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A heavy rainfall event associated with the passage of Tropical Storm Rachel (1999) over southern Taiwan was studied in which a conceptual model was proposed. In the model, Tropical Storm Paul (1999) plays an important role in impeding the movement of Rachel, thus becoming one of the key factors in enhancing the rainfall amount in southern Taiwan. To further quantify the above concept, a mesoscale numerical model is used to evaluate the influence of Paul on the simulated rainfall associated with Rachel near Taiwan. Sensitivity experiments are performed by removing the circulation of Paul, and/or the large-scale monsoon trough system, where Paul is imbedded. The potential vorticity diagnosis shows that the movement of Rachel is indeed affected by the presence of Paul. Nevertheless, a more detailed analysis shows that it is the presence of the entire monsoon trough that impedes the movement of Rachel and steers the storm toward southwestern Taiwan especially before its landfall. In all, these results generally support the conceptual model with regard to the heavy rainfall mechanism proposed in a previous study. Moreover, this study further points out that it is the circulation associated with both Paul and the entire monsoon trough that affects the movement of Rachel. In addition, the analyses based on the no-terrain simulation depict the relationships among the moisture-rich air from the South China Sea associated with Rachel, relatively dry air from South China, and the mechanism of forming a warm and dry region to the eastern side of the Taiwan terrain, which greatly influences the heavy rainfall distribution in the event.

Objective: To evaluate the benefits of a new approach, endoscopic parotidectomy through a postauricular skin incision by using an ultrasonically activated scalpel. Study Design: An investigation of the outcome of endoscopic parotidectomy at a tertiary referral medical center. Methods: Fourteen operations for selected patients presenting with benign parotid tail disease were performed via minimally invasive endoscopic resection by a single surgeon (MK Chen). Results: All 14 operations were successfully performed endoscopically, and no conversions to conventional open resection were necessary. The procedures lasted 60 to 160 minutes. Two patients had transient grade II facial paresis. The scars were almost invisible due to their concealed location behind the ear. Conclusions: Minimally invasive endoscope-assisted parotidectomy is a feasible method for treatment of benign lesions located in the parotid tail. The main advantage of this procedure is that the small operative scar is concealed in the postauricular area resulting in improved cosmetic results.

BACKGROUND. Heterogeneity of primary tumor volume within tumors of the same classification indicates a need to elucidate the effects of primary tumor volume on treatment outcomes in patients with nasopharyngeal carcinoma (NPC). METHODS. From 1994 through 1996, 129 patients with newly diagnosed NPC who were treated with high-dose radiotherapy were enrolled in the study. Computed tomography-derived primary tumor volume was measured using the summationof-area technique. Correlations between American Joint Committee on Cancer (AJCC) disease stage, primary tumor volume, and disease-specific survival were assessed using a Cox regression model. Cross-validation based on receiver operating characteristic (ROC) curve also was examined. RESULTS. Compared with the AJCC staging system and the TNM classification system, primary tumor volume was better at determining cumulative survival for patients with NPC. Hazard ratios increased with tumor volume, ranging from 6.68 (95% confidence interval [95% CI], 1.89 –23.67) for tumor volumes between 20 – 40 mL, 18.03 (95% CI, 4.80 – 67.75) for tumor volumes between 40 – 60 mL, and 26.06 (95% CI, 7.70 – 88.20) for tumor volumes 60 mL. With both tumor volume and T classification in the same Cox regression model, only tumor volume remained statistically significant in the prognosis of NPC. The validation results with ROC curves also revealed that, in predicting patient outcome, primary tumor volume (area under the ROC 83.33%) was superior to disease stage (area under the ROC 66.53%) and TNM classification (area under the ROC 58.61%). CONCLUSIONS. The incorporation of primary tumor volume may lead to a further refinement of the current AJCC staging system, particularly for patients with large primary tumor volumes ( 60 mL), who require more aggressive treatment. Cancer 2004;100:2160 – 6. © 2004 American Cancer Society.

Background Tumor volume is an important prognostic factor in patients with malignancy treated with primary radiotherapy. It is necessary to have a clear understanding of the nasopharyngeal primary tumor volume and the treatment outcome, especially in the advanced T-staged tumors. Methods From 1994–1996, 76 newly diagnosed patients with advanced T-staged nasopharyngeal carcinomas who were treated with high-dose radiotherapy with or without chemotherapy were included in this study. CT-derived primary tumor volume was obtained after the summation of area technique. Results The median primary tumor volume was 29.6 mL in T3 disease and 54.1 mL in T4 disease, with a range of 8.0–131.8 in T3 disease, and 6.7–223.1 ml in T4 disease. Large primary tumor volume was associated with a significantly poor disease-specific survival (p < .0001), whereas the T stage carried no prognostic significance (p = .43). Conclusions In advanced T-staged (T3 and T4) nasopharyngeal tumors, a substantial variation of primary tumor volume was present within the same T stage, and primary tumor volume represented a more important prognostic factor for treatment outcome. Volumetric measurements of primary tumors in advanced nasopharyngeal tumors would refine the TNM staging system. Patients with large primary tumor volume should be treated more aggressively. © 2002 Wiley Periodicals, Inc. Head Neck 24: 940–946, 2002

This paper proposes a new intelligent surveillance system for parking lot management in underground environments. The feature based image stitching and image blending techniques are used to let video streams captured by multiple cameras be fused into single output whose blind area could be easily seen through. Such a system allows that anyone can immediately understand what is going on in the whole monitored area with a simple glance and without prior geometrical knowledge of the place because the blind area is translucent. The image stitching processes consists of four main parts:(1) feature correspondence detection and fundamental matrix estimation, (2) outlier filtering scheme based on the epipolar geometry and RANSAC, (3) computing the homography matrices between each pair of images, (4) projectively warping the images with their corresponding homography matrices, and conducting image fusion with the non-overlapping parts of the warped images. Finally, the process of translucent blending is applied to eliminate the blind areas inside the stitched image, and then the corresponding cameras behind the occluding pillar provide pixels for translucentizing. The authors have implemented the preliminary system with six surveillance cameras at underground parking lot environments, and experiment results of real world video sequences have been performed to verify the proposed design.

Deep neck infections may be lethal if life-threatening complications occur, especially in immunocompromised hosts such as diabetic patients. This study was undertaken to better define the clinical features and prognosis of deep neck infections in the diabetic patients with special emphasis on the use of empirical antibiotics and the role and timing of surgical management.A retrospective analysis of 105 consecutive patients treated at a single institution during a 9-year period was conducted. Of these, 30 patients also presented with diabetes mellitus.Compared with the nondiabetic patients, the unique features of deep neck infections in diabetic patients were as follows: (1) older age, (2) tendency of unclear infection source, (3) tendency to involve multiple spaces, (4) required more aggressive surgical intervention, (5) prolonged hospitalization, and (6) higher complication rate. The differences were statistically significant (P.05). There were no significant differences in the complete blood count/ differential count positive findings and fever between the 2 groups (P.05). Bacterial cultures showed that Klebsilla pneumoniae was the most common causative pathogen in diabetic patients.In deep neck infection patients with diabetes mellitus, the clinical course is more severe and there is a poorer prognosis. Thus, in treating them, we should keep close observation, appropriately control the diabetes, detect the life-threatening complications early, perform aggressive surgical treatment if fluctuation or complication occurs, and take into account the preponderance of K pneumoniae when administering the empirical antibiotics.

Conclusions. With the assistance of the harmonic scalpel, endoscopic surgery is eligible for advanced nasopharyngeal angiofibromas with skull base or infratemoporal fossa invasion. Objectives. To evaluate the safety and efficacy of strictly endoscopic removal of early and advanced stage nasopharyngeal angiofibromas. Patients and methods. Eight operations for seven consecutive patients presenting with a nasopharyngeal angiofibroma were performed via minimally invasive endoscopic resection by a single surgeon (M.K.C.). All patients were operated with curative intent. Results. Using Radkowski staging, one, two, one, one, and three tumors were stage Ia, IIa, IIb, IIc, and IIIa lesions, respectively. All the tumors were removed successfully by strictly endoscopic surgery. No complications associated with the operation occurred. The average follow-up was 54 months. One recurrence (14.3%) occurred in this series and the salvage surgery was performed by second curative endoscopic procedure.

Objectif: Investiguer la relation entre l'expression de la proteine p53 et le volume tumoral chez des patients porteurs de carcinome nasopharynge. Devis: Etude retrospective dans une centre de soins tertiaires a Taichung, Taiwan. Methode: Quarante-deux patients recemment diagnostiques ont participe a cette etude. Variables evaluees: La relation entre le statut du p53, le stade TNM, et le volume tumoral mesure par tomodensitometrie (CT scan). Resultats: Les patients avec des valeurs elevees de marquage du p53 avaient des volumes tumoraux plus grands (p = .03). De plus le p53 etaient independant du stade clinique (p = .84). Conclusion: Nous avons trouve une correlation positive significative entre le volume tumoral au site primaire et le statut du p53.

OBJECTIVE To investigate the relationship between primary tumour volumes and treatment outcomes within T3- and T4-staged nasopharyngeal carcinoma. DESIGN Retrospective study. SETTING Tertiary care centre. METHODS Forty newly diagnosed T3-staged patients and 36 newly diagnosed T4-staged patients participated in the study. MAIN OUTCOME MEASURES Computed tomography-derived primary tumour volume was obtained from the summation of areas technique. The probabilities of achieving tumour control and patient survival were estimated using the product-limit method of Kaplan and Meier. The log rank test was used to examine significance. RESULTS In T3-staged nasopharyngeal carcinoma, the median primary tumour volume was 29.6 mL, with a range from 8.0 to 131.8 mL. After segregating the primary tumour volume into two subgroups ( 30 mL), large primary tumour volume was associated with a significantly poorer disease-specific survival (p = .0001). In T4-staged cases, the median primary tumour volume was 54.07 mL, with a range from 6.7 to 223.1 mL. After segregating the primary tumour volume into two subgroups ( 60 mL), larger primary tumour volume was associated with a significantly poorer disease-specific survival (p = .0022). CONCLUSION Within the same T3- and T4-staged nasopharyngeal carcinoma, the primary tumour volume represented an important prognostic factor. To improve the treatment outcome of T3- and T4-staged nasopharyngeal carcinoma with large primary tumour volumes, more aggressive treatment is needed.

Objectifs: Le but de cette etude est d'investiguer la variabilite du volume tumoral dans les carcinomes nasopharynges et de le comparer avec la classification de 1997 de l'American Joint Committee on Cancer. Devis: Etude prospective. Localisation: Centre de soins tertiaires. Methode: Nous avons evalue une serie de 33 patients nouvellement diagnostiques et traites avec radiotherapie externe a hautes doses. Mesures: Nous avons evalue les volumes tumoraux en utilisant une technique d'addition des aires sur des epreuves tomodensitometriques et determine la variabilite du volume tumoral. Nous avons utilise le test Mann-Whitney pour faire l'analyse statistique. Resultats: Nous avons note une grande variation dans le volume tumoral en particulier chez les cas de pathologies avancees. Conclusion: Les carcinomes nasopharynges presentent une variabilite importante dans le volume de tumeur primaire. L'addition de ce facteur a la classification tumorale pourrait raffiner le systeme developpe en 1997.

Endoscopic thoracic sympathectomy or sympathicotomy is a safe and effective method of treating primary hyperhidrosis (PH), but postoperative compensatory sweating may be a problem. There are few reports of sympathetic blockade by clipping for PH. We present our experience of endoscopic thoracic sympathetic block (ETSB) by clipping in treating palmar (PAH) and axillary hyperhidrosis (AH) in children and adolescents. Between May 1997 and June 1998, a total of 78 patients with PAH or AH underwent ETSB by clipping using an 8-mm, 0 degrees thoracoscope. There were 33 males and 45 females with a mean age of 14.1 years (range 9-16 y). All patients were placed in a semi-sitting position under single-lumen intubation anesthesia; 52 patients with PAH underwent T2 sympathetic block by clipping at the 2nd and 3rd rib beds, and T3 and T4 sympathetic block was performed at the 3rd, 4th and 5th rib beds in 26 patients with AH. A total of 156 sympathetic blocks by clipping were achieved. The operation was usually accomplished within 20 min (range 16-30 min). Most patients were discharged within 4 h after the operation. There were neither surgical complications nor mortality. The mean postoperative follow-up period was 32.7 months (range 26-40). Improvement of PAH or AH could be obtained in all cases; 70 patients (85.4%) developed compensatory sweating of the trunk and lower limbs. One patient with PAH underwent a reverse operation with improvement of the sweating 14 days after removal of the endo-clips. ETSB by clipping is thus a safe and effective method for treating PH in children and adolescents; compensatory sweating may be improved after a reverse operation with removal of the endo-clip.

OBJECTIVE To investigate the relationship between primary tumour volumes and treatment outcomes in early T-stage nasopharyngeal carcinoma. DESIGN Retrospective study. SETTING Tertiary care centre. METHOD A consecutive series of 52 newly diagnosed patients of early T-stage nasopharyngeal carcinoma who were treated with high-dose radiotherapy. MAIN OUTCOME MEASURES Computed tomography-derived primary tumour volume was obtained following the summation of area technique. The cancer-related survival according to T stage and primary tumour volumes was analyzed. RESULTS The median primary tumour volume was 5.48 mL in T1 disease, 17.95 mL in T2a disease, and 19.15 mL in T2b disease, with a range of 3.23 to 9.65 mL in T1 disease, 6.31 to 64.54 mL in T2a disease, and 11.27 to 131.82 mL in T2b disease. Large primary tumour volume was associated with a significantly poor disease-specific survival (p = .0003), whereas the T stage that segregated into T2a and T2b carried no prognostic significance (p = .441). CONCLUSIONS A substantial variation of primary tumour volume was present within the T2a and T2b stages, and primary tumour volume represented a more important prognostic factor. Volumetric measurements of primary tumours in early T-stage nasopharyngeal tumours would better refine the tumour, node, metastasis staging system. Patients with large primary tumour volume should be treated more aggressively.

OBJECTIVE To investigate the intraobserver and interobserver variability of computed tomography-based volume measurements of nasopharyngeal carcinoma. DESIGN Prospective study. SETTING Tertiary care centre. METHODS The primary tumour volume of 13 nasopharyngeal carcinomas was repeatedly measured by two trained observers independently in two different sessions, using the summation of area technique. MAIN OUTCOME MEASURES Mean tumour volume and its standard deviation were calculated for each tumour. Statistical analysis was done with multivariate analysis, linear regression, and a two-way analysis of variance (ANOVA) random effects model. RESULTS The coefficient of variation was less than 20% in 11 volume measurements, but a large discrepancy between observers was noted in two tumours with involvement of the paranasal sinuses. A good linear correlation was found between mean tumour volume and its standard deviation: standard deviation = 0.26 volume - 2.48 (r = .80). When the two tumours with a large coefficient of variation were excluded, the two-way ANOVA random effects model revealed that both the interobserver (p = .83) and the intraobserver (p = .90) effect are not statistically significant; interobserver variability was the major component of total variability (71.0%). CONCLUSIONS Total variability in the computed tomography-based measurement of nasopharyngeal carcinoma volume is small by having the measurements done by a trained observer, except in tumours with involvement of the paranasal sinuses.