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Hemodynamic changes associated with a novel concentration of lidocaine HCl for impacted lower third molar surgery

  • Ping, Bushara;Kiattavorncharoen, Sirichai;Durward, Callum;Im, Puthavy;Saengsirinavin, Chavengkiat;Wongsirichat, Natthamet
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.15 no.3
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    • pp.121-128
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    • 2015
  • Background: The authors studied the hemodynamic effect influent by using the novel high concentration of lidocaine HCl for surgical removal impacted lower third molar. The objective of this study was to evaluate the hemodynamic change when using different concentrations of lidocaine in impacted lower third molar surgery. Methods: Split mouth single blind study comprising 31 healthy patients with a mean age of 23 years (range 19-33 years). Subjects had symmetrically impacted lower third molars as observed on panoramic radiograph. Each participant required 2 surgical interventions by the same surgeon with a 3-week washout period washout period. The participants were alternately assigned one of two types of local anesthetic (left or right) for the first surgery, then the other type of anesthetic for the second surgery. One solution was 4% lidocaine with 1:100,000 epinephrine and the other was 2% lidocaine with 1:100,000 epinephrine. A standard IANB with 1.8 ml volume was used. Any requirement for additional anesthetic and patient pain intra-operation was recorded. Post-operatively, patient was instructed to fill in the patient report form for any adverse effect and local anesthetic preference in terms of intra-operative pain. This form was collected at the seven day follow up appointment. Results: In the 4% lidocaine group, the heart rate increased during the first minute post-injection (P < 0.05). However, there was no significant change in arterial blood pressure during the operation. In the 2% lidocaine group, there was a significant increase in arterial blood pressure and heart rate in the first minute following injection for every procedure. When the hemodynamic changes in each group were compared, the 4% lidocaine group had significantly lower arterial blood pressure compared to the 2% lidocaine group following injection. Post-operatively, no adverse effects were observed by the operator and patient in either local anesthetic group. Patients reported less pain intra-operation in the 4% lidocaine group compared with the 2% lidocaine group (P < .05). Conclusions: Our results suggest that a 4% concentration of lidocaine HCl with 1:100,000 epinephrine has better clinical efficacy than 2% lidocaine HCl with 1:100,000 epinephrine when used for surgical extraction of lower third molars. Neither drug had any clinical adverse effects.

Switching Genioplasty- a New Genioplasty Technique in Order to Resolve Asymmetry of Chin Area: Case Report (이부 비대칭 치료를 위한 새로운 이부 성형술의 소개 - 전환 이부성형술: 증례보고)

  • Seo, Hyun-Soo;Lee, Young-Joo;Byeon, Kwang-Seob;Hong, Soon-Min;Park, Jun-Woo;Hong, Ji-Sook;Park, Yang-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.1
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    • pp.55-61
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    • 2011
  • Conventional slinding genioplsty has the risk of mental nerve injury after operation and difficult to correct vertical asymmetry of chin. So, authors propose a new genioplasty to correct asymmetry of chin. Switching genioplasty is a modification method of conventional genioplasty. Between mandibular right and left canine, osteotomy line of triangular shape make until mandibular lower border. In large side, osteotome line of wedge shape is added to reduction. After osteotomy, segment of wedge shape was separated from chin. Distal segment was rotated to reduction side. Because of rotation of distal segment, space is made in opposite side. Seperated segement of wedge shape from large side is switched this space to fill. So, stability of distal segment is achieved. Authors applied to swiching genioplasty the patients who was remained the chin asymmetry after both sagittal split ramus osteotome was done because mandible asymmetry. After operation, patient and operator were satisfied with excellent esthetic results without any other complication. The switching genioplasty is effective surgical technique for chin asymmetry because it has more advantages than conventional sliding genioplasty. First, other donor side does not need for bone graft. Second, the switching genioplasty can reduce infection, bone resroption, dehiscence, capsular contraction after allograft. Third, have little mental nerve damage. Forth, anteroposterior correction is possible. Fifth, operation time is less than other genioplasty for chin asymmetry.

A Multi-modal Continuous Network Design Model by Using Cooperative Game Approach (협력적 게임을 이용한 다수단 연속형 교통망 설계 모형)

  • Kim, Byeong-Gwan;Lee, Yeong-In;Im, Yong-Taek;Im, Gang-Won
    • Journal of Korean Society of Transportation
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    • v.29 no.1
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    • pp.81-93
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    • 2011
  • This research deals with the multi-modal continuous network design problem to resolve the transportation policy problems for constructing and operating transportation facilities with considering the mutual decision-making process between transportation operator and user in the multi-modal network. Particularly, in the consideration of changes in travel pattern between transport modes due to the changes in transportation policy, road network for passenger car and transit network for public transportation are considered together. In the development of network design model, more rational Stackelberg equilibrium(cooperative game) rather than more general Nash equilibrium(non-cooperative game) approach is used and sensitivity analysis considering transport mode is used. A multi-modal continuous network design model in this study is developed for the arbitrary continuous network design parameters(${\epsilon},\hat{\epsilon},p$) of transportation policy decisions. As examples of application and evaluation for these design parameters, the developed model is applied to calculate 1)the optimal capacity of road link in the road transport policy, 2)the optimal frequency of transit line in public transport policy and 3)the optimal modal split in transport modal share policy.

Prediction of Postoperative Lung Function in Lung Cancer Patients Using Machine Learning Models

  • Oh Beom Kwon;Solji Han;Hwa Young Lee;Hye Seon Kang;Sung Kyoung Kim;Ju Sang Kim;Chan Kwon Park;Sang Haak Lee;Seung Joon Kim;Jin Woo Kim;Chang Dong Yeo
    • Tuberculosis and Respiratory Diseases
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    • v.86 no.3
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    • pp.203-215
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    • 2023
  • Background: Surgical resection is the standard treatment for early-stage lung cancer. Since postoperative lung function is related to mortality, predicted postoperative lung function is used to determine the treatment modality. The aim of this study was to evaluate the predictive performance of linear regression and machine learning models. Methods: We extracted data from the Clinical Data Warehouse and developed three sets: set I, the linear regression model; set II, machine learning models omitting the missing data: and set III, machine learning models imputing the missing data. Six machine learning models, the least absolute shrinkage and selection operator (LASSO), Ridge regression, ElasticNet, Random Forest, eXtreme gradient boosting (XGBoost), and the light gradient boosting machine (LightGBM) were implemented. The forced expiratory volume in 1 second measured 6 months after surgery was defined as the outcome. Five-fold cross-validation was performed for hyperparameter tuning of the machine learning models. The dataset was split into training and test datasets at a 70:30 ratio. Implementation was done after dataset splitting in set III. Predictive performance was evaluated by R2 and mean squared error (MSE) in the three sets. Results: A total of 1,487 patients were included in sets I and III and 896 patients were included in set II. In set I, the R2 value was 0.27 and in set II, LightGBM was the best model with the highest R2 value of 0.5 and the lowest MSE of 154.95. In set III, LightGBM was the best model with the highest R2 value of 0.56 and the lowest MSE of 174.07. Conclusion: The LightGBM model showed the best performance in predicting postoperative lung function.

Non-Contrast Cine Cardiac Magnetic Resonance Derived-Radiomics for the Prediction of Left Ventricular Adverse Remodeling in Patients With ST-Segment Elevation Myocardial Infarction

  • Xin A;Mingliang Liu;Tong Chen;Feng Chen;Geng Qian;Ying Zhang;Yundai Chen
    • Korean Journal of Radiology
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    • v.24 no.9
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    • pp.827-837
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    • 2023
  • Objective: To investigate the predictive value of radiomics features based on cardiac magnetic resonance (CMR) cine images for left ventricular adverse remodeling (LVAR) after acute ST-segment elevation myocardial infarction (STEMI). Materials and Methods: We conducted a retrospective, single-center, cohort study involving 244 patients (random-split into 170 and 74 for training and testing, respectively) having an acute STEMI (88.5% males, 57.0 ± 10.3 years of age) who underwent CMR examination at one week and six months after percutaneous coronary intervention. LVAR was defined as a 20% increase in left ventricular end-diastolic volume 6 months after acute STEMI. Radiomics features were extracted from the oneweek CMR cine images using the least absolute shrinkage and selection operator regression (LASSO) analysis. The predictive performance of the selected features was evaluated using receiver operating characteristic curve analysis and the area under the curve (AUC). Results: Nine radiomics features with non-zero coefficients were included in the LASSO regression of the radiomics score (RAD score). Infarct size (odds ratio [OR]: 1.04 (1.00-1.07); P = 0.031) and RAD score (OR: 3.43 (2.34-5.28); P < 0.001) were independent predictors of LVAR. The RAD score predicted LVAR, with an AUC (95% confidence interval [CI]) of 0.82 (0.75-0.89) in the training set and 0.75 (0.62-0.89) in the testing set. Combining the RAD score with infarct size yielded favorable performance in predicting LVAR, with an AUC of 0.84 (0.72-0.95). Moreover, the addition of the RAD score to the left ventricular ejection fraction (LVEF) significantly increased the AUC from 0.68 (0.52-0.84) to 0.82 (0.70-0.93) (P = 0.018), which was also comparable to the prediction provided by the combined microvascular obstruction, infarct size, and LVEF with an AUC of 0.79 (0.65-0.94) (P = 0.727). Conclusion: Radiomics analysis using non-contrast cine CMR can predict LVAR after STEMI independently and incrementally to LVEF and may provide an alternative to traditional CMR parameters.

Research on Mechanized Upland Reclamation Works An Experiment for the Selection of Optimum Teeth Interval and the Analysis of Efficiency of Stumping and Root-Clearing Methods by Rake Dozer. (Report 1) (야산 기계화 개간공법에 관한 연구 -레이크 도저의 적정 이빨 간격의 선택과 발배근작업능률 시험(제1보)-)

  • 류한열;정하우박승우
    • Magazine of the Korean Society of Agricultural Engineers
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    • v.17 no.3
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    • pp.3860-3871
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    • 1975
  • This experiment was carried out to establish the mechanized methods in stumping and root-clearing, which were the most important works in the reclamation of sloping uplands. The determination of optimum teeth interval of rake blades and its operation methods to reduce the quantity of transported topsoil during the works, are the aims of this investigation. A newly designed rake blade, whose net teeth intervals could be regulated by three stages as 15cm, 25cm, and 35cm, was manufactured to attach to the bulldozer of 13ton. The experiments were carried out at Kilsang-Myon, Kwangwha-Gun, from Aug. 9 to Aug. 23, 1975. For each interval, 36 test plots of 50${\times}$10mn in size, which were regulated under three levels of land slopes of 10, 20, and 30% and two different tree stand density of high or medium values, were randomly chosen and arranged by two-replicated split-split plot design. Each stump classified by its diameter was stumped and cleared by the rake dozer to be related between diameter and stumping time. The results obtained in this experiment can be summarized as follows: 1. Stumping times for the diameters ranging from 6 to 18cm of stumps are almost the same and they are not varied by the difference of teeth intervals of rake dozer. 2. By back-ward stumping method, the number of stumps which can be stumped per hour ranges almost from 100 to 170, showing significant difference with respect to the teeth intervals. The working area is sharply varied with not only the stand density of stumps but the teeth intervals. 3. Optimum stumping distance for each teeth interval of rake dozer to minimize the quantity of transported topsoil are varied with such the rates as it is 15m or 20m for 15cm of teeth interval, but 25m for 25cm or 35cm, respectively. The clearing distance could be chosen almost double as long as the operating distance. 4. The working areas per hour of the simultaneous stumping and clearing methods are no significant difference among the various treatments of working conditions, but they are affected by the operating techniques. However, the influencing factors of the working conditions as classified before and the working directions are ranged from 10 to 15 per cent of total working area, respectively. 5. The residual rates of stumps which are not stumped by the rake dozer in each test plot are generally reduced as the teeth interval gets narrower, but there are no significant difference among them. The mean residual rates average to be about 4% for the simultaneous stumping and clearing method. The back-ward stumping method are recommended to be supervised and directed by more than one man, to show the operator where the stumps are located. 6. The results according to the stumping and clearing methods are summarized as Table IV-2. And the selection of working methods is recommended to follow as shown in Fig. IV-9 with respect to the stand density of the field. 7. Generally speaking, the narrower the teeth interval, the better become the working results, but the more the quantity of transported topsoil is increased. Therefore, it is recommended that the teeth interval should be reduced from the present distance of more than 30cm to 25cm or 15cm, by developing suitable working methods through more field works and experiments.

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