Yasmin Genevieve Hernandez-Barco;Dania Daye;Carlos F. Fernandez-del Castillo;Regina F. Parker;Brenna W. Casey;Andrew L. Warshaw;Cristina R. Ferrone;Keith D. Lillemoe;Motaz Qadan
Annals of Hepato-Biliary-Pancreatic Surgery
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v.27
no.2
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pp.195-200
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2023
Backgrounds/Aims: We aimed to build a machine learning tool to help predict low-grade intraductal papillary mucinous neoplasms (IPMNs) in order to avoid unnecessary surgical resection. IPMNs are precursors to pancreatic cancer. Surgical resection remains the only recognized treatment for IPMNs yet carries some risks of morbidity and potential mortality. Existing clinical guidelines are imperfect in distinguishing low-risk cysts from high-risk cysts that warrant resection. Methods: We built a linear support vector machine (SVM) learning model using a prospectively maintained surgical database of patients with resected IPMNs. Input variables included 18 demographic, clinical, and imaging characteristics. The outcome variable was the presence of low-grade or high-grade IPMN based on post-operative pathology results. Data were divided into a training/validation set and a testing set at a ratio of 4:1. Receiver operating characteristics analysis was used to assess classification performance. Results: A total of 575 patients with resected IPMNs were identified. Of them, 53.4% had low-grade disease on final pathology. After classifier training and testing, a linear SVM-based model (IPMN-LEARN) was applied on the validation set. It achieved an accuracy of 77.4%, with a positive predictive value of 83%, a specificity of 72%, and a sensitivity of 83% in predicting low-grade disease in patients with IPMN. The model predicted low-grade lesions with an area under the curve of 0.82. Conclusions: A linear SVM learning model can identify low-grade IPMNs with good sensitivity and specificity. It may be used as a complement to existing guidelines to identify patients who could avoid unnecessary surgical resection.
Objectives : The aim of this study was to investigate the number of self-report symptoms for temporomandibular disorders(TMD) and related factors in the third grade students of high school. Methods : A total of 1,043 high school the 3rd students age 16 20 completed a questionnaire from 11 high schools in Andong city from April to June 2010. Student's t-test was used to analyze the difference of TMD number. Multiple regression analysis was performed to determine the effects of independent variables on TMD number. Results : 1. Students who have one TMD were 71.3%, two 41.7% and over three 25.7%, respectively. 2. The number of TMD symptom of students who have no good habits such as clenching, bite lip and cheeks, resting on hand, chewing gum, hard foods, and unilateral chewing was a statistically significant higher than those who doesn't have ones(p=0.00). 3. TMD number of students who have been under more stress was a significantly higher than those who didn't have been(p=0.00). 4. Bite lip and cheek(${\beta}$=0.03, p=0.037), chewing gum(${\beta}$=0.03, p=0.029), resting on hand(${\beta}$=0.04, p=0.006), hard foods(${\beta}$=0.07, p=0.000), and stress out(${\beta}$=-0.03, p=0.018) were significantly associated with TMD number by multiple regression analysis. Conclusions : Variables associated with TMD were bite lip and cheek, chewing gum, resting on hand, hard foods, and stress out factor. According to our findings, it is so important to teach good habits on oral health to the 3rd grade students in high school. Further prospective study should explore cause of TDM from those variables.
Softners-BHICS, BBICS, and BTICS were prepared from 1, 2-disubstituted imidazoline compounds, such as 1-behenoylaminoethyl-1-glycidyl-2-heneicosylimidazolinium chloride(BHIC), 1-behenoylbis(aminoethyl)-1-glycidyl-2-heneicosylimidazolinium chloride (BBIC), and 1-behenoyltris(aminoethyl)-1-glycidyl-2-heneicosylimidazolinium chloride(BTIC), and treated to acrylic fiber. The measurements of softness, lubricating and antistatic properties showed that they have not only good softness and lubricating property but also a little antistatic property. Furthermore, the initial bending resistance for BBICS and BTICS was 5 grade, and remained 3~4 grade after 5 times washing. As results of these tests, they showed good softner effects having durability. The prepared softners were proved to be durable softner through a series of experimental results for washable properties of feeling by varying treating temperature and pH change.
Objective : We proposed fundmental rules of prospective on legal and institutional position and role of Korean medicine doctors working at public health center. Methods : By the result of this research on the current situation, the grade and allowance given to the Korean medicine doctors working at public health center were different every self-governing body. Results : The reason the Korean Medicine Doctor can't serve as a regular order of 5th grade is that the 'The Enforcement Regulation about Administrative Organization and the Standard of Pixed Number of person of Self-Governing Body(지방자치단체의 행정기구와 정원기준등에 관한 규정 시행규칙)' prescribes the number of regular order of 5th grade is regulated within 7% among the number of regular order officials. But not appointing to office as the regular order of 5th grade infringes on the Constitution, the highest law. The reason the Korean Medicine Doctors can't be appointed to office as the regular order officials by the self-governing body is that 'The Enforcement Order of the Law of Preservation of good health of Local Area(지역보건법시행령)' prescribes the Korean Medicine Doctors are not indispensable to Public Health Center. But in fact, the Korean Medicine Doctors can execute many kinds of work such as medical examination or instructing house nursing. Conclusion : The Korean Medicine Doctors working at Public Health Center serve at low positions as daily use or common use, not receiving a regular order. All laws including the Constitution(헌법), the Medical Services Law(의료법), the Law of Preservation of good health of Local Area(지역보건법), the National Public Service Law(국가공무원법), the Local Public Service Law(지방공무원법) and the Law of Higher Education Law(고등교육법) describe that the Korean Medicine Doctors and the Western Medicine Doctors are equal to their position and right.
Objective : The purpose of this study was to investigate the prognostic factors in patients who suffered an intracerebral hemorrhage(ICH) due to a ruptured middle cerebral artery(MCA) aneurysm. Methods : Among 148 case of ruptured MCA aneurysm, ruptured MCA aneurysm with ICH was compared with ruptured MCA aneurysm alone. According to factors, the prognosis in these two groups was analyzed. Prognosis was evaluated postoperatively by applying Glasgow Outcome Scale(GOS) at discharge. Prognostic factors were evaluated with Chi square test, Mann-Whitney test and ANOVA test with differences being considered significant for value less than 0.05. Results : Ruptured MCA aneurysm alone revealed better consciousness on admission and final outcome than those combined with ICH. Ruptured MCA aneurysm alone showed 74% in H-H grade I, II and 82% in GOS I, II. But ruptured MCA aneurysm with ICH showed 63% in H-H grade IV, V and 52% in GOS IV, V. Age, sex, lesion site, aneurysmal size, temoporary clipping time, interval to operation, operative approach were statistically not significant in prognosis(p>0.05). But H-H grade on admission(p<0.05), complication(esp. cerebral infarction)(p<0.05), preoperative ICH volume and site(p<0.01), preoperative midline shifting(p<0.01), remained ICH volume(p<0.05) showed significance statistically. Conclusion : Prognostic factors are helpful to neurosurgeon to estimate clinical and neurological outcome postoperatively. We suggest that the good prognostic factors in ruptured MCA aneurysm with ICH were good H-H grade on admission, cerebral infarction(-), preoperative ICH volume <25cc, temporal and intrasylvian ICH, preoperative midline shifting <5mm, remained ICH volume <10cc.
This study is the descriptive survey for the purpose of providing the basic data that establishes the strategy to promote adolescent's hope by the examining of self-esteem, academic achievement, family functioning and hope of adolescents and the investigating of the factors influencing the hope in adolescents. The subjects for this study were 456 students of the first and second year of man's senior high school that located in Seoul. The data were gathered from 16th to 31st of the October 2000. For the survey tool, it was used that the Family Assessment Device(FAD) of Epstein, Baldwin & Bishop(1983), the Self-Esteem Inventory(SEI) of Coopersmith(1975), the class record order and Hinds & Gatusso(1991)'s Hopefulness Scale for Adolescents(HSA). The collected data was analyzed by statistics methods as the descriptive and frequency analysis, t-test, ANOVA, Pearson and Spearman correlation coefficients and Stepwise multiple regression of SAS program. The results of this study were following : 1. The mean score of self-esteem of young people was 51.06±6.83 and the mean grade was 2.04. The high academic achievement was 29.2%, middle grade was 52.7%, and low grade was 18.1%. The mean score of the family functioning was 38.30±6.98 and the mean grade was 2.25. The mean score of hope was 84.26±16.45 and the mean grade was 3.51. 2. The hope in adolescents was significantly different according to their father's school career. The mean score of the group that the father's school career was below junior high school was 77.32. That was significantly lower than the mean score 84.59 of the group that the father's school career was above college and the mean score 85.18 of senior high school group(F=4.04, P= 0.0183). 3. The self-esteem was represented the positive correlation with family functioning(r=0.43) and the all of the 4 subscales(r=0.31, 0.41, 0.39, 0.30). And, it was highly ranked as much as family functioning was good. The academic achievement was represented the positive correlation with self-esteem(r= 0.15). Also, the positive correlation was shown between the affective responsiveness, role recognition and emotional support as the subscales of family functioning and academic achievement(r=0.11, 0.12). And so, academic achievement was high as much as self-esteem was high and affective responsiveness and role recognition and emotional support were good. The hope was represented positive correlation with self-esteem and academic achievement(r=0.42, 0.26), and with the whole of family functioning(r=0.15) and the 4 subscales(r=0.13, 0.16, 0.11, 0.13). So, hope was high as much as self-esteem was high, academic achievement was high and family functioning was good. 4. The influencing factors on the hope of adolescents were self-esteem(17.63%), academic achievement(3.41%), father's school career(0.84%). These factors made it possible to explain 21.88% of hope.
Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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v.30
no.2
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pp.118-123
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2019
Background and Objectives Voice evaluation is classified into subjective tests such as auditory perception and self-measurement, and objective tests such as acoustic and aerodynamic analysis. When evaluating dysphonia, subjective and objective test results do not always match. The purpose of this study was to analyze the relationship between subjective and objective evaluation in patients with dysphonia and to identify meaningful parameters by disease. Materials and Method The total of 322 patients who visited voice clinic from May 2017 to May 2018 were included in this study. Laryngeal lesions were identified using stroboscopy. Pearson correlation test was performed to analyse correlation between subjective tests including GRBAS scale and voice handicap index, and objective tests including jitter, shimmer, noise to harmonic ratio (NHR), cepstral peak prominence (CPP), maximal phonation time (MPT), mean flow rate, and subglottic pressure. Results In vocal nodule and sulcus vocalis, among GRBAS system, grade and breathiness showed good correlation with CPP, and roughness showed good correlation with jitter or shimmer. In unilateral vocal cord paralysis (UVCP), grade and breathiness showed a very good correlation with CPP, and also good correlation with jitter, shimmer, NHR, and MPT. Also asthenia showed good correlation with CPP and MPT. Vocal polyp has a limited association with other diseases. Conclusion In patients with dysphonia, grade and breathiness showed good correlation with CPP, jitter, and shimmer, and reflect the state of voice change well especially in UVCP, CPP, and MPT.
The purpose of this study was to investigate the job value type of dental hygiene students. The questionaire given to 823 dental hygiene students from three college in Gwangju and Chunnam Colleges. The results of this study were as follows: 1. dental hygiene students, job value type were divided 6 categories: Competency, Contribution, Achievement, Reward, status, stability. 2. The higher status was at c college and at good relationship group and more perceived bad health and at work experience group. 3. The higher was reward at c college and lower grade and at good relationship group and more perceived good health and at work experience group. 4. The higher was status at c college and lower grade and lower age and at work experience group. 5. The higher was competency at c college and at good relationship group and more perceived bad health and .at work experience group. 6. The higher was contribution lower grade and more perceived bad health and at work experience group. 7. The higher was achievement at c college and at good relationship group and more perceived good health group.
Background: The standard radiotherapy (RT) fractionation practiced in India and worldwide is 50Gy in 25 fractions over 5 weeks to the chest wall or whole breast followed by tumour bed boost in case of breast conservation (BCS). A body of validated data exists regarding hypofractionation in breast cancer. We here report initial results for 135 patients treated at our center with the START-B type of fractionation. Materials and Methods: From May 2011 till July 2012, women with all stages of breast cancer (excluding metastatic), who had undergone BCS or mastectomy were planned for 40Gy in 15 fractions over 3weeks to chest wall/whole breast and supraclavicular fossa (where indicated) followed by tumour bed boost in BCS patients. Planning was done using Casebow's technique. The primary end point was to assess the acute toxicity and the cosmetic outcomes. Using cosmetic scales; patients were assessed during radiotherapy and at subsequent follow up visits with the radiation oncologist. Results: Of the 135 patients, 62 had undergone BCS and 73 mastectomy. Median age of the population was 52 years. Some 80% were T1&T2 tumours in BCS whereas most patients in mastectomy group were T3&T4 tumours (60%). 45% were node negative in BCS group whilst it was 23% in the mastectomy group. Average NPI scores were 3.9 and 4.9, respectively. Most frequently reported histopathology report was infiltrating ductal carcinoma (87%), grade III being most common (58%), and 69% were ER positive tumours, and 30% were Her 2 Neu positive. Triple negative tumours accounted for 13% and their mean age was young (43 yrs.) The maximum acute skin toxicity at the end of treatment was Grade 1 in 94% of the mastectomy grouppatients and 71% in BCS patients. Grade 2 toxicity was 6% in mast group and 23% in BCS group. Grade 3 was 6% in BCS group, no grade 3 toxicity in mastectomy patients and there was no grade 4 skin toxicity in any case. Post RT at 1 month; 39% of BCS patients had persisting Grade I skin reaction which was only 2% in mastectomy patients. At 3 months post RT, 18% patients had persisting hyperpigmentation. At 6 months 8% patients had persisting erythema in the BCS group only. Some 3% BCS and 8% mastectomy patients had lymph edema till the date of evaluation. Cosmetic outcome in BCS patients remained good to excellent 6 months post surgery and radiotherapy. 1 patient of BCS and 3 patients of mast had developed metastatic disease at the time of evaluation. Conclusions: Hypofractionated RT is well tolerated in Indian population with reduced acute skin toxicity and good cosmetic outcome. Regimens such as these should be encouraged in other centers to increase machine output time. The study is on-going to assess long term results.
The Sewability was tested with the seam strength and Puckering Grade by a general sewing machine according to some properties of simulated Leather, yarn tensile strength needle and stitches. The main results tested are as follows ; 1. The thick and uncomfortable leather is unable to be sewed by a general sewing machine, but the thin and soft one is able to. 2. The interval between stitches depends on type of leather used, and the variance in accordance with type of leather varies much more in the case of narrower interval. 3. When the sewability of leather-surface is not so good, is desirable to pour oil on the surface for the purpose of better efficiency. 4. The seam strength is directly proportional to interval of stitch and tensile strength of yarn and leather used, and needle No. 14 is more effective than No.1l. 5. The more the soft and thin leather is, the lower the Puckering Grade becomes. Type of yarn and interval of stitches do not seem to effect the Puckering Grade.
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