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Utilization of Supplemental Regional Anesthesia in Lobectomy for Lung Cancer in the United States: A Retrospective Study

  • Alwatari, Yahya;Vudatha, Vignesh;Scheese, Daniel;Rustom, Salem;Ayalew, Dawit;Sevdalis, Athanasios E.;Julliard, Walker;Shah, Rachit D.
    • Journal of Chest Surgery
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    • v.55 no.3
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    • pp.225-232
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    • 2022
  • Background: Pulmonary lobectomy is the standard of care for the treatment of early-stage non-small cell lung cancer. This study investigated the rate of utilization of supplemental anesthesia in patients undergoing video-assisted thoracoscopic surgery (VATS) or open lobectomy using a national database and assessed the effect of regional block (RB) on postoperative outcomes. Methods: Patients who underwent lobectomy for lung cancer between 2014-2019 were identified in the American College of Surgeons National Surgical Quality Improvement Program. The patients' primary mode of anesthesia and supplemental anesthesia were recorded. Preoperative characteristics and postoperative outcomes were compared between 2 surgical groups: those who underwent general anesthesia (GA) alone versus GA with RB. Multivariable regression analyses were performed on the outcomes of interest. Results: In total, 13,578 patients met the study criteria, with 87% undergoing GA and the remaining 13% receiving GA and RB. The use of neuraxial anesthesia decreased over the years, while RB use increased up to 20% in 2019. Age, body mass index, and preoperative comorbidities were comparable between groups. Patients who underwent VATS were more likely to receive RB than those who underwent thoracotomy. RB was most often utilized by thoracic surgeons. An adjusted analysis showed that RB use was associated with shorter hospital stays and a reduced likelihood of prolonged length of stay, but a higher rate of surgical site infections (SSIs). Conclusion: In a large surgical database, there was underutilization of supplemental anesthesia in patients undergoing lobectomy for lung cancer. RB utilization was associated with a shorter length of hospital stay and an increase in SSI incidence.

Designing of the Statistical Models for Imprinting Patterns of Quantitative Traits Loci (QTL) in Swine (돼지에 있어서 양적 형질 유전자좌(QTL) 발현 특성 분석을 위한 통계적 검정 모형 설정)

  • Yoon D. H.;Kong H. S.;Cho Y. M.;Lee J. W.;Choi I. S.;Lee H. K.;Jeon G. J.;Oh S. J.;Cheong I. C.
    • Journal of Embryo Transfer
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    • v.19 no.3
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    • pp.291-299
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    • 2004
  • Characterization of quantitative trait loci (QTL) was investigated in the experimental cross population between Berkshire and Yorkshire breed. A total of 512 F$_2$ offspring from 65 matting of F$_1$ parents were phenotyped the carcass traits included average daily gain (ADG), average backfat thickness (ABF), tenth rip backfat thickness (TRF), loin eye area (LEA), and last rip backfat thickness (LRF). All animals were genotyped for 125 markers across the genome. Marker linkage maps were derived and used in QTL analysis based on line cross least squares regression interval mapping. A decision tree to identify QTL with imprinting effects was developed based on tests against the Mendelian mode of QTL expression. To set the evidence of QTL presence, empirical significance thresholds were derived at chromosome-wise and genome-wise levels using specialized permutation strategies. Significance thresholds derived by the permutation test were validated in the data set based on simulation of a pedigree and data structure similar to the Berkshire-Yorkshire population. Genome scan revealed significant evidences for 13 imprinted QTLs affecting growth and body compositions of which nine were identified to be QTL with paternally expressed inheritance mode. Four of QTLs in the loin eye area (LEA), and tenth rip backfat thickness (TRF), a maternally expressed QTL were found on chromosome 10 and 12. These results support the useful statistical models to analyse the imprinting far the QTLs related carcass trait.

DISCRIMINATION OF EARLY MATURING PADDY RICE CROPS USING MULTI-TEMPORAL SAR IMAGES

  • Hong, Suk-Young;Jang, Min-Won;Kim, Yi-Hyun;Park, No-Wook
    • Proceedings of the KSRS Conference
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    • 2007.10a
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    • pp.243-245
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    • 2007
  • This study was begun to classify the paddy fields by the rice varieties and to monitor the temporal change in rice growth using SAR backscatter coefficients $({\sigma}^{circ})$. For nine fine-beam mode images of Radarsat-1 SAR, a growing period time-series of backscatter coefficients was set up from April to October in 2005, and was compared with the field-measured rice growth parameters such as LAI (leaf area index), plant height, fresh and dry biomass, and water content in grain and plant for 45 parcels in Dangjin-gun, Chungcheongnam Province, South Korea. The average backscatter coefficients for early-maturing rice varieties (13 parcels) were ranged from -18.17dB to -6.06dB and were lower than for medium-late maturing rice varieties during most of the growing season. At around the heading stage (July 30) for early-maturing rice, both rice crops showed the highest backscatter coefficient values and the difference was the greatest before harvesting early-maturing rice. The temporal difference in backscatter coefficients between rice varieties was expected to play a key role to identify early-maturing rice fields. On the other hand, comparison with field-measured rice growth parameters showed that the backscatter coefficients decreased or stayed on the plateau after heading stage even though the growth of rice canopy advanced.

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A Study about Impact of Battery SOC on Fuel Economy of Conventional Diesel Vehicle (배터리 충전상태가 경유자동차 에너지소비효율에 미치는 영향 연구)

  • Kim, Sungwoo;Kim, Kiho;Ha, Jonghan;Kwon, Seokjoo;Seo, Youngho
    • Transactions of the Korean Society of Automotive Engineers
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    • v.24 no.4
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    • pp.480-486
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    • 2016
  • Manufacturers have been applying several technologies that can improve the fuel economy of their cars. The regulated voltage control(RVC) system, is one of those technologies being used in passenger cars. In RVC, the voltage of an alternator is controlled depending on the electrical load demand or battery SOC, although each manufacturer differs from another in terms of detail. RVC can reduce the load of an alternator by consuming the stored energy of a battery and simultaneously generate energy. In this paper, a diesel passenger car equipped with an RVC system was tested under FTP-75 and HWFET modes to evaluate fuel economy as their initial battery SOC(100, 90, 80 and 60 %). The test results showed that the initial SOC affects fuel economy only under the FTP-75 mode. FTP-75 fuel economy of the 60% SOC was 13.2 % lower than the 100 % SOC. Also, the simultaneous consumption of the two energy sources did not appear in 60 % SOC.

Comparison of Health Status and Mini Nutritional Assessment according to Self-esteem of Elderly in Care Hospital (요양병원 입원 노인의 자아존중감에 따른 건강상태와 간이영양상태 비교)

  • Kim, Eun-mi;Kwon, Jin
    • Journal of the East Asian Society of Dietary Life
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    • v.25 no.4
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    • pp.631-642
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    • 2015
  • The purpose of the study was to examine health status and mini nutritional assessment (MNA) according to self-esteem status of elderly in care hospital. The survey was carried out from $13^{th}$ to $31^{st}$ of September, 2014 in five care hospitals. Analysis was performed for 226 subjects. Evaluation criteria included demographics, clinical status, MNA, health-related quality of life (EQ-5D) and self-esteem. The SE I, SE II and SE III groups were divided by self-esteem scores. Data were analyzed one-way ANOVA, Duncan' multiple range test and Pearson's correlation using SPSS 15.0. Education level, religion, dental condition and medical endurance type were significantly different in all groups. Many elderly people were normal BMI ($20.94{\sim}21.67kg/m^2$). Self-esteem significantly increased in order of SE I, SE II and SE III. Mobility, usual activity and anxiety or depression were significantly different in all groups, and EQ-5D of SE II and SE III groups were significantly higher than that of SE I group. Comparison of MNA screening score in elderly patients was as follows : Score for food intake, psychological stress or acute disease, neuropsychological problems, pressure scores or skin ulcer, protein intake, mode of feeding, nutritional status and health status in SE I group were significantly lower than those of SE II and SE III groups. Mobility and drug intake of SE I group were significantly lower than those of SE III groups. Fruit and vegetable intake SE I group were significantly higher than those of SE II and SE III groups. MIS (Malnutrition Indicator Score) was significantly different among the SE I, SE II and SE III groups. We conclude that self-esteem score is positively correlated with protein intake, nutrition status, health status and MIS in elderly care hospital. To improve nutritional status of elderly in care hospitals, systematic nutrition management and self-esteem education program should be implemented.

Colorless Amplified WDM-PON Employing Broadband Light Source Seeded Optical Sources and Channel-by-Channel Dispersion Compensators for >100 km Reach

  • Kang, Byoung-Wook;Lee, Kwanil;Lee, Sang Bae;Kim, Chul Han
    • Journal of the Optical Society of Korea
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    • v.18 no.5
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    • pp.436-441
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    • 2014
  • We have demonstrated an amplified wavelength-division multiplexed (WDM) passive optical network (PON) by using broadband light source (BLS) seeded optical sources and chirped fiber Bragg gratings (FBGs) based dispersion compensators. Chirped FBGs located at central office (CO) were fabricated and used as channel-by-channel dispersion compensators in order to mitigate the dispersion-induced distortion of both downstream and upstream signals. Owing to a low insertion loss of chirped FBG based dispersion compensator, the optical signal-to-noise ratio (OSNR) of the downstream signal could be improved to be ~28 dB. Thus, we re-confirmed that an error-free transmission of 1.25 Gb/s signals over a 100 km single-mode fiber (SMF) link could be achieved with a proposed amplified WDM-PON architecture. We have also evaluated the impact of various noises on the system's performance, and found that the low OSNR of the downstream signal would be a main limiting factor on the maximum reach of the proposed amplified WDM-PON architecture. From the measured ~13 dB improvement in OSNR of the downstream signal compared to our previously-proposed dispersion compensating module based scheme, we believe that the proposed architecture can accommodate a reach of longer than 100 km SMF link easily.

Fabrication of EEG Measuring System with High Precision Characteristics (고정밀도의 뇌파측정시스템 개발 연구)

  • 도영수;장호경;한병국
    • Progress in Medical Physics
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    • v.13 no.3
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    • pp.156-162
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    • 2002
  • In this study, we attempted in preparing high precision EEG measuring equipment. To measure EEG in high efficiency, pre-amplifier should get high performance common mode rejection ratio. Also, separation amplifier is essential to eliminate common line noise. So, our study were pointed at elevating the efficiency of eliminating noise, user safety and low noise characteristics. Prepared high precision pre-amplifier for EEG was A/D converted to automatically classify $\alpha$ wave, $\beta$ wave and $\theta$ wave. And converted data were Fast Fourier Transformed with real time DSP (Digital Signal Processing). Clinical demonstrations were carried out with healthy students, aged between 20 to 26 who has no histories of illness. To recognize the efficiency of the EEG, prepared EEG were used with MS equipment in low stimulated state and high stimulated state. Then, we studied at the effect of sensitivity on brain wave. From this study, it is known that our EEG equipment is efficient in sensitivity evaluation and suitable stimulations for each psychological state are required.

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Post Annealing Effect on the Characteristics of Al2O3 Thin Films Deposited by Aerosol Deposition on 4H-SiC (4H-SiC기판 위에 Aerosol Deposition으로 증착된 Al2O3박막의 후열처리 효과)

  • Yu, Susanna;Kang, Min-Seok;Kim, Hong-Ki;Lee, Young-Hie;Koo, Sang-Mo
    • Journal of the Korean Institute of Electrical and Electronic Material Engineers
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    • v.27 no.8
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    • pp.486-490
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    • 2014
  • $Al_2O_3$ films on silicon carbide were fabricated by Aerosol deposition with annealing temperature at $800^{\circ}C$ and $1,000^{\circ}C$. The effect of thermal treatment on physical properties of $Al_2O_3$ thin films has been investigated by XRD (X-ray diffraction), AFM (atomic force microscope), SEM (scanning electron microscope), and AES (auger electron spectroscopy). Also electrical properties have been investigated by Keithley 4,200 semiconductor parameter analyzer to explain the interface trapped charge density ($D_{it}$), flatband voltage ($V_{FB}$) and leakage current ($I_o$). $Al_2O_3$ films become crystallized with increasing temperature by calculating full width at half maximum (FWHM) of diffraction peaks, also surface morphology is observed by topography measurement in non-contact mode AFM. $D_{it}$ was $2.26{\times}10^{-12}eV^{-1}.cm^{-2}$ at $800^{\circ}C$ annealed sample, which is the lowest value in all samples. Also the sample annealed at $800^{\circ}C$ has the lowest leakage current of $4.89{\times}10^{-13}A$.

Segregation Mode of Plant Height in Crosses of Rice Cultivars ⅩIV. Segregation of Culm Length and $GA_3$ Response in Crosses of Dwarf Cultivars (수도 품종간 교잡에 있어서 간장의 유전분리 ⅩIV. 단간 품종간 조합에 있어서 간장과 $GA_3$ 반응성의 분리)

  • ;Mun-Hue Heu
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.35 no.2
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    • pp.165-170
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    • 1990
  • In order to determine the relationship between dwarf gene and GA$_3$ response, three dwarf cultivars, Fukei 71, Seolak, and Tanginbozu, which were known to have d 50, d 47 and d 35 gene, respectively, were used as parents in this study. Three parents and their F$_1$ and F$_2$ generations were grown. Tillers of each plant were devided into two parts at 15 days after transplanting and was transplanted. One part of them was sprayed with GA$_3$ 50 ppm at booting stage. The internode length were measured at ripening stage in terms of GA$_3$ response. The internode was significantly elongated in Seolak and Tanginbozu, but not in Fukei 71. All F$_1$ plants of the crosses were tall, and their internode and culm were significantly elongated with the spraying of GA$_3$. Dwarf plants which are not responded to GA$_3$ were selected in the F$_2$'s of Seolak/Fukei 71 and Fukei 71/Tanginbozu crosses, and backcrossed to Fukei 71. All of these BC$_1$F$_1$ plants were uniform in the culm length and not responded to GA$_3$ treatment. The dwarf gene, d 50 of Fukei 71 seems to be closely associated with the facter of non-response to GA$_3$.

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The Study on New Radiating Structure with Multi-Layered Two-Dimensional Metallic Disk Array for Shaping flat-Topped Element Pattern (구형 빔 패턴 형성을 위한 다층 이차원 원형 도체 배열을 갖는 새로운 방사 구조에 대한 연구)

  • 엄순영;스코벨레프;전순익;최재익;박한규
    • The Journal of Korean Institute of Electromagnetic Engineering and Science
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    • v.13 no.7
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    • pp.667-678
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    • 2002
  • In this paper, a new radiating structure with a multi-layered two-dimensional metallic disk array was proposed for shaping the flat-topped element pattern. It is an infinite periodic planar array structure with metallic disks finitely stacked above the radiating circular waveguide apertures. The theoretical analysis was in detail performed using rigid full-wave analysis, and was based on modal representations for the fields in the partial regions of the array structure and for the currents on the metallic disks. The final system of linear algebraic equations was derived using the orthogonal property of vector wave functions, mode-matching method, boundary conditions and Galerkin's method, and also their unknown modal coefficients needed for calculation of the array characteristics were determined by Gauss elimination method. The application of the algorithm was demonstrated in an array design for shaping the flat-topped element patterns of $\pm$20$^{\circ}$ beam width in Ka-band. The optimal design parameters normalized by a wavelength for general applications are presented, which are obtained through optimization process on the basis of simulation and design experience. A Ka-band experimental breadboard with symmetric nineteen elements was fabricated to compare simulation results with experimental results. The metallic disks array structure stacked above the radiating circular waveguide apertures was realized using ion-beam deposition method on thin polymer films. It was shown that the calculated and measured element patterns of the breadboard were in very close agreement within the beam scanning range. The result analysis for side lobe and grating lobe was done, and also a blindness phenomenon was discussed, which may cause by multi-layered metallic disk structure at the broadside. Input VSWR of the breadboard was less than 1.14, and its gains measured at 29.0 GHz. 29.5 GHz and 30 GHz were 10.2 dB, 10.0 dB and 10.7 dB, respectively. The experimental and simulation results showed that the proposed multi-layered metallic disk array structure could shape the efficient flat-topped element pattern.