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The Gravity Recovery and Climate Experiment Follow-On (GRACE-FO), launched in May 2018, provides invaluable information about mass change in the Earth system, continuing the legacy of GRACE. Fundamental requirements for successful mass change recovery are precise orbit determination and inter-satellite ranging, determination of the relative clock alignment of the ultra-stable oscillators (USOs), precise attitude determination, and accelerometry. NASA/Caltech Jet Propulsion Laboratory is the official Level-1 data processing and analysis center, and is currently processing using software version 04. Here we present analysis of the aforementioned GRACE-FO sensor data, as well an overview of the current GRACE reprocessing, and a discussion of measurement system performance. The research presented in this abstract has been carried out at the Jet Propulsion Laboratory, California Institute of Technology, under a contract with the National Aeronautics and Space Administration.

Purpose For severe lung injuries or acute respiratory distress syndrome that occurs during critical care due to trauma, extracorporeal membrane oxygenation (ECMO) may be used as a salvage treatment. This study aimed to describe the experiences at a single center with the use of ECMO in trauma patients. Methods We enrolled a total of 25 trauma patients who were treated with ECMO between January 2015 and December 2019 at a regional trauma center. We analyzed and compared patients’ characteristics between survivors and non-survivors through a medical chart review. We also compared the characteristics of patients between direct and indirect lung injury groups. Results The mean age of the 25 patients was 45.9±19.5 years, and 19 patients (76.0%) were male. The mean Injury Severity Score was 26.1±10.1. Ten patients (40.0%) had an Abbreviated Injury Scale (AIS) 3 score of 4, and six patients (24.0%) had an AIS 3 score of 5. There were 19 cases (76.6%) of direct lung injury. The mortality rate was 60.0% (n=15). Sixteen patients (64.0%) received a loading dose of heparin for the initiation of ECMO. There was no significant difference in heparin use between the survivors and non-survivors (70% in survivors vs. 60% in non-survivors, p=0.691). When comparing the direct and indirect lung injury groups, there were no significant differences in variables other than age and ECMO onset time. Conclusions If more evidence is gathered, risk factors and indications will be identified and we expect that more trauma patients will receive appropriate treatment with ECMO.

This monocentric, single-blinded, randomized controlled noninferiority trial investigated the analgesic efficacy of erector spinae plane block (ESPB) combined with intercostal nerve block (ICNB) compared to that of thoracic paravertebral block (PVB) with ICNB in 52 patients undergoing video-assisted thoracic surgery (VATS). The endpoints included the difference in visual analog scale (VAS) scores for pain (0–10, where 10 = worst imaginable pain) in the postanesthetic care unit (PACU) and 24 and 48 h postoperatively between the ESPB and PVB groups. The secondary endpoints included patient satisfaction (1–5, where 5 = extremely satisfied) and total analgesic requirement in morphine milligram equivalents (MME). Median VAS scores were not significantly different between the groups (PACU: 2.0 (1.8, 5.3) vs. 2.0 (2.0, 4.0), p = 0.970; 24 h: 2.0 (0.8, 3.0) vs. 2.0 (1.0, 3.5), p = 0.993; 48 h: 1.0 (0.0, 3.5) vs. 1.0 (0.0, 5.0), p = 0.985). The upper limit of the 95% CI for the differences (PACU: 1.428, 24 h: 1.052, 48 h: 1.176) was within the predefined noninferiority margin of 2. Total doses of rescue analgesics (110.24 ± 103.64 vs. 118.40 ± 93.52 MME, p = 0.767) and satisfaction scores (3.5 (3.0, 4.0) vs. 4.0 (3.0, 5.0), p = 0.227) were similar. Thus, the ESPB combined with ICNB may be an efficacious option after VATS.

Objective To compare the diagnostic performance of contrast-enhanced radial T1-weighted gradient-echo 3-tesla (3T) magnetic resonance imaging (MRI) and computed tomography (CT) for the detection of visceral pleural surface invasion (VPSI). Visceral pleural invasion by non-small-cell lung cancer (NSCLC) can be classified into two types: PL1 (without VPSI), invasion of the elastic layer of the visceral pleura without reaching the visceral pleural surface, and PL2 (with VPSI), full invasion of the visceral pleura. Materials and methods Thirty-three patients with pathologically confirmed VPSI by NSCLC were retrospectively reviewed. Multidetector CT and contrast-enhanced 3T MRI with a free-breathing radial three-dimensional fat-suppressed volumetric interpolated breath-hold examination (VIBE) pulse sequence were compared in terms of the length of contact, angle of mass margin, and arch distance-to-maximum tumor diameter ratio. Supplemental evaluation of the tumor-pleura interface (smooth versus irregular) could only be performed with MRI (not discernible on CT). Results At the tumor-pleura interface, radial VIBE MRI revealed a smooth margin in 20 of 21 patients without VPSI and an irregular margin in 10 of 12 patients with VPSI, yielding an accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and F-score for VPSI detection of 91%, 83%, 95%, 91%, 91%, and 87%, respectively. The McNemar test and receiver operating characteristics curve analysis revealed no significant differences between the diagnostic accuracies of CT and MRI for evaluating the contact length, angle of mass margin, or arch distance-to-maximum tumor diameter ratio as predictors of VPSI. Conclusion The diagnostic performance of contrast-enhanced radial T1-weighted gradient-echo 3T MRI and CT were equal in terms of the contact length, angle of mass margin, and arch distance-to-maximum tumor diameter ratio. The advantage of MRI is its clear depiction of the tumor-pleura interface margin, facilitating VPSI detection.

BACKGROUND: Pneumothorax refers to the abnormal presence of air in the thoracic cavity. Pulmonary emphysema (PE) is often detected during computed tomography (CT), one of the radiological investigations used to diagnose pneumothorax and devise treatment plans in former or current smokers who present with pneumothorax. However, there are few reports that describe the recurrence rate and risk factors associated with recurrence in patients with PE and pneumothorax. METHODS: This study retrospectively cross-sectional analyzed the medical records of 164 patients diagnosed with their first episode of secondary spontaneous pneumothorax and admitted to a tertiary care hospital, between March 2013 and February 2019. The CT scans of 98 patients revealed PE, and 49 patients of those underwent pulmonary function tests (PFTs) after the resolution of pneumothorax. Risk factors for recurrence were analyzed using Cox proportional hazard regression. RESULTS: All the subjects were male and former or current smokers, with a median age of 72 years. Thirty-seven (75.5%) patients were treated with tube thoracostomy alone, whereas 12 (24.5%) patients underwent chemical pleurodesis via chest tube or video-assisted thoracoscopic surgery. After recovery from pneumothorax, these patients underwent PFT within a median time period of 5.8 months. Median forced vital capacity and forced expiratory volume in 1 second (FEV(1)) were 3.02 L (91% predicted) and 1.58 L (67% predicted), respectively. In the current study, the recurrence rate of pneumothorax was observed to be 30.6%, within a median time period of 12.4 months. In multivariable-adjusted analysis, decreased FEV(1) was observed to be significantly higher in the patients who exhibited recurrence of pneumothorax than in those who did not (adjusted hazard ratio, 0.408; P=0.025). CONCLUSIONS: In patients with PE and pneumothorax, PFT, performed after recovery, could be a useful test for predicting the recurrence of pneumothorax.

Interferon (IFN)-β and/or tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) secreted by adipose tissue-derived mesenchymal stem cells (ASCs) have been proposed as key mechanistic factors in anti-cancer efficacy in lung cancer and breast cancer cells, where they act through paracrine signaling. We hypothesized that IFN-β and TRAIL produced by ASCs suppress proliferation of hepatocellular carcinoma cells (HCCs). The present study evaluated the anti-cancer effects of ASCs on HCCs in vitro. We found that indirect co-culture with ASCs diminished growth of Huh7 hepatocellular carcinoma cells with increased protein levels of p53/p21 and phosphorylated STAT1 (pSTAT1), without apoptosis. Treatment with ASC-conditioned medium (ASC-CM) also decreased growth of Huh7 cells through elevated p53/p21 and pSTAT1 signaling. ASC-CM-mediated inhibition of cell growth was neutralized in Huh7 cells treated with anti-IFN-β antibody compared to that in ASC-CM-treated Huh7 cells incubated with an anti-TRAIL antibody. Treatment with JAK1/JAK2 inhibitors recovered inhibition of growth in Huh7 cells incubated in ASC-CM or IFN-β via down-regulation of pSTAT1/p53/p21. However, treatment of IFN-β resulted in no alterations in resistance of Huh7 cells to TRAIL. Our findings suggest that ASCs decrease growth through activated STAT1-mediated p53/p21 by IFN-β, but not TRAIL, in Huh7 cells.

Thoracic surgery using CO2 insufflation maintains closed-chest one-lung ventilation (OLV) that may provide the necessary heart–lung interaction for the dynamic indices to predict fluid responsiveness. We studied whether pulse pressure variation (PPV) and stroke volume variation (SVV) can predict fluid responsiveness during thoracoscopic surgery. Forty patients were enrolled in the study. OLV was performed with a tidal volume of 6 mL/kg at a positive end-expiratory pressure of 5 cm H2O, while CO2 was insufflated to the contralateral side at 8 mm Hg. Patients whose stroke volume index (SVI) increased ≥15% after fluid challenge (7 mL/kg) were defined as fluid responders. The predictive ability of PPV and SVV on fluid responsiveness was investigated using the area under the receiver-operator characteristic curve (AUROC), which was also assessed according to the right or left lateral decubitus position considering the intrathoracic location of the right-sided superior vena cava. AUROCs of PPV and SVV for predicting fluid responsiveness were 0.65 (95% confidence interval 0.47–0.83, p = 0.113) and 0.64 (95% confidence interval 0.45–0.82, p = 0.147), respectively. The AUROCs of indices did not exhibit any statistical significance according to position. Dynamic indices of preload cannot predict fluid responsiveness during one-lung ventilation with CO2 gas insufflation.

The Gravity Recovery and Climate Experiment Follow-On (GRACE-FO), launched in May 2018, provides invaluable information about mass change in the Earth system, continuing the legacy of GRACE. Fundamental requirements for successful mass change recovery are precise orbit determination and inter-satellite ranging, determination of the relative clock alignment of the ultra-stable oscillators (USOs), precise attitude determination, and accelerometry. NASA/Caltech Jet Propulsion Laboratory is the official Level-1 data processing and analysis center, and is currently processing software version 04. Here we present analysis of the aforementioned GRACE-FO sensor data, as well a preview of an upcoming GRACE reprocessing, and a discussion of measurement performance.

Purpose Pediatric thoracic trauma differs from those of adult in terms of the small anatomy and rapid tissue recovery. Therefore, it is important to know the characteristics of the pediatric thoracic trauma to improve treatment results. In addition, this study examined the changes in pediatric thoracic trauma features and results from the establishment of a level 1 regional trauma center. Methods Data of 168 patients’ ≤ 15 years old diagnosed with thoracic trauma between 2008 and 2019 were retrospectively analyzed. Results Pedestrian traffic accidents were the most common cause of chest injury. The average injury severity score was 17.1 ± 12.4 and the average pediatric trauma score was 5.6 ± 4.1. Lung contusion was the most common in 134 cases. There were 48 cases of closed thoracostomy. There was one thoracotomy for cardiac laceration, one case for extracorporeal membranous oxygenation, and six cases for embolization. Of all, 25 patients died, providing a mortality rate of 14.9%. In addition, independent risk factors of in-hospital mortality were hemopneumothorax and cardiac contusion. Since 2014, when the level 1 regional trauma center was established, more severely injured thoracic trauma patients came. However, the mortality was similar in the two periods. Conclusions Understanding the clinical features of pediatric thoracic trauma patients can help in efficient treatment. In addition, as the severity of pediatric thoracic trauma patients has increased due to the establishment of the regional trauma center, so pediatric trauma center should be organized in regional trauma center to improve the outcomes of pediatric thoracic trauma.

On May 22, 2020, the Gravity Recovery and Climate Experiment Follow-On (GRACE-FO), will celebrate two years of successful in-orbit operation. The primary goal of this satellite mission is to provide information about time variations of the Earth’s gravity field. This is possible due to precise orbit determination and inter-satellite ranging by determining the relative clock alignment of the USOs, precise attitude determination and accelerometry. High quality satellite observations are one of the fundamental requirements for successful gravity field recovery. NASA/Caltech Jet Propulsion Laboratory is the official Level-1 data processing and analysis center. The GRACE-FO Level-1 data are currently being processed with software version V04. This software will be used also for final reprocessing of the GRACE (2002-2017) Level-1 data. Here we present the analysis of two years of GRACE-FO sensor data as well as a preview of the reprocessed GRACE data, and discuss the measurement performance.

Background The objective of this study was to analyze the differences in clinical presentation and characteristics with regard to diaphragmatic injury between blunt trauma patients with severe low rib fractures and those without severe low rib fractures. Methods The medical records of all patients with diaphragmatic injuries who were surgically treated at this level I trauma center, between January 2004 and December 2016 were reviewed. Patient notes, radiologic findings, and operative reports were evaluated. All of the diaphragmatic injuries were confirmed based on the operative findings. Rib fracture with displacement between the ends of the fracture of more than half the width of the fractured rib on computed tomography was classified as ‘severe rib fracture'. Patients were categorized into 2 groups and analyzed: those who had more than one severe rib fracture in low ribs on the ipsilateral side of the diaphragm injury (Severe group), and those with no severe rib fracture (Non-severe group). Results Delayed diagnosis of diaphragmatic injury was more frequent in the Severe group than in the Non-severe group (81.8% vs 36.8%, p -value = 0.026). With regard to initial indications for operation, intrathoracic visceral herniation was more frequent in the Non-severe group (78.9% vs 18.2%, p -value = 0.002), while hemothorax was more frequent in the Severe group (63.6% vs 5.3%, p -value = 0.001). Central type diaphragmatic laceration was more frequent in the Non-severe group than in the Severe group (78.9% vs 18.2%, p -value = 0.002). The diameter of diaphragmatic injury was larger in the Non-severe group than in the Severe group (9.70 ± 4.10 cm vs 4.80 ± 3.60 cm, p -value = 0.004). Conclusion The results of this study imply that a low threshold for thoracotomy or laparotomy should be considered in blunt trauma patients with severe low rib fractures for the purpose of hidden diaphragmatic injury detection and management.

Background Since anatomical lung resection by video-assisted thoracoscopic surgery (VATS) was first introduced, VATS has played a major role in lung cancer. However, conversion to thoracotomy is a major concern because an unexpected thoracotomy increases the risk of potentially adverse outcomes. Therefore, we compared patients who were and were not converted to thoracotomy and identified the risk factors for thoracotomy conversion. Methods Between January 2005 and December 2013, 69 of 1,110 VATS lobectomies for lung cancer required an unexpected conversion to thoracotomy. Each converted patient was individually matched to 3 randomly selected nonconverted patients based on date of operation, type of operation, and pathologic stage. Results The most common cause of conversion was fibrocalcified lymph nodes, found in 28 patients (40.6%), followed by vascular injury in 20, tumor invasion or extension in 11, pleural adhesion in 5, incomplete interlobar fissure in 3, and failure of single-lung ventilation in 2. The differences in overall postoperative complications and in-hospital deaths were not significant; however, respiratory complications were significantly more common in the conversion group ( p = 0.012). The independent risk factors for conversion were age 65 years and older, forced expiratory volume in 1 second of less than 1.8 L, and the presence of fibrocalcified lymph nodes on preoperative chest computed tomography. Conclusions Unexpected conversion to thoracotomy during VATS lobectomy in lung cancer does not appear to increase overall surgical morbidity and mortality. However, with high-risk patients, the surgeon requires careful selection for VATS candidate. Also, if necessary, the decision to convert must be made promptly to reduce possible critical respiratory complications.

Closed tube thoracostomy is often used to evacuate a primary spontaneous pneumothorax (PSP). Occasionally, this procedure is complicated by placement of the chest tube location in the fissural area instead of pleural space. There is a paucity of studies on outcomes according to chest tube placement. As such, we investigated outcomes of chest tube placement in fissural versus pleural area in closed thoracostomy for PSP. Patients between 14 and 65 years of age who had been treated with chest tube insertion to evacuate PSP were selected based on retrospective review of medical records. Patients selected for this study received chest tube placement at either the fissural or pleural spaces. Those with pre-existing lung disease or those transferred into our hospital after closed thoracostomy were excluded. Of the 255 patients with PSP treated with chest tube insertion, 172 patients were enrolled in this study. Twenty-nine (16.9%) had fissural tube placement and 143 (83.1%) had pleural tube placement. A higher proportion of patients in the fissural versus pleural group required additional chest tube insertion (20.7% vs 4.9%, P = 0.010, respectively). There was no significant difference in body mass index, smoker status, symptom duration, number of episodes, post-thoracostomy complications, need for subsequent management, and duration of hospitalization in either group. In closed thoracostomy for PSP, there is a higher chance of tube dysfunction when the chest tube is positioned at fissural area as compared with the pleural space.

Cardiac rupture following blunt thoracic trauma is rarely encountered, since it commonly causes death at the scene. With advances in critical care, blunt cardiac rupture has been successfully treated with well-organized team approach including an emergency physician, anesthesiologist, and cardiac surgeon. We encountered a patient with blunt cardiac rupture of the junction of the superior vena cava and right atrium that extended 7 cm to the right ventricular junction. The patient was successfully resuscitated after a closed thoracostomy and pericardiocentesis with fluid loading. Cardiac injury was repaired via mid-sternotomy without cardiopulmonary bypass. The patient recovered without complications and was discharged on the 7th day after surgery.

The paper proposed a sizing method of an energy storage system(ESS) for peak shaving of high-speed railway substations based on load profile patterns of substations. A lithium based battery ESS was selected since it can produce high-power at high speed that peak shaving requires, and also takes up a relatively smaller space for installation. Adequate size of the ESS, minimum capacity which can technically meet a peak shaving target, was determined by collectively considering load patterns of a target substation, characteristics of the ESS to be installed, and optimal scheduling of the ESS. In case study, a local substation was considered to demonstrate the proposed sizing method. Also economic analysis with the determined size of ESS was performed to calculate electricity cost savings of the peak shaving ESS, and to offer pay-back period and return on investment.

Vacuum-assisted closure therapy is an alternative method for a massive subcutaneous emphysema treatment. It is easily applicable and shows rapid effectiveness in massive subcutaneous emphysema, intractable with chest tube drainage.

Internet banking service has a advantage that is unrestricted b y time. If automated programs are able to attack Internet banking services, a number of accounts can be attacked at the same time and as a result, damage will be considerably increased. To cope with such attacks, two methods, VPS and MS w atermark, were introduced by Arcot and MS respectively. The methods use text-based CAPTCHAs in the process of transfer approval to distinguish automated programs from legal human users. In this paper, we point out the security threats of the methods when those are applied to Internet banking services. Especially, we consider the attack that are performed by extract specific string from text-based CAPTCHAs and it's countermeasure. Also we suggest a method of enhancing security of internet banking services. Our method is based on contents-based CAPTCHAs that are consist of known transfer info rmation between user and server.Keywords: CAPTCHA, Internet banking, MITB, secure card, OTP접수일(2013년 1월 14일), 수정일(1차: 2013년 3월 27일, 2차: 2013년 5월 20일), 게재확정일(2013년 6월 13일)* 이 논문은 인하대학교의 지원에 의하여 연구되었음.†주저자, 181cm76kg245@gmail.com ‡교신저자, khlee@suwon.ac.kr (Corresponding author)

Chest drainage systems are usually composed of chest tube and underwater-seal bottle. But this conventional system may restrict patients doing exercise and give clinicians obscure data about when to remove tubes because there is no objective indicator. Recently developed digital chest drainage systems may facilitate interpretation of the grade of air leak and make it easy for clinicians to decide when to remove chest tubes. In addition, with combination of wireless internet devices, monitoring and managing of drainage system distant from the patient is possible.Sixty patients of primary pneumothorax were included in a prospective randomized study and divided into two groups. Group I (study) consisted of digital chest drainage system while in group II (control), conventional underwater-seal chest bottle system was used. Data was collected from January, 2012 to September, 2013 in Eulji University Hospital, Daejeon, Korea.There was no difference in age, sex, smoking history and postoperative pain between two groups. But the average length of drainage was 2.2 days in group I and 3.1 days in group II (P0.006). And more, about 90% of the patients in group I was satisfied with using new device for convenience.Digital system was beneficial on reducing the length of tube drainage by real time monitoring. It also had advantage in portability, loudness and gave more satisfaction than conventional system. Moreover, internet based digital drainage system will be a good method in thoracic telemedicine area in the near future.

The demographics and prognosis of non-small cell lung cancer patients have changed during the last few decades. We conducted this study to assess the change in demographics and prognosis in resected non-small cell lung cancer patients during a 20-yr single-institution study in Korea. We retrospectively reviewed the medical records of 2,076 non-small cell lung cancer patients who underwent pulmonary resection between 1990 and 2009. Their clinical characteristics and survival were analyzed over a five-year period. With time, the proportions of female, adenocarcinoma, stage IA, and lobectomy patients increased, whereas the proportions of male, squamous cell carcinoma, stage IIIA, and pneumonectomy patients decreased. These demographic changes caused improved prognosis. The five-year survival rate of all patients was 53.9%. The five-year survival rate increased from 31.9% in 1990-1994, to 43.6% in 1995-1999, 51.3% in 2000-2004, and 69.7% in 2005-2009 (P < 0.001). In conclusion, among patients with resected non-small cell lung cancer, the proportions of female, adenocarcinoma, stage IA, and lobectomy patients have increased, and the five-year survival rate has gradually improved during the last 20 yr in Korea.

Purpose Radiographic carpal chondromalacia (RCC) was defined as the presence of cortical sclerosis or subchondral changes, such as a lucent defect or cystic changes in a carpal on plain radiographs. The purpose of this study was to investigate the factors associated with the occurrence of RCC in idiopathic ulnar impaction syndrome and to determine the efficacy of ulnar shortening osteotomy on patient outcome and RCC. Methods Thirty-nine patients (42 wrists) with idiopathic ulnar impaction syndrome were treated with either ulnar shortening osteotomy or arthroscopic wafer resection. Patients were divided into 2 groups according to the presence (RCC group; 17 patients, 19 wrists) or absence (non-RCC group: 22 patients, 23 wrists) of RCC on preoperative radiographs. To determine the factors associated with RCC, a comparative analysis of these 2 groups was performed with respect to sex, age, duration of symptoms, positive ulnar variance, pain scores, and Chun and Palmer grading system. The RCC area was measured on serial radiographs taken during follow-up. Progressive changes of RCC area and clinical outcomes were evaluated. Results Patients in the RCC group were older, exhibited greater positive ulnar variance, and demonstrated a significantly higher mean pain score before surgery. The RCC was found to reverse over the year following ulnar shortening osteotomy and did not recur up to 2 years after surgery. In 3 wrists, RCC had completely disappeared at the last follow-up. All patients showed improved clinical outcomes. Conclusions The RCC changes correlated with older age, a positive ulnar variance, and preoperative pain severity. The RCC progressively reversed after ulnar shortening osteotomy, and this reversal of radiographic changes correlated with clinical improvements. Type of study/level of evidence Therapeutic IV.

Background: Pneumonectomy remains the ultimate curative treatment modality for destroyed lung caused by tuberculosis despite multiple risks involved in the procedure. We retrospectively evaluated patients who underwent pneumonectomy for treatment of sequelae of pulmonary tuberculosis to determine the risk factors of early and long-term outcomes. Materials and Methods: Between January 1980 and December 2008, pneumonectomy or pleuropneumonectomy was performed in 73 consecutive patients with destroyed lung caused by tuberculosis. There were 48 patients with empyema (12 with bronchopleural fistula [BPF]), 11 with aspergilloma and 7 with multidrug resistant tuberculosis. Results: There were 5 operative mortalities (6.8%). One patient had intraoperative uncontrolled arrhythmia, one had a postoperative cardiac arrest, and three had postoperative respiratory failure. A total of 29 patients (39.7%) suffered from postoperative complications. Twelve patients (16.7%) were found to have postpneumonectomy empyema (PPE), 4 patients had wound infections (5.6%), and 7 patients required re-exploration due to postoperative bleeding (9.7%). The prevalence of PPE increased in patients with preoperative empyema (p=0.019). There were five patients with postoperative BPF, four of which occurred in right-side operation. The only risk factor for BPF was the right-side operation (p=0.023). The 5- and 10-year survival rates were 88.9% and 76.2%, respectively. The risk factors for late deaths were old age (≥50 years, p=0.02) and low predicted postoperative forced expiratory volume in one second (FEV1) (＜1.2 L, p=0.02). Conclusion: Although PPE increases in patients with preoperative empyema and postoperative BPF increases in right-side operation, the mortality rates and long-term survival rates were found to be satisfactory. However, the follow-up care for patients with low predicted postoperative FEV1 should continue for prevention and early detection of pulmonary complication related to impaired pulmonary function.

This paper deals with the power integration of large urban railway systems to improve regenerative energy utilization. Current regenerative energy utilization is low because there is no special plan for using this energy. If the railway system is integrated with other railway systems, the efficiency is expected to be improved. Through the case studies, to find the realistic effect of integrated operation, real system for the Seoul Metro lines, especially line 5 and 7, had been applied.

Background The purpose of this study was to clarify the relationship between the tumor infiltrating lymphocytes and clinical outcome in patients with thymic carcinoma. Methods Tissue specimens from 32 patients who underwent surgical resection for thymic carcinoma were immunohistochemically analyzed for CD4, CD8 and CD20 expression. Results Tumor-infiltrating lymphocytes were generally more abundant in the stroma. The patients with low CD4+ lymphocytes ( p = 0.037) and low CD20+ lymphocytes ( p = 0.045) within tumor stroma showed poor survival. Furthermore, concurrent low levels of CD4+ and CD20+ ( p = 0.014), CD8+ and CD20+ ( p = 0.025), and, CD4+, CD8+, and CD20+ ( p = 0.025) in tumor stroma were significantly associated with poor prognosis when compared to the others group. Conclusion Our results indicate that infiltrating CD4+, CD8+, and CD20+ lymphocytes in cancer stroma may cooperate to suppress cancer progression and their presence together appear to be prognostic factor in thymic carcinoma.

In this paper, it is proposed for algorithm to detect human efficiently using a edge symmetry and gradient directional characteristics in realtime by the feature extraction in a single input image. Proposed algorithm is composed of three stages, preprocessing, region partition of human candidates, verification of candidate regions. Here, preprocessing stage is strong the image regardless of the intensity and brightness of surrounding environment, also detects a contour with characteristics of human as considering the shape features size and the condition of human for characteristic of human. And stage for region partition of human candidates has separated the region with edge symmetry for human and size in the detected contour, also divided 1st candidates region with applying the adaboost algorithm. Finally, the candidate region verification stage makes excellent the performance for the false detection by verifying the candidate region using feature vector of a gradient for divided local area and classifier. The results of the simulations, which is applying the proposed algorithm, the processing speed of the proposed algorithms is improved approximately 1.7 times, also, the FNR(False Negative Rate) is confirmed to be better 3% than the conventional algorithm which is a single structure algorithm.

In this paper, it was segmented the face color distribution using YCbCr color model, which is one of the feature-based methods, and preprocessing stage was to be insensitive to the sensitivity for light which is one of the disadvantages for the feature-based methods by the quantization. In addition, it has raised the accuracy of image synthesis with characteristics which is selected the object of the most same image as the shape of pattern using rough set. In this paper, the detection rates of the proposed face detection algorithm was confirmed to be better about 2~3% than the conventional algorithms regardless of the size and direction on the various faces by simulation.

In this paper, it is realized an image filter for a noise elimination using a recurrent neural networks with fuzzy. The proposed fuzzy neural networks structure is to converge weights and the number of iteration for a certain value by using basically recurrent neural networks structure and is simplified computation and complexity of mathematics by applying the hybrid fuzzy membership function operator. In this paper, the proposed method, the recurrent neural networks applying fuzzy which is collected a certain value, has been proved improving average 0.38dB than the conventional method, the generalied recurrent neural networks, by using PSNR. Also, a result image of the proposed method was similar to the original image than a result image of the conventional method by comparing to visual images.

Background: Following major lung resection, patients have routinely been monitored in the intensive care unit (ICU). Recently, however, patients are increasingly being placed in a general thoracic ward (GTW). We investigated the safety and efficacy of the GTW care after lobectomy for lung cancer. Materials and Methods: 316 patients who had undergone lobectomy for lung cancer were reviewed. These patients were divided into two groups: 275 patients were cared for in the ICU while 41 patients were care for in the GTW immediately post-operation. After propensity score matching, postoperative complications and hospital costs were analyzed. Risk factors for early complications were analyzed with the whole cohort. Results: Early complications (until the end of the first postoperative day) occurred in 11 (3.5%) patients. Late complications occurred in 42 patients (13.3%). After propensity score matching, the incidence of early complications, late complications, and mortality were not different between the two groups. The mean expense was higher in the ICU group. Risk factors for early complications were cardiac comorbidities and low expected forced expiratory volume in one second. The location of postoperative care had no influence on outcome. Conclusion: Immediate postoperative care after lobectomy for lung cancer in a GTW was safe and cost-effective without compromising outcomes in low-risk patients.

Each pixels become got pixel value for color of only one from among colors because of bayer pattern that light receiving device of image sensor which is used in HHP and digital camera writes only one color. Information of the missing pixels could infer perfect color image from using information of neighbor pixels by using CFA(Color Filter Array). In this paper, we derive relation between the average of the data from the light receiving device of image sensor and each color channel data. And by using this relation, a new efficient edge color fuzzy method for color interpolation is proposed. Also, missing luminance signal channel interpolation was fuzzy interpolation along any edges direction for reducing color noise and interpolating efficiently it. And in this paper, the proposed method has been proved improving average 2.4dB than the conventional method by using PSNR. Also, resolution of the image of the proposed method was similar to the original image by visual images, we has been verified to be decreased a chromatic aberration than image of conventional algorithms with simulation result.

Empyema after lung transplantation causes dysfunction of the allograft, and it has the potential to cause mortality and morbidity, but the technical difficulty of surgically treating this empyema makes this type of treatment unfavorable. We report here on two cases of decortication for empyema after lung transplantation.

In this paper, we propose a system which easily controls the existing serially connected multi-channel speakers in a general personal computer by using a USB(Universal Serial Bus) interface. The personal computer as a host of the USB interface analyzes a sound source and sends audio data in a real-time fashion by the use of the isochronous transmission, one of four transmission methods provided by the USB interface. In addition, a channel is assigned by means of the bulk transmission, one of four transmission methods provided by the USB interface. Transmitted data from the USB host are sent to each speaker through compression and packet generation process. Each speaker detects corresponding digital data and regenerates audio signals through DAC(Digital-to-Analog Converter). A user can easily select a sound source file and a channel by the use of a GUI environment in a personal computer.

Background: Sternal fractures are relatively rare, and caused mainly by blunt anterior chest wall trauma. In most cases, sternal fractures are treated conservatively. However, if the patient exhibits problematic symptoms such as intractable chest wall pain or bony crepitus due to sternal instability, surgical correction is indicated. But no consensus exists regarding the most appropriate surgical method. We analyzed the results of surgical fixation in cases of sternal fracture in order to identify which surgical method led to the best outcomes. Methods: We retrospectively reviewed the medical records of patients with sternal fractures from December 2008 to December 2011, and found 19 patients who underwent open reduction and internal fixation of the sternum with a longitudinal plate (L-group) or a T-shaped plate (T-group). We investigated patients’ characteristics, clinical details regarding each case of chest trauma, the presence of other associated injuries, the type of open reduction and fixation, whether a combined operation was performed, and postoperative complications. Results: Of the 19 patients, 10 patients (52.6%) were male, and their average age was 56.8 years (range, 32 to 82 years). Seven patients (36.8%) had isolated sternal fractures, while 12 (63.2%) had other associated injuries. Seven patients (36.8%) were in the L-group and 12 patients (63.2%) were in the T-group. Three patients in the L-group (42.9%) showed a loosening of the fixation. In all patients in the T-group, the fracture exhibited stable alignment. Conclusion: Open reduction and internal fixation with a T-shaped plate in sternal fractures is a safer and more efficient treatment method than treatment with a longitudinal plate, especially in patients with a severely displaced sternum or anterior flail chest, than a longitudinal plate.

Benzyl 4-halobenzyl and ally benzyl disulfide were synthesized as diallyl disulfide analogues and their tumor growth inhibitory effects on the cancer cells (SNU C5 and MCF-7) were comparable to that of diallyl disulfide, indicating that the disulfide functional group was responsible for the tumor growth inhibitory effects. Cu(I)-assisted radioiodination of benzyl 4-bromobenzyl disulfide gave benzyl 4-[123I/125I]iodobenzyl disulfide in 30-40% radiochemical yield. The radiolabeled disulfide was taken up by the cancer cells in a time-dependent manner, and the uptake was inhibited by the pretreatment of S-methyl methanethiosulfonate (MMTS), phorone and diallyl disulfide. This study suggested that the radiolabeled dibenzyl disulfide was taken up by the cancer cells via thiol-disulfide exchange and retained inside the cells.

A 31-year-old female was referred from other hospital due to migrating chest pain, mild cough, and blood-tinged sputum for three days before admission. Laboratory tests were unremarkable. Chest computed tomography revealed an elliptical necrotic mass at the left anterior mediastinum, measuring 7×3×4 cm. With the impression of mediastinal abscess or loculated empyema, thoracoscopic resection was performed. There was severe pleural adhesion around the mass. The mass could be resected by the wedge resection of the adhesed upper lobe tissue of left lung around the mass. Final pathologic diagnosis was ectopic pancreas.