• Title/Summary/Keyword: Recurrent points

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Treatment of MFH(Malignant fibrous histiocytoma) in Extremity (사지에 발생한 악성섬유조직구종의 치료 경험)

  • Kang, Jong Hwa;Lee, Won Jai;Lew, Dae Hyun;Rah, Dong Kyun;Tark, Kwan Chul
    • Archives of Plastic Surgery
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    • v.35 no.4
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    • pp.439-445
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    • 2008
  • Purpose: Malignant fibrous histiocytoma(MFH) is the most common soft tissue sarcoma in adult. As to this date, tissue development, treatment and prognosis of the tumor has not been definitely clarified, however, it has been reported that wide surgical resection of the tumor along with the radiotheraphy and chemotheraphy is needed for treatment. In MFH with high recurrence rate, the reconstruction method and points to be considered for reconstruction in recurrent case were studied in 10 patients who were treated in our hospital. Methods: From August of 1991 to August 2007, location of tumor, initial mass size, 1st recurred period, lymph node metastasis, recurrence rate, treatment modality, complication, reconstruction in recurrent defect, and follow up period was studied in 10 patients who underwent reconstruction at our Plastic surgery department following wide excision. Results: The average age was 62.8(46 - 73) years old, average follow up period was 7.7(1 - 17) years. Various reconstructions has been performed for recurrent cases and postoperative chemotheraphy and radiotheraphy was done. As for reconstruction in recurrent cases, After wide excision, local flap was performed in 6 cases, and free flap in 2 cases. After radiotherapy, osteoradionecrosis was occurred in 4 cases. Recurrence rate was 1 - 5(2.6) times and reconstruction due to recurrence was 7 out of 10 cases(70%). Conclusion: The treatment modality of MFH is not yet defined. Due to it's high recurrence rate, radiotherapy and chemotherapy is commonly combined with surgery. Even still, additional excision and reconstruction may be required. Therefore, possibility of re-operation must be considered when performing every excision and reconstruction; in case a recurrence or osteoradionecrosis occurs. Free flap coverage should be left as the last resort, according to the principle of reconstruction. Nevertheless, if the defect is large or osteoradionecrosis is present, it will benefit greatly to the patient's quality of life.

In-depth exploration of machine learning algorithms for predicting sidewall displacement in underground caverns

  • Hanan Samadi;Abed Alanazi;Sabih Hashim Muhodir;Shtwai Alsubai;Abdullah Alqahtani;Mehrez Marzougui
    • Geomechanics and Engineering
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    • v.37 no.4
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    • pp.307-321
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    • 2024
  • This paper delves into the critical assessment of predicting sidewall displacement in underground caverns through the application of nine distinct machine learning techniques. The accurate prediction of sidewall displacement is essential for ensuring the structural safety and stability of underground caverns, which are prone to various geological challenges. The dataset utilized in this study comprises a total of 310 data points, each containing 13 relevant parameters extracted from 10 underground cavern projects located in Iran and other regions. To facilitate a comprehensive evaluation, the dataset is evenly divided into training and testing subset. The study employs a diverse array of machine learning models, including recurrent neural network, back-propagation neural network, K-nearest neighbors, normalized and ordinary radial basis function, support vector machine, weight estimation, feed-forward stepwise regression, and fuzzy inference system. These models are leveraged to develop predictive models that can accurately forecast sidewall displacement in underground caverns. The training phase involves utilizing 80% of the dataset (248 data points) to train the models, while the remaining 20% (62 data points) are used for testing and validation purposes. The findings of the study highlight the back-propagation neural network (BPNN) model as the most effective in providing accurate predictions. The BPNN model demonstrates a remarkably high correlation coefficient (R2 = 0.99) and a low error rate (RMSE = 4.27E-05), indicating its superior performance in predicting sidewall displacement in underground caverns. This research contributes valuable insights into the application of machine learning techniques for enhancing the safety and stability of underground structures.

Aspiration Cytology of Epithelioid Sarcoma - A Cese Report - (유상피 육종의 흡인 세포학 - 1예 보고 -)

  • Cho, Kyung-Ja;Kim, Jung-Youn;Lee, Seung-Sook;Khang, Shin-Kwang
    • The Korean Journal of Cytopathology
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    • v.7 no.1
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    • pp.84-87
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    • 1996
  • Cytologic features of the fine needle aspiration of metastatic epithelioid sarcoma are presented. The patient was a 48 year-old male who had been sufferring from recurrent and metastatic tumors of the right upper extremity for 6 years. The aspirate from the axillary mass cytologically consisted of isolated large polygonal cells with abundant, cyanophilic, slightly granular cytoplasm. Eccentrically located large round nuclei showed finely dispersed chromatin, small nucleoli, occasional convolution and folding of nuclear membrane, and frequent binucleation. Although both histologic and cytologic similarity of epithelioid sarcoma to squamous cell carcinoma is well known, findings of cyanophilic granular cytoplasm, convoluted nuclei, and binucleation appeared to be the differential points.

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Left Thoracic Sympathetic Ganglionectomy with Thoracoscope for the Treatment of the Long QT Syndrome -A case report- (Long QT 증후군 환자에게 시행한 좌측 흉부 교감신경절 절제술 -1례 보고-)

  • 홍남기;정태은;이정철;한승세;이동협
    • Journal of Chest Surgery
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    • v.33 no.9
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    • pp.766-769
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    • 2000
  • The long QT syndromes have been classified into acquired or inheritary forms, both of which are associated with a characteristic type of life-threatening polymorphic ventricular tachycardia called torsade de points. Beta-adrenergic blocker is the first cholic treatment, but in those whom cardiac events are not prevented by $\beta$-blockade, left thoracic sympathetic ganglionectomy may be useful in selected cases. A 50-year-old woman had an recurrent syncopal attack in which she was unconscious for 1-2 min and 1-2 times a month for 10 years. The EKG revealed that QT & QTc intervals were 744 and 632 msec respectively. Treatment with Beta-adrenergic blocker and calcium channel blocker was ineffective in preventing recurrence of syncopal spell. Therefore, she underwent left thoracic sympathetic ganglionectomy with thoracoscope. During the 9 months after operation, she was free of syncopal episodes and is doing well.

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Risk Factors for Recurrence of Anterior Shoulder Instability after Arthroscopic Surgery with Suture Anchors

  • Choi, Chang-Hyuk;Kim, Seok-Jun;Chae, Seung-Bum;Lee, Jae-Keun;Kim, Dong-Young
    • Clinics in Shoulder and Elbow
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    • v.19 no.2
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    • pp.78-83
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    • 2016
  • Background: We investigated the risk factors for the recurrence of anterior shoulder instability after arthroscopic surgery with suture anchors and the clinical outcomes after reoperation. Methods: A total of 281 patients (February 2001 to December 2012) were enrolled into our study, and postoperative subluxation and dislocation were considered as recurrence of the condition. We analyzed radiologic results and functional outcome including the American Shoulder and Elbow Surgeons Evaluation Form, the Korean Shoulder Society Score, and the Rowe scores. Results: Of the 281 patients, instability recurred in 51 patients (18.1%). Sixteen out of 51 patients (31.4%) received a reoperation. In terms of the functional outcome, we found that the intact group, comprising patients without recurrence, had a significantly better functional outcome than those in the recurrent group. The size of glenoid defect at the time of initial surgery significantly differed between intact and recurrent group (p<0.05). We found that the number of dislocations, the time from the initial presentation of symptoms to surgery, and the number of anchor points significantly differed between initial operation and revision group (p<0.05). The functional outcome after revision surgery was comparable to intact group after initial operation. Conclusions: Eighteen percent of recurrence occurred after arthroscopic instability surgery, and 5.6% received reoperation surgery. Risk factors for recurrence was the initial size of glenoid defect. In cases of revision surgery, good clinical outcomes could be achieved using additional suture anchor.

Outcomes of arthroscopic capsulolabral reconstruction for anterior instability with greater than 20% glenoid bone defects: are Latarjet procedures absolutely indicated for these patients?

  • Kim, Sae Hoon;Jung, Whanik;Rhee, Sung-Min;Kim, Ji Un;Oh, Joo Han
    • Clinics in Shoulder and Elbow
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    • v.23 no.2
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    • pp.62-70
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    • 2020
  • Background: Recent studies have reported high rates of recurrence of shoulder instability in patients with glenoid bone defects greater than 20% after capsulolabral reconstruction. The purpose of the present study was to evaluate the failure rate of arthroscopic capsulolabral reconstruction for the treatment of anterior instability in the presence of glenoid bone deficits >20%. Methods: Retrospective analyses were conducted among cases with anterior shoulder instability and glenoid bone defects of >20% that were treated by arthroscopic capsulolabral reconstruction with a minimum 2-year follow-up (30 cases). We included the following variables: age, bone defect size, instability severity index score (ISIS), on-/off-track assessment, incidence recurrent instability, and return to sports. Results: The mean glenoid bone defect size was 25.8%±4.2% (range, 20.4%-37.2%), and 18 cases (60%) had defects of >25%. Bony Bankart lesions were identified in 11 cases (36.7%). Eleven cases (36.7%) had ISIS scores >6 points and 21 cases (70%) had off-track lesions. No cases of recurrent instability were identified over a mean follow-up of 39.9 months (range, 24-86 months), but a sense of subluxation was reported by three patients. Return to sports at the preinjury level was possible in 24 cases (80%), and the average satisfaction rating was 92%. Conclusions: Arthroscopic soft tissue reconstruction was successful for treating anterior shoulder instability among patients with glenoid bone defects >20%, even enabling return to sports. Future studies should focus on determining the range of bone defect sizes that can be successfully managed by soft tissue repair.

Computing machinery techniques for performance prediction of TBM using rock geomechanical data in sedimentary and volcanic formations

  • Hanan Samadi;Arsalan Mahmoodzadeh;Shtwai Alsubai;Abdullah Alqahtani;Abed Alanazi;Ahmed Babeker Elhag
    • Geomechanics and Engineering
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    • v.37 no.3
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    • pp.223-241
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    • 2024
  • Evaluating the performance of Tunnel Boring Machines (TBMs) stands as a pivotal juncture in the domain of hard rock mechanized tunneling, essential for achieving both a dependable construction timeline and utilization rate. In this investigation, three advanced artificial neural networks namely, gated recurrent unit (GRU), back propagation neural network (BPNN), and simple recurrent neural network (SRNN) were crafted to prognosticate TBM-rate of penetration (ROP). Drawing from a dataset comprising 1125 data points amassed during the construction of the Alborze Service Tunnel, the study commenced. Initially, five geomechanical parameters were scrutinized for their impact on TBM-ROP efficiency. Subsequent statistical analyses narrowed down the effective parameters to three, including uniaxial compressive strength (UCS), peak slope index (PSI), and Brazilian tensile strength (BTS). Among the methodologies employed, GRU emerged as the most robust model, demonstrating exceptional predictive prowess for TBM-ROP with staggering accuracy metrics on the testing subset (R2 = 0.87, NRMSE = 6.76E-04, MAD = 2.85E-05). The proposed models present viable solutions for analogous ground and TBM tunneling scenarios, particularly beneficial in routes predominantly composed of volcanic and sedimentary rock formations. Leveraging forecasted parameters holds the promise of enhancing both machine efficiency and construction safety within TBM tunneling endeavors.

Inferior Capsular Shift Procedure for Multidirectional Instability of the Shoulder in Contact Athletes (접촉성 운동선수의 다방성 불안정 견관절의 하관절낭 이동술)

  • Kim Young Kyu;Baek Seung Jeong
    • Clinics in Shoulder and Elbow
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    • v.2 no.1
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    • pp.53-59
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    • 1999
  • Initial treatment of multidirectional instability of the shoulder would be a thorough rehabilitation program. If rehabilitation fails to resolve a patient's symptoms, the most commonly performed surgical procedure remains the inferior capsular shift. Eleven patients who had disabling multidirectional instability of the shoulder were managed with the inferior capsular shift. All of the procedure were performed by means of an anterior approach and a laterally based capsular shift. All of the patients were the contact athletes. The purpose of our study was to evaluate the efficacy of the inferior capsular shift procedure in the contact athletic patients, to review the loss of external rotation postoperatively and to discuss their return to sports. Mean follow up duration was 14.5 months(range, 12 to 24). Pain was relieved postoperatively in all cases and most patients could get stability except one case of recurrent subluxation. The average loss of external rotation and forward flexion after the operation were Y and 30 at last follow up. By the rating scale from American Shoulder and Elbow Society, overall scores improved from 49 points to 85 points. The results were excellent or good in 9 patients(82%) out of 11 patients. In reference to return to sports, 10 patients(91 %) of 11 patients returned to their sports with 7 patients (64%) returning at the same levels of competitiveness. The inferior capsular shift procedure was considered to be a recommendable method for the management of the multidirectional instability of the shoulder.

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Parallel Injection Method for Improving Descriptive Performance of Bi-GRU Image Captions (Bi-GRU 이미지 캡션의 서술 성능 향상을 위한 Parallel Injection 기법 연구)

  • Lee, Jun Hee;Lee, Soo Hwan;Tae, Soo Ho;Seo, Dong Hoan
    • Journal of Korea Multimedia Society
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    • v.22 no.11
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    • pp.1223-1232
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    • 2019
  • The injection is the input method of the image feature vector from the encoder to the decoder. Since the image feature vector contains object details such as color and texture, it is essential to generate image captions. However, the bidirectional decoder model using the existing injection method only inputs the image feature vector in the first step, so image feature vectors of the backward sequence are vanishing. This problem makes it difficult to describe the context in detail. Therefore, in this paper, we propose the parallel injection method to improve the description performance of image captions. The proposed Injection method fuses all embeddings and image vectors to preserve the context. Also, We optimize our image caption model with Bidirectional Gated Recurrent Unit (Bi-GRU) to reduce the amount of computation of the decoder. To validate the proposed model, experiments were conducted with a certified image caption dataset, demonstrating excellence in comparison with the latest models using BLEU and METEOR scores. The proposed model improved the BLEU score up to 20.2 points and the METEOR score up to 3.65 points compared to the existing caption model.

Arthroscopic Capsulolabral Repair Using Absorbable Suture-Anchor for the Traumatic Anterior Instability of Shoulder (흡수성 suture-anchor를 이용한 견관절 전방 불안정성의 재건술)

  • Kim Seung-Ki;Song In-Soo;Seo Hyun Mo;Moon Myung-Sang;Lin Guang
    • Clinics in Shoulder and Elbow
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    • v.7 no.2
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    • pp.65-69
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    • 2004
  • Purpose: The purpose of this study is to evaluate the short-term clinical outcome of the capsulolabral repair using absorbable suture anchor in traumatic anterior instability of shoulder. Materials and Methods: From June 2000 to September 2001, 15 shoulders with recurrent anterior instability were operated with arthroscopic Bankart repair using absorbable suture-anchor 'PANALOK' (Mitek, westwood, MA), and were followed up over 1 year (average; 13 months). The mean age was 23-years. There were fourteen males and one female. The mean duration from the initial symptoms to the operation was 24 months. Associated pathologies were Hill-Sachs defect in 12 cases, SLAP in 6 cases, and partial rotator cuff tear in 2 cases. The results were evaluated by patien's satisfaction, Modified Rowe Score in regard to joint stability, mobility, pain and function in comparison with the preoperative ones, and other complications. Results: At the last follow-up, the total Rowe Score increased from 38 points to 92 points. There were no recurrence and 14 patients among 15 patients gained pre-operative level of sports activity and no other complications. Conclusion: Effective capsulolabral repair could be obtained by the absorbable anchoring without any untoward complications. This procedure is simple and safe one and this system can be a good substitute for the metallic anchor.