• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.27 no.4
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• pp.380-387
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• 2023

Backgrounds/Aims: In 2019, the grading and staging system for neuroendocrine neoplasms (NENs) was significantly changed. In this study, we report the clinicopathological characteristics and surgical outcomes of patients with extrahepatic biliary NENs who underwent curative resection with or without adjuvant treatment. Methods: We retrospectively reviewed a database of 16 patients who developed NENs, neuroendocrine carcinoma (NEC), and mixed endocrine non-endocrine neoplasms (MiNENs) after curative resection. Among them, eight patients had ampulla of Vater (AoV) tumors, and eight patients had non-AoV tumors. Results: G1 and G2 were more frequently observed in the AoV group than in the non-AoV group (12.5% and 62.5%, respectively). In contrast, NEC and MiNEN were more common in the non-AoV group (50.0%). High Ki-67 index (> 20%) and perineural invasion (PNI) were more frequently observed in the non-AoV group. Advanced age (> 65 years), mitotic count > 20 per 2 mm², and Ki-67 index > 20% were strongly correlated with patient survival (p = 0.018, 0.009, and 0.044, respectively). Advanced age (> 65 years) and mitotic count > 20 per 2 mm² were significantly correlated with disease recurrence (p = 0.033 and 0.010, respectively). Conclusions: AoV and non-AoV tumors had significant differences in the histologic grade, Ki67, and PNI. Patients with non-AoV tumors had an increased risk for survival and recurrence than those in the AoV group. For extrahepatic biliary NENs, early detection of tumors, adequate surgery, and aggressive adjuvant treatment for high-risk patients are important to achieve long-term survival and prevent disease recurrence.

• Proceedings of the Korean Institute of Intelligent Systems Conference
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• 1993.06a
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• pp.1041-1043
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• 1993

Fuzzy logic based Control Theory has gained much interest in the industrial world, thanks to its ability to formalize and solve in a very natural way many problems that are very difficult to quantify at an analytical level. This paper shows a solution for treating membership function inside hardware circuits. The proposed hardware structure optimizes the memoried size by using particular form of the vectorial representation. The process of memorizing fuzzy sets, i.e. their membership function, has always been one of the more problematic issues for the hardware implementation, due to the quite large memory space that is needed. To simplify such an implementation, it is commonly [1,2,8,9,10,11] used to limit the membership functions either to those having triangular or trapezoidal shape, or pre-definite shape. These kinds of functions are able to cover a large spectrum of applications with a limited usage of memory, since they can be memorized by specifying very few parameters ( ight, base, critical points, etc.). This however results in a loss of computational power due to computation on the medium points. A solution to this problem is obtained by discretizing the universe of discourse U, i.e. by fixing a finite number of points and memorizing the value of the membership functions on such points [3,10,14,15]. Such a solution provides a satisfying computational speed, a very high precision of definitions and gives the users the opportunity to choose membership functions of any shape. However, a significant memory waste can as well be registered. It is indeed possible that for each of the given fuzzy sets many elements of the universe of discourse have a membership value equal to zero. It has also been noticed that almost in all cases common points among fuzzy sets, i.e. points with non null membership values are very few. More specifically, in many applications, for each element u of U, there exists at most three fuzzy sets for which the membership value is ot null [3,5,6,7,12,13]. Our proposal is based on such hypotheses. Moreover, we use a technique that even though it does not restrict the shapes of membership functions, it reduces strongly the computational time for the membership values and optimizes the function memorization. In figure 1 it is represented a term set whose characteristics are common for fuzzy controllers and to which we will refer in the following. The above term set has a universe of discourse with 128 elements (so to have a good resolution), 8 fuzzy sets that describe the term set, 32 levels of discretization for the membership values. Clearly, the number of bits necessary for the given specifications are 5 for 32 truth levels, 3 for 8 membership functions and 7 for 128 levels of resolution. The memory depth is given by the dimension of the universe of the discourse (128 in our case) and it will be represented by the memory rows. The length of a world of memory is defined by: Length = nem (dm(m)＋dm(fm) Where: fm is the maximum number of non null values in every element of the universe of the discourse, dm(m) is the dimension of the values of the membership function m, dm(fm) is the dimension of the word to represent the index of the highest membership function. In our case then Length=24. The memory dimension is therefore 128*24 bits. If we had chosen to memorize all values of the membership functions we would have needed to memorize on each memory row the membership value of each element. Fuzzy sets word dimension is 8*5 bits. Therefore, the dimension of the memory would have been 128*40 bits. Coherently with our hypothesis, in fig. 1 each element of universe of the discourse has a non null membership value on at most three fuzzy sets. Focusing on the elements 32,64,96 of the universe of discourse, they will be memorized as follows: The computation of the rule weights is done by comparing those bits that represent the index of the membership function, with the word of the program memor . The output bus of the Program Memory (μCOD), is given as input a comparator (Combinatory Net). If the index is equal to the bus value then one of the non null weight derives from the rule and it is produced as output, otherwise the output is zero (fig. 2). It is clear, that the memory dimension of the antecedent is in this way reduced since only non null values are memorized. Moreover, the time performance of the system is equivalent to the performance of a system using vectorial memorization of all weights. The dimensioning of the word is influenced by some parameters of the input variable. The most important parameter is the maximum number membership functions (nfm) having a non null value in each element of the universe of discourse. From our study in the field of fuzzy system, we see that typically nfm 3 and there are at most 16 membership function. At any rate, such a value can be increased up to the physical dimensional limit of the antecedent memory. A less important role n the optimization process of the word dimension is played by the number of membership functions defined for each linguistic term. The table below shows the request word dimension as a function of such parameters and compares our proposed method with the method of vectorial memorization[10]. Summing up, the characteristics of our method are: Users are not restricted to membership functions with specific shapes. The number of the fuzzy sets and the resolution of the vertical axis have a very small influence in increasing memory space. Weight computations are done by combinatorial network and therefore the time performance of the system is equivalent to the one of the vectorial method. The number of non null membership values on any element of the universe of discourse is limited. Such a constraint is usually non very restrictive since many controllers obtain a good precision with only three non null weights. The method here briefly described has been adopted by our group in the design of an optimized version of the coprocessor described in [10].

• Journal of the Korean Association of Geographic Information Studies
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• v.13 no.4
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• pp.111-124
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• 2010

To monitor the environment of land surface change is considered as an important research field since those parameters are related with land use, climate change, meteorological study, agriculture modulation, surface energy balance, and surface environment system. For the change detection, many different methods have been presented for distributing more detailed information with various tools from ground based measurement to satellite multi-spectral sensor. Recently, using high resolution satellite data is considered the most efficient way to monitor extensive land environmental system especially for higher spatial and temporal resolution. In this study, we use two different spatial resolution satellites; the one is SPOT/VEGETATION with 1 km spatial resolution to detect coarse resolution of the area change and determine objective threshold. The other is Landsat satellite having high resolution to figure out detailed land environmental change. According to their spatial resolution, they show different observation characteristics such as repeat cycle, and the global coverage. By correlating two kinds of satellites, we can detect land surface change from mid resolution to high resolution. The K-mean clustering algorithm is applied to detect changed area with two different temporal images. When using solar spectral band, there are complicate surface reflectance scattering characteristics which make surface change detection difficult. That effect would be leading serious problems when interpreting surface characteristics. For example, in spite of constant their own surface reflectance value, it could be changed according to solar, and sensor relative observation location. To reduce those affects, in this study, long-term Normalized Difference Vegetation Index (NDVI) with solar spectral channels performed for atmospheric and bi-directional correction from SPOT/VEGETATION data are utilized to offer objective threshold value for detecting land surface change, since that NDVI has less sensitivity for solar geometry than solar channel. The surface change detection based on long-term NDVI shows improved results than when only using Landsat.

• Journal of Oral Medicine and Pain
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• v.33 no.4
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• pp.305-316
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• 2008

The mandibular advancement device(MAD) has been used to help manage snoring and obstructive sleep apnea. The aims of this study were to specify the demographic and clinical characteristics of the patients receiving long-term treatment with MAD and to quantify the compliance with and side effects of the use of the device. Of 103 patients who were treated with MAD for at least one full year after delivery date, 49 were able to be contacted with telephone and complete follow-up questionnaires were obtainable. They were telephoned to determine whether they were still using the device. If not, they were asked when and why they stopped using it. Patients were also asked how much effectiveness of the MAD in decreasing snoring and how much they and their bed-partners were satisfied with the MAD therapy. The initial respiratory disturbance indices and pre-treatment snoring frequency and intensity were obtained from the medical records of initial visit. All the data were compared between users and nonusers. The results were as follows: 1. Of 49 patients 25 are still using the device, but 24 stopped using it. Among nonusers nobody stopped wearing the device within first 1 month, but 37.5% of nonusers stopped wearing it in the following 6 months, and another 4.2% before the end of the first year. 2. The one-year compliance of the MAD therapy was 79.59%. 3. There were no significant differences in mean age, mean body mass index, and gender distribution between users group and nonusers group. 4. There was no significant difference in mean respiratory disturbance index at initial visit between users group and nonusers group. 5. There was no significant difference in pre-treatment snoring frequency and intensity between users group and nonusers group. 6. The degree of decrease in snoring with use of MAD was significantly higher in the users when compared to nonusers. 7. Patient's overall satisfaction with treatment outcome was significantly higher in the users when compared to nonusers. 8. Bed partner's satisfaction with treatment outcome tended to be higher in the users when compared to nonusers. 9. The most frequent reasons why patients discontinued wearing the MAD were: jaw pain(25%), dental pain(20.83%), broken appliance(20.83%), hassle using(16.67%), lost weight(8.3%), dental work(8.3%), no or little effect(4.17%), sleep disturbance(4.27).

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.9
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• pp.3879-3884
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• 2014

Background: In chronic hepatitis B (CHB), the presence of hepatic steatosis (HS) seems to be associated with known host and viral factors which may influence the long-term prognosis of chronic hepatitis B (CHB), probably leading to cirrhosis and hepatocellular carcinoma (HCC). Different from chronic hepatitis C (CHC), factors associated with HS in CHB are not clearly explored. Materials and Methods: 160 CHB patients were divided into two groups depending on the results of liver biopsy. Group I consisted of 71 patients with confirmed steatosis. Group II comprised 89 patients without steatosis. The groups were compared in terms of basal characteristics, body mass index (BMI), liver enzymes (ALT, AST, ALP), serum fasting blood sugar (FBS) and lipids, hepatitis B e antigen (HBeAg), viral load, and histological findings. Results: In terms of host factors, male gender, older age, BMI, high serum FBS and lipid levels were associated with HS. On the other hand, ALT levels, the HAI scores of necroinflammation and stage of fibrosis did not associate with HS. On multivariate analysis, parameters of sex, BMI, cholesterol and FBS levels were independently associated with HS. Regarding viral factors, HBeAg negativity was significantly associated with HS (81.7%, p value 0.006), but not HBV DNA level (p value 0.520). Conclusions: HS in CHB appears to be unrelated to the status of HBV replication. However, fibrosis progression in CHB is related to variable host factors. HS may be enhanced through these factors in HBV chronic patients.

• Journal of Chest Surgery
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• v.53 no.5
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• pp.270-276
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• 2020

Background: We investigated the impact of previous catheter ablation (CA) on the midterm outcomes of totally thoracoscopic ablation in patients with lone atrial fibrillation (AF). Methods: Between February 2012 and July 2018, 332 patients underwent totally thoracoscopic ablation for the treatment of AF (persistent AF; n=264, 80%). The patients were stratified into CA (n=47, 14%) and non-CA (nCA; n=285, 86%) groups according to their CA history. Results: All the baseline clinical characteristics and risk factors were similar between the groups except for age, percentage of male patients, prevalence of paroxysmal AF, prior percutaneous coronary intervention, and left atrial volume index (LAVI). No significant intergroup differences were observed in the incidence of early and late complications. At late follow-up, normal sinus rhythm was observed in 92% (43 of 47) of the patients in the CA group and 85% (242 of 285) of the patients in the nCA group (p=0.268). The rate of freedom from AF recurrence at 5 years was 55.3%±11.0% in the CA group, which was similar to that in the nCA group (55.7%±5.1%, p=0.690). In Cox regression analysis, preoperative brain natriuretic peptide levels and LAVI were associated with AF recurrence, but CA history was not significant. Conclusion: Totally thoracoscopic ablation was safe and effective in treating AF irrespective of CA history. A history of CA did not appear to affect the procedural complexity.

• Journal of Nutrition and Health
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• v.35 no.9
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• pp.962-969
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• 2002

This study examined the effect of calcium supplementation and exercise on bone mineral density (BMD) and general characteristics, dietary intake and biochemical measurements for 45 healthy middle-aged women (40-57 years). Subjects were divided in to 4 groups; control group (G1), exercise group (G2), calcium supplementation group (G3), and calcium supplementation with exercise group (G4). The subjects were 45.8$\pm$ 0.66 years old. BMI(kg/$m^2$) was 23.31 $\pm$ 0.63 in Gl group, 22.92 $\pm$ 0.51 in G2 group, 23.64 $\pm$ 0.61 in G3 group, 23.40 $\pm$ 0.37 in G4 group, and BMI of all groups were in normal value. Energy intake was 1332.28㎉/day, 60% of RDA, so that may be unbalance of micronutrients. Especially, calcium intake was 62.8% of RDA that was very low level. Osteocalcine was not statistically significant but calcium supplementation group (G3) be showed increase. BMD was usually decreased by Aging, but in this study was increased in the all group, except control group. It showed increase of BMD for calcium supplementation and/or exercise. Overall results indicate that calcium supplementation and/or exercise increased BMD of middle-aged women, but long-term calcium supplementation and exercise will be able to more effect.(Korean J Nutrition 35(9) : 962~969, 2002)

• The Journal of the Korea Contents Association
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• v.14 no.3
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• pp.374-384
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• 2014

In this paper, characteristics of transactions by investors were examined based on the relationship between South Korea's stock market trends and the amount of net purchasing by investors. The study period is from January of 2004 to December of 2011, a total 1,991 days on 96 months. Data used for correlation and regression analysis include the value of the KOSPI index at the end of each month, the monthly net purchase amount of each of the groups, as well the daily volume, the daily price. In this study, the long-term phase of the market divided by refining. and each of the investment position of invest group was investigated. As a result, foreign investors are a net selling position when market was rising phase of the tertiary. And private investors were a net short positions when the market was decline phase of the tertiary. Regardless of the flow changes, the private investors had opposite position to the flow of the mark, also they had opposite position to the position of the foreign investors.

• Nutrition Research and Practice
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• v.8 no.1
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• pp.94-102
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• 2014

Diet attrition and failure of long term treatment are very frequent in obese patients. This study aimed to identify pre-treatment variables determining dropout and to customise the characteristics of those most likely to abandon the program before treatment, thus making it possible to modify the therapy to increase compliance. A total of 146 outpatients were consecutively enrolled; 73 patients followed a prescriptive diet while 73 followed a novel brief group Cognitive Behavioural Treatment (CBT) in addition to prescriptive diet. The two interventions lasted for six months. Anthropometric, demographic, psychological parameters and feeding behaviour were assessed, the last two with the Italian instrument VCAO Ansisa; than, a semi-structured interview was performed on motivation to lose weight. To identify the baseline dropout risk factors among these parameters, univariate and multivariate logistic models were used. Comparison of the results in the two different treatments showed a higher attrition rate in CBT group, despite no statistically significant difference between the two treatment arms (P = 0.127). Dropout patients did not differ significantly from those who did not dropout with regards to sex, age, Body Mass Index (BMI), history of cycling, education, work and marriage. Regardless of weight loss, the most important factor that determines the dropout appears to be a high level of stress revealed by General Health Questionnaire-28 items (GHQ-28) score within VCAO test. The identification of hindering factors during the assessment is fundamental to reduce the dropout risk. For subjects at risk, it would be useful to dedicate a stress management program before beginning a dietary restriction.

• Journal of Biosystems Engineering
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• v.39 no.3
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• pp.158-165
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• 2014

Purpose: The objective of this paper was to compare test standards regarding the performance and safety of agricultural tractors to identify the differences in test conditions, measurement tolerances, and test procedures. Based on the comparison, some recommendations were proposed for possible revisions or improvements to current tractor test standards. Methods: The test standards and codes of major standards development organizations (SDOs), such as the Organization for Economic Cooperation and Development (OECD), the International Organization for Standardization (ISO), the American Society of Agricultural and Biological Engineers (ASABE), EC type approval, and the board of actions of the Nebraska Tractor Test Laboratories (NTTL), were selected and analyzed. Comparison of the test standards: The ISO provides references for fuel and lubricants for tractor tests, and the OECD provides additional measurements for calculating fuel consumption characteristics during the power take-off (PTO) tests. The ISO, EC type approval, and the ASABE provide PTO protective device and the safety requirements. During drawbar power tests, seven transmission ratios are selected for fully automatic transmissions, according to the OECD. In case of hydraulic lift tests, ISO 789-2 and OECD Code 2 advise the use of a static lift force, while SAE J283 advises the use of additional dynamic lift capacity tests for a better representation of in-field operations. The OECD, the ISO, and EC type approval determine the seat index point (SIP), whereas the ASABE determines the seat reference point (SRP) for roll-over protective structure (ROPS) tests. Diversified measurement tolerances were among the braking performance test standards. The European Union (EU) has developed daily limits for vibration exposures with adaptations from ISO 2631-1. Electromagnetic compatibility evaluations are emerging of high-efficiency tractors due to the long-term conformance to electromagnetic emissions and interferences. Comparisons of tractor test standards discussed in this paper are expected to provide useful information for tractor manufacturers and standards development personnel to improve the performance and safety test standards of tractors.