Slide Session : OS-HEM-03 ; Hematology : Hemophagocytic Syndrome in Internal Medicine: Iden-tification of Infectious Triggers, Therapeutic Manage-ment and Mortality in 88 Patients (REGHEM-GEAS-SEMI)

( Pilar BRITO ZERÓN ),( Marta PEREZ DE LIS NOVO ),( Roberto PÉREZ ALVAREZ ),( Pedro MORAL MORAL ),( Aleida MARTÍNEZ ZAPICO ),( Guadalupe FRAILE ),( Eva FONSECA ),( María VAQUERO HERRERO ),( Angela RUI 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: To analyze the therapeutic management and the main epidemiological and clinical characteristics related to survival in a large series of patients with hemophagocytic syndrome (HS) diagnosed in Departments of Internal Medicine. Methods: In June 2013, the Study Group of Autoimmune Diseases (GEAS-SEMI) creates a national registry of patients with HS. Patients were diagnosed according to the fulfillment of the criteria of the Histiocytosis Society in 1991 and updated in 2004. Results: At June 15, 2014, the REGHEM registry included 88 patients with HS, 35 (40%) men and 55 (60%) women, with a mean age at diagnosis of 49.16 years (range 12- 84 years). During the admission that led to the diagnosis of SH, acute infections were identified in 50 (57%) patients, including viruses (n=20), bacteria (n=13), mycobacteria (n=8) and parasites/fungi (n=13). Patients were treated with corticosteroids (n=40), etoposide (n=12), cyclosporin A (n=12), methotrexate (n=4), tacrolimus (n=2) rituximab (n=3), intravenous immunoglobulins (n=2) and chemotherapy (n=5). A total of 44 (50%) patients died. The main factors associated with mortality were analytical parameters at diagnosis such as the presence of severe anemia (Hb <9 g/L, 89% vs 66%, p=0.01), platelet count <100,000/mm3 (96% vs 64%, p<0.001), neutropenia <1000/mm3 (59% vs 39%, p=0.044), and bacterial infections as precipitating agent (77% vs 45%, p=0.034); a clinical presentation including lymphadenopathy was associated with a lower mortality (59% vs 39%, p=0.044). Conclusions: Hemophagocytic syndrome is a severe multisystemic disease associated in nearly 50% of cases with an acute infection, and usually requires vital support in intensive care units. Despite this and the use of a complex therapeutic approach, half of the patients died. The main prognostic factor identified is the presence at diagnosis of severe cytopenias and the coexistence of bacterial infections.

Slide Session : OS-RHEU-07 ; Rheumatology : Predicting Death in Patients with Primary Sjogren Syndrome: Prognostic Factors and Standardized Mortality Ratio in Comparison to the General Population (RESSPGEAS- SEMI)

( Pilar BRITO ZERÓN ),( Marta PEREZ DE LIS NOVO ),( Belchin KOSTOV ),( Roser SOLANS ),( Guadalupe FRAILE ),( Carlos SUÁREZ CUERVO ),( Arnau CASANOVAS ),( Francisco Javier RASCÓN ),( Rami QANNETA ),( R 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: To analyze prognostic factors and standardized mortality ratio (SMR) with respect to the general population in a cohort of Spanish patients with primary Sjogren`s syndrome (SS). Methods: In October 2013, the RESSP-GEAS-SEMI database included 1045 consecutive patients who met the 2002 SS-criteria. Hazard ratios (HR) and confi dence intervals (95% CI) obtained in the adjusted regression model were calculated. The SMR was estimated using the life tables of the general population of Spain in 2012. Results: The cohort included 982 (94%) women with a mean age at diagnosis of 54 years and a mean disease evolution of 118 months; 115 (11%) patients died due to systemic disease (n=18), infection (n=21), cardiovascular disease (n=35), hematologic malignancy (n=10) and other causes (n=31). The SMR for the total cohort of patients (adjusted for age and sex with the general Spanish population) was 4.66. Survival rates at 5, 10, 20 and 30 years were 96.0%, 90.5%, 80.9% and 60.4%, respectively. The Cox-regression analysis identifi ed the following baseline variables at diagnosis associated with death: male gender (HR 2.98, p<0.001), altered parotid scintigraphy (HR 2.81, p=0.043), lymphopenia (HR 1.63, p=0.034), anti-La antibodies (HR 1.51, p=0.034), low C3 (HR 1.93, p=0.034), low C4 (HR 2.06, p=0.016), monoclonal gammopathy (HR 1.81, p=0.047) and cryoglobulins (HR 2.58, p<0.001). The main baseline factors associated with mortality caused by systemic disease were systemic-activity at diagnosis, cytopenias, monoclonal gammopathy, cryoglobulins, and hypocomplementemia. Conclusions: Primary SS should not be considered a mild disease, since mortality is almost 5 times greater with respect to general population, with an overall survival at 20 years of 81%. Patients with a lower survival are those who present with active disease at diagnosis and associated immunological markers of B-cell hyperactivity.

Transoral Robotic Thyroidectomy: Description of the Surgical Technique in the Cadaveric Model

Özer Makay;Varlık Erol 대한갑상선-내분비외과학회 2018 The Koreran journal of Endocrine Surgery Vol.18 No.2

Purpose: Nowadays, minimally invasive surgical approach in thyroid surgery is getting more and more attention. The purpose of this report is to describe the surgical technique of transoral robotic thyroidectomy (TORT) in the cadaveric model which is the one of these minimally invasive methods. Methods: Transoral thyroidectomy through vestibular approach was performed on 67 year old lady fresh cadaveric model. The da Vinci Xi surgical system (Intuitive Surgical, Inc.) was used to complete TORT. Total thyroidectomy was successfully completed. Results: Total thyroidectomy was successfully completed and all vital structures (recurrent laryngeal nerves and parathyroid glands) were identified and preserved. Conclusion: TORT is a technique that can be successfully applied on the cadaver. We believe that this tecnique is an alternative approach in scarless thyroid surgery that can be safely applied to selected patients.

Agricultural Development and Rural Construction in Taiwan

Chien-Zer Liu 한국국제농업개발학회 2001 韓國國際農業開發學會誌 Vol.13 No.2

Agricultural Development and Rural Construction in Taiwan

Liu, Chien- Zer 한국국제농업개발학회 2001 韓國國際農業開發學會誌 Vol.13 No.2

Taiwan agriculture has enjoyed a fast development with fruitful results since the land reform(1949 - 1953) in Taiwan. Agricultural economy has improved significantly. Agricultural development has also become one of the most important factors that facilitate the rapid development of industries. However, agricultural development is a dynamic and long term developing process towards modernization. Following with the fast economic growth, the structure of agricultural sector must be adjusted in order to satisfy the requirement of social economic development, and to meet new challenges under the new economic environment. International trade in Taiwan has had an impressive growth during these recent years. Taiwan is the 15th largest international trade nation and its trade relationship with other countries are very close. Because of the trade liberalization and globalization, Taiwan is actively seeking to join the World Trade Organization(WTO) in order to facilitate more economic development, to open up broader economic relations, and to improve Taiwan's international status. Taiwan economy may enjoy WTO membership right in fair trade after joining the organization, however, at the same time, the agricultural sector has to obey the rules by lowering import tariff, removing non-tariff import protection, and reducing subsidiary policies which distort the market. Although some of agricultural protective policies can be sought within permitted regulation scope, the impacts of Taiwan agriculture by opening domestic markets, reducing trade barriers, and removing some protective policies are very huge. Taiwan's agriculture is featured by small-scale farming pattern and has an international discompetitiveness. It is unavoidable that the agriculture sector will face many challenges from free trade. Under the impacts and challenges of trade liberalization and globalization, how to improve productivity and competitiveness by adjusting Taiwan agricultural structure will be an very important issue. How to secure the continuous development of Taiwan agriculture and how to improve the farmers' welfare by adjusting agricultural policy to strengthen rural infrastructure will be another important issues too. These questions are the objectives we need to concern. This paper will first illustrate the goals of Taiwan's agricultural development under the possible impacts of trade liberalization and globalization. Later, the adjustment direction of Taiwan agricultural policies will be described from the viewpoint of rural development. Such policy adjustment should achieve the policy goal and the rural development strategy of $quot;Develop agriculture, Construct rural area, and Take care of farmers$quot; which is in terms of overall rural development strategy. Finally, the strategies are expected to promote the development of Taiwan's agriculture.

A novel dynamic walker with heel, ankle, and toe rocker motions

Kumar, R. Prasanth,Ö,zer, Abdullah,Kim, Gabsoon,Yoon, Jungwon Cambridge University Press 2011 Robotica Vol.29 No.6

<B>SUMMARY</B><P>This paper proposes a novel dynamic walker capable of walking with heel, ankle, and toe rocker motions. The heel and toe rocker motions are obtained by using inelastic stoppers between leg and foot, which limit the range of rotation of the foot about the ankle joint. A generalized set of equations of motion and associated transition equations applicable for multiple foot segments is derived. Passive dynamic walking is studied with equal heel and toe strike angles for the case of symmetric foot walking. It is shown that by including the ankle joint, low-speed walking is made possible. The energy efficiency of the proposed walker is studied theoretically and through numerical simulations. Finally, three different underactuated modes of active walking that do not require toe and heel actuation are presented. In order to implement these modes of walking, the proposed walker can be constructed with little modification from an existing flat-foot walker that uses ankle rocker motion alone. Results show that substantial benefits can be obtained in efficiency and stability compared to point/flat-foot walker of the same leg length and mass distribution.</P>

Quantum oscillations in the surface excitations of ultrathin Mg(0001) films

Teng, Ao,Kempa, Krzysztof,Ö,zer, Mustafa M.,Hus, Saban M.,Snijders, Paul C.,Lee, Geunseop,Weitering, Hanno H. American Physical Society 2014 Physical review. B, Condensed matter and materials Vol.90 No.11

Is Hearing Loss in Infants Associated With Risk Factors? Evaluation of the Frequency of Risk Factors

Çiǧdem Tepe Karaca,Çaǧatay Oysu,Sema Zer Toros,Barıș Naiboǧlu,Ayșegül Verim 대한이비인후과학회 2014 Clinical and Experimental Otorhinolaryngology Vol.7 No.4

Objectives. To evaluate the frequency of risk factors and their influence on the evoked otoacoustic emission (OAE) of in- fants. Methods. All newborns between November 2009 and June 2012 in Haydarpaşa Numune Education and Research Hospi- tal were tested on distortion evoked OAE screening test. Total of 2,284 infants were examined. Sex, maternal infec- tious disease, birth type (vaginal birth or caesarean sectio), birth weight, familial hearing loss, intermarriage of par- ents, hyperbilirubinemia, intensive care were analyzed as risk factors. Results. Total of 2,284 neonates were screened (1,220 males and 1,064 females) for the presence of OAE in both ears. Vagi- nal delivery, maternal infections during pregnancy, intermarriage of parents relative, low birth weight(<1,500 g) are related risk factors to failure of screening with OAE in our study. There was no statistically significant difference in sex ratios, birth weight, familial hearing loss, hyperbilirubinemia, and intensive care stay. Conclusion. Risk factors are only as useful as their predictive power. Not enough is known about which risk factors are rel- evant, which babies have the risk factors, or which babies will fail to attend follow-up, the effectiveness of targeted hearing loss testing is questionable at this point in time. A system needs to be developed to clarify which risk factors are discoverable, predictive and useful.

Protective Effect of Aqueous Garlic Extract Against Renal Ischemia/Reperfusion Injury in Rats

Göksel Şener,Levent Kabasakal,Özer Şehirli,Şule Çetinel,Esra Cikler,Nursal Gedik 한국식품영양과학회 2005 Journal of medicinal food Vol.8 No.3

Determination of Cutting Parameters in End Milling Operation based on the Optical Surface Roughness Measurement

Özer Taga,Zeki Kiral,Kemal Yaman 한국정밀공학회 2016 International Journal of Precision Engineering and Vol.17 No.5

In this study, a milling system based on the in-line surface roughness measurement during machining process is developed using Artificial Neural Network (ANN) technique. In the proposed system, optimum feed rate and cutting speed are determined by ANN so as to provide the desired surface roughness, which is an important criterion for high quality surface. For this purpose, firstly an algorithm determining the operating principle of the system is developed. According to this algorithm, the optimum cutting parameters are predicted for end milling (finishing) operation by measuring semi-finish machining surface roughness via an optical sensor and then end milling operation is performed with the cutting parameters determined by the system. In the experimental part of this study, surface quality is observed for the milling process before and after the intervention of the system and the results is compared. The experimental results show that the system can be integrated with the modern machining systems in order to obtain the desired surface quality levels.