• Title/Summary/Keyword: One-stage operation

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A 2.4-GHz Dual-Mode CMOS Power Amplifier with a Bypass Structure Using Three-Port Transformer to Improve Efficiency (3-포드 변압기를 이용한 바이패스 구조를 적용하여 효율이 개선된 이중 모드 2.4-GHz CMOS 전력 증폭기)

  • Jang, Joseph;Yoo, Jinho;Lee, Milim;Park, Changkun
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.23 no.6
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    • pp.719-725
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    • 2019
  • We propose a 2.4-GHz CMOS power amplifier (PA) with a bypass structure to improve the power-added efficiency (PAE) in the low-power region. The primary winding of the output transformer is split into two parts. One of the primary windings is connected to the output of the power stage for high-power mode. The other primary winding is connected to the output of the driver stage for low-power mode. Operation of the high power mode is similar to conventional PAs. On the other hand, the output power of the driver stage becomes the output power of the overall PA in the low power mode. Owing to a turning-off of the power stage, the power consumption is decreased in low-power mode. We designed the CMOS PA using a 180-nm RFCMOS process. The measured maximum output power is 27.78 dBm with a PAE of 20.5%. At a measured output power of 16 dBm, the PAE is improved from 2.5% to 12.7%.

Adjuvant Radiotherapy Following Radical Hysterectomy and Bilateral Pelvic Lymph Node Dissection for the Uterine Cervical Cancer : Prognostic Factors and Failure Patterns (근칙적 절제술과 술후 방사선치료를 시행한 자궁경부암 환자의 치료성적, 예루인자와 실패양상)

  • Choi, Doo-Ho
    • Radiation Oncology Journal
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    • v.15 no.4
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    • pp.357-367
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    • 1997
  • Purpose : To identify variable prognostic factors and analyse failure patterns in the uterine cervix cancer after radical operation and adjuvant radio-therapy, a retrospective analysis was undertaken. Materals and Methods : I analysed one hundred and twenty four patients with uterine cervix cancer, FIGO stage IB, IIA and IIB, treated with radical hysterectomy and pelvic lymph node dissection followed by adjuvant radio-therapy between May 1985 and May 1994. Minimum follow up period was 24 months. All of them were treated with full dose external radiotherapy with linear accelerator and/or high dese rate intracavitary radiation. Results : Overall 5 year survival rate and relapse free survival rate were $75.4\%,\;73.5\%$, respectively. Significant prognostic factors by relapse free survival were wall involvement thickness, lymph node location and number, parametrium involvement, tumor size, stage, uterine body involvement, vaginal resection margin involvement. By multivariate analysis, lymph node matastasis. tumor size and vaginal resection margin involvement were significant prognostic factos. Treatment related failure were 33 cases. Locoregional failure were more likely in the stage IIB, lymph node positive or vaginal resection margin positive patients whereas distant failures were relatively more frequent in stage IB, IIA and lymph node, vaginal resection negative patients. In stage IIB, 5 year relapse free survival rate was only $56\%$ and nine of twenty two patients recurred. Conculsion : Postoperative radiotherapy results are good for patients with relatively low risk factor. But the results are poor for patients with multiple, high risk factors or stage IIB. To control recurrence for patients with high risk factors, postoperative adjuvant radiotherapy is not sufficient treatment method. To raise control rate adding other methods such as radiosensitizing agent or chemotherapy is necessary and prospectively randomized study is needed for evaluation of postoperative radiotherapy efficacy and /or other methods. And it is reasonable to treat primary radical radiotherapy for patients with stage IIB cervical cancer instead of radical operation and adjuvant radiotherapy and/or chemotherapy regimen.

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The Role of Primary Radiotherapy for Squamous Cell Carcinoma of the Suprag1ottic Larynx (성문상부 상피세포암에서의 근치적 방사선치료의 역할)

  • Kim, Won-Taek;Kim, Dong-Won;Kwon, Byung-Hyun;Nam, Ji-Ho;Hur, Won-Joo
    • Radiation Oncology Journal
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    • v.18 no.4
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    • pp.233-243
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    • 2000
  • Purpose : First of all, this study was performed to assess the result of curative radiotherapy and to evaluate different possible prognostic factors for squamous cell carcinoma of the supraglottic larynx treated at the Pusan National University Hospital. The second goal of this study was by comparing our data with those of other study groups, to determine the better treatment policy of supraglottic cancer in future. Methods and Material : Thirty-two patients with squamous cell carcinoma of the supraglottic larynx were treated with radiotherapy at Pusan National University Hospital, from August 1985 to December 1996. Minimum follow-up period was 29 months, Twenty-seven patients (84.4$\%$) were followed up over 5 years. Radiotherapy was delivered with 6 MV photons to the primary laryngeal tumor and regional iymphatics with shrinking field technique. Ail patients received radiotherapy under conventional fractionated schedule (once a day). Median total tumor dose was 70.2 Gy (range, 55.8 to 75.6 Gy) on primary or gross tumor lesion. Thirteen patients had Induction chemotherapy with cisplatln and 5-fluorouracil (1-3 cycles). Patient distribution, according to the different stages, were as follows: stage I, 5/32 (15.6$\%$): stage II, 10/32 (31.3$\%$); stage III, 8/32 (25$\%$): stage IV, 9/32 (28.1$\%$). Results :The 5-year overall survival rate of the whole series (32 patients) was 51.7$\%$. The overall survival rate at 5-years was 80$\%$ in stage I, 66.7$\%$ in stage II, 42.9$\%$ in stage III, 25$\%$ in stage IV (p=0.0958). The S-year local control rates after radiotherapy were as fellows: stage I, 100$\%$; stage II, 60$\%$ stage III, 62.5$\%$; stage IV, 44.4$\%$ (p=0.233). Overall vocal preservation rates was 65.6$\%$, 100% In stage I, 70% in stage II, 62.5$\%$ In stage III, 44.4$\%$ in stage IV (p=0.210). There was no statistical significance in survival and local control rate between neoadjuvant chemotherapy followed by radiotherapy group and radiotherapy alone group. Severe laryngeal edema was found in 2 cases after radiotllerapy, emergent tracheostomy was done. Four patients were died from distant metastsis, . three in lung, one in brain. Double primary tumor was found in 2 cases, one in lung (metachronous), another in thyroid (synchronous). Ulcerative lesions were revealed as unfavorable prognostic factor ( p=0.0215), and radiation dose (more or less than 70.2 Gy) was an important factor on survival (p=0.002). Conclusion : The role of radiotherapy treatment of supraglottic carcinoma is to important factor on survival and to preserve the laryngeal function. Based on our data and other studies, early and moderately advanced supragiottic carcinomas could be successfully treated with either consewative surgery or radiotherapy alone. Both modalities showed similar results in survival and vocal preservation. For the advanced cases, radiotherapy alone is Inadequate for curative aim and surgery combined with radiotherapy should be done in operable patients. When patients refuse operation or want to preserve vocal function, or for the patients with inoperable medical conditions, combined chemoradiotherapy (concurrent) or altered fractionated radiotherapy with or without radiosensitizer should be taken into consideration in future.

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The surgical experiences of esophageal reconstruction with stomach at the middle and lower esophageal and cardia cancer (중,하부 식도및 분문에 발생한 식도 종양의 위장을 이용한 식도재건술의 외과적 치험)

  • 강경민;박재홍
    • Journal of Chest Surgery
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    • v.29 no.6
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    • pp.626-631
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    • 1996
  • The forty patients with carcirLoma of the esophagus or cardia seen at National Medical Center between November 1983 and April 1994 underwent surgical exploration. The esophagogastrectomy was carried out in 29 of 40 patients, one case through right thoracotomy, the others through left thoracotomy. Two patients underwent colon bypass surgeries due to upper esophageal cancer Transhiatal esop agectomy was performed In one case. Feeding gastrostomy or feeding jejunostomy were performed in 8 patients due to the advanced stage or malnutrition. In this report, we evaluated the long-term results in the 28 patients who underwent esophagogastrectomy for palliation through the left thoracotomy. There were 25 men(89%) and 3 women(11 %), and the mean age was 58.65$\pm$7.15 years(range, 46 to 73 years). The most frequent preoperative symptoms included dysphagia (22), weight loss (15), chest pain (6), vomiting (1), and hoarsness (1). Twenty-three patients had sqamous cell cancers of mid-and lower esophagus and five adenocarcionomas of cardia. One patient died in the hospital within 30 days of the op- eration for a hospital mortality rate of ).7%, Cause of death was sepsis due to anastomotic leakage. There were five additional complications in five patients; acute respiratory distress syndrome (1), post-op- erative bleeding (1), diaphragmatic hernia (1), acute renal failure (1) and late raft stenosis (1). The one year, 1틴o years, and three years acturial survival rate were 75.6$\pm$9.5%, 43.2$\pm$ 11.6%, 21.6: 10.5$\circledcirc$ re- spectively. The average survival was 21.8 months. The data from this study suggest that esophagogastrectomy through the left thoracotomy can achieve resonable long-term palliation for carci- noma of the esophagus. The operation can be performed with a low operative mortality and few serious postoperative complications.

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Comparative study of off-clamp, laparoscopic partial nephrectomy (OCLPN) and conventional hilar control, laparoscopic partial nephrectomy (HCLPN) for renal tumors: One-year follow-up results of renal function change

  • Kang, Su Hwan;Rhew, Hyun Yul;Kim, Taek Sang
    • Kosin Medical Journal
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    • v.33 no.2
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    • pp.191-199
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    • 2018
  • Objectives: We designed the study to compare the oncologic and renal function outcomes of off-clamp, laparoscopic partial nephrectomy (OCLPN) and conventional laparoscopic partial nephrectomy (HCLPN) for renal tumors. Methods: Between March 2008 and July 2015, 114 patients who underwent laparoscopic partial nephrectomy (LPN) of a renal neoplasm were studied. We performed LPN without hilar clamp on 40 patients (OCLPN, Group 1), and conventional LPN with hilar control and renorrhaphy on another 40 patients (HCLPN, Group 2). We retrospectively reviewed the medical records of each patient's age, sex, R.E.N.A.L. nephrometry score (RNS), operation time, complications, hospitalization period, tumor size, positive resection margin, histologic classification of tumor, pathologic stage, Fuhrman grade, estimated blood loss (EBL), warm ischemic time (WIT), and estimated glomerular filtration rate (eGFR) before and one year after surgery. Results: There were no significant differences in age, sex, preoperative eGFR, EBL, surgical (anesthesia) time, and tumor size between the two groups. The mean eGFR was not significantly different between the OCLPN and HCLPN groups 1 month (95 and $86.2mL/min/1.73m^2$, respectively; P = 0.106), 6 months (92.9 and $83.6mL/min/1.73m^2$, respectively; P = 0.151) and 12 months (93.8 and $84.7mL/min/1.73m^2$, respectively; P = 0.077) postoperatively. The change in eGFR after one year was 3.9% in the OCLPN group and -7.9% in the HCLPN group. Conclusions: OCLPN was superior to HCLPN in preserving renal function one year after surgery, and there was no statistically significant difference in tumor treatment results.

Outcome of Staged Repair of Tetralogy of Fallot with Pulmonary Atresia and a Ductus-dependent Pulmonary Circulation: Should Primary Repair Be Considered?

  • Kim, Hyung-Tae;Sung, Si-Chan;Chang, Yun-Hee;Jung, Won-Kil;Lee, Hyoung-Doo;Park, Ji-Ae;Huh, Up
    • Journal of Chest Surgery
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    • v.44 no.6
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    • pp.392-398
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    • 2011
  • Background: The tetralogy of Fallot (TOF) with pulmonary atresia (PA) and a ductus-dependent pulmonary circulation (no major aorto-pulmonary collateral arteries (MAPCAs)) has been treated with staged repair or primary repair depending on the preference of surgeons or institutions. We evaluated the 19-year outcome of staged repair for this anomaly to find out whether our surgical strategy should be changed. Materials and Methods: Forty-four patients with TOF/PA with patent ductus arteriosus (PDA) who underwent staged repair from June 1991 to October 2010 were included in this retrospective study. The patients with MAPCAs were excluded. The average age at the first palliative shunt surgery was $40.8{\pm}67.5$ days (range: 0~332 days). Thirty-one patients (31/44, 70%) were neonates. The average weight was $3.5{\pm}1.6$ kg (range: 1.6~8.7 kg). A modified Blalock-Taussig (BT) shunt was performed in 38 patients, classic BT shunt in 4 patients, and central shunt in 2 patients. Six patients required concomitant procedures: pulmonary artery angioplasty was performed in 4 patients, pulmonary artery reconstruction in one patient, and re-implantation of the left pulmonary artery to the main pulmonary artery in one patient. Four patients required a second shunt operation before the definitive repair was performed. Thirty-three patients underwent definitive repair at $24.2{\pm}13.3$ months (range: 7.3~68 months) after the first palliative operation. The average age at the time of definitive repair was $25.4{\pm}13.5$ months (range: 7.6~68.6 months) and their average weight was $11.0{\pm}2.1$ kg. For definitive repair, 3 types of right ventricular outflow procedures were used: extra-cardiac conduit was performed in 30 patients, trans-annular patch in 2 patients, and REV operation in 1 patient. One patient was lost to follow-up after hospital discharge. The mean follow-up duration for the rest of the patients was $72{\pm}37$ months (range: 4~160 months). Results: Ten patients (10/44, 22.7%) died before the definitive repair was performed. Four of them died during hospitalization after the shunt operation. Six deaths were thought to be shunt-related. The average time of shunt-related deaths after shunt procedures was 8.7 months (range: 2 days~25.3 months). There was no operative mortality after the definitive repair, but one patient died from dilated cardiomyopathy caused by myocarditis 8 years and 3 months after the definitive repair. Five-year and 10-year survival rates after the first palliative operation were 76.8% and 69.1%, respectively. Conclusion: There was a high overall mortality rate in staged repair for the patients with TOF/PA with PDA. Majority of deaths occurred before the definitive repair was performed. Therefore, primary repair or early second stage definitive repair should be considered to enhance the survival rate for patients with TOF/PA with PDA.

Feasibility Study of Case-Finding for Breast Cancer by Community Health Workers in Rural Bangladesh

  • Chowdhury, Touhidul Imran;Love, Richard Reed;Chowdhury, Mohammad Touhidul Imran;Artif, Abu Saeem;Ahsan, Hasib;Mamun, Anwarul;Khanam, Tahmina;Woods, James;Salim, Reza
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7853-7857
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    • 2015
  • Background: Mortality from breast cancer is high in low- and middle-income countries, in part because most patients have advanced stage disease when first diagnosed. Case-finding may be one approach to changing this situation. Materials and Methods: We conducted a pilot study to explore the feasibility of population-based case finding for breast cancer by community health workers (CHWs) using different data collection methods and approaches to management of women found to have breast abnormalities. After training 8 CHWs in breast problem recognition, manual paper data collection and operation of a cell-phone software platform for reporting demographic, history and physical finding information, these CHWs visited 3150 women >age 18 and over they could find-- from 2356 households in 8 villages in rural Bangladesh. By 4 random assignments of villages, data were collected manually (Group 1), or with the cell-phone program alone (Group 2) or with management algorithms (Groups 3 and 4), and women adjudged to have a serious breast problem were shown a motivational video (Group 3), or navigated/accompanied to a breast problem center for evaluation (Group 4). Results: Only three visited women refused evaluation. The manual data acquisition group (1) had missing data in 80% of cases, and took an average of 5 minutes longer to acquire, versus no missing data in the cell phone-reporting groups (2,3 and 4). One woman was identified with stage III breast cancer, and was appropriately treated. Conclusions: Among very poor rural Bangladeshi women, there was very limited reluctance to undergo breast evaluation. The estimated rarity of clinical breast cancer is supported by these population-based findings. The feasibility and efficient use of mobile technology in this setting is supported. Successor studies may most appropriately be trials focusing on improving the suggested benefits of motivation and navigation, on increasing the numbers of cases found, and on stage of disease at diagnosis as the primary endpoint.

Hardware Design of High Performance HEVC Deblocking Filter for UHD Videos (UHD 영상을 위한 고성능 HEVC 디블록킹 필터 설계)

  • Park, Jaeha;Ryoo, Kwangki
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.19 no.1
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    • pp.178-184
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    • 2015
  • This paper proposes a hardware architecture for high performance Deblocking filter(DBF) in High Efficiency Video Coding for UHD(Ultra High Definition) videos. This proposed hardware architecture which has less processing time has a 4-stage pipelined architecture with two filters and parallel boundary strength module. Also, the proposed filter can be used in low-voltage design by using clock gating architecture in 4-stage pipeline. The segmented memory architecture solves the hazard issue that arises when single port SRAM is accessed. The proposed order of filtering shortens the delay time that arises when storing data into the single port SRAM at the pre-processing stage. The DBF hardware proposed in this paper was designed with Verilog HDL, and was implemented with 22k logic gates as a result of synthesis using TSMC 0.18um CMOS standard cell library. Furthermore, the dynamic frequency can process UHD 8k($7680{\times}4320$) samples@60fps using a frequency of 150MHz with an 8K resolution and maximum dynamic frequency is 285MHz. Result from analysis shows that the proposed DBF hardware architecture operation cycle for one process coding unit has improved by 32% over the previous one.

Factors Impacting the Work Efficiency and Stress of Case Managers with the Korea Worker's Compensation & Welfare Service (근로복지공단 사례관리자의 업무 효율 및 스트레스에 영향을 미치는 요인)

  • Lee, Su-jin;Kim, Seung Won
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.32 no.1
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    • pp.64-77
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    • 2022
  • Objectives: The purpose of this study is to objectify the level of case management performance and the factors influencing performance, to improve the case management performance at the Korea Worker's Compensation & Welfare Service (KWCWS) on the basis of the recognition of the objective realities of case management by job coordinators at the KWCWS, to develop a model of case management fit for the KWCWS, and to provide a basis for establishing guidelines for standardized case management. Methods: A total of 156 questionnaires were distributed to job coordinators at the KWCWS's headquarters, six regional headquarters, and 55 branches. One hundred forty-one questionnaires were collected and 126 were analyzed statistically using SPSS 21.0. Factor analysis and reliability analysis were conducted to verify the validity and reliability of the main measurement items in the research model. Frequency analysis was conducted for general characteristics of survey subjects. Frequency analysis or descriptive statistics were conducted to identify the level of independent variables (case manager's individual variables, job variables, institutional and organizational variables). Dependent variables (case management performance) and the degree of correlation were analyzed through correlation analysis between research variables. Multiple regression analysis and hierarchical regression analysis were conducted to examine the effect of independent variables on case management performance. Results: The results of the study showed that the level of overall performance in the five stages of case management was ordinary, with an average level of 3.45 on a 5-point scale. Levels of performance by step were institutional approach and intake (3.69), assessment (3.63), goal setting and intervention planning (3.46), implementation of intervention plan (3.32), and evaluation and termination (3.20), in that order. The explanatory power of case management performance (overall) by case managers with the KWCWS was case manager's institutional and organizational variables, job variables, and individual variables, in that order. At each stage of case management, the explanatory power of a case manager's institutional and organizational variables was found to be the greatest. The model changes at each stage of case management assume similar aspects statistically. In hierarchical regression analysis, it was institutional support that had a significant effect on case management performance (overall), and institutional support had the greatest effect. The results of multiple regression analysis in which all variables are input simultaneously showed that institutional support and expertise as well as self-efficacy had a positive effect. However, case management work experience, expertise (technology), and autonomy were found to have a negative effect during the stage of case management performance. Conclusions: As a result of the study, it was confirmed that raising the case manager's expertise and support from the institution and organization are important factors to improve the level of case management performance. The research also derived practical ways of reinforcement of case manager capacity, institutional and organizational support, operation of rehabilitation-case management teams, and occupational health-related aspects.

Clinical Implication of Cyclooxygenase-2 Expression for Rectal Cancer Patients with Lymph Node Involvement (림프절 전이를 동반한 직장암 환자들에서 Cyclooxygenase-2 발현의 임상적 의미)

  • Lee, Hyung-Sik;Choi, Young-Min;Hur, Won-Joo;Kim, Su-Jin;Kim, Dae-Cheol;Roh, Mee-Sook;Hong, Young-Seoub;Park, Ki-Jae
    • Radiation Oncology Journal
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    • v.27 no.4
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    • pp.210-217
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    • 2009
  • Purpose: To assess the influence of cyclooxygenase-2 (COX-2) expression on the survival of patients with a combination of rectal cancer and lymph node metastasis. Materials and Methods: The study included rectal cancer patients treated by radical surgery and postoperative radiotherapy at the Dong-A university hospital from 1998 to 2004. A retrospective analysis was performed on a subset of patients that also had lymph node metastasis. After excluding eight of 86 patients, due to missing tissue samples in three, malignant melanoma in one, treatment of gastric cancer around one year before diagnosis in one, detection of lung cancer after one year of diagnosis in one, liver metastasis in one, and refusal of radiotherapy after 720 cGy in one, 78 patients were analyzed. The immunohistochemistry for COX-2 was conducted with an autostainer (BenchMark; Ventana, Tucson, AZ, USA). An image analyzer (TissueMine; Bioimagene, Cupertino, CA, USA) was used for analysis after scanning (ScanScope; Aperio, Vista, CA, USA). A survival analysis was performed using the Kaplan Meier method and significance was evaluated using the log rank test. Results: COX-2 was stained positively in 62 patients (79.5%) and negatively in 16 (20.5%). A total of 6 (7.7%), 15 (19.2%), and 41 (52.6%) patients were of grades 1, 2, and 3, respectively for COX-2 expression. No correlation was found between being positive of COX-2 patient characteristics, which include age (<60-year old vs. $\geq$60), sex, operation methods (abdominoperineal resection vs. lower anterior resection), degrees of differentiation, tumor size (<5 cm vs. $\geq$5 cm), T stages, N stages, and stages (IIIa, IIIb, IIIc). The 5-year overall and 5-year disease free survival rates for the entire patient population were 57.0% and 51.6%, respectively. The 5-year overall survival rates for the COX-2 positive and negative patients were 53.0% and 72.9%, respectively (p=0.146). Further, the 5-year disease free survival rates for the COX-2 positive and negative patients were 46.3% and 72.7%, respectively (p=0.118). The 5-year overall survival rates were significantly different (p<0.05) for the degree of differentiation, N stage, and stage, whereas the 5-year disease free survival rates were significant for N stage and stage. Conclusion: Being positive for and the degree of COX-2 expression did not have a significant influence on the survival of rectal cancer patients with lymph node metastasis. However, N stage and stage did significantly influence the rateof survival. Further analysis of a greater sample size is necessary for the verification of the effect of COX-2 expression on the survival of rectal cancer patients with lymph node involvement.