25.8$^{\circ}C$. Early neurologic abnormalities occurred in 47 patients : seizure attacks in 28 patients, motor paralyses with or w thout seizure in 12, blindness in 2, and no recovery of consciousness in 5 patients. The rate of incidence of early neurologic abnormalities was calculated at 15.7%. 25 patients showed late neuropsychologic sequelae, such as motor paralysis (9 patients), recurrent seizures (6), developmental delay (8), and definitely low intelligence (2). The rate of incidence of late neurologic sequelae was 8.5%, By statistical analysis, the following factors were identified as the risk factors for post-arrest neurologic abnormalities ; 1) long duration of circulatory arrest, 2) lower-than-ideal body weight, 3) preexisting neurological abnormalities, 4) associated non-cardiovascular congenital anouialies, and 5) low blood pressure during the early post-arrest period. It is concluded that circulatory arrest under deep hypothermia is a relatively safe means for pediatric cardiac surgery with acceptable risk. However, to warrant maximal safety, it is desirable to limit the duration of arrest to less th n 40 minutes. In addition, it is our contention that the early post-arrest period is a very critical period during which maintenance of adequate perfusion pressure in important for the neurologic outcome.

• Pediatric Infection and Vaccine
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• v.17 no.2
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• pp.169-176
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• 2010

Purpose : We aimed to evaluate predictive parameters for non-response to intravenous immunoglobulin (IVIG) in patients with Kawasaki disease (KD) before IVIG use using two controls. Methods : We evaluated 229 consecutive KD patients who were treated with 2 g/kg of IVIG at a single center. Those who had persistent fever >24 hours after IVIG infusion made up the 23 IVIG non-responders; the first control included a total 206 defervesced cases and the second control included 46 cases that were matched for age and pre-treatment fever duration to non-responders. Results : Demographic and clinical characteristics were similar in IVIG non-responders and responders at presentation. As for laboratory findings, the neutrophil differential, CRP, AST, ALT, and LDH were higher, and lymphocyte differential, total protein, albumin, platelet count, and total cholesterol were significantly lower in IVIG non-responders compared to responders by univariate analysis in both study designs. However in multivariate analysis, non-responders showed a significantly higher neutrophil differential (cutoff value, >77%, sensitivity 68.4% and specificity 79.5%) and lower cholesterol (<124 mg/dL, sensitivity 79% and specificity 70.5%). Whereas plasma albumin (<3.6 g/dL, sensitivity 73.7% and specificity 60%) was the sole laboratory parameter of non-responders in the second study design. Conclusion : Severity of inflammation in KD was reflected by higher or lower laboratory values at presentation. Because the multivariate analysis for these indices may be influenced by some confounding factors, including the numbers of patients of different ages and fever duration, other assessment modalities are needed for KD patients with the greatest risk of coronary artery lesions.

• Journal of agriculture & life science
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• v.44 no.5
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• pp.117-127
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• 2010

The purpose of this study is to analyze the temporal and spatial characteristics of water quality data of Nakdonggang watershed which is second largest watershed in South Korea. The correlation between the water quality items for rainy and non-rainy seasons were also analyzed for two TMDL sites which are Gumi and Namji. BOD data of two Total Maximum Daily Loads (TMDL) target sites were compared with TMDL criteria, 3-year arithmetic mean BOD concentration of the target sites should not exceed the target concentration for 2 consecutive years, to figure out current water quality status. Spatial analysis results showed that the correlation coefficient between Goryeong and Hyunpung was highest with the value of 0.978 followed by Hapcheon and Namji with the value of 0.874. The observed BOD data of Gumi station fluctuated around the TMDL criterion, 1.8mg/L while Namji station mostly exceed the criterion, 2.6mg/L. The criteria values for each target sites are defined by Ministry of Environment. The major factor of correlation coefficient was the distance between the stations. The correlation between the water quality items for non-rainy season showed no relation while the correlation between COD and SS was high followed by COD and TP for Gumi and Namji.