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21.
BG Hattler C Madia C Johnson JM Armitage RL Hardesty RL Kormos SM Pham DN Payne BP Griffith 《Canadian Metallurgical Quarterly》1994,58(5):1348-1352
In an era of progressive cost containment and public scrutiny, the wisdom of aggressive surgical therapy for high-risk candidates has been questioned. At our center in the previous 24 months, 728 patients with coronary artery disease were entered into The Society of Thoracic Surgeons national database, and the hospital outcomes plus length of stay were analyzed. Patients were separated according to the predicted mortality based on the groupings in The Society of Thoracic Surgeons database: 0 to 5% (453 patients); 5% to 10% (126 patients); 10% to 20% (96 patients); 20% to 30% (17 patients); and 30% and greater (36 patients). There was a close correlation with the predicted rates of mortality. Importantly, the preoperative risk stratification demonstrated a strong correlation with the significant morbidity and excessive length of stay in the highest-risk groups (predicted risk of 20% to > or = 30%). The incidences of the most common complications in the group with the highest predicted risk (> or = 30%) were 28%, renal failure; 33%, ventilator dependence; and 17%, cardiac arrest. In addition, at short-term follow-up (6 to 8 months), a 24.3% mortality was identified in patients with a predicted mortality that exceeded 20%. These data quantify the risks and morbidities associated with the care of seriously ill patients with coronary artery disease and demonstrate the need for professional and public discussions focusing on the association of a high preoperative risk status and the consumption of resources. 相似文献
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23.
R Kneen NG Pham T Solomon TM Tran TT Nguyen BL Tran J Wain NP Day TH Tran CM Parry NJ White 《Canadian Metallurgical Quarterly》1998,27(4):845-850
PURPOSE: To review the University of Florida experience in treating ependymomas, analyze prognostic factors, and provide treatment recommendations. METHODS AND MATERIALS: Forty-one patients with ependymoma and no metastases outside the central nervous system received postoperative radiotherapy with curative intent between 1966 and 1989. Ten patients had supratentorial lesions, 22 had infratentorial lesions, and 9 had spinal cord lesions. All patients had surgery (stereotactic biopsy, subtotal resection, or gross total resection). Most patients with high-grade lesions received radiotherapy to the craniospinal axis. Low-grade intracranial lesions received more limited treatment. Spinal cord lesions were treated using either partial spine or whole spine fields. RESULTS: Of 32 intracranial tumors, 21 recurred, all at the primary site; no spinal cord tumors recurred. Overall 10-year survival rates were 51% (absolute) and 46% (relapse-free); by tumor site: spinal cord, 100%; infratentorial, 45%; supratentorial, 20% (p = 0.002). On multivariate analysis, tumor site was the only factor that influenced absolute survival (p = 0.0004); other factors evaluated included grade, gender, age, duration of symptoms, resection extent, primary tumor dose, treatment field extent, surgery-to-radiotherapy interval, and days under radiotherapy treatment. CONCLUSIONS: Patients with supratentorial or infratentorial tumors receive irradiation, regardless of grade. Craniospinal-axis fields are used when spinal seeding is radiographically or pathologically evident. Spinal cord tumors are treated using localized fields to the primary site if not completely resected. Failure to control disease at the primary site remains the main impediment to cure. 相似文献
24.
S Chang SL Parker T Pham AU Buzdar SD Hursting 《Canadian Metallurgical Quarterly》1998,82(12):2366-2372
BACKGROUND: Little is known about the cause of inflammatory breast carcinoma (IBC), the most aggressive form of breast cancer. To the authors' knowledge, no studies have investigated whether IBC risk factors are different from those for breast carcinoma overall, and there has been only one report of IBC incidence and survival patterns. METHODS: The authors used data from the Surveillance, Epidemiology, and End Results program of the National Cancer Institute for the period 1975-1992 to calculate age-adjusted incidence and survival rates for 913 white and 121 African American women with IBC involving dermal invasion of lymphatic ducts and 166,375 white and 13,674 African American women with other types of breast carcinoma (non-IBC). RESULTS: Between 1975-1977 and 1990-1992, IBC incidence doubled, increasing among whites from 0.3 to 0.7 cases per 100,000 person-years and among African Americans from 0.6 to 1.1 cases. However, rates for African Americans varied due to the small numbers of IBC cases. The twofold increase in IBC incidence was higher than that observed for non-IBC during the same period (27% for African Americans and 25% for whites). IBC patients were significantly younger at diagnosis than non-IBC patients; and among both IBC and non-IBC patients, African Americans were younger than whites. Overall survival was significantly worse for IBC patients than for non-IBC patients and for African Americans than for whites. Among whites, 3-year survival improved more for IBC patients than for non-IBC patients between 1975-1979 and 1988-1992, increasing from 32% to 42% for IBC patients (P=0.0001) and from 80% to 85% for non-IBC patients (P=0.0001). CONCLUSIONS: The disparities observed in incidence trends and age at diagnosis, particularly according to race, highlight the need for further investigation of the differences between IBC and non-IBC incidence. 相似文献
26.
Tuan D. Pham Dinh T.P. Le Jinwei Xu Duc T. Nguyen Robert G. Martindale Clifford W. Deveney 《Computer methods and programs in biomedicine》2014
An abdominal wall hernia is a protrusion of the intestine through an opening or area of weakness in the abdominal wall. Correct pre-operative identification of abdominal wall hernia meshes could help surgeons adjust the surgical plan to meet the expected difficulty and morbidity of operating through or removing the previous mesh. First, we present herein for the first time the application of image analysis for automated identification of hernia meshes. Second, we discuss the novel development of a new entropy-based image texture feature using geostatistics and indicator kriging. Third, we seek to enhance the hernia mesh identification by combining the new texture feature with the gray-level co-occurrence matrix feature of the image. The two features can characterize complementary information of anatomic details of the abdominal hernia wall and its mesh on computed tomography. Experimental results have demonstrated the effectiveness of the proposed study. The new computational tool has potential for personalized mesh identification which can assist surgeons in the diagnosis and repair of complex abdominal wall hernias. 相似文献
27.
Extraction and implementation of muscle synergies in neuro-mechanical control of upper limb movement
Hang Pham Yohei Ariga Kenta Tominaga Takanori Oku Kanna Nakayama Mitsunori Uemura 《Advanced Robotics》2014,28(11):745-757
This work faces the redundancy problem, a central concern in robotics, in a particular force-producing task by using muscle synergies to simplify the control. We extracted muscle synergies from human electromyograph signals and interpreted the physical meaning of the identified muscle synergies. Based on the human analysis results, we hypothesized a novel control framework that can explain the mechanism of the human motor control. The framework was tested in controlling a pneumatic-driven robotic arm to perform a reaching task. This control method, which uses only two synergies as manipulated variables for driving antagonistic pneumatic artificial muscles to generate desired movements, would be useful to deal with the redundancy problem; thus, suggesting a simple but efficient control for human-like robots to work safely and compliantly with humans. 相似文献
28.
Steady state shear flow in rectilinear coordinates can be generated by a direct shear rheometer. The rheological behavior of polymeric melts under shear flow can be characterized by the inception of steady shear flow and stress relaxation after cessation of steady shear flow. Experiments were performed for bisphenol A polycarbonate with various mol wts. The elastic components, such as the primary normal stress differences and the elastic recoverable shear strain of the polymeric melts, can be determined from the shear moduli. © 1993 John Wiley & Sons, Inc. 相似文献
29.
Anugrah K. Pamosoaji Pham Thuong Cat 《International journal of systems science》2014,45(12):2515-2528
An obstacle avoidance problem of rear-steered wheeled vehicles in consideration of the presence of uncertainties is addressed. Modelling errors and additional uncertainties are taken into consideration. Controller designs for driving and steering motors are designed. A proportional-derivative-type driving motor controller and a sliding-mode steering controller combined with radial basis function neural network (RBFNN) based estimators are proposed. The convergence properties of the RBFNN-based estimators are proven by the Stone–Weierstrass theorem. The stability of the proposed control law is proven using Lyapunov stability analysis. The obstacle avoidance strategy utilising the sliding surface adjustment to an existing navigation method is presented. It is concluded that the driving velocity and steering-angle performances of the proposed control system are satisfactory. 相似文献
30.