The purpose of this study is to evaluate utility of rotating adjustment using Xsight spine tracking system in 3D DOF location adjusting method, to minimize error between 6D DOF and 3D DOF in fiducial tracking system. In this study, the result of 6D DOF target location error is $0.124{\pm}0.058mm$, using fiducial inside tumor 3D DOF $0.673{\pm}0.142mm$, outside tumor $1.126{\pm}0.253mm$, apply with Xsight spine tracking system 3D DOF $0.542{\pm}0.103mm$. As the experiment shows, it was demonstrated that rotating adjustment through Xsight spine tracking system is valuable in case of treatment in 3D DOF location error that makes increasing accuracy and dose distribution each approximately 48% and 3%. In accordance with result of this study is useful rotation.
Craig Basman;Caroline Ong;Tikal Kansara;Zain Kassam;Caleb Wutawunashe;Jennifer Conroy;Arber Kodra;Biana Trost;Priti Mehla;Luigi Pirelli;Jacob Scheinerman;Varinder P Singh;Chad A Kliger
Journal of Cardiovascular Imaging
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v.31
no.1
/
pp.18-23
/
2023
BACKGROUND: Three-dimensional (3D) transesophageal echocardiogram (TEE) is the gold standard for the diagnosis of degenerative mitral regurgitation (dMR) and preoperative planning for transcatheter mitral valve repair (TMVr). TEE is an invasive modality requiring anesthesia and esophageal intubation. The severe acute respiratory syndrome coronavirus 2 pandemic has limited the number of elective invasive procedures. Multi-detector computed tomographic angiography (MDCT) provides high-resolution images and 3D reconstructions to assess complex mitral anatomy. We hypothesized that MDCT would reveal similar information to TEE relevant to TMVr, thus deferring the need for a preoperative TEE in certain situations like during a pandemic. METHODS: We retrospectively analyzed data on patients who underwent or were evaluated for TMVr for dMR with preoperative MDCT and TEE between 2017 and 2019. Two TEE and 2 MDCT readers, blinded to patient outcome, analyzed: leaflet pathology (flail, degenerative, mixed), leaflet location, mitral valve area (MVA), flail width/gap, anterior-posterior (AP) and commissural diameters, posterior leaflet length, leaflet thickness, presence of mitral valve cleft and degree of mitral annular calcification (MAC). RESULTS: A total of 22 (out of 87) patients had preoperative MDCT. MDCT correctly identified the leaflet pathology in 77% (17/22), flail leaflet in 91% (10/11), MAC degree in 91% (10/11) and the dysfunctional leaflet location in 95% (21/22) of patients. There were no differences in the measurements for MVA, flail width, commissural or AP diameter, posterior leaflet length, and leaflet thickness. MDCT overestimated the measurements of flail gap. CONCLUSIONS: For preoperative TMVr planning, MDCT provided similar measurements to TEE in our study.
This study aims to define concepts on Hospital Design Focused on System to respond to the development and change by comparing general design methods of the General hospital architecture in Korea and analyze elements suitable to concepts on Hospital Design Focused on System in the General hospital architecture through examining the transformation of General hospitals in Korea. Essential architectural elements composing the Hospital Design Focused on System are as follows. First of all, the elements which can react to development of hospital architecture are HOSPITAL STREET and site situation. Secondly, core, equipment shaft, column, MAIN STREET and air handling unit room are elements of great importance as the location of these elements determines the dimensions and scale of the space which hospital functions are assigned to. Third, the area in regard to the rate of change is formed by MAIN STREET, which is the primary element, and envelope. The depth between MAIN STREET and envelope is defined as space depth. The flexible area is determined depending on this space depth and thus how to set up this flexible area determines the degree of readiness in responding to the change.
Background: To evaluate pathological features of head and neck squamous cell carcinoma (HNSCC) and to compare these pathological features in patients younger and older than 40 years. Materials and Methods: All resection specimens of HNSCC between 2010 and 2013 evaluated. Tumor characteristics - grade, location (site) cervical node status, alongwith presence or absence of extranodal extension, lymphovascular invasion, gender and age - were extracted from surgical pathology reports. Results: Among these n=19 patients (21.8%) were 40 years or younger and n=68 patients (78.2%) were above 40 years of age. The mean age was 34 (20-40 years) in the younger group and 56 (42-86) in the older group. The most common location of HNSCC in both groups was the oral cavity. The analysis of histopathological features including grade of tumor, tumor size, extranodal extension and comparison between two groups do not show any significant difference. Conclusions: There are no specific pathological characteristics of HNSCC in young patients. An interesting observation is that exposure to expected risk factors is similar in both groups, in younger patients they have less time to act and yet tumors are the same in terms of tumor size, lymph node status and lymphovascular invasion. Therefore further research is recommended to look for potentiating factors.
The 14-3-3 proteins are highly conserved, ubiquitous molecules involved in a variety of biologic phenomena, such as cell cycle control, and apoptosis. However, their expression in cholangiocarcinoma has not been previously characterized. In this paper, immunohistochemistry using specific anti-14-3-3 monoclonal antibodies was performed on formalin-fixed;, paraffin embedded archival tissue from 86 patients of cholangiocarcinoma. We also examined the correlation between expression and survival rate and clinicopathologic factors such as tumor location, tumor size, pathologic differentiation, lymphatic permeation, lymph node metastasis, and tumor stage. Positive 14-3-3 proteins expression was observed for 6 isoforms (${\beta}$, ${\sigma}$, ${\gamma}$, ${\theta}$, ${\delta}$, ${\eta}$) of these proteins in 86 patients of cholangiocarcinoma. ${\beta}$ and ${\sigma}$ isoform immunoreactivity was correlated with lymph node metastasis, tumor stage and patients' survival rate. In addition, ${\delta}$ isoform immunoreactivity showed trends with tumor location, tumor size, pathologic differentiation and tumor stage, while the ${\theta}$ isoform was correlated with pathologic differentiation. These results indicated that upregulated expression of some isoforms of 14-3-3 may be a common mechanism for evading apoptosis in cholangiocarcinoma, so that targeting 14-3-3 may be a novel promising strategy for the treatment of this tumor.
The Journal of the Korean bone and joint tumor society
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v.3
no.1
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pp.1-8
/
1997
Osteosarcoma is the most common primary bony malignancy and its survivorship has been progressed markedly through refined chemotherapy and surgery. But still there are many non-responders and analysis of prognostic factors may be helpful for them. Two hundred and sixty-six patients were enlisted between Mar, 1985 and Sep. 1994. Among them our inclusion criteria were: 1)primary, nonmetastatic classical osteosarcoma 2)extremity in location 3)no prior treatment at other institute and completed neoadjuvant chemotherapy and surgery according to our protocol. One hundred and eleven cases were eligible. Analyzed factors were:age, sex, location, tumor size, and pathologic response. Statistical methods were log-rank test for univariate and Cox's test for multivariate analysis. Male to female ratio was 69:42 with an average age of 17.2 years. Locations of tumor were distal femur 59, proximal tibia 29, and proximal humerus 8. Tumor size were measured by its maximal diameter and 48 cases were above 10cm and 47 cases were below 10cm. For pathologic response, 57 cases showed more than 90% and 54 cases were less than that. Limb salvage procedure was 101 cases and amputation was 10 cases and their local recurrence rate were 3.6%. Average follow-up period was 24(9-78.2) months and their final status was CDF 86, AWD 8, NED 5, and DOD 12 cases. In univariate study: type of operation(p=0.005), tumor size(p=0.005), and pathologic response(p=0.02) were significant variables. Pathologic response(p=0.03) and type of operation(p=0.01) were meaningful prognostic factors on multivariate analysis. But the latter result was interpreted as a bias, so pathologic response remained as a sole meaningful prognostic factor. More aggressive chemotherapy will be needed to improve the survival.
Objective : Delayed hinge fracture (HF) that develops after cervical open door laminoplasty can be a source of postoperative complications such as axial pain. However, risk factors related to this complication remain unclear. We performed a retrospective clinical series to determine risk factors for delayed HF following plate-only open-door cervical laminoplasty. Methods : Patients who underwent plate-only open-door laminoplasty and had available postoperative computed tomography (CT) scans (80 patients with 270 laminae) were enrolled. Hinge status, hinge gutter location, open location, hinge width, number of screws used, operation level, and open angle were observed in the CT to determine radiographic outcome. Demographic data were collected as well. Radiographic and clinical parameters were analyzed using univariate and multivariate logistic regression analysis to determine the risk factors for HF. Results : Univariate logistic regression analysis results indicated poor initial hinge status, medially placed hinge gutter, double screw fixation on the elevated lamina, upper surgical level, and wide open angle as predictors for HF (p<0.05). Initial hinge status seemed to be the most powerful risk factor for HF (p=0.000) and thus was collinear with other variables. Therefore, multivariate logistic regression analysis was performed excluding initial hinge status, and the results indicated that medially placed hinge gutter, double screw fixation on the elevated lamina, and upper surgical level were risk factors for HF after adjustment for other confounding factors. Conclusion : To prevent HF and to draw a successful postoperative outcome after cervical laminoplasty, surgical and clinical precautions should be considered.
The proper management of the pediatric facial bone fracture is critical in the facial bone development. This study characterizes the surgically treated patient population suffering from facial bone fractures by the use of current data from a large series consisting of 201 cases. The data was gathered through a retrospective chart review of patients surgically treated for facial bone fractures at the department of plastic and reconstructive surgery, Sanggye Paik hospital, Inje university medical center, collected over 10-years period from January, 1993 to December, 2002. Data regarding patient demographics(age, sex), seasonal distribution, location of fractures, and the causes of injury with admission periods, were collected. In total, there were 201cases of pediatric facial bone fractures. Male patients outnumbered female patients by a 5.48: 1 ratio and were found to engage in a wider range of behaviors that resulted in facial bone fractures. Physical violence was the leading cause of pediatric facial bone fractures(27.9%), followed by sports-related mechanisms (22.9%) and falling down(17.9%). The most prevalent age group was 11-15 years-old(71.1%) and there was a 14.3% prevalence in March. Among the location of fractures, the nasal bone was the most prevalent, accounting for 82.3% of injuries, followed by the orbit(9.95%), and the mandible fractures(7.5%). Most patients(59.7%) were treated within 6-9 days after trauma and the mean hospitalization period was 8-11 days. We should follow up the surgically treated patients, and they will be further evaluated about postoperative sequele and effect on the facial bone development. These studies demonstrate differences in the demographics and clinical presentation that, if applied to patients, will enable a more accurate diagnosis and proper management.
Kim, Choon Soo;Na, Young Cheon;Yun, Chi Sun;Huh, Woo Hoe;Lim, Bo Ra
Archives of Craniofacial Surgery
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v.21
no.3
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pp.171-175
/
2020
Background: Epidermoid cysts are benign tumors derived from the infundibular portion of hair follicles and thus have a flattened surface epithelium and keratohyaline granules. They can occur at any age but are most frequently reported in adults, and more often occur in men than women. Most epidermoid cyst operations are performed for cosmetic purposes, or to relieve inflammation. The definitive treatment is complete excision or destruction of the cyst. The aim of this study was to improve understanding of epidermoid cysts. Methods: We analyzed 432 cases of epidermoid cyst in 398 patients that underwent complete excision and biopsy between April 2001 and March 2020, according to patient age, patient gender, and lesion location. Results: From all epidermoid cyst excisions performed, 17.6% were for patients in their 40s and 50s, 16.8% for those in their 20s, 16.1% for those in their 30s, 14.6% for those aged 60 or older, 5.0% for teenagers, and 0.5% for those under 10 years. Cases of epidermoid cysts occurred at a men-to-women ratio of about 3:2, with 59.5% of cases in men and 40.5% in women. By lesion location, 65.0% of cases were on the face, 10.9% on the trunk, 7.9% on the scalp, 7.9% on the neck, 4.3% on lower extremities, 3.9% on upper extremities, and 0.2% on genitalia. On the face, 20.8% of cases were on the cheek, 12.7% on the periauricular area, 10.9% on the periorbital area, 6.0% on the frontal area, 5.6% on the mental area, 3.7% on the perioral area, 2.8% on the nasal area, and 2.5% on the temporal area. Conclusion: The proportion of women with epidermoid cysts was higher in our study than in previous studies. Moreover, the results showed that surgery has been on the rise in recent years, with facial surgery being the most common.
The main objective of this paper is to perform an empirical analysis on the relationship between various marketing activities and financial performance of Korean hospitals. A survey was conducted through structured questionnaire for 495 hospitals, and data from 218 hospitals were utilized in the final anaylsis.(response rate: 44%) Survey items include general characteristics of the hospitals(size, type, location), degree of competition, financial performance. marketing organization! budget, and level of various marketing activities in service development, access improvement, promotion, and pricing. We examine descriptive statistics of the response scores on marketing activities to evaluate the current status of marketing management of Korean hospitals, compare the results across hospital size, type and location, and perform regression analysis to investigate the relaionship between marketing and financial performance. Major findings are as follows: 1) About 46% of the responding hospitals have marketing departments although they are named as 'planning' or 'PR' departments, and the marketing budget on average represents 1.74% of the total expenditures. 2) Average level of marketing activities is calculated to be about 3.32 on 5-point scale, meaning that Korean hospitals implement their marketing programs 'somewhat actively'; however, the scores on the areas of marketing plannning and strategy are relatively low. 3) Large hospitals tend to be more active in marketing than small hospitals, and public hospitals' activities in marketing are not lower compared to private hospitals. 4) Level of overall marketing activities is positively related with financial performance measured by various finacial indicators except for profitability, implying that marketing is successful in revenue generation but needs to be more cost-effective. Also, when the marketing variables are separately included in the regression, no significant relationship is found, which means that various marketing activities are more effective when they are collectively implemented.
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