• Title/Summary/Keyword: Suboptimal control

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Postoperative radiotherapy dose correlates with locoregional control in patients with extra-hepatic bile duct cancer

  • Im, Jung Ho;Seong, Jinsil;Lee, Jeongshim;Kim, Yong Bae;Lee, Ik Jae;Park, Jun Sung;Yoon, Dong Sup;Kim, Kyung Sik;Lee, Woo Jung
    • Radiation Oncology Journal
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    • v.32 no.1
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    • pp.7-13
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    • 2014
  • Purpose: To evaluate the results of postoperative radiotherapy in patients with extra-hepatic bile duct cancer (EHBDC) and identify the prognostic factors for local control and survival. Materials and Methods: Between January 2001 and December 2010, we retrospectively reviewed the cases of 70 patients with EHBDC who had undergone curative resection and received postoperative radiotherapy. The median radiation dose was 50.4 Gy (range, 41.4 to 54 Gy). The resection margin status was R0 in 30 patients (42.9%), R1 in 25 patients (35.7%), and R2 in 15 patients (21.4%). Results: The 5-year rates of overall survival (OS), event-free survival (EFS), and locoregional control (LRC) for all patients were 42.9%, 38.3%, and 61.2%, respectively. The major pattern of failure was distant relapses (33 patients, 47.1%). A multivariate analysis showed that the postradiotherapy CA19-9 level, radiation dose (${\geq}50$ Gy), R2 resection margins, perineural invasion, and T stage were the significant prognostic factors for OS, EFS, and LRC. OS was not significantly different between the patients receiving R0 and R1 resections, but was significantly lower among those receiving R2 resection (54.6%, 56.1%, and 7.1% for R0, R1, and R2 resections, respectively). Conclusion: In patients with EHBDC who had undergone curative resection, a postoperative radiotherapy dose less than 50 Gy was suboptimal for OS and LRC. Higher radiation doses may be needed to obtain better LRC. Further investigation of novel therapy or palliative treatment should be considered for patients receiving R2 resection.

Design of an Optimal Adaptive Filter for the Cancellation of M-wave in the EMG Controlled Functional Electrical Stimulation for Paralyzed Individuals (마비환자의 근전도제에기능적전기자극을 위한 M-wave 제거용 최적적응필터 설계)

  • Yeom Hojoon;Park Youngcheol;Lee Younghee;Yoon Youngro;Shin Taemin;Yoon Hyoungro
    • Journal of Biomedical Engineering Research
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    • v.25 no.6
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    • pp.479-487
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    • 2004
  • Biopotential signals have been used as command in systems using electrical stimulation of motor nerves to restore movement after an injury to the central nervous system (CNS). In order to use the voluntary EMG (electromyography) among the biopotentials as a control signal for the electrical stimulation of the same muscle for CNS injury patients, it is necessary to remove M-wave of having high magnitude from raw data. We designed an optimal filter for removing the M-wave and preserving the voluntary EMG and showed that the optimal filter is eigen filter. We also proved that the previous method using the prediction error filter(PEF) is a suboptimal filtering in the sense of preserving the voluntary EMG. On basis of the data obtained from a model for M-wave and voluntary EMG and from actual CNS injury patients, with false-positive rate analysis, the proposed adaptive filter showed a very promising performance in comparison with previous method.

Establishment of Featal Heart Surgery with an Improvement of the Placental Blood Flow in Cardiopulmonary Bypass Using Fetal Lamb Model (양태아를 이용한 심폐우회술에서의 태반혈류개선을 통한 태아심장수술의 기반기술 확립)

  • 이정렬;박천수;임홍국;배은정;안규리
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.11-18
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    • 2004
  • Background: We tested the effect of indomethacine and total spinal anesthesia on the improvement of placental flow during cardiopulmonary bypass on fetal lamb. Material and Method: Twenty fetuses at 120 to 150 days of gestation were subjected to bypass via trans-sternal approach with a 12 G pulmonary arterial cannula and 14 to 18 F venous cannula for 30 minutes. All ewes received general anesthesia with ketamine. In all the fetuses, no anesthetic agents were used except muscle relaxant. Ten served as a control group in which placenta was worked as an oxygenator during bypass (Control group). The remainder worked as an experimental group in which pretreatment with indomethacine and total spinal anesthesia was performed before bypass with the same extracorporeal circulation technique as control group (Experimental group). Observations were made every 10 minutes during a 30-minute bypass and 30-minute post bypass period. Result: Weights of the fetuses ranged from 2.2 to 5.2 kg. In Control group, means of arterial pressure decreased from 44.7 to 14.4 mmHg and means of Pa$CO_2$ increased from 61.9 to 129.6 mmHg at each time points during bypass. Flow rate was suboptimal (74.3 to 97.0 $m\ell$/kg/min) during bypass. All hearts fibrillated immediately after the discontinuation of bypass. On the contrary, in Experimental group, means of arterial pressure reamined higher (45.8 to 30 mmHg) during bypass (p<0.05). Means of Pa$CO_2$ were less ranging from 59.8 to 79.4 mmHg during bypass (P<0.05). Flow rates were higher (78.8 to 120.2 $m\ell$/kg/min) during bypass (p<0.05). There were slower deterioration of cardiac function after cessation of bypass. Conclusion: In this study, we demonstrated that the placental flow was increased during fetal cardiopulmonary bypass in the group pretreated with indomethacine and total spinal anesthesia. However, further studies with modifications of the bypass including a creation of more concise bypass circuit, and a use of axial pump are mandatory for the clinical application.

Ecological Health Assessments on Turbidwater in the Downstream After a Construction of Yongdam Dam (용담댐 건설후 하류부 하천 생태계의 탁수영향 평가)

  • Kim, Ja-Hyun;Seo, Jin-Won;Na, Young-Eun;An, Kwang-Guk
    • Korean Journal of Ecology and Environment
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    • v.40 no.1
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    • pp.130-142
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    • 2007
  • This study was to examine impacts of turbid water on fish community in the downstream of Yongdam Dam during the period from June to October 2006. For the research, we selected six sampling sites in the field: two sites were controls with no influences of turbid water from the dam and other remaining four sites were the stations for an assessment of potential turbid effects. We evaluated integrative health conditions throughout applications of various models such as necropsy-based fish health assessment model (FHA), Index of Biological Integrity (IBI) using fish assemblages, and Qualitative Habitat Evaluation Index (QHEI). Laboratory tests on fish exposure under 400 NTU were performed to find out impact of turbid water using scanning electron microscope (SEM). Results showed that fine solid particles were clogging in the gill in the treatments, while particles were not found in the control. This results indicate that when inorganic turbidity increases abruptedly, fish may have a mechanical abrasion or respiratory blocking. The stream health condition, based on the IBI values, ranged between 38 and 48 (average: 42), indicating a "excellent" or "good" condition after the criteria of US EPA (1993). In the mean time, physical habitat condition, based on the QHEI, ranged 97 to 187 (average 154), indicating a "suboptimal condition". These biological outcomes were compared with chemical dataset: IBI values were more correlated (r=0.526, p<0.05, n=18) with QHEI rather than chemical water quality, based on turbidity (r=0.260, p>0.05, n=18). Analysis of the FHA showed that the individual health indicated "excellent condition", while QHEI showed no habitat disturbances (especially bottom substrate and embeddeness), food-web, and spawning place. Consequently, we concluded that the ecological health in downstream of Yongdam Dam was not impacted by the turbid water.

Influence of Daytime Temperature on the Time Required for Fruit Harvest and Yield of Hot Pepper (주간온도가 고추의 수확 소요일수 및 수량에 미치는 영향)

  • Lee, Sang-Gyu;Choi, Chang-Sun;Lee, Jun-Gu;Jang, Yoon-Ah;Nam, Chun-Woo;Lee, Hee-Ju;Suh, Jeong-Min;Kang, Jum-Soon
    • Journal of Environmental Science International
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    • v.22 no.9
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    • pp.1181-1186
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    • 2013
  • Due to climate change, the occurrence of abnormal weather conditions has become more frequent, causing damage to vegetable crops grown in Korea. Hot pepper, Chinese cabbage and radish, the three most popular vegetables in Korea, are produced more in the field than in the greenhouse. It has been a trend that the time for field transplanting of seedlings is getting earlier and earlier as the spring temperatures keep rising. Seedlings transplanted too early in the spring take a longer time to resume the normal growth, because they are exposed to suboptimal temperature conditions. This study examined the influence of air temperature during seedling growth on the time required to reach the first fruit maturity and yield of hot pepper. Seedling plants of 'Super Manita' hot pepper was grown in temperatures $2.5^{\circ}C$ and $5.0^{\circ}C$ lower than the optimum temperature (determined by the average of temperatures for the past 5 years). Seedlings were transplanted into round plastic containers (30-cm diam., 45-cm height) and were placed in growth chambers in which the ambient temperature was controlled under natural sunlight. The growth of seedlings under lowered temperatures was reduced compared to the control. The mineral (K, Mg, P, N) concentrations in the leaf tissues were higher when plants were grown with the ambient temperature $2.5^{\circ}C$ lower than the optimum, regardless of changes in other growth parameters. Tissue calcium (Ca) concentration was the highest in the plants grown with optimum temperature. The carbohydrate to nitrogen (C/N) ratio, which was the highest (18.3) in the plants grown with optimum temperature, decreased concomitantly as the ambient temperature was lowered $2.5^{\circ}C$ and $5.0^{\circ}C$. The yield of the early harvested fruits was also reduced as the ambient temperature became lower. The first fruit harvest date for the plants grown with optimum temperature (June 27) was 13 days and 40 days, respectively, earlier than that in plants grown with $2.5^{\circ}C$ (July 10) and $5.0^{\circ}C$ (Aug 6) lower ambient temperatures. The fruit yield per plant for the optimum temperature (724 g) was the greatest compared to those grown with $2.5^{\circ}C$ (446 g) and $5.0^{\circ}C$ (236 g) lower temperatures. The result of this study suggests that the growers should be cautioned not to transplant their hot pepper seedlings too early into the field, since it may delay the time of first harvest eventually reducing total fruit yield.