Background : Primary malignant tumors of the trachea are extremely rare entities and account for a mere 0.1 per cent of all malignancies of the respiratory tract. Because of vague localizing signs, symptoms and a usually negative routine chest film, the patients with tracheal tumors are often treated for asthma or chronic obstructive pulmonary disease for considerable period of time before correct diagnosis. Method : We have made a review of the 17 cases of primary tracheal tumors in recent 15 years. We reviewed the clinical features including history of smoking and respiratory symptoms, the official readings of initial routine chest film, the cytologic examination of sputum, the time of delay in diagnosis, and the response according to the therapeutic modalities. Results : Eight out of 9 patients with squamous cell carcinoma(SCC) were above 50 years old, five out of 6 patients with adenoid cystic carcinoma(ACC) were below 50 years old. The most common location of primary tracheal tumors was the upper one-third of trachea in 8 cases(47%). The most frequent symptoms were dyspnea in 13/17 cases(76%) and then stridor or wheezing, cough. and sputum in order. The routine chest roentgenographic examinations were not helpful to diagnose tracheal carcinoma and the cytologic examinations of sputums were helpful to diagnose tracheal carcinoma in only one case with adenocarcinoma. The mean times of delay in diagnosis of patients with sec and ACC were 5 months and 24.9 months respectively. We had bronchial asthma in 8 cases(47%) and tracheal tumors in 4 cases(23%) as initial clinical impression. Conclusion : We would like to perform more comprehensive diagnostic tools(high KVP technique, the fibroptic bronchoscopic examination, chest CT scan etc.) in patients who had the suggestive points for the tracheal tumorse(1. unexplained hemoptysis or hoarsness, 2. inspiratory wheezing or stridor, 3. wax and waning of dyspnea according to changes of position, 4. progressive asthmatics unresponsive to antiasthmatic therapy) and radical resection of tumor or external radiation therapy with curative aim as possible.
The Journal of the Korean bone and joint tumor society
/
v.20
no.1
/
pp.14-21
/
2014
Purpose: To analyze the clinical features and treatment outcome of Langerhans' cell histocytosis. Materials and Methods: From August 1996 to June 2013, 28 patients who histologically proven with LCH were analyzed of medical records, radiography, pathologic character retrospectively. Results: A total of 28 cases of LCH including 22 child has been reported. Onset age was 0.6 to 51 years old, occurred in the average age was 14.8 years. Follow-up period was 6 months to 134 months average was 44.6 months. The M:F ratio was 2.5:1. The initial symptoms was pain in 18 cases, 5 cases of pathologic fracture, 3 case of palpable mass, 1 case of discovered by accident in radiography, 1 case of torticollis. In radiological examination osteolysis was seen all cases, 7 cases showed a periosteal reaction, 1 case showed soft tissue extension. Clinical type of all cases were eosinophilic granuloma. 25 cases were classified as unifocal disease and 3 cases were multifocal single systemic diseases. In all cases, incisional biopsy was performed. After histologic confirmed, 14 cases was treated with curettage or surgical excision of the lesion and the other 14 cases were followed up without treatment. There is no death during follow up period. 11 cases has no radiological improvement after 3-6 months observation, intralesional steroid injection was performed. Conclusion: Patients with LCH who has rapid systemic onset is very rare, so if you meet the young children who suspected LCH, you shoulder avoid the examination which cause excessive radiation exposure to the young patient. In order to confirm the diagnosis of disease, biopsy is needed. Close observation after confirmed by histological method will bring the satisfactory results. But the patients who had pathologic fracture or wide bone destruction already may need curettage and bone grafting to lesion or internal fixation. The lesion which has no radiological improvement after 3-6 months observation or appear with pain interferes daily life may need local steroid injection as a good treatment.
Purpose: We investigated whether the diagnostic performance of SPECT scintimammography (SMM) can be improved by adding computer-aided diagnosis (CAD) of ultrasonography (US). Materials and methods: We reviewed breast SPECT SMM images and corresponding US images from 40 patients with breast masses (21 malignant and 19 benign tumors). The quantitative data of SPECT SMM were obtained as the uptake ratio of lesion to contralateral normal breast. The morphologic features of the breast lesions on US were extracted and quantitated using the automated CAD software program. The diagnostic performance of SPECT SMM and CAD of US alone was determined using receiver operating characteristic (ROC) curve analysis. The best discriminating parameter (D-value) combining SPECT SMM and the CAD of US was created. The sensitivity, specificity and accuracy of combined two diagnostic modalities were compared to those of a single one. Results: Both SPECT SMM and CAD of US showed a relatively good diagnostic performance (area under curve = 0.846 and 0.831, respectively). Combining the results of SPECT SMM and CAD of US resulted in improved diagnostic performance (area under curve =0.860), but there was no statistical differerence in sensitivity, specificity and accuracy between the combined method and a single modality. Conclusion: It seems that combining the results of SPECT SMM and CAD of breast US do not significantly improve the diagnostic performance for diagnosis of breast cancer, compared with that of SPECT SMM alone. However, SPECT SMM and CAD of US may complement each other in differential diagnosis of breast cancer.
The change of external/internal factors of the cell rquires specific biological functions to maintain life. Such functions encourage particular genes to jnteract/regulate each other in multiple ways. Accordingly, we applied a linear decomposition model IFSA, which derives hidden variables, called the 'expression mode' that corresponds to the functions. To interpret gene interaction/regulation, we used a cross-correlation method given an expression mode. Linear decomposition models such as principal component analysis (PCA) and independent component analysis (ICA) were shown to be useful in analyzing high dimensional DNA microarray data, compared to clustering methods. These methods assume that gene expression is controlled by a linear combination of uncorrelated/indepdendent latent variables. However these methods have some difficulty in grouping similar patterns which are slightly time-delayed or asymmetric since only exactly matched Patterns are considered. In order to overcome this, we employ the (IFSA) method of [1] to locate phase- and shut-invariant features. Membership scoring functions play an important role to classify genes since linear decomposition models basically aim at data reduction not but at grouping data. We address a new function essential to the IFSA method. In this paper we stress that IFSA is useful in grouping functionally-related genes in the presence of time-shift and expression phase variance. Ultimately, we propose a new approach to investigate the multiple interaction information of genes.
Ji, Jong-Hun;Park, Sang-Eun;Kim, Young-Yul;Shin, Eun-Su;Park, Bo-Youn;Jeong, Jae-Jung
Clinics in Shoulder and Elbow
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v.13
no.1
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pp.20-26
/
2010
Purpose: To evaluate clinical features and surgical results for rotator cuff tear secondary to shoulder dislocation in middle-aged and elderly patients. Materials and Methods: We reviewed 19 patients over 50 years of age who had rotator cuff tears combined with shoulder dislocation between October 2004 and October 2008. There were 7 males and 12 females with a mean age 64.7 years (range, 50 to 78 years). The average follow-up duration was 22 months (range, 8 to 56 months). We investigated the number of dislocations, the size of the cuff tear, the presence of Bankart lesions and the time interval from dislocation to surgery. We also investigated the ASES score, UCLA score, SST score, and shoulder range of motion before and after surgery. We analyzed clinical outcomes and contributing factors. Results: ASES scores improved from 30.2 preoperatively to 72.3 postoperatively; UCLA scores improved from 12.9 to 26.5; SST scores improved from 2.4 to 7.3. Range of motion improved significantly: forward flexion, abduction, external rotation and internal rotation were, respectively, $110.8({\pm}39.3)^{\circ}$, $107.7({\pm}40)^{\circ}$, $22.5({\pm}17.6)^{\circ}$ and L5 level preoperatively; postoperatively they were $153.6({\pm}20.6)^{\circ}$, $152.1({\pm}20.8)^{\circ}$, $36.4({\pm}22.7)^{\circ}$ and L1 level. Age, the presence of Bankart lesions and the number of dislocations were not correlated with clinical outcomes. But the size of the cuff tear was correlated with clinical results. Also, the duration from dislocation to surgery was correlated with postoperative UCLA and SST scores (p=0.039, p=0.038). Conclusion: For shoulder dislocation, it is important to achieve early diagnoses of rotator cuff tears in middle-aged and elderly patients. If these injuries are both present, early rotator cuff repair should be performed for better clinical results.
To enhance the competitive advantage in a constantly changing business environment, an enterprise management must make the right decision in many business activities based on both internal and external information. Thus, providing accurate information plays a prominent role in management's decision making. Intuitively, historical data can provide a feasible estimate through the forecasting models. Therefore, if the service department can estimate the service quantity for the next period, the service department can then effectively control the inventory of service related resources such as human, parts, and other facilities. In addition, the production department can make load map for improving its product quality. Therefore, obtaining an accurate service forecast most likely appears to be critical to manufacturing companies. Numerous investigations addressing this problem have generally employed statistical methods, such as regression or autoregressive and moving average simulation. However, these methods are only efficient for data with are seasonal or cyclical. If the data are influenced by the special characteristics of product, they are not feasible. In our research, we propose a forecasting framework that predicts service demand of manufacturing organization by combining Case-based reasoning (CBR) and leveraging an unsupervised artificial neural network based clustering analysis (i.e., Self-Organizing Maps; SOM). We believe that this is one of the first attempts at applying unsupervised artificial neural network-based machine-learning techniques in the service forecasting domain. Our proposed approach has several appealing features : (1) We applied CBR and SOM in a new forecasting domain such as service demand forecasting. (2) We proposed our combined approach between CBR and SOM in order to overcome limitations of traditional statistical forecasting methods and We have developed a service forecasting tool based on the proposed approach using an unsupervised artificial neural network and Case-based reasoning. In this research, we conducted an empirical study on a real digital TV manufacturer (i.e., Company A). In addition, we have empirically evaluated the proposed approach and tool using real sales and service related data from digital TV manufacturer. In our empirical experiments, we intend to explore the performance of our proposed service forecasting framework when compared to the performances predicted by other two service forecasting methods; one is traditional CBR based forecasting model and the other is the existing service forecasting model used by Company A. We ran each service forecasting 144 times; each time, input data were randomly sampled for each service forecasting framework. To evaluate accuracy of forecasting results, we used Mean Absolute Percentage Error (MAPE) as primary performance measure in our experiments. We conducted one-way ANOVA test with the 144 measurements of MAPE for three different service forecasting approaches. For example, the F-ratio of MAPE for three different service forecasting approaches is 67.25 and the p-value is 0.000. This means that the difference between the MAPE of the three different service forecasting approaches is significant at the level of 0.000. Since there is a significant difference among the different service forecasting approaches, we conducted Tukey's HSD post hoc test to determine exactly which means of MAPE are significantly different from which other ones. In terms of MAPE, Tukey's HSD post hoc test grouped the three different service forecasting approaches into three different subsets in the following order: our proposed approach > traditional CBR-based service forecasting approach > the existing forecasting approach used by Company A. Consequently, our empirical experiments show that our proposed approach outperformed the traditional CBR based forecasting model and the existing service forecasting model used by Company A. The rest of this paper is organized as follows. Section 2 provides some research background information such as summary of CBR and SOM. Section 3 presents a hybrid service forecasting framework based on Case-based Reasoning and Self-Organizing Maps, while the empirical evaluation results are summarized in Section 4. Conclusion and future research directions are finally discussed in Section 5.
Journal of The Korean Society of Inherited Metabolic disease
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v.16
no.1
/
pp.34-41
/
2016
Adult-onset type II citrullinemia (CTLN2) is characterized by episodes of neurologic symptoms associated with hyperammonemia leading to disorientation, irritability, seizures, and coma. CTLN2 is distinct from classical citrullinemia, which is caused by a mutation of the argininosuccinic acid synthetase (ASS) gene. The serum citrulline level is elevated, while the activity of ASS in liver tissue is decreased. CTLN2 is known to have a poor prognosis if the proper treatment is not taken. We reported a female aged 37 years who developed recurrent attacks of altered consciousness, aberrant behavior, and vomiting. We initially suspected the patient had CTLN2 because of the signs of hyperammonemic encephalopathy, such as altered mentality, memory disturbance, and aberrant behaviors provoked by exercise-induced stress and excessive intravenous amino acid administration. Through her peculiar diet preferences and laboratory findings that included hyperammonemia and citrullinemia, we diagnosed the patient as CTLN2, and SLC25A13 sequencing revealed known compound heterozygous mutations (IVS11+1G>A, c.674C> A). Her parents were heterozygous carriers, and we identified that her older sister had the same mutations. The older sister had not experienced any episodes of hyperammonemia, but she had peculiar diet preferences. The patient and her sister have been well with conservative management. When considering the clinical course of CTLN2, it was meaningful that the older sister could be diagnosed early in an asymptomatic period and that preemptive treatment was employed. Through this case, CTLN2 should be considered in adults who present symptoms of hyperammonemic encephalopathy without a definite etiology. Because of its rare incidence and similar clinical features, CTLN2 is frequently misdiagnosed as hepatic encephalopathy, and it shows a poor prognosis due to the lack of early diagnosis and proper treatment. A high-carbohydrate diet, which is usually used to treat other urea cycle defects, can also exaggerate the clinical course of CTLN2, so proper metabolic screening tests and genetic studies should be performed.
Purposes : The purpose of this study was to analyze factors that could affect health of radiological technologists, which is useful for health care and development of programs for health promotion. Methods : Subjects were 234 of radiological technologists who work in general hospitals. Some questionnaires were made about perceptions of health condition and promotional behavior of health for this study. The questionnaires of health perception were 20 items that consist of the present condition of health, health concern and sensitivity. The reliability was sufficient(Cronbach's $\alpha=0.79$). The other questionnaires about health promotion behavior were 47 items that consist of self-realization, health responsibility, exercise, nutrition, personal relationships, and stress management. The results turned out to bewas sufficient (Cronbach's $\alpha=0.93$). Every data was treated statistically, comparison of average(t-test, ANOVA), correlation, and multiple regression. Results : Related factors to health promotion behavior were age, marriage, salary, class of one's position, career, employment, and religion, in general features. In health life habit, related factors were smoke and exercise. Results of health promotion behavior was 2.90 of mean score, 0.37 of standard deviation. Correlations between factors of health perception and health promotion behavior was positive(p<0.01). Health promotion behavior were affected by sensitivity, presents condition of health, exercise, smoke, career. Sensitivity was the most affectable variable, which means that promotional behavior score became higher and higher as the score of sensitivity and present condition were increased. In addition, persons who exercise regularly, had been smoked, and has higher career showed higher score of promotional behavior. Conclusion : Radiological technologists have to keep their health, trying not to infected by a disease. Most of all, no smoking and regular exercise are the most important thing to all of members.
Study is about Bit Coin that is electronic cash that is received attention globally in recent. It is increasing domestically that uses bit coin for convenience of micro payment, and also bit coin is possible to exchange each countries' currency. In this point, we searched understanding degree and acceptance of bit coin. Also we applied transformed TAM(Technology Acceptance Model) to search factors that have an effect on consumers' intention to use it. In advance, we analyze features of bit coin, and extract factors through preceding researches for existing electronic cash, because studies for intention to use bit coin are weak in internal and external. First of results is that 'economic efficiency' which is a characteristic variable of bit coin influences 'intention to use,' a dependent variable through 'perceived usefulness,' a parameter. It was investigated that monetary and mental costs that was costed when we use bit coin were less than using other cash. Secondly, 'payment convenience' that is a characteristic variable affects 'intention to use', a dependent variable through 'perceived usefulness,' a parameter. It was measured that problems of inconvenience that include transaction process, cash management time shortage and exchange changes will be solved by using bit coin. Thirdly, 'reliability' that is a perceived risk variable of bit coin has a direct effect on 'intention to use,' a dependent variable. It was investigated that we could achieve purpose of payment because we weren't influenced by breakdown on system by processing distributed database in some computers. Fourthly, 'perceived usefulness,' a parameter of bit coin directly affects 'intention to use,' a dependent variable. Then consumers who want to use bit coin are fascinated bit coin for various usability. Moreover, we want to provide implications to all of finance corporations, companies related electronic cash and bit coin users based on these results.
Purpose: To report on the changes in the patterns of care and survival over time for esthesioneuroblastoma. Materials and Methods: We retrospectively analyzed 42 previously untreated and histologically confirmed esthesioneuroblastoma patients seen between March 1989 and June 2007. According to Kadish's classification, 3 patients (7%) were stage A, 6 (14%) at stage B, and 33 (79%) at stage C. Of the 33 Kadish C patients, 19 and 14 patients were treated from 1989 through 2000 and from 2001 through 2007, respectively. Treatment included surgical resection, radiotherapy, chemotherapy, or a combination of these methods. Chemotherapy was administered to 8 of 19 patients (42%) seen from 1989 through 2000, whereas all of the 14 patients seen from 2001 through 2007 received chemotherapy (p<0.001). No patient was treated by three-dimensional conformal radiotherapy (3D-CRT) from 1989 through 2000, however 8 of 14 patients (67%) seen from 2001 through 2007 underwent 3D-CRT (p<0.001). The median follow-up time for surviving patients was 6.5 years (range, 2.2~15.8 years). Results: The 5-year overall survival (OS) and progression-free survival (PFS) rates for the entire cohort were 53% and 39%, respectively. The 5-year OS was 100% for Kadish stages A or B and 39% for stage C (p=0.007). For patients with stage C disease who were treated from 1989 to 2000 and from 2001 to 2007, the 5-year OS rate was 26% and 59% (p=0.029), respectively and the corresponding 5-year PFS rate was 16% and 46% (p=0.001), respectively. Intraorbital extension and treatment era (1989~2000 vs. 2001~2007) were found as independent factors for OS and PFS in a multivariate analyses. Conclusion: The results of this study suggest that treatment era, which features a distinction in treatment modality and technique with the introduction of 3D-CRT, may be the cause of improved OS and PFS in Kadish stage C patients. To achieve better outcomes for patients with Kadish stage C, combined chemoradiotherapy, especially 3D-CRT, is recommended in addition to surgery.
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