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Nodal Outcomes of Uniportal versus Multiportal Video-Assisted Thoracoscopic Surgery for Clinical Stage I Lung Cancer

  • Choi, Jung Suk;Lee, Jiyun;Moon, Young Kyu;Moon, Seok Whan;Park, Jae Kil;Moon, Mi Hyoung
    • Journal of Chest Surgery
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    • v.53 no.3
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    • pp.104-113
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    • 2020
  • Background: Accurate intraoperative assessment of mediastinal lymph nodes is a critical aspect of lung cancer surgery. The efficacy and potential for upstaging implicit in these dissections must therefore be revisited in the current era of uniportal video-assisted thoracoscopic surgery (VATS). Methods: A retrospective study was conducted in which 544 patients with stage I (T1abc-T2a, N0, M0) primary lung cancer were analyzed. To assess risk factors for nodal upstaging and to limit any imbalance imposed by surgical choices, we constructed an inverse probability of treatment-weighted (IPTW) logistic regression model (in addition to non-weighted logistic models). We also evaluated risk factors for early locoregional recurrence using IPTW logistic regression analysis. Results: In the comparison of uniportal and multiportal VATS, the resected lymph node count (14.03±8.02 vs. 14.41±7.41, respectively; p=0.48) and rate of nodal upstaging (6.5% vs. 8.7%, respectively; p=0.51) appeared similar. Predictors of nodal upstaging included tumor size (odds ratio [OR], 1.74; 95% confidence interval [CI], 1.12-2.70), carcinoembryonic antigen level (OR, 1.11; 95% CI, 1.04-1.18), and histologically confirmed pleural invasion (OR, 3.97; 95% CI, 1.89-8.34). The risk factors for locoregional recurrence within 1 year were found to be number of resected N2 nodes, age, and nodal upstaging. Conclusion: Uniportal and multiportal VATS appear similar with regard to accuracy and thoroughness, showing no significant difference in the extent of nodal dissection.

Effect of Accelerated Aging on the Color Stability of Dual-Cured Self-Adhesive Resin Cements

  • Kim, Ah-Rang;Jeon, Yong-Chan;Jeong, Chang-Mo;Yun, Mi-Jung;Huh, Jung-Bo
    • Journal of Korean Dental Science
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    • v.8 no.2
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    • pp.49-56
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    • 2015
  • Purpose: The effect of accelerated aging on color stability of various dual-cured self-adhesive resin cements were evaluated in this study. Materials and Methods: Color stability was examined using three different brands of dual-cured self-adhesive resin cements: G-CEM LinkAce (GC America), MaxCem Elite (Kerr), and PermaCem 2.0 (DMG) with the equivalent color shade. Each resin cement was filled with Teflon mold which has 6 mm diameter and 2 mm thickness. Each specimen was light cured for 20 seconds using light emitting diode (LED) light curing unit. In order to evaluate the effect of accelerated aging on color stability, color parameters (Commission Internationale de l'Eclairage, CIE $L^*$, $a^*$, $b^*$) and color differences (${\Delta}E^*$) were measured at three times: immediately, after 24 hours, and after thermocycling. The $L^*$, $a^*$, $b^*$ values were analyzed using Friedman test and ${\Delta}E^*$ values on the effect of 24 hours and accelerated aging were analyzed using t-test. These values were compared with the limit value of color difference (${\Delta}E^*=3.7$) for dental restoration. One-way ANOVA and Scheff's test (P<0.05) were performed to analyze each ${\Delta}E^*$ values between cements at each test period. Result: There was statistically significant difference in comparison of color specification ($L^*$, $a^*$, $b^*$) values after accelerated aging except $L^*$ value of G-CEM LinkAce (P<0.05). After 24 hours, color difference (${\Delta}E^*$) values were ranged from 2.47 to 3.48 and $L^*$ values decreased and $b^*$ values increased in all types of cement and MaxCem Elite had high color stability (P<0.05). After thermocycling, color change's tendency of cement was varied and color difference (${\Delta}E^*$) values were ranged from 0.82 to 2.87 and G-CEM LinkAce had high color stability (P<0.05). Conclusion: Color stability of dual-cured self-adhesive resin cements after accelerated aging was evaluated and statistically significant color changes occurred within clinically acceptable range.

Comparison Study about Surface Mapping of Motor Points in Biceps Brachii Muscle Using Surface EMG and Electric Probe (표면 근전도와 전기 탐침기를 이용한 상완이두근의 운동점 표지 비교 연구)

  • Park, Jaewon;Keum, Dongho
    • Journal of Korean Medicine Rehabilitation
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    • v.28 no.1
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    • pp.85-96
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    • 2018
  • Objectives This study was performed to compare the electrical methods of motor points mapping using surface EMG and electric probe (Pointer Excel II). Methods 32 healthy adults (male 16, female 16) were selected. and classified into two groups; surface EMG group, electric probe (Pointer Excel II) group. In surface EMG group, motor points were searched by recoding the compound muscle potentials. In electric probe (Pointer Excel II) group, motor points were searched by scanning the skin with Pointer Excel II at low level stimulation. The locations of the motor points were expressed as X and Y values in relation to the reference line. The horizontal reference line was set as elbow crease and the vertical reference line was set as the line connecting coracoid process to the center of the horizontal reference line. The data was analyzed by 'Independent T-test' and 'equivalence test'. Results 1. The motor points of short head and long head of biceps brachii muscle were located at about 2/3 length of the vertical reference line from coracoid process and about 1/5~1/4 length of the half of the horizontal reference line from the vertical reference line in both group. 2. The motor points of the short head were located more distally and close to the vertical reference line (p<0.001). 3. In surface EMG group, the motor points of the long head were located more laterally in the female than male. And the motor points of the long head were located more distally in the left side than right side (p<0.05). In electric probe (Pointer Excel II) group, similar tendency was observed but there was no statistically significant difference (p>0.05). 4. As a result of the equivalence test between surface EMG group and electric probe (Pointer Excel II) group, the confidence intervals of the difference were within the equivalence limit. Therefore, the locations of the motor points searched by two ways are equa l (p>0.05, equivalence interval=3%). Conclusions The results indicate that electric probe (Pointer Excel II) can be used to search the motor points instead of surface EMG. This might improve the clinical efficiency when using the motor points to treat muscle dysfunction.

Geant4 Code Based Simulation of 6 MV Photon Beam for Analysis of Dose Distribution (Geant4 코드를 이용한 선형가속기 6 MV 광자선의 선량분포에 관한 연구)

  • Lee, Jun-Seong;Kim, Yang-Soo;Lee, Sun-Young
    • Journal of radiological science and technology
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    • v.45 no.5
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    • pp.449-455
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    • 2022
  • This study is to present a Geant4 code for the simulation of the absorbed dose distribution given by a medical linac for 6 MV photon beam. The dose distribution was verified by comparison with calculated beam data and beam data measured in water phantom. They were performed for percentage depth dose(PDD) and beam profile of cross-plane for two field sizes of 10 × 10 and 15 × 15 cm2. Deviations of a percentage and distance were obtained. In energy spectrum, the mean energy was 1.69 MeV. Results were in agreement with PDD and beam profile of the phantom with a tolerance limit. The differences in the central beam axis data 𝜹1 for PDD had been less than 2% and in the build up region, these differences increased up to 4.40% for 10 cm square field. The maximum differences of 𝜹2 for beam profile were calculated with a result of 4.35% and 5.32% for 10 cm, 15 cm square fields, respectively. It can be observed that the difference was below 4% in 𝜹3 and 𝜹4. For two field sizes of 𝜹50-90 and RW50, the results agreed to within 2 mm. The results of the t-test showed that no statistically significant differences were found between the data for PDD of 𝜹1, p>0.05. A significant difference on PDD was observed for field sizes of 10 × 10 cm2, p=0.041. No significant differences were found in the beam profile of 𝜹3, 𝜹4, RW50, and 𝜹50-90. Significant differences on beam profile of 𝜹2 were observed for field sizes of 10 × 10 cm2, p=0.025 and for 15 × 15 cm2, p=0.037. This work described the development and reproducibility of Geant4 code for verification of dose distribution.

Validation of LC-MS/MS Method for Determination of Rabeprazole in Human Plasma : Application of Pharmacokinetics Study (인체 혈장중 라베프라졸의 정량을 위한 LC-MS/MS 분석법 검증 및 단일 용량 투여에 의한 약물동태 연구)

  • Tak, Sung-Kwon;Seo, Ji-Hyung;Ryu, Ju-Hee;Choi, Sang-Joon;Lee, Myung-Jae;Kang, Jong-Min;Lee, Jin-Sung;Hong, Seung-Jae;Yim, Sung-Vin;Lee, Kyung-Tae
    • Journal of Pharmaceutical Investigation
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    • v.39 no.1
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    • pp.73-78
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    • 2009
  • A simple LC-MS/MS method of rabeprazole in human plasma was developed and validated. Rabeprazole and Internal standard (I.S), omeprazole, were extracted from human plasma by liquid liquid extraction, chromatographic separation of rabaprazole in plasma was achieved at $45^{\circ}C$ with a Shiseido UG120 $C_{18}$ column and methanol-10 mM ammonium acetate buffer (pH 9.42 with ammonium water), as mobile phase. Rabeprazole produced a protonated precursor ion [$(M+H)^+$] at m/z 360.10 and corresponding product ion at m/z 242.21. Internal standard produced a protonated precursor ion [$(M+H)^+$] at 346.09 and corresponding product ion at m/z 198.09. This method showed linear response over the concentration range of $1{\sim}500\;ng/mL$ with correalation coefficient greater than 0.99. The lower limit of quantitation (LLOQ) using 0.2 mL plasma was 1 ng/mL, which was sensitive enough for pharmacokinetics studies. The method was specific and validated with a limit of quantitation of 1 ng/mL. The intra-day and inter-day precision and accuracy were acceptable for all samples including the LLOQ. The applicability of the method was demonstrated by analysis of plasma after administration of a single 10 mg dose to 36 healthy subject. From the plasma rabeprazole concentration versus time curves, the mean $AUC_t$ (The area under the plasma concentration-time curve from time 0 to 12 hr ) was $691.36{\pm}321.88\;ng{\cdot}hr/mL$, $C_{max}$ (maximum plasma drug concentration) of $353.21{\pm}131.52\;ng/mL$ reached $3.4{\pm}1.1\;hr$ after adiministration. The mean biological half-life of rabeprazole was $1.37{\pm}0.75\;hr$. Based on the results, this simple method could readily be used in pharmacokinetics studies.

The Impact of Justice of Layoff on Management Trust, Job Satisfaction and Organizational Commitment in the Hotel Corporations (호텔기업에 있어 구조조정상의 공정성 지각이 경영진의 신뢰, 직무만족 및 조직몰입에 미치는 영향)

  • Kim, Young-Soon;Ahn, Dae-Hee
    • Journal of Global Scholars of Marketing Science
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    • v.18 no.1
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    • pp.115-139
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    • 2008
  • Since financial crisis of IMF resulted in intensive competitiveness and adverse management environment, many hotel industries have responded it with restructuring. Since this restructuring is accompanied by reduction of employees, hence comes the recognition of justice in the procedure of restructuring. When the surviving employees in the restructuring process recognize unfairness in the procedure and practical operations, organization effectiveness can not be maintained due to losing trust of their employers. In this paper I will examine the relationship between validity of restructuring and compensatory programs for layoffs and surviving employees' trust of the employers. Also I will find out the relationship between remaining employees' trust of the employers and their job satisfaction and organization commitment. Through this relationship, we can prepare an alternative to reduce negative effect of restructuring. The hypotheses of this study are proposed as follows: H1: The higher surviving employees' recognition of procedural justice in restructuring process is, the higher their trust with a manager of the company is. H2: The higher surviving employees' recognition of distributive justice in restructuring process is, the higher their trust with a manager of the company is. H3: The higher surviving employees' recognition of procedural justice in restructuring process is, the higher their job satisfaction is. H4: The higher surviving employees' recognition of distributive justice in restructuring process is, the higher their job satisfaction is. H5: The higher surviving employees' recognition of procedural justice in restructuring process is, the higher their organization commitment is. H6: The higher surviving employees' recognition of distributive justice in restructuring process is, the higher their organization commitment is. H7: The higher surviving employees' trust with a manager of the company in restructuring process is, the higher their job satisfaction is. H8: The higher surviving employees' trust with a manager of the company in restructuring process is, the higher their organization commitment is. For the purposes of this study, employees working in luxury hotels located in Seoul were targeted. Self-administered questionnaires were distributed to those who consented with the investigation after explaining the purpose of the survey. A total of 500 questionnaires were distributed and 450 questionnaire were returned to the researcher for analysis. 430 of the returned questionnaires were used for analysis. As for the education for this survey, 250 junior college graduates or under (58.1%), 143 college graduates (33.3%) and 37 graduate school graduates (8.6%). As for the marital status, 315 persons (73.3%) are single and 115 are married (26.7%). As for the monthly income, 49 people (11.48%) are less than 2 million won, 148 (34.4%) are between 2 million and less than 2.5 million won, 153 (35.6%) are between 2.5 million to less than 3 million won, 80 (18.6%) are more than 3 million won. As for the workplace, 293 people (68.1%) work for the F&B department, 73 (17.0%) for rooms department, 41 (9.5%) for operation/ marketing department, 23 (5.3%) for account/ general affair department. As for the period of employment, 85 people (19.8%) are less than 5 years, 150 (34.9%) are between 6 to 9 years, 143 (33.3%) are between 10 to 14 years. and 52 (3.%) are more than 15 years. An exploratory factor analysis was used to survey validity and reliability of calculating tool on perceived values. This study used correlation between individual items and whole items and Cronbach's alpha value of multiple-item scale which is usually used to assess scale and reliability. Reliability of conceptual sub-dimension was assessed by basing on repeated procedure of correlation between individual items and whole items and factor loading. 1. Verification of correlation between validity of restructuring and trust This research showed that procedural and distributive justice of restructuring affects trust positively. The path coefficient between procedural justice of restructuring and trust is 0.719(t=10.135, p=0.000), and thereby the higher procedural justice results in higher trust. The path coefficient between distributive justice of restructuring and trust is 0.160(t=3.291, p=0.001), and thereby the higher distributive justice results in higher trust. Hence H1 and H2 are accepted. 2. Verification of correlation between validity of restructuring and job satisfaction The path coefficient between procedural justice of restructuring and job satisfaction is 0.179(t=2.202, p=0.028), and thereby the higher procedural justice results in higher job satisfaction. The path coefficient between distributive justice of restructuring and job satisfaction is 0.074(t=1.620, p=0.105), and thereby distributive justice of restructuring has no relationship with job satisfaction. Hence H3 is accepted, but H4 is removed. 3. Verification of correlation between validity of restructuring and organization commitment The path coefficient between procedural justice of restructuring and organization commitment is 0.188(t=2.466, p=0.014), and thereby the higher procedural justice results in higher organization commitment. The path coefficient between distributive justice of restructuring and organization commitment is 0.118(t=2.720, p=0.007), and thereby the higher distributive justice results in higher organization commitment. Hence H5 and H6 are accepted. 4. Verification of correlation between trust and job satisfaction The path coefficient between trust and job satisfaction is 0.610(t=6.736, p=0.000), and thereby the correlation has a meaningful result. Since the higher trust of the employer results in higher job satisfaction, H7 is accepted. 5. Verification of correlation between trust and organization commitment The path coefficient between procedural justice of restructuring and job satisfaction is 0.446(t=5.547 p=0.000), and thereby the higher trust of the employer results in higher organization commitment. Hence H8 is accepted. This research aimed to help the employers of hotel industries by analyzing the effects of validity of restructuring on employees' trust, job satisfaction and organization commitment. The research found that employer's validity of restructuring has significant affects on the degree of employee's trust with a manager, thereby reducing the negative effects of restructuring and enhancing organization commitment and job satisfaction. The principal purpose of this research is to confirm the correlation between employees' perceived validity of restructuring and their trust with a manager. Also whether this correlation results in competitive edge of the company is also investigated. It is also pointed out that employees had to participated the procedure of restructuring, sharing the philosophy and reason of restructuring. This participation and furthermore compensatory methods can reduce employees' anxiety of organization operations. Variable of trust appeared to have impact on intermediation effect between perceived variable of validity and job satisfaction, organization commitment, so that increase of trust with a manager plays an crucial role in increasing organization effectiveness. Since this research did not cover whole hotel industries which underwent restructuring, it showed a limit. Unlike previous studies which dealt with validity and trust of superior bosses, this research focussed on employers. Also the organization citizenship which is not considered in this study will be dealt with in the future study.

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A new nano-composite carbon ink for disposable dopamine biosensors (나노컴포지트 카본 잉크가 전착된 일회용 도파민 바이오센서)

  • Dinakaran, T.;Chang, S.-C.
    • Analytical Science and Technology
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    • v.29 no.1
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    • pp.35-42
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    • 2016
  • A new nano-composite carbon ink for the development of disposable dopamine (DA) biosensors based on screen-printed carbon electrodes (SPCEs) is introduced. The method developed uses SPCEs coupled with a tyrosinase modified nano-composite carbon ink. The ink was prepared by an “in-house” procedure with reduced graphene oxide (rGO), Pt nanoparticles (PtNP), and carbon materials such as carbon black and graphite. The rGO-PtNP carbon composite ink was used to print the working electrodes of the SPCEs and the reference counter electrodes were printed by using a commercial Ag/AgCl ink. After the construction of nano-composite SPCEs, tyrosinase was immobilized onto the working electrodes by using a biocompatible matrix, chitosan. The composite of nano-materials was characterized by X-ray photoelectron spectroscopy (XPS) and the performance characteristics of the sensors were evaluated by using voltammetric and amperometric techniques. The cyclic voltammetry results indicated that the sensors prepared with the rGO-PtNP-carbon composite ink revealed a significant improvement in electro-catalytic activity to DA compared with the results obtained from bare or only PtNP embedded carbon inks. Optimum experimental parameters such as pH and operating potential were evaluated and calibration curves for dopamine were constructed with the results obtained from a series of amperometric detections at −0.1 V vs. Ag/AgCl. The limit of detection was found to be 14 nM in a linear range of 10 nM to 100 µM of DA, and the sensor’s sensitivity was calculated to be 0.4 µAµM−1cm−2.

Characterization and Evaluation of Worker s Exposure to Airborne Glass Fibers in Glass Wool Manufacturing Industry (유리섬유 단열재 제조업 근로자의 공기중 유리섬유 폭로 특성 및 평가 방법에 관한 연구)

  • 신용철;이광용;박천재;이나루;정동인;오세민
    • Journal of Environmental Health Sciences
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    • v.22 no.2
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    • pp.43-57
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    • 1996
  • To characterize worker's exposure to glass fibers, to find the correlation between airborne total dust concentrations and fiber concentrations and to recommend an appropriate evaluation method for worker's exposure to fibrous dusts in glass wool industry, we carried out this study. Average respirable fiber levels at five factories were 0.013-0.056 f/cc, and fairly below the OSHA PEL, 1 f/cc. A factory showed the lowest airborne fiber level, 0.013 f/cc, which was different significantly from those of other factories of which average fiber concentration was 0.046 f/cc. The cutting and grinding operations of insulation products resulted in higher airborne fiber cocentrations than any other processes(p<0.05). To characterize airborne fiber dimension, fiber length and diamter were determined using phase contrast microscope. The geometric means of airborne fiber lengths were $42-105 \mu m$. One factory had airborne fibers whose length distribution(GM = $105 \mu m$) was different from those of other factories(GM = $42-50 \mu m$). The percentages of respirable fibers less thinner than 3 gm were 38.9-90.9% at four factories, and two factories of them had the higher percentages than others. The findings explain for variation of airborne fiber diameters between factories. On the other hand, between the processes were the difference of fiber-length distributions observed. The cutting and grinding operations showed shorter fiber-length distributions than the fiber forming one. However, fiber-diameter distributions or respirable fiber contents were similar in all processes. The airborne fiber concentrations and the dust concentrations had relatively weak correlation(r=0.25), thus number of fibers couldn't be expected reliably from dust amount. Fiber count is appropriate for assessing accurate exposures and health effects caused by fibrous dusts including glass fibers. Ministry of Labor have established occupational exposure limit to glass fibers as nuisiance dust, but should establish it on the basis of respirable fiber concentration to provide adequate protection for worker's health

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A Ripple Rejection Inherited RPWM for VSI Working with Fluctuating DC Link Voltage

  • Jarin, T.;Subburaj, P.;Bright, Shibu J V
    • Journal of Electrical Engineering and Technology
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    • v.10 no.5
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    • pp.2018-2030
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    • 2015
  • A two stage ac drive configuration consisting of a single-phase line commutated rectifier and a three-phase voltage source inverter (VSI) is very common in low and medium power applications. The deterministic pulse width modulation (PWM) methods like sinusoidal PWM (SPWM) could not be considered as an ideal choice for modern drives since they result mechanical vibration and acoustic noise, and limit the application scope. This is due to the incapability of the deterministic PWM strategies in sprawling the harmonic power. The random PWM (RPWM) approaches could solve this issue by creating continuous harmonic profile instead of discrete clusters of dominant harmonics. Insufficient filtering at dc link results in the amplitude distortion of the input dc voltage to the VSI and has the most significant impact on the spectral errors (difference between theoretical and practical spectra). It is obvious that the sprawling effect of RPWM undoubtedly influenced by input fluctuation and the discrete harmonic clusters may reappear. The influence of dc link fluctuation on harmonics and their spreading effect in the VSI remains invalidated. A case study is done with four different filter capacitor values in this paper and results are compared with the constant dc input operation. This paper also proposes an ingenious RPWM, a ripple dosed sinusoidal reference-random carrier PWM (RDSRRCPWM), which has the innate capacity of suppressing the effect of input fluctuation in the output than the other modern PWM methods. MATLAB based simulation study reveals the fundamental component, total harmonic distortion (THD) and harmonic spread factor (HSF) for various modulation indices. The non-ideal dc link is managed well with the developed RDSRRCPWM applied to the VSI and tested in a proto type VSI using the field programmable gate array (FPGA).

The Effect of Treadmill and Body Weight Support Treadmill Training on Balance and Gait Ability in Hemiplegia Patients (편마비 환자의 트레드밀과 체중지지의 트레드밀 훈련이 균형능력 및 보행능력에 미치는 영향)

  • Kim, Sung-Chul;Hur, Young-Goo
    • Journal of Korean Physical Therapy Science
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    • v.25 no.1
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    • pp.31-43
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    • 2018
  • Purpose: The purpose of this study is to investigate and to verification of changes that the effect of treadmill and body weight support treadmill training on balance and gait ability for sub-acute stroke patients during 4 week. Method: 16 subjects who was diagnosed stroke were divided into 2 groups(8-treadmill training group, 8-body weight support treadmill group) by randomized control trial. Both training programs were consisted with 40 minuted, 5 times a week for 4 weeks and after training programs. Analysis: We analysed effects and changes on balance and gait ability. Analyses were performed using PASW ver. 18.0 and results were reported as mean ${\pm}$ standard deviation (S.D.). To investigate within group comparisons and to verification on effects of exercise, we did paired t test and repeated measured ANOVA test. Significance was set at p<.05. Result: Both training programs showed positive changes in Limit of Stability but significant results which is area of hemiside, area of intact side, area of posterior, total area were reported in body weight support treadmill training group. Changes of Berg Balance Scale was significantly increase and it had significant correlation between groups. Changes of 6 Minutes Walking Test was significant increase in both groups but there was no significant changes on Foot print and Romberg test. Conclusion: After considering all factors, both training programs showed effect on improvement of balance and gait ability in sub-acute stroke patients, but body weight support treadmill training group had better improvement in dynamic balance than treadmill training group. For the increase of balance and gait ability in sub-acute stroke patients, we need to continues study on difference of treadmill and body weight support treadmill and then we will give stroke patients a better satisfaction if we develop and provide a rehabilitation program for improvement of balance and gait ability.