• Title/Summary/Keyword: IMA

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Prognosis for Pneumonic-Type Invasive Mucinous Adenocarcinoma in a Single Lobe on CT: Is It Reasonable to Designate It as Clinical T3?

  • Wooil Kim;Sang Min Lee;Jung Bok Lee;Joon Beom Seo;Hong Kwan Kim;Jhingook Kim;Ho Yun Lee
    • Korean Journal of Radiology
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    • v.23 no.3
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    • pp.370-380
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    • 2022
  • Objective: To compare pneumonic-type invasive mucinous adenocarcinoma (pIMA) confined to a single lobe with clinical T2, T3, and T4 stage lung cancer without pathological node metastasis regarding survival after curative surgery and to identify prognostic factors for pIMA. Materials and Methods: From January 2010 to December 2017, 41 patients (15 male; mean age ± standard deviation, 66.0 ± 9.9 years) who had pIMA confined to a single lobe on computed tomography (CT) and underwent curative surgery were identified in two tertiary hospitals. Three hundred and thirteen patients (222 male; 66.3 ± 9.4 years) who had non-small cell lung cancer (NSCLC) without pathological node metastasis and underwent curative surgery in one participating institution formed a reference group. Relapse-free survival (RFS) and overall survival (OS) were calculated using the Kaplan-Meier method. Cox proportional hazard regression analysis was performed to identify factors associated with the survival of patients with pIMA. Results: The 5-year RFS and OS rates in patients with pIMA were 33.1% and 56.0%, respectively, compared with 74.3% and 91%, 64.3% and 71.8%, and 46.9% and 49.5% for patients with clinical stage T2, T3, and T4 NSCLC in the reference group, respectively. The RFS of patients with pIMA was comparable to that of patients with clinical stage T4 NSCLC and significantly worse than that of patients with clinical stage T3 NSCLC (p = 0.012). The differences in OS between patients with pIMA and those with clinical stage T3 or T4 NSCLC were not significant (p = 0.11 and p = 0.37, respectively). In patients with pIMA, the presence of separate nodules was a significant factor associated with poor RFS and OS {unadjusted hazard ratio (HR), 4.66 (95% confidence interval [CI], 1.95-11.11), p < 0.001 for RFS; adjusted HR, 4.53 (95% CI, 1.59-12.89), p = 0.005 for OS}. Conclusion: The RFS of patients with pIMA was comparable to that of patients with clinical stage T4 lung cancer. Separate nodules on CT were associated with poor RFS and OS in patients with pIMA.

Differences of 1-2 Intermetatarsal Angle between Intra-operative nonweight-bearing and Postoperative weight-bearing in Proximal Metatarsal Osteotomy for Hallux Valgus (무지 외반증의 근위 중족골 절골술에 있어서 수술 중 비체중부하와 수술 후 제중부하 방사선 소견에서의 제 1-2 종족골간 각의 차이)

  • Sung, Il-Hoon;Kim, Joo-Hak;Whang, Khun-Sung
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.1
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    • pp.7-12
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    • 2003
  • Purpose: To study the relationship of the 1st to 2nd intermetatarsal angle(1-2 IMA) between the intra-operative and weight bearing postoperative anterior-posterior(AP) radiography, and evaluate the intra-operative predictability for the postoperative 1-2 IMA after proximal metatarsal osteotomy(PMO) in the hallux valgus deformity. Materials and Methods: 20 cases of moderate to severe hallux valgus patients were included in this study. After the oblique PMO(Ludloff procedure) was performed and the osteotomy site was fixed temporarily, the AP view was taken intra-operatively. About 10 weeks after surgery, postoperative weight bearing AP view was taken. The pre -. intra -, and postoperative 1-2 IMAs were compared and ana lysed statistically. Results: The 1-2 IMAs of the weight bearing preoperative, non-weight bearing intra-operative and weight bearing postoperative AP view were $15.9^{\circ}{\pm}1.8^{\circ},\;4.7^{\circ}{\pm}2.1^{\circ}$, and $6.8^{\circ}{\pm}2.5^{\circ}$ (Mean${\pm}$SD) respectively. The postoperative 1-2 IMA was greater than intra-operative measurement by $2.1^{\circ}{\pm}1.8^{\circ}$ (range; $-1^{\circ}$ to $6^{\circ}$) which was stastistically significant(p<0.05). To get less than $9^{\circ}$ postoperatively as an average normal, intra-operative 1-2 IMA should be within $3.8^{\circ}$ to $5.2^{\circ}$ (95% confidence interval), and intra-operative 1-2 IMA should be within $3.4^{\circ}{\pm}$to $5.4^{\circ}$(95% confidence interval) to get more than $6^{\circ}$ difference between preoperative and postoperative 1-2 IMA, which is regarded as more than average correction by the distal metatarsal osteotomy. Conclusion: In hallux valgus surgery, it should be considered that intra-operative 1-2 IMA was less than the postoperative. To achieve postoperative 1-2 IMA less than $9^{\circ}$ and more than correction angle of $6^{\circ}$, it is suggested that the intra-operative 1-2 IMA should be measured less than about $5^{\circ}$.

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Relationship between Ischemia-Modified Albumin and the Healing Period of Amputation Wounds in Patients with Diabetes Mellitus Following Non-traumatic Below-Knee Amputation (당뇨족으로 인한 비외상성 하퇴부 절단 환자에서 시행한 절단부 창상의 치유 기간과 Ischemia-Modified Albumin과의 관계)

  • Si Young Heo;Myoung Jin Lee;Hyeon jun Kim;Sung Bin Byun
    • Journal of Korean Foot and Ankle Society
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    • v.27 no.2
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    • pp.49-54
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    • 2023
  • Purpose: The present study examined the effectiveness of the preoperative ischemia-modified albumin (IMA) levels in predicting the healing period of amputation wounds in patients with diabetes mellitus following a non-traumatic below-knee amputation (BKA). Materials and Methods: This study enrolled 41 diabetic foot ulcer patients who underwent BKA at the authors' hospital diabetic foot center from April 2016 to April 2022. Among the 41 patients, 29 (70.7%) were male and 12 (29.3%) were female. Their mean age was 64.54±11.38 years (41~81 years). The mean follow-up period was 19.48±5.56 weeks (14~48 weeks) after BKA. The patients were divided into two groups (high IMA group and normal IMA group), which evaluated the healing period, wound dehiscence, and revision operation rate using a Fisher's exact test and Mann-Whitney U test. Three orthopedic surgeons performed stump wound evaluation, and they were evaluated as healing when all sutures were fused without oozing. Results: Thirty patients (73.2%) (group A) showed a high level of IMA (median: 91.2 U/mL), and 11 (26.8%) patients (group B) showed a normal range of IMA (median: 82.7 U/mL). In group A, the median period for wound healing took 1.4 weeks longer, which was significant (p=0.001). No statistical relationship was observed between wound dehiscence, revision operation rate, and IMA value. There was no correlation between the other risk factors (estimated glomerular filtration rate, HbA1c) and the wound healing period. Conclusion: Although there was a limitation in using IMA as the sole factor to predict the healing period of amputation wounds in patients after BKA, this study revealed a significant positive correlation between IMA and the period of stump healing after BKA. Therefore, the preoperative IMA levels may help predict the period of stump healing after BKA.

Primary Invasive Mucinous Adenocarcinoma of the Lung: Prognostic Value of CT Imaging Features Combined with Clinical Factors

  • Tingting Wang;Yang Yang;Xinyue Liu;Jiajun Deng;Junqi Wu;Likun Hou;Chunyan Wu;Yunlang She;Xiwen Sun;Dong Xie;Chang Chen
    • Korean Journal of Radiology
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    • v.22 no.4
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    • pp.652-662
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    • 2021
  • Objective: To investigate the association between CT imaging features and survival outcomes in patients with primary invasive mucinous adenocarcinoma (IMA). Materials and Methods: Preoperative CT image findings were consecutively evaluated in 317 patients with resected IMA from January 2011 to December 2015. The association between CT features and long-term survival were assessed by univariate analysis. The independent prognostic factors were identified by the multivariate Cox regression analyses. The survival comparison of IMA patients was investigated using the Kaplan-Meier method and propensity scores. Furthermore, the prognostic impact of CT features was assessed based on different imaging subtypes, and the results were adjusted using the Bonferroni method. Results: The median follow-up time was 52.8 months; the 5-year disease-free survival (DFS) and overall survival rates of resected IMAs were 68.5% and 77.6%, respectively. The univariate analyses of all IMA patients demonstrated that 15 CT imaging features, in addition to the clinicopathologic characteristics, significantly correlated with the recurrence or death of IMA patients. The multivariable analysis revealed that five of them, including imaging subtype (p = 0.002), spiculation (p < 0.001), tumor density (p = 0.008), air bronchogram (p < 0.001), emphysema (p < 0.001), and location (p = 0.029) were independent prognostic factors. The subgroup analysis demonstrated that pneumonic-type IMA had a significantly worse prognosis than solitary-type IMA. Moreover, for solitary-type IMAs, the most independent CT imaging biomarkers were air bronchogram and emphysema with an adjusted p value less than 0.05; for pneumonic-type IMA, the tumors with mixed consolidation and ground-glass opacity were associated with a longer DFS (adjusted p = 0.012). Conclusion: CT imaging features characteristic of IMA may provide prognostic information and individual risk assessment in addition to the recognized clinical predictors.

An Extension of the Optimality of Exponential Smoothing to Integrated Moving Average Process (일반적인 IMA과정에 대한 지수평활 최적성의 확장)

  • Park, Hae-Chul;Park, Sung-Joo
    • Journal of the military operations research society of Korea
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    • v.8 no.1
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    • pp.99-107
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    • 1982
  • This paper is concerned with the optimality of exponential smoothing applied to the general IMA process with different moving average and differencing orders. Numerical experiments were performed for IMA(m,n) process with various combinations of m and n, and the corresponding forecast errors were compared. Results show that the higher differencing order is more critical to the optimality of exponential smoothing, i.e., the IMA process with the higher moving average order, forecasted by exponential smoothing, has comparatively smaller forecast error. If the difference between the differencing order and the moving average order becomes larger, the accuracy of forecast by exponential smoothing declines gradually.

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Design of On-line Process Control with Variable Measurement Interval

  • Park, Changsoon
    • Journal of the Korean Statistical Society
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    • v.29 no.3
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    • pp.319-336
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    • 2000
  • A mixed model with a white noise process and an IMA(0,1,1) process is considered as a process model. It is assumed that the process is a white noise in the absence of a special cause and the process changes to an IMA(0,1,1) due to a special cause. One useful scheme in measuring the process level is to use the variable measurement interval (VMI) between measurement times according to the value of the previous chart statistic. The advantage of the VMI scheme is to measure the process level infrequently when in control to save the measurement cost and to measure frequently when out of control to save the off-target cost. This paper considers the VMI scheme in order to detect changes in the process model from a white noise to an IMA(0,1,1). The VMI scheme is shown to be effective compared to the standard fixed measurement interval (FMI) scheme in both statistical and economic contexts.

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Incidence of Hallux Valgus Interphalangeus in the Normal and Hallux Valgus Feet and its Correlations with Hallux Valgus Angle and Intermetatarsal Angle (정상 족과 무지 외반증에서의 무지 지간 외반증의 발생 빈도와 무지 외반각과 제1-2 중족골간 각과의 연관성에 대한 분석)

  • Kim, You-Jin;Jung, Hong-Geun;Bahng, Seung-Chul
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.1
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    • pp.13-17
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    • 2007
  • Purpose: In order to achieve successful outcome for the hallux valgus surgery, it is mandatory to consider the possible associated hallux valgus interphalangeus, and therefore the hallux interphalangeal angle (HIA) other than hallux valgus angle (HVA) and intermetatarsal angle (IMA) has been well appreciated. The purpose of this study is to evaluate the incidence of hallux interphalangeal angle in the normal and hallux valgus feet and also the statistical correlations of HIA with HVA and IMA in the 2 groups. Materials and Methods: The study is base on the standing foot AP radiographs of the 100 normal feet (HVA<$12^{\circ}$ and $IMA<9^{\circ}$) and 100 hallux valgus feet (HVA>$25^{\circ}$ and IMA>$12^{\circ}$). We measured the hallux valgus angle, intermetatarsal angle and hallux interphalangeal angle, where we defined the hallux valgus interphalangeus when the HIA was more than $10^{\circ}$. We evaluated the incidence of the hallux valgus interphalangeus in the normal and hallux valgus groups and the correlations of the HIA with HVA and IMA. Results: In normal feet group, hallux valgus interphalangeus comprised 82%, while there were only 20% of HVI in hallux valgus group. Among 200 total feet, there was negative correlations between the HVA and HIA as well as IMA and HIA statistically (p<0.01). Conclusion: There was lower incidence of hallux valgus interphalangeus in the hallux valgus group compared to the normal feet group.

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IMA based Platform Architecture for Improving Portability of Flight Software (비행 소프트웨어의 이식성 향상을 위한 IMA 기반 플랫폼 아키텍처)

  • Seo, Yongjin;Kim, Hyeon Soo
    • Journal of Internet Computing and Services
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    • v.15 no.1
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    • pp.1-17
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    • 2014
  • Flight software operated on the on-board computers in the satellite has requirements such as real-time, high reliability. These requirements make dependency between the flight software and operating environments. Further, whenever a new system is built, such problem drives that all flight software are redeveloped. Thus, the dependency problem between them should be solved. And the problem can be resolved by improving the portability of the flight software. In order to improve the portability it is required to minimize the porting cost. In this paper, we classify the portability with the portability achieving methods. Using the classified portability, we propose a platform architecture that is based on the IMA concept and provides various portability capabilities. The proposed architecture enables us to solve the problem about the development of the flight software.

Evaluation of the role of ischemia modified albumin in neonatal hypoxic-ischemic encephalopathy

  • Talat, Mohamed A.;Saleh, Rabab M.;Shehab, Mohammed M.;Khalifa, Naglaa A.;Sakr, Maha Mahmoud Hamed;Elmesalamy, Walaa M.
    • Clinical and Experimental Pediatrics
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    • v.63 no.8
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    • pp.329-334
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    • 2020
  • Background: Birth asphyxia is a leading cause of neonatal mortality. Ischemia-modified albumin (IMA) levels may have a predictive role in the identification and prevention of hypoxic disorders, as they increase in cases of ischemia of the liver, heart, brain, bowel, and kidney. Purpose: This study aimed to assess the value of IMA levels as a diagnostic marker for neonatal hypoxic-ischemic encephalopathy (HIE). Methods: Sixty newborns who fulfilled 3 or more of the clinical and biochemical criteria and developed HIE as defined by Levene staging were included in our study as the asphyxia group. Neonates with congenital malformation, systemic infection, intrauterine growth retardation, low-birth weight, cardiac or hemolytic disease, family history of neurological diseases, congenital or perinatal infections, preeclampsia, diabetes, and renal diseases were excluded from the study. Sixty healthy neonates matched for gestational age and with no maternal history of illness, established respiration at birth, and an Apgar score ≥7 at 1 and 5 minutes were included as the control group. IMA was determined by double-antibody enzyme-linked immunosorbent assay of a cord blood sample collected within 30 minutes after birth. Results: Cord blood IMA levels were higher in asphyxiated newborns than in controls (250.83±36.07 pmol/mL vs. 120.24±38.9 pmol/mL). Comparison of IMA levels by HIE stage revealed a highly significant difference among them (207.3±26.65, 259.28±11.68, 294.99±4.41 pmol/mL for mild, moderate, and severe, respectively). At a cutoff of 197.6 pmol/mL, the sensitivity was 84.5%, specificity was 86%, positive predictive value was 82.8%, negative predictive value was 88.3%, and area under the curve was 0.963 (P<0.001). Conclusion: IMA levels can be a reliable marker for the early diagnosis of neonatal HIE and can be a predictor of injury severity.