Automatic Sequential Stitching of High-Resolution Panorama for Android Devices Using Precapture Feature Detection and the Orientation Sensor.

Image processing on smartphones, which are resource-limited devices, is challenging. Panorama generation on modern mobile phones is a requirement of most mobile phone users. This paper presents an automatic sequential image stitching algorithm with high-resolution panorama generation and addresses the issue of stitching failure on smartphone devices. A robust method is used to automatically control the events involved in panorama generation from image capture to image stitching on Android operating systems. The image frames are taken in a firm spatial interval using the orientation sensor included in smartphone devices. The features-based stitching algorithm is used for panorama generation, with a novel modification to address the issue of stitching failure (inability to find local features causes this issue) when performing sequential stitching over mobile devices. We also address the issue of distortion in sequential stitching. Ultimately, in this study, we built an Android application that can construct a high-resolution panorama sequentially with automatic frame capture based on an orientation sensor and device rotation. We present a novel research methodology (called "Sense-Panorama") for panorama construction along with a development guide for smartphone developers. Based on our experiments, performed by Samsung Galaxy SM-N960N, which carries system on chip (SoC) as Qualcomm Snapdragon 845 and a CPU of 4 × 2.8 GHz Kyro 385, our method can generate a high-resolution panorama. Compared to the existing methods, the results show improvement in visual quality for both subjective and objective evaluation.

Subjective Assessment of Objective Image Quality Metrics Range Guaranteeing Visually Lossless Compression.

The usage of media such as images and videos has been extensively increased in recent years. It has become impractical to store images and videos acquired by camera sensors in their raw form due to their huge storage size. Generally, image data is compressed with a compression algorithm and then stored or transmitted to another platform. Thus, image compression helps to reduce the storage size and transmission cost of the images and videos. However, image compression might cause visual artifacts, depending on the compression level. In this regard, performance evaluation of the compression algorithms is an essential task needed to reconstruct images with visually or near-visually lossless quality in case of lossy compression. The performance of the compression algorithms is assessed by both subjective and objective image quality assessment (IQA) methodologies. In this paper, subjective and objective IQA methods are integrated to evaluate the range of the image quality metrics (IQMs) values that guarantee the visually or near-visually lossless compression performed by the JPEG 1 standard (ISO/IEC 10918). A novel "Flicker Test Software" is developed for conducting the proposed subjective and objective evaluation study. In the flicker test, the selected test images are subjectively analyzed by subjects at different compression levels. The IQMs are calculated at the previous compression level, when the images were visually lossless for each subject. The results analysis shows that the objective IQMs with more closely packed values having the least standard deviation that guaranteed the visually lossless compression of the images with JPEG 1 are the feature similarity index measure (FSIM), the multiscale structural similarity index measure (MS-SSIM), and the information content weighted SSIM (IW-SSIM), with average values of 0.9997, 0.9970, and 0.9970 respectively.

Large chondral defect not covered by meniscal allograft is associated with inferior graft survivorship after lateral meniscal allograft transplantation.

PURPOSE: This study aimed to evaluate graft survivorship according to the size and location of chondral defects and its effect on clinical outcomes after meniscal allograft transplantation (MAT). It was hypothesized that large chondral defects would be associated with inferior outcomes. METHODS: Patients who underwent lateral MAT with fresh-frozen allografts between 2007 and 2016 were retrospectively reviewed. The inclusion criteria were patients with femoral or tibial chondral defects (International Cartilage Repair Society grade 4) who were followed up more than 2 years with 3.0-T magnetic resonance imaging (MRI) scans. Maximal lesion diameter and location were assessed on MRI. The patients were divided into two groups, with chondral defects of < 3 and ≥ 3 cm2 on the tibial side. Graft survivorship was compared between the two groups. Graft failure was defined as revisional MAT, meniscal tear or meniscectomy greater than one-third of the allograft on MRI. Clinical outcomes were evaluated using the modified Lysholm score. RESULTS: Twenty-eight knees in 26 patients (mean age 37.4 ± 10.3 years) with a mean follow-up of 3.6 ± 1.0 (range 2.0-5.4) years were identified. Nineteen knees in 17 patients had both femoral and tibial chondral defects, 7 knees in 7 patients had only femoral chondral defects, and 2 knees in 2 patients had only tibial chondral defects. The mean preoperative femoral and tibial chondral defect sizes were 1.7 ± 1.2 and 3.0 ± 1.4 cm2, respectively. Among the seven graft failures, no graft failure occurred in the cases with tibial chondral defects of < 3 cm2. Tibial chondral defects of ≥ 3 cm2 were significantly associated with graft failure (P = 0.004; odds ratio 28.3; 95% confidence interval 2.5-4006.7). Defects of < 3 cm2 were located primarily in the posterior aspect of the lateral tibial plateau, and most lesions were covered by allograft (7/9, 77.8%). The modified Lysholm scores significantly improved irrespective of chondral defects size (P < 0.001). CONCLUSIONS: Larger chondral defects, more than 3 cm2 on the tibial side, were associated with inferior graft survivorship but did not influence the clinical outcomes after MAT at the 3.6-year follow-up. Chondral defect location was associated with defect size. LEVEL OF EVIDENCE: IV.

Readmission and Resource Use After Robotic-Assisted versus Open Pancreaticoduodenectomy: 2010-2017.

BACKGROUND: Unplanned rehospitalization is considered an adverse quality of care indicator. Minimally invasive operations carry the potential to reduce resource use while enhancing recovery. Robotic-assisted pancreaticoduodenectomy (RAPD) has been used to improve outcomes of its morbid open counterpart. We sought to identify factors associated with readmission between RAPD and open pancreaticoduodenectomy (OPD). MATERIALS AND METHODS: We used the 2010-17 National Readmissions Database to identify adults who underwent RAPD or OPD. The primary outcome was 30-day readmission. Secondary outcomes included readmission diagnosis: index, readmission, and total (index + readmission) length of stay, costs, and mortality. RESULTS: Of an estimated 84,036 patients undergoing pancreaticoduodenectomy, 96.9% survived index hospitalization. Frequency of both RAPD and OPD increased during the study period with similar mortality (2.5% versus 3.2%, P = 0.46). Compared with OPD, RAPD was not an independent predictor of 30-day readmission (adjusted odds ratio (AOR): 1.0, P = 0.98). Disposition with home health care (AOR: 1.1, P < 0.001) or to a skilled nursing facility (AOR: 1.5, P < 0.001) was significantly associated with increased 30-day readmission. CONCLUSIONS: Readmission after pancreaticoduodenectomy is common, regardless of surgical approach. Although RAPD saves in-patient days on index admission, readmission rates and length of stay are similar between the two modalities. Neither RAPD nor OPD is a risk factor for readmission, highlighting the complexity of pancreaticoduodenectomy, with complications that may result from factors independent of the operative approach.

There Is No Difference in Radiographic Outcomes After Average 9 Years After Arthroscopic Partial Medial Meniscectomy for Both Posterior Horn Tears and Posterior Horn Root Tears.

PURPOSE: To compare the serial changes in radiographic outcomes in terms of the mechanical axis (MA) angle and medial joint space width (JSW) between medial meniscus posterior root tear (MM PRT) and non-root tear (MM NRT) after arthroscopic partial meniscectomy (APM). METHODS: Patients who underwent APM for degenerative MM PRT or MM NRT from January 1999 to July 2012 were retrospectively reviewed. One hundred ten patients each in the MM PRT group and the MM NRT group, who were matched through propensity score matching (adjusting for confounding factors such as age, sex, body mass index, anatomic axis, cartilage state of the medial compartment, and follow-up period), were included in the study. The MA angle on weightbearing whole-leg radiographs and the medial JSW on weightbearing 45° flexion posteroanterior radiographs were measured to evaluate the radiographic outcomes. The serial changes were compared between radiographs taken before surgery, at postoperative 3 to 5 years, and at postoperative 5 years to the last follow-up. The linear mixed model was used to compare the changes in radiographic outcomes during the follow-up period between groups. RESULTS: The 2 groups were balanced with standardized mean differences of <0.2 after propensity score matching. Both the MM PRT and NRT groups showed increased varus alignment after surgery. However, there was no significant difference in the change in the MA angle during the follow-up period between groups (P = .182). The medial JSW also showed progression of joint space narrowing after surgery in both groups; however, there was no significant difference in the change in medial JSW during the follow-up period between groups (P = .270). CONCLUSION: The radiographic outcomes after partial meniscectomy in terms of the MA angle and medial JSW show comparable results between degenerative MM PRT and NRT after proper matching of confounding factors. LEVEL OF EVIDENCE: Level III, retrospective comparative study.

Degenerative medial meniscus posterior root tear and non-root tear do not show differences in joint survival and clinical outcome after partial meniscectomy.

PURPOSE: No comparative studies of outcomes between degenerative medial meniscus posterior root tear (MM PRT) and non-root tear (NRT) have been conducted. This study aimed to compare joint survival and clinical outcome between MM PRT and MM NRT after partial meniscectomy with proper control of confounding factors. METHODS: One hundred and ten patients each in MM PRT and MM NRT groups who underwent arthroscopic partial meniscectomy were retrospectively evaluated through propensity score matching. Joint survival was assessed on the basis of surgical and radiographic failures. Clinical outcomes were assessed using the Lysholm score. RESULTS: The confounding variables were well balanced between the groups, with standardized mean differences of < 0.2 after propensity score matching. Failures occurred in 30 (27.3%) and 35 patients (31.8%) in the MM PRT group and MM NRT group, respectively. The estimated mean survival times were 12.5 years (95% confidence interval [CI] 11.5-13.5) and 11.7 years (10.7-12.7), respectively. There were no significant differences in the overall survival rate and Lysholm score between the two groups (n.s.). CONCLUSION: In middle-aged patients with degenerative MM PRT, joint survival and clinical outcome showed comparable results with those with MM NRT after partial meniscectomy. Arthroscopic partial meniscectomy is one of the effective treatments for MM PRT with consideration of various patient factors. LEVEL OF EVIDENCE: III.

Increased preoperative medial and lateral laxity is a predictor of overcorrection in open wedge high tibial osteotomy.

PURPOSE: This study aimed at determining whether overcorrection after open wedge high tibial osteotomy (OWHTO) would be predicted by the magnitude of preoperative medial and lateral coronal soft tissue laxity around the knee joint. METHODS: Overall, 68 knees of 62 patients who underwent OWHTO for primary medial osteoarthritis were retrospectively reviewed. The mechanical hip-knee-ankle (HKA) axis, weight-bearing line (WBL) ratio, medial proximal tibial angle (MPTA), joint line obliquity, coronal subluxation, and joint line convergence angle (JLCA) were measured on full-weight-bearing long-standing HKA radiographs preoperatively and at 1 year postoperatively. The varus valgus stress angle was measured on preoperative radiographs. The correction amount due to soft tissue factors was calculated as the difference between the WBL ratio on postoperative 1-year radiographs and that on virtually corrected preoperative radiographs with the same amount of MPTA at 1 year postoperatively. The patients were grouped according to the presence or absence of a ≥ 10% overcorrection of WBL ratio (overcorrection or expected correction). Multiple logistic regression analysis was performed to identify the preoperative risk factors of overcorrection. RESULTS: The average WBL ratio was corrected from 19.0 ± 13.5% preoperatively to 61.6 ± 9.1% postoperatively (P < 0.001). The average MPTA changed from 85.1 ± 1.7° preoperatively to 93.6 ± 2.6° postoperatively, resulting in an average tibia correction angle of 8.6 ± 3.1°. The average estimated correction from soft tissue factors was 5.8 ± 7.4% of the WBL ratio. Soft tissue correction of the WBL ratio > 10% was confirmed in 17 patients (28%). The preoperative JLCA and valgus stress angle were significantly greater in the overcorrection group than in the expected correction group: 5.0 ± 1.7° vs. 3.4 ± 1.9° (P = 0.003) and 2.4 ± 1.0° vs. 1.3 ± 1.2° (P = 0.002), respectively. Among the radiologic parameters, the presence of both ≥ 4° JLCA and ≥ 1.5° valgus stress angle was the only significant risk factor for overcorrection from soft tissue factors (P = 0.006; odds ratio, 30.2). CONCLUSIONS: The magnitude of both medial and lateral coronal soft tissue laxity was a predictor of overcorrection from soft tissue factors after OWHTO. Overcorrection was more likely to occur in cases with both ≥ 4° JLCA and ≥ 1.5° valgus stress angle. LEVEL OF EVIDENCE: III.

Recipient working status is independently associated with outcomes in heart and lung transplantation.

Employment status may capture elements of patients' physical strength, mental resilience, and socioeconomic status to better prognosticate transplant outcomes. This study characterized the effect of working status on thoracic transplant outcomes by evaluating the United Network for Organ Sharing registry for adult lung or heart transplants from 2005 to 2016. Kaplan-Meier estimates illustrated 5-year and 10-year survival by working status at transplant, while multivariable Cox proportional hazards regressions controlled for baseline differences, including functional and socioeconomic status. Of 17 778 lung transplant recipients, 1700 (9.6%) worked at transplant and experienced significantly lower 5-year mortality than nonworking recipients (38.6% vs 45.5%, P < 0.001). Of 21 394 heart transplant recipients, 1289 (6.0%) were employed and experienced significantly lower 10-year mortality than nonworking recipients (34.1% vs 40.2%, P < 0.001). Adjusted Cox regressions demonstrated that employment significantly reduced mortality independent of functional status for both lung (HR: 0.86 [0.78-0.95], P = 0.003) and heart (HR: 0.84 [0.72-0.97], P = 0.023) recipients. After accounting for insurance status, the effect of working status persisted only in lung transplantation (HR: 0.89 [0.81-0.98], P = 0.023). Since heart and lung transplant candidates employed at transplant face lower long-term mortality, working status must encompass a broad set of physical, psychological, and socioeconomic variables that may prognosticate post-transplant outcomes.

Association between diverticular disease requiring surgical intervention and mortality in the postlung transplant population - a retrospective cohort study.

Lung Transplant recipients are at increased risk of complicated diverticular disease. We aim to assess the rate of diverticular surgery in a postlung transplantation population and identify risk factors for surgery. We performed a retrospective cohort study of lung transplant recipients from 2007 to 2011. Demographic variables were evaluated with the Mann-Whitney U and chi-squared tests. Cox regression was performed to evaluate 1- and 2-year landmark survival, assess predictor variables of diverticular surgery and evaluate impact of surgery on CLAD development. Of 17 of 158 patients (10.7%) underwent diverticular-related surgery. Surgical patients had significantly worse survival than nonsurgical patients at 1 year [aHR 2.93 (1.05-8.21), P = 0.041] and 2 year [aHR 4.17 (1.26-13.84), P = 0.020] landmark analyses. Transplant indication of alpha-1 antitrypsin disease and cystic fibrosis were significantly associated with the need for diverticular surgery. Emergent surgery was associated with poorer survival [aHR 5.12(1.00-26.27), P = 0.050]. Lung transplant patients requiring surgery for complicated diverticular disease have significantly poorer survival than those who do not require surgery. Surgery was more common in patients transplanted for A1AT and CF. Optimal assessment and risk stratification of diverticular disease is necessary to prevent excessive morbidity and mortality following transplantation.

Lung transplantation in the Lung Allocation Score era: Medium-term analysis from a single center.

In 2005, the Lung Allocation Score (LAS) was implemented as the allocation system for lungs in the US. We sought to compare 5-year lung transplant outcomes before and after the institution of the LAS. Between 2000 and 2011, 501 adult patients were identified, with 132 from January 2000 to April 2005 (Pre-LAS era) and 369 from May 2005 to December 2011 (Post-LAS era). Kruskal-Wallis or chi-squared test was used to determine significance between groups. Survival was censored at 5 years. Overall, the post-LAS era was associated with more restrictive lung disease, higher LAS scores, shorter wait-list times, more preoperative immunosuppression, and more single lung transplantation. In addition, post-LAS patients had higher O2 requirements with greater preoperative pulmonary impairment. Postoperatively, 30-day mortality improved in post-LAS era (1.6% vs 5.3%, P = .048). During the pre- and post-LAS eras, 5-year survival was 52.3% and 55.3%, respectively (P = .414). The adjusted risk of mortality was not different in the post-LAS era (P = .139). Freedom from chronic lung allograft dysfunction was significantly higher in the post-LAS era (P = .002). In this single-center report, implementation of the LAS score has led to allocation to sicker patients without decrement in short- or medium-term outcomes. Freedom from CLAD at 5 years is improving after LAS implementation.

Efficacy and safety of acupuncture for functional constipation: a randomised, sham-controlled pilot trial.

BACKGROUND: The prevalence of functional constipation (FC) is 3-27%, and FC has been reported to cause discomfort in daily life and various complications. The treatment for FC depends on laxatives, and thus, effective and non-toxic alternative treatments are needed. METHODS: We conducted a randomised, sham-controlled parallel-design, pilot trial. Participants with FC were randomly assigned to either the real acupuncture (RA) or sham acupuncture (SA) group. The RA consisted of eight fixed acupuncture points (bilateral ST25, ST27, BL52 and BL25) and four additional points targeted to the individual based on Traditional Korean medicine (TKM). SA consisted of shallow acupuncture insertion at 12 non-acupuncture points. Twelve sessions were provided over 4 weeks. The outcome measures were weekly defecation frequency (DF), spontaneous complete bowel movement (SCBM), Bristol stool scale (BSS) score and constipation assessment scale (CAS) score. The participants were followed for 4 weeks after the treatment. RESULTS: Thirty participants were enrolled (15:15). The mean DF were 5.86 ± 5.62, 5.43 ± 3.39 and 5.79 ± 3.64 in the RA group and 3.73 ± 1.62, 5.00 ± 1.77 and 5.40 ± 1.96 in the SA group at weeks 1, 5, and 9, respectively. The increases in weekly SCBMs were 2.50 ± 3.86 and 2.71 ± 4.01 with RA and 2.33 ± 2.74 and 1.93 ± 2.25 with SA at weeks 5 and 9, respectively (mean difference [MD] 0.78). The BSS scores were 0.57 ± 1.72 and 1.09 ± 1.30 with RA and 0.15 ± 1.06 and 0.14 ± 0.88 with SA at weeks 5 and 9, respectively (MD 0.95). The CAS score changes were - 3.21 ± 2.91 and - 3.50 ± 3.98 with RA and - 2.67 + ±2.82 and - 2.87 ± 2.95 with SA at weeks 5 and 9, respectively. Greater improvements were observed in subgroup analysis of participants with hard stool. The numbers of participants who developed adverse events (AEs) were equal in both groups (four in each group), and the AEs were not directly related to the intervention. CONCLUSIONS: This clinical trial shows feasibility with minor modifications to the primary outcome measure and comparator. Acupuncture showed clinically meaningful improvements in terms of SCBMs occurring more than 3 times per week and in these improvements being maintained for 4 weeks after treatment completion. As this is a pilot trial, future studies are warranted to confirm the efficacy and safety. TRIAL REGISTRATION: KCT0000926 (Registered on 14 November 2013).

Efficacy of an Extracellular Matrix in Systemic Loading Conditions in Congenital Heart Surgery.

Extracellular matrices (ECM) are commonly used to repair congenital heart defects; however, there is a lack of literature pertaining to outcomes with ECM use in high-pressure conditions. Between 2011 and 2014, a total of 202 patients underwent congenital heart disease repair using the ECM placed in a systemic pressure condition. The operative sites included: defects in the ventricular septum, mitral valve, aortic valve, ascending aorta, and aortic arch. Patients were followed and evaluated for mortality and reoperations due to loss of ECM integrity. Echocardiograms were evaluated for graft malfunction such as aneurysmal dilation, VSD formation, valve malfunction, or outflow tract obstruction. Patients were followed for an average of 1492 days (Median = 1583). Out of the 202 patients, 7 (3.5%) died due to complications unrelated to ECM, and 10 (5%) underwent reoperations due to complications of ECM integrity. Reoperations were as follows: two of 6 patients receiving aortic leaflet replacement required reoperation for leaflet failure; four of 12 patients receiving mitral valve leaflet repairs required reoperation for leaflet failure; and four of 142 patients with VSD repair required reoperation for residual shunting. The average time to reoperation was 208 days. There were no outflow tract obstructions or aneurysmal dilatations observed. This modern case series suggests that the ECM is efficacious and sustainable under systemic conditions in congenital heart defect repair. However, concerns remain about the use of ECM in aortic valve repair and infant mitral valve repair. Further studies are needed to evaluate long-term ECM integrity.

Association Between Hematologic and Inflammatory Markers and 31 Thrombotic and Hemorrhagic Events in Berlin Heart Excor Patients.

Bleeding and thrombotic events remain a significant cause of morbidity in pediatric patients supported with ventricular assist devices (VADs). The objective of this study is to identify the association between markers of anticoagulation and bleeding and thrombosis events during Berlin Heart ExCor support. A retrospective, single-center analysis of 9 patients supported with the Berlin Heart ExCor was performed. Inflammatory and anticoagulation parameters including C-reactive protein, fibrinogen, partial thromboplastin time (PTT), and platelet count were measured at 48 and 24 h before and after bleeding or thrombosis events. Patients served as their own controls, and the same parameters were measured during a control period where subjects did not experience either event. All patients received the anticoagulation regimen proposed by Berlin Heart. A total of 31 bleeding or thrombotic events were identified and matched to 18 control events. Patient with predominantly thrombotic events tended to weigh less than those with bleeding events (Δ7.7 kg, p < 0.001). PTT levels were higher before and after bleeding (Δ17.36, p = 0.002) and thrombosis (Δ8.75, p < 0.001) events relative to control. Heparin dose decreased after a thrombosis event (Δ-5.67, p = 0.097), and this decrease was significantly different from control (p = 0.032). Non-collinearity between heparin dose and PTT should prompt further inflammatory and hematological investigation. In addition, heavier patients were more prone to bleeding complications. The role of inflammation in the development of thrombus or hemorrhages in the pediatric VAD population needs to be studied further.

Arthroscopic repair of horizontal meniscal cleavage tears with marrow-stimulating technique.

PURPOSE: The purpose of this study was to evaluate patients after arthroscopic repair of meniscal horizontal tears with a marrow-stimulating technique through clinical signs and second-look arthroscopy. METHODS: We retrospectively reviewed a consecutive series of 32 meniscal repairs with horizontal cleavage tears and evaluated them through clinical assessment and second-look arthroscopic examinations. Arthroscopic meniscal repair and a marrow-stimulating technique were performed. Functional outcomes were evaluated using the visual analog scale (VAS) pain score, Lysholm knee scoring scale, and Tegner activity scale. Assessment of meniscal healing was evaluated clinically by the presence of meniscal signs; second-look arthroscopy was performed in 11 patients. Correlation between chronicity of a meniscal lesion (time from initial symptom [TFIS]) and meniscal healing was evaluated. RESULTS: The mean follow-up period was 45.6 ± 13.9 months. Improvements in mean VAS scores from 6.7 to 1.9 (P < .001) were observed. The Lysholm score increased from 48.0 ± 14.4 to 92.0 ± 6.3 (P < .001). The Tegner activity score increased from 3.3 ± 1.1 to 6.8 ± 0.8 (P < .001). At the last follow-up, 29 of 32 patients (91%) were evaluated as healing in the clinical assessment. Of the 11 patients who underwent second-look arthroscopy, 8 (73%) showed complete healing, 2 (18%) had incomplete healing, and 1 (9%) failed to heal. Correlation between TFIS and meniscal healing was clinically significant (P = .001) but arthroscopically insignificant (P = .085) on second-look arthroscopy. CONCLUSIONS: The meniscal repair procedure for horizontal cleavage tears in the present study suggests an alternative treatment option to approach the treatment of meniscal tears extending into the avascular zone and degenerative tissue. The marrow-stimulating technique using a cannulated reamer can be considered as an alternative method for the augmentation of meniscal healing. LEVEL OF EVIDENCE: Level IV, therapeutic case series.

The prognostic value of immunohistochemical markers for oral tongue squamous cell carcinoma.

The objective of the study was to examine the prognostic value of hypoxia-inducible factor-1α (HIF-1α), carbonic anhydrase-IX (CA-IX), cyclooxygenase-2 (COX-2), Ki-67, and erythropoietin receptor in patients with oral tongue squamous cell carcinoma. Immunohistochemical analysis of marker expression was performed on tissue samples from 25 patients with tongue squamous cell carcinoma. The Kaplan-Meier method, univariate and multivariate analyses, and the Cox proportional hazards model were used to examine associations between patient and tumor characteristics, and the immunohistochemical results and disease-specific survival. There was no association between the expression of the five markers and disease-specific survival, and there was no statistically significant difference in the hazards ratio according to postoperative radiotherapy. There was no correlation between marker expression and prognosis. There was no association between marker expression and radioresistance or disease-specific survival. Therefore, HIF-1α, CA-IX, COX-2, Ki-67, and erythropoietin receptor are not suitable prognostic markers for tongue squamous cell carcinoma.

Salivary duct carcinoma of the parotid gland: is adjuvant HER-2-targeted therapy required?

PURPOSE: Salivary duct carcinoma (SDC) of the parotid gland is a highly aggressive and uncommon tumor. Overexpression of human epidermal growth factor receptor 2 (HER-2) is characteristic of SDC. HER-2 overexpression is considered a poor prognostic marker for SDC, and anti-HER-2 therapy has been suggested as a therapeutic option. MATERIALS AND METHODS: Two patients with SDC were analyzed for HER-2 overexpression and gene amplification using immunohistochemistry and fluorescence in situ hybridization. RESULTS: In 1 patient, no expression of HER-2 was found. In the other patient, HER-2 was demonstrated. The patient with HER-2 overexpression had a worse prognosis, and trastuzumab proved to be an effective treatment. CONCLUSIONS: The present results have also suggested that HER-2 overexpression is associated with a poor prognosis. Therefore, HER-2 status should be evaluated at least in the presence of advanced SDC, and targeted therapy should be considered in the adjuvant setting.

Failure to rescue following emergency general surgery: A national analysis.

Background: Failure to rescue (FTR) is increasingly recognized as a quality metric but remains understudied in emergency general surgery (EGS). We sought to identify patient and operative factors associated with FTR to better inform standardized metrics to mitigate this potentially preventable event. Methods: All adult (≥18 years) non-elective hospitalizations for large bowel resection, small bowel resection, repair of perforated ulcer, laparotomy and lysis of adhesions were identified in the 2016-2020 National Readmissions Database. Patients undergoing trauma-related operations or procedures ≤2 days of admission were excluded. FTR was defined as in-hospital death following acute kidney injury requiring dialysis (AKI), myocardial infarction, pneumonia, respiratory failure, sepsis, stroke, or thromboembolism. Multilevel mixed-effect models were developed to assess factors linked with FTR. Results: Among 826,548 EGS operations satisfying inclusion criteria, 298,062 (36.1 %) developed at least one MAE. Of those experiencing MAE, 43,477 (14.6 %) ultimately did not survive to discharge (FTR). Following adjustment for fixed hospital level effects, only 3.5 % of the variance in FTR was attributable to center-level differences. Relative to private insurance and the highest income quartile, Medicaid insurance (AOR 1.33; 95%CI, 1.23-1.43) and the lowest income quartile (AOR 1.22; 95%CI, 1.17-1.29) were linked with increased odds of FTR.A subset analysis stratified complication-specific rates of FTR by insurance status. Relative to private insurance, Medicaid coverage and uninsured status were linked with greater odds of FTR following perioperative sepsis, pneumonia, and AKI. Conclusion: Our findings underscore the need for increased screening and vigilance following perioperative complications to mitigate disparities in patient outcomes following high-risk EGS.

Vocal cord paralysis caused by stingray.

Foreign bodies in the oral cavity and pharynx are commonly encountered in the emergency room and outpatient departments, and the most frequently observed of these foreign bodies are fish bones. Among the possible complications resulting from a pharyngeal foreign body, vocal cord fixation is extremely rare, with only three cases previously reported in the English literature. The mechanisms of vocal cord fixation can be classified into mechanical articular fixation, direct injury of the recurrent laryngeal nerve, or recurrent laryngeal nerve paralysis secondary to inflammation. The case discussed here is different from previous cases. We report a rare case of vocal cord paralysis caused by the venom of a stingray tail in the hypopharynx.

A Novel Multimedia Player for International Standard-JPEG Snack.

The advancement in mobile communication and technologies has led to the usage of short-form digital content increasing daily. This short-form content is mainly based on images that urged the joint photographic experts' group (JPEG) to introduce a novel international standard, JPEG Snack (International Organization for Standardization (ISO)/ International Electrotechnical Commission (IEC) IS, 19566-8). In JPEG Snack, the multimedia content is embedded into a main background JPEG file, and the resulting JPEG Snack file is saved and transmitted as a .jpg file. If someone does not have a JPEG Snack Player, their device decoder will treat it as a JPEG file and display a background image only. As the standard has been proposed recently, the JPEG Snack Player is needed. In this article, we present a methodology to develop JPEG Snack Player. JPEG Snack Player uses a JPEG Snack decoder and renders media objects on the background JPEG file according to the instructions in the JPEG Snack file. We also present some results and computational complexity metrics for the JPEG Snack Player.

Clinical characteristics and treatment of benign paroxysmal positional vertigo after traumatic brain injury.

BACKGROUND: Traumatic brain injury (TBI) has been reported to be a common cause of benign paroxysmal positional vertigo (BPPV). However, only a few studies have investigated BPPV after TBI. The aim of this study was to identify the clinical characteristics of BPPV after TBI and to determine whether there are clinical differences between BPPV after TBI and idiopathic BPPV. METHODS: The authors reviewed the medical records of 192 consecutive patients with positional vertigo after head injury during the period 2003 to 2009 and investigated 112 patients with idiopathic BPPV treated over the same period. The clinical characteristics of BPPV after TBI and the clinical differences between the traumatic BPPV and idiopathic BPPV groups were investigated. RESULTS: A total of 32 patients with BPPV after TBI fulfilled the inclusion criteria. Twenty-four patients in the traumatic BPPV group had posterior semicircular canal-BPPV and 11 patients lateral semicircular canal-BPPV. A total of 58 repositioning maneuver sessions were performed in these 32 patients. Members of the traumatic BPPV group required more treatment sessions than members of the idiopathic group (p<0.05), but no tendency to recur was observed in the traumatic group (p>0.05). Recurrence rates in the traumatic and idiopathic BPPV groups were 15.6% and 18.8%, respectively (p>0.05). CONCLUSIONS: It is likely that BPPV after TBI is more difficult to treat than idiopathic BPPV, but no tendency to recur was observed in patients who developed BPPV after TBI compared with idiopathic BPPV. Further prospective clinical meta-analytic studies are needed to investigate the outcome of BPPV after TBI.