• Title/Summary/Keyword: Mean Reduction Method

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Self-Monitoring of Blood Pressure and Feed-back Using APP in TReatment of UnconTrolled Hypertension (SMART-BP): A Randomized Clinical Trial

  • Dong-Ju Choi;Jin Joo Park;Minjae Yoon;Sung-Ji Park;Sang-Ho Jo;Eung Ju Kim;Soo-Joong Kim;Sungyoung Lee
    • Korean Circulation Journal
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    • v.52 no.10
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    • pp.785-794
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    • 2022
  • Background and Objectives: Self-monitoring of blood pressure (SMBP) is a reliable method used to assess BP accurately. However, patients do not often know how to respond to the measured BP value. We developed a mobile application-based feed-back algorithm (SMBP-App) for tailored recommendations. In this study, we aim to evaluate whether SMBP-App is superior to SMBP alone in terms of BP reduction and drug adherence improvement in patients with hypertension. Methods: Self-Monitoring of blood pressure and Feed-back using APP in Treatment of UnconTrolled Hypertension (SMART-BP) is a prospective, randomized, open-label, multicenter trial to evaluate the efficacy of SMBP-App compared with SMBP alone. Patients with uncomplicated essential hypertension will be randomly assigned to the SMBP-App (90 patients) and SMBP alone (90 patients) groups. In the SMBP group, the patients will perform home BP measurement and receive the standard care, whereas in the SMBP-App group, the patients will receive additional recommendations from the application in response to the obtained BP value. Follow-up visits will be scheduled at 12 and 24 weeks after randomization. The primary endpoint of the study is the mean home systolic BP. The secondary endpoints include the drug adherence, the home diastolic BP, home and office BP. Conclusions: SMART-BP is a prospective, randomized, open-label, multicenter trial to evaluate the efficacy of SMBP-App. If we can confirm its efficacy, SMBP-App may be scaled-up to improve the treatment of hypertension.

Comparison of Two Methods for Determining Initial Radius in the Sphere Decoder (스피어 디코더에서 초기 반지름을 결정하는 두 가지 방법에 대한 비교 연구)

  • Jeon, Eun-Sung;Kim, Yo-Han;Kim, Dong-Ku
    • Journal of Advanced Navigation Technology
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    • v.10 no.4
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    • pp.371-376
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    • 2006
  • The initial radius of sphere decoder has great effect on the bit error rate performance and computational complexity. Until now, it has been determined either by considering the statistical property of channel or by using of MMSE solution. The initial radius obtained by using statistical property of channel includes the lattice point corresponding to the transmit signal vector with very high probability. The method using MMSE solution first calculates out the MMSE solution of the received signal, then maps the hard decision of this solution into the received signal space, and finally the distance between the mapped point and the received signal is selected as the initial radius of the sphere decoding. In this paper, we derive a simple equation for initial radius selection which uses statistical property of channel and compare it with the method using MMSE solution. To compare two methods we define new metric 'Tightness'. Through the simulation, we observe that in low and moderate SNR region, the method using MMSE solution provides more complexity reduction for decoding while in high SNR region, the method using channel statistics is better.

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A Hydrological Study on Rainfall Frequency Atlas in Korea (한국 확률강우량도 작성을 위한 수문학적 연구)

  • 이원환
    • Water for future
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    • v.10 no.1
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    • pp.39-51
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    • 1977
  • The purpose of this study is to make "The Rainfall Frequency Atlas in Korea" by the analytical method with new hydrological concepts. In this study, all of the rainfall datas in Korea was used for surveying of the basic data, and so we can get 103 sites for annual rainfall data and 100 sites for the max. in a day that are suitable to the purpose of the study. The above data groups are possible to estimate the normal standard period by the moving average method with $\pm$5% of significance level of variance ratio between the max. and min. moving average and arithmetic mean, but it may be impossible to study until 1990's for the short duration under 18-hr because the sites, having the short duration data, are only 12. The results of this study are as follows; 1. The normal standard period estimated by the moving average method is 20 year with $\pm$5% of significance level of variance ratio, and 30 year with$\pm$2-3%. 2. For the annual and max. rainfall in a day, it is possible to make the rainfall frequency atlas with 30normal standard period, but it may be impossible until 1990's for short duration. 3. "Y-k method" developed by writer is best suitable in the rainfal frequency analysis in Korea because of its convenience and reduction in the amount of calculation compared with other methods. 4. To improve the utilization of the rainfall frequency atlas, the larger-sized and the more detailed iso-precipitation atlas must be drawn.atlas must be drawn.

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Outside Temperature Prediction Based on Artificial Neural Network for Estimating the Heating Load in Greenhouse (인공신경망 기반 온실 외부 온도 예측을 통한 난방부하 추정)

  • Kim, Sang Yeob;Park, Kyoung Sub;Ryu, Keun Ho
    • KIPS Transactions on Software and Data Engineering
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    • v.7 no.4
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    • pp.129-134
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    • 2018
  • Recently, the artificial neural network (ANN) model is a promising technique in the prediction, numerical control, robot control and pattern recognition. We predicted the outside temperature of greenhouse using ANN and utilized the model in greenhouse control. The performance of ANN model was evaluated and compared with multiple regression model(MRM) and support vector machine (SVM) model. The 10-fold cross validation was used as the evaluation method. In order to improve the prediction performance, the data reduction was performed by correlation analysis and new factor were extracted from measured data to improve the reliability of training data. The backpropagation algorithm was used for constructing ANN, multiple regression model was constructed by M5 method. And SVM model was constructed by epsilon-SVM method. As the result showed that the RMSE (Root Mean Squared Error) value of ANN, MRM and SVM were 0.9256, 1.8503 and 7.5521 respectively. In addition, by applying the prediction model to greenhouse heating load calculation, it can increase the income by reducing the energy cost in the greenhouse. The heating load of the experimented greenhouse was 3326.4kcal/h and the fuel consumption was estimated to be 453.8L as the total heating time is $10000^{\circ}C/h$. Therefore, data mining technology of ANN can be applied to various agricultural fields such as precise greenhouse control, cultivation techniques, and harvest prediction, thereby contributing to the development of smart agriculture.

Studies on Ancylostomiasis I. An Experimental Study on Hookworm Infection and Anemia (구충증(鉤蟲症)에 관(關)한 연구(硏究) 제1편(第1篇) 구충(鉤蟲)의 감염(感染) 및 구충성빈혈(鉤蟲性貧血)에 관(關)한 고찰(考奈))

  • Lee, Mun-Ho;Kim, Dong-Jip;Lee, Jang-Kyu;Seo, Byong-Sul;Lee, Soon-Hyung
    • The Korean Journal of Nuclear Medicine
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    • v.1 no.1
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    • pp.55-66
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    • 1967
  • In view of its prevalence in the Far East area, a more detailed knowledge on the hookworm infection is one of the very important medical problems. The present study was aimed to; determine the infectivity of the artificially hatched ancylostoma duodenale larvae in man after its oral administration, evaluate the clinical symptomatology of such infection, determine the date of first appearance of the ova in the stool, calculate the blood loss per worm per day, assess the relation-ships between the ova count, infectivity(worm load), blood loss and severity of anemia. An erythrokinetic study was also done to analyse the characteristics of hookworm anemia by means of $^{59}Fe\;and\;^{51}Cr$. Materials and Methods Ten healthy male volunteers(doctors, medical students and laboratory technicians) with the ages ranging from 21 to 40 years were selected as the experimental materials. They had no history of hookworm infection for preceding several years, and care was taken not to be exposed to reinfection. A baseline study including a through physical examinations and laboratory investigations such as complete blood counts, stool examination and estimation of the serum iron levels was done, and a vermifuge, bephenium hydroxynaphoate, was given 10 days prior to the main experiment. The ancylostoma duodenale filariform larvae were obtained in the following manner; The pure ancylostoma duodenale ova were obtained from the hookworm anemia patients and a modified filter paper method was adopted to harvest larger number of infective larvae, which were washed several times with saline. The actively moving mature larvae were put into the gelatine capsules, 150 in each, and were given to the volunteers in the fasting state with 300ml. of water. The volunteers were previously treated with intramuscular injection of 15mg. of chlorpromazine in order to prevent the eventual nausea and vomiting after the larvae intake. The clinical symptoms and signs mainly of the respiratory and gastrointestinal tracts, appearance of the ova and occult blood in the stool etc. were checked every day for the first 20 days and then twice weekly until the end of the experiment, which usually lasted for about 3 months. Roentgenological survey of the lungs was also done. The hematological changes such as the red blood cell, white blood cell and eosinophil cell counts, hemoglobin content and serum iron levels were studied. The appearance of the ova in the stool was examined by the formalin ether method and the ova were counted in triplicate on two successive days using the Stoll's dilution method. The ferrokinetic data were calculated by the modified Huff's method and the apparent half survival time of the red blood cells by the modified Gray's method. The isotopes were simultaneously tagged and injected intravenously, and then the stool and blood samples were collected as was described by Roche et al., namely, three separate 4-day stool samples with the blood sample drawing before each 4-day stool collection. The radio-activities of the stools ashfied and the blood were separately measured by the pulse-height analyser. The daily blood loss was calculated with the following formula; daily blood loss in $ml.=\frac{cpm/g\;stool{\times}weight\;in\;g\;of\;4-day\;stool}{cpm/ml\;blood{\times}4}$ The average of these three 4-day periods was given as the daily blood loss in each patient. The blood loss per day per worm was calculated by simply dividing the daily blood loss by the number of the hookworm recovered after the vermifuge given twice a week at the termination of the experiment. The iron loss in mg. through the gastrointestinal tract was estimated with the daily iron loss in $mg=\frac{g\;Hgb/100ml{\times}ml\;daily\;blood\;loss{\times}3.40}{100}$ 3.40=mg of iron per g Hgb following formula; Results 1. The respiratory symptoms such as cough and sputum were noted in almost all cases within a week after the infection, which lasted about 2 weeks. The roentgenological findings of the chest were essentially normal. A moderate degree of febril reaction appeared within 2 weeks with a duration of 3 or 4 days. 2. The gastrointestinal symptoms such as nausea, epigastric fullness, abdominal pain and loose bowel appeared in all cases immediately after the larvae intake. 3. The reduction of the red blood cell count was not remarkable, however, the hemoglobin content and especially the serum iron level showed the steady decreases until the end of the experiment. 4. The white blood cells and eosinophil cells, on the contrary, showed increases in parallel and reached peaks in 20 to 30 days after the infection. A small secondary rise was noted in 2 months. 5. The ova first appeared in the stool in 40. 1 days after the infection, ranging from 29 to 51 days, during which the occult blood reaction of the stool became also positive in almost cases. 6. The number of ova recovered per day was 164, 320 on the average, ranging from 89,500 to 253,800. The number of the worm evacuated by vermifuge was in rough correlation with the number of ova recovered. 7. The infectivity of ancylostoma duodenale was 14% on the average, ranging from 7.3 to 20.0%, which is relatively lower than those reported by other workers. 8. The mean fecal blood loss was 5.78ml. per day, with a range of from 2.6 to 11.7ml., and the mean blood loss per worm per day was 0.30ml., with a range of from 0.13 to 0.73ml., which is in rough coincidence with those reported by other authors. There appeared to exist, however, no correlation between the blood loss and the number of ova recovered. 9. The mean fecal iron loss was 2.02mg. per day, with a range of from 1.20 to 3.89mg., which is less than those appeared in the literature. 10. The mean plasma iron disappearance rate was 0.80hr., with a range of from 0.62 to 0.95hr., namely, a slight accerelation. 11. The hookworm anemia appeared to be iron deficiency in origin caused by continuous intestinal blood loss.

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Early and Midterm Results of the Extracardiac Fontan Operation and the Change of Internal Diameter of the Conduit (심외도관 폰탄수술후 중단기 성적 및 심외도관의 내경의 변화)

  • 성시찬;김시호
    • Journal of Chest Surgery
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    • v.35 no.3
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    • pp.177-181
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    • 2002
  • Background: Follow-up studies have shown that although outcomes have improved substantially over time, results of the Fontan operation and its modifications remain suboptimal. In this study, we reviewed our experience with the extracardiac conduit Fontan operation, with a focus early and midterm change of internal diameter of PTFE conduit. Material and Method: Between April 1997 and July 2000 were reviewed. Twelve patients (M:6, F:6, mean age 42.04 $\pm$ 12.43months, mean body weight 13.80$\pm$ 1.94kg) underwent extracardiac conduit Fontan operation with expanded PTFE graft. Mean cardiopulmonary bypass time was 109.7$\pm$26.99minute and mean operation time was 455$\pm$89.51minute. Intraoperative fenestration was performed in 10 patients. The aortic cross clamping was not performed in all patients. Result: There was no early deaths and no postoperative dysrhythmia. Postoperative protein losing enteropathy and prolonged pleural effusion occurred in 1(8.3%) and 4 patients(33.3%). Conduit patency was evaluated by magnetic resonance imaging studies. A 9.84$\pm$3.84% mean reduction in conduit internal diameter and there was no statistical correlation between the change of internal diameter of conduit and the postoperative duration after partial correlation analysis(r=0.019, p=0.955). Conclusion: These results demonstrate that the extracardiac conduit Fontan operation provies good early and midterm results and may reduce the prevalence of late arrhythmia. And there is no correlation between the change of internal diameter of conduit and the postoperative duration after extracardiac conduit Fontan operation with the expanded PTFE graft conduit.

The prospective preliminary clinical study of open reduction and internal fixation of mandibular angle fractures using 2 miniplates (하악 우각부 골절 시 2개의 miniplate를 이용한 관혈적 정복술에 대한 전향적 예비 임상연구)

  • Yang, Seung-Bin;Jang, Chang-Su;Kim, Ju-Won;Yim, Jin-Hyuk;Kim, Jwa-Young;Yang, Byoung-Eun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.4
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    • pp.320-324
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    • 2010
  • Introduction: The placement of a single miniplate is not sufficient to achieve rigid fixation in mandibular angle fractures. It often causes difficulties in reducing the intermaxillary fixation (IMF) period. Consequently, the placement of 2 miniplates is preferable. The intraoral approach in an open reduction and internal fixation (ORIF) of a mandibular angle fracture with 2 miniplates is often challenging. Accordingly, an alternative of transbuccal approach is performed. However, this method leaves a scar on the face and can result in facial nerve injury. This clinical study suggests a protocol that can maintain rigid fixation without a transbuccal approach in mandibular angle fractures. Materials and Methods: The subjects were 7 patients who sustained fractures of the mandibular angle and treated at Department of Oral and maxillofacial surgery, Sacred Heart Hospital, Hallym University. ORIF under general anesthesia was done using the intraoral approach. One miniplate was inserted on external oblique ridge of the mandible, and the other was placed on lateral surface of the mandibular body with contra-angle drill and driver. A radiographic assessment and occlusal contact point examination was carried out before surgery, and 2, 4 and 6 weeks after surgery. Results: The mean operation time was 80 minutes. Regarding the occlusion state, the number of contact points increased after surgery. Paresthesia and infection were reported to be complications before surgery. Conclusion: The placement of 2 miniplates using contra-angle drill for ORIF of mandibular angle fractures allows early movement of the mandible without IMF. We propose this approach to reduce the patients’discomfort and simplify the surgical procedure.

Early Results of Extracardiac Fontan Operation (심장외폰탄수술의 조기성적)

  • 김웅한;정도현;김수철;전홍주;이창하;김욱성;오삼세;정철현;나찬영
    • Journal of Chest Surgery
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    • v.31 no.7
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    • pp.650-659
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    • 1998
  • Between August 1996 and August 1997, 22 patients underwent extracardiac Fontan operations. The basic diagnoses included univentricular heart of the right ventricular type (n=12); univentricular heart of the left ventricular type (n=4); tricuspid atresia (n=4); left isomerism, transposition of great arteries, ventricular septal defect and pulmonary stenosis (n=1); and criss-cross heart with uneven ventricle (n=1). The median age of the 14 men and 8 women was 29 months (range from 21 months to 26 years). Previous procedures included bidirectional cavopulmonary shunt (n=15, interval=15.6$\pm$3.4 months), Kawashima operation (n=4, interval=37.5$\pm$20 months), and classic Glenn shunt (n=1, interval=14 years). In 2 patients, extracardiac Fontan operations were done without any previous procedures. A 16- to 22-mm flexible Gore-Tex tube graft (n=18), Hemashield graft (n=3), or, alternatively, a nonvalved aortic allograft (n=1) was cut and anastomosed end-to-end between inferior vena cava and undersurface of pulmonary artery using Gore-Tex or Prolene suture in a running fashion. In risk Fontan patients (n=12), a communication between the extracardiac conduit and the right atrium was constructed. In the most 13 recent patients, the procedures were done without cross-clamping of the aorta and with a beating heart. Operative mortality was 9.1% (n=2). Complications included persistent chest tube drainage for more than 7 days (n=5), chorea (n=2), and low cardiac output (n=1). There were no late deaths. Follow-up echocardiogram (mean: 6 months) demonstrated satisfactory hemodynamic results in the surviving 20 patients. Potential advantages of this technique consist of minimization of surgical manipulation of atrial tissue, reduction or elimination of myocardial ischemia, creationof a uniform and stable inferior vena cava-to-pulmonary artery conduit, and increased flexibility and safety in certain high-risk patients such as those with increased pulmonary vascular resistance, pulmonary hypertension, and impaired ventricular function. Further investigations during a longer follow-up are needed to confirm the intermediate and long-term results, especially the reduction of late atrial arrhythmias.

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Outcomes Based on Risk Assessment of Anastomotic Leakage after Rectal Cancer Surgery

  • Gong, Jian-Ping;Yang, Liu;Huang, Xin-En;Sun, Bei-Cheng;Zhou, Jian-Nong;Yu, Dong-Sheng;Zhou, Xin;Li, Dong-Zheng;Guan, Xin;Wang, Dong-Feng
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.2
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    • pp.707-712
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    • 2014
  • Purpose: Anastomotic leakage (AL) is associated with high morbidity and mortality, high reoperation rates, and increased hospital length of stay. Here we investigated the risk factors for AL after anterior resection for rectal cancer with a double stapling technique. Patients and Methods: Data for 460 patients who underwent primary anterior resection with a double stapling technique for rectal carcinoma at a single institution from 2003 to 2007 were prospectively collected. All patients experienced a total mesorectal excision (TME) operation. Clinical AL was defined as the presence of leakage signs and confirmed by diagnostic work-up according to ICD-9 codes 997.4, 567.22 (abdominopelvic abscess), and 569.81 (fistula of the intestine). Univariate and logistic regression analyses of 20 variables were undertaken to determine risk factors for AL. Survival was analysed using the Cox regression method. Results: AL was noted in 35 (7.6%) of 460 patients with rectal cancer. :Median age of the patients was 65 (50-74) and 161 (35%) were male. The diagnosis of AL was made between the 6th and 12th postoperative day (POD; mean 8th POD). After univariate and multivariate analysis, age (p=0.004), gender (p=0.007), tumor site (p<0.001), preoperative body mass index (EMI) (p<0.001), the reduction of TSGF on 5th POD less than 10U/ml (p=0.044) and the pH value of pelvic dranage less than or equal to 6.978 on 3rd POD (p<0.001) were selected as 6 independent risk factors for AL. It was shown that significant differences in survival of the patients were AL-related (p<0.001), high ASA score related (p=0.036), high-level EMI related (p=0.007) and advanced TNM stage related

The Surgical Treatment of Chronic Avulsion Fracture of the Anterior Cruciate Ligament (진구성 전방 십자 인대 견열 골절의 수술적 치료)

  • Song Eun-Kyoo;Seol Jong-Yoon;Choi Jin
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.1
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    • pp.31-36
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    • 2002
  • Objective : The purpose of this study was to evaluate the clinical and radiological results after treatment of old ACL(anterior cruciate ligament) avulsion fracture of tibia. Materials and Method : 11 cases who were followed up at least 2 years after treatment in chronic ACL avulsion fracture of tibia were included in this study. The average age of patients was 26(9-66) years and the mean period of follow up was 53(24-131) months. After evaluation of the lesion and treatment of associated lesion under arthroscope, open reduction and internal fixation or fragment removal was performed. Pull-out suture was performed in 8 cases, screw fixation in 2 cases. Results : The Lysholm knee score was 64.3 in average preoperatively and improved to 96.2 average at follow up. On the Lachman test, there were mild(+) instabilities in 7 cases, moderate(++) in 4 cases. On the postoperative Lachman test, there were no instabilities in 9 cases, mild(+) instabilities in only 2 cases. According to Meyers and Mckeever's evaluation protocol, 9 cases $(81.8\%)$ were excellent, 2 case $(18.2\%)$, good. On preoperative instrumented anterior laxity test with $Telos^{\circledR}$, side to side difference in 201b was 7.8(10-4) min in average and 2.1(6-0) mm in average at follow-up. Conclusion : In chronic ACL avulsion fracture, it is thought that combination of arthroscopic evaluation of associated injury and open reduction and fixation and fragment removal can bring about satisfactory results.

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